|
PR EXC 1/> SM/LG LESIONS INTESTNE MULT ENTEROTOMIE
|
Professional
|
Both
|
$3,605.00
|
|
|
Service Code
|
HCPCS 44111
|
| Min. Negotiated Rate |
$266.79 |
| Max. Negotiated Rate |
$2,343.25 |
| Rate for Payer: Aetna Commercial |
$1,266.86
|
| Rate for Payer: Aetna Medicare |
$983.24
|
| Rate for Payer: BCBS Complete |
$659.32
|
| Rate for Payer: BCBS MAPPO |
$945.42
|
| Rate for Payer: BCBS Trust/PPO |
$266.79
|
| Rate for Payer: BCN Commercial |
$1,435.25
|
| Rate for Payer: BCN Medicare Advantage |
$945.42
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Cofinity Commercial |
$1,361.40
|
| Rate for Payer: Cofinity Commercial |
$1,266.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$945.42
|
| Rate for Payer: Mclaren Medicaid |
$627.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$992.69
|
| Rate for Payer: Meridian Medicaid |
$659.32
|
| Rate for Payer: Nomi Health Commercial |
$1,134.50
|
| Rate for Payer: PACE SWMI |
$945.42
|
| Rate for Payer: PHP Medicare Advantage |
$945.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$627.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,343.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,748.62
|
| Rate for Payer: Priority Health Medicare |
$954.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,748.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$945.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$945.42
|
| Rate for Payer: UHC Exchange |
$945.42
|
| Rate for Payer: UHC Medicare Advantage |
$945.42
|
| Rate for Payer: UHCCP Medicaid |
$627.92
|
|
|
PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<
|
Facility
|
OP
|
$224.00
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
11440
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$53.20 |
| Max. Negotiated Rate |
$523.36 |
| Rate for Payer: Aetna Commercial |
$190.40
|
| Rate for Payer: Aetna Medicare |
$58.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.00
|
| Rate for Payer: BCBS Complete |
$523.36
|
| Rate for Payer: BCBS MAPPO |
$56.00
|
| Rate for Payer: BCBS Trust/PPO |
$184.15
|
| Rate for Payer: BCN Commercial |
$174.16
|
| Rate for Payer: BCN Medicare Advantage |
$56.00
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$192.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.00
|
| Rate for Payer: Healthscope Commercial |
$201.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.00
|
| Rate for Payer: Mclaren Medicaid |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.80
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.40
|
| Rate for Payer: Nomi Health Commercial |
$183.68
|
| Rate for Payer: PACE Senior Care Partners |
$53.20
|
| Rate for Payer: PACE SWMI |
$56.00
|
| Rate for Payer: PHP Commercial |
$190.40
|
| Rate for Payer: PHP Medicare Advantage |
$56.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.60
|
| Rate for Payer: Priority Health HMO/PPO |
$194.88
|
| Rate for Payer: Priority Health Medicare |
$56.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.08
|
| Rate for Payer: Railroad Medicare Medicare |
$56.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.12
|
| Rate for Payer: UHC Core |
$187.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.00
|
| Rate for Payer: UHC Exchange |
$56.00
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: UHCCP Medicaid |
$498.41
|
| Rate for Payer: VA VA |
$56.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.00
|
|
|
PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<
|
Facility
|
IP
|
$224.00
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
11440
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$145.60 |
| Max. Negotiated Rate |
$201.60 |
| Rate for Payer: Aetna Commercial |
$190.40
|
| Rate for Payer: BCBS Trust/PPO |
$182.85
|
| Rate for Payer: BCN Commercial |
$173.11
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$192.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.20
|
| Rate for Payer: Healthscope Commercial |
$201.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.40
|
| Rate for Payer: Nomi Health Commercial |
$183.68
|
| Rate for Payer: PHP Commercial |
$190.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.60
|
| Rate for Payer: Priority Health HMO/PPO |
$194.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.12
|
| Rate for Payer: UHC Core |
$187.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.00
|
|
|
PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 11440
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$169.24 |
| Rate for Payer: Aetna Commercial |
$134.13
|
| Rate for Payer: Aetna Medicare |
$104.10
|
| Rate for Payer: BCBS Complete |
$72.91
|
| Rate for Payer: BCBS MAPPO |
$100.10
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$169.24
|
| Rate for Payer: BCN Medicare Advantage |
$100.10
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$144.14
|
| Rate for Payer: Cofinity Commercial |
$134.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.10
|
| Rate for Payer: Mclaren Medicaid |
$69.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.10
|
| Rate for Payer: Meridian Medicaid |
$72.91
|
| Rate for Payer: Nomi Health Commercial |
$120.12
|
| Rate for Payer: PACE SWMI |
$100.10
|
| Rate for Payer: PHP Medicare Advantage |
$100.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.60
|
| Rate for Payer: Priority Health HMO/PPO |
$146.29
|
| Rate for Payer: Priority Health Medicare |
$101.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.10
|
| Rate for Payer: UHC Exchange |
$100.10
|
| Rate for Payer: UHC Medicare Advantage |
$100.10
|
| Rate for Payer: UHCCP Medicaid |
$69.44
|
|
|
PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 11440
|
| Hospital Charge Code |
11440
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$169.24 |
| Rate for Payer: Aetna Commercial |
$134.13
|
| Rate for Payer: Aetna Medicare |
$104.10
|
| Rate for Payer: BCBS Complete |
$72.91
|
| Rate for Payer: BCBS MAPPO |
$100.10
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$169.24
|
| Rate for Payer: BCN Medicare Advantage |
$100.10
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$144.14
|
| Rate for Payer: Cofinity Commercial |
$134.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.10
|
| Rate for Payer: Mclaren Medicaid |
$69.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.10
|
| Rate for Payer: Meridian Medicaid |
$72.91
|
| Rate for Payer: Nomi Health Commercial |
$120.12
|
| Rate for Payer: PACE SWMI |
$100.10
|
| Rate for Payer: PHP Medicare Advantage |
$100.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.60
|
| Rate for Payer: Priority Health HMO/PPO |
$146.29
|
| Rate for Payer: Priority Health Medicare |
$101.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.10
|
| Rate for Payer: UHC Exchange |
$100.10
|
| Rate for Payer: UHC Medicare Advantage |
$100.10
|
| Rate for Payer: UHCCP Medicaid |
$69.44
|
|
|
PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M > 4.0CM
|
Professional
|
Both
|
$826.00
|
|
|
Service Code
|
HCPCS 11446
|
| Min. Negotiated Rate |
$150.00 |
| Max. Negotiated Rate |
$536.90 |
| Rate for Payer: Aetna Commercial |
$407.40
|
| Rate for Payer: Aetna Medicare |
$316.19
|
| Rate for Payer: BCBS Complete |
$215.83
|
| Rate for Payer: BCBS MAPPO |
$304.03
|
| Rate for Payer: BCBS Trust/PPO |
$150.00
|
| Rate for Payer: BCN Commercial |
$449.99
|
| Rate for Payer: BCN Medicare Advantage |
$304.03
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cofinity Commercial |
$437.80
|
| Rate for Payer: Cofinity Commercial |
$407.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.03
|
| Rate for Payer: Mclaren Medicaid |
$205.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$319.23
|
| Rate for Payer: Meridian Medicaid |
$215.83
|
| Rate for Payer: Nomi Health Commercial |
$364.84
|
| Rate for Payer: PACE SWMI |
$304.03
|
| Rate for Payer: PHP Medicare Advantage |
$304.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.90
|
| Rate for Payer: Priority Health HMO/PPO |
$430.30
|
| Rate for Payer: Priority Health Medicare |
$307.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$430.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$304.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$304.03
|
| Rate for Payer: UHC Exchange |
$304.03
|
| Rate for Payer: UHC Medicare Advantage |
$304.03
|
| Rate for Payer: UHCCP Medicaid |
$205.55
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
HCPCS 11420
|
| Min. Negotiated Rate |
$53.46 |
| Max. Negotiated Rate |
$150.39 |
| Rate for Payer: Aetna Commercial |
$104.45
|
| Rate for Payer: Aetna Medicare |
$81.07
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$77.95
|
| Rate for Payer: BCBS Trust/PPO |
$100.72
|
| Rate for Payer: BCN Commercial |
$150.39
|
| Rate for Payer: BCN Medicare Advantage |
$77.95
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cofinity Commercial |
$112.25
|
| Rate for Payer: Cofinity Commercial |
$104.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.95
|
| Rate for Payer: Mclaren Medicaid |
$53.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.85
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Nomi Health Commercial |
$93.54
|
| Rate for Payer: PACE SWMI |
$77.95
|
| Rate for Payer: PHP Medicare Advantage |
$77.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.95
|
| Rate for Payer: Priority Health HMO/PPO |
$111.97
|
| Rate for Payer: Priority Health Medicare |
$78.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.95
|
| Rate for Payer: UHC Exchange |
$77.95
|
| Rate for Payer: UHC Medicare Advantage |
$77.95
|
| Rate for Payer: UHCCP Medicaid |
$53.46
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 11421
|
| Hospital Charge Code |
11421
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$338.18 |
| Rate for Payer: Aetna Commercial |
$138.19
|
| Rate for Payer: Aetna Medicare |
$107.26
|
| Rate for Payer: BCBS Complete |
$74.02
|
| Rate for Payer: BCBS MAPPO |
$103.13
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$188.87
|
| Rate for Payer: BCN Medicare Advantage |
$103.13
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$148.51
|
| Rate for Payer: Cofinity Commercial |
$138.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.13
|
| Rate for Payer: Mclaren Medicaid |
$70.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.29
|
| Rate for Payer: Meridian Medicaid |
$74.02
|
| Rate for Payer: Nomi Health Commercial |
$123.76
|
| Rate for Payer: PACE SWMI |
$103.13
|
| Rate for Payer: PHP Medicare Advantage |
$103.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
| Rate for Payer: Priority Health HMO/PPO |
$148.55
|
| Rate for Payer: Priority Health Medicare |
$104.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.13
|
| Rate for Payer: UHC Exchange |
$103.13
|
| Rate for Payer: UHC Medicare Advantage |
$103.13
|
| Rate for Payer: UHCCP Medicaid |
$70.50
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
11421
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$61.99 |
| Max. Negotiated Rate |
$523.36 |
| Rate for Payer: Aetna Commercial |
$221.85
|
| Rate for Payer: Aetna Medicare |
$67.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.56
|
| Rate for Payer: BCBS Complete |
$523.36
|
| Rate for Payer: BCBS MAPPO |
$65.25
|
| Rate for Payer: BCBS Trust/PPO |
$214.57
|
| Rate for Payer: BCN Commercial |
$202.93
|
| Rate for Payer: BCN Medicare Advantage |
$65.25
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$224.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.25
|
| Rate for Payer: Healthscope Commercial |
$234.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.75
|
| Rate for Payer: Mclaren Medicaid |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.51
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.85
|
| Rate for Payer: Nomi Health Commercial |
$214.02
|
| Rate for Payer: PACE Senior Care Partners |
$61.99
|
| Rate for Payer: PACE SWMI |
$65.25
|
| Rate for Payer: PHP Commercial |
$221.85
|
| Rate for Payer: PHP Medicare Advantage |
$65.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
| Rate for Payer: Priority Health HMO/PPO |
$227.07
|
| Rate for Payer: Priority Health Medicare |
$65.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.87
|
| Rate for Payer: Railroad Medicare Medicare |
$65.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.68
|
| Rate for Payer: UHC Core |
$217.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.25
|
| Rate for Payer: UHC Exchange |
$65.25
|
| Rate for Payer: UHC Medicare Advantage |
$65.25
|
| Rate for Payer: UHCCP Medicaid |
$498.41
|
| Rate for Payer: VA VA |
$65.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.75
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
11421
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$169.65 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna Commercial |
$221.85
|
| Rate for Payer: BCBS Trust/PPO |
$213.05
|
| Rate for Payer: BCN Commercial |
$201.70
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$224.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.80
|
| Rate for Payer: Healthscope Commercial |
$234.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.85
|
| Rate for Payer: Nomi Health Commercial |
$214.02
|
| Rate for Payer: PHP Commercial |
$221.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
| Rate for Payer: Priority Health HMO/PPO |
$227.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.68
|
| Rate for Payer: UHC Core |
$217.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.75
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 11421
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$338.18 |
| Rate for Payer: Aetna Commercial |
$138.19
|
| Rate for Payer: Aetna Medicare |
$107.26
|
| Rate for Payer: BCBS Complete |
$74.02
|
| Rate for Payer: BCBS MAPPO |
$103.13
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$188.87
|
| Rate for Payer: BCN Medicare Advantage |
$103.13
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$148.51
|
| Rate for Payer: Cofinity Commercial |
$138.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.13
|
| Rate for Payer: Mclaren Medicaid |
$70.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.29
|
| Rate for Payer: Meridian Medicaid |
$74.02
|
| Rate for Payer: Nomi Health Commercial |
$123.76
|
| Rate for Payer: PACE SWMI |
$103.13
|
| Rate for Payer: PHP Medicare Advantage |
$103.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
| Rate for Payer: Priority Health HMO/PPO |
$148.55
|
| Rate for Payer: Priority Health Medicare |
$104.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.13
|
| Rate for Payer: UHC Exchange |
$103.13
|
| Rate for Payer: UHC Medicare Advantage |
$103.13
|
| Rate for Payer: UHCCP Medicaid |
$70.50
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM
|
Facility
|
IP
|
$291.00
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
11422
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$189.15 |
| Max. Negotiated Rate |
$261.90 |
| Rate for Payer: Aetna Commercial |
$247.35
|
| Rate for Payer: BCBS Trust/PPO |
$237.54
|
| Rate for Payer: BCN Commercial |
$224.88
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$250.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.80
|
| Rate for Payer: Healthscope Commercial |
$261.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.35
|
| Rate for Payer: Nomi Health Commercial |
$238.62
|
| Rate for Payer: PHP Commercial |
$247.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.15
|
| Rate for Payer: Priority Health HMO/PPO |
$253.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$194.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.08
|
| Rate for Payer: UHC Core |
$242.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.25
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 11422
|
| Hospital Charge Code |
11422
|
| Min. Negotiated Rate |
$32.57 |
| Max. Negotiated Rate |
$211.65 |
| Rate for Payer: Aetna Commercial |
$172.74
|
| Rate for Payer: Aetna Medicare |
$134.07
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS MAPPO |
$128.91
|
| Rate for Payer: BCBS Trust/PPO |
$32.57
|
| Rate for Payer: BCN Commercial |
$211.65
|
| Rate for Payer: BCN Medicare Advantage |
$128.91
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$185.63
|
| Rate for Payer: Cofinity Commercial |
$172.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.91
|
| Rate for Payer: Mclaren Medicaid |
$88.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.36
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Nomi Health Commercial |
$154.69
|
| Rate for Payer: PACE SWMI |
$128.91
|
| Rate for Payer: PHP Medicare Advantage |
$128.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.15
|
| Rate for Payer: Priority Health HMO/PPO |
$185.12
|
| Rate for Payer: Priority Health Medicare |
$130.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.91
|
| Rate for Payer: UHC Exchange |
$128.91
|
| Rate for Payer: UHC Medicare Advantage |
$128.91
|
| Rate for Payer: UHCCP Medicaid |
$88.40
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 11422
|
| Min. Negotiated Rate |
$32.57 |
| Max. Negotiated Rate |
$211.65 |
| Rate for Payer: Aetna Commercial |
$172.74
|
| Rate for Payer: Aetna Medicare |
$134.07
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS MAPPO |
$128.91
|
| Rate for Payer: BCBS Trust/PPO |
$32.57
|
| Rate for Payer: BCN Commercial |
$211.65
|
| Rate for Payer: BCN Medicare Advantage |
$128.91
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$185.63
|
| Rate for Payer: Cofinity Commercial |
$172.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.91
|
| Rate for Payer: Mclaren Medicaid |
$88.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.36
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Nomi Health Commercial |
$154.69
|
| Rate for Payer: PACE SWMI |
$128.91
|
| Rate for Payer: PHP Medicare Advantage |
$128.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.15
|
| Rate for Payer: Priority Health HMO/PPO |
$185.12
|
| Rate for Payer: Priority Health Medicare |
$130.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.91
|
| Rate for Payer: UHC Exchange |
$128.91
|
| Rate for Payer: UHC Medicare Advantage |
$128.91
|
| Rate for Payer: UHCCP Medicaid |
$88.40
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM
|
Facility
|
OP
|
$291.00
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
11422
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$69.11 |
| Max. Negotiated Rate |
$1,205.21 |
| Rate for Payer: Aetna Commercial |
$247.35
|
| Rate for Payer: Aetna Medicare |
$75.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$90.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$90.94
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$72.75
|
| Rate for Payer: BCBS Trust/PPO |
$239.23
|
| Rate for Payer: BCN Commercial |
$226.25
|
| Rate for Payer: BCN Medicare Advantage |
$72.75
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$250.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.75
|
| Rate for Payer: Healthscope Commercial |
$261.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.25
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.39
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.35
|
| Rate for Payer: Nomi Health Commercial |
$238.62
|
| Rate for Payer: PACE Senior Care Partners |
$69.11
|
| Rate for Payer: PACE SWMI |
$72.75
|
| Rate for Payer: PHP Commercial |
$247.35
|
| Rate for Payer: PHP Medicare Advantage |
$72.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.15
|
| Rate for Payer: Priority Health HMO/PPO |
$253.17
|
| Rate for Payer: Priority Health Medicare |
$73.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$194.97
|
| Rate for Payer: Railroad Medicare Medicare |
$72.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.08
|
| Rate for Payer: UHC Core |
$242.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.75
|
| Rate for Payer: UHC Exchange |
$72.75
|
| Rate for Payer: UHC Medicare Advantage |
$72.75
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$72.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.25
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Professional
|
Both
|
$401.00
|
|
|
Service Code
|
HCPCS 11423
|
| Hospital Charge Code |
11423
|
| Min. Negotiated Rate |
$102.45 |
| Max. Negotiated Rate |
$338.18 |
| Rate for Payer: Aetna Commercial |
$201.05
|
| Rate for Payer: Aetna Medicare |
$156.04
|
| Rate for Payer: BCBS Complete |
$107.57
|
| Rate for Payer: BCBS MAPPO |
$150.04
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$241.09
|
| Rate for Payer: BCN Medicare Advantage |
$150.04
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cofinity Commercial |
$216.06
|
| Rate for Payer: Cofinity Commercial |
$201.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.04
|
| Rate for Payer: Mclaren Medicaid |
$102.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.54
|
| Rate for Payer: Meridian Medicaid |
$107.57
|
| Rate for Payer: Nomi Health Commercial |
$180.05
|
| Rate for Payer: PACE SWMI |
$150.04
|
| Rate for Payer: PHP Medicare Advantage |
$150.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.65
|
| Rate for Payer: Priority Health HMO/PPO |
$214.02
|
| Rate for Payer: Priority Health Medicare |
$151.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.04
|
| Rate for Payer: UHC Exchange |
$150.04
|
| Rate for Payer: UHC Medicare Advantage |
$150.04
|
| Rate for Payer: UHCCP Medicaid |
$102.45
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Professional
|
Both
|
$401.00
|
|
|
Service Code
|
HCPCS 11423
|
| Min. Negotiated Rate |
$102.45 |
| Max. Negotiated Rate |
$338.18 |
| Rate for Payer: Aetna Commercial |
$201.05
|
| Rate for Payer: Aetna Medicare |
$156.04
|
| Rate for Payer: BCBS Complete |
$107.57
|
| Rate for Payer: BCBS MAPPO |
$150.04
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$241.09
|
| Rate for Payer: BCN Medicare Advantage |
$150.04
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cofinity Commercial |
$216.06
|
| Rate for Payer: Cofinity Commercial |
$201.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.04
|
| Rate for Payer: Mclaren Medicaid |
$102.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.54
|
| Rate for Payer: Meridian Medicaid |
$107.57
|
| Rate for Payer: Nomi Health Commercial |
$180.05
|
| Rate for Payer: PACE SWMI |
$150.04
|
| Rate for Payer: PHP Medicare Advantage |
$150.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.65
|
| Rate for Payer: Priority Health HMO/PPO |
$214.02
|
| Rate for Payer: Priority Health Medicare |
$151.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.04
|
| Rate for Payer: UHC Exchange |
$150.04
|
| Rate for Payer: UHC Medicare Advantage |
$150.04
|
| Rate for Payer: UHCCP Medicaid |
$102.45
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Facility
|
OP
|
$401.00
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
11423
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$95.24 |
| Max. Negotiated Rate |
$1,205.21 |
| Rate for Payer: Aetna Commercial |
$340.85
|
| Rate for Payer: Aetna Medicare |
$104.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$125.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$125.31
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$100.25
|
| Rate for Payer: BCBS Trust/PPO |
$329.66
|
| Rate for Payer: BCN Commercial |
$311.78
|
| Rate for Payer: BCN Medicare Advantage |
$100.25
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cofinity Commercial |
$344.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.25
|
| Rate for Payer: Healthscope Commercial |
$360.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.75
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.26
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$115.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.85
|
| Rate for Payer: Nomi Health Commercial |
$328.82
|
| Rate for Payer: PACE Senior Care Partners |
$95.24
|
| Rate for Payer: PACE SWMI |
$100.25
|
| Rate for Payer: PHP Commercial |
$340.85
|
| Rate for Payer: PHP Medicare Advantage |
$100.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.65
|
| Rate for Payer: Priority Health HMO/PPO |
$348.87
|
| Rate for Payer: Priority Health Medicare |
$101.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.67
|
| Rate for Payer: Railroad Medicare Medicare |
$100.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.88
|
| Rate for Payer: UHC Core |
$334.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.25
|
| Rate for Payer: UHC Exchange |
$100.25
|
| Rate for Payer: UHC Medicare Advantage |
$100.25
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$100.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.75
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Facility
|
IP
|
$401.00
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
11423
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$260.65 |
| Max. Negotiated Rate |
$360.90 |
| Rate for Payer: Aetna Commercial |
$340.85
|
| Rate for Payer: BCBS Trust/PPO |
$327.34
|
| Rate for Payer: BCN Commercial |
$309.89
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cofinity Commercial |
$344.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.80
|
| Rate for Payer: Healthscope Commercial |
$360.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.85
|
| Rate for Payer: Nomi Health Commercial |
$328.82
|
| Rate for Payer: PHP Commercial |
$340.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.65
|
| Rate for Payer: Priority Health HMO/PPO |
$348.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.88
|
| Rate for Payer: UHC Core |
$334.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.75
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Facility
|
IP
|
$513.00
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
11424
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$333.45 |
| Max. Negotiated Rate |
$461.70 |
| Rate for Payer: Aetna Commercial |
$436.05
|
| Rate for Payer: BCBS Trust/PPO |
$418.76
|
| Rate for Payer: BCN Commercial |
$396.45
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cofinity Commercial |
$441.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$410.40
|
| Rate for Payer: Healthscope Commercial |
$461.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$384.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$436.05
|
| Rate for Payer: Nomi Health Commercial |
$420.66
|
| Rate for Payer: PHP Commercial |
$436.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.45
|
| Rate for Payer: Priority Health HMO/PPO |
$446.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$343.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$451.44
|
| Rate for Payer: UHC Core |
$428.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$384.75
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Facility
|
OP
|
$513.00
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
11424
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$121.84 |
| Max. Negotiated Rate |
$1,205.21 |
| Rate for Payer: Aetna Commercial |
$436.05
|
| Rate for Payer: Aetna Medicare |
$133.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.31
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$128.25
|
| Rate for Payer: BCBS Trust/PPO |
$421.74
|
| Rate for Payer: BCN Commercial |
$398.86
|
| Rate for Payer: BCN Medicare Advantage |
$128.25
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cofinity Commercial |
$441.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$410.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.25
|
| Rate for Payer: Healthscope Commercial |
$461.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$384.75
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.66
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$436.05
|
| Rate for Payer: Nomi Health Commercial |
$420.66
|
| Rate for Payer: PACE Senior Care Partners |
$121.84
|
| Rate for Payer: PACE SWMI |
$128.25
|
| Rate for Payer: PHP Commercial |
$436.05
|
| Rate for Payer: PHP Medicare Advantage |
$128.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.45
|
| Rate for Payer: Priority Health HMO/PPO |
$446.31
|
| Rate for Payer: Priority Health Medicare |
$129.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$343.71
|
| Rate for Payer: Railroad Medicare Medicare |
$128.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$451.44
|
| Rate for Payer: UHC Core |
$428.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.25
|
| Rate for Payer: UHC Exchange |
$128.25
|
| Rate for Payer: UHC Medicare Advantage |
$128.25
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$128.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$384.75
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Professional
|
Both
|
$513.00
|
|
|
Service Code
|
HCPCS 11424
|
| Hospital Charge Code |
11424
|
| Min. Negotiated Rate |
$117.79 |
| Max. Negotiated Rate |
$2,640.00 |
| Rate for Payer: Aetna Commercial |
$232.36
|
| Rate for Payer: Aetna Medicare |
$180.34
|
| Rate for Payer: BCBS Complete |
$123.68
|
| Rate for Payer: BCBS MAPPO |
$173.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,640.00
|
| Rate for Payer: BCN Commercial |
$277.61
|
| Rate for Payer: BCN Medicare Advantage |
$173.40
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cofinity Commercial |
$249.70
|
| Rate for Payer: Cofinity Commercial |
$232.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.40
|
| Rate for Payer: Mclaren Medicaid |
$117.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.07
|
| Rate for Payer: Meridian Medicaid |
$123.68
|
| Rate for Payer: Nomi Health Commercial |
$208.08
|
| Rate for Payer: PACE SWMI |
$173.40
|
| Rate for Payer: PHP Medicare Advantage |
$173.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.45
|
| Rate for Payer: Priority Health HMO/PPO |
$246.53
|
| Rate for Payer: Priority Health Medicare |
$175.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.40
|
| Rate for Payer: UHC Exchange |
$173.40
|
| Rate for Payer: UHC Medicare Advantage |
$173.40
|
| Rate for Payer: UHCCP Medicaid |
$117.79
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Professional
|
Both
|
$513.00
|
|
|
Service Code
|
HCPCS 11424
|
| Min. Negotiated Rate |
$117.79 |
| Max. Negotiated Rate |
$2,640.00 |
| Rate for Payer: Aetna Commercial |
$232.36
|
| Rate for Payer: Aetna Medicare |
$180.34
|
| Rate for Payer: BCBS Complete |
$123.68
|
| Rate for Payer: BCBS MAPPO |
$173.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,640.00
|
| Rate for Payer: BCN Commercial |
$277.61
|
| Rate for Payer: BCN Medicare Advantage |
$173.40
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cofinity Commercial |
$249.70
|
| Rate for Payer: Cofinity Commercial |
$232.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.40
|
| Rate for Payer: Mclaren Medicaid |
$117.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.07
|
| Rate for Payer: Meridian Medicaid |
$123.68
|
| Rate for Payer: Nomi Health Commercial |
$208.08
|
| Rate for Payer: PACE SWMI |
$173.40
|
| Rate for Payer: PHP Medicare Advantage |
$173.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.45
|
| Rate for Payer: Priority Health HMO/PPO |
$246.53
|
| Rate for Payer: Priority Health Medicare |
$175.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.40
|
| Rate for Payer: UHC Exchange |
$173.40
|
| Rate for Payer: UHC Medicare Advantage |
$173.40
|
| Rate for Payer: UHCCP Medicaid |
$117.79
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM
|
Professional
|
Both
|
$706.00
|
|
|
Service Code
|
HCPCS 11426
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$458.90 |
| Rate for Payer: Aetna Commercial |
$345.65
|
| Rate for Payer: Aetna Medicare |
$268.27
|
| Rate for Payer: BCBS Complete |
$182.72
|
| Rate for Payer: BCBS MAPPO |
$257.95
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$388.74
|
| Rate for Payer: BCN Medicare Advantage |
$257.95
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cofinity Commercial |
$371.45
|
| Rate for Payer: Cofinity Commercial |
$345.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.95
|
| Rate for Payer: Mclaren Medicaid |
$174.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.85
|
| Rate for Payer: Meridian Medicaid |
$182.72
|
| Rate for Payer: Nomi Health Commercial |
$309.54
|
| Rate for Payer: PACE SWMI |
$257.95
|
| Rate for Payer: PHP Medicare Advantage |
$257.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.90
|
| Rate for Payer: Priority Health HMO/PPO |
$363.93
|
| Rate for Payer: Priority Health Medicare |
$260.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$363.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.95
|
| Rate for Payer: UHC Exchange |
$257.95
|
| Rate for Payer: UHC Medicare Advantage |
$257.95
|
| Rate for Payer: UHCCP Medicaid |
$174.02
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM
|
Facility
|
IP
|
$706.00
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
11426
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$458.90 |
| Max. Negotiated Rate |
$635.40 |
| Rate for Payer: Aetna Commercial |
$600.10
|
| Rate for Payer: BCBS Trust/PPO |
$576.31
|
| Rate for Payer: BCN Commercial |
$545.60
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cofinity Commercial |
$607.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.80
|
| Rate for Payer: Healthscope Commercial |
$635.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$600.10
|
| Rate for Payer: Nomi Health Commercial |
$578.92
|
| Rate for Payer: PHP Commercial |
$600.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.90
|
| Rate for Payer: Priority Health HMO/PPO |
$614.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$473.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$621.28
|
| Rate for Payer: UHC Core |
$589.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.50
|
|
