|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 11400
|
| Min. Negotiated Rate |
$54.32 |
| Max. Negotiated Rate |
$6,962.48 |
| Rate for Payer: Aetna Commercial |
$108.37
|
| Rate for Payer: Aetna Medicare |
$84.10
|
| Rate for Payer: BCBS Complete |
$57.04
|
| Rate for Payer: BCBS MAPPO |
$80.87
|
| Rate for Payer: BCBS Trust/PPO |
$6,962.48
|
| Rate for Payer: BCN Commercial |
$151.17
|
| Rate for Payer: BCN Medicare Advantage |
$80.87
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$116.45
|
| Rate for Payer: Cofinity Commercial |
$108.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.87
|
| Rate for Payer: Mclaren Medicaid |
$54.32
|
| Rate for Payer: Meridian Medicaid |
$57.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.91
|
| Rate for Payer: PACE SWMI |
$80.87
|
| Rate for Payer: PHP Medicare Advantage |
$80.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.17
|
| Rate for Payer: Priority Health Medicare |
$80.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.87
|
| Rate for Payer: UHC Medicare Advantage |
$83.30
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
11400
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$47.50 |
| Max. Negotiated Rate |
$484.61 |
| Rate for Payer: Aetna Commercial |
$170.00
|
| Rate for Payer: Aetna Medicare |
$52.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.50
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$50.00
|
| Rate for Payer: BCBS Trust/PPO |
$155.50
|
| Rate for Payer: BCN Commercial |
$155.50
|
| Rate for Payer: BCN Medicare Advantage |
$50.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$172.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.00
|
| Rate for Payer: Healthscope Commercial |
$180.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.00
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.00
|
| Rate for Payer: PACE Senior Care Partners |
$47.50
|
| Rate for Payer: PACE SWMI |
$50.00
|
| Rate for Payer: PHP Commercial |
$170.00
|
| Rate for Payer: PHP Medicare Advantage |
$50.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$174.00
|
| Rate for Payer: Priority Health Medicare |
$50.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.98
|
| Rate for Payer: Railroad Medicare Medicare |
$50.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.00
|
| Rate for Payer: UHC Core |
$167.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.00
|
| Rate for Payer: UHC Medicare Advantage |
$51.50
|
| Rate for Payer: VA VA |
$50.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.00
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
11400
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$121.98 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna Commercial |
$170.00
|
| Rate for Payer: BCBS Trust/PPO |
$154.56
|
| Rate for Payer: BCN Commercial |
$154.56
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$172.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.00
|
| Rate for Payer: Healthscope Commercial |
$180.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.00
|
| Rate for Payer: PHP Commercial |
$170.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$174.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.00
|
| Rate for Payer: UHC Core |
$167.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.00
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Facility
|
IP
|
$242.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
11401
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$147.60 |
| Max. Negotiated Rate |
$217.80 |
| Rate for Payer: Aetna Commercial |
$205.70
|
| Rate for Payer: BCBS Trust/PPO |
$187.02
|
| Rate for Payer: BCN Commercial |
$187.02
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$208.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.60
|
| Rate for Payer: Healthscope Commercial |
$217.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$205.70
|
| Rate for Payer: PHP Commercial |
$205.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.96
|
| Rate for Payer: UHC Core |
$202.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.50
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Facility
|
OP
|
$242.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
11401
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$274.65 |
| Rate for Payer: Aetna Commercial |
$205.70
|
| Rate for Payer: Aetna Medicare |
$62.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75.62
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$60.50
|
| Rate for Payer: BCBS Trust/PPO |
$188.16
|
| Rate for Payer: BCN Commercial |
$188.16
|
| Rate for Payer: BCN Medicare Advantage |
$60.50
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$208.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.50
|
| Rate for Payer: Healthscope Commercial |
$217.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.50
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$63.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$205.70
|
| Rate for Payer: PACE Senior Care Partners |
$57.48
|
| Rate for Payer: PACE SWMI |
$60.50
|
| Rate for Payer: PHP Commercial |
$205.70
|
| Rate for Payer: PHP Medicare Advantage |
$60.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.54
|
| Rate for Payer: Priority Health Medicare |
$60.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.60
|
| Rate for Payer: Railroad Medicare Medicare |
$60.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.96
|
| Rate for Payer: UHC Core |
$202.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.50
|
| Rate for Payer: UHC Medicare Advantage |
$62.32
|
| Rate for Payer: VA VA |
$60.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.50
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 11401
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$5,569.98 |
| Rate for Payer: Aetna Commercial |
$137.66
|
| Rate for Payer: Aetna Medicare |
$106.84
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$102.73
|
| Rate for Payer: BCBS Trust/PPO |
$5,569.98
|
| Rate for Payer: BCN Commercial |
$184.56
|
| Rate for Payer: BCN Medicare Advantage |
$102.73
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$147.93
|
| Rate for Payer: Cofinity Commercial |
$137.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.73
|
| Rate for Payer: Mclaren Medicaid |
$67.95
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$107.87
|
| Rate for Payer: PACE SWMI |
$102.73
|
| Rate for Payer: PHP Medicare Advantage |
$102.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.30
|
| Rate for Payer: Priority Health Medicare |
$102.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.73
|
| Rate for Payer: UHC Medicare Advantage |
$105.81
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 11401
|
| Hospital Charge Code |
11401
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$5,569.98 |
| Rate for Payer: Aetna Commercial |
$137.66
|
| Rate for Payer: Aetna Medicare |
$106.84
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$102.73
|
| Rate for Payer: BCBS Trust/PPO |
$5,569.98
|
| Rate for Payer: BCN Commercial |
$184.56
|
| Rate for Payer: BCN Medicare Advantage |
$102.73
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$147.93
|
| Rate for Payer: Cofinity Commercial |
$137.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.73
|
| Rate for Payer: Mclaren Medicaid |
$67.95
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$107.87
|
| Rate for Payer: PACE SWMI |
$102.73
|
| Rate for Payer: PHP Medicare Advantage |
$102.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.30
|
| Rate for Payer: Priority Health Medicare |
$102.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.73
|
| Rate for Payer: UHC Medicare Advantage |
$105.81
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM
|
Facility
|
OP
|
$269.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
11402
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$63.89 |
| Max. Negotiated Rate |
$484.61 |
| Rate for Payer: Aetna Commercial |
$228.65
|
| Rate for Payer: Aetna Medicare |
$69.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.06
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$67.25
|
| Rate for Payer: BCBS Trust/PPO |
$209.15
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$67.25
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$231.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.25
|
| Rate for Payer: Healthscope Commercial |
$242.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.75
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$70.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$228.65
|
| Rate for Payer: PACE Senior Care Partners |
$63.89
|
| Rate for Payer: PACE SWMI |
$67.25
|
| Rate for Payer: PHP Commercial |
$228.65
|
| Rate for Payer: PHP Medicare Advantage |
$67.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.03
|
| Rate for Payer: Priority Health Medicare |
$67.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.06
|
| Rate for Payer: Railroad Medicare Medicare |
$67.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.72
|
| Rate for Payer: UHC Core |
$224.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.25
|
| Rate for Payer: UHC Medicare Advantage |
$69.27
|
| Rate for Payer: VA VA |
$67.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.75
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM
|
Facility
|
IP
|
$269.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
11402
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$164.06 |
| Max. Negotiated Rate |
$242.10 |
| Rate for Payer: Aetna Commercial |
$228.65
|
| Rate for Payer: BCBS Trust/PPO |
$207.88
|
| Rate for Payer: BCN Commercial |
$207.88
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$231.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.20
|
| Rate for Payer: Healthscope Commercial |
$242.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$228.65
|
| Rate for Payer: PHP Commercial |
$228.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.72
|
| Rate for Payer: UHC Core |
$224.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.75
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 11402
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$1,392.50 |
| Rate for Payer: Aetna Commercial |
$150.00
|
| Rate for Payer: Aetna Medicare |
$116.42
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS MAPPO |
$111.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,392.50
|
| Rate for Payer: BCN Commercial |
$202.61
|
| Rate for Payer: BCN Medicare Advantage |
$111.94
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$161.19
|
| Rate for Payer: Cofinity Commercial |
$150.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.94
|
| Rate for Payer: Mclaren Medicaid |
$74.34
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$117.54
|
| Rate for Payer: PACE SWMI |
$111.94
|
| Rate for Payer: PHP Medicare Advantage |
$111.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.81
|
| Rate for Payer: Priority Health Medicare |
$111.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$111.94
|
| Rate for Payer: UHC Medicare Advantage |
$115.30
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 11402
|
| Hospital Charge Code |
11402
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$1,392.50 |
| Rate for Payer: Aetna Commercial |
$150.00
|
| Rate for Payer: Aetna Medicare |
$116.42
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS MAPPO |
$111.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,392.50
|
| Rate for Payer: BCN Commercial |
$202.61
|
| Rate for Payer: BCN Medicare Advantage |
$111.94
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$150.00
|
| Rate for Payer: Cofinity Commercial |
$161.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.94
|
| Rate for Payer: Mclaren Medicaid |
$74.34
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$117.54
|
| Rate for Payer: PACE SWMI |
$111.94
|
| Rate for Payer: PHP Medicare Advantage |
$111.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.81
|
| Rate for Payer: Priority Health Medicare |
$111.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$111.94
|
| Rate for Payer: UHC Medicare Advantage |
$115.30
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM
|
Facility
|
IP
|
$322.00
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
11403
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$196.39 |
| Max. Negotiated Rate |
$289.80 |
| Rate for Payer: Aetna Commercial |
$273.70
|
| Rate for Payer: BCBS Trust/PPO |
$248.84
|
| Rate for Payer: BCN Commercial |
$248.84
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$276.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.60
|
| Rate for Payer: Healthscope Commercial |
$289.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$273.70
|
| Rate for Payer: PHP Commercial |
$273.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$280.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.36
|
| Rate for Payer: UHC Core |
$268.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.50
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM
|
Facility
|
OP
|
$322.00
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
11403
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$76.48 |
| Max. Negotiated Rate |
$484.61 |
| Rate for Payer: Aetna Commercial |
$273.70
|
| Rate for Payer: Aetna Medicare |
$83.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.62
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$80.50
|
| Rate for Payer: BCBS Trust/PPO |
$250.36
|
| Rate for Payer: BCN Commercial |
$250.36
|
| Rate for Payer: BCN Medicare Advantage |
$80.50
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$276.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.50
|
| Rate for Payer: Healthscope Commercial |
$289.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.50
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$273.70
|
| Rate for Payer: PACE Senior Care Partners |
$76.48
|
| Rate for Payer: PACE SWMI |
$80.50
|
| Rate for Payer: PHP Commercial |
$273.70
|
| Rate for Payer: PHP Medicare Advantage |
$80.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$280.14
|
| Rate for Payer: Priority Health Medicare |
$80.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.39
|
| Rate for Payer: Railroad Medicare Medicare |
$80.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.36
|
| Rate for Payer: UHC Core |
$268.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.50
|
| Rate for Payer: UHC Medicare Advantage |
$82.92
|
| Rate for Payer: VA VA |
$80.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.50
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 11403
|
| Hospital Charge Code |
11403
|
| Min. Negotiated Rate |
$96.28 |
| Max. Negotiated Rate |
$338.18 |
| Rate for Payer: Aetna Commercial |
$193.55
|
| Rate for Payer: Aetna Medicare |
$150.22
|
| Rate for Payer: BCBS Complete |
$101.09
|
| Rate for Payer: BCBS MAPPO |
$144.44
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$233.24
|
| Rate for Payer: BCN Medicare Advantage |
$144.44
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$193.55
|
| Rate for Payer: Cofinity Commercial |
$207.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.44
|
| Rate for Payer: Mclaren Medicaid |
$96.28
|
| Rate for Payer: Meridian Medicaid |
$101.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$151.66
|
| Rate for Payer: PACE SWMI |
$144.44
|
| Rate for Payer: PHP Medicare Advantage |
$144.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.91
|
| Rate for Payer: Priority Health Medicare |
$144.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.44
|
| Rate for Payer: UHC Medicare Advantage |
$148.77
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 11403
|
| Min. Negotiated Rate |
$96.28 |
| Max. Negotiated Rate |
$338.18 |
| Rate for Payer: Aetna Commercial |
$193.55
|
| Rate for Payer: Aetna Medicare |
$150.22
|
| Rate for Payer: BCBS Complete |
$101.09
|
| Rate for Payer: BCBS MAPPO |
$144.44
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$233.24
|
| Rate for Payer: BCN Medicare Advantage |
$144.44
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$207.99
|
| Rate for Payer: Cofinity Commercial |
$193.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.44
|
| Rate for Payer: Mclaren Medicaid |
$96.28
|
| Rate for Payer: Meridian Medicaid |
$101.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$151.66
|
| Rate for Payer: PACE SWMI |
$144.44
|
| Rate for Payer: PHP Medicare Advantage |
$144.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.91
|
| Rate for Payer: Priority Health Medicare |
$144.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.44
|
| Rate for Payer: UHC Medicare Advantage |
$148.77
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM
|
Facility
|
OP
|
$456.00
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
11404
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$108.30 |
| Max. Negotiated Rate |
$1,116.73 |
| Rate for Payer: Aetna Commercial |
$387.60
|
| Rate for Payer: Aetna Medicare |
$118.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$142.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$142.50
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$114.00
|
| Rate for Payer: BCBS Trust/PPO |
$354.54
|
| Rate for Payer: BCN Commercial |
$354.54
|
| Rate for Payer: BCN Medicare Advantage |
$114.00
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cofinity Commercial |
$392.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$364.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.00
|
| Rate for Payer: Healthscope Commercial |
$410.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$342.00
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$131.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$387.60
|
| Rate for Payer: PACE Senior Care Partners |
$108.30
|
| Rate for Payer: PACE SWMI |
$114.00
|
| Rate for Payer: PHP Commercial |
$387.60
|
| Rate for Payer: PHP Medicare Advantage |
$114.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$319.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.72
|
| Rate for Payer: Priority Health Medicare |
$114.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$278.11
|
| Rate for Payer: Railroad Medicare Medicare |
$114.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$401.28
|
| Rate for Payer: UHC Core |
$380.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.00
|
| Rate for Payer: UHC Medicare Advantage |
$117.42
|
| Rate for Payer: VA VA |
$114.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$342.00
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM
|
Professional
|
Both
|
$456.00
|
|
|
Service Code
|
HCPCS 11404
|
| Hospital Charge Code |
11404
|
| Min. Negotiated Rate |
$105.86 |
| Max. Negotiated Rate |
$319.20 |
| Rate for Payer: Aetna Commercial |
$214.27
|
| Rate for Payer: Aetna Medicare |
$166.30
|
| Rate for Payer: BCBS Complete |
$111.15
|
| Rate for Payer: BCBS MAPPO |
$159.90
|
| Rate for Payer: BCBS Trust/PPO |
$302.17
|
| Rate for Payer: BCN Commercial |
$264.65
|
| Rate for Payer: BCN Medicare Advantage |
$159.90
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cofinity Commercial |
$230.26
|
| Rate for Payer: Cofinity Commercial |
$214.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.90
|
| Rate for Payer: Mclaren Medicaid |
$105.86
|
| Rate for Payer: Meridian Medicaid |
$111.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$167.90
|
| Rate for Payer: PACE SWMI |
$159.90
|
| Rate for Payer: PHP Medicare Advantage |
$159.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$319.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$201.82
|
| Rate for Payer: Priority Health Medicare |
$159.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.90
|
| Rate for Payer: UHC Medicare Advantage |
$164.70
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM
|
Professional
|
Both
|
$456.00
|
|
|
Service Code
|
HCPCS 11404
|
| Min. Negotiated Rate |
$105.86 |
| Max. Negotiated Rate |
$319.20 |
| Rate for Payer: Aetna Commercial |
$214.27
|
| Rate for Payer: Aetna Medicare |
$166.30
|
| Rate for Payer: BCBS Complete |
$111.15
|
| Rate for Payer: BCBS MAPPO |
$159.90
|
| Rate for Payer: BCBS Trust/PPO |
$302.17
|
| Rate for Payer: BCN Commercial |
$264.65
|
| Rate for Payer: BCN Medicare Advantage |
$159.90
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cofinity Commercial |
$230.26
|
| Rate for Payer: Cofinity Commercial |
$214.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.90
|
| Rate for Payer: Mclaren Medicaid |
$105.86
|
| Rate for Payer: Meridian Medicaid |
$111.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$167.90
|
| Rate for Payer: PACE SWMI |
$159.90
|
| Rate for Payer: PHP Medicare Advantage |
$159.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$319.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$201.82
|
| Rate for Payer: Priority Health Medicare |
$159.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.90
|
| Rate for Payer: UHC Medicare Advantage |
$164.70
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM
|
Facility
|
IP
|
$456.00
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
11404
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$278.11 |
| Max. Negotiated Rate |
$410.40 |
| Rate for Payer: Aetna Commercial |
$387.60
|
| Rate for Payer: BCBS Trust/PPO |
$352.40
|
| Rate for Payer: BCN Commercial |
$352.40
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cofinity Commercial |
$392.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$364.80
|
| Rate for Payer: Healthscope Commercial |
$410.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$342.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$387.60
|
| Rate for Payer: PHP Commercial |
$387.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$319.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$278.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$401.28
|
| Rate for Payer: UHC Core |
$380.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$342.00
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM
|
Professional
|
Both
|
$644.00
|
|
|
Service Code
|
HCPCS 11406
|
| Hospital Charge Code |
11406
|
| Min. Negotiated Rate |
$159.54 |
| Max. Negotiated Rate |
$450.80 |
| Rate for Payer: Aetna Commercial |
$324.80
|
| Rate for Payer: Aetna Medicare |
$252.09
|
| Rate for Payer: BCBS Complete |
$167.52
|
| Rate for Payer: BCBS MAPPO |
$242.39
|
| Rate for Payer: BCBS Trust/PPO |
$201.42
|
| Rate for Payer: BCN Commercial |
$375.00
|
| Rate for Payer: BCN Medicare Advantage |
$242.39
|
| Rate for Payer: Cash Price |
$515.20
|
| Rate for Payer: Cash Price |
$515.20
|
| Rate for Payer: Cofinity Commercial |
$349.04
|
| Rate for Payer: Cofinity Commercial |
$324.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.39
|
| Rate for Payer: Mclaren Medicaid |
$159.54
|
| Rate for Payer: Meridian Medicaid |
$167.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$254.51
|
| Rate for Payer: PACE SWMI |
$242.39
|
| Rate for Payer: PHP Medicare Advantage |
$242.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$303.76
|
| Rate for Payer: Priority Health Medicare |
$242.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$303.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.39
|
| Rate for Payer: UHC Medicare Advantage |
$249.66
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM
|
Facility
|
OP
|
$644.00
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
11406
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$152.95 |
| Max. Negotiated Rate |
$1,116.73 |
| Rate for Payer: Aetna Commercial |
$547.40
|
| Rate for Payer: Aetna Medicare |
$167.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$201.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$201.25
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$161.00
|
| Rate for Payer: BCBS Trust/PPO |
$500.71
|
| Rate for Payer: BCN Commercial |
$500.71
|
| Rate for Payer: BCN Medicare Advantage |
$161.00
|
| Rate for Payer: Cash Price |
$515.20
|
| Rate for Payer: Cash Price |
$515.20
|
| Rate for Payer: Cofinity Commercial |
$553.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$515.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.00
|
| Rate for Payer: Healthscope Commercial |
$579.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$483.00
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$169.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$185.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$547.40
|
| Rate for Payer: PACE Senior Care Partners |
$152.95
|
| Rate for Payer: PACE SWMI |
$161.00
|
| Rate for Payer: PHP Commercial |
$547.40
|
| Rate for Payer: PHP Medicare Advantage |
$161.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.28
|
| Rate for Payer: Priority Health Medicare |
$161.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$392.78
|
| Rate for Payer: Railroad Medicare Medicare |
$161.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$566.72
|
| Rate for Payer: UHC Core |
$537.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.00
|
| Rate for Payer: UHC Medicare Advantage |
$165.83
|
| Rate for Payer: VA VA |
$161.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$483.00
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM
|
Facility
|
IP
|
$644.00
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
11406
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$392.78 |
| Max. Negotiated Rate |
$579.60 |
| Rate for Payer: Aetna Commercial |
$547.40
|
| Rate for Payer: BCBS Trust/PPO |
$497.68
|
| Rate for Payer: BCN Commercial |
$497.68
|
| Rate for Payer: Cash Price |
$515.20
|
| Rate for Payer: Cofinity Commercial |
$553.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$515.20
|
| Rate for Payer: Healthscope Commercial |
$579.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$483.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$547.40
|
| Rate for Payer: PHP Commercial |
$547.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$392.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$566.72
|
| Rate for Payer: UHC Core |
$537.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$483.00
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM
|
Professional
|
Both
|
$644.00
|
|
|
Service Code
|
HCPCS 11406
|
| Min. Negotiated Rate |
$159.54 |
| Max. Negotiated Rate |
$450.80 |
| Rate for Payer: Aetna Commercial |
$324.80
|
| Rate for Payer: Aetna Medicare |
$252.09
|
| Rate for Payer: BCBS Complete |
$167.52
|
| Rate for Payer: BCBS MAPPO |
$242.39
|
| Rate for Payer: BCBS Trust/PPO |
$201.42
|
| Rate for Payer: BCN Commercial |
$375.00
|
| Rate for Payer: BCN Medicare Advantage |
$242.39
|
| Rate for Payer: Cash Price |
$515.20
|
| Rate for Payer: Cash Price |
$515.20
|
| Rate for Payer: Cofinity Commercial |
$324.80
|
| Rate for Payer: Cofinity Commercial |
$349.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.39
|
| Rate for Payer: Mclaren Medicaid |
$159.54
|
| Rate for Payer: Meridian Medicaid |
$167.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$254.51
|
| Rate for Payer: PACE SWMI |
$242.39
|
| Rate for Payer: PHP Medicare Advantage |
$242.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$303.76
|
| Rate for Payer: Priority Health Medicare |
$242.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$303.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.39
|
| Rate for Payer: UHC Medicare Advantage |
$249.66
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM
|
Professional
|
Both
|
$273.00
|
|
|
Service Code
|
HCPCS 11441
|
| Hospital Charge Code |
11441
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$205.36 |
| Rate for Payer: Aetna Commercial |
$171.84
|
| Rate for Payer: Aetna Medicare |
$133.37
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCBS MAPPO |
$128.24
|
| Rate for Payer: BCBS Trust/PPO |
$185.19
|
| Rate for Payer: BCN Commercial |
$205.36
|
| Rate for Payer: BCN Medicare Advantage |
$128.24
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cofinity Commercial |
$171.84
|
| Rate for Payer: Cofinity Commercial |
$184.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.24
|
| Rate for Payer: Mclaren Medicaid |
$85.84
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$134.65
|
| Rate for Payer: PACE SWMI |
$128.24
|
| Rate for Payer: PHP Medicare Advantage |
$128.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$163.18
|
| Rate for Payer: Priority Health Medicare |
$128.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$163.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.24
|
| Rate for Payer: UHC Medicare Advantage |
$132.09
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM
|
Professional
|
Both
|
$273.00
|
|
|
Service Code
|
HCPCS 11441
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$205.36 |
| Rate for Payer: Aetna Commercial |
$171.84
|
| Rate for Payer: Aetna Medicare |
$133.37
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCBS MAPPO |
$128.24
|
| Rate for Payer: BCBS Trust/PPO |
$185.19
|
| Rate for Payer: BCN Commercial |
$205.36
|
| Rate for Payer: BCN Medicare Advantage |
$128.24
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cofinity Commercial |
$171.84
|
| Rate for Payer: Cofinity Commercial |
$184.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.24
|
| Rate for Payer: Mclaren Medicaid |
$85.84
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$134.65
|
| Rate for Payer: PACE SWMI |
$128.24
|
| Rate for Payer: PHP Medicare Advantage |
$128.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$163.18
|
| Rate for Payer: Priority Health Medicare |
$128.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$163.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.24
|
| Rate for Payer: UHC Medicare Advantage |
$132.09
|
|
