|
HC SESAME SEED IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200101
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC SETUP 1
|
Facility
|
IP
|
$33.54
|
|
| Hospital Charge Code |
27000145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.80 |
| Max. Negotiated Rate |
$30.19 |
| Rate for Payer: Aetna Commercial |
$28.51
|
| Rate for Payer: BCBS Trust/PPO |
$27.38
|
| Rate for Payer: BCN Commercial |
$25.92
|
| Rate for Payer: Cash Price |
$26.83
|
| Rate for Payer: Cofinity Commercial |
$28.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.83
|
| Rate for Payer: Healthscope Commercial |
$30.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.51
|
| Rate for Payer: Nomi Health Commercial |
$27.50
|
| Rate for Payer: PHP Commercial |
$28.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.80
|
| Rate for Payer: Priority Health HMO/PPO |
$29.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.52
|
| Rate for Payer: UHC Core |
$28.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.16
|
|
|
HC SETUP 1
|
Facility
|
OP
|
$33.54
|
|
| Hospital Charge Code |
27000145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.97 |
| Max. Negotiated Rate |
$30.19 |
| Rate for Payer: Aetna Commercial |
$28.51
|
| Rate for Payer: Aetna Medicare |
$8.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.48
|
| Rate for Payer: BCBS Complete |
$13.42
|
| Rate for Payer: BCBS MAPPO |
$8.38
|
| Rate for Payer: BCBS Trust/PPO |
$27.57
|
| Rate for Payer: BCN Commercial |
$26.08
|
| Rate for Payer: BCN Medicare Advantage |
$8.38
|
| Rate for Payer: Cash Price |
$26.83
|
| Rate for Payer: Cofinity Commercial |
$28.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.38
|
| Rate for Payer: Healthscope Commercial |
$30.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.51
|
| Rate for Payer: Nomi Health Commercial |
$27.50
|
| Rate for Payer: PACE Senior Care Partners |
$7.97
|
| Rate for Payer: PACE SWMI |
$8.38
|
| Rate for Payer: PHP Commercial |
$28.51
|
| Rate for Payer: PHP Medicare Advantage |
$8.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.80
|
| Rate for Payer: Priority Health HMO/PPO |
$29.18
|
| Rate for Payer: Priority Health Medicare |
$8.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.47
|
| Rate for Payer: Railroad Medicare Medicare |
$8.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.52
|
| Rate for Payer: UHC Core |
$28.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.38
|
| Rate for Payer: UHC Exchange |
$8.38
|
| Rate for Payer: UHC Medicare Advantage |
$8.38
|
| Rate for Payer: VA VA |
$8.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.16
|
|
|
HC SEX HORMONE BINDING GLOBULIN
|
Facility
|
IP
|
$60.34
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100422
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.22 |
| Max. Negotiated Rate |
$54.31 |
| Rate for Payer: Aetna Commercial |
$51.29
|
| Rate for Payer: BCBS Trust/PPO |
$49.26
|
| Rate for Payer: BCN Commercial |
$46.63
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cofinity Commercial |
$51.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.27
|
| Rate for Payer: Healthscope Commercial |
$54.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.29
|
| Rate for Payer: Nomi Health Commercial |
$49.48
|
| Rate for Payer: PHP Commercial |
$51.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.22
|
| Rate for Payer: Priority Health HMO/PPO |
$52.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.10
|
| Rate for Payer: UHC Core |
$50.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.26
|
|
|
HC SEX HORMONE BINDING GLOBULIN
|
Facility
|
OP
|
$60.34
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100422
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.33 |
| Max. Negotiated Rate |
$54.31 |
| Rate for Payer: Aetna Commercial |
$51.29
|
| Rate for Payer: Aetna Medicare |
$15.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.86
|
| Rate for Payer: BCBS Complete |
$16.50
|
| Rate for Payer: BCBS MAPPO |
$15.08
|
| Rate for Payer: BCBS Trust/PPO |
$49.61
|
| Rate for Payer: BCN Commercial |
$46.91
|
| Rate for Payer: BCN Medicare Advantage |
$15.08
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cofinity Commercial |
$51.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$54.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.26
|
| Rate for Payer: Mclaren Medicaid |
$15.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.84
|
| Rate for Payer: Meridian Medicaid |
$16.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.29
|
| Rate for Payer: Nomi Health Commercial |
$49.48
|
| Rate for Payer: PACE Senior Care Partners |
$14.33
|
| Rate for Payer: PACE SWMI |
$15.08
|
| Rate for Payer: PHP Commercial |
$51.29
|
| Rate for Payer: PHP Medicare Advantage |
$15.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.22
|
| Rate for Payer: Priority Health HMO/PPO |
$52.50
|
| Rate for Payer: Priority Health Medicare |
$15.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.43
|
| Rate for Payer: Railroad Medicare Medicare |
$15.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.10
|
| Rate for Payer: UHC Core |
$50.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.08
|
| Rate for Payer: UHC Exchange |
$15.08
|
| Rate for Payer: UHC Medicare Advantage |
$15.08
|
| Rate for Payer: UHCCP Medicaid |
$15.71
|
| Rate for Payer: VA VA |
$15.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.26
|
|
|
HC SEX HORMONE GLOBULIN BMH
|
Facility
|
IP
|
$85.13
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100718
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.33 |
| Max. Negotiated Rate |
$76.62 |
| Rate for Payer: Aetna Commercial |
$72.36
|
| Rate for Payer: BCBS Trust/PPO |
$69.49
|
| Rate for Payer: BCN Commercial |
$65.79
|
| Rate for Payer: Cash Price |
$68.10
|
| Rate for Payer: Cofinity Commercial |
$73.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.10
|
| Rate for Payer: Healthscope Commercial |
$76.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.36
|
| Rate for Payer: Nomi Health Commercial |
$69.81
|
| Rate for Payer: PHP Commercial |
$72.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.33
|
| Rate for Payer: Priority Health HMO/PPO |
$74.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.91
|
| Rate for Payer: UHC Core |
$71.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.85
|
|
|
HC SEX HORMONE GLOBULIN BMH
|
Facility
|
OP
|
$85.13
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100718
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.71 |
| Max. Negotiated Rate |
$76.62 |
| Rate for Payer: Aetna Commercial |
$72.36
|
| Rate for Payer: Aetna Medicare |
$22.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.60
|
| Rate for Payer: BCBS Complete |
$16.50
|
| Rate for Payer: BCBS MAPPO |
$21.28
|
| Rate for Payer: BCBS Trust/PPO |
$69.99
|
| Rate for Payer: BCN Commercial |
$66.19
|
| Rate for Payer: BCN Medicare Advantage |
$21.28
|
| Rate for Payer: Cash Price |
$68.10
|
| Rate for Payer: Cash Price |
$68.10
|
| Rate for Payer: Cofinity Commercial |
$73.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.28
|
| Rate for Payer: Healthscope Commercial |
$76.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.85
|
| Rate for Payer: Mclaren Medicaid |
$15.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.35
|
| Rate for Payer: Meridian Medicaid |
$16.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.36
|
| Rate for Payer: Nomi Health Commercial |
$69.81
|
| Rate for Payer: PACE Senior Care Partners |
$20.22
|
| Rate for Payer: PACE SWMI |
$21.28
|
| Rate for Payer: PHP Commercial |
$72.36
|
| Rate for Payer: PHP Medicare Advantage |
$21.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.33
|
| Rate for Payer: Priority Health HMO/PPO |
$74.06
|
| Rate for Payer: Priority Health Medicare |
$21.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.04
|
| Rate for Payer: Railroad Medicare Medicare |
$21.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.91
|
| Rate for Payer: UHC Core |
$71.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.28
|
| Rate for Payer: UHC Exchange |
$21.28
|
| Rate for Payer: UHC Medicare Advantage |
$21.28
|
| Rate for Payer: UHCCP Medicaid |
$15.71
|
| Rate for Payer: VA VA |
$21.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.85
|
|
|
HC SGOT AST
|
Facility
|
OP
|
$19.46
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
30100441
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$17.51 |
| Rate for Payer: Aetna Commercial |
$16.54
|
| Rate for Payer: Aetna Medicare |
$5.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.08
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$4.86
|
| Rate for Payer: BCBS Trust/PPO |
$16.00
|
| Rate for Payer: BCN Commercial |
$15.13
|
| Rate for Payer: BCN Medicare Advantage |
$4.86
|
| Rate for Payer: Cash Price |
$15.57
|
| Rate for Payer: Cash Price |
$15.57
|
| Rate for Payer: Cofinity Commercial |
$16.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.86
|
| Rate for Payer: Healthscope Commercial |
$17.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.60
|
| Rate for Payer: Mclaren Medicaid |
$3.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.11
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.54
|
| Rate for Payer: Nomi Health Commercial |
$15.96
|
| Rate for Payer: PACE Senior Care Partners |
$4.62
|
| Rate for Payer: PACE SWMI |
$4.86
|
| Rate for Payer: PHP Commercial |
$16.54
|
| Rate for Payer: PHP Medicare Advantage |
$4.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.65
|
| Rate for Payer: Priority Health HMO/PPO |
$16.93
|
| Rate for Payer: Priority Health Medicare |
$4.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.04
|
| Rate for Payer: Railroad Medicare Medicare |
$4.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.12
|
| Rate for Payer: UHC Core |
$16.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.86
|
| Rate for Payer: UHC Exchange |
$4.86
|
| Rate for Payer: UHC Medicare Advantage |
$4.86
|
| Rate for Payer: UHCCP Medicaid |
$3.75
|
| Rate for Payer: VA VA |
$4.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.60
|
|
|
HC SGOT AST
|
Facility
|
IP
|
$19.46
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
30100441
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.65 |
| Max. Negotiated Rate |
$17.51 |
| Rate for Payer: Aetna Commercial |
$16.54
|
| Rate for Payer: BCBS Trust/PPO |
$15.89
|
| Rate for Payer: BCN Commercial |
$15.04
|
| Rate for Payer: Cash Price |
$15.57
|
| Rate for Payer: Cofinity Commercial |
$16.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.57
|
| Rate for Payer: Healthscope Commercial |
$17.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.54
|
| Rate for Payer: Nomi Health Commercial |
$15.96
|
| Rate for Payer: PHP Commercial |
$16.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.65
|
| Rate for Payer: Priority Health HMO/PPO |
$16.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.12
|
| Rate for Payer: UHC Core |
$16.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.60
|
|
|
HC SGPT ALT
|
Facility
|
IP
|
$19.62
|
|
|
Service Code
|
CPT 84460
|
| Hospital Charge Code |
30100442
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$17.66 |
| Rate for Payer: Aetna Commercial |
$16.68
|
| Rate for Payer: BCBS Trust/PPO |
$16.02
|
| Rate for Payer: BCN Commercial |
$15.16
|
| Rate for Payer: Cash Price |
$15.70
|
| Rate for Payer: Cofinity Commercial |
$16.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.70
|
| Rate for Payer: Healthscope Commercial |
$17.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.68
|
| Rate for Payer: Nomi Health Commercial |
$16.09
|
| Rate for Payer: PHP Commercial |
$16.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.75
|
| Rate for Payer: Priority Health HMO/PPO |
$17.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.27
|
| Rate for Payer: UHC Core |
$16.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.72
|
|
|
HC SGPT ALT
|
Facility
|
OP
|
$19.62
|
|
|
Service Code
|
CPT 84460
|
| Hospital Charge Code |
30100442
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$17.66 |
| Rate for Payer: Aetna Commercial |
$16.68
|
| Rate for Payer: Aetna Medicare |
$5.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.13
|
| Rate for Payer: BCBS Complete |
$4.02
|
| Rate for Payer: BCBS MAPPO |
$4.90
|
| Rate for Payer: BCBS Trust/PPO |
$16.13
|
| Rate for Payer: BCN Commercial |
$15.25
|
| Rate for Payer: BCN Medicare Advantage |
$4.90
|
| Rate for Payer: Cash Price |
$15.70
|
| Rate for Payer: Cash Price |
$15.70
|
| Rate for Payer: Cofinity Commercial |
$16.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.90
|
| Rate for Payer: Healthscope Commercial |
$17.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.72
|
| Rate for Payer: Mclaren Medicaid |
$3.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.15
|
| Rate for Payer: Meridian Medicaid |
$4.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.68
|
| Rate for Payer: Nomi Health Commercial |
$16.09
|
| Rate for Payer: PACE Senior Care Partners |
$4.66
|
| Rate for Payer: PACE SWMI |
$4.90
|
| Rate for Payer: PHP Commercial |
$16.68
|
| Rate for Payer: PHP Medicare Advantage |
$4.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.75
|
| Rate for Payer: Priority Health HMO/PPO |
$17.07
|
| Rate for Payer: Priority Health Medicare |
$4.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.15
|
| Rate for Payer: Railroad Medicare Medicare |
$4.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.27
|
| Rate for Payer: UHC Core |
$16.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.90
|
| Rate for Payer: UHC Exchange |
$4.90
|
| Rate for Payer: UHC Medicare Advantage |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$3.83
|
| Rate for Payer: VA VA |
$4.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.72
|
|
|
HC SHAVE EPIDURAL SKIN LESION 1.1-2.0 CM
|
Facility
|
IP
|
$304.84
|
|
|
Service Code
|
CPT 11312
|
| Hospital Charge Code |
76100073
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$198.15 |
| Max. Negotiated Rate |
$274.36 |
| Rate for Payer: Aetna Commercial |
$259.11
|
| Rate for Payer: BCBS Trust/PPO |
$248.84
|
| Rate for Payer: BCN Commercial |
$235.58
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Commercial |
$262.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: Nomi Health Commercial |
$249.97
|
| Rate for Payer: PHP Commercial |
$259.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.15
|
| Rate for Payer: Priority Health HMO/PPO |
$265.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.26
|
| Rate for Payer: UHC Core |
$254.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.63
|
|
|
HC SHAVE EPIDURAL SKIN LESION 1.1-2.0 CM
|
Facility
|
OP
|
$304.84
|
|
|
Service Code
|
CPT 11312
|
| Hospital Charge Code |
76100073
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.40 |
| Max. Negotiated Rate |
$297.19 |
| Rate for Payer: Aetna Commercial |
$259.11
|
| Rate for Payer: Aetna Medicare |
$79.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.26
|
| Rate for Payer: BCBS Complete |
$297.19
|
| Rate for Payer: BCBS MAPPO |
$76.21
|
| Rate for Payer: BCBS Trust/PPO |
$250.61
|
| Rate for Payer: BCN Commercial |
$237.01
|
| Rate for Payer: BCN Medicare Advantage |
$76.21
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Commercial |
$262.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.21
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.63
|
| Rate for Payer: Mclaren Medicaid |
$283.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.02
|
| Rate for Payer: Meridian Medicaid |
$297.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: Nomi Health Commercial |
$249.97
|
| Rate for Payer: PACE Senior Care Partners |
$72.40
|
| Rate for Payer: PACE SWMI |
$76.21
|
| Rate for Payer: PHP Commercial |
$259.11
|
| Rate for Payer: PHP Medicare Advantage |
$76.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.15
|
| Rate for Payer: Priority Health HMO/PPO |
$265.21
|
| Rate for Payer: Priority Health Medicare |
$76.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.24
|
| Rate for Payer: Railroad Medicare Medicare |
$76.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.26
|
| Rate for Payer: UHC Core |
$254.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.21
|
| Rate for Payer: UHC Exchange |
$76.21
|
| Rate for Payer: UHC Medicare Advantage |
$76.21
|
| Rate for Payer: UHCCP Medicaid |
$283.02
|
| Rate for Payer: VA VA |
$76.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.63
|
|
|
HC SHAVE EPIDURAL SKIN LESION > 2.0 CM
|
Facility
|
IP
|
$304.84
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
76100074
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$198.15 |
| Max. Negotiated Rate |
$274.36 |
| Rate for Payer: Aetna Commercial |
$259.11
|
| Rate for Payer: BCBS Trust/PPO |
$248.84
|
| Rate for Payer: BCN Commercial |
$235.58
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Commercial |
$262.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: Nomi Health Commercial |
$249.97
|
| Rate for Payer: PHP Commercial |
$259.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.15
|
| Rate for Payer: Priority Health HMO/PPO |
$265.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.26
|
| Rate for Payer: UHC Core |
$254.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.63
|
|
|
HC SHAVE EPIDURAL SKIN LESION > 2.0 CM
|
Facility
|
OP
|
$304.84
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
76100074
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.40 |
| Max. Negotiated Rate |
$297.19 |
| Rate for Payer: Aetna Commercial |
$259.11
|
| Rate for Payer: Aetna Medicare |
$79.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.26
|
| Rate for Payer: BCBS Complete |
$297.19
|
| Rate for Payer: BCBS MAPPO |
$76.21
|
| Rate for Payer: BCBS Trust/PPO |
$250.61
|
| Rate for Payer: BCN Commercial |
$237.01
|
| Rate for Payer: BCN Medicare Advantage |
$76.21
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Commercial |
$262.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.21
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.63
|
| Rate for Payer: Mclaren Medicaid |
$283.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.02
|
| Rate for Payer: Meridian Medicaid |
$297.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: Nomi Health Commercial |
$249.97
|
| Rate for Payer: PACE Senior Care Partners |
$72.40
|
| Rate for Payer: PACE SWMI |
$76.21
|
| Rate for Payer: PHP Commercial |
$259.11
|
| Rate for Payer: PHP Medicare Advantage |
$76.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.15
|
| Rate for Payer: Priority Health HMO/PPO |
$265.21
|
| Rate for Payer: Priority Health Medicare |
$76.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.24
|
| Rate for Payer: Railroad Medicare Medicare |
$76.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.26
|
| Rate for Payer: UHC Core |
$254.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.21
|
| Rate for Payer: UHC Exchange |
$76.21
|
| Rate for Payer: UHC Medicare Advantage |
$76.21
|
| Rate for Payer: UHCCP Medicaid |
$283.02
|
| Rate for Payer: VA VA |
$76.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.63
|
|
|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.5 CM OR LESS
|
Facility
|
IP
|
$281.59
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
76100087
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.03 |
| Max. Negotiated Rate |
$253.43 |
| Rate for Payer: Aetna Commercial |
$239.35
|
| Rate for Payer: BCBS Trust/PPO |
$229.86
|
| Rate for Payer: BCN Commercial |
$217.61
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$242.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Healthscope Commercial |
$253.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: PHP Commercial |
$239.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health HMO/PPO |
$244.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.80
|
| Rate for Payer: UHC Core |
$235.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.19
|
|
|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.5 CM OR LESS
|
Facility
|
OP
|
$281.59
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
76100087
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.88 |
| Max. Negotiated Rate |
$253.43 |
| Rate for Payer: Aetna Commercial |
$239.35
|
| Rate for Payer: Aetna Medicare |
$73.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.00
|
| Rate for Payer: BCBS Complete |
$147.80
|
| Rate for Payer: BCBS MAPPO |
$70.40
|
| Rate for Payer: BCBS Trust/PPO |
$231.50
|
| Rate for Payer: BCN Commercial |
$218.94
|
| Rate for Payer: BCN Medicare Advantage |
$70.40
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$242.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.40
|
| Rate for Payer: Healthscope Commercial |
$253.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.19
|
| Rate for Payer: Mclaren Medicaid |
$140.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.92
|
| Rate for Payer: Meridian Medicaid |
$147.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: PACE Senior Care Partners |
$66.88
|
| Rate for Payer: PACE SWMI |
$70.40
|
| Rate for Payer: PHP Commercial |
$239.35
|
| Rate for Payer: PHP Medicare Advantage |
$70.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health HMO/PPO |
$244.98
|
| Rate for Payer: Priority Health Medicare |
$71.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.67
|
| Rate for Payer: Railroad Medicare Medicare |
$70.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.80
|
| Rate for Payer: UHC Core |
$235.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.40
|
| Rate for Payer: UHC Exchange |
$70.40
|
| Rate for Payer: UHC Medicare Advantage |
$70.40
|
| Rate for Payer: UHCCP Medicaid |
$140.75
|
| Rate for Payer: VA VA |
$70.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.19
|
|
|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.6 CM TO 1.0 CM
|
Facility
|
IP
|
$281.59
|
|
|
Service Code
|
CPT 11311
|
| Hospital Charge Code |
76100088
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.03 |
| Max. Negotiated Rate |
$253.43 |
| Rate for Payer: Aetna Commercial |
$239.35
|
| Rate for Payer: BCBS Trust/PPO |
$229.86
|
| Rate for Payer: BCN Commercial |
$217.61
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$242.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Healthscope Commercial |
$253.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: PHP Commercial |
$239.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health HMO/PPO |
$244.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.80
|
| Rate for Payer: UHC Core |
$235.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.19
|
|
|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.6 CM TO 1.0 CM
|
Facility
|
OP
|
$281.59
|
|
|
Service Code
|
CPT 11311
|
| Hospital Charge Code |
76100088
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.88 |
| Max. Negotiated Rate |
$253.43 |
| Rate for Payer: Aetna Commercial |
$239.35
|
| Rate for Payer: Aetna Medicare |
$73.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.00
|
| Rate for Payer: BCBS Complete |
$147.80
|
| Rate for Payer: BCBS MAPPO |
$70.40
|
| Rate for Payer: BCBS Trust/PPO |
$231.50
|
| Rate for Payer: BCN Commercial |
$218.94
|
| Rate for Payer: BCN Medicare Advantage |
$70.40
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$242.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.40
|
| Rate for Payer: Healthscope Commercial |
$253.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.19
|
| Rate for Payer: Mclaren Medicaid |
$140.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.92
|
| Rate for Payer: Meridian Medicaid |
$147.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: PACE Senior Care Partners |
$66.88
|
| Rate for Payer: PACE SWMI |
$70.40
|
| Rate for Payer: PHP Commercial |
$239.35
|
| Rate for Payer: PHP Medicare Advantage |
$70.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health HMO/PPO |
$244.98
|
| Rate for Payer: Priority Health Medicare |
$71.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.67
|
| Rate for Payer: Railroad Medicare Medicare |
$70.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.80
|
| Rate for Payer: UHC Core |
$235.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.40
|
| Rate for Payer: UHC Exchange |
$70.40
|
| Rate for Payer: UHC Medicare Advantage |
$70.40
|
| Rate for Payer: UHCCP Medicaid |
$140.75
|
| Rate for Payer: VA VA |
$70.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.19
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
OP
|
$161.82
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
76100084
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$38.43 |
| Max. Negotiated Rate |
$147.80 |
| Rate for Payer: Aetna Commercial |
$137.55
|
| Rate for Payer: Aetna Medicare |
$42.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.57
|
| Rate for Payer: BCBS Complete |
$147.80
|
| Rate for Payer: BCBS MAPPO |
$40.46
|
| Rate for Payer: BCBS Trust/PPO |
$133.03
|
| Rate for Payer: BCN Commercial |
$125.82
|
| Rate for Payer: BCN Medicare Advantage |
$40.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$139.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.46
|
| Rate for Payer: Healthscope Commercial |
$145.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.36
|
| Rate for Payer: Mclaren Medicaid |
$140.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.48
|
| Rate for Payer: Meridian Medicaid |
$147.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: PACE Senior Care Partners |
$38.43
|
| Rate for Payer: PACE SWMI |
$40.46
|
| Rate for Payer: PHP Commercial |
$137.55
|
| Rate for Payer: PHP Medicare Advantage |
$40.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health HMO/PPO |
$140.78
|
| Rate for Payer: Priority Health Medicare |
$40.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.42
|
| Rate for Payer: Railroad Medicare Medicare |
$40.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.40
|
| Rate for Payer: UHC Core |
$135.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.46
|
| Rate for Payer: UHC Exchange |
$40.46
|
| Rate for Payer: UHC Medicare Advantage |
$40.46
|
| Rate for Payer: UHCCP Medicaid |
$140.75
|
| Rate for Payer: VA VA |
$40.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.36
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 11305
|
| Hospital Charge Code |
76100084
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.18 |
| Max. Negotiated Rate |
$145.64 |
| Rate for Payer: Aetna Commercial |
$137.55
|
| Rate for Payer: BCBS Trust/PPO |
$132.09
|
| Rate for Payer: BCN Commercial |
$125.05
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$139.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Healthscope Commercial |
$145.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: PHP Commercial |
$137.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health HMO/PPO |
$140.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.40
|
| Rate for Payer: UHC Core |
$135.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.36
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
76100085
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.18 |
| Max. Negotiated Rate |
$145.64 |
| Rate for Payer: Aetna Commercial |
$137.55
|
| Rate for Payer: BCBS Trust/PPO |
$132.09
|
| Rate for Payer: BCN Commercial |
$125.05
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$139.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Healthscope Commercial |
$145.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: PHP Commercial |
$137.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health HMO/PPO |
$140.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.40
|
| Rate for Payer: UHC Core |
$135.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.36
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
OP
|
$161.82
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
76100085
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$38.43 |
| Max. Negotiated Rate |
$147.80 |
| Rate for Payer: Aetna Commercial |
$137.55
|
| Rate for Payer: Aetna Medicare |
$42.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.57
|
| Rate for Payer: BCBS Complete |
$147.80
|
| Rate for Payer: BCBS MAPPO |
$40.46
|
| Rate for Payer: BCBS Trust/PPO |
$133.03
|
| Rate for Payer: BCN Commercial |
$125.82
|
| Rate for Payer: BCN Medicare Advantage |
$40.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$139.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.46
|
| Rate for Payer: Healthscope Commercial |
$145.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.36
|
| Rate for Payer: Mclaren Medicaid |
$140.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.48
|
| Rate for Payer: Meridian Medicaid |
$147.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: PACE Senior Care Partners |
$38.43
|
| Rate for Payer: PACE SWMI |
$40.46
|
| Rate for Payer: PHP Commercial |
$137.55
|
| Rate for Payer: PHP Medicare Advantage |
$40.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health HMO/PPO |
$140.78
|
| Rate for Payer: Priority Health Medicare |
$40.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.42
|
| Rate for Payer: Railroad Medicare Medicare |
$40.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.40
|
| Rate for Payer: UHC Core |
$135.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.46
|
| Rate for Payer: UHC Exchange |
$40.46
|
| Rate for Payer: UHC Medicare Advantage |
$40.46
|
| Rate for Payer: UHCCP Medicaid |
$140.75
|
| Rate for Payer: VA VA |
$40.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.36
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
IP
|
$281.59
|
|
|
Service Code
|
CPT 11307
|
| Hospital Charge Code |
76100086
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.03 |
| Max. Negotiated Rate |
$253.43 |
| Rate for Payer: Aetna Commercial |
$239.35
|
| Rate for Payer: BCBS Trust/PPO |
$229.86
|
| Rate for Payer: BCN Commercial |
$217.61
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$242.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Healthscope Commercial |
$253.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: PHP Commercial |
$239.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health HMO/PPO |
$244.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.80
|
| Rate for Payer: UHC Core |
$235.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.19
|
|
|
HC SHAVE LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
OP
|
$281.59
|
|
|
Service Code
|
CPT 11307
|
| Hospital Charge Code |
76100086
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.88 |
| Max. Negotiated Rate |
$253.43 |
| Rate for Payer: Aetna Commercial |
$239.35
|
| Rate for Payer: Aetna Medicare |
$73.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.00
|
| Rate for Payer: BCBS Complete |
$147.80
|
| Rate for Payer: BCBS MAPPO |
$70.40
|
| Rate for Payer: BCBS Trust/PPO |
$231.50
|
| Rate for Payer: BCN Commercial |
$218.94
|
| Rate for Payer: BCN Medicare Advantage |
$70.40
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$242.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.40
|
| Rate for Payer: Healthscope Commercial |
$253.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.19
|
| Rate for Payer: Mclaren Medicaid |
$140.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.92
|
| Rate for Payer: Meridian Medicaid |
$147.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: PACE Senior Care Partners |
$66.88
|
| Rate for Payer: PACE SWMI |
$70.40
|
| Rate for Payer: PHP Commercial |
$239.35
|
| Rate for Payer: PHP Medicare Advantage |
$70.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health HMO/PPO |
$244.98
|
| Rate for Payer: Priority Health Medicare |
$71.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.67
|
| Rate for Payer: Railroad Medicare Medicare |
$70.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.80
|
| Rate for Payer: UHC Core |
$235.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.40
|
| Rate for Payer: UHC Exchange |
$70.40
|
| Rate for Payer: UHC Medicare Advantage |
$70.40
|
| Rate for Payer: UHCCP Medicaid |
$140.75
|
| Rate for Payer: VA VA |
$70.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.19
|
|
