|
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 |
$103.13 |
| Max. Negotiated Rate |
$169.65 |
| Rate for Payer: Aetna Commercial |
$138.19
|
| Rate for Payer: Aetna Medicare |
$107.26
|
| Rate for Payer: BCBS Complete |
$104.40
|
| Rate for Payer: BCBS MAPPO |
$103.13
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.29
|
| 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 Cigna Priority Health |
$169.65
|
| Rate for Payer: Priority Health Medicare |
$104.16
|
| 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
|
|
|
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 |
$103.13 |
| Max. Negotiated Rate |
$169.65 |
| Rate for Payer: Aetna Commercial |
$138.19
|
| Rate for Payer: Aetna Medicare |
$107.26
|
| Rate for Payer: BCBS Complete |
$104.40
|
| Rate for Payer: BCBS MAPPO |
$103.13
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.29
|
| 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 Cigna Priority Health |
$169.65
|
| Rate for Payer: Priority Health Medicare |
$104.16
|
| 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
|
|
|
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 |
$116.40 |
| Max. Negotiated Rate |
$189.15 |
| Rate for Payer: Aetna Commercial |
$172.74
|
| Rate for Payer: Aetna Medicare |
$134.07
|
| Rate for Payer: BCBS Complete |
$116.40
|
| Rate for Payer: BCBS MAPPO |
$128.91
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.36
|
| 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 Cigna Priority Health |
$189.15
|
| Rate for Payer: Priority Health Medicare |
$130.20
|
| 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
|
|
|
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 |
$116.40 |
| Max. Negotiated Rate |
$189.15 |
| Rate for Payer: Aetna Commercial |
$172.74
|
| Rate for Payer: Aetna Medicare |
$134.07
|
| Rate for Payer: BCBS Complete |
$116.40
|
| Rate for Payer: BCBS MAPPO |
$128.91
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.36
|
| 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 Cigna Priority Health |
$189.15
|
| Rate for Payer: Priority Health Medicare |
$130.20
|
| 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
|
|
|
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 |
$1,230.09 |
| 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 |
$1,230.09
|
| 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 |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.39
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| 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 |
$1,171.43
|
| 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 |
$242.99
|
| 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 |
$1,171.43
|
| 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 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 |
$242.99
|
| 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
|
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 |
$334.83
|
| 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
|
Professional
|
Both
|
$401.00
|
|
|
Service Code
|
HCPCS 11423
|
| Min. Negotiated Rate |
$150.04 |
| Max. Negotiated Rate |
$260.65 |
| Rate for Payer: Aetna Commercial |
$201.05
|
| Rate for Payer: Aetna Medicare |
$156.04
|
| Rate for Payer: BCBS Complete |
$160.40
|
| Rate for Payer: BCBS MAPPO |
$150.04
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.54
|
| 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 Cigna Priority Health |
$260.65
|
| Rate for Payer: Priority Health Medicare |
$151.54
|
| 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
|
|
|
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 |
$1,230.09 |
| 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 |
$1,230.09
|
| 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 |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.26
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| 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 |
$1,171.43
|
| 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 |
$334.83
|
| 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 |
$1,171.43
|
| 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
|
Professional
|
Both
|
$401.00
|
|
|
Service Code
|
HCPCS 11423
|
| Hospital Charge Code |
11423
|
| Min. Negotiated Rate |
$150.04 |
| Max. Negotiated Rate |
$260.65 |
| Rate for Payer: Aetna Commercial |
$201.05
|
| Rate for Payer: Aetna Medicare |
$156.04
|
| Rate for Payer: BCBS Complete |
$160.40
|
| Rate for Payer: BCBS MAPPO |
$150.04
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.54
|
| 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 Cigna Priority Health |
$260.65
|
| Rate for Payer: Priority Health Medicare |
$151.54
|
| 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
|
|
|
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 |
$173.40 |
| Max. Negotiated Rate |
$333.45 |
| Rate for Payer: Aetna Commercial |
$232.36
|
| Rate for Payer: Aetna Medicare |
$180.34
|
| Rate for Payer: BCBS Complete |
$205.20
|
| Rate for Payer: BCBS MAPPO |
$173.40
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.07
|
| 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 Cigna Priority Health |
$333.45
|
| Rate for Payer: Priority Health Medicare |
$175.13
|
| 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
|
|
|
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
|
Professional
|
Both
|
$513.00
|
|
|
Service Code
|
HCPCS 11424
|
| Hospital Charge Code |
11424
|
| Min. Negotiated Rate |
$173.40 |
| Max. Negotiated Rate |
$333.45 |
| Rate for Payer: Aetna Commercial |
$232.36
|
| Rate for Payer: Aetna Medicare |
$180.34
|
| Rate for Payer: BCBS Complete |
$205.20
|
| Rate for Payer: BCBS MAPPO |
$173.40
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.07
|
| 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 Cigna Priority Health |
$333.45
|
| Rate for Payer: Priority Health Medicare |
$175.13
|
| 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
|
|
|
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 |
$1,230.09 |
| 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 |
$1,230.09
|
| 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 |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.66
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| 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 |
$1,171.43
|
| 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 |
$1,171.43
|
| 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 > 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
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM
|
Professional
|
Both
|
$706.00
|
|
|
Service Code
|
HCPCS 11426
|
| Hospital Charge Code |
11426
|
| Min. Negotiated Rate |
$257.95 |
| Max. Negotiated Rate |
$458.90 |
| Rate for Payer: Aetna Commercial |
$345.65
|
| Rate for Payer: Aetna Medicare |
$268.27
|
| Rate for Payer: BCBS Complete |
$282.40
|
| Rate for Payer: BCBS MAPPO |
$257.95
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.85
|
| 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 Cigna Priority Health |
$458.90
|
| Rate for Payer: Priority Health Medicare |
$260.53
|
| 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
|
|
|
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 |
$257.95 |
| Max. Negotiated Rate |
$458.90 |
| Rate for Payer: Aetna Commercial |
$345.65
|
| Rate for Payer: Aetna Medicare |
$268.27
|
| Rate for Payer: BCBS Complete |
$282.40
|
| Rate for Payer: BCBS MAPPO |
$257.95
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.85
|
| 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 Cigna Priority Health |
$458.90
|
| Rate for Payer: Priority Health Medicare |
$260.53
|
| 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
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM
|
Facility
|
OP
|
$706.00
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
11426
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$167.68 |
| Max. Negotiated Rate |
$2,172.87 |
| Rate for Payer: Aetna Commercial |
$600.10
|
| Rate for Payer: Aetna Medicare |
$183.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.62
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$176.50
|
| Rate for Payer: BCBS Trust/PPO |
$580.40
|
| Rate for Payer: BCN Commercial |
$548.91
|
| Rate for Payer: BCN Medicare Advantage |
$176.50
|
| Rate for Payer: Cash Price |
$564.80
|
| 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: Health Alliance Plan Medicare Advantage |
$176.50
|
| Rate for Payer: Healthscope Commercial |
$635.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.50
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.32
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$600.10
|
| Rate for Payer: Nomi Health Commercial |
$578.92
|
| Rate for Payer: PACE Senior Care Partners |
$167.68
|
| Rate for Payer: PACE SWMI |
$176.50
|
| Rate for Payer: PHP Commercial |
$600.10
|
| Rate for Payer: PHP Medicare Advantage |
$176.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.90
|
| Rate for Payer: Priority Health HMO/PPO |
$614.22
|
| Rate for Payer: Priority Health Medicare |
$178.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$473.02
|
| Rate for Payer: Railroad Medicare Medicare |
$176.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$621.28
|
| Rate for Payer: UHC Core |
$589.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.50
|
| Rate for Payer: UHC Exchange |
$176.50
|
| Rate for Payer: UHC Medicare Advantage |
$176.50
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$176.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.50
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 11400
|
| Min. Negotiated Rate |
$79.42 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Aetna Commercial |
$106.42
|
| Rate for Payer: Aetna Medicare |
$82.60
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCBS MAPPO |
$79.42
|
| Rate for Payer: BCN Medicare Advantage |
$79.42
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$114.36
|
| Rate for Payer: Cofinity Commercial |
$106.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.39
|
| Rate for Payer: Nomi Health Commercial |
$95.30
|
| Rate for Payer: PACE SWMI |
$79.42
|
| Rate for Payer: PHP Medicare Advantage |
$79.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health Medicare |
$80.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.42
|
| Rate for Payer: UHC Exchange |
$79.42
|
| Rate for Payer: UHC Medicare Advantage |
$79.42
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 11400
|
| Hospital Charge Code |
11400
|
| Min. Negotiated Rate |
$79.42 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Aetna Commercial |
$106.42
|
| Rate for Payer: Aetna Medicare |
$82.60
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCBS MAPPO |
$79.42
|
| Rate for Payer: BCN Medicare Advantage |
$79.42
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$114.36
|
| Rate for Payer: Cofinity Commercial |
$106.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.39
|
| Rate for Payer: Nomi Health Commercial |
$95.30
|
| Rate for Payer: PACE SWMI |
$79.42
|
| Rate for Payer: PHP Medicare Advantage |
$79.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health Medicare |
$80.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.42
|
| Rate for Payer: UHC Exchange |
$79.42
|
| Rate for Payer: UHC Medicare Advantage |
$79.42
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Facility
|
IP
|
$204.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
11400
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$132.60 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Aetna Commercial |
$173.40
|
| Rate for Payer: BCBS Trust/PPO |
$166.53
|
| Rate for Payer: BCN Commercial |
$157.65
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$175.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Healthscope Commercial |
$183.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.40
|
| Rate for Payer: Nomi Health Commercial |
$167.28
|
| Rate for Payer: PHP Commercial |
$173.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO |
$177.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.52
|
| Rate for Payer: UHC Core |
$170.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.00
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Facility
|
OP
|
$204.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
11400
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$48.45 |
| Max. Negotiated Rate |
$534.17 |
| Rate for Payer: Aetna Commercial |
$173.40
|
| Rate for Payer: Aetna Medicare |
$53.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.75
|
| Rate for Payer: BCBS Complete |
$534.17
|
| Rate for Payer: BCBS MAPPO |
$51.00
|
| Rate for Payer: BCBS Trust/PPO |
$167.71
|
| Rate for Payer: BCN Commercial |
$158.61
|
| Rate for Payer: BCN Medicare Advantage |
$51.00
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$175.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.00
|
| Rate for Payer: Healthscope Commercial |
$183.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.00
|
| Rate for Payer: Mclaren Medicaid |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.55
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.40
|
| Rate for Payer: Nomi Health Commercial |
$167.28
|
| Rate for Payer: PACE Senior Care Partners |
$48.45
|
| Rate for Payer: PACE SWMI |
$51.00
|
| Rate for Payer: PHP Commercial |
$173.40
|
| Rate for Payer: PHP Medicare Advantage |
$51.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO |
$177.48
|
| Rate for Payer: Priority Health Medicare |
$51.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.68
|
| Rate for Payer: Railroad Medicare Medicare |
$51.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.52
|
| Rate for Payer: UHC Core |
$170.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.00
|
| Rate for Payer: UHC Exchange |
$51.00
|
| Rate for Payer: UHC Medicare Advantage |
$51.00
|
| Rate for Payer: UHCCP Medicaid |
$508.70
|
| Rate for Payer: VA VA |
$51.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.00
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Professional
|
Both
|
$247.00
|
|
|
Service Code
|
HCPCS 11401
|
| Hospital Charge Code |
11401
|
| Min. Negotiated Rate |
$98.80 |
| Max. Negotiated Rate |
$160.55 |
| Rate for Payer: Aetna Commercial |
$133.50
|
| Rate for Payer: Aetna Medicare |
$103.62
|
| Rate for Payer: BCBS Complete |
$98.80
|
| Rate for Payer: BCBS MAPPO |
$99.63
|
| Rate for Payer: BCN Medicare Advantage |
$99.63
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cofinity Commercial |
$143.47
|
| Rate for Payer: Cofinity Commercial |
$133.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.61
|
| Rate for Payer: Nomi Health Commercial |
$119.56
|
| Rate for Payer: PACE SWMI |
$99.63
|
| Rate for Payer: PHP Medicare Advantage |
$99.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.55
|
| Rate for Payer: Priority Health Medicare |
$100.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.63
|
| Rate for Payer: UHC Exchange |
$99.63
|
| Rate for Payer: UHC Medicare Advantage |
$99.63
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Facility
|
OP
|
$247.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
11401
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$58.66 |
| Max. Negotiated Rate |
$303.32 |
| Rate for Payer: Aetna Commercial |
$209.95
|
| Rate for Payer: Aetna Medicare |
$64.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.19
|
| Rate for Payer: BCBS Complete |
$303.32
|
| Rate for Payer: BCBS MAPPO |
$61.75
|
| Rate for Payer: BCBS Trust/PPO |
$203.06
|
| Rate for Payer: BCN Commercial |
$192.04
|
| Rate for Payer: BCN Medicare Advantage |
$61.75
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cofinity Commercial |
$212.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.75
|
| Rate for Payer: Healthscope Commercial |
$222.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.25
|
| Rate for Payer: Mclaren Medicaid |
$288.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.84
|
| Rate for Payer: Meridian Medicaid |
$303.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.95
|
| Rate for Payer: Nomi Health Commercial |
$202.54
|
| Rate for Payer: PACE Senior Care Partners |
$58.66
|
| Rate for Payer: PACE SWMI |
$61.75
|
| Rate for Payer: PHP Commercial |
$209.95
|
| Rate for Payer: PHP Medicare Advantage |
$61.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.55
|
| Rate for Payer: Priority Health HMO/PPO |
$214.89
|
| Rate for Payer: Priority Health Medicare |
$62.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.49
|
| Rate for Payer: Railroad Medicare Medicare |
$61.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.36
|
| Rate for Payer: UHC Core |
$206.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.75
|
| Rate for Payer: UHC Exchange |
$61.75
|
| Rate for Payer: UHC Medicare Advantage |
$61.75
|
| Rate for Payer: UHCCP Medicaid |
$288.86
|
| Rate for Payer: VA VA |
$61.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.25
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Professional
|
Both
|
$247.00
|
|
|
Service Code
|
HCPCS 11401
|
| Min. Negotiated Rate |
$98.80 |
| Max. Negotiated Rate |
$160.55 |
| Rate for Payer: Aetna Commercial |
$133.50
|
| Rate for Payer: Aetna Medicare |
$103.62
|
| Rate for Payer: BCBS Complete |
$98.80
|
| Rate for Payer: BCBS MAPPO |
$99.63
|
| Rate for Payer: BCN Medicare Advantage |
$99.63
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cofinity Commercial |
$143.47
|
| Rate for Payer: Cofinity Commercial |
$133.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.61
|
| Rate for Payer: Nomi Health Commercial |
$119.56
|
| Rate for Payer: PACE SWMI |
$99.63
|
| Rate for Payer: PHP Medicare Advantage |
$99.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.55
|
| Rate for Payer: Priority Health Medicare |
$100.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.63
|
| Rate for Payer: UHC Exchange |
$99.63
|
| Rate for Payer: UHC Medicare Advantage |
$99.63
|
|
