|
HC EXCHANGE TRANSFUSION NONINFANT
|
Facility
|
OP
|
$1,524.05
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
39100001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$309.69 |
| Max. Negotiated Rate |
$1,371.64 |
| Rate for Payer: Aetna Commercial |
$1,295.44
|
| Rate for Payer: Aetna Medicare |
$396.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$476.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$476.27
|
| Rate for Payer: BCBS Complete |
$325.20
|
| Rate for Payer: BCBS MAPPO |
$381.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,252.92
|
| Rate for Payer: BCN Commercial |
$1,184.95
|
| Rate for Payer: BCN Medicare Advantage |
$381.01
|
| Rate for Payer: Cash Price |
$1,219.24
|
| Rate for Payer: Cash Price |
$1,219.24
|
| Rate for Payer: Cofinity Commercial |
$1,310.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,219.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$381.01
|
| Rate for Payer: Healthscope Commercial |
$1,371.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,143.04
|
| Rate for Payer: Mclaren Medicaid |
$309.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$400.06
|
| Rate for Payer: Meridian Medicaid |
$325.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,295.44
|
| Rate for Payer: Nomi Health Commercial |
$1,249.72
|
| Rate for Payer: PACE Senior Care Partners |
$361.96
|
| Rate for Payer: PACE SWMI |
$381.01
|
| Rate for Payer: PHP Commercial |
$1,295.44
|
| Rate for Payer: PHP Medicare Advantage |
$381.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$990.63
|
| Rate for Payer: Priority Health HMO/PPO |
$1,325.92
|
| Rate for Payer: Priority Health Medicare |
$384.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,021.11
|
| Rate for Payer: Railroad Medicare Medicare |
$381.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,341.16
|
| Rate for Payer: UHC Core |
$1,272.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$381.01
|
| Rate for Payer: UHC Exchange |
$381.01
|
| Rate for Payer: UHC Medicare Advantage |
$381.01
|
| Rate for Payer: UHCCP Medicaid |
$309.69
|
| Rate for Payer: VA VA |
$381.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,143.04
|
|
|
HC EXCHANGE WIRE PTCA
|
Facility
|
IP
|
$550.26
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$357.67 |
| Max. Negotiated Rate |
$495.23 |
| Rate for Payer: Aetna Commercial |
$467.72
|
| Rate for Payer: BCBS Trust/PPO |
$449.18
|
| Rate for Payer: BCN Commercial |
$425.24
|
| Rate for Payer: Cash Price |
$440.21
|
| Rate for Payer: Cofinity Commercial |
$473.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.21
|
| Rate for Payer: Healthscope Commercial |
$495.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$412.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$467.72
|
| Rate for Payer: Nomi Health Commercial |
$451.21
|
| Rate for Payer: PHP Commercial |
$467.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.67
|
| Rate for Payer: Priority Health HMO/PPO |
$478.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$368.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$484.23
|
| Rate for Payer: UHC Core |
$459.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$412.70
|
|
|
HC EXCHANGE WIRE PTCA
|
Facility
|
OP
|
$550.26
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$130.69 |
| Max. Negotiated Rate |
$495.23 |
| Rate for Payer: Aetna Commercial |
$467.72
|
| Rate for Payer: Aetna Medicare |
$143.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$171.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$171.96
|
| Rate for Payer: BCBS Complete |
$220.10
|
| Rate for Payer: BCBS MAPPO |
$137.56
|
| Rate for Payer: BCBS Trust/PPO |
$452.37
|
| Rate for Payer: BCN Commercial |
$427.83
|
| Rate for Payer: BCN Medicare Advantage |
$137.56
|
| Rate for Payer: Cash Price |
$440.21
|
| Rate for Payer: Cofinity Commercial |
$473.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.56
|
| Rate for Payer: Healthscope Commercial |
$495.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$412.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$158.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$467.72
|
| Rate for Payer: Nomi Health Commercial |
$451.21
|
| Rate for Payer: PACE Senior Care Partners |
$130.69
|
| Rate for Payer: PACE SWMI |
$137.56
|
| Rate for Payer: PHP Commercial |
$467.72
|
| Rate for Payer: PHP Medicare Advantage |
$137.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.67
|
| Rate for Payer: Priority Health HMO/PPO |
$478.73
|
| Rate for Payer: Priority Health Medicare |
$138.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$368.67
|
| Rate for Payer: Railroad Medicare Medicare |
$137.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$484.23
|
| Rate for Payer: UHC Core |
$459.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.56
|
| Rate for Payer: UHC Exchange |
$137.56
|
| Rate for Payer: UHC Medicare Advantage |
$137.56
|
| Rate for Payer: VA VA |
$137.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$412.70
|
|
|
HC EXCIS/DESTRUCT INTRANASAL LESION INT APPR
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
76100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,237.70 |
| Max. Negotiated Rate |
$7,252.20 |
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: BCBS Trust/PPO |
$6,577.75
|
| Rate for Payer: BCN Commercial |
$6,227.22
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,043.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,607.56
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO |
$7,010.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,398.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,091.04
|
| Rate for Payer: UHC Core |
$6,728.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
|
HC EXCIS/DESTRUCT INTRANASAL LESION INT APPR
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
76100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,913.78 |
| Max. Negotiated Rate |
$7,252.20 |
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna Medicare |
$2,095.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,518.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,518.12
|
| Rate for Payer: BCBS Complete |
$2,412.36
|
| Rate for Payer: BCBS MAPPO |
$2,014.50
|
| Rate for Payer: BCBS Trust/PPO |
$6,624.48
|
| Rate for Payer: BCN Commercial |
$6,265.10
|
| Rate for Payer: BCN Medicare Advantage |
$2,014.50
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,014.50
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,043.50
|
| Rate for Payer: Mclaren Medicaid |
$2,297.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,115.22
|
| Rate for Payer: Meridian Medicaid |
$2,412.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,316.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,607.56
|
| Rate for Payer: PACE Senior Care Partners |
$1,913.78
|
| Rate for Payer: PACE SWMI |
$2,014.50
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: PHP Medicare Advantage |
$2,014.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,297.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO |
$7,010.46
|
| Rate for Payer: Priority Health Medicare |
$2,034.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,398.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,014.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,091.04
|
| Rate for Payer: UHC Core |
$6,728.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,014.50
|
| Rate for Payer: UHC Exchange |
$2,014.50
|
| Rate for Payer: UHC Medicare Advantage |
$2,014.50
|
| Rate for Payer: UHCCP Medicaid |
$2,297.33
|
| Rate for Payer: VA VA |
$2,014.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
76100095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$279.31 |
| Max. Negotiated Rate |
$1,205.21 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna Medicare |
$305.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$367.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$367.52
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$294.01
|
| Rate for Payer: BCBS Trust/PPO |
$966.83
|
| Rate for Payer: BCN Commercial |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$294.01
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.01
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.71
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$338.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PACE Senior Care Partners |
$279.31
|
| Rate for Payer: PACE SWMI |
$294.01
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: PHP Medicare Advantage |
$294.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,023.16
|
| Rate for Payer: Priority Health Medicare |
$296.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.95
|
| Rate for Payer: Railroad Medicare Medicare |
$294.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.92
|
| Rate for Payer: UHC Core |
$982.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$294.01
|
| Rate for Payer: UHC Exchange |
$294.01
|
| Rate for Payer: UHC Medicare Advantage |
$294.01
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$294.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
76100095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$1,058.44 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: BCBS Trust/PPO |
$960.01
|
| Rate for Payer: BCN Commercial |
$908.85
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,023.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.92
|
| Rate for Payer: UHC Core |
$982.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
76100096
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$1,058.44 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: BCBS Trust/PPO |
$960.01
|
| Rate for Payer: BCN Commercial |
$908.85
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,023.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.92
|
| Rate for Payer: UHC Core |
$982.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
76100096
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$279.31 |
| Max. Negotiated Rate |
$1,058.44 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna Medicare |
$305.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$367.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$367.52
|
| Rate for Payer: BCBS Complete |
$523.36
|
| Rate for Payer: BCBS MAPPO |
$294.01
|
| Rate for Payer: BCBS Trust/PPO |
$966.83
|
| Rate for Payer: BCN Commercial |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$294.01
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.01
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Mclaren Medicaid |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.71
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$338.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PACE Senior Care Partners |
$279.31
|
| Rate for Payer: PACE SWMI |
$294.01
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: PHP Medicare Advantage |
$294.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,023.16
|
| Rate for Payer: Priority Health Medicare |
$296.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.95
|
| Rate for Payer: Railroad Medicare Medicare |
$294.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.92
|
| Rate for Payer: UHC Core |
$982.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$294.01
|
| Rate for Payer: UHC Exchange |
$294.01
|
| Rate for Payer: UHC Medicare Advantage |
$294.01
|
| Rate for Payer: UHCCP Medicaid |
$498.41
|
| Rate for Payer: VA VA |
$294.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
76100097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$1,058.44 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: BCBS Trust/PPO |
$960.01
|
| Rate for Payer: BCN Commercial |
$908.85
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,023.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.92
|
| Rate for Payer: UHC Core |
$982.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
76100097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$279.31 |
| Max. Negotiated Rate |
$1,205.21 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna Medicare |
$305.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$367.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$367.52
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$294.01
|
| Rate for Payer: BCBS Trust/PPO |
$966.83
|
| Rate for Payer: BCN Commercial |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$294.01
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.01
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.71
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$338.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PACE Senior Care Partners |
$279.31
|
| Rate for Payer: PACE SWMI |
$294.01
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: PHP Medicare Advantage |
$294.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,023.16
|
| Rate for Payer: Priority Health Medicare |
$296.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.95
|
| Rate for Payer: Railroad Medicare Medicare |
$294.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.92
|
| Rate for Payer: UHC Core |
$982.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$294.01
|
| Rate for Payer: UHC Exchange |
$294.01
|
| Rate for Payer: UHC Medicare Advantage |
$294.01
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$294.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
76100098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$1,058.44 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: BCBS Trust/PPO |
$960.01
|
| Rate for Payer: BCN Commercial |
$908.85
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,023.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.92
|
| Rate for Payer: UHC Core |
$982.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
76100098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$279.31 |
| Max. Negotiated Rate |
$1,205.21 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna Medicare |
$305.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$367.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$367.52
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$294.01
|
| Rate for Payer: BCBS Trust/PPO |
$966.83
|
| Rate for Payer: BCN Commercial |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$294.01
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.01
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.71
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$338.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PACE Senior Care Partners |
$279.31
|
| Rate for Payer: PACE SWMI |
$294.01
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: PHP Medicare Advantage |
$294.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,023.16
|
| Rate for Payer: Priority Health Medicare |
$296.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.95
|
| Rate for Payer: Railroad Medicare Medicare |
$294.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.92
|
| Rate for Payer: UHC Core |
$982.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$294.01
|
| Rate for Payer: UHC Exchange |
$294.01
|
| Rate for Payer: UHC Medicare Advantage |
$294.01
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$294.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 3.1 TO 4.0 CM
|
Facility
|
OP
|
$1,942.27
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
76100099
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$461.29 |
| Max. Negotiated Rate |
$1,748.04 |
| Rate for Payer: Aetna Commercial |
$1,650.93
|
| Rate for Payer: Aetna Medicare |
$504.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$606.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$606.96
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$485.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,596.74
|
| Rate for Payer: BCN Commercial |
$1,510.11
|
| Rate for Payer: BCN Medicare Advantage |
$485.57
|
| Rate for Payer: Cash Price |
$1,553.82
|
| Rate for Payer: Cash Price |
$1,553.82
|
| Rate for Payer: Cofinity Commercial |
$1,670.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,553.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$485.57
|
| Rate for Payer: Healthscope Commercial |
$1,748.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,456.70
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.85
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$558.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,650.93
|
| Rate for Payer: Nomi Health Commercial |
$1,592.66
|
| Rate for Payer: PACE Senior Care Partners |
$461.29
|
| Rate for Payer: PACE SWMI |
$485.57
|
| Rate for Payer: PHP Commercial |
$1,650.93
|
| Rate for Payer: PHP Medicare Advantage |
$485.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.48
|
| Rate for Payer: Priority Health HMO/PPO |
$1,689.77
|
| Rate for Payer: Priority Health Medicare |
$490.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,301.32
|
| Rate for Payer: Railroad Medicare Medicare |
$485.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,709.20
|
| Rate for Payer: UHC Core |
$1,621.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$485.57
|
| Rate for Payer: UHC Exchange |
$485.57
|
| Rate for Payer: UHC Medicare Advantage |
$485.57
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$485.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,456.70
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 3.1 TO 4.0 CM
|
Facility
|
IP
|
$1,942.27
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
76100099
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,262.48 |
| Max. Negotiated Rate |
$1,748.04 |
| Rate for Payer: Aetna Commercial |
$1,650.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,585.48
|
| Rate for Payer: BCN Commercial |
$1,500.99
|
| Rate for Payer: Cash Price |
$1,553.82
|
| Rate for Payer: Cofinity Commercial |
$1,670.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,553.82
|
| Rate for Payer: Healthscope Commercial |
$1,748.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,456.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,650.93
|
| Rate for Payer: Nomi Health Commercial |
$1,592.66
|
| Rate for Payer: PHP Commercial |
$1,650.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.48
|
| Rate for Payer: Priority Health HMO/PPO |
$1,689.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,301.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,709.20
|
| Rate for Payer: UHC Core |
$1,621.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,456.70
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA OVER 4.0 CM
|
Facility
|
IP
|
$1,942.27
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
76100100
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,262.48 |
| Max. Negotiated Rate |
$1,748.04 |
| Rate for Payer: Aetna Commercial |
$1,650.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,585.48
|
| Rate for Payer: BCN Commercial |
$1,500.99
|
| Rate for Payer: Cash Price |
$1,553.82
|
| Rate for Payer: Cofinity Commercial |
$1,670.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,553.82
|
| Rate for Payer: Healthscope Commercial |
$1,748.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,456.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,650.93
|
| Rate for Payer: Nomi Health Commercial |
$1,592.66
|
| Rate for Payer: PHP Commercial |
$1,650.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.48
|
| Rate for Payer: Priority Health HMO/PPO |
$1,689.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,301.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,709.20
|
| Rate for Payer: UHC Core |
$1,621.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,456.70
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA OVER 4.0 CM
|
Facility
|
OP
|
$1,942.27
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
76100100
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$461.29 |
| Max. Negotiated Rate |
$2,128.93 |
| Rate for Payer: Aetna Commercial |
$1,650.93
|
| Rate for Payer: Aetna Medicare |
$504.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$606.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$606.96
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$485.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,596.74
|
| Rate for Payer: BCN Commercial |
$1,510.11
|
| Rate for Payer: BCN Medicare Advantage |
$485.57
|
| Rate for Payer: Cash Price |
$1,553.82
|
| Rate for Payer: Cash Price |
$1,553.82
|
| Rate for Payer: Cofinity Commercial |
$1,670.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,553.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$485.57
|
| Rate for Payer: Healthscope Commercial |
$1,748.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,456.70
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.85
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$558.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,650.93
|
| Rate for Payer: Nomi Health Commercial |
$1,592.66
|
| Rate for Payer: PACE Senior Care Partners |
$461.29
|
| Rate for Payer: PACE SWMI |
$485.57
|
| Rate for Payer: PHP Commercial |
$1,650.93
|
| Rate for Payer: PHP Medicare Advantage |
$485.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.48
|
| Rate for Payer: Priority Health HMO/PPO |
$1,689.77
|
| Rate for Payer: Priority Health Medicare |
$490.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,301.32
|
| Rate for Payer: Railroad Medicare Medicare |
$485.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,709.20
|
| Rate for Payer: UHC Core |
$1,621.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$485.57
|
| Rate for Payer: UHC Exchange |
$485.57
|
| Rate for Payer: UHC Medicare Advantage |
$485.57
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$485.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,456.70
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
OP
|
$838.73
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
76100089
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$199.20 |
| Max. Negotiated Rate |
$754.86 |
| Rate for Payer: Aetna Commercial |
$712.92
|
| Rate for Payer: Aetna Medicare |
$218.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.10
|
| Rate for Payer: BCBS Complete |
$523.36
|
| Rate for Payer: BCBS MAPPO |
$209.68
|
| Rate for Payer: BCBS Trust/PPO |
$689.52
|
| Rate for Payer: BCN Commercial |
$652.11
|
| Rate for Payer: BCN Medicare Advantage |
$209.68
|
| Rate for Payer: Cash Price |
$670.98
|
| Rate for Payer: Cash Price |
$670.98
|
| Rate for Payer: Cofinity Commercial |
$721.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$670.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.68
|
| Rate for Payer: Healthscope Commercial |
$754.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$629.05
|
| Rate for Payer: Mclaren Medicaid |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$220.17
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$712.92
|
| Rate for Payer: Nomi Health Commercial |
$687.76
|
| Rate for Payer: PACE Senior Care Partners |
$199.20
|
| Rate for Payer: PACE SWMI |
$209.68
|
| Rate for Payer: PHP Commercial |
$712.92
|
| Rate for Payer: PHP Medicare Advantage |
$209.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$545.17
|
| Rate for Payer: Priority Health HMO/PPO |
$729.70
|
| Rate for Payer: Priority Health Medicare |
$211.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$561.95
|
| Rate for Payer: Railroad Medicare Medicare |
$209.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$738.08
|
| Rate for Payer: UHC Core |
$700.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.68
|
| Rate for Payer: UHC Exchange |
$209.68
|
| Rate for Payer: UHC Medicare Advantage |
$209.68
|
| Rate for Payer: UHCCP Medicaid |
$498.41
|
| Rate for Payer: VA VA |
$209.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$629.05
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
IP
|
$838.73
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
76100089
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$545.17 |
| Max. Negotiated Rate |
$754.86 |
| Rate for Payer: Aetna Commercial |
$712.92
|
| Rate for Payer: BCBS Trust/PPO |
$684.66
|
| Rate for Payer: BCN Commercial |
$648.17
|
| Rate for Payer: Cash Price |
$670.98
|
| Rate for Payer: Cofinity Commercial |
$721.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$670.98
|
| Rate for Payer: Healthscope Commercial |
$754.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$629.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$712.92
|
| Rate for Payer: Nomi Health Commercial |
$687.76
|
| Rate for Payer: PHP Commercial |
$712.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$545.17
|
| Rate for Payer: Priority Health HMO/PPO |
$729.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$561.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$738.08
|
| Rate for Payer: UHC Core |
$700.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$629.05
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.6 CM TO 1.0 CM
|
Facility
|
OP
|
$600.08
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
76100090
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$142.52 |
| Max. Negotiated Rate |
$540.07 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna Medicare |
$156.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$187.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.52
|
| Rate for Payer: BCBS Complete |
$297.19
|
| Rate for Payer: BCBS MAPPO |
$150.02
|
| Rate for Payer: BCBS Trust/PPO |
$493.33
|
| Rate for Payer: BCN Commercial |
$466.56
|
| Rate for Payer: BCN Medicare Advantage |
$150.02
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.02
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.06
|
| Rate for Payer: Mclaren Medicaid |
$283.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.52
|
| Rate for Payer: Meridian Medicaid |
$297.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: Nomi Health Commercial |
$492.07
|
| Rate for Payer: PACE Senior Care Partners |
$142.52
|
| Rate for Payer: PACE SWMI |
$150.02
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: PHP Medicare Advantage |
$150.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health HMO/PPO |
$522.07
|
| Rate for Payer: Priority Health Medicare |
$151.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.05
|
| Rate for Payer: Railroad Medicare Medicare |
$150.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.07
|
| Rate for Payer: UHC Core |
$501.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.02
|
| Rate for Payer: UHC Exchange |
$150.02
|
| Rate for Payer: UHC Medicare Advantage |
$150.02
|
| Rate for Payer: UHCCP Medicaid |
$283.02
|
| Rate for Payer: VA VA |
$150.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.06
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.6 CM TO 1.0 CM
|
Facility
|
IP
|
$600.08
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
76100090
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$390.05 |
| Max. Negotiated Rate |
$540.07 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: BCBS Trust/PPO |
$489.85
|
| Rate for Payer: BCN Commercial |
$463.74
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: Nomi Health Commercial |
$492.07
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health HMO/PPO |
$522.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.07
|
| Rate for Payer: UHC Core |
$501.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.06
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 1.1 CM TO 2.0 CM
|
Facility
|
IP
|
$1,294.26
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
76100091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$841.27 |
| Max. Negotiated Rate |
$1,164.83 |
| Rate for Payer: Aetna Commercial |
$1,100.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,056.50
|
| Rate for Payer: BCN Commercial |
$1,000.20
|
| Rate for Payer: Cash Price |
$1,035.41
|
| Rate for Payer: Cofinity Commercial |
$1,113.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,035.41
|
| Rate for Payer: Healthscope Commercial |
$1,164.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$970.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,100.12
|
| Rate for Payer: Nomi Health Commercial |
$1,061.29
|
| Rate for Payer: PHP Commercial |
$1,100.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$841.27
|
| Rate for Payer: Priority Health HMO/PPO |
$1,126.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$867.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,138.95
|
| Rate for Payer: UHC Core |
$1,080.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$970.70
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 1.1 CM TO 2.0 CM
|
Facility
|
OP
|
$1,294.26
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
76100091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$307.39 |
| Max. Negotiated Rate |
$1,164.83 |
| Rate for Payer: Aetna Commercial |
$1,100.12
|
| Rate for Payer: Aetna Medicare |
$336.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$404.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$404.46
|
| Rate for Payer: BCBS Complete |
$523.36
|
| Rate for Payer: BCBS MAPPO |
$323.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,064.01
|
| Rate for Payer: BCN Commercial |
$1,006.29
|
| Rate for Payer: BCN Medicare Advantage |
$323.56
|
| Rate for Payer: Cash Price |
$1,035.41
|
| Rate for Payer: Cash Price |
$1,035.41
|
| Rate for Payer: Cofinity Commercial |
$1,113.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,035.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.56
|
| Rate for Payer: Healthscope Commercial |
$1,164.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$970.70
|
| Rate for Payer: Mclaren Medicaid |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.74
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$372.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,100.12
|
| Rate for Payer: Nomi Health Commercial |
$1,061.29
|
| Rate for Payer: PACE Senior Care Partners |
$307.39
|
| Rate for Payer: PACE SWMI |
$323.56
|
| Rate for Payer: PHP Commercial |
$1,100.12
|
| Rate for Payer: PHP Medicare Advantage |
$323.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$841.27
|
| Rate for Payer: Priority Health HMO/PPO |
$1,126.01
|
| Rate for Payer: Priority Health Medicare |
$326.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$867.15
|
| Rate for Payer: Railroad Medicare Medicare |
$323.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,138.95
|
| Rate for Payer: UHC Core |
$1,080.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$323.56
|
| Rate for Payer: UHC Exchange |
$323.56
|
| Rate for Payer: UHC Medicare Advantage |
$323.56
|
| Rate for Payer: UHCCP Medicaid |
$498.41
|
| Rate for Payer: VA VA |
$323.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$970.70
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
76100092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$279.31 |
| Max. Negotiated Rate |
$1,058.44 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna Medicare |
$305.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$367.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$367.52
|
| Rate for Payer: BCBS Complete |
$523.36
|
| Rate for Payer: BCBS MAPPO |
$294.01
|
| Rate for Payer: BCBS Trust/PPO |
$966.83
|
| Rate for Payer: BCN Commercial |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$294.01
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.01
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Mclaren Medicaid |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.71
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$338.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PACE Senior Care Partners |
$279.31
|
| Rate for Payer: PACE SWMI |
$294.01
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: PHP Medicare Advantage |
$294.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,023.16
|
| Rate for Payer: Priority Health Medicare |
$296.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.95
|
| Rate for Payer: Railroad Medicare Medicare |
$294.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.92
|
| Rate for Payer: UHC Core |
$982.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$294.01
|
| Rate for Payer: UHC Exchange |
$294.01
|
| Rate for Payer: UHC Medicare Advantage |
$294.01
|
| Rate for Payer: UHCCP Medicaid |
$498.41
|
| Rate for Payer: VA VA |
$294.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
76100092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$1,058.44 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: BCBS Trust/PPO |
$960.01
|
| Rate for Payer: BCN Commercial |
$908.85
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,023.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.92
|
| Rate for Payer: UHC Core |
$982.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
