|
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 |
$1,230.09 |
| 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 |
$1,230.09
|
| 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 |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.71
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| 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 |
$1,171.43
|
| 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 |
$1,171.43
|
| 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 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 |
$1,230.09 |
| 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 |
$1,230.09
|
| 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 |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.71
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| 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 |
$1,171.43
|
| 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 |
$1,171.43
|
| 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 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 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 |
$1,230.09
|
| 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 |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.85
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| 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 |
$1,171.43
|
| 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 |
$1,171.43
|
| 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 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 |
$2,172.87 |
| 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 |
$2,172.87
|
| 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 |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.85
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| 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 |
$2,069.26
|
| 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 |
$2,069.26
|
| 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 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 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 |
$534.17
|
| 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 |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$220.17
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| 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 |
$508.70
|
| 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 |
$508.70
|
| 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
|
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 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 |
$187.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.53
|
| Rate for Payer: BCBS Complete |
$303.32
|
| 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 |
$288.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.52
|
| Rate for Payer: Meridian Medicaid |
$303.32
|
| 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 |
$288.86
|
| 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 |
$288.86
|
| 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 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 |
$534.17
|
| 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 |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.74
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| 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 |
$508.70
|
| 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 |
$508.70
|
| 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 |
$534.17
|
| 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 |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.71
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| 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 |
$508.70
|
| 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 |
$508.70
|
| 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
|
|
|
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 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 |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$352.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,160.20
|
| Rate for Payer: BCN Commercial |
$1,097.25
|
| Rate for Payer: BCN Medicare Advantage |
$352.81
|
| 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 |
$352.81
|
| Rate for Payer: Healthscope Commercial |
$1,270.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,058.44
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.46
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| 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 |
$352.81
|
| Rate for Payer: PHP Commercial |
$1,199.57
|
| Rate for Payer: PHP Medicare Advantage |
$352.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| 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 |
$352.81
|
| 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 |
$352.81
|
| Rate for Payer: UHC Exchange |
$352.81
|
| Rate for Payer: UHC Medicare Advantage |
$352.81
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$352.81
|
| 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 |
$1,230.09
|
| 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 |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$556.20
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| 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 |
$1,171.43
|
| 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 |
$1,171.43
|
| 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
|
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 CYST/BREAST LESION
|
Facility
|
OP
|
$4,727.92
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,122.88 |
| 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 |
$1,477.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,477.47
|
| Rate for Payer: BCBS Complete |
$2,907.19
|
| Rate for Payer: BCBS MAPPO |
$1,181.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,886.82
|
| 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 |
$2,768.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,241.08
|
| Rate for Payer: Meridian Medicaid |
$2,907.19
|
| 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 |
$2,768.57
|
| 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 |
$2,768.57
|
| Rate for Payer: VA VA |
$1,181.98
|
| 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 |
$735.32
|
| 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 |
$700.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.33
|
| Rate for Payer: Meridian Medicaid |
$735.32
|
| 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 |
$700.25
|
| 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 |
$700.25
|
| 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
|
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 |
$2,462.14
|
| 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 |
$2,344.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,115.22
|
| Rate for Payer: Meridian Medicaid |
$2,462.14
|
| 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 |
$2,344.74
|
| 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 |
$2,344.74
|
| Rate for Payer: VA VA |
$2,014.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
