|
HC EXC LESION MUCOSA SBMCSL VESTIBULE SMPL RPR
|
Facility
|
OP
|
$4,268.00
|
|
|
Service Code
|
CPT 40812
|
| Hospital Charge Code |
76100430
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,013.65 |
| Max. Negotiated Rate |
$3,841.20 |
| Rate for Payer: Aetna Commercial |
$3,627.80
|
| Rate for Payer: Aetna Medicare |
$1,109.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,333.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,333.75
|
| Rate for Payer: BCBS Complete |
$1,124.59
|
| Rate for Payer: BCBS MAPPO |
$1,067.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,508.72
|
| Rate for Payer: BCN Commercial |
$3,318.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,067.00
|
| Rate for Payer: Cash Price |
$3,414.40
|
| Rate for Payer: Cash Price |
$3,414.40
|
| Rate for Payer: Cofinity Commercial |
$3,670.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,414.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,067.00
|
| Rate for Payer: Healthscope Commercial |
$3,841.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,201.00
|
| Rate for Payer: Mclaren Medicaid |
$1,070.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,120.35
|
| Rate for Payer: Meridian Medicaid |
$1,124.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,227.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,627.80
|
| Rate for Payer: Nomi Health Commercial |
$3,499.76
|
| Rate for Payer: PACE Senior Care Partners |
$1,013.65
|
| Rate for Payer: PACE SWMI |
$1,067.00
|
| Rate for Payer: PHP Commercial |
$3,627.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,067.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,774.20
|
| Rate for Payer: Priority Health HMO/PPO |
$3,713.16
|
| Rate for Payer: Priority Health Medicare |
$1,077.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,859.56
|
| Rate for Payer: Railroad Medicare Medicare |
$1,067.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,755.84
|
| Rate for Payer: UHC Core |
$3,563.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,067.00
|
| Rate for Payer: UHC Exchange |
$1,067.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,067.00
|
| Rate for Payer: UHCCP Medicaid |
$1,070.97
|
| Rate for Payer: VA VA |
$1,067.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,201.00
|
|
|
HC EXC LESION PALATE UVULA W/O CLOSURE
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 42104
|
| Hospital Charge Code |
76100467
|
|
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 EXC LESION PALATE UVULA W/O CLOSURE
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 42104
|
| Hospital Charge Code |
76100467
|
|
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
|
|
|
HC EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 40510
|
| Hospital Charge Code |
76100457
|
|
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
|
|
|
HC EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 40510
|
| Hospital Charge Code |
76100457
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11620
|
| Hospital Charge Code |
76100107
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11620
|
| Hospital Charge Code |
76100107
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 TO 1.0 CM
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
76100108
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 TO 1.0 CM
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
76100108
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.0 TO 2.0 CM
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
76100109
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.0 TO 2.0 CM
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
76100109
|
|
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 EXC SINGLE EXTERNAL PAPILLA OR TAG, ANUS
|
Facility
|
OP
|
$1,567.19
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
76100280
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$372.21 |
| Max. Negotiated Rate |
$1,410.47 |
| Rate for Payer: Aetna Commercial |
$1,332.11
|
| Rate for Payer: Aetna Medicare |
$407.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.75
|
| Rate for Payer: BCBS Complete |
$895.16
|
| Rate for Payer: BCBS MAPPO |
$391.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,288.39
|
| Rate for Payer: BCN Commercial |
$1,218.49
|
| Rate for Payer: BCN Medicare Advantage |
$391.80
|
| Rate for Payer: Cash Price |
$1,253.75
|
| Rate for Payer: Cash Price |
$1,253.75
|
| Rate for Payer: Cofinity Commercial |
$1,347.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,253.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.80
|
| Rate for Payer: Healthscope Commercial |
$1,410.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,175.39
|
| Rate for Payer: Mclaren Medicaid |
$852.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.39
|
| Rate for Payer: Meridian Medicaid |
$895.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.11
|
| Rate for Payer: Nomi Health Commercial |
$1,285.10
|
| Rate for Payer: PACE Senior Care Partners |
$372.21
|
| Rate for Payer: PACE SWMI |
$391.80
|
| Rate for Payer: PHP Commercial |
$1,332.11
|
| Rate for Payer: PHP Medicare Advantage |
$391.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$852.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,018.67
|
| Rate for Payer: Priority Health HMO/PPO |
$1,363.46
|
| Rate for Payer: Priority Health Medicare |
$395.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,050.02
|
| Rate for Payer: Railroad Medicare Medicare |
$391.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,379.13
|
| Rate for Payer: UHC Core |
$1,308.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.80
|
| Rate for Payer: UHC Exchange |
$391.80
|
| Rate for Payer: UHC Medicare Advantage |
$391.80
|
| Rate for Payer: UHCCP Medicaid |
$852.47
|
| Rate for Payer: VA VA |
$391.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,175.39
|
|
|
HC EXC SINGLE EXTERNAL PAPILLA OR TAG, ANUS
|
Facility
|
IP
|
$1,567.19
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
76100280
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,018.67 |
| Max. Negotiated Rate |
$1,410.47 |
| Rate for Payer: Aetna Commercial |
$1,332.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,279.30
|
| Rate for Payer: BCN Commercial |
$1,211.12
|
| Rate for Payer: Cash Price |
$1,253.75
|
| Rate for Payer: Cofinity Commercial |
$1,347.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,253.75
|
| Rate for Payer: Healthscope Commercial |
$1,410.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,175.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.11
|
| Rate for Payer: Nomi Health Commercial |
$1,285.10
|
| Rate for Payer: PHP Commercial |
$1,332.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,018.67
|
| Rate for Payer: Priority Health HMO/PPO |
$1,363.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,050.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,379.13
|
| Rate for Payer: UHC Core |
$1,308.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,175.39
|
|
|
HC EXC SKIN MALIG 2.1-3CM FACE, FACIAL
|
Facility
|
OP
|
$2,146.61
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
76100215
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$509.82 |
| Max. Negotiated Rate |
$1,931.95 |
| Rate for Payer: Aetna Commercial |
$1,824.62
|
| Rate for Payer: Aetna Medicare |
$558.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$670.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$670.82
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$536.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,764.73
|
| Rate for Payer: BCN Commercial |
$1,668.99
|
| Rate for Payer: BCN Medicare Advantage |
$536.65
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cofinity Commercial |
$1,846.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.65
|
| Rate for Payer: Healthscope Commercial |
$1,931.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.96
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.49
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$617.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.62
|
| Rate for Payer: Nomi Health Commercial |
$1,760.22
|
| Rate for Payer: PACE Senior Care Partners |
$509.82
|
| Rate for Payer: PACE SWMI |
$536.65
|
| Rate for Payer: PHP Commercial |
$1,824.62
|
| Rate for Payer: PHP Medicare Advantage |
$536.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,867.55
|
| Rate for Payer: Priority Health Medicare |
$542.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,438.23
|
| Rate for Payer: Railroad Medicare Medicare |
$536.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,889.02
|
| Rate for Payer: UHC Core |
$1,792.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.65
|
| Rate for Payer: UHC Exchange |
$536.65
|
| Rate for Payer: UHC Medicare Advantage |
$536.65
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$536.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.96
|
|
|
HC EXC SKIN MALIG 2.1-3CM FACE, FACIAL
|
Facility
|
IP
|
$2,146.61
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
76100215
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,395.30 |
| Max. Negotiated Rate |
$1,931.95 |
| Rate for Payer: Aetna Commercial |
$1,824.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,752.28
|
| Rate for Payer: BCN Commercial |
$1,658.90
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cofinity Commercial |
$1,846.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.29
|
| Rate for Payer: Healthscope Commercial |
$1,931.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.62
|
| Rate for Payer: Nomi Health Commercial |
$1,760.22
|
| Rate for Payer: PHP Commercial |
$1,824.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,867.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,438.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,889.02
|
| Rate for Payer: UHC Core |
$1,792.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.96
|
|
|
HC EXC SKIN MALIG 2.1-3 CM REMAINDER BODY
|
Facility
|
IP
|
$2,146.61
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
76100212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,395.30 |
| Max. Negotiated Rate |
$1,931.95 |
| Rate for Payer: Aetna Commercial |
$1,824.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,752.28
|
| Rate for Payer: BCN Commercial |
$1,658.90
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cofinity Commercial |
$1,846.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.29
|
| Rate for Payer: Healthscope Commercial |
$1,931.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.62
|
| Rate for Payer: Nomi Health Commercial |
$1,760.22
|
| Rate for Payer: PHP Commercial |
$1,824.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,867.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,438.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,889.02
|
| Rate for Payer: UHC Core |
$1,792.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.96
|
|
|
HC EXC SKIN MALIG 2.1-3 CM REMAINDER BODY
|
Facility
|
OP
|
$2,146.61
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
76100212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$509.82 |
| Max. Negotiated Rate |
$1,931.95 |
| Rate for Payer: Aetna Commercial |
$1,824.62
|
| Rate for Payer: Aetna Medicare |
$558.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$670.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$670.82
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$536.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,764.73
|
| Rate for Payer: BCN Commercial |
$1,668.99
|
| Rate for Payer: BCN Medicare Advantage |
$536.65
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cofinity Commercial |
$1,846.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.65
|
| Rate for Payer: Healthscope Commercial |
$1,931.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.96
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.49
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$617.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.62
|
| Rate for Payer: Nomi Health Commercial |
$1,760.22
|
| Rate for Payer: PACE Senior Care Partners |
$509.82
|
| Rate for Payer: PACE SWMI |
$536.65
|
| Rate for Payer: PHP Commercial |
$1,824.62
|
| Rate for Payer: PHP Medicare Advantage |
$536.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,867.55
|
| Rate for Payer: Priority Health Medicare |
$542.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,438.23
|
| Rate for Payer: Railroad Medicare Medicare |
$536.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,889.02
|
| Rate for Payer: UHC Core |
$1,792.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.65
|
| Rate for Payer: UHC Exchange |
$536.65
|
| Rate for Payer: UHC Medicare Advantage |
$536.65
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$536.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.96
|
|
|
HC EXC SKIN MALIG 3.1-4CM FACE, FACIAL
|
Facility
|
OP
|
$2,146.61
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
76100216
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$509.82 |
| Max. Negotiated Rate |
$1,931.95 |
| Rate for Payer: Aetna Commercial |
$1,824.62
|
| Rate for Payer: Aetna Medicare |
$558.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$670.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$670.82
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$536.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,764.73
|
| Rate for Payer: BCN Commercial |
$1,668.99
|
| Rate for Payer: BCN Medicare Advantage |
$536.65
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cofinity Commercial |
$1,846.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.65
|
| Rate for Payer: Healthscope Commercial |
$1,931.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.96
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.49
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$617.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.62
|
| Rate for Payer: Nomi Health Commercial |
$1,760.22
|
| Rate for Payer: PACE Senior Care Partners |
$509.82
|
| Rate for Payer: PACE SWMI |
$536.65
|
| Rate for Payer: PHP Commercial |
$1,824.62
|
| Rate for Payer: PHP Medicare Advantage |
$536.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,867.55
|
| Rate for Payer: Priority Health Medicare |
$542.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,438.23
|
| Rate for Payer: Railroad Medicare Medicare |
$536.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,889.02
|
| Rate for Payer: UHC Core |
$1,792.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.65
|
| Rate for Payer: UHC Exchange |
$536.65
|
| Rate for Payer: UHC Medicare Advantage |
$536.65
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$536.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.96
|
|
|
HC EXC SKIN MALIG 3.1-4CM FACE, FACIAL
|
Facility
|
IP
|
$2,146.61
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
76100216
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,395.30 |
| Max. Negotiated Rate |
$1,931.95 |
| Rate for Payer: Aetna Commercial |
$1,824.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,752.28
|
| Rate for Payer: BCN Commercial |
$1,658.90
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cofinity Commercial |
$1,846.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.29
|
| Rate for Payer: Healthscope Commercial |
$1,931.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.62
|
| Rate for Payer: Nomi Health Commercial |
$1,760.22
|
| Rate for Payer: PHP Commercial |
$1,824.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,867.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,438.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,889.02
|
| Rate for Payer: UHC Core |
$1,792.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.96
|
|
|
HC EXC SKIN MALIG 3.1-4 CM REMAINDER BODY
|
Facility
|
OP
|
$2,146.61
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
76100213
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$509.82 |
| Max. Negotiated Rate |
$1,931.95 |
| Rate for Payer: Aetna Commercial |
$1,824.62
|
| Rate for Payer: Aetna Medicare |
$558.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$670.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$670.82
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$536.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,764.73
|
| Rate for Payer: BCN Commercial |
$1,668.99
|
| Rate for Payer: BCN Medicare Advantage |
$536.65
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cofinity Commercial |
$1,846.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.65
|
| Rate for Payer: Healthscope Commercial |
$1,931.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.96
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.49
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$617.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.62
|
| Rate for Payer: Nomi Health Commercial |
$1,760.22
|
| Rate for Payer: PACE Senior Care Partners |
$509.82
|
| Rate for Payer: PACE SWMI |
$536.65
|
| Rate for Payer: PHP Commercial |
$1,824.62
|
| Rate for Payer: PHP Medicare Advantage |
$536.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,867.55
|
| Rate for Payer: Priority Health Medicare |
$542.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,438.23
|
| Rate for Payer: Railroad Medicare Medicare |
$536.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,889.02
|
| Rate for Payer: UHC Core |
$1,792.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.65
|
| Rate for Payer: UHC Exchange |
$536.65
|
| Rate for Payer: UHC Medicare Advantage |
$536.65
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$536.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.96
|
|
|
HC EXC SKIN MALIG 3.1-4 CM REMAINDER BODY
|
Facility
|
IP
|
$2,146.61
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
76100213
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,395.30 |
| Max. Negotiated Rate |
$1,931.95 |
| Rate for Payer: Aetna Commercial |
$1,824.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,752.28
|
| Rate for Payer: BCN Commercial |
$1,658.90
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cofinity Commercial |
$1,846.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.29
|
| Rate for Payer: Healthscope Commercial |
$1,931.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.62
|
| Rate for Payer: Nomi Health Commercial |
$1,760.22
|
| Rate for Payer: PHP Commercial |
$1,824.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,867.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,438.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,889.02
|
| Rate for Payer: UHC Core |
$1,792.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.96
|
|
|
HC EXC SKIN MALIG >4CM FACE, FACIAL
|
Facility
|
OP
|
$3,711.63
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
76100217
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$881.51 |
| Max. Negotiated Rate |
$3,340.47 |
| Rate for Payer: Aetna Commercial |
$3,154.89
|
| Rate for Payer: Aetna Medicare |
$965.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,159.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,159.88
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$927.91
|
| Rate for Payer: BCBS Trust/PPO |
$3,051.33
|
| Rate for Payer: BCN Commercial |
$2,885.79
|
| Rate for Payer: BCN Medicare Advantage |
$927.91
|
| Rate for Payer: Cash Price |
$2,969.30
|
| Rate for Payer: Cash Price |
$2,969.30
|
| Rate for Payer: Cofinity Commercial |
$3,192.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,969.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$927.91
|
| Rate for Payer: Healthscope Commercial |
$3,340.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,783.72
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$974.30
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,067.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,154.89
|
| Rate for Payer: Nomi Health Commercial |
$3,043.54
|
| Rate for Payer: PACE Senior Care Partners |
$881.51
|
| Rate for Payer: PACE SWMI |
$927.91
|
| Rate for Payer: PHP Commercial |
$3,154.89
|
| Rate for Payer: PHP Medicare Advantage |
$927.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,412.56
|
| Rate for Payer: Priority Health HMO/PPO |
$3,229.12
|
| Rate for Payer: Priority Health Medicare |
$937.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,486.79
|
| Rate for Payer: Railroad Medicare Medicare |
$927.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,266.23
|
| Rate for Payer: UHC Core |
$3,099.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$927.91
|
| Rate for Payer: UHC Exchange |
$927.91
|
| Rate for Payer: UHC Medicare Advantage |
$927.91
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$927.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,783.72
|
|
|
HC EXC SKIN MALIG >4CM FACE, FACIAL
|
Facility
|
IP
|
$3,711.63
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
76100217
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,412.56 |
| Max. Negotiated Rate |
$3,340.47 |
| Rate for Payer: Aetna Commercial |
$3,154.89
|
| Rate for Payer: BCBS Trust/PPO |
$3,029.80
|
| Rate for Payer: BCN Commercial |
$2,868.35
|
| Rate for Payer: Cash Price |
$2,969.30
|
| Rate for Payer: Cofinity Commercial |
$3,192.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,969.30
|
| Rate for Payer: Healthscope Commercial |
$3,340.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,783.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,154.89
|
| Rate for Payer: Nomi Health Commercial |
$3,043.54
|
| Rate for Payer: PHP Commercial |
$3,154.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,412.56
|
| Rate for Payer: Priority Health HMO/PPO |
$3,229.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,486.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,266.23
|
| Rate for Payer: UHC Core |
$3,099.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,783.72
|
|
|
HC EXC SKIN MALIG >4 CM TRUNK, ARM, LEG
|
Facility
|
OP
|
$2,146.61
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
76100211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$509.82 |
| Max. Negotiated Rate |
$1,931.95 |
| Rate for Payer: Aetna Commercial |
$1,824.62
|
| Rate for Payer: Aetna Medicare |
$558.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$670.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$670.82
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$536.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,764.73
|
| Rate for Payer: BCN Commercial |
$1,668.99
|
| Rate for Payer: BCN Medicare Advantage |
$536.65
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cofinity Commercial |
$1,846.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.65
|
| Rate for Payer: Healthscope Commercial |
$1,931.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.96
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.49
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$617.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.62
|
| Rate for Payer: Nomi Health Commercial |
$1,760.22
|
| Rate for Payer: PACE Senior Care Partners |
$509.82
|
| Rate for Payer: PACE SWMI |
$536.65
|
| Rate for Payer: PHP Commercial |
$1,824.62
|
| Rate for Payer: PHP Medicare Advantage |
$536.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,867.55
|
| Rate for Payer: Priority Health Medicare |
$542.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,438.23
|
| Rate for Payer: Railroad Medicare Medicare |
$536.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,889.02
|
| Rate for Payer: UHC Core |
$1,792.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.65
|
| Rate for Payer: UHC Exchange |
$536.65
|
| Rate for Payer: UHC Medicare Advantage |
$536.65
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$536.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.96
|
|
|
HC EXC SKIN MALIG >4 CM TRUNK, ARM, LEG
|
Facility
|
IP
|
$2,146.61
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
76100211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,395.30 |
| Max. Negotiated Rate |
$1,931.95 |
| Rate for Payer: Aetna Commercial |
$1,824.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,752.28
|
| Rate for Payer: BCN Commercial |
$1,658.90
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cofinity Commercial |
$1,846.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.29
|
| Rate for Payer: Healthscope Commercial |
$1,931.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.62
|
| Rate for Payer: Nomi Health Commercial |
$1,760.22
|
| Rate for Payer: PHP Commercial |
$1,824.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,867.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,438.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,889.02
|
| Rate for Payer: UHC Core |
$1,792.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.96
|
|
