|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Facility
|
IP
|
$247.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
11401
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$160.55 |
| Max. Negotiated Rate |
$222.30 |
| Rate for Payer: Aetna Commercial |
$209.95
|
| Rate for Payer: BCBS Trust/PPO |
$201.63
|
| Rate for Payer: BCN Commercial |
$190.88
|
| 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: Healthscope Commercial |
$222.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.95
|
| Rate for Payer: Nomi Health Commercial |
$202.54
|
| Rate for Payer: PHP Commercial |
$209.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.55
|
| Rate for Payer: Priority Health HMO/PPO |
$214.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.36
|
| Rate for Payer: UHC Core |
$206.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.25
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM
|
Professional
|
Both
|
$274.00
|
|
|
Service Code
|
HCPCS 11402
|
| Hospital Charge Code |
11402
|
| Min. Negotiated Rate |
$109.13 |
| Max. Negotiated Rate |
$178.10 |
| Rate for Payer: Aetna Commercial |
$146.23
|
| Rate for Payer: Aetna Medicare |
$113.50
|
| Rate for Payer: BCBS Complete |
$109.60
|
| Rate for Payer: BCBS MAPPO |
$109.13
|
| Rate for Payer: BCN Medicare Advantage |
$109.13
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cofinity Commercial |
$157.15
|
| Rate for Payer: Cofinity Commercial |
$146.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.59
|
| Rate for Payer: Nomi Health Commercial |
$130.96
|
| Rate for Payer: PACE SWMI |
$109.13
|
| Rate for Payer: PHP Medicare Advantage |
$109.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.10
|
| Rate for Payer: Priority Health Medicare |
$110.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.13
|
| Rate for Payer: UHC Exchange |
$109.13
|
| Rate for Payer: UHC Medicare Advantage |
$109.13
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM
|
Facility
|
IP
|
$274.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
11402
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$178.10 |
| Max. Negotiated Rate |
$246.60 |
| Rate for Payer: Aetna Commercial |
$232.90
|
| Rate for Payer: BCBS Trust/PPO |
$223.67
|
| Rate for Payer: BCN Commercial |
$211.75
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cofinity Commercial |
$235.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.20
|
| Rate for Payer: Healthscope Commercial |
$246.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.90
|
| Rate for Payer: Nomi Health Commercial |
$224.68
|
| Rate for Payer: PHP Commercial |
$232.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.10
|
| Rate for Payer: Priority Health HMO/PPO |
$238.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.12
|
| Rate for Payer: UHC Core |
$228.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.50
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM
|
Professional
|
Both
|
$274.00
|
|
|
Service Code
|
HCPCS 11402
|
| Min. Negotiated Rate |
$109.13 |
| Max. Negotiated Rate |
$178.10 |
| Rate for Payer: Aetna Commercial |
$146.23
|
| Rate for Payer: Aetna Medicare |
$113.50
|
| Rate for Payer: BCBS Complete |
$109.60
|
| Rate for Payer: BCBS MAPPO |
$109.13
|
| Rate for Payer: BCN Medicare Advantage |
$109.13
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cofinity Commercial |
$157.15
|
| Rate for Payer: Cofinity Commercial |
$146.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.59
|
| Rate for Payer: Nomi Health Commercial |
$130.96
|
| Rate for Payer: PACE SWMI |
$109.13
|
| Rate for Payer: PHP Medicare Advantage |
$109.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.10
|
| Rate for Payer: Priority Health Medicare |
$110.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.13
|
| Rate for Payer: UHC Exchange |
$109.13
|
| Rate for Payer: UHC Medicare Advantage |
$109.13
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM
|
Facility
|
OP
|
$274.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
11402
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$65.08 |
| Max. Negotiated Rate |
$534.17 |
| Rate for Payer: Aetna Commercial |
$232.90
|
| Rate for Payer: Aetna Medicare |
$71.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.62
|
| Rate for Payer: BCBS Complete |
$534.17
|
| Rate for Payer: BCBS MAPPO |
$68.50
|
| Rate for Payer: BCBS Trust/PPO |
$225.26
|
| Rate for Payer: BCN Commercial |
$213.03
|
| Rate for Payer: BCN Medicare Advantage |
$68.50
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cofinity Commercial |
$235.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.50
|
| Rate for Payer: Healthscope Commercial |
$246.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.50
|
| Rate for Payer: Mclaren Medicaid |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.92
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.90
|
| Rate for Payer: Nomi Health Commercial |
$224.68
|
| Rate for Payer: PACE Senior Care Partners |
$65.08
|
| Rate for Payer: PACE SWMI |
$68.50
|
| Rate for Payer: PHP Commercial |
$232.90
|
| Rate for Payer: PHP Medicare Advantage |
$68.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.10
|
| Rate for Payer: Priority Health HMO/PPO |
$238.38
|
| Rate for Payer: Priority Health Medicare |
$69.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.58
|
| Rate for Payer: Railroad Medicare Medicare |
$68.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.12
|
| Rate for Payer: UHC Core |
$228.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.50
|
| Rate for Payer: UHC Exchange |
$68.50
|
| Rate for Payer: UHC Medicare Advantage |
$68.50
|
| Rate for Payer: UHCCP Medicaid |
$508.70
|
| Rate for Payer: VA VA |
$68.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.50
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM
|
Facility
|
OP
|
$328.00
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
11403
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$77.90 |
| Max. Negotiated Rate |
$534.17 |
| Rate for Payer: Aetna Commercial |
$278.80
|
| Rate for Payer: Aetna Medicare |
$85.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.50
|
| Rate for Payer: BCBS Complete |
$534.17
|
| Rate for Payer: BCBS MAPPO |
$82.00
|
| Rate for Payer: BCBS Trust/PPO |
$269.65
|
| Rate for Payer: BCN Commercial |
$255.02
|
| Rate for Payer: BCN Medicare Advantage |
$82.00
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$282.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.00
|
| Rate for Payer: Healthscope Commercial |
$295.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.00
|
| Rate for Payer: Mclaren Medicaid |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.10
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.80
|
| Rate for Payer: Nomi Health Commercial |
$268.96
|
| Rate for Payer: PACE Senior Care Partners |
$77.90
|
| Rate for Payer: PACE SWMI |
$82.00
|
| Rate for Payer: PHP Commercial |
$278.80
|
| Rate for Payer: PHP Medicare Advantage |
$82.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: Priority Health HMO/PPO |
$285.36
|
| Rate for Payer: Priority Health Medicare |
$82.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.76
|
| Rate for Payer: Railroad Medicare Medicare |
$82.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.64
|
| Rate for Payer: UHC Core |
$273.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.00
|
| Rate for Payer: UHC Exchange |
$82.00
|
| Rate for Payer: UHC Medicare Advantage |
$82.00
|
| Rate for Payer: UHCCP Medicaid |
$508.70
|
| Rate for Payer: VA VA |
$82.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.00
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM
|
Professional
|
Both
|
$328.00
|
|
|
Service Code
|
HCPCS 11403
|
| Min. Negotiated Rate |
$131.20 |
| Max. Negotiated Rate |
$213.20 |
| Rate for Payer: Aetna Commercial |
$190.74
|
| Rate for Payer: Aetna Medicare |
$148.03
|
| Rate for Payer: BCBS Complete |
$131.20
|
| Rate for Payer: BCBS MAPPO |
$142.34
|
| Rate for Payer: BCN Medicare Advantage |
$142.34
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$204.97
|
| Rate for Payer: Cofinity Commercial |
$190.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.46
|
| Rate for Payer: Nomi Health Commercial |
$170.81
|
| Rate for Payer: PACE SWMI |
$142.34
|
| Rate for Payer: PHP Medicare Advantage |
$142.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: Priority Health Medicare |
$143.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.34
|
| Rate for Payer: UHC Exchange |
$142.34
|
| Rate for Payer: UHC Medicare Advantage |
$142.34
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM
|
Professional
|
Both
|
$328.00
|
|
|
Service Code
|
HCPCS 11403
|
| Hospital Charge Code |
11403
|
| Min. Negotiated Rate |
$131.20 |
| Max. Negotiated Rate |
$213.20 |
| Rate for Payer: Aetna Commercial |
$190.74
|
| Rate for Payer: Aetna Medicare |
$148.03
|
| Rate for Payer: BCBS Complete |
$131.20
|
| Rate for Payer: BCBS MAPPO |
$142.34
|
| Rate for Payer: BCN Medicare Advantage |
$142.34
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$204.97
|
| Rate for Payer: Cofinity Commercial |
$190.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.46
|
| Rate for Payer: Nomi Health Commercial |
$170.81
|
| Rate for Payer: PACE SWMI |
$142.34
|
| Rate for Payer: PHP Medicare Advantage |
$142.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: Priority Health Medicare |
$143.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.34
|
| Rate for Payer: UHC Exchange |
$142.34
|
| Rate for Payer: UHC Medicare Advantage |
$142.34
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM
|
Facility
|
IP
|
$328.00
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
11403
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$213.20 |
| Max. Negotiated Rate |
$295.20 |
| Rate for Payer: Aetna Commercial |
$278.80
|
| Rate for Payer: BCBS Trust/PPO |
$267.75
|
| Rate for Payer: BCN Commercial |
$253.48
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$282.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.40
|
| Rate for Payer: Healthscope Commercial |
$295.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.80
|
| Rate for Payer: Nomi Health Commercial |
$268.96
|
| Rate for Payer: PHP Commercial |
$278.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: Priority Health HMO/PPO |
$285.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.64
|
| Rate for Payer: UHC Core |
$273.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.00
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM
|
Facility
|
OP
|
$465.00
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
11404
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$110.44 |
| Max. Negotiated Rate |
$1,230.09 |
| Rate for Payer: Aetna Commercial |
$395.25
|
| Rate for Payer: Aetna Medicare |
$120.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$145.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$145.31
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$116.25
|
| Rate for Payer: BCBS Trust/PPO |
$382.28
|
| Rate for Payer: BCN Commercial |
$361.54
|
| Rate for Payer: BCN Medicare Advantage |
$116.25
|
| Rate for Payer: Cash Price |
$372.00
|
| Rate for Payer: Cash Price |
$372.00
|
| Rate for Payer: Cofinity Commercial |
$399.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$372.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.25
|
| Rate for Payer: Healthscope Commercial |
$418.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$348.75
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.06
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$133.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$395.25
|
| Rate for Payer: Nomi Health Commercial |
$381.30
|
| Rate for Payer: PACE Senior Care Partners |
$110.44
|
| Rate for Payer: PACE SWMI |
$116.25
|
| Rate for Payer: PHP Commercial |
$395.25
|
| Rate for Payer: PHP Medicare Advantage |
$116.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$302.25
|
| Rate for Payer: Priority Health HMO/PPO |
$404.55
|
| Rate for Payer: Priority Health Medicare |
$117.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$311.55
|
| Rate for Payer: Railroad Medicare Medicare |
$116.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$409.20
|
| Rate for Payer: UHC Core |
$388.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.25
|
| Rate for Payer: UHC Exchange |
$116.25
|
| Rate for Payer: UHC Medicare Advantage |
$116.25
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$116.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$348.75
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM
|
Professional
|
Both
|
$465.00
|
|
|
Service Code
|
HCPCS 11404
|
| Min. Negotiated Rate |
$157.35 |
| Max. Negotiated Rate |
$302.25 |
| Rate for Payer: Aetna Commercial |
$210.85
|
| Rate for Payer: Aetna Medicare |
$163.64
|
| Rate for Payer: BCBS Complete |
$186.00
|
| Rate for Payer: BCBS MAPPO |
$157.35
|
| Rate for Payer: BCN Medicare Advantage |
$157.35
|
| Rate for Payer: Cash Price |
$372.00
|
| Rate for Payer: Cash Price |
$372.00
|
| Rate for Payer: Cofinity Commercial |
$226.58
|
| Rate for Payer: Cofinity Commercial |
$210.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.22
|
| Rate for Payer: Nomi Health Commercial |
$188.82
|
| Rate for Payer: PACE SWMI |
$157.35
|
| Rate for Payer: PHP Medicare Advantage |
$157.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$302.25
|
| Rate for Payer: Priority Health Medicare |
$158.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.35
|
| Rate for Payer: UHC Exchange |
$157.35
|
| Rate for Payer: UHC Medicare Advantage |
$157.35
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM
|
Professional
|
Both
|
$465.00
|
|
|
Service Code
|
HCPCS 11404
|
| Hospital Charge Code |
11404
|
| Min. Negotiated Rate |
$157.35 |
| Max. Negotiated Rate |
$302.25 |
| Rate for Payer: Aetna Commercial |
$210.85
|
| Rate for Payer: Aetna Medicare |
$163.64
|
| Rate for Payer: BCBS Complete |
$186.00
|
| Rate for Payer: BCBS MAPPO |
$157.35
|
| Rate for Payer: BCN Medicare Advantage |
$157.35
|
| Rate for Payer: Cash Price |
$372.00
|
| Rate for Payer: Cash Price |
$372.00
|
| Rate for Payer: Cofinity Commercial |
$226.58
|
| Rate for Payer: Cofinity Commercial |
$210.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.22
|
| Rate for Payer: Nomi Health Commercial |
$188.82
|
| Rate for Payer: PACE SWMI |
$157.35
|
| Rate for Payer: PHP Medicare Advantage |
$157.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$302.25
|
| Rate for Payer: Priority Health Medicare |
$158.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.35
|
| Rate for Payer: UHC Exchange |
$157.35
|
| Rate for Payer: UHC Medicare Advantage |
$157.35
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM
|
Facility
|
IP
|
$465.00
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
11404
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$302.25 |
| Max. Negotiated Rate |
$418.50 |
| Rate for Payer: Aetna Commercial |
$395.25
|
| Rate for Payer: BCBS Trust/PPO |
$379.58
|
| Rate for Payer: BCN Commercial |
$359.35
|
| Rate for Payer: Cash Price |
$372.00
|
| Rate for Payer: Cofinity Commercial |
$399.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$372.00
|
| Rate for Payer: Healthscope Commercial |
$418.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$348.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$395.25
|
| Rate for Payer: Nomi Health Commercial |
$381.30
|
| Rate for Payer: PHP Commercial |
$395.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$302.25
|
| Rate for Payer: Priority Health HMO/PPO |
$404.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$311.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$409.20
|
| Rate for Payer: UHC Core |
$388.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$348.75
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM
|
Professional
|
Both
|
$657.00
|
|
|
Service Code
|
HCPCS 11406
|
| Min. Negotiated Rate |
$238.04 |
| Max. Negotiated Rate |
$427.05 |
| Rate for Payer: Aetna Commercial |
$318.97
|
| Rate for Payer: Aetna Medicare |
$247.56
|
| Rate for Payer: BCBS Complete |
$262.80
|
| Rate for Payer: BCBS MAPPO |
$238.04
|
| Rate for Payer: BCN Medicare Advantage |
$238.04
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cofinity Commercial |
$342.78
|
| Rate for Payer: Cofinity Commercial |
$318.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.94
|
| Rate for Payer: Nomi Health Commercial |
$285.65
|
| Rate for Payer: PACE SWMI |
$238.04
|
| Rate for Payer: PHP Medicare Advantage |
$238.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.05
|
| Rate for Payer: Priority Health Medicare |
$240.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.04
|
| Rate for Payer: UHC Exchange |
$238.04
|
| Rate for Payer: UHC Medicare Advantage |
$238.04
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM
|
Professional
|
Both
|
$657.00
|
|
|
Service Code
|
HCPCS 11406
|
| Hospital Charge Code |
11406
|
| Min. Negotiated Rate |
$238.04 |
| Max. Negotiated Rate |
$427.05 |
| Rate for Payer: Aetna Commercial |
$318.97
|
| Rate for Payer: Aetna Medicare |
$247.56
|
| Rate for Payer: BCBS Complete |
$262.80
|
| Rate for Payer: BCBS MAPPO |
$238.04
|
| Rate for Payer: BCN Medicare Advantage |
$238.04
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cofinity Commercial |
$342.78
|
| Rate for Payer: Cofinity Commercial |
$318.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.94
|
| Rate for Payer: Nomi Health Commercial |
$285.65
|
| Rate for Payer: PACE SWMI |
$238.04
|
| Rate for Payer: PHP Medicare Advantage |
$238.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.05
|
| Rate for Payer: Priority Health Medicare |
$240.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.04
|
| Rate for Payer: UHC Exchange |
$238.04
|
| Rate for Payer: UHC Medicare Advantage |
$238.04
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM
|
Facility
|
OP
|
$657.00
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
11406
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$156.04 |
| Max. Negotiated Rate |
$1,230.09 |
| Rate for Payer: Aetna Commercial |
$558.45
|
| Rate for Payer: Aetna Medicare |
$170.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$205.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$205.31
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$164.25
|
| Rate for Payer: BCBS Trust/PPO |
$540.12
|
| Rate for Payer: BCN Commercial |
$510.82
|
| Rate for Payer: BCN Medicare Advantage |
$164.25
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cofinity Commercial |
$565.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$525.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.25
|
| Rate for Payer: Healthscope Commercial |
$591.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$492.75
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.46
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$558.45
|
| Rate for Payer: Nomi Health Commercial |
$538.74
|
| Rate for Payer: PACE Senior Care Partners |
$156.04
|
| Rate for Payer: PACE SWMI |
$164.25
|
| Rate for Payer: PHP Commercial |
$558.45
|
| Rate for Payer: PHP Medicare Advantage |
$164.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.05
|
| Rate for Payer: Priority Health HMO/PPO |
$571.59
|
| Rate for Payer: Priority Health Medicare |
$165.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$440.19
|
| Rate for Payer: Railroad Medicare Medicare |
$164.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$578.16
|
| Rate for Payer: UHC Core |
$548.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.25
|
| Rate for Payer: UHC Exchange |
$164.25
|
| Rate for Payer: UHC Medicare Advantage |
$164.25
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$164.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$492.75
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM
|
Facility
|
IP
|
$657.00
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
11406
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$427.05 |
| Max. Negotiated Rate |
$591.30 |
| Rate for Payer: Aetna Commercial |
$558.45
|
| Rate for Payer: BCBS Trust/PPO |
$536.31
|
| Rate for Payer: BCN Commercial |
$507.73
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cofinity Commercial |
$565.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$525.60
|
| Rate for Payer: Healthscope Commercial |
$591.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$492.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$558.45
|
| Rate for Payer: Nomi Health Commercial |
$538.74
|
| Rate for Payer: PHP Commercial |
$558.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.05
|
| Rate for Payer: Priority Health HMO/PPO |
$571.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$440.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$578.16
|
| Rate for Payer: UHC Core |
$548.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$492.75
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS 11441
|
| Min. Negotiated Rate |
$111.20 |
| Max. Negotiated Rate |
$180.70 |
| Rate for Payer: Aetna Commercial |
$167.47
|
| Rate for Payer: Aetna Medicare |
$129.98
|
| Rate for Payer: BCBS Complete |
$111.20
|
| Rate for Payer: BCBS MAPPO |
$124.98
|
| Rate for Payer: BCN Medicare Advantage |
$124.98
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$179.97
|
| Rate for Payer: Cofinity Commercial |
$167.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.23
|
| Rate for Payer: Nomi Health Commercial |
$149.98
|
| Rate for Payer: PACE SWMI |
$124.98
|
| Rate for Payer: PHP Medicare Advantage |
$124.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.70
|
| Rate for Payer: Priority Health Medicare |
$126.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.98
|
| Rate for Payer: UHC Exchange |
$124.98
|
| Rate for Payer: UHC Medicare Advantage |
$124.98
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM
|
Facility
|
OP
|
$278.00
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
11441
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$66.03 |
| Max. Negotiated Rate |
$534.17 |
| Rate for Payer: Aetna Commercial |
$236.30
|
| Rate for Payer: Aetna Medicare |
$72.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.88
|
| Rate for Payer: BCBS Complete |
$534.17
|
| Rate for Payer: BCBS MAPPO |
$69.50
|
| Rate for Payer: BCBS Trust/PPO |
$228.54
|
| Rate for Payer: BCN Commercial |
$216.15
|
| Rate for Payer: BCN Medicare Advantage |
$69.50
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$239.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.50
|
| Rate for Payer: Healthscope Commercial |
$250.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.50
|
| Rate for Payer: Mclaren Medicaid |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.97
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.30
|
| Rate for Payer: Nomi Health Commercial |
$227.96
|
| Rate for Payer: PACE Senior Care Partners |
$66.03
|
| Rate for Payer: PACE SWMI |
$69.50
|
| Rate for Payer: PHP Commercial |
$236.30
|
| Rate for Payer: PHP Medicare Advantage |
$69.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.70
|
| Rate for Payer: Priority Health HMO/PPO |
$241.86
|
| Rate for Payer: Priority Health Medicare |
$70.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.26
|
| Rate for Payer: Railroad Medicare Medicare |
$69.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.64
|
| Rate for Payer: UHC Core |
$232.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.50
|
| Rate for Payer: UHC Exchange |
$69.50
|
| Rate for Payer: UHC Medicare Advantage |
$69.50
|
| Rate for Payer: UHCCP Medicaid |
$508.70
|
| Rate for Payer: VA VA |
$69.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.50
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS 11441
|
| Hospital Charge Code |
11441
|
| Min. Negotiated Rate |
$111.20 |
| Max. Negotiated Rate |
$180.70 |
| Rate for Payer: Aetna Commercial |
$167.47
|
| Rate for Payer: Aetna Medicare |
$129.98
|
| Rate for Payer: BCBS Complete |
$111.20
|
| Rate for Payer: BCBS MAPPO |
$124.98
|
| Rate for Payer: BCN Medicare Advantage |
$124.98
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$179.97
|
| Rate for Payer: Cofinity Commercial |
$167.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.23
|
| Rate for Payer: Nomi Health Commercial |
$149.98
|
| Rate for Payer: PACE SWMI |
$124.98
|
| Rate for Payer: PHP Medicare Advantage |
$124.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.70
|
| Rate for Payer: Priority Health Medicare |
$126.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.98
|
| Rate for Payer: UHC Exchange |
$124.98
|
| Rate for Payer: UHC Medicare Advantage |
$124.98
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM
|
Facility
|
IP
|
$278.00
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
11441
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$180.70 |
| Max. Negotiated Rate |
$250.20 |
| Rate for Payer: Aetna Commercial |
$236.30
|
| Rate for Payer: BCBS Trust/PPO |
$226.93
|
| Rate for Payer: BCN Commercial |
$214.84
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$239.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.40
|
| Rate for Payer: Healthscope Commercial |
$250.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.30
|
| Rate for Payer: Nomi Health Commercial |
$227.96
|
| Rate for Payer: PHP Commercial |
$236.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.70
|
| Rate for Payer: Priority Health HMO/PPO |
$241.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.64
|
| Rate for Payer: UHC Core |
$232.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.50
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM
|
Facility
|
IP
|
$353.00
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
11442
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$229.45 |
| Max. Negotiated Rate |
$317.70 |
| Rate for Payer: Aetna Commercial |
$300.05
|
| Rate for Payer: BCBS Trust/PPO |
$288.15
|
| Rate for Payer: BCN Commercial |
$272.80
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cofinity Commercial |
$303.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.40
|
| Rate for Payer: Healthscope Commercial |
$317.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.05
|
| Rate for Payer: Nomi Health Commercial |
$289.46
|
| Rate for Payer: PHP Commercial |
$300.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.45
|
| Rate for Payer: Priority Health HMO/PPO |
$307.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$236.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.64
|
| Rate for Payer: UHC Core |
$294.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.75
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM
|
Professional
|
Both
|
$353.00
|
|
|
Service Code
|
HCPCS 11442
|
| Min. Negotiated Rate |
$138.77 |
| Max. Negotiated Rate |
$229.45 |
| Rate for Payer: Aetna Commercial |
$185.95
|
| Rate for Payer: Aetna Medicare |
$144.32
|
| Rate for Payer: BCBS Complete |
$141.20
|
| Rate for Payer: BCBS MAPPO |
$138.77
|
| Rate for Payer: BCN Medicare Advantage |
$138.77
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cofinity Commercial |
$199.83
|
| Rate for Payer: Cofinity Commercial |
$185.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.71
|
| Rate for Payer: Nomi Health Commercial |
$166.52
|
| Rate for Payer: PACE SWMI |
$138.77
|
| Rate for Payer: PHP Medicare Advantage |
$138.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.45
|
| Rate for Payer: Priority Health Medicare |
$140.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.77
|
| Rate for Payer: UHC Exchange |
$138.77
|
| Rate for Payer: UHC Medicare Advantage |
$138.77
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM
|
Facility
|
OP
|
$353.00
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
11442
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$83.84 |
| Max. Negotiated Rate |
$534.17 |
| Rate for Payer: Aetna Commercial |
$300.05
|
| Rate for Payer: Aetna Medicare |
$91.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$110.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$110.31
|
| Rate for Payer: BCBS Complete |
$534.17
|
| Rate for Payer: BCBS MAPPO |
$88.25
|
| Rate for Payer: BCBS Trust/PPO |
$290.20
|
| Rate for Payer: BCN Commercial |
$274.46
|
| Rate for Payer: BCN Medicare Advantage |
$88.25
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cofinity Commercial |
$303.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.25
|
| Rate for Payer: Healthscope Commercial |
$317.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.75
|
| Rate for Payer: Mclaren Medicaid |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.66
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$101.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.05
|
| Rate for Payer: Nomi Health Commercial |
$289.46
|
| Rate for Payer: PACE Senior Care Partners |
$83.84
|
| Rate for Payer: PACE SWMI |
$88.25
|
| Rate for Payer: PHP Commercial |
$300.05
|
| Rate for Payer: PHP Medicare Advantage |
$88.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.45
|
| Rate for Payer: Priority Health HMO/PPO |
$307.11
|
| Rate for Payer: Priority Health Medicare |
$89.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$236.51
|
| Rate for Payer: Railroad Medicare Medicare |
$88.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.64
|
| Rate for Payer: UHC Core |
$294.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.25
|
| Rate for Payer: UHC Exchange |
$88.25
|
| Rate for Payer: UHC Medicare Advantage |
$88.25
|
| Rate for Payer: UHCCP Medicaid |
$508.70
|
| Rate for Payer: VA VA |
$88.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.75
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM
|
Professional
|
Both
|
$353.00
|
|
|
Service Code
|
HCPCS 11442
|
| Hospital Charge Code |
11442
|
| Min. Negotiated Rate |
$138.77 |
| Max. Negotiated Rate |
$229.45 |
| Rate for Payer: Aetna Commercial |
$185.95
|
| Rate for Payer: Aetna Medicare |
$144.32
|
| Rate for Payer: BCBS Complete |
$141.20
|
| Rate for Payer: BCBS MAPPO |
$138.77
|
| Rate for Payer: BCN Medicare Advantage |
$138.77
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cofinity Commercial |
$199.83
|
| Rate for Payer: Cofinity Commercial |
$185.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.71
|
| Rate for Payer: Nomi Health Commercial |
$166.52
|
| Rate for Payer: PACE SWMI |
$138.77
|
| Rate for Payer: PHP Medicare Advantage |
$138.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.45
|
| Rate for Payer: Priority Health Medicare |
$140.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.77
|
| Rate for Payer: UHC Exchange |
$138.77
|
| Rate for Payer: UHC Medicare Advantage |
$138.77
|
|
