|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
OP
|
$1,411.26
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
76100093
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$335.17 |
| Max. Negotiated Rate |
$1,270.13 |
| Rate for Payer: Aetna Commercial |
$1,199.57
|
| Rate for Payer: Aetna Medicare |
$366.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$441.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$441.02
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$352.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,160.20
|
| Rate for Payer: BCN Commercial |
$1,097.25
|
| Rate for Payer: BCN Medicare Advantage |
$352.82
|
| Rate for Payer: Cash Price |
$1,129.01
|
| Rate for Payer: Cash Price |
$1,129.01
|
| Rate for Payer: Cofinity Commercial |
$1,213.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,129.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.82
|
| Rate for Payer: Healthscope Commercial |
$1,270.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,058.44
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.46
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$405.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,199.57
|
| Rate for Payer: Nomi Health Commercial |
$1,157.23
|
| Rate for Payer: PACE Senior Care Partners |
$335.17
|
| Rate for Payer: PACE SWMI |
$352.82
|
| Rate for Payer: PHP Commercial |
$1,199.57
|
| Rate for Payer: PHP Medicare Advantage |
$352.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.32
|
| Rate for Payer: Priority Health HMO/PPO |
$1,227.80
|
| Rate for Payer: Priority Health Medicare |
$356.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$945.54
|
| Rate for Payer: Railroad Medicare Medicare |
$352.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,241.91
|
| Rate for Payer: UHC Core |
$1,178.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.82
|
| Rate for Payer: UHC Exchange |
$352.82
|
| Rate for Payer: UHC Medicare Advantage |
$352.82
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$352.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,058.44
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
IP
|
$1,411.26
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
76100093
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$917.32 |
| Max. Negotiated Rate |
$1,270.13 |
| Rate for Payer: Aetna Commercial |
$1,199.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,152.01
|
| Rate for Payer: BCN Commercial |
$1,090.62
|
| Rate for Payer: Cash Price |
$1,129.01
|
| Rate for Payer: Cofinity Commercial |
$1,213.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,129.01
|
| Rate for Payer: Healthscope Commercial |
$1,270.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,058.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,199.57
|
| Rate for Payer: Nomi Health Commercial |
$1,157.23
|
| Rate for Payer: PHP Commercial |
$1,199.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.32
|
| Rate for Payer: Priority Health HMO/PPO |
$1,227.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$945.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,241.91
|
| Rate for Payer: UHC Core |
$1,178.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,058.44
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
OP
|
$2,118.85
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$503.23 |
| Max. Negotiated Rate |
$1,906.96 |
| Rate for Payer: Aetna Commercial |
$1,801.02
|
| Rate for Payer: Aetna Medicare |
$550.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$662.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$662.14
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$529.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,741.91
|
| Rate for Payer: BCN Commercial |
$1,647.41
|
| Rate for Payer: BCN Medicare Advantage |
$529.71
|
| Rate for Payer: Cash Price |
$1,695.08
|
| Rate for Payer: Cash Price |
$1,695.08
|
| Rate for Payer: Cofinity Commercial |
$1,822.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,695.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.71
|
| Rate for Payer: Healthscope Commercial |
$1,906.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,589.14
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$556.20
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$609.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,801.02
|
| Rate for Payer: Nomi Health Commercial |
$1,737.46
|
| Rate for Payer: PACE Senior Care Partners |
$503.23
|
| Rate for Payer: PACE SWMI |
$529.71
|
| Rate for Payer: PHP Commercial |
$1,801.02
|
| Rate for Payer: PHP Medicare Advantage |
$529.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,377.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,843.40
|
| Rate for Payer: Priority Health Medicare |
$535.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,419.63
|
| Rate for Payer: Railroad Medicare Medicare |
$529.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,864.59
|
| Rate for Payer: UHC Core |
$1,769.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$529.71
|
| Rate for Payer: UHC Exchange |
$529.71
|
| Rate for Payer: UHC Medicare Advantage |
$529.71
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$529.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,589.14
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
IP
|
$2,118.85
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,377.25 |
| Max. Negotiated Rate |
$1,906.96 |
| Rate for Payer: Aetna Commercial |
$1,801.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,729.62
|
| Rate for Payer: BCN Commercial |
$1,637.45
|
| Rate for Payer: Cash Price |
$1,695.08
|
| Rate for Payer: Cofinity Commercial |
$1,822.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,695.08
|
| Rate for Payer: Healthscope Commercial |
$1,906.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,589.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,801.02
|
| Rate for Payer: Nomi Health Commercial |
$1,737.46
|
| Rate for Payer: PHP Commercial |
$1,801.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,377.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,843.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,419.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,864.59
|
| Rate for Payer: UHC Core |
$1,769.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,589.14
|
|
|
HC EXCISE CYST/BREAST LESION
|
Facility
|
OP
|
$4,727.92
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$515.37 |
| Max. Negotiated Rate |
$4,255.13 |
| Rate for Payer: Aetna Commercial |
$4,018.73
|
| Rate for Payer: Aetna Medicare |
$1,229.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,477.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,477.48
|
| Rate for Payer: BCBS Complete |
$2,848.40
|
| Rate for Payer: BCBS MAPPO |
$1,181.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,886.82
|
| Rate for Payer: BCCCP Commercial |
$515.37
|
| Rate for Payer: BCN Commercial |
$3,675.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,181.98
|
| Rate for Payer: Cash Price |
$3,782.34
|
| Rate for Payer: Cash Price |
$3,782.34
|
| Rate for Payer: Cofinity Commercial |
$4,066.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,782.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,181.98
|
| Rate for Payer: Healthscope Commercial |
$4,255.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,545.94
|
| Rate for Payer: Mclaren Medicaid |
$2,712.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,241.08
|
| Rate for Payer: Meridian Medicaid |
$2,848.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,359.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,018.73
|
| Rate for Payer: Nomi Health Commercial |
$3,876.89
|
| Rate for Payer: PACE Senior Care Partners |
$1,122.88
|
| Rate for Payer: PACE SWMI |
$1,181.98
|
| Rate for Payer: PHP Commercial |
$4,018.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,181.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,712.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,073.15
|
| Rate for Payer: Priority Health HMO/PPO |
$4,113.29
|
| Rate for Payer: Priority Health Medicare |
$1,193.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,167.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,181.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,160.57
|
| Rate for Payer: UHC Core |
$3,947.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,181.98
|
| Rate for Payer: UHC Exchange |
$1,181.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,181.98
|
| Rate for Payer: UHCCP Medicaid |
$2,712.59
|
| Rate for Payer: VA VA |
$1,181.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,545.94
|
|
|
HC EXCISE CYST/BREAST LESION
|
Facility
|
IP
|
$4,727.92
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,073.15 |
| Max. Negotiated Rate |
$4,255.13 |
| Rate for Payer: Aetna Commercial |
$4,018.73
|
| Rate for Payer: BCBS Trust/PPO |
$3,859.40
|
| Rate for Payer: BCN Commercial |
$3,653.74
|
| Rate for Payer: Cash Price |
$3,782.34
|
| Rate for Payer: Cofinity Commercial |
$4,066.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,782.34
|
| Rate for Payer: Healthscope Commercial |
$4,255.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,545.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,018.73
|
| Rate for Payer: Nomi Health Commercial |
$3,876.89
|
| Rate for Payer: PHP Commercial |
$4,018.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,073.15
|
| Rate for Payer: Priority Health HMO/PPO |
$4,113.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,167.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,160.57
|
| Rate for Payer: UHC Core |
$3,947.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,545.94
|
|
|
HC EXCISE LESION EYELID WITHOUT CLOSURE
|
Facility
|
IP
|
$869.83
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
36100521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$565.39 |
| Max. Negotiated Rate |
$782.85 |
| Rate for Payer: Aetna Commercial |
$739.36
|
| Rate for Payer: BCBS Trust/PPO |
$710.04
|
| Rate for Payer: BCN Commercial |
$672.20
|
| Rate for Payer: Cash Price |
$695.86
|
| Rate for Payer: Cofinity Commercial |
$748.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.86
|
| Rate for Payer: Healthscope Commercial |
$782.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$652.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$739.36
|
| Rate for Payer: Nomi Health Commercial |
$713.26
|
| Rate for Payer: PHP Commercial |
$739.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$565.39
|
| Rate for Payer: Priority Health HMO/PPO |
$756.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$582.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$765.45
|
| Rate for Payer: UHC Core |
$726.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$652.37
|
|
|
HC EXCISE LESION EYELID WITHOUT CLOSURE
|
Facility
|
OP
|
$869.83
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
36100521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$206.58 |
| Max. Negotiated Rate |
$782.85 |
| Rate for Payer: Aetna Commercial |
$739.36
|
| Rate for Payer: Aetna Medicare |
$226.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.82
|
| Rate for Payer: BCBS Complete |
$720.45
|
| Rate for Payer: BCBS MAPPO |
$217.46
|
| Rate for Payer: BCBS Trust/PPO |
$715.09
|
| Rate for Payer: BCN Commercial |
$676.29
|
| Rate for Payer: BCN Medicare Advantage |
$217.46
|
| Rate for Payer: Cash Price |
$695.86
|
| Rate for Payer: Cash Price |
$695.86
|
| Rate for Payer: Cofinity Commercial |
$748.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.46
|
| Rate for Payer: Healthscope Commercial |
$782.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$652.37
|
| Rate for Payer: Mclaren Medicaid |
$686.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.33
|
| Rate for Payer: Meridian Medicaid |
$720.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$739.36
|
| Rate for Payer: Nomi Health Commercial |
$713.26
|
| Rate for Payer: PACE Senior Care Partners |
$206.58
|
| Rate for Payer: PACE SWMI |
$217.46
|
| Rate for Payer: PHP Commercial |
$739.36
|
| Rate for Payer: PHP Medicare Advantage |
$217.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$686.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$565.39
|
| Rate for Payer: Priority Health HMO/PPO |
$756.75
|
| Rate for Payer: Priority Health Medicare |
$219.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$582.79
|
| Rate for Payer: Railroad Medicare Medicare |
$217.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$765.45
|
| Rate for Payer: UHC Core |
$726.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.46
|
| Rate for Payer: UHC Exchange |
$217.46
|
| Rate for Payer: UHC Medicare Advantage |
$217.46
|
| Rate for Payer: UHCCP Medicaid |
$686.10
|
| Rate for Payer: VA VA |
$217.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$652.37
|
|
|
HC EXCISE LESION MUCOSA & SBMCSL VESTIB CPLX RPR
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 40814
|
| Hospital Charge Code |
76100490
|
|
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 EXCISE LESION MUCOSA & SBMCSL VESTIB CPLX RPR
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 40814
|
| Hospital Charge Code |
76100490
|
|
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 LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
76100461
|
|
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 EXCISE LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
76100461
|
|
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 LIP OR CHEEK FOLD
|
Facility
|
IP
|
$3,964.53
|
|
|
Service Code
|
CPT 40819
|
| Hospital Charge Code |
76100517
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,576.94 |
| Max. Negotiated Rate |
$3,568.08 |
| Rate for Payer: Aetna Commercial |
$3,369.85
|
| Rate for Payer: BCBS Trust/PPO |
$3,236.25
|
| Rate for Payer: BCN Commercial |
$3,063.79
|
| Rate for Payer: Cash Price |
$3,171.62
|
| Rate for Payer: Cofinity Commercial |
$3,409.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,171.62
|
| Rate for Payer: Healthscope Commercial |
$3,568.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,973.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,369.85
|
| Rate for Payer: Nomi Health Commercial |
$3,250.91
|
| Rate for Payer: PHP Commercial |
$3,369.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,576.94
|
| Rate for Payer: Priority Health HMO/PPO |
$3,449.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,656.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,488.79
|
| Rate for Payer: UHC Core |
$3,310.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,973.40
|
|
|
HC EXCISE LIP OR CHEEK FOLD
|
Facility
|
OP
|
$3,964.53
|
|
|
Service Code
|
CPT 40819
|
| Hospital Charge Code |
76100517
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$941.58 |
| Max. Negotiated Rate |
$3,568.08 |
| Rate for Payer: Aetna Commercial |
$3,369.85
|
| Rate for Payer: Aetna Medicare |
$1,030.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,238.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,238.92
|
| Rate for Payer: BCBS Complete |
$1,101.85
|
| Rate for Payer: BCBS MAPPO |
$991.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,259.24
|
| Rate for Payer: BCN Commercial |
$3,082.42
|
| Rate for Payer: BCN Medicare Advantage |
$991.13
|
| Rate for Payer: Cash Price |
$3,171.62
|
| Rate for Payer: Cash Price |
$3,171.62
|
| Rate for Payer: Cofinity Commercial |
$3,409.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,171.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$991.13
|
| Rate for Payer: Healthscope Commercial |
$3,568.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,973.40
|
| Rate for Payer: Mclaren Medicaid |
$1,049.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,040.69
|
| Rate for Payer: Meridian Medicaid |
$1,101.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,139.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,369.85
|
| Rate for Payer: Nomi Health Commercial |
$3,250.91
|
| Rate for Payer: PACE Senior Care Partners |
$941.58
|
| Rate for Payer: PACE SWMI |
$991.13
|
| Rate for Payer: PHP Commercial |
$3,369.85
|
| Rate for Payer: PHP Medicare Advantage |
$991.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,049.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,576.94
|
| Rate for Payer: Priority Health HMO/PPO |
$3,449.14
|
| Rate for Payer: Priority Health Medicare |
$1,001.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,656.24
|
| Rate for Payer: Railroad Medicare Medicare |
$991.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,488.79
|
| Rate for Payer: UHC Core |
$3,310.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$991.13
|
| Rate for Payer: UHC Exchange |
$991.13
|
| Rate for Payer: UHC Medicare Advantage |
$991.13
|
| Rate for Payer: UHCCP Medicaid |
$1,049.31
|
| Rate for Payer: VA VA |
$991.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,973.40
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.5 CM OR LESS
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
76100110
|
|
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 MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.5 CM OR LESS
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
76100110
|
|
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 MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$600.08
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
76100111
|
|
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 MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$600.08
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
76100111
|
|
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 |
$523.36
|
| 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 |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.52
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| 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 |
$498.41
|
| 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 |
$498.41
|
| Rate for Payer: VA VA |
$150.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.06
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$600.08
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
76100112
|
|
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 |
$523.36
|
| 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 |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.52
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| 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 |
$498.41
|
| 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 |
$498.41
|
| Rate for Payer: VA VA |
$150.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.06
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$600.08
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
76100112
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS <=0.5 CM
|
Facility
|
IP
|
$189.35
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
76100145
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.08 |
| Max. Negotiated Rate |
$170.42 |
| Rate for Payer: Aetna Commercial |
$160.95
|
| Rate for Payer: BCBS Trust/PPO |
$154.57
|
| Rate for Payer: BCN Commercial |
$146.33
|
| Rate for Payer: Cash Price |
$151.48
|
| Rate for Payer: Cofinity Commercial |
$162.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.48
|
| Rate for Payer: Healthscope Commercial |
$170.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.95
|
| Rate for Payer: Nomi Health Commercial |
$155.27
|
| Rate for Payer: PHP Commercial |
$160.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.08
|
| Rate for Payer: Priority Health HMO/PPO |
$164.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.63
|
| Rate for Payer: UHC Core |
$158.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.01
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS <=0.5 CM
|
Facility
|
OP
|
$189.35
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
76100145
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$44.97 |
| Max. Negotiated Rate |
$523.36 |
| Rate for Payer: Aetna Commercial |
$160.95
|
| Rate for Payer: Aetna Medicare |
$49.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.17
|
| Rate for Payer: BCBS Complete |
$523.36
|
| Rate for Payer: BCBS MAPPO |
$47.34
|
| Rate for Payer: BCBS Trust/PPO |
$155.66
|
| Rate for Payer: BCN Commercial |
$147.22
|
| Rate for Payer: BCN Medicare Advantage |
$47.34
|
| Rate for Payer: Cash Price |
$151.48
|
| Rate for Payer: Cash Price |
$151.48
|
| Rate for Payer: Cofinity Commercial |
$162.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.34
|
| Rate for Payer: Healthscope Commercial |
$170.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.01
|
| Rate for Payer: Mclaren Medicaid |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.70
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.95
|
| Rate for Payer: Nomi Health Commercial |
$155.27
|
| Rate for Payer: PACE Senior Care Partners |
$44.97
|
| Rate for Payer: PACE SWMI |
$47.34
|
| Rate for Payer: PHP Commercial |
$160.95
|
| Rate for Payer: PHP Medicare Advantage |
$47.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.08
|
| Rate for Payer: Priority Health HMO/PPO |
$164.73
|
| Rate for Payer: Priority Health Medicare |
$47.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.86
|
| Rate for Payer: Railroad Medicare Medicare |
$47.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.63
|
| Rate for Payer: UHC Core |
$158.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.34
|
| Rate for Payer: UHC Exchange |
$47.34
|
| Rate for Payer: UHC Medicare Advantage |
$47.34
|
| Rate for Payer: UHCCP Medicaid |
$498.41
|
| Rate for Payer: VA VA |
$47.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.01
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$600.08
|
|
|
Service Code
|
CPT 11601
|
| Hospital Charge Code |
76100104
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$600.08
|
|
|
Service Code
|
CPT 11601
|
| Hospital Charge Code |
76100104
|
|
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 |
$523.36
|
| 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 |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.52
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| 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 |
$498.41
|
| 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 |
$498.41
|
| Rate for Payer: VA VA |
$150.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.06
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$600.08
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
76100105
|
|
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
|
|
