|
PR EXCISION LESION PANCREAS
|
Professional
|
Both
|
$2,343.00
|
|
|
Service Code
|
HCPCS 48120
|
| Min. Negotiated Rate |
$667.76 |
| Max. Negotiated Rate |
$2,039.92 |
| Rate for Payer: Aetna Commercial |
$1,496.65
|
| Rate for Payer: Aetna Medicare |
$1,171.50
|
| Rate for Payer: BCBS Complete |
$701.15
|
| Rate for Payer: BCN Commercial |
$1,674.21
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Mclaren Medicaid |
$667.76
|
| Rate for Payer: Meridian Medicaid |
$701.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,757.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$667.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,039.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,039.92
|
| Rate for Payer: UHC Medicaid |
$667.76
|
| Rate for Payer: UHCCP Medicaid |
$667.76
|
|
|
PR EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK
|
Professional
|
Both
|
$1,384.00
|
|
|
Service Code
|
HCPCS 27630
|
| Min. Negotiated Rate |
$221.09 |
| Max. Negotiated Rate |
$1,038.00 |
| Rate for Payer: Aetna Commercial |
$477.87
|
| Rate for Payer: Aetna Medicare |
$692.00
|
| Rate for Payer: BCBS Complete |
$232.14
|
| Rate for Payer: BCN Commercial |
$549.28
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Mclaren Medicaid |
$221.09
|
| Rate for Payer: Meridian Medicaid |
$232.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,038.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$587.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$587.15
|
| Rate for Payer: UHC Medicaid |
$221.09
|
| Rate for Payer: UHCCP Medicaid |
$221.09
|
|
|
PR EXCISION LESION TENDON SHEATH FOREARM&/WRIST
|
Professional
|
Both
|
$1,190.00
|
|
|
Service Code
|
HCPCS 25110
|
| Min. Negotiated Rate |
$215.34 |
| Max. Negotiated Rate |
$892.50 |
| Rate for Payer: Aetna Commercial |
$456.59
|
| Rate for Payer: Aetna Medicare |
$595.00
|
| Rate for Payer: BCBS Complete |
$226.11
|
| Rate for Payer: BCN Commercial |
$536.33
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Mclaren Medicaid |
$215.34
|
| Rate for Payer: Meridian Medicaid |
$226.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$573.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$573.31
|
| Rate for Payer: UHC Medicaid |
$215.34
|
| Rate for Payer: UHCCP Medicaid |
$215.34
|
|
|
PR EXCISION LESION TONGUE W/O CLOSURE
|
Professional
|
Both
|
$392.00
|
|
|
Service Code
|
HCPCS 41110
|
| Min. Negotiated Rate |
$75.83 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna Commercial |
$170.28
|
| Rate for Payer: Aetna Medicare |
$196.00
|
| Rate for Payer: BCBS Complete |
$79.62
|
| Rate for Payer: BCN Commercial |
$195.21
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Mclaren Medicaid |
$75.83
|
| Rate for Payer: Meridian Medicaid |
$79.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$294.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$237.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$237.85
|
| Rate for Payer: UHC Medicaid |
$75.83
|
| Rate for Payer: UHCCP Medicaid |
$75.83
|
|
|
PR EXCISION LINGUAL FRENUM FRENECTOMY
|
Professional
|
Both
|
$460.00
|
|
|
Service Code
|
HCPCS 41115
|
| Min. Negotiated Rate |
$84.99 |
| Max. Negotiated Rate |
$345.00 |
| Rate for Payer: Aetna Commercial |
$191.54
|
| Rate for Payer: Aetna Medicare |
$230.00
|
| Rate for Payer: BCBS Complete |
$89.24
|
| Rate for Payer: BCN Commercial |
$220.11
|
| Rate for Payer: Cash Price |
$368.00
|
| Rate for Payer: Cash Price |
$368.00
|
| Rate for Payer: Mclaren Medicaid |
$84.99
|
| Rate for Payer: Meridian Medicaid |
$89.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$268.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.18
|
| Rate for Payer: UHC Medicaid |
$84.99
|
| Rate for Payer: UHCCP Medicaid |
$84.99
|
|
|
PR EXCISION LOCAL LESION EPIDIDYMIS
|
Professional
|
Both
|
$636.00
|
|
|
Service Code
|
HCPCS 54830
|
| Min. Negotiated Rate |
$221.73 |
| Max. Negotiated Rate |
$612.99 |
| Rate for Payer: Aetna Commercial |
$476.03
|
| Rate for Payer: Aetna Medicare |
$318.00
|
| Rate for Payer: BCBS Complete |
$232.82
|
| Rate for Payer: BCN Commercial |
$562.72
|
| Rate for Payer: Cash Price |
$508.80
|
| Rate for Payer: Cash Price |
$508.80
|
| Rate for Payer: Mclaren Medicaid |
$221.73
|
| Rate for Payer: Meridian Medicaid |
$232.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$477.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$612.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$612.99
|
| Rate for Payer: UHC Medicaid |
$221.73
|
| Rate for Payer: UHCCP Medicaid |
$221.73
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Facility
|
IP
|
$343.00
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$238.73 |
| Max. Negotiated Rate |
$308.70 |
| Rate for Payer: Aetna Commercial |
$291.55
|
| Rate for Payer: BCBS Trust/PPO |
$283.28
|
| Rate for Payer: BCN Commercial |
$283.28
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$294.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.40
|
| Rate for Payer: Healthscope Commercial |
$308.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.55
|
| Rate for Payer: Nomi Health Commercial |
$281.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.25
|
| Rate for Payer: PHP Commercial |
$291.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.73
|
| Rate for Payer: UHC Core |
$286.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.25
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 11640
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$257.25 |
| Rate for Payer: Aetna Commercial |
$134.58
|
| Rate for Payer: Aetna Medicare |
$171.50
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCN Commercial |
$150.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Mclaren Medicaid |
$70.72
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$174.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.57
|
| Rate for Payer: UHC Medicaid |
$70.72
|
| Rate for Payer: UHCCP Medicaid |
$70.72
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Facility
|
OP
|
$343.00
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$60.47 |
| Max. Negotiated Rate |
$308.70 |
| Rate for Payer: Aetna Commercial |
$291.55
|
| Rate for Payer: Aetna Medicare |
$89.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.19
|
| Rate for Payer: BCBS Complete |
$63.49
|
| Rate for Payer: BCBS MAPPO |
$85.75
|
| Rate for Payer: BCBS Trust/PPO |
$281.98
|
| Rate for Payer: BCN Commercial |
$281.98
|
| Rate for Payer: BCN Medicare Advantage |
$85.75
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$294.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.75
|
| Rate for Payer: Healthscope Commercial |
$308.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.25
|
| Rate for Payer: Mclaren Medicaid |
$60.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.04
|
| Rate for Payer: Meridian Medicaid |
$63.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.55
|
| Rate for Payer: Nomi Health Commercial |
$281.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.25
|
| Rate for Payer: PACE Senior Care Partners |
$81.46
|
| Rate for Payer: PACE SWMI |
$85.75
|
| Rate for Payer: PHP Commercial |
$291.55
|
| Rate for Payer: PHP Medicare Advantage |
$85.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.41
|
| Rate for Payer: Priority Health Medicare |
$86.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.73
|
| Rate for Payer: Railroad Medicare Medicare |
$85.75
|
| Rate for Payer: UHC Core |
$286.40
|
| Rate for Payer: UHC Exchange |
$85.75
|
| Rate for Payer: UHC Medicaid |
$60.47
|
| Rate for Payer: UHC Medicare Advantage |
$85.75
|
| Rate for Payer: UHCCP Medicaid |
$60.47
|
| Rate for Payer: VA VA |
$85.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.25
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
11640
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$257.25 |
| Rate for Payer: Aetna Commercial |
$134.58
|
| Rate for Payer: Aetna Medicare |
$171.50
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCN Commercial |
$150.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Mclaren Medicaid |
$70.72
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$174.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.57
|
| Rate for Payer: UHC Medicaid |
$70.72
|
| Rate for Payer: UHCCP Medicaid |
$70.72
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Facility
|
IP
|
$406.00
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
11641
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$282.58 |
| Max. Negotiated Rate |
$365.40 |
| Rate for Payer: Aetna Commercial |
$345.10
|
| Rate for Payer: BCBS Trust/PPO |
$335.32
|
| Rate for Payer: BCN Commercial |
$335.32
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cofinity Commercial |
$349.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.80
|
| Rate for Payer: Healthscope Commercial |
$365.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.10
|
| Rate for Payer: Nomi Health Commercial |
$332.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.50
|
| Rate for Payer: PHP Commercial |
$345.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$353.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$282.58
|
| Rate for Payer: UHC Core |
$339.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Professional
|
Both
|
$406.00
|
|
|
Service Code
|
HCPCS 11641
|
| Hospital Charge Code |
11641
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$304.50 |
| Rate for Payer: Aetna Commercial |
$165.44
|
| Rate for Payer: Aetna Medicare |
$203.00
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCN Commercial |
$184.57
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Mclaren Medicaid |
$85.84
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$214.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.22
|
| Rate for Payer: UHC Medicaid |
$85.84
|
| Rate for Payer: UHCCP Medicaid |
$85.84
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Professional
|
Both
|
$406.00
|
|
|
Service Code
|
HCPCS 11641
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$304.50 |
| Rate for Payer: Aetna Commercial |
$165.44
|
| Rate for Payer: Aetna Medicare |
$203.00
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCN Commercial |
$184.57
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Mclaren Medicaid |
$85.84
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$214.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.22
|
| Rate for Payer: UHC Medicaid |
$85.84
|
| Rate for Payer: UHCCP Medicaid |
$85.84
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Facility
|
OP
|
$406.00
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
11641
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$71.58 |
| Max. Negotiated Rate |
$365.40 |
| Rate for Payer: Aetna Commercial |
$345.10
|
| Rate for Payer: Aetna Medicare |
$105.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.88
|
| Rate for Payer: BCBS Complete |
$75.15
|
| Rate for Payer: BCBS MAPPO |
$101.50
|
| Rate for Payer: BCBS Trust/PPO |
$333.77
|
| Rate for Payer: BCN Commercial |
$333.77
|
| Rate for Payer: BCN Medicare Advantage |
$101.50
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cofinity Commercial |
$349.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.50
|
| Rate for Payer: Healthscope Commercial |
$365.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.50
|
| Rate for Payer: Mclaren Medicaid |
$71.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.58
|
| Rate for Payer: Meridian Medicaid |
$75.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.10
|
| Rate for Payer: Nomi Health Commercial |
$332.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.50
|
| Rate for Payer: PACE Senior Care Partners |
$96.42
|
| Rate for Payer: PACE SWMI |
$101.50
|
| Rate for Payer: PHP Commercial |
$345.10
|
| Rate for Payer: PHP Medicare Advantage |
$101.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$353.22
|
| Rate for Payer: Priority Health Medicare |
$102.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$282.58
|
| Rate for Payer: Railroad Medicare Medicare |
$101.50
|
| Rate for Payer: UHC Core |
$339.01
|
| Rate for Payer: UHC Exchange |
$101.50
|
| Rate for Payer: UHC Medicaid |
$71.58
|
| Rate for Payer: UHC Medicare Advantage |
$101.50
|
| Rate for Payer: UHCCP Medicaid |
$71.58
|
| Rate for Payer: VA VA |
$101.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Facility
|
IP
|
$614.00
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
11642
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$427.34 |
| Max. Negotiated Rate |
$552.60 |
| Rate for Payer: Aetna Commercial |
$521.90
|
| Rate for Payer: BCBS Trust/PPO |
$507.10
|
| Rate for Payer: BCN Commercial |
$507.10
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Commercial |
$528.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.20
|
| Rate for Payer: Healthscope Commercial |
$552.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$521.90
|
| Rate for Payer: Nomi Health Commercial |
$503.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.50
|
| Rate for Payer: PHP Commercial |
$521.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$534.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$427.34
|
| Rate for Payer: UHC Core |
$512.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Facility
|
OP
|
$614.00
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
11642
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$108.25 |
| Max. Negotiated Rate |
$552.60 |
| Rate for Payer: Aetna Commercial |
$521.90
|
| Rate for Payer: Aetna Medicare |
$159.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.88
|
| Rate for Payer: BCBS Complete |
$113.65
|
| Rate for Payer: BCBS MAPPO |
$153.50
|
| Rate for Payer: BCBS Trust/PPO |
$504.77
|
| Rate for Payer: BCN Commercial |
$504.77
|
| Rate for Payer: BCN Medicare Advantage |
$153.50
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Commercial |
$528.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.50
|
| Rate for Payer: Healthscope Commercial |
$552.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.50
|
| Rate for Payer: Mclaren Medicaid |
$108.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.18
|
| Rate for Payer: Meridian Medicaid |
$113.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$168.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$521.90
|
| Rate for Payer: Nomi Health Commercial |
$503.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.50
|
| Rate for Payer: PACE Senior Care Partners |
$145.82
|
| Rate for Payer: PACE SWMI |
$153.50
|
| Rate for Payer: PHP Commercial |
$521.90
|
| Rate for Payer: PHP Medicare Advantage |
$153.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$534.18
|
| Rate for Payer: Priority Health Medicare |
$155.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$427.34
|
| Rate for Payer: Railroad Medicare Medicare |
$153.50
|
| Rate for Payer: UHC Core |
$512.69
|
| Rate for Payer: UHC Exchange |
$153.50
|
| Rate for Payer: UHC Medicaid |
$108.25
|
| Rate for Payer: UHC Medicare Advantage |
$153.50
|
| Rate for Payer: UHCCP Medicaid |
$108.25
|
| Rate for Payer: VA VA |
$153.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 11642
|
| Hospital Charge Code |
11642
|
| Min. Negotiated Rate |
$98.62 |
| Max. Negotiated Rate |
$460.50 |
| Rate for Payer: Aetna Commercial |
$194.03
|
| Rate for Payer: Aetna Medicare |
$307.00
|
| Rate for Payer: BCBS Complete |
$103.55
|
| Rate for Payer: BCN Commercial |
$215.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Mclaren Medicaid |
$98.62
|
| Rate for Payer: Meridian Medicaid |
$103.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.77
|
| Rate for Payer: UHC Medicaid |
$98.62
|
| Rate for Payer: UHCCP Medicaid |
$98.62
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 11642
|
| Min. Negotiated Rate |
$98.62 |
| Max. Negotiated Rate |
$460.50 |
| Rate for Payer: Aetna Commercial |
$194.03
|
| Rate for Payer: Aetna Medicare |
$307.00
|
| Rate for Payer: BCBS Complete |
$103.55
|
| Rate for Payer: BCN Commercial |
$215.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Mclaren Medicaid |
$98.62
|
| Rate for Payer: Meridian Medicaid |
$103.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.77
|
| Rate for Payer: UHC Medicaid |
$98.62
|
| Rate for Payer: UHCCP Medicaid |
$98.62
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Facility
|
OP
|
$767.00
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
11643
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$135.22 |
| Max. Negotiated Rate |
$690.30 |
| Rate for Payer: Aetna Commercial |
$651.95
|
| Rate for Payer: Aetna Medicare |
$199.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$239.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$239.69
|
| Rate for Payer: BCBS Complete |
$141.97
|
| Rate for Payer: BCBS MAPPO |
$191.75
|
| Rate for Payer: BCBS Trust/PPO |
$630.55
|
| Rate for Payer: BCN Commercial |
$630.55
|
| Rate for Payer: BCN Medicare Advantage |
$191.75
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cofinity Commercial |
$659.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$613.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.75
|
| Rate for Payer: Healthscope Commercial |
$690.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$575.25
|
| Rate for Payer: Mclaren Medicaid |
$135.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.34
|
| Rate for Payer: Meridian Medicaid |
$141.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$220.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$210.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$651.95
|
| Rate for Payer: Nomi Health Commercial |
$628.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$575.25
|
| Rate for Payer: PACE Senior Care Partners |
$182.16
|
| Rate for Payer: PACE SWMI |
$191.75
|
| Rate for Payer: PHP Commercial |
$651.95
|
| Rate for Payer: PHP Medicare Advantage |
$191.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$135.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$667.29
|
| Rate for Payer: Priority Health Medicare |
$193.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$533.83
|
| Rate for Payer: Railroad Medicare Medicare |
$191.75
|
| Rate for Payer: UHC Core |
$640.45
|
| Rate for Payer: UHC Exchange |
$191.75
|
| Rate for Payer: UHC Medicaid |
$135.22
|
| Rate for Payer: UHC Medicare Advantage |
$191.75
|
| Rate for Payer: UHCCP Medicaid |
$135.22
|
| Rate for Payer: VA VA |
$191.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$575.25
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Facility
|
IP
|
$767.00
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
11643
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$533.83 |
| Max. Negotiated Rate |
$690.30 |
| Rate for Payer: Aetna Commercial |
$651.95
|
| Rate for Payer: BCBS Trust/PPO |
$633.47
|
| Rate for Payer: BCN Commercial |
$633.47
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cofinity Commercial |
$659.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$613.60
|
| Rate for Payer: Healthscope Commercial |
$690.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$575.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$651.95
|
| Rate for Payer: Nomi Health Commercial |
$628.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$575.25
|
| Rate for Payer: PHP Commercial |
$651.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$667.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$533.83
|
| Rate for Payer: UHC Core |
$640.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$575.25
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Professional
|
Both
|
$767.00
|
|
|
Service Code
|
HCPCS 11643
|
| Min. Negotiated Rate |
$123.33 |
| Max. Negotiated Rate |
$575.25 |
| Rate for Payer: Aetna Commercial |
$243.96
|
| Rate for Payer: Aetna Medicare |
$383.50
|
| Rate for Payer: BCBS Complete |
$129.50
|
| Rate for Payer: BCN Commercial |
$269.39
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Mclaren Medicaid |
$123.33
|
| Rate for Payer: Meridian Medicaid |
$129.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$575.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$312.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$312.67
|
| Rate for Payer: UHC Medicaid |
$123.33
|
| Rate for Payer: UHCCP Medicaid |
$123.33
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Professional
|
Both
|
$767.00
|
|
|
Service Code
|
HCPCS 11643
|
| Hospital Charge Code |
11643
|
| Min. Negotiated Rate |
$123.33 |
| Max. Negotiated Rate |
$575.25 |
| Rate for Payer: Aetna Commercial |
$243.96
|
| Rate for Payer: Aetna Medicare |
$383.50
|
| Rate for Payer: BCBS Complete |
$129.50
|
| Rate for Payer: BCN Commercial |
$269.39
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Mclaren Medicaid |
$123.33
|
| Rate for Payer: Meridian Medicaid |
$129.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$575.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$312.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$312.67
|
| Rate for Payer: UHC Medicaid |
$123.33
|
| Rate for Payer: UHCCP Medicaid |
$123.33
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Facility
|
IP
|
$950.00
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
11644
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$661.20 |
| Max. Negotiated Rate |
$855.00 |
| Rate for Payer: Aetna Commercial |
$807.50
|
| Rate for Payer: BCBS Trust/PPO |
$784.61
|
| Rate for Payer: BCN Commercial |
$784.61
|
| Rate for Payer: Cash Price |
$760.00
|
| Rate for Payer: Cofinity Commercial |
$817.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$760.00
|
| Rate for Payer: Healthscope Commercial |
$855.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$712.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$807.50
|
| Rate for Payer: Nomi Health Commercial |
$779.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$712.50
|
| Rate for Payer: PHP Commercial |
$807.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$826.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$661.20
|
| Rate for Payer: UHC Core |
$793.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$712.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Professional
|
Both
|
$950.00
|
|
|
Service Code
|
HCPCS 11644
|
| Hospital Charge Code |
11644
|
| Min. Negotiated Rate |
$152.93 |
| Max. Negotiated Rate |
$712.50 |
| Rate for Payer: Aetna Commercial |
$303.84
|
| Rate for Payer: Aetna Medicare |
$475.00
|
| Rate for Payer: BCBS Complete |
$160.58
|
| Rate for Payer: BCN Commercial |
$332.62
|
| Rate for Payer: Cash Price |
$760.00
|
| Rate for Payer: Cash Price |
$760.00
|
| Rate for Payer: Mclaren Medicaid |
$152.93
|
| Rate for Payer: Meridian Medicaid |
$160.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$712.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$386.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$386.04
|
| Rate for Payer: UHC Medicaid |
$152.93
|
| Rate for Payer: UHCCP Medicaid |
$152.93
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Facility
|
OP
|
$950.00
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
11644
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$167.49 |
| Max. Negotiated Rate |
$855.00 |
| Rate for Payer: Aetna Commercial |
$807.50
|
| Rate for Payer: Aetna Medicare |
$247.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.88
|
| Rate for Payer: BCBS Complete |
$175.84
|
| Rate for Payer: BCBS MAPPO |
$237.50
|
| Rate for Payer: BCBS Trust/PPO |
$781.00
|
| Rate for Payer: BCN Commercial |
$781.00
|
| Rate for Payer: BCN Medicare Advantage |
$237.50
|
| Rate for Payer: Cash Price |
$760.00
|
| Rate for Payer: Cofinity Commercial |
$817.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$760.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.50
|
| Rate for Payer: Healthscope Commercial |
$855.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$712.50
|
| Rate for Payer: Mclaren Medicaid |
$167.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.38
|
| Rate for Payer: Meridian Medicaid |
$175.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$807.50
|
| Rate for Payer: Nomi Health Commercial |
$779.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$712.50
|
| Rate for Payer: PACE Senior Care Partners |
$225.62
|
| Rate for Payer: PACE SWMI |
$237.50
|
| Rate for Payer: PHP Commercial |
$807.50
|
| Rate for Payer: PHP Medicare Advantage |
$237.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$826.50
|
| Rate for Payer: Priority Health Medicare |
$239.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$661.20
|
| Rate for Payer: Railroad Medicare Medicare |
$237.50
|
| Rate for Payer: UHC Core |
$793.25
|
| Rate for Payer: UHC Exchange |
$237.50
|
| Rate for Payer: UHC Medicaid |
$167.49
|
| Rate for Payer: UHC Medicare Advantage |
$237.50
|
| Rate for Payer: UHCCP Medicaid |
$167.49
|
| Rate for Payer: VA VA |
$237.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$712.50
|
|
