|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.6 CM TO 1.0 CM
|
Facility
|
IP
|
$276.07
|
|
|
Service Code
|
CPT 11311
|
| Hospital Charge Code |
76100088
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$168.38 |
| Max. Negotiated Rate |
$248.46 |
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: BCBS Trust/PPO |
$213.35
|
| Rate for Payer: BCN Commercial |
$213.35
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.94
|
| Rate for Payer: UHC Core |
$230.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.6 CM TO 1.0 CM
|
Facility
|
OP
|
$276.07
|
|
|
Service Code
|
CPT 11311
|
| Hospital Charge Code |
76100088
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.57 |
| Max. Negotiated Rate |
$248.46 |
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: Aetna Medicare |
$71.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.27
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$69.02
|
| Rate for Payer: BCBS Trust/PPO |
$214.64
|
| Rate for Payer: BCN Commercial |
$214.64
|
| Rate for Payer: BCN Medicare Advantage |
$69.02
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.02
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PACE Senior Care Partners |
$65.57
|
| Rate for Payer: PACE SWMI |
$69.02
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: PHP Medicare Advantage |
$69.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.18
|
| Rate for Payer: Priority Health Medicare |
$69.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.38
|
| Rate for Payer: Railroad Medicare Medicare |
$69.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.94
|
| Rate for Payer: UHC Core |
$230.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.02
|
| Rate for Payer: UHC Medicare Advantage |
$71.09
|
| Rate for Payer: VA VA |
$69.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
IP
|
$158.65
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
76100084
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.76 |
| Max. Negotiated Rate |
$142.78 |
| Rate for Payer: Aetna Commercial |
$134.85
|
| Rate for Payer: BCBS Trust/PPO |
$122.60
|
| Rate for Payer: BCN Commercial |
$122.60
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cofinity Commercial |
$136.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.92
|
| Rate for Payer: Healthscope Commercial |
$142.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.85
|
| Rate for Payer: PHP Commercial |
$134.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.61
|
| Rate for Payer: UHC Core |
$132.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.99
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
OP
|
$158.65
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
76100084
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$37.68 |
| Max. Negotiated Rate |
$142.78 |
| Rate for Payer: Aetna Commercial |
$134.85
|
| Rate for Payer: Aetna Medicare |
$41.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.58
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$39.66
|
| Rate for Payer: BCBS Trust/PPO |
$123.35
|
| Rate for Payer: BCN Commercial |
$123.35
|
| Rate for Payer: BCN Medicare Advantage |
$39.66
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cofinity Commercial |
$136.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.66
|
| Rate for Payer: Healthscope Commercial |
$142.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.99
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.85
|
| Rate for Payer: PACE Senior Care Partners |
$37.68
|
| Rate for Payer: PACE SWMI |
$39.66
|
| Rate for Payer: PHP Commercial |
$134.85
|
| Rate for Payer: PHP Medicare Advantage |
$39.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.03
|
| Rate for Payer: Priority Health Medicare |
$39.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.76
|
| Rate for Payer: Railroad Medicare Medicare |
$39.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.61
|
| Rate for Payer: UHC Core |
$132.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.66
|
| Rate for Payer: UHC Medicare Advantage |
$40.85
|
| Rate for Payer: VA VA |
$39.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.99
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
IP
|
$158.65
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
76100085
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.76 |
| Max. Negotiated Rate |
$142.78 |
| Rate for Payer: Aetna Commercial |
$134.85
|
| Rate for Payer: BCBS Trust/PPO |
$122.60
|
| Rate for Payer: BCN Commercial |
$122.60
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cofinity Commercial |
$136.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.92
|
| Rate for Payer: Healthscope Commercial |
$142.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.85
|
| Rate for Payer: PHP Commercial |
$134.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.61
|
| Rate for Payer: UHC Core |
$132.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.99
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
OP
|
$158.65
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
76100085
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$37.68 |
| Max. Negotiated Rate |
$142.78 |
| Rate for Payer: Aetna Commercial |
$134.85
|
| Rate for Payer: Aetna Medicare |
$41.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.58
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$39.66
|
| Rate for Payer: BCBS Trust/PPO |
$123.35
|
| Rate for Payer: BCN Commercial |
$123.35
|
| Rate for Payer: BCN Medicare Advantage |
$39.66
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cofinity Commercial |
$136.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.66
|
| Rate for Payer: Healthscope Commercial |
$142.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.99
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.85
|
| Rate for Payer: PACE Senior Care Partners |
$37.68
|
| Rate for Payer: PACE SWMI |
$39.66
|
| Rate for Payer: PHP Commercial |
$134.85
|
| Rate for Payer: PHP Medicare Advantage |
$39.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.03
|
| Rate for Payer: Priority Health Medicare |
$39.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.76
|
| Rate for Payer: Railroad Medicare Medicare |
$39.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.61
|
| Rate for Payer: UHC Core |
$132.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.66
|
| Rate for Payer: UHC Medicare Advantage |
$40.85
|
| Rate for Payer: VA VA |
$39.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.99
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
IP
|
$276.07
|
|
|
Service Code
|
CPT 11307
|
| Hospital Charge Code |
76100086
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$168.38 |
| Max. Negotiated Rate |
$248.46 |
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: BCBS Trust/PPO |
$213.35
|
| Rate for Payer: BCN Commercial |
$213.35
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.94
|
| Rate for Payer: UHC Core |
$230.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
OP
|
$276.07
|
|
|
Service Code
|
CPT 11307
|
| Hospital Charge Code |
76100086
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.57 |
| Max. Negotiated Rate |
$248.46 |
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: Aetna Medicare |
$71.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.27
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$69.02
|
| Rate for Payer: BCBS Trust/PPO |
$214.64
|
| Rate for Payer: BCN Commercial |
$214.64
|
| Rate for Payer: BCN Medicare Advantage |
$69.02
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.02
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PACE Senior Care Partners |
$65.57
|
| Rate for Payer: PACE SWMI |
$69.02
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: PHP Medicare Advantage |
$69.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.18
|
| Rate for Payer: Priority Health Medicare |
$69.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.38
|
| Rate for Payer: Railroad Medicare Medicare |
$69.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.94
|
| Rate for Payer: UHC Core |
$230.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.02
|
| Rate for Payer: UHC Medicare Advantage |
$71.09
|
| Rate for Payer: VA VA |
$69.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA >2CM
|
Facility
|
IP
|
$488.58
|
|
|
Service Code
|
CPT 11308
|
| Hospital Charge Code |
76100289
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$297.98 |
| Max. Negotiated Rate |
$439.72 |
| Rate for Payer: Aetna Commercial |
$415.29
|
| Rate for Payer: BCBS Trust/PPO |
$377.57
|
| Rate for Payer: BCN Commercial |
$377.57
|
| Rate for Payer: Cash Price |
$390.86
|
| Rate for Payer: Cofinity Commercial |
$420.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$390.86
|
| Rate for Payer: Healthscope Commercial |
$439.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$366.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$415.29
|
| Rate for Payer: PHP Commercial |
$415.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$297.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.95
|
| Rate for Payer: UHC Core |
$407.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$366.44
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA >2CM
|
Facility
|
OP
|
$488.58
|
|
|
Service Code
|
CPT 11308
|
| Hospital Charge Code |
76100289
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.04 |
| Max. Negotiated Rate |
$439.72 |
| Rate for Payer: Aetna Commercial |
$415.29
|
| Rate for Payer: Aetna Medicare |
$127.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.68
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$122.14
|
| Rate for Payer: BCBS Trust/PPO |
$379.87
|
| Rate for Payer: BCN Commercial |
$379.87
|
| Rate for Payer: BCN Medicare Advantage |
$122.14
|
| Rate for Payer: Cash Price |
$390.86
|
| Rate for Payer: Cash Price |
$390.86
|
| Rate for Payer: Cofinity Commercial |
$420.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$390.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.14
|
| Rate for Payer: Healthscope Commercial |
$439.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$366.44
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$128.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$415.29
|
| Rate for Payer: PACE Senior Care Partners |
$116.04
|
| Rate for Payer: PACE SWMI |
$122.14
|
| Rate for Payer: PHP Commercial |
$415.29
|
| Rate for Payer: PHP Medicare Advantage |
$122.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.06
|
| Rate for Payer: Priority Health Medicare |
$122.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$297.98
|
| Rate for Payer: Railroad Medicare Medicare |
$122.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.95
|
| Rate for Payer: UHC Core |
$407.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.14
|
| Rate for Payer: UHC Medicare Advantage |
$125.81
|
| Rate for Payer: VA VA |
$122.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$366.44
|
|
|
HC SHAVE LESION TRUCK, ARM, LEGS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$158.65
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
76100081
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$37.68 |
| Max. Negotiated Rate |
$142.78 |
| Rate for Payer: Aetna Commercial |
$134.85
|
| Rate for Payer: Aetna Medicare |
$41.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.58
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$39.66
|
| Rate for Payer: BCBS Trust/PPO |
$123.35
|
| Rate for Payer: BCN Commercial |
$123.35
|
| Rate for Payer: BCN Medicare Advantage |
$39.66
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cofinity Commercial |
$136.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.66
|
| Rate for Payer: Healthscope Commercial |
$142.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.99
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.85
|
| Rate for Payer: PACE Senior Care Partners |
$37.68
|
| Rate for Payer: PACE SWMI |
$39.66
|
| Rate for Payer: PHP Commercial |
$134.85
|
| Rate for Payer: PHP Medicare Advantage |
$39.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.03
|
| Rate for Payer: Priority Health Medicare |
$39.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.76
|
| Rate for Payer: Railroad Medicare Medicare |
$39.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.61
|
| Rate for Payer: UHC Core |
$132.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.66
|
| Rate for Payer: UHC Medicare Advantage |
$40.85
|
| Rate for Payer: VA VA |
$39.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.99
|
|
|
HC SHAVE LESION TRUCK, ARM, LEGS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$158.65
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
76100081
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.76 |
| Max. Negotiated Rate |
$142.78 |
| Rate for Payer: Aetna Commercial |
$134.85
|
| Rate for Payer: BCBS Trust/PPO |
$122.60
|
| Rate for Payer: BCN Commercial |
$122.60
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cofinity Commercial |
$136.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.92
|
| Rate for Payer: Healthscope Commercial |
$142.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.85
|
| Rate for Payer: PHP Commercial |
$134.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.61
|
| Rate for Payer: UHC Core |
$132.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.99
|
|
|
HC SHAVE LESION TRUNK, ARM, LEGS 0.5 CM OR LESS
|
Facility
|
OP
|
$158.65
|
|
|
Service Code
|
CPT 11300
|
| Hospital Charge Code |
76100080
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$37.68 |
| Max. Negotiated Rate |
$274.65 |
| Rate for Payer: Aetna Commercial |
$134.85
|
| Rate for Payer: Aetna Medicare |
$41.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.58
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$39.66
|
| Rate for Payer: BCBS Trust/PPO |
$123.35
|
| Rate for Payer: BCN Commercial |
$123.35
|
| Rate for Payer: BCN Medicare Advantage |
$39.66
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cofinity Commercial |
$136.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.66
|
| Rate for Payer: Healthscope Commercial |
$142.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.99
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.85
|
| Rate for Payer: PACE Senior Care Partners |
$37.68
|
| Rate for Payer: PACE SWMI |
$39.66
|
| Rate for Payer: PHP Commercial |
$134.85
|
| Rate for Payer: PHP Medicare Advantage |
$39.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.03
|
| Rate for Payer: Priority Health Medicare |
$39.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.76
|
| Rate for Payer: Railroad Medicare Medicare |
$39.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.61
|
| Rate for Payer: UHC Core |
$132.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.66
|
| Rate for Payer: UHC Medicare Advantage |
$40.85
|
| Rate for Payer: VA VA |
$39.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.99
|
|
|
HC SHAVE LESION TRUNK, ARM, LEGS 0.5 CM OR LESS
|
Facility
|
IP
|
$158.65
|
|
|
Service Code
|
CPT 11300
|
| Hospital Charge Code |
76100080
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.76 |
| Max. Negotiated Rate |
$142.78 |
| Rate for Payer: Aetna Commercial |
$134.85
|
| Rate for Payer: BCBS Trust/PPO |
$122.60
|
| Rate for Payer: BCN Commercial |
$122.60
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cofinity Commercial |
$136.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.92
|
| Rate for Payer: Healthscope Commercial |
$142.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.85
|
| Rate for Payer: PHP Commercial |
$134.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.61
|
| Rate for Payer: UHC Core |
$132.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.99
|
|
|
HC SHAVE LESION TRUNK, ARM, LEGS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$158.65
|
|
|
Service Code
|
CPT 11302
|
| Hospital Charge Code |
76100082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.76 |
| Max. Negotiated Rate |
$142.78 |
| Rate for Payer: Aetna Commercial |
$134.85
|
| Rate for Payer: BCBS Trust/PPO |
$122.60
|
| Rate for Payer: BCN Commercial |
$122.60
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cofinity Commercial |
$136.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.92
|
| Rate for Payer: Healthscope Commercial |
$142.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.85
|
| Rate for Payer: PHP Commercial |
$134.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.61
|
| Rate for Payer: UHC Core |
$132.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.99
|
|
|
HC SHAVE LESION TRUNK, ARM, LEGS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$158.65
|
|
|
Service Code
|
CPT 11302
|
| Hospital Charge Code |
76100082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$37.68 |
| Max. Negotiated Rate |
$142.78 |
| Rate for Payer: Aetna Commercial |
$134.85
|
| Rate for Payer: Aetna Medicare |
$41.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.58
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$39.66
|
| Rate for Payer: BCBS Trust/PPO |
$123.35
|
| Rate for Payer: BCN Commercial |
$123.35
|
| Rate for Payer: BCN Medicare Advantage |
$39.66
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cofinity Commercial |
$136.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.66
|
| Rate for Payer: Healthscope Commercial |
$142.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.99
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.85
|
| Rate for Payer: PACE Senior Care Partners |
$37.68
|
| Rate for Payer: PACE SWMI |
$39.66
|
| Rate for Payer: PHP Commercial |
$134.85
|
| Rate for Payer: PHP Medicare Advantage |
$39.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.03
|
| Rate for Payer: Priority Health Medicare |
$39.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.76
|
| Rate for Payer: Railroad Medicare Medicare |
$39.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.61
|
| Rate for Payer: UHC Core |
$132.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.66
|
| Rate for Payer: UHC Medicare Advantage |
$40.85
|
| Rate for Payer: VA VA |
$39.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.99
|
|
|
HC SHAVE LESION TRUNK, ARM, LEGS OVER 2.0 CM
|
Facility
|
IP
|
$144.23
|
|
|
Service Code
|
CPT 11303
|
| Hospital Charge Code |
76100083
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$87.97 |
| Max. Negotiated Rate |
$129.81 |
| Rate for Payer: Aetna Commercial |
$122.60
|
| Rate for Payer: BCBS Trust/PPO |
$111.46
|
| Rate for Payer: BCN Commercial |
$111.46
|
| Rate for Payer: Cash Price |
$115.38
|
| Rate for Payer: Cofinity Commercial |
$124.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$115.38
|
| Rate for Payer: Healthscope Commercial |
$129.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$122.60
|
| Rate for Payer: PHP Commercial |
$122.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.92
|
| Rate for Payer: UHC Core |
$120.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.17
|
|
|
HC SHAVE LESION TRUNK, ARM, LEGS OVER 2.0 CM
|
Facility
|
OP
|
$144.23
|
|
|
Service Code
|
CPT 11303
|
| Hospital Charge Code |
76100083
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$34.25 |
| Max. Negotiated Rate |
$274.65 |
| Rate for Payer: Aetna Commercial |
$122.60
|
| Rate for Payer: Aetna Medicare |
$37.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.07
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$36.06
|
| Rate for Payer: BCBS Trust/PPO |
$112.14
|
| Rate for Payer: BCN Commercial |
$112.14
|
| Rate for Payer: BCN Medicare Advantage |
$36.06
|
| Rate for Payer: Cash Price |
$115.38
|
| Rate for Payer: Cash Price |
$115.38
|
| Rate for Payer: Cofinity Commercial |
$124.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$115.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.06
|
| Rate for Payer: Healthscope Commercial |
$129.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.17
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$122.60
|
| Rate for Payer: PACE Senior Care Partners |
$34.25
|
| Rate for Payer: PACE SWMI |
$36.06
|
| Rate for Payer: PHP Commercial |
$122.60
|
| Rate for Payer: PHP Medicare Advantage |
$36.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.48
|
| Rate for Payer: Priority Health Medicare |
$36.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.97
|
| Rate for Payer: Railroad Medicare Medicare |
$36.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.92
|
| Rate for Payer: UHC Core |
$120.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.06
|
| Rate for Payer: UHC Medicare Advantage |
$37.14
|
| Rate for Payer: VA VA |
$36.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.17
|
|
|
HC SHEEP SORREL IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC SHEEP SORREL IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC SHINGLES VACCINE
|
Facility
|
OP
|
$271.52
|
|
|
Service Code
|
CPT 90736
|
| Hospital Charge Code |
63600063
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$64.49 |
| Max. Negotiated Rate |
$244.37 |
| Rate for Payer: Aetna Commercial |
$230.79
|
| Rate for Payer: Aetna Medicare |
$70.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.85
|
| Rate for Payer: BCBS Complete |
$108.61
|
| Rate for Payer: BCBS MAPPO |
$67.88
|
| Rate for Payer: BCBS Trust/PPO |
$211.11
|
| Rate for Payer: BCN Commercial |
$211.11
|
| Rate for Payer: BCN Medicare Advantage |
$67.88
|
| Rate for Payer: Cash Price |
$217.22
|
| Rate for Payer: Cofinity Commercial |
$233.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.88
|
| Rate for Payer: Healthscope Commercial |
$244.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$71.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$230.79
|
| Rate for Payer: PACE Senior Care Partners |
$64.49
|
| Rate for Payer: PACE SWMI |
$67.88
|
| Rate for Payer: PHP Commercial |
$230.79
|
| Rate for Payer: PHP Medicare Advantage |
$67.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.22
|
| Rate for Payer: Priority Health Medicare |
$67.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.60
|
| Rate for Payer: Railroad Medicare Medicare |
$67.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.94
|
| Rate for Payer: UHC Core |
$226.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.88
|
| Rate for Payer: UHC Medicare Advantage |
$69.92
|
| Rate for Payer: VA VA |
$67.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.64
|
|
|
HC SHINGLES VACCINE
|
Facility
|
IP
|
$271.52
|
|
|
Service Code
|
CPT 90736
|
| Hospital Charge Code |
63600063
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$165.60 |
| Max. Negotiated Rate |
$244.37 |
| Rate for Payer: Aetna Commercial |
$230.79
|
| Rate for Payer: BCBS Trust/PPO |
$209.83
|
| Rate for Payer: BCN Commercial |
$209.83
|
| Rate for Payer: Cash Price |
$217.22
|
| Rate for Payer: Cofinity Commercial |
$233.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.22
|
| Rate for Payer: Healthscope Commercial |
$244.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$230.79
|
| Rate for Payer: PHP Commercial |
$230.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.94
|
| Rate for Payer: UHC Core |
$226.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.64
|
|
|
HC SHRIMP IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200061
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC SHRIMP IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200061
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC SICKLE CELL CMS F/U
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51500011
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$76.24 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$106.25
|
| Rate for Payer: BCBS Trust/PPO |
$96.60
|
| Rate for Payer: BCN Commercial |
$96.60
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$107.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Healthscope Commercial |
$112.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.25
|
| Rate for Payer: PHP Commercial |
$106.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.00
|
| Rate for Payer: UHC Core |
$104.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.75
|
|
