|
HC EXC SKIN MALIG >4 REMAINDER BODY
|
Facility
|
OP
|
$3,711.63
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
76100214
|
|
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 >4 REMAINDER BODY
|
Facility
|
IP
|
$3,711.63
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
76100214
|
|
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 THROMBOSED HEMORRHOID EXTERN
|
Facility
|
OP
|
$3,236.56
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
36000106
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$768.68 |
| Max. Negotiated Rate |
$2,912.90 |
| Rate for Payer: Aetna Commercial |
$2,751.08
|
| Rate for Payer: Aetna Medicare |
$841.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,011.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,011.42
|
| Rate for Payer: BCBS Complete |
$895.16
|
| Rate for Payer: BCBS MAPPO |
$809.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,660.78
|
| Rate for Payer: BCN Commercial |
$2,516.43
|
| Rate for Payer: BCN Medicare Advantage |
$809.14
|
| Rate for Payer: Cash Price |
$2,589.25
|
| Rate for Payer: Cash Price |
$2,589.25
|
| Rate for Payer: Cofinity Commercial |
$2,783.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,589.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$809.14
|
| Rate for Payer: Healthscope Commercial |
$2,912.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,427.42
|
| Rate for Payer: Mclaren Medicaid |
$852.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$849.60
|
| Rate for Payer: Meridian Medicaid |
$895.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$930.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,751.08
|
| Rate for Payer: Nomi Health Commercial |
$2,653.98
|
| Rate for Payer: PACE Senior Care Partners |
$768.68
|
| Rate for Payer: PACE SWMI |
$809.14
|
| Rate for Payer: PHP Commercial |
$2,751.08
|
| Rate for Payer: PHP Medicare Advantage |
$809.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$852.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,103.76
|
| Rate for Payer: Priority Health HMO/PPO |
$2,815.81
|
| Rate for Payer: Priority Health Medicare |
$817.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,168.50
|
| Rate for Payer: Railroad Medicare Medicare |
$809.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,848.17
|
| Rate for Payer: UHC Core |
$2,702.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$809.14
|
| Rate for Payer: UHC Exchange |
$809.14
|
| Rate for Payer: UHC Medicare Advantage |
$809.14
|
| Rate for Payer: UHCCP Medicaid |
$852.47
|
| Rate for Payer: VA VA |
$809.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,427.42
|
|
|
HC EXC THROMBOSED HEMORRHOID EXTERN
|
Facility
|
IP
|
$3,236.56
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
36000106
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,103.76 |
| Max. Negotiated Rate |
$2,912.90 |
| Rate for Payer: Aetna Commercial |
$2,751.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,642.00
|
| Rate for Payer: BCN Commercial |
$2,501.21
|
| Rate for Payer: Cash Price |
$2,589.25
|
| Rate for Payer: Cofinity Commercial |
$2,783.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,589.25
|
| Rate for Payer: Healthscope Commercial |
$2,912.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,427.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,751.08
|
| Rate for Payer: Nomi Health Commercial |
$2,653.98
|
| Rate for Payer: PHP Commercial |
$2,751.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,103.76
|
| Rate for Payer: Priority Health HMO/PPO |
$2,815.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,168.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,848.17
|
| Rate for Payer: UHC Core |
$2,702.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,427.42
|
|
|
HC EXC TUMOR SOFT TISS FACE AND SCALP SUBFASCIAL <2CM
|
Facility
|
IP
|
$4,540.00
|
|
|
Service Code
|
CPT 21013
|
| Hospital Charge Code |
76100526
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,951.00 |
| Max. Negotiated Rate |
$4,086.00 |
| Rate for Payer: Aetna Commercial |
$3,859.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,706.00
|
| Rate for Payer: BCN Commercial |
$3,508.51
|
| Rate for Payer: Cash Price |
$3,632.00
|
| Rate for Payer: Cofinity Commercial |
$3,904.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,632.00
|
| Rate for Payer: Healthscope Commercial |
$4,086.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,405.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,859.00
|
| Rate for Payer: Nomi Health Commercial |
$3,722.80
|
| Rate for Payer: PHP Commercial |
$3,859.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,951.00
|
| Rate for Payer: Priority Health HMO/PPO |
$3,949.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,041.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,995.20
|
| Rate for Payer: UHC Core |
$3,790.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,405.00
|
|
|
HC EXC TUMOR SOFT TISS FACE AND SCALP SUBFASCIAL <2CM
|
Facility
|
OP
|
$4,540.00
|
|
|
Service Code
|
CPT 21013
|
| Hospital Charge Code |
76100526
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,078.25 |
| Max. Negotiated Rate |
$4,086.00 |
| Rate for Payer: Aetna Commercial |
$3,859.00
|
| Rate for Payer: Aetna Medicare |
$1,180.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,418.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,418.75
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$1,135.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,732.33
|
| Rate for Payer: BCN Commercial |
$3,529.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,135.00
|
| Rate for Payer: Cash Price |
$3,632.00
|
| Rate for Payer: Cash Price |
$3,632.00
|
| Rate for Payer: Cofinity Commercial |
$3,904.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,632.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,135.00
|
| Rate for Payer: Healthscope Commercial |
$4,086.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,405.00
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,191.75
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,305.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,859.00
|
| Rate for Payer: Nomi Health Commercial |
$3,722.80
|
| Rate for Payer: PACE Senior Care Partners |
$1,078.25
|
| Rate for Payer: PACE SWMI |
$1,135.00
|
| Rate for Payer: PHP Commercial |
$3,859.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,135.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,951.00
|
| Rate for Payer: Priority Health HMO/PPO |
$3,949.80
|
| Rate for Payer: Priority Health Medicare |
$1,146.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,041.80
|
| Rate for Payer: Railroad Medicare Medicare |
$1,135.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,995.20
|
| Rate for Payer: UHC Core |
$3,790.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,135.00
|
| Rate for Payer: UHC Exchange |
$1,135.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,135.00
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$1,135.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,405.00
|
|
|
HC EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>
|
Facility
|
IP
|
$4,540.00
|
|
|
Service Code
|
CPT 25071
|
| Hospital Charge Code |
76100431
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,951.00 |
| Max. Negotiated Rate |
$4,086.00 |
| Rate for Payer: Aetna Commercial |
$3,859.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,706.00
|
| Rate for Payer: BCN Commercial |
$3,508.51
|
| Rate for Payer: Cash Price |
$3,632.00
|
| Rate for Payer: Cofinity Commercial |
$3,904.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,632.00
|
| Rate for Payer: Healthscope Commercial |
$4,086.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,405.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,859.00
|
| Rate for Payer: Nomi Health Commercial |
$3,722.80
|
| Rate for Payer: PHP Commercial |
$3,859.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,951.00
|
| Rate for Payer: Priority Health HMO/PPO |
$3,949.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,041.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,995.20
|
| Rate for Payer: UHC Core |
$3,790.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,405.00
|
|
|
HC EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>
|
Facility
|
OP
|
$4,540.00
|
|
|
Service Code
|
CPT 25071
|
| Hospital Charge Code |
76100431
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,078.25 |
| Max. Negotiated Rate |
$4,086.00 |
| Rate for Payer: Aetna Commercial |
$3,859.00
|
| Rate for Payer: Aetna Medicare |
$1,180.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,418.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,418.75
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$1,135.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,732.33
|
| Rate for Payer: BCN Commercial |
$3,529.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,135.00
|
| Rate for Payer: Cash Price |
$3,632.00
|
| Rate for Payer: Cash Price |
$3,632.00
|
| Rate for Payer: Cofinity Commercial |
$3,904.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,632.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,135.00
|
| Rate for Payer: Healthscope Commercial |
$4,086.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,405.00
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,191.75
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,305.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,859.00
|
| Rate for Payer: Nomi Health Commercial |
$3,722.80
|
| Rate for Payer: PACE Senior Care Partners |
$1,078.25
|
| Rate for Payer: PACE SWMI |
$1,135.00
|
| Rate for Payer: PHP Commercial |
$3,859.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,135.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,951.00
|
| Rate for Payer: Priority Health HMO/PPO |
$3,949.80
|
| Rate for Payer: Priority Health Medicare |
$1,146.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,041.80
|
| Rate for Payer: Railroad Medicare Medicare |
$1,135.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,995.20
|
| Rate for Payer: UHC Core |
$3,790.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,135.00
|
| Rate for Payer: UHC Exchange |
$1,135.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,135.00
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$1,135.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,405.00
|
|
|
HC EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
IP
|
$8,111.04
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
76100413
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,272.18 |
| Max. Negotiated Rate |
$7,299.94 |
| Rate for Payer: Aetna Commercial |
$6,894.38
|
| Rate for Payer: BCBS Trust/PPO |
$6,621.04
|
| Rate for Payer: BCN Commercial |
$6,268.21
|
| Rate for Payer: Cash Price |
$6,488.83
|
| Rate for Payer: Cofinity Commercial |
$6,975.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,488.83
|
| Rate for Payer: Healthscope Commercial |
$7,299.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,083.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,894.38
|
| Rate for Payer: Nomi Health Commercial |
$6,651.05
|
| Rate for Payer: PHP Commercial |
$6,894.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,272.18
|
| Rate for Payer: Priority Health HMO/PPO |
$7,056.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,434.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,137.72
|
| Rate for Payer: UHC Core |
$6,772.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,083.28
|
|
|
HC EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
OP
|
$8,111.04
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
76100413
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,926.37 |
| Max. Negotiated Rate |
$7,299.94 |
| Rate for Payer: Aetna Commercial |
$6,894.38
|
| Rate for Payer: Aetna Medicare |
$2,108.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,534.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,534.70
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$2,027.76
|
| Rate for Payer: BCBS Trust/PPO |
$6,668.09
|
| Rate for Payer: BCN Commercial |
$6,306.33
|
| Rate for Payer: BCN Medicare Advantage |
$2,027.76
|
| Rate for Payer: Cash Price |
$6,488.83
|
| Rate for Payer: Cash Price |
$6,488.83
|
| Rate for Payer: Cofinity Commercial |
$6,975.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,488.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,027.76
|
| Rate for Payer: Healthscope Commercial |
$7,299.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,083.28
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,129.15
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,331.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,894.38
|
| Rate for Payer: Nomi Health Commercial |
$6,651.05
|
| Rate for Payer: PACE Senior Care Partners |
$1,926.37
|
| Rate for Payer: PACE SWMI |
$2,027.76
|
| Rate for Payer: PHP Commercial |
$6,894.38
|
| Rate for Payer: PHP Medicare Advantage |
$2,027.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,272.18
|
| Rate for Payer: Priority Health HMO/PPO |
$7,056.60
|
| Rate for Payer: Priority Health Medicare |
$2,048.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,434.40
|
| Rate for Payer: Railroad Medicare Medicare |
$2,027.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,137.72
|
| Rate for Payer: UHC Core |
$6,772.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,027.76
|
| Rate for Payer: UHC Exchange |
$2,027.76
|
| Rate for Payer: UHC Medicare Advantage |
$2,027.76
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$2,027.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,083.28
|
|
|
HC EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ >3CM
|
Facility
|
OP
|
$3,618.87
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
76100245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$859.48 |
| Max. Negotiated Rate |
$3,256.98 |
| Rate for Payer: Aetna Commercial |
$3,076.04
|
| Rate for Payer: Aetna Medicare |
$940.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,130.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,130.90
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$904.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,975.07
|
| Rate for Payer: BCN Commercial |
$2,813.67
|
| Rate for Payer: BCN Medicare Advantage |
$904.72
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cofinity Commercial |
$3,112.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,895.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$904.72
|
| Rate for Payer: Healthscope Commercial |
$3,256.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,714.15
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$949.95
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,040.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,076.04
|
| Rate for Payer: Nomi Health Commercial |
$2,967.47
|
| Rate for Payer: PACE Senior Care Partners |
$859.48
|
| Rate for Payer: PACE SWMI |
$904.72
|
| Rate for Payer: PHP Commercial |
$3,076.04
|
| Rate for Payer: PHP Medicare Advantage |
$904.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.27
|
| Rate for Payer: Priority Health HMO/PPO |
$3,148.42
|
| Rate for Payer: Priority Health Medicare |
$913.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,424.64
|
| Rate for Payer: Railroad Medicare Medicare |
$904.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,184.61
|
| Rate for Payer: UHC Core |
$3,021.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$904.72
|
| Rate for Payer: UHC Exchange |
$904.72
|
| Rate for Payer: UHC Medicare Advantage |
$904.72
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$904.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,714.15
|
|
|
HC EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ >3CM
|
Facility
|
IP
|
$3,618.87
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
76100245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,352.27 |
| Max. Negotiated Rate |
$3,256.98 |
| Rate for Payer: Aetna Commercial |
$3,076.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,954.08
|
| Rate for Payer: BCN Commercial |
$2,796.66
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cofinity Commercial |
$3,112.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,895.10
|
| Rate for Payer: Healthscope Commercial |
$3,256.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,714.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,076.04
|
| Rate for Payer: Nomi Health Commercial |
$2,967.47
|
| Rate for Payer: PHP Commercial |
$3,076.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.27
|
| Rate for Payer: Priority Health HMO/PPO |
$3,148.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,424.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,184.61
|
| Rate for Payer: UHC Core |
$3,021.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,714.15
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <3CM
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 22902
|
| Hospital Charge Code |
76100277
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,392.35 |
| Max. Negotiated Rate |
$1,927.87 |
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,748.58
|
| Rate for Payer: BCN Commercial |
$1,655.40
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,863.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,435.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,885.03
|
| Rate for Payer: UHC Core |
$1,788.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.56
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <3CM
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 22902
|
| Hospital Charge Code |
76100277
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$508.74 |
| Max. Negotiated Rate |
$1,927.87 |
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna Medicare |
$556.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$669.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$669.40
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$535.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,761.00
|
| Rate for Payer: BCN Commercial |
$1,665.47
|
| Rate for Payer: BCN Medicare Advantage |
$535.52
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$535.52
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.56
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$562.30
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$615.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: PACE Senior Care Partners |
$508.74
|
| Rate for Payer: PACE SWMI |
$535.52
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: PHP Medicare Advantage |
$535.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,863.61
|
| Rate for Payer: Priority Health Medicare |
$540.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,435.19
|
| Rate for Payer: Railroad Medicare Medicare |
$535.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,885.03
|
| Rate for Payer: UHC Core |
$1,788.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$535.52
|
| Rate for Payer: UHC Exchange |
$535.52
|
| Rate for Payer: UHC Medicare Advantage |
$535.52
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$535.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.56
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <5CM
|
Facility
|
OP
|
$3,570.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
76100398
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$847.88 |
| Max. Negotiated Rate |
$3,213.00 |
| Rate for Payer: Aetna Commercial |
$3,034.50
|
| Rate for Payer: Aetna Medicare |
$928.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,115.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,115.62
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$892.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,934.90
|
| Rate for Payer: BCN Commercial |
$2,775.68
|
| Rate for Payer: BCN Medicare Advantage |
$892.50
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cofinity Commercial |
$3,070.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$892.50
|
| Rate for Payer: Healthscope Commercial |
$3,213.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.50
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$937.12
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,026.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.50
|
| Rate for Payer: Nomi Health Commercial |
$2,927.40
|
| Rate for Payer: PACE Senior Care Partners |
$847.88
|
| Rate for Payer: PACE SWMI |
$892.50
|
| Rate for Payer: PHP Commercial |
$3,034.50
|
| Rate for Payer: PHP Medicare Advantage |
$892.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.50
|
| Rate for Payer: Priority Health HMO/PPO |
$3,105.90
|
| Rate for Payer: Priority Health Medicare |
$901.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,391.90
|
| Rate for Payer: Railroad Medicare Medicare |
$892.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,141.60
|
| Rate for Payer: UHC Core |
$2,980.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$892.50
|
| Rate for Payer: UHC Exchange |
$892.50
|
| Rate for Payer: UHC Medicare Advantage |
$892.50
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$892.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.50
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <5CM
|
Facility
|
IP
|
$3,570.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
76100398
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,320.50 |
| Max. Negotiated Rate |
$3,213.00 |
| Rate for Payer: Aetna Commercial |
$3,034.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,914.19
|
| Rate for Payer: BCN Commercial |
$2,758.90
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cofinity Commercial |
$3,070.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.00
|
| Rate for Payer: Healthscope Commercial |
$3,213.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.50
|
| Rate for Payer: Nomi Health Commercial |
$2,927.40
|
| Rate for Payer: PHP Commercial |
$3,034.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.50
|
| Rate for Payer: Priority Health HMO/PPO |
$3,105.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,391.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,141.60
|
| Rate for Payer: UHC Core |
$2,980.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.50
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SQ < 3CM
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 21930
|
| Hospital Charge Code |
76100227
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$508.74 |
| Max. Negotiated Rate |
$1,927.87 |
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna Medicare |
$556.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$669.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$669.40
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$535.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,761.00
|
| Rate for Payer: BCN Commercial |
$1,665.47
|
| Rate for Payer: BCN Medicare Advantage |
$535.52
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$535.52
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.56
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$562.30
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$615.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: PACE Senior Care Partners |
$508.74
|
| Rate for Payer: PACE SWMI |
$535.52
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: PHP Medicare Advantage |
$535.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,863.61
|
| Rate for Payer: Priority Health Medicare |
$540.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,435.19
|
| Rate for Payer: Railroad Medicare Medicare |
$535.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,885.03
|
| Rate for Payer: UHC Core |
$1,788.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$535.52
|
| Rate for Payer: UHC Exchange |
$535.52
|
| Rate for Payer: UHC Medicare Advantage |
$535.52
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$535.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.56
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SQ < 3CM
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 21930
|
| Hospital Charge Code |
76100227
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,392.35 |
| Max. Negotiated Rate |
$1,927.87 |
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,748.58
|
| Rate for Payer: BCN Commercial |
$1,655.40
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,863.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,435.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,885.03
|
| Rate for Payer: UHC Core |
$1,788.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.56
|
|
|
HC EXC TUMOR SOFT TISSUE, BACK/FLANK, SUBFASCIAL <5CM
|
Facility
|
OP
|
$3,618.87
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
76100268
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$859.48 |
| Max. Negotiated Rate |
$3,256.98 |
| Rate for Payer: Aetna Commercial |
$3,076.04
|
| Rate for Payer: Aetna Medicare |
$940.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,130.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,130.90
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$904.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,975.07
|
| Rate for Payer: BCN Commercial |
$2,813.67
|
| Rate for Payer: BCN Medicare Advantage |
$904.72
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cofinity Commercial |
$3,112.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,895.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$904.72
|
| Rate for Payer: Healthscope Commercial |
$3,256.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,714.15
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$949.95
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,040.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,076.04
|
| Rate for Payer: Nomi Health Commercial |
$2,967.47
|
| Rate for Payer: PACE Senior Care Partners |
$859.48
|
| Rate for Payer: PACE SWMI |
$904.72
|
| Rate for Payer: PHP Commercial |
$3,076.04
|
| Rate for Payer: PHP Medicare Advantage |
$904.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.27
|
| Rate for Payer: Priority Health HMO/PPO |
$3,148.42
|
| Rate for Payer: Priority Health Medicare |
$913.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,424.64
|
| Rate for Payer: Railroad Medicare Medicare |
$904.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,184.61
|
| Rate for Payer: UHC Core |
$3,021.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$904.72
|
| Rate for Payer: UHC Exchange |
$904.72
|
| Rate for Payer: UHC Medicare Advantage |
$904.72
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$904.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,714.15
|
|
|
HC EXC TUMOR SOFT TISSUE, BACK/FLANK, SUBFASCIAL <5CM
|
Facility
|
IP
|
$3,618.87
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
76100268
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,352.27 |
| Max. Negotiated Rate |
$3,256.98 |
| Rate for Payer: Aetna Commercial |
$3,076.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,954.08
|
| Rate for Payer: BCN Commercial |
$2,796.66
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cofinity Commercial |
$3,112.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,895.10
|
| Rate for Payer: Healthscope Commercial |
$3,256.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,714.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,076.04
|
| Rate for Payer: Nomi Health Commercial |
$2,967.47
|
| Rate for Payer: PHP Commercial |
$3,076.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.27
|
| Rate for Payer: Priority Health HMO/PPO |
$3,148.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,424.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,184.61
|
| Rate for Payer: UHC Core |
$3,021.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,714.15
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SUBQ >3CM
|
Facility
|
OP
|
$2,427.69
|
|
|
Service Code
|
CPT 21931
|
| Hospital Charge Code |
76100244
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$576.58 |
| Max. Negotiated Rate |
$2,184.92 |
| Rate for Payer: Aetna Commercial |
$2,063.54
|
| Rate for Payer: Aetna Medicare |
$631.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$758.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$758.65
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$606.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,995.80
|
| Rate for Payer: BCN Commercial |
$1,887.53
|
| Rate for Payer: BCN Medicare Advantage |
$606.92
|
| Rate for Payer: Cash Price |
$1,942.15
|
| Rate for Payer: Cash Price |
$1,942.15
|
| Rate for Payer: Cofinity Commercial |
$2,087.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,942.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.92
|
| Rate for Payer: Healthscope Commercial |
$2,184.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,820.77
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.27
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$697.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,063.54
|
| Rate for Payer: Nomi Health Commercial |
$1,990.71
|
| Rate for Payer: PACE Senior Care Partners |
$576.58
|
| Rate for Payer: PACE SWMI |
$606.92
|
| Rate for Payer: PHP Commercial |
$2,063.54
|
| Rate for Payer: PHP Medicare Advantage |
$606.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.00
|
| Rate for Payer: Priority Health HMO/PPO |
$2,112.09
|
| Rate for Payer: Priority Health Medicare |
$612.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,626.55
|
| Rate for Payer: Railroad Medicare Medicare |
$606.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,136.37
|
| Rate for Payer: UHC Core |
$2,027.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.92
|
| Rate for Payer: UHC Exchange |
$606.92
|
| Rate for Payer: UHC Medicare Advantage |
$606.92
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$606.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,820.77
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SUBQ >3CM
|
Facility
|
IP
|
$2,427.69
|
|
|
Service Code
|
CPT 21931
|
| Hospital Charge Code |
76100244
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,578.00 |
| Max. Negotiated Rate |
$2,184.92 |
| Rate for Payer: Aetna Commercial |
$2,063.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,981.72
|
| Rate for Payer: BCN Commercial |
$1,876.12
|
| Rate for Payer: Cash Price |
$1,942.15
|
| Rate for Payer: Cofinity Commercial |
$2,087.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,942.15
|
| Rate for Payer: Healthscope Commercial |
$2,184.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,820.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,063.54
|
| Rate for Payer: Nomi Health Commercial |
$1,990.71
|
| Rate for Payer: PHP Commercial |
$2,063.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.00
|
| Rate for Payer: Priority Health HMO/PPO |
$2,112.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,626.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,136.37
|
| Rate for Payer: UHC Core |
$2,027.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,820.77
|
|
|
HC EXC TUMOR SOFT TISSUE FACE SCALP SUBQ <2CM
|
Facility
|
OP
|
$4,438.35
|
|
|
Service Code
|
CPT 21011
|
| Hospital Charge Code |
76100323
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,054.11 |
| Max. Negotiated Rate |
$3,994.51 |
| Rate for Payer: Aetna Commercial |
$3,772.60
|
| Rate for Payer: Aetna Medicare |
$1,153.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,386.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,386.98
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$1,109.59
|
| Rate for Payer: BCBS Trust/PPO |
$3,648.77
|
| Rate for Payer: BCN Commercial |
$3,450.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,109.59
|
| Rate for Payer: Cash Price |
$3,550.68
|
| Rate for Payer: Cash Price |
$3,550.68
|
| Rate for Payer: Cofinity Commercial |
$3,816.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,550.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,109.59
|
| Rate for Payer: Healthscope Commercial |
$3,994.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,328.76
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,165.07
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,276.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,772.60
|
| Rate for Payer: Nomi Health Commercial |
$3,639.45
|
| Rate for Payer: PACE Senior Care Partners |
$1,054.11
|
| Rate for Payer: PACE SWMI |
$1,109.59
|
| Rate for Payer: PHP Commercial |
$3,772.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,109.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,884.93
|
| Rate for Payer: Priority Health HMO/PPO |
$3,861.36
|
| Rate for Payer: Priority Health Medicare |
$1,120.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,973.69
|
| Rate for Payer: Railroad Medicare Medicare |
$1,109.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,905.75
|
| Rate for Payer: UHC Core |
$3,706.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,109.59
|
| Rate for Payer: UHC Exchange |
$1,109.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,109.59
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$1,109.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,328.76
|
|
|
HC EXC TUMOR SOFT TISSUE FACE SCALP SUBQ <2CM
|
Facility
|
IP
|
$4,438.35
|
|
|
Service Code
|
CPT 21011
|
| Hospital Charge Code |
76100323
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,884.93 |
| Max. Negotiated Rate |
$3,994.51 |
| Rate for Payer: Aetna Commercial |
$3,772.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,623.03
|
| Rate for Payer: BCN Commercial |
$3,429.96
|
| Rate for Payer: Cash Price |
$3,550.68
|
| Rate for Payer: Cofinity Commercial |
$3,816.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,550.68
|
| Rate for Payer: Healthscope Commercial |
$3,994.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,328.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,772.60
|
| Rate for Payer: Nomi Health Commercial |
$3,639.45
|
| Rate for Payer: PHP Commercial |
$3,772.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,884.93
|
| Rate for Payer: Priority Health HMO/PPO |
$3,861.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,973.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,905.75
|
| Rate for Payer: UHC Core |
$3,706.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,328.76
|
|
|
HC EXC TUMOR SOFT TISSUE FACE/SCALP, SUBQ 2CM OR >
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 21012
|
| Hospital Charge Code |
76100246
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,392.35 |
| Max. Negotiated Rate |
$1,927.87 |
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,748.58
|
| Rate for Payer: BCN Commercial |
$1,655.40
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,863.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,435.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,885.03
|
| Rate for Payer: UHC Core |
$1,788.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.56
|
|
