|
HC SESAME SEED IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200101
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC SESAME SEED IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200101
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC SETUP 1
|
Facility
|
OP
|
$34.21
|
|
| Hospital Charge Code |
27000145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$30.79 |
| Rate for Payer: Aetna Commercial |
$29.08
|
| Rate for Payer: Aetna Medicare |
$8.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.69
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$8.55
|
| Rate for Payer: BCBS Trust/PPO |
$28.12
|
| Rate for Payer: BCN Commercial |
$28.12
|
| Rate for Payer: BCN Medicare Advantage |
$8.55
|
| Rate for Payer: Cash Price |
$27.37
|
| Rate for Payer: Cofinity Commercial |
$29.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.55
|
| Rate for Payer: Healthscope Commercial |
$30.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.66
|
| Rate for Payer: Mclaren Medicaid |
$6.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.98
|
| Rate for Payer: Meridian Medicaid |
$6.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.08
|
| Rate for Payer: Nomi Health Commercial |
$28.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.66
|
| Rate for Payer: PACE Senior Care Partners |
$8.12
|
| Rate for Payer: PACE SWMI |
$8.55
|
| Rate for Payer: PHP Commercial |
$29.08
|
| Rate for Payer: PHP Medicare Advantage |
$8.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.76
|
| Rate for Payer: Priority Health Medicare |
$8.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.81
|
| Rate for Payer: Railroad Medicare Medicare |
$8.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.10
|
| Rate for Payer: UHC Core |
$28.57
|
| Rate for Payer: UHC Exchange |
$8.55
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHC Medicare Advantage |
$8.55
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: VA VA |
$8.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.66
|
|
|
HC SETUP 1
|
Facility
|
IP
|
$34.21
|
|
| Hospital Charge Code |
27000145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.81 |
| Max. Negotiated Rate |
$30.79 |
| Rate for Payer: Aetna Commercial |
$29.08
|
| Rate for Payer: BCBS Trust/PPO |
$28.25
|
| Rate for Payer: BCN Commercial |
$28.25
|
| Rate for Payer: Cash Price |
$27.37
|
| Rate for Payer: Cofinity Commercial |
$29.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.37
|
| Rate for Payer: Healthscope Commercial |
$30.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.08
|
| Rate for Payer: Nomi Health Commercial |
$28.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.66
|
| Rate for Payer: PHP Commercial |
$29.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.10
|
| Rate for Payer: UHC Core |
$28.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.66
|
|
|
HC SEX HORMONE BINDING GLOBULIN
|
Facility
|
OP
|
$61.55
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100422
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.85 |
| Max. Negotiated Rate |
$55.40 |
| Rate for Payer: Aetna Commercial |
$52.32
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.23
|
| Rate for Payer: BCBS Complete |
$11.39
|
| Rate for Payer: BCBS MAPPO |
$15.39
|
| Rate for Payer: BCBS Trust/PPO |
$50.60
|
| Rate for Payer: BCN Commercial |
$50.60
|
| Rate for Payer: BCN Medicare Advantage |
$15.39
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cofinity Commercial |
$52.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.39
|
| Rate for Payer: Healthscope Commercial |
$55.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.16
|
| Rate for Payer: Mclaren Medicaid |
$10.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.16
|
| Rate for Payer: Meridian Medicaid |
$11.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.32
|
| Rate for Payer: Nomi Health Commercial |
$50.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.16
|
| Rate for Payer: PACE Senior Care Partners |
$14.62
|
| Rate for Payer: PACE SWMI |
$15.39
|
| Rate for Payer: PHP Commercial |
$52.32
|
| Rate for Payer: PHP Medicare Advantage |
$15.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.55
|
| Rate for Payer: Priority Health Medicare |
$15.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.84
|
| Rate for Payer: Railroad Medicare Medicare |
$15.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.16
|
| Rate for Payer: UHC Core |
$51.39
|
| Rate for Payer: UHC Exchange |
$15.39
|
| Rate for Payer: UHC Medicaid |
$10.85
|
| Rate for Payer: UHC Medicare Advantage |
$15.39
|
| Rate for Payer: UHCCP Medicaid |
$10.85
|
| Rate for Payer: VA VA |
$15.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.16
|
|
|
HC SEX HORMONE BINDING GLOBULIN
|
Facility
|
IP
|
$61.55
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100422
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.84 |
| Max. Negotiated Rate |
$55.40 |
| Rate for Payer: Aetna Commercial |
$52.32
|
| Rate for Payer: BCBS Trust/PPO |
$50.83
|
| Rate for Payer: BCN Commercial |
$50.83
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cofinity Commercial |
$52.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.24
|
| Rate for Payer: Healthscope Commercial |
$55.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.32
|
| Rate for Payer: Nomi Health Commercial |
$50.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.16
|
| Rate for Payer: PHP Commercial |
$52.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.16
|
| Rate for Payer: UHC Core |
$51.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.16
|
|
|
HC SEX HORMONE GLOBULIN BMH
|
Facility
|
OP
|
$86.83
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100718
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.31 |
| Max. Negotiated Rate |
$78.15 |
| Rate for Payer: Aetna Commercial |
$73.81
|
| Rate for Payer: Aetna Medicare |
$22.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.13
|
| Rate for Payer: BCBS Complete |
$16.07
|
| Rate for Payer: BCBS MAPPO |
$21.71
|
| Rate for Payer: BCBS Trust/PPO |
$71.38
|
| Rate for Payer: BCN Commercial |
$71.38
|
| Rate for Payer: BCN Medicare Advantage |
$21.71
|
| Rate for Payer: Cash Price |
$69.46
|
| Rate for Payer: Cofinity Commercial |
$74.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.71
|
| Rate for Payer: Healthscope Commercial |
$78.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.12
|
| Rate for Payer: Mclaren Medicaid |
$15.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.79
|
| Rate for Payer: Meridian Medicaid |
$16.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.81
|
| Rate for Payer: Nomi Health Commercial |
$71.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.12
|
| Rate for Payer: PACE Senior Care Partners |
$20.62
|
| Rate for Payer: PACE SWMI |
$21.71
|
| Rate for Payer: PHP Commercial |
$73.81
|
| Rate for Payer: PHP Medicare Advantage |
$21.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75.54
|
| Rate for Payer: Priority Health Medicare |
$21.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.43
|
| Rate for Payer: Railroad Medicare Medicare |
$21.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.41
|
| Rate for Payer: UHC Core |
$72.50
|
| Rate for Payer: UHC Exchange |
$21.71
|
| Rate for Payer: UHC Medicaid |
$15.31
|
| Rate for Payer: UHC Medicare Advantage |
$21.71
|
| Rate for Payer: UHCCP Medicaid |
$15.31
|
| Rate for Payer: VA VA |
$21.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.12
|
|
|
HC SEX HORMONE GLOBULIN BMH
|
Facility
|
IP
|
$86.83
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100718
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$60.43 |
| Max. Negotiated Rate |
$78.15 |
| Rate for Payer: Aetna Commercial |
$73.81
|
| Rate for Payer: BCBS Trust/PPO |
$71.71
|
| Rate for Payer: BCN Commercial |
$71.71
|
| Rate for Payer: Cash Price |
$69.46
|
| Rate for Payer: Cofinity Commercial |
$74.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.46
|
| Rate for Payer: Healthscope Commercial |
$78.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.81
|
| Rate for Payer: Nomi Health Commercial |
$71.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.12
|
| Rate for Payer: PHP Commercial |
$73.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.41
|
| Rate for Payer: UHC Core |
$72.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.12
|
|
|
HC SGOT AST
|
Facility
|
IP
|
$19.85
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
30100441
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.82 |
| Max. Negotiated Rate |
$17.86 |
| Rate for Payer: Aetna Commercial |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$16.39
|
| Rate for Payer: BCN Commercial |
$16.39
|
| Rate for Payer: Cash Price |
$15.88
|
| Rate for Payer: Cofinity Commercial |
$17.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.88
|
| Rate for Payer: Healthscope Commercial |
$17.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.87
|
| Rate for Payer: Nomi Health Commercial |
$16.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.89
|
| Rate for Payer: PHP Commercial |
$16.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.47
|
| Rate for Payer: UHC Core |
$16.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.89
|
|
|
HC SGOT AST
|
Facility
|
OP
|
$19.85
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
30100441
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$17.86 |
| Rate for Payer: Aetna Commercial |
$16.87
|
| Rate for Payer: Aetna Medicare |
$5.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.20
|
| Rate for Payer: BCBS Complete |
$3.67
|
| Rate for Payer: BCBS MAPPO |
$4.96
|
| Rate for Payer: BCBS Trust/PPO |
$16.32
|
| Rate for Payer: BCN Commercial |
$16.32
|
| Rate for Payer: BCN Medicare Advantage |
$4.96
|
| Rate for Payer: Cash Price |
$15.88
|
| Rate for Payer: Cofinity Commercial |
$17.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.96
|
| Rate for Payer: Healthscope Commercial |
$17.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.89
|
| Rate for Payer: Mclaren Medicaid |
$3.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.21
|
| Rate for Payer: Meridian Medicaid |
$3.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.87
|
| Rate for Payer: Nomi Health Commercial |
$16.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.89
|
| Rate for Payer: PACE Senior Care Partners |
$4.71
|
| Rate for Payer: PACE SWMI |
$4.96
|
| Rate for Payer: PHP Commercial |
$16.87
|
| Rate for Payer: PHP Medicare Advantage |
$4.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$5.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.82
|
| Rate for Payer: Railroad Medicare Medicare |
$4.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.47
|
| Rate for Payer: UHC Core |
$16.57
|
| Rate for Payer: UHC Exchange |
$4.96
|
| Rate for Payer: UHC Medicaid |
$3.50
|
| Rate for Payer: UHC Medicare Advantage |
$4.96
|
| Rate for Payer: UHCCP Medicaid |
$3.50
|
| Rate for Payer: VA VA |
$4.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.89
|
|
|
HC SGPT ALT
|
Facility
|
OP
|
$20.01
|
|
|
Service Code
|
CPT 84460
|
| Hospital Charge Code |
30100442
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.53 |
| Max. Negotiated Rate |
$18.01 |
| Rate for Payer: Aetna Commercial |
$17.01
|
| Rate for Payer: Aetna Medicare |
$5.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.25
|
| Rate for Payer: BCBS Complete |
$3.70
|
| Rate for Payer: BCBS MAPPO |
$5.00
|
| Rate for Payer: BCBS Trust/PPO |
$16.45
|
| Rate for Payer: BCN Commercial |
$16.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.00
|
| Rate for Payer: Cash Price |
$16.01
|
| Rate for Payer: Cofinity Commercial |
$17.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.00
|
| Rate for Payer: Healthscope Commercial |
$18.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.01
|
| Rate for Payer: Mclaren Medicaid |
$3.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.25
|
| Rate for Payer: Meridian Medicaid |
$3.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.01
|
| Rate for Payer: Nomi Health Commercial |
$16.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.01
|
| Rate for Payer: PACE Senior Care Partners |
$4.75
|
| Rate for Payer: PACE SWMI |
$5.00
|
| Rate for Payer: PHP Commercial |
$17.01
|
| Rate for Payer: PHP Medicare Advantage |
$5.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.41
|
| Rate for Payer: Priority Health Medicare |
$5.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.93
|
| Rate for Payer: Railroad Medicare Medicare |
$5.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.61
|
| Rate for Payer: UHC Core |
$16.71
|
| Rate for Payer: UHC Exchange |
$5.00
|
| Rate for Payer: UHC Medicaid |
$3.53
|
| Rate for Payer: UHC Medicare Advantage |
$5.00
|
| Rate for Payer: UHCCP Medicaid |
$3.53
|
| Rate for Payer: VA VA |
$5.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.01
|
|
|
HC SGPT ALT
|
Facility
|
IP
|
$20.01
|
|
|
Service Code
|
CPT 84460
|
| Hospital Charge Code |
30100442
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.93 |
| Max. Negotiated Rate |
$18.01 |
| Rate for Payer: Aetna Commercial |
$17.01
|
| Rate for Payer: BCBS Trust/PPO |
$16.53
|
| Rate for Payer: BCN Commercial |
$16.53
|
| Rate for Payer: Cash Price |
$16.01
|
| Rate for Payer: Cofinity Commercial |
$17.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.01
|
| Rate for Payer: Healthscope Commercial |
$18.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.01
|
| Rate for Payer: Nomi Health Commercial |
$16.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.01
|
| Rate for Payer: PHP Commercial |
$17.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.61
|
| Rate for Payer: UHC Core |
$16.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.01
|
|
|
HC SHAVE EPIDURAL SKIN LESION 1.1-2.0 CM
|
Facility
|
IP
|
$310.94
|
|
|
Service Code
|
CPT 11312
|
| Hospital Charge Code |
76100073
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$216.41 |
| Max. Negotiated Rate |
$279.85 |
| Rate for Payer: Aetna Commercial |
$264.30
|
| Rate for Payer: BCBS Trust/PPO |
$256.81
|
| Rate for Payer: BCN Commercial |
$256.81
|
| Rate for Payer: Cash Price |
$248.75
|
| Rate for Payer: Cofinity Commercial |
$267.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.75
|
| Rate for Payer: Healthscope Commercial |
$279.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$264.30
|
| Rate for Payer: Nomi Health Commercial |
$254.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.21
|
| Rate for Payer: PHP Commercial |
$264.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$270.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$216.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.63
|
| Rate for Payer: UHC Core |
$259.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.21
|
|
|
HC SHAVE EPIDURAL SKIN LESION 1.1-2.0 CM
|
Facility
|
OP
|
$310.94
|
|
|
Service Code
|
CPT 11312
|
| Hospital Charge Code |
76100073
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$54.82 |
| Max. Negotiated Rate |
$279.85 |
| Rate for Payer: Aetna Commercial |
$264.30
|
| Rate for Payer: Aetna Medicare |
$80.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$97.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$97.17
|
| Rate for Payer: BCBS Complete |
$57.55
|
| Rate for Payer: BCBS MAPPO |
$77.73
|
| Rate for Payer: BCBS Trust/PPO |
$255.62
|
| Rate for Payer: BCN Commercial |
$255.62
|
| Rate for Payer: BCN Medicare Advantage |
$77.73
|
| Rate for Payer: Cash Price |
$248.75
|
| Rate for Payer: Cofinity Commercial |
$267.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.73
|
| Rate for Payer: Healthscope Commercial |
$279.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.21
|
| Rate for Payer: Mclaren Medicaid |
$54.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.62
|
| Rate for Payer: Meridian Medicaid |
$57.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$264.30
|
| Rate for Payer: Nomi Health Commercial |
$254.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.21
|
| Rate for Payer: PACE Senior Care Partners |
$73.85
|
| Rate for Payer: PACE SWMI |
$77.73
|
| Rate for Payer: PHP Commercial |
$264.30
|
| Rate for Payer: PHP Medicare Advantage |
$77.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$270.52
|
| Rate for Payer: Priority Health Medicare |
$78.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$216.41
|
| Rate for Payer: Railroad Medicare Medicare |
$77.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.63
|
| Rate for Payer: UHC Core |
$259.63
|
| Rate for Payer: UHC Exchange |
$77.73
|
| Rate for Payer: UHC Medicaid |
$54.82
|
| Rate for Payer: UHC Medicare Advantage |
$77.73
|
| Rate for Payer: UHCCP Medicaid |
$54.82
|
| Rate for Payer: VA VA |
$77.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.21
|
|
|
HC SHAVE EPIDURAL SKIN LESION > 2.0 CM
|
Facility
|
OP
|
$310.94
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
76100074
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$54.82 |
| Max. Negotiated Rate |
$279.85 |
| Rate for Payer: Aetna Commercial |
$264.30
|
| Rate for Payer: Aetna Medicare |
$80.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$97.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$97.17
|
| Rate for Payer: BCBS Complete |
$57.55
|
| Rate for Payer: BCBS MAPPO |
$77.73
|
| Rate for Payer: BCBS Trust/PPO |
$255.62
|
| Rate for Payer: BCN Commercial |
$255.62
|
| Rate for Payer: BCN Medicare Advantage |
$77.73
|
| Rate for Payer: Cash Price |
$248.75
|
| Rate for Payer: Cofinity Commercial |
$267.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.73
|
| Rate for Payer: Healthscope Commercial |
$279.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.21
|
| Rate for Payer: Mclaren Medicaid |
$54.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.62
|
| Rate for Payer: Meridian Medicaid |
$57.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$264.30
|
| Rate for Payer: Nomi Health Commercial |
$254.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.21
|
| Rate for Payer: PACE Senior Care Partners |
$73.85
|
| Rate for Payer: PACE SWMI |
$77.73
|
| Rate for Payer: PHP Commercial |
$264.30
|
| Rate for Payer: PHP Medicare Advantage |
$77.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$270.52
|
| Rate for Payer: Priority Health Medicare |
$78.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$216.41
|
| Rate for Payer: Railroad Medicare Medicare |
$77.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.63
|
| Rate for Payer: UHC Core |
$259.63
|
| Rate for Payer: UHC Exchange |
$77.73
|
| Rate for Payer: UHC Medicaid |
$54.82
|
| Rate for Payer: UHC Medicare Advantage |
$77.73
|
| Rate for Payer: UHCCP Medicaid |
$54.82
|
| Rate for Payer: VA VA |
$77.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.21
|
|
|
HC SHAVE EPIDURAL SKIN LESION > 2.0 CM
|
Facility
|
IP
|
$310.94
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
76100074
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$216.41 |
| Max. Negotiated Rate |
$279.85 |
| Rate for Payer: Aetna Commercial |
$264.30
|
| Rate for Payer: BCBS Trust/PPO |
$256.81
|
| Rate for Payer: BCN Commercial |
$256.81
|
| Rate for Payer: Cash Price |
$248.75
|
| Rate for Payer: Cofinity Commercial |
$267.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.75
|
| Rate for Payer: Healthscope Commercial |
$279.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$264.30
|
| Rate for Payer: Nomi Health Commercial |
$254.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.21
|
| Rate for Payer: PHP Commercial |
$264.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$270.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$216.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.63
|
| Rate for Payer: UHC Core |
$259.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.21
|
|
|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.5 CM OR LESS
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
76100087
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$50.64 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna Medicare |
$74.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.76
|
| Rate for Payer: BCBS Complete |
$53.16
|
| Rate for Payer: BCBS MAPPO |
$71.81
|
| Rate for Payer: BCBS Trust/PPO |
$236.12
|
| Rate for Payer: BCN Commercial |
$236.12
|
| Rate for Payer: BCN Medicare Advantage |
$71.81
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.81
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Mclaren Medicaid |
$50.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.40
|
| Rate for Payer: Meridian Medicaid |
$53.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PACE Senior Care Partners |
$68.21
|
| Rate for Payer: PACE SWMI |
$71.81
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: PHP Medicare Advantage |
$71.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.88
|
| Rate for Payer: Priority Health Medicare |
$72.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.91
|
| Rate for Payer: Railroad Medicare Medicare |
$71.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.75
|
| Rate for Payer: UHC Core |
$239.83
|
| Rate for Payer: UHC Exchange |
$71.81
|
| Rate for Payer: UHC Medicaid |
$50.64
|
| Rate for Payer: UHC Medicare Advantage |
$71.81
|
| Rate for Payer: UHCCP Medicaid |
$50.64
|
| Rate for Payer: VA VA |
$71.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.5 CM OR LESS
|
Facility
|
IP
|
$287.22
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
76100087
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$199.91 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: BCBS Trust/PPO |
$237.21
|
| Rate for Payer: BCN Commercial |
$237.21
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.75
|
| Rate for Payer: UHC Core |
$239.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.6 CM TO 1.0 CM
|
Facility
|
IP
|
$287.22
|
|
|
Service Code
|
CPT 11311
|
| Hospital Charge Code |
76100088
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$199.91 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: BCBS Trust/PPO |
$237.21
|
| Rate for Payer: BCN Commercial |
$237.21
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.75
|
| Rate for Payer: UHC Core |
$239.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.6 CM TO 1.0 CM
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 11311
|
| Hospital Charge Code |
76100088
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$50.64 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna Medicare |
$74.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.76
|
| Rate for Payer: BCBS Complete |
$53.16
|
| Rate for Payer: BCBS MAPPO |
$71.81
|
| Rate for Payer: BCBS Trust/PPO |
$236.12
|
| Rate for Payer: BCN Commercial |
$236.12
|
| Rate for Payer: BCN Medicare Advantage |
$71.81
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.81
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Mclaren Medicaid |
$50.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.40
|
| Rate for Payer: Meridian Medicaid |
$53.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PACE Senior Care Partners |
$68.21
|
| Rate for Payer: PACE SWMI |
$71.81
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: PHP Medicare Advantage |
$71.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.88
|
| Rate for Payer: Priority Health Medicare |
$72.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.91
|
| Rate for Payer: Railroad Medicare Medicare |
$71.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.75
|
| Rate for Payer: UHC Core |
$239.83
|
| Rate for Payer: UHC Exchange |
$71.81
|
| Rate for Payer: UHC Medicaid |
$50.64
|
| Rate for Payer: UHC Medicare Advantage |
$71.81
|
| Rate for Payer: UHCCP Medicaid |
$50.64
|
| Rate for Payer: VA VA |
$71.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
OP
|
$165.06
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
76100084
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.10 |
| Max. Negotiated Rate |
$148.55 |
| Rate for Payer: Aetna Commercial |
$140.30
|
| Rate for Payer: Aetna Medicare |
$42.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.58
|
| Rate for Payer: BCBS Complete |
$30.55
|
| Rate for Payer: BCBS MAPPO |
$41.27
|
| Rate for Payer: BCBS Trust/PPO |
$135.70
|
| Rate for Payer: BCN Commercial |
$135.70
|
| Rate for Payer: BCN Medicare Advantage |
$41.27
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Commercial |
$141.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.27
|
| Rate for Payer: Healthscope Commercial |
$148.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.80
|
| Rate for Payer: Mclaren Medicaid |
$29.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.33
|
| Rate for Payer: Meridian Medicaid |
$30.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Nomi Health Commercial |
$135.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: PACE Senior Care Partners |
$39.20
|
| Rate for Payer: PACE SWMI |
$41.27
|
| Rate for Payer: PHP Commercial |
$140.30
|
| Rate for Payer: PHP Medicare Advantage |
$41.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$143.60
|
| Rate for Payer: Priority Health Medicare |
$41.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.88
|
| Rate for Payer: Railroad Medicare Medicare |
$41.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.25
|
| Rate for Payer: UHC Core |
$137.83
|
| Rate for Payer: UHC Exchange |
$41.27
|
| Rate for Payer: UHC Medicaid |
$29.10
|
| Rate for Payer: UHC Medicare Advantage |
$41.27
|
| Rate for Payer: UHCCP Medicaid |
$29.10
|
| Rate for Payer: VA VA |
$41.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.80
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
IP
|
$165.06
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
76100084
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.88 |
| Max. Negotiated Rate |
$148.55 |
| Rate for Payer: Aetna Commercial |
$140.30
|
| Rate for Payer: BCBS Trust/PPO |
$136.32
|
| Rate for Payer: BCN Commercial |
$136.32
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Commercial |
$141.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Healthscope Commercial |
$148.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Nomi Health Commercial |
$135.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: PHP Commercial |
$140.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$143.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.25
|
| Rate for Payer: UHC Core |
$137.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.80
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
IP
|
$165.06
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
76100085
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.88 |
| Max. Negotiated Rate |
$148.55 |
| Rate for Payer: Aetna Commercial |
$140.30
|
| Rate for Payer: BCBS Trust/PPO |
$136.32
|
| Rate for Payer: BCN Commercial |
$136.32
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Commercial |
$141.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Healthscope Commercial |
$148.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Nomi Health Commercial |
$135.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: PHP Commercial |
$140.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$143.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.25
|
| Rate for Payer: UHC Core |
$137.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.80
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
OP
|
$165.06
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
76100085
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.10 |
| Max. Negotiated Rate |
$148.55 |
| Rate for Payer: Aetna Commercial |
$140.30
|
| Rate for Payer: Aetna Medicare |
$42.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.58
|
| Rate for Payer: BCBS Complete |
$30.55
|
| Rate for Payer: BCBS MAPPO |
$41.27
|
| Rate for Payer: BCBS Trust/PPO |
$135.70
|
| Rate for Payer: BCN Commercial |
$135.70
|
| Rate for Payer: BCN Medicare Advantage |
$41.27
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Commercial |
$141.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.27
|
| Rate for Payer: Healthscope Commercial |
$148.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.80
|
| Rate for Payer: Mclaren Medicaid |
$29.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.33
|
| Rate for Payer: Meridian Medicaid |
$30.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Nomi Health Commercial |
$135.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: PACE Senior Care Partners |
$39.20
|
| Rate for Payer: PACE SWMI |
$41.27
|
| Rate for Payer: PHP Commercial |
$140.30
|
| Rate for Payer: PHP Medicare Advantage |
$41.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$143.60
|
| Rate for Payer: Priority Health Medicare |
$41.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.88
|
| Rate for Payer: Railroad Medicare Medicare |
$41.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.25
|
| Rate for Payer: UHC Core |
$137.83
|
| Rate for Payer: UHC Exchange |
$41.27
|
| Rate for Payer: UHC Medicaid |
$29.10
|
| Rate for Payer: UHC Medicare Advantage |
$41.27
|
| Rate for Payer: UHCCP Medicaid |
$29.10
|
| Rate for Payer: VA VA |
$41.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.80
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 11307
|
| Hospital Charge Code |
76100086
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$50.64 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna Medicare |
$74.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.76
|
| Rate for Payer: BCBS Complete |
$53.16
|
| Rate for Payer: BCBS MAPPO |
$71.81
|
| Rate for Payer: BCBS Trust/PPO |
$236.12
|
| Rate for Payer: BCN Commercial |
$236.12
|
| Rate for Payer: BCN Medicare Advantage |
$71.81
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.81
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Mclaren Medicaid |
$50.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.40
|
| Rate for Payer: Meridian Medicaid |
$53.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PACE Senior Care Partners |
$68.21
|
| Rate for Payer: PACE SWMI |
$71.81
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: PHP Medicare Advantage |
$71.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.88
|
| Rate for Payer: Priority Health Medicare |
$72.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.91
|
| Rate for Payer: Railroad Medicare Medicare |
$71.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.75
|
| Rate for Payer: UHC Core |
$239.83
|
| Rate for Payer: UHC Exchange |
$71.81
|
| Rate for Payer: UHC Medicaid |
$50.64
|
| Rate for Payer: UHC Medicare Advantage |
$71.81
|
| Rate for Payer: UHCCP Medicaid |
$50.64
|
| Rate for Payer: VA VA |
$71.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
