|
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 |
$1,205.21 |
| 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 |
$1,205.21
|
| 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 |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.46
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| 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 |
$1,147.75
|
| 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 |
$1,147.75
|
| Rate for Payer: VA VA |
$164.25
|
| 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 |
$86.05 |
| Max. Negotiated Rate |
$205.36 |
| Rate for Payer: Aetna Commercial |
$167.47
|
| Rate for Payer: Aetna Medicare |
$129.98
|
| Rate for Payer: BCBS Complete |
$90.35
|
| Rate for Payer: BCBS MAPPO |
$124.98
|
| Rate for Payer: BCBS Trust/PPO |
$185.19
|
| Rate for Payer: BCN Commercial |
$205.36
|
| 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: Mclaren Medicaid |
$86.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.23
|
| Rate for Payer: Meridian Medicaid |
$90.35
|
| 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 Choice Medicaid |
$86.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.70
|
| Rate for Payer: Priority Health HMO/PPO |
$181.96
|
| Rate for Payer: Priority Health Medicare |
$126.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.96
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$86.05
|
|
|
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 |
$86.05 |
| Max. Negotiated Rate |
$205.36 |
| Rate for Payer: Aetna Commercial |
$167.47
|
| Rate for Payer: Aetna Medicare |
$129.98
|
| Rate for Payer: BCBS Complete |
$90.35
|
| Rate for Payer: BCBS MAPPO |
$124.98
|
| Rate for Payer: BCBS Trust/PPO |
$185.19
|
| Rate for Payer: BCN Commercial |
$205.36
|
| 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: Mclaren Medicaid |
$86.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.23
|
| Rate for Payer: Meridian Medicaid |
$90.35
|
| 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 Choice Medicaid |
$86.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.70
|
| Rate for Payer: Priority Health HMO/PPO |
$181.96
|
| Rate for Payer: Priority Health Medicare |
$126.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.96
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$86.05
|
|
|
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 |
$66.02 |
| Max. Negotiated Rate |
$523.36 |
| 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 |
$523.36
|
| Rate for Payer: BCBS MAPPO |
$69.50
|
| Rate for Payer: BCBS Trust/PPO |
$228.54
|
| Rate for Payer: BCN Commercial |
$216.14
|
| 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 |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.98
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| 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 |
$66.02
|
| 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 |
$498.41
|
| 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 |
$70.20
|
| 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 |
$498.41
|
| 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
|
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
|
Professional
|
Both
|
$353.00
|
|
|
Service Code
|
HCPCS 11442
|
| Hospital Charge Code |
11442
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$229.45 |
| Rate for Payer: Aetna Commercial |
$185.95
|
| Rate for Payer: Aetna Medicare |
$144.32
|
| Rate for Payer: BCBS Complete |
$99.97
|
| Rate for Payer: BCBS MAPPO |
$138.77
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$228.13
|
| 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: Mclaren Medicaid |
$95.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.71
|
| Rate for Payer: Meridian Medicaid |
$99.97
|
| 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 Choice Medicaid |
$95.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.45
|
| Rate for Payer: Priority Health HMO/PPO |
$200.48
|
| Rate for Payer: Priority Health Medicare |
$140.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.48
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$95.21
|
|
|
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 |
$294.76
|
| 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
|
Facility
|
OP
|
$353.00
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
11442
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$83.84 |
| Max. Negotiated Rate |
$523.36 |
| 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 |
$523.36
|
| 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 |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.66
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| 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 |
$498.41
|
| 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 |
$294.76
|
| 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 |
$498.41
|
| 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
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$229.45 |
| Rate for Payer: Aetna Commercial |
$185.95
|
| Rate for Payer: Aetna Medicare |
$144.32
|
| Rate for Payer: BCBS Complete |
$99.97
|
| Rate for Payer: BCBS MAPPO |
$138.77
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$228.13
|
| 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: Mclaren Medicaid |
$95.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.71
|
| Rate for Payer: Meridian Medicaid |
$99.97
|
| 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 Choice Medicaid |
$95.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.45
|
| Rate for Payer: Priority Health HMO/PPO |
$200.48
|
| Rate for Payer: Priority Health Medicare |
$140.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.48
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$95.21
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM
|
Facility
|
OP
|
$449.00
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
11443
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$106.64 |
| Max. Negotiated Rate |
$1,205.21 |
| Rate for Payer: Aetna Commercial |
$381.65
|
| Rate for Payer: Aetna Medicare |
$116.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$140.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$140.31
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$112.25
|
| Rate for Payer: BCBS Trust/PPO |
$369.12
|
| Rate for Payer: BCN Commercial |
$349.10
|
| Rate for Payer: BCN Medicare Advantage |
$112.25
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cofinity Commercial |
$386.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.25
|
| Rate for Payer: Healthscope Commercial |
$404.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$336.75
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.86
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$381.65
|
| Rate for Payer: Nomi Health Commercial |
$368.18
|
| Rate for Payer: PACE Senior Care Partners |
$106.64
|
| Rate for Payer: PACE SWMI |
$112.25
|
| Rate for Payer: PHP Commercial |
$381.65
|
| Rate for Payer: PHP Medicare Advantage |
$112.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.85
|
| Rate for Payer: Priority Health HMO/PPO |
$390.63
|
| Rate for Payer: Priority Health Medicare |
$113.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$300.83
|
| Rate for Payer: Railroad Medicare Medicare |
$112.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.12
|
| Rate for Payer: UHC Core |
$374.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.25
|
| Rate for Payer: UHC Exchange |
$112.25
|
| Rate for Payer: UHC Medicare Advantage |
$112.25
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$112.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$336.75
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM
|
Facility
|
IP
|
$449.00
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
11443
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$291.85 |
| Max. Negotiated Rate |
$404.10 |
| Rate for Payer: Aetna Commercial |
$381.65
|
| Rate for Payer: BCBS Trust/PPO |
$366.52
|
| Rate for Payer: BCN Commercial |
$346.99
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cofinity Commercial |
$386.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.20
|
| Rate for Payer: Healthscope Commercial |
$404.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$336.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$381.65
|
| Rate for Payer: Nomi Health Commercial |
$368.18
|
| Rate for Payer: PHP Commercial |
$381.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.85
|
| Rate for Payer: Priority Health HMO/PPO |
$390.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$300.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.12
|
| Rate for Payer: UHC Core |
$374.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$336.75
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM
|
Professional
|
Both
|
$449.00
|
|
|
Service Code
|
HCPCS 11443
|
| Hospital Charge Code |
11443
|
| Min. Negotiated Rate |
$116.09 |
| Max. Negotiated Rate |
$291.85 |
| Rate for Payer: Aetna Commercial |
$227.97
|
| Rate for Payer: Aetna Medicare |
$176.94
|
| Rate for Payer: BCBS Complete |
$121.89
|
| Rate for Payer: BCBS MAPPO |
$170.13
|
| Rate for Payer: BCBS Trust/PPO |
$125.51
|
| Rate for Payer: BCN Commercial |
$268.97
|
| Rate for Payer: BCN Medicare Advantage |
$170.13
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cofinity Commercial |
$244.99
|
| Rate for Payer: Cofinity Commercial |
$227.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.13
|
| Rate for Payer: Mclaren Medicaid |
$116.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.64
|
| Rate for Payer: Meridian Medicaid |
$121.89
|
| Rate for Payer: Nomi Health Commercial |
$204.16
|
| Rate for Payer: PACE SWMI |
$170.13
|
| Rate for Payer: PHP Medicare Advantage |
$170.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.85
|
| Rate for Payer: Priority Health HMO/PPO |
$243.82
|
| Rate for Payer: Priority Health Medicare |
$171.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$243.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.13
|
| Rate for Payer: UHC Exchange |
$170.13
|
| Rate for Payer: UHC Medicare Advantage |
$170.13
|
| Rate for Payer: UHCCP Medicaid |
$116.09
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM
|
Professional
|
Both
|
$449.00
|
|
|
Service Code
|
HCPCS 11443
|
| Min. Negotiated Rate |
$116.09 |
| Max. Negotiated Rate |
$291.85 |
| Rate for Payer: Aetna Commercial |
$227.97
|
| Rate for Payer: Aetna Medicare |
$176.94
|
| Rate for Payer: BCBS Complete |
$121.89
|
| Rate for Payer: BCBS MAPPO |
$170.13
|
| Rate for Payer: BCBS Trust/PPO |
$125.51
|
| Rate for Payer: BCN Commercial |
$268.97
|
| Rate for Payer: BCN Medicare Advantage |
$170.13
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cofinity Commercial |
$244.99
|
| Rate for Payer: Cofinity Commercial |
$227.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.13
|
| Rate for Payer: Mclaren Medicaid |
$116.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.64
|
| Rate for Payer: Meridian Medicaid |
$121.89
|
| Rate for Payer: Nomi Health Commercial |
$204.16
|
| Rate for Payer: PACE SWMI |
$170.13
|
| Rate for Payer: PHP Medicare Advantage |
$170.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.85
|
| Rate for Payer: Priority Health HMO/PPO |
$243.82
|
| Rate for Payer: Priority Health Medicare |
$171.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$243.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.13
|
| Rate for Payer: UHC Exchange |
$170.13
|
| Rate for Payer: UHC Medicare Advantage |
$170.13
|
| Rate for Payer: UHCCP Medicaid |
$116.09
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM
|
Facility
|
IP
|
$577.00
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
11444
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$375.05 |
| Max. Negotiated Rate |
$519.30 |
| Rate for Payer: Aetna Commercial |
$490.45
|
| Rate for Payer: BCBS Trust/PPO |
$471.01
|
| Rate for Payer: BCN Commercial |
$445.91
|
| Rate for Payer: Cash Price |
$461.60
|
| Rate for Payer: Cofinity Commercial |
$496.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.60
|
| Rate for Payer: Healthscope Commercial |
$519.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.45
|
| Rate for Payer: Nomi Health Commercial |
$473.14
|
| Rate for Payer: PHP Commercial |
$490.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$375.05
|
| Rate for Payer: Priority Health HMO/PPO |
$501.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$386.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$507.76
|
| Rate for Payer: UHC Core |
$481.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.75
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM
|
Professional
|
Both
|
$577.00
|
|
|
Service Code
|
HCPCS 11444
|
| Hospital Charge Code |
11444
|
| Min. Negotiated Rate |
$146.76 |
| Max. Negotiated Rate |
$540.00 |
| Rate for Payer: Aetna Commercial |
$289.82
|
| Rate for Payer: Aetna Medicare |
$224.93
|
| Rate for Payer: BCBS Complete |
$154.10
|
| Rate for Payer: BCBS MAPPO |
$216.28
|
| Rate for Payer: BCBS Trust/PPO |
$540.00
|
| Rate for Payer: BCN Commercial |
$333.37
|
| Rate for Payer: BCN Medicare Advantage |
$216.28
|
| Rate for Payer: Cash Price |
$461.60
|
| Rate for Payer: Cash Price |
$461.60
|
| Rate for Payer: Cofinity Commercial |
$311.44
|
| Rate for Payer: Cofinity Commercial |
$289.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.28
|
| Rate for Payer: Mclaren Medicaid |
$146.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.09
|
| Rate for Payer: Meridian Medicaid |
$154.10
|
| Rate for Payer: Nomi Health Commercial |
$259.54
|
| Rate for Payer: PACE SWMI |
$216.28
|
| Rate for Payer: PHP Medicare Advantage |
$216.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$375.05
|
| Rate for Payer: Priority Health HMO/PPO |
$306.58
|
| Rate for Payer: Priority Health Medicare |
$218.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$306.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.28
|
| Rate for Payer: UHC Exchange |
$216.28
|
| Rate for Payer: UHC Medicare Advantage |
$216.28
|
| Rate for Payer: UHCCP Medicaid |
$146.76
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM
|
Facility
|
OP
|
$577.00
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
11444
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$137.04 |
| Max. Negotiated Rate |
$1,205.21 |
| Rate for Payer: Aetna Commercial |
$490.45
|
| Rate for Payer: Aetna Medicare |
$150.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$180.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$180.31
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$144.25
|
| Rate for Payer: BCBS Trust/PPO |
$474.35
|
| Rate for Payer: BCN Commercial |
$448.62
|
| Rate for Payer: BCN Medicare Advantage |
$144.25
|
| Rate for Payer: Cash Price |
$461.60
|
| Rate for Payer: Cash Price |
$461.60
|
| Rate for Payer: Cofinity Commercial |
$496.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.25
|
| Rate for Payer: Healthscope Commercial |
$519.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.75
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.46
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.45
|
| Rate for Payer: Nomi Health Commercial |
$473.14
|
| Rate for Payer: PACE Senior Care Partners |
$137.04
|
| Rate for Payer: PACE SWMI |
$144.25
|
| Rate for Payer: PHP Commercial |
$490.45
|
| Rate for Payer: PHP Medicare Advantage |
$144.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$375.05
|
| Rate for Payer: Priority Health HMO/PPO |
$501.99
|
| Rate for Payer: Priority Health Medicare |
$145.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$386.59
|
| Rate for Payer: Railroad Medicare Medicare |
$144.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$507.76
|
| Rate for Payer: UHC Core |
$481.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.25
|
| Rate for Payer: UHC Exchange |
$144.25
|
| Rate for Payer: UHC Medicare Advantage |
$144.25
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$144.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.75
|
|
|
PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM
|
Professional
|
Both
|
$577.00
|
|
|
Service Code
|
HCPCS 11444
|
| Min. Negotiated Rate |
$146.76 |
| Max. Negotiated Rate |
$540.00 |
| Rate for Payer: Aetna Commercial |
$289.82
|
| Rate for Payer: Aetna Medicare |
$224.93
|
| Rate for Payer: BCBS Complete |
$154.10
|
| Rate for Payer: BCBS MAPPO |
$216.28
|
| Rate for Payer: BCBS Trust/PPO |
$540.00
|
| Rate for Payer: BCN Commercial |
$333.37
|
| Rate for Payer: BCN Medicare Advantage |
$216.28
|
| Rate for Payer: Cash Price |
$461.60
|
| Rate for Payer: Cash Price |
$461.60
|
| Rate for Payer: Cofinity Commercial |
$311.44
|
| Rate for Payer: Cofinity Commercial |
$289.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.28
|
| Rate for Payer: Mclaren Medicaid |
$146.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.09
|
| Rate for Payer: Meridian Medicaid |
$154.10
|
| Rate for Payer: Nomi Health Commercial |
$259.54
|
| Rate for Payer: PACE SWMI |
$216.28
|
| Rate for Payer: PHP Medicare Advantage |
$216.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$375.05
|
| Rate for Payer: Priority Health HMO/PPO |
$306.58
|
| Rate for Payer: Priority Health Medicare |
$218.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$306.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.28
|
| Rate for Payer: UHC Exchange |
$216.28
|
| Rate for Payer: UHC Medicare Advantage |
$216.28
|
| Rate for Payer: UHCCP Medicaid |
$146.76
|
|
|
PR EXC BENIGN TUM CRANIAL BONE W/O OPTIC NRV DCMPRN
|
Professional
|
Both
|
$7,984.00
|
|
|
Service Code
|
HCPCS 61563
|
| Min. Negotiated Rate |
$382.49 |
| Max. Negotiated Rate |
$5,189.60 |
| Rate for Payer: Aetna Commercial |
$2,636.54
|
| Rate for Payer: Aetna Medicare |
$2,046.27
|
| Rate for Payer: BCBS Complete |
$1,355.99
|
| Rate for Payer: BCBS MAPPO |
$1,967.57
|
| Rate for Payer: BCBS Trust/PPO |
$382.49
|
| Rate for Payer: BCN Commercial |
$4,057.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,967.57
|
| Rate for Payer: Cash Price |
$6,387.20
|
| Rate for Payer: Cash Price |
$6,387.20
|
| Rate for Payer: Cofinity Commercial |
$2,833.30
|
| Rate for Payer: Cofinity Commercial |
$2,636.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,967.57
|
| Rate for Payer: Mclaren Medicaid |
$1,291.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,065.95
|
| Rate for Payer: Meridian Medicaid |
$1,355.99
|
| Rate for Payer: Nomi Health Commercial |
$2,361.08
|
| Rate for Payer: PACE SWMI |
$1,967.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,967.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,291.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,189.60
|
| Rate for Payer: Priority Health HMO/PPO |
$3,434.47
|
| Rate for Payer: Priority Health Medicare |
$1,987.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,434.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,967.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,967.57
|
| Rate for Payer: UHC Exchange |
$1,967.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,967.57
|
| Rate for Payer: UHCCP Medicaid |
$1,291.42
|
|
|
PR EXC BENIGN TUMOR/CYST MAXL INTRA-ORAL OSTEOT
|
Professional
|
Both
|
$2,311.00
|
|
|
Service Code
|
HCPCS 21048
|
| Min. Negotiated Rate |
$642.62 |
| Max. Negotiated Rate |
$3,701.02 |
| Rate for Payer: Aetna Commercial |
$1,265.09
|
| Rate for Payer: Aetna Medicare |
$981.86
|
| Rate for Payer: BCBS Complete |
$674.75
|
| Rate for Payer: BCBS MAPPO |
$944.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,701.02
|
| Rate for Payer: BCN Commercial |
$1,452.35
|
| Rate for Payer: BCN Medicare Advantage |
$944.10
|
| Rate for Payer: Cash Price |
$1,848.80
|
| Rate for Payer: Cash Price |
$1,848.80
|
| Rate for Payer: Cofinity Commercial |
$1,359.50
|
| Rate for Payer: Cofinity Commercial |
$1,265.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$944.10
|
| Rate for Payer: Mclaren Medicaid |
$642.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$991.30
|
| Rate for Payer: Meridian Medicaid |
$674.75
|
| Rate for Payer: Nomi Health Commercial |
$1,132.92
|
| Rate for Payer: PACE SWMI |
$944.10
|
| Rate for Payer: PHP Medicare Advantage |
$944.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,502.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,517.94
|
| Rate for Payer: Priority Health Medicare |
$953.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,517.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$944.10
|
| Rate for Payer: UHC Exchange |
$944.10
|
| Rate for Payer: UHC Medicare Advantage |
$944.10
|
| Rate for Payer: UHCCP Medicaid |
$642.62
|
|
|
PR EXC BENIGN TUMOR/CYST MAXL/ZYGOMA ENCL & CURTG
|
Professional
|
Both
|
$1,024.00
|
|
|
Service Code
|
HCPCS 21030
|
| Min. Negotiated Rate |
$234.73 |
| Max. Negotiated Rate |
$998.90 |
| Rate for Payer: Aetna Commercial |
$459.77
|
| Rate for Payer: Aetna Medicare |
$356.83
|
| Rate for Payer: BCBS Complete |
$246.47
|
| Rate for Payer: BCBS MAPPO |
$343.11
|
| Rate for Payer: BCBS Trust/PPO |
$998.90
|
| Rate for Payer: BCN Commercial |
$672.42
|
| Rate for Payer: BCN Medicare Advantage |
$343.11
|
| Rate for Payer: Cash Price |
$819.20
|
| Rate for Payer: Cash Price |
$819.20
|
| Rate for Payer: Cofinity Commercial |
$494.08
|
| Rate for Payer: Cofinity Commercial |
$459.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.11
|
| Rate for Payer: Mclaren Medicaid |
$234.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.27
|
| Rate for Payer: Meridian Medicaid |
$246.47
|
| Rate for Payer: Nomi Health Commercial |
$411.73
|
| Rate for Payer: PACE SWMI |
$343.11
|
| Rate for Payer: PHP Medicare Advantage |
$343.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.60
|
| Rate for Payer: Priority Health HMO/PPO |
$551.61
|
| Rate for Payer: Priority Health Medicare |
$346.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$551.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$343.11
|
| Rate for Payer: UHC Exchange |
$343.11
|
| Rate for Payer: UHC Medicare Advantage |
$343.11
|
| Rate for Payer: UHCCP Medicaid |
$234.73
|
|
|
PR EXC BRANCHIAL CLEFT CYST BELOW SUBQ TISS&/PHRYNX
|
Professional
|
Both
|
$1,655.00
|
|
|
Service Code
|
HCPCS 42815
|
| Min. Negotiated Rate |
$278.41 |
| Max. Negotiated Rate |
$1,075.75 |
| Rate for Payer: Aetna Commercial |
$684.15
|
| Rate for Payer: Aetna Medicare |
$530.98
|
| Rate for Payer: BCBS Complete |
$364.33
|
| Rate for Payer: BCBS MAPPO |
$510.56
|
| Rate for Payer: BCBS Trust/PPO |
$278.41
|
| Rate for Payer: BCN Commercial |
$796.55
|
| Rate for Payer: BCN Medicare Advantage |
$510.56
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Cofinity Commercial |
$735.21
|
| Rate for Payer: Cofinity Commercial |
$684.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.56
|
| Rate for Payer: Mclaren Medicaid |
$346.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.09
|
| Rate for Payer: Meridian Medicaid |
$364.33
|
| Rate for Payer: Nomi Health Commercial |
$612.67
|
| Rate for Payer: PACE SWMI |
$510.56
|
| Rate for Payer: PHP Medicare Advantage |
$510.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.75
|
| Rate for Payer: Priority Health HMO/PPO |
$971.85
|
| Rate for Payer: Priority Health Medicare |
$515.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$971.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$510.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.56
|
| Rate for Payer: UHC Exchange |
$510.56
|
| Rate for Payer: UHC Medicare Advantage |
$510.56
|
| Rate for Payer: UHCCP Medicaid |
$346.98
|
|
|
PR EXC BRANCHIAL CLEFT CYST CONFINED SKN&SUBQ TIS
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 42810
|
| Min. Negotiated Rate |
$183.82 |
| Max. Negotiated Rate |
$575.66 |
| Rate for Payer: Aetna Commercial |
$359.48
|
| Rate for Payer: Aetna Medicare |
$279.00
|
| Rate for Payer: BCBS Complete |
$193.01
|
| Rate for Payer: BCBS MAPPO |
$268.27
|
| Rate for Payer: BCBS Trust/PPO |
$196.53
|
| Rate for Payer: BCN Commercial |
$575.66
|
| Rate for Payer: BCN Medicare Advantage |
$268.27
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$386.31
|
| Rate for Payer: Cofinity Commercial |
$359.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.27
|
| Rate for Payer: Mclaren Medicaid |
$183.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.68
|
| Rate for Payer: Meridian Medicaid |
$193.01
|
| Rate for Payer: Nomi Health Commercial |
$321.92
|
| Rate for Payer: PACE SWMI |
$268.27
|
| Rate for Payer: PHP Medicare Advantage |
$268.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.55
|
| Rate for Payer: Priority Health HMO/PPO |
$513.07
|
| Rate for Payer: Priority Health Medicare |
$270.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$513.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$268.27
|
| Rate for Payer: UHC Exchange |
$268.27
|
| Rate for Payer: UHC Medicare Advantage |
$268.27
|
| Rate for Payer: UHCCP Medicaid |
$183.82
|
|
|
PR EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES
|
Professional
|
Both
|
$1,263.00
|
|
|
Service Code
|
HCPCS 19125
|
| Min. Negotiated Rate |
$13.80 |
| Max. Negotiated Rate |
$840.53 |
| Rate for Payer: Aetna Commercial |
$602.16
|
| Rate for Payer: Aetna Medicare |
$467.34
|
| Rate for Payer: BCBS Complete |
$315.57
|
| Rate for Payer: BCBS MAPPO |
$449.37
|
| Rate for Payer: BCBS Trust/PPO |
$13.80
|
| Rate for Payer: BCN Commercial |
$840.53
|
| Rate for Payer: BCN Medicare Advantage |
$449.37
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cofinity Commercial |
$647.09
|
| Rate for Payer: Cofinity Commercial |
$602.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.37
|
| Rate for Payer: Mclaren Medicaid |
$300.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.84
|
| Rate for Payer: Meridian Medicaid |
$315.57
|
| Rate for Payer: Nomi Health Commercial |
$539.24
|
| Rate for Payer: PACE SWMI |
$449.37
|
| Rate for Payer: PHP Medicare Advantage |
$449.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.95
|
| Rate for Payer: Priority Health HMO/PPO |
$632.13
|
| Rate for Payer: Priority Health Medicare |
$453.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$632.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$449.37
|
| Rate for Payer: UHC Exchange |
$449.37
|
| Rate for Payer: UHC Medicare Advantage |
$449.37
|
| Rate for Payer: UHCCP Medicaid |
$300.54
|
|
|
PR EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES
|
Professional
|
Both
|
$1,263.00
|
|
|
Service Code
|
HCPCS 19125
|
| Hospital Charge Code |
19125
|
| Min. Negotiated Rate |
$13.80 |
| Max. Negotiated Rate |
$840.53 |
| Rate for Payer: Aetna Commercial |
$602.16
|
| Rate for Payer: Aetna Medicare |
$467.34
|
| Rate for Payer: BCBS Complete |
$315.57
|
| Rate for Payer: BCBS MAPPO |
$449.37
|
| Rate for Payer: BCBS Trust/PPO |
$13.80
|
| Rate for Payer: BCN Commercial |
$840.53
|
| Rate for Payer: BCN Medicare Advantage |
$449.37
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cofinity Commercial |
$647.09
|
| Rate for Payer: Cofinity Commercial |
$602.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.37
|
| Rate for Payer: Mclaren Medicaid |
$300.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.84
|
| Rate for Payer: Meridian Medicaid |
$315.57
|
| Rate for Payer: Nomi Health Commercial |
$539.24
|
| Rate for Payer: PACE SWMI |
$449.37
|
| Rate for Payer: PHP Medicare Advantage |
$449.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.95
|
| Rate for Payer: Priority Health HMO/PPO |
$632.13
|
| Rate for Payer: Priority Health Medicare |
$453.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$632.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$449.37
|
| Rate for Payer: UHC Exchange |
$449.37
|
| Rate for Payer: UHC Medicare Advantage |
$449.37
|
| Rate for Payer: UHCCP Medicaid |
$300.54
|
|
|
PR EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES
|
Facility
|
OP
|
$1,263.00
|
|
|
Service Code
|
CPT 19125
|
| Hospital Charge Code |
19125
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$299.96 |
| Max. Negotiated Rate |
$2,848.40 |
| Rate for Payer: Aetna Commercial |
$1,073.55
|
| Rate for Payer: Aetna Medicare |
$328.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$394.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$394.69
|
| Rate for Payer: BCBS Complete |
$2,848.40
|
| Rate for Payer: BCBS MAPPO |
$315.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,038.31
|
| Rate for Payer: BCCCP Commercial |
$569.78
|
| Rate for Payer: BCN Commercial |
$981.98
|
| Rate for Payer: BCN Medicare Advantage |
$315.75
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cofinity Commercial |
$1,086.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,010.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.75
|
| Rate for Payer: Healthscope Commercial |
$1,136.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$947.25
|
| Rate for Payer: Mclaren Medicaid |
$2,712.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$331.54
|
| Rate for Payer: Meridian Medicaid |
$2,848.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$363.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,073.55
|
| Rate for Payer: Nomi Health Commercial |
$1,035.66
|
| Rate for Payer: PACE Senior Care Partners |
$299.96
|
| Rate for Payer: PACE SWMI |
$315.75
|
| Rate for Payer: PHP Commercial |
$1,073.55
|
| Rate for Payer: PHP Medicare Advantage |
$315.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,712.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.95
|
| Rate for Payer: Priority Health HMO/PPO |
$1,098.81
|
| Rate for Payer: Priority Health Medicare |
$318.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$846.21
|
| Rate for Payer: Railroad Medicare Medicare |
$315.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,111.44
|
| Rate for Payer: UHC Core |
$1,054.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$315.75
|
| Rate for Payer: UHC Exchange |
$315.75
|
| Rate for Payer: UHC Medicare Advantage |
$315.75
|
| Rate for Payer: UHCCP Medicaid |
$2,712.59
|
| Rate for Payer: VA VA |
$315.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$947.25
|
|
