|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Professional
|
Both
|
$950.00
|
|
|
Service Code
|
HCPCS 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 >4.0 CM
|
Facility
|
OP
|
$950.00
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
11646
|
|
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
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Professional
|
Both
|
$950.00
|
|
|
Service Code
|
HCPCS 11646
|
| Min. Negotiated Rate |
$212.36 |
| Max. Negotiated Rate |
$712.50 |
| Rate for Payer: Aetna Commercial |
$422.43
|
| Rate for Payer: Aetna Medicare |
$475.00
|
| Rate for Payer: BCBS Complete |
$222.98
|
| Rate for Payer: BCN Commercial |
$458.28
|
| Rate for Payer: Cash Price |
$760.00
|
| Rate for Payer: Cash Price |
$760.00
|
| Rate for Payer: Mclaren Medicaid |
$212.36
|
| Rate for Payer: Meridian Medicaid |
$222.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$712.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$531.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$531.89
|
| Rate for Payer: UHC Medicaid |
$212.36
|
| Rate for Payer: UHCCP Medicaid |
$212.36
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Professional
|
Both
|
$950.00
|
|
|
Service Code
|
HCPCS 11646
|
| Hospital Charge Code |
11646
|
| Min. Negotiated Rate |
$212.36 |
| Max. Negotiated Rate |
$712.50 |
| Rate for Payer: Aetna Commercial |
$422.43
|
| Rate for Payer: Aetna Medicare |
$475.00
|
| Rate for Payer: BCBS Complete |
$222.98
|
| Rate for Payer: BCN Commercial |
$458.28
|
| Rate for Payer: Cash Price |
$760.00
|
| Rate for Payer: Cash Price |
$760.00
|
| Rate for Payer: Mclaren Medicaid |
$212.36
|
| Rate for Payer: Meridian Medicaid |
$222.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$712.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$531.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$531.89
|
| Rate for Payer: UHC Medicaid |
$212.36
|
| Rate for Payer: UHCCP Medicaid |
$212.36
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Facility
|
IP
|
$950.00
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
11646
|
|
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 S/N/H/F/G 0.5 CM/<
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 11620
|
| Min. Negotiated Rate |
$69.65 |
| Max. Negotiated Rate |
$249.00 |
| Rate for Payer: Aetna Commercial |
$131.33
|
| Rate for Payer: Aetna Medicare |
$166.00
|
| Rate for Payer: BCBS Complete |
$73.13
|
| Rate for Payer: BCN Commercial |
$185.25
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Mclaren Medicaid |
$69.65
|
| Rate for Payer: Meridian Medicaid |
$73.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$169.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.55
|
| Rate for Payer: UHC Medicaid |
$69.65
|
| Rate for Payer: UHCCP Medicaid |
$69.65
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM
|
Professional
|
Both
|
$391.00
|
|
|
Service Code
|
HCPCS 11621
|
| Min. Negotiated Rate |
$82.43 |
| Max. Negotiated Rate |
$293.25 |
| Rate for Payer: Aetna Commercial |
$158.81
|
| Rate for Payer: Aetna Medicare |
$195.50
|
| Rate for Payer: BCBS Complete |
$86.55
|
| Rate for Payer: BCN Commercial |
$225.09
|
| Rate for Payer: Cash Price |
$312.80
|
| Rate for Payer: Cash Price |
$312.80
|
| Rate for Payer: Mclaren Medicaid |
$82.43
|
| Rate for Payer: Meridian Medicaid |
$86.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$293.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$206.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$206.02
|
| Rate for Payer: UHC Medicaid |
$82.43
|
| Rate for Payer: UHCCP Medicaid |
$82.43
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Facility
|
OP
|
$437.00
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
11622
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$77.04 |
| Max. Negotiated Rate |
$393.30 |
| Rate for Payer: Aetna Commercial |
$371.45
|
| Rate for Payer: Aetna Medicare |
$113.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.56
|
| Rate for Payer: BCBS Complete |
$80.89
|
| Rate for Payer: BCBS MAPPO |
$109.25
|
| Rate for Payer: BCBS Trust/PPO |
$359.26
|
| Rate for Payer: BCN Commercial |
$359.26
|
| Rate for Payer: BCN Medicare Advantage |
$109.25
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cofinity Commercial |
$375.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.25
|
| Rate for Payer: Healthscope Commercial |
$393.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.75
|
| Rate for Payer: Mclaren Medicaid |
$77.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.71
|
| Rate for Payer: Meridian Medicaid |
$80.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.45
|
| Rate for Payer: Nomi Health Commercial |
$358.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.75
|
| Rate for Payer: PACE Senior Care Partners |
$103.79
|
| Rate for Payer: PACE SWMI |
$109.25
|
| Rate for Payer: PHP Commercial |
$371.45
|
| Rate for Payer: PHP Medicare Advantage |
$109.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$380.19
|
| Rate for Payer: Priority Health Medicare |
$110.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$304.15
|
| Rate for Payer: Railroad Medicare Medicare |
$109.25
|
| Rate for Payer: UHC Core |
$364.89
|
| Rate for Payer: UHC Exchange |
$109.25
|
| Rate for Payer: UHC Medicaid |
$77.04
|
| Rate for Payer: UHC Medicare Advantage |
$109.25
|
| Rate for Payer: UHCCP Medicaid |
$77.04
|
| Rate for Payer: VA VA |
$109.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.75
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Professional
|
Both
|
$437.00
|
|
|
Service Code
|
HCPCS 11622
|
| Min. Negotiated Rate |
$91.80 |
| Max. Negotiated Rate |
$327.75 |
| Rate for Payer: Aetna Commercial |
$179.90
|
| Rate for Payer: Aetna Medicare |
$218.50
|
| Rate for Payer: BCBS Complete |
$96.39
|
| Rate for Payer: BCN Commercial |
$253.97
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Mclaren Medicaid |
$91.80
|
| Rate for Payer: Meridian Medicaid |
$96.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$232.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.45
|
| Rate for Payer: UHC Medicaid |
$91.80
|
| Rate for Payer: UHCCP Medicaid |
$91.80
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Professional
|
Both
|
$437.00
|
|
|
Service Code
|
HCPCS 11622
|
| Hospital Charge Code |
11622
|
| Min. Negotiated Rate |
$91.80 |
| Max. Negotiated Rate |
$327.75 |
| Rate for Payer: Aetna Commercial |
$179.90
|
| Rate for Payer: Aetna Medicare |
$218.50
|
| Rate for Payer: BCBS Complete |
$96.39
|
| Rate for Payer: BCN Commercial |
$253.97
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Mclaren Medicaid |
$91.80
|
| Rate for Payer: Meridian Medicaid |
$96.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$232.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.45
|
| Rate for Payer: UHC Medicaid |
$91.80
|
| Rate for Payer: UHCCP Medicaid |
$91.80
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Facility
|
IP
|
$437.00
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
11622
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$304.15 |
| Max. Negotiated Rate |
$393.30 |
| Rate for Payer: Aetna Commercial |
$371.45
|
| Rate for Payer: BCBS Trust/PPO |
$360.92
|
| Rate for Payer: BCN Commercial |
$360.92
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cofinity Commercial |
$375.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.60
|
| Rate for Payer: Healthscope Commercial |
$393.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.45
|
| Rate for Payer: Nomi Health Commercial |
$358.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.75
|
| Rate for Payer: PHP Commercial |
$371.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$380.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$304.15
|
| Rate for Payer: UHC Core |
$364.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.75
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Facility
|
OP
|
$543.00
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
11623
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$95.73 |
| Max. Negotiated Rate |
$488.70 |
| Rate for Payer: Aetna Commercial |
$461.55
|
| Rate for Payer: Aetna Medicare |
$141.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$169.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$169.69
|
| Rate for Payer: BCBS Complete |
$100.51
|
| Rate for Payer: BCBS MAPPO |
$135.75
|
| Rate for Payer: BCBS Trust/PPO |
$446.40
|
| Rate for Payer: BCN Commercial |
$446.40
|
| Rate for Payer: BCN Medicare Advantage |
$135.75
|
| Rate for Payer: Cash Price |
$434.40
|
| Rate for Payer: Cofinity Commercial |
$466.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.75
|
| Rate for Payer: Healthscope Commercial |
$488.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.25
|
| Rate for Payer: Mclaren Medicaid |
$95.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.54
|
| Rate for Payer: Meridian Medicaid |
$100.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$149.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.55
|
| Rate for Payer: Nomi Health Commercial |
$445.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$407.25
|
| Rate for Payer: PACE Senior Care Partners |
$128.96
|
| Rate for Payer: PACE SWMI |
$135.75
|
| Rate for Payer: PHP Commercial |
$461.55
|
| Rate for Payer: PHP Medicare Advantage |
$135.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$472.41
|
| Rate for Payer: Priority Health Medicare |
$137.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.93
|
| Rate for Payer: Railroad Medicare Medicare |
$135.75
|
| Rate for Payer: UHC Core |
$453.40
|
| Rate for Payer: UHC Exchange |
$135.75
|
| Rate for Payer: UHC Medicaid |
$95.73
|
| Rate for Payer: UHC Medicare Advantage |
$135.75
|
| Rate for Payer: UHCCP Medicaid |
$95.73
|
| Rate for Payer: VA VA |
$135.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.25
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Professional
|
Both
|
$543.00
|
|
|
Service Code
|
HCPCS 11623
|
| Min. Negotiated Rate |
$113.32 |
| Max. Negotiated Rate |
$407.25 |
| Rate for Payer: Aetna Commercial |
$224.21
|
| Rate for Payer: Aetna Medicare |
$271.50
|
| Rate for Payer: BCBS Complete |
$118.99
|
| Rate for Payer: BCN Commercial |
$313.73
|
| Rate for Payer: Cash Price |
$434.40
|
| Rate for Payer: Cash Price |
$434.40
|
| Rate for Payer: Mclaren Medicaid |
$113.32
|
| Rate for Payer: Meridian Medicaid |
$118.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$407.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$287.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$287.14
|
| Rate for Payer: UHC Medicaid |
$113.32
|
| Rate for Payer: UHCCP Medicaid |
$113.32
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Professional
|
Both
|
$543.00
|
|
|
Service Code
|
HCPCS 11623
|
| Hospital Charge Code |
11623
|
| Min. Negotiated Rate |
$113.32 |
| Max. Negotiated Rate |
$407.25 |
| Rate for Payer: Aetna Commercial |
$224.21
|
| Rate for Payer: Aetna Medicare |
$271.50
|
| Rate for Payer: BCBS Complete |
$118.99
|
| Rate for Payer: BCN Commercial |
$313.73
|
| Rate for Payer: Cash Price |
$434.40
|
| Rate for Payer: Cash Price |
$434.40
|
| Rate for Payer: Mclaren Medicaid |
$113.32
|
| Rate for Payer: Meridian Medicaid |
$118.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$407.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$287.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$287.14
|
| Rate for Payer: UHC Medicaid |
$113.32
|
| Rate for Payer: UHCCP Medicaid |
$113.32
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Facility
|
IP
|
$543.00
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
11623
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$377.93 |
| Max. Negotiated Rate |
$488.70 |
| Rate for Payer: Aetna Commercial |
$461.55
|
| Rate for Payer: BCBS Trust/PPO |
$448.46
|
| Rate for Payer: BCN Commercial |
$448.46
|
| Rate for Payer: Cash Price |
$434.40
|
| Rate for Payer: Cofinity Commercial |
$466.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.40
|
| Rate for Payer: Healthscope Commercial |
$488.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.55
|
| Rate for Payer: Nomi Health Commercial |
$445.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$407.25
|
| Rate for Payer: PHP Commercial |
$461.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$472.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.93
|
| Rate for Payer: UHC Core |
$453.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.25
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Facility
|
OP
|
$613.00
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$108.07 |
| Max. Negotiated Rate |
$551.70 |
| Rate for Payer: Aetna Commercial |
$521.05
|
| Rate for Payer: Aetna Medicare |
$159.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.56
|
| Rate for Payer: BCBS Complete |
$113.47
|
| Rate for Payer: BCBS MAPPO |
$153.25
|
| Rate for Payer: BCBS Trust/PPO |
$503.95
|
| Rate for Payer: BCN Commercial |
$503.95
|
| Rate for Payer: BCN Medicare Advantage |
$153.25
|
| Rate for Payer: Cash Price |
$490.40
|
| Rate for Payer: Cofinity Commercial |
$527.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$490.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.25
|
| Rate for Payer: Healthscope Commercial |
$551.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.75
|
| Rate for Payer: Mclaren Medicaid |
$108.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.91
|
| Rate for Payer: Meridian Medicaid |
$113.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$168.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$521.05
|
| Rate for Payer: Nomi Health Commercial |
$502.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.75
|
| Rate for Payer: PACE Senior Care Partners |
$145.59
|
| Rate for Payer: PACE SWMI |
$153.25
|
| Rate for Payer: PHP Commercial |
$521.05
|
| Rate for Payer: PHP Medicare Advantage |
$153.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$533.31
|
| Rate for Payer: Priority Health Medicare |
$154.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$426.65
|
| Rate for Payer: Railroad Medicare Medicare |
$153.25
|
| Rate for Payer: UHC Core |
$511.86
|
| Rate for Payer: UHC Exchange |
$153.25
|
| Rate for Payer: UHC Medicaid |
$108.07
|
| Rate for Payer: UHC Medicare Advantage |
$153.25
|
| Rate for Payer: UHCCP Medicaid |
$108.07
|
| Rate for Payer: VA VA |
$153.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.75
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Professional
|
Both
|
$613.00
|
|
|
Service Code
|
HCPCS 11624
|
| Hospital Charge Code |
11624
|
| Min. Negotiated Rate |
$129.50 |
| Max. Negotiated Rate |
$459.75 |
| Rate for Payer: Aetna Commercial |
$254.89
|
| Rate for Payer: Aetna Medicare |
$306.50
|
| Rate for Payer: BCBS Complete |
$135.97
|
| Rate for Payer: BCN Commercial |
$356.06
|
| Rate for Payer: Cash Price |
$490.40
|
| Rate for Payer: Cash Price |
$490.40
|
| Rate for Payer: Mclaren Medicaid |
$129.50
|
| Rate for Payer: Meridian Medicaid |
$135.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$325.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.89
|
| Rate for Payer: UHC Medicaid |
$129.50
|
| Rate for Payer: UHCCP Medicaid |
$129.50
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Facility
|
IP
|
$613.00
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$426.65 |
| Max. Negotiated Rate |
$551.70 |
| Rate for Payer: Aetna Commercial |
$521.05
|
| Rate for Payer: BCBS Trust/PPO |
$506.28
|
| Rate for Payer: BCN Commercial |
$506.28
|
| Rate for Payer: Cash Price |
$490.40
|
| Rate for Payer: Cofinity Commercial |
$527.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$490.40
|
| Rate for Payer: Healthscope Commercial |
$551.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$521.05
|
| Rate for Payer: Nomi Health Commercial |
$502.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.75
|
| Rate for Payer: PHP Commercial |
$521.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$533.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$426.65
|
| Rate for Payer: UHC Core |
$511.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.75
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Professional
|
Both
|
$613.00
|
|
|
Service Code
|
HCPCS 11624
|
| Min. Negotiated Rate |
$129.50 |
| Max. Negotiated Rate |
$459.75 |
| Rate for Payer: Aetna Commercial |
$254.89
|
| Rate for Payer: Aetna Medicare |
$306.50
|
| Rate for Payer: BCBS Complete |
$135.97
|
| Rate for Payer: BCN Commercial |
$356.06
|
| Rate for Payer: Cash Price |
$490.40
|
| Rate for Payer: Cash Price |
$490.40
|
| Rate for Payer: Mclaren Medicaid |
$129.50
|
| Rate for Payer: Meridian Medicaid |
$135.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$325.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.89
|
| Rate for Payer: UHC Medicaid |
$129.50
|
| Rate for Payer: UHCCP Medicaid |
$129.50
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Facility
|
IP
|
$958.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
11626
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$666.77 |
| Max. Negotiated Rate |
$862.20 |
| Rate for Payer: Aetna Commercial |
$814.30
|
| Rate for Payer: BCBS Trust/PPO |
$791.21
|
| Rate for Payer: BCN Commercial |
$791.21
|
| Rate for Payer: Cash Price |
$766.40
|
| Rate for Payer: Cofinity Commercial |
$823.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$766.40
|
| Rate for Payer: Healthscope Commercial |
$862.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$718.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$814.30
|
| Rate for Payer: Nomi Health Commercial |
$785.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$718.50
|
| Rate for Payer: PHP Commercial |
$814.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$833.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$666.77
|
| Rate for Payer: UHC Core |
$799.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$718.50
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Facility
|
OP
|
$958.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
11626
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$168.90 |
| Max. Negotiated Rate |
$862.20 |
| Rate for Payer: Aetna Commercial |
$814.30
|
| Rate for Payer: Aetna Medicare |
$249.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$299.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$299.38
|
| Rate for Payer: BCBS Complete |
$177.33
|
| Rate for Payer: BCBS MAPPO |
$239.50
|
| Rate for Payer: BCBS Trust/PPO |
$787.57
|
| Rate for Payer: BCN Commercial |
$787.57
|
| Rate for Payer: BCN Medicare Advantage |
$239.50
|
| Rate for Payer: Cash Price |
$766.40
|
| Rate for Payer: Cofinity Commercial |
$823.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$766.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.50
|
| Rate for Payer: Healthscope Commercial |
$862.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$718.50
|
| Rate for Payer: Mclaren Medicaid |
$168.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.47
|
| Rate for Payer: Meridian Medicaid |
$177.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$275.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$263.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$814.30
|
| Rate for Payer: Nomi Health Commercial |
$785.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$718.50
|
| Rate for Payer: PACE Senior Care Partners |
$227.53
|
| Rate for Payer: PACE SWMI |
$239.50
|
| Rate for Payer: PHP Commercial |
$814.30
|
| Rate for Payer: PHP Medicare Advantage |
$239.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$833.46
|
| Rate for Payer: Priority Health Medicare |
$241.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$666.77
|
| Rate for Payer: Railroad Medicare Medicare |
$239.50
|
| Rate for Payer: UHC Core |
$799.93
|
| Rate for Payer: UHC Exchange |
$239.50
|
| Rate for Payer: UHC Medicaid |
$168.90
|
| Rate for Payer: UHC Medicare Advantage |
$239.50
|
| Rate for Payer: UHCCP Medicaid |
$168.90
|
| Rate for Payer: VA VA |
$239.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$718.50
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Professional
|
Both
|
$958.00
|
|
|
Service Code
|
HCPCS 11626
|
| Min. Negotiated Rate |
$162.09 |
| Max. Negotiated Rate |
$718.50 |
| Rate for Payer: Aetna Commercial |
$315.59
|
| Rate for Payer: Aetna Medicare |
$479.00
|
| Rate for Payer: BCBS Complete |
$170.19
|
| Rate for Payer: BCN Commercial |
$343.61
|
| Rate for Payer: Cash Price |
$766.40
|
| Rate for Payer: Cash Price |
$766.40
|
| Rate for Payer: Mclaren Medicaid |
$162.09
|
| Rate for Payer: Meridian Medicaid |
$170.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$718.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$398.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$398.81
|
| Rate for Payer: UHC Medicaid |
$162.09
|
| Rate for Payer: UHCCP Medicaid |
$162.09
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Professional
|
Both
|
$958.00
|
|
|
Service Code
|
HCPCS 11626
|
| Hospital Charge Code |
11626
|
| Min. Negotiated Rate |
$162.09 |
| Max. Negotiated Rate |
$718.50 |
| Rate for Payer: Aetna Commercial |
$315.59
|
| Rate for Payer: Aetna Medicare |
$479.00
|
| Rate for Payer: BCBS Complete |
$170.19
|
| Rate for Payer: BCN Commercial |
$343.61
|
| Rate for Payer: Cash Price |
$766.40
|
| Rate for Payer: Cash Price |
$766.40
|
| Rate for Payer: Mclaren Medicaid |
$162.09
|
| Rate for Payer: Meridian Medicaid |
$170.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$718.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$398.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$398.81
|
| Rate for Payer: UHC Medicaid |
$162.09
|
| Rate for Payer: UHCCP Medicaid |
$162.09
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Facility
|
IP
|
$827.00
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
11606
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$575.59 |
| Max. Negotiated Rate |
$744.30 |
| Rate for Payer: Aetna Commercial |
$702.95
|
| Rate for Payer: BCBS Trust/PPO |
$683.02
|
| Rate for Payer: BCN Commercial |
$683.02
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cofinity Commercial |
$711.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$661.60
|
| Rate for Payer: Healthscope Commercial |
$744.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$620.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$702.95
|
| Rate for Payer: Nomi Health Commercial |
$678.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$620.25
|
| Rate for Payer: PHP Commercial |
$702.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$719.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$575.59
|
| Rate for Payer: UHC Core |
$690.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$620.25
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Facility
|
OP
|
$827.00
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
11606
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$145.80 |
| Max. Negotiated Rate |
$744.30 |
| Rate for Payer: Aetna Commercial |
$702.95
|
| Rate for Payer: Aetna Medicare |
$215.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$258.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$258.44
|
| Rate for Payer: BCBS Complete |
$153.08
|
| Rate for Payer: BCBS MAPPO |
$206.75
|
| Rate for Payer: BCBS Trust/PPO |
$679.88
|
| Rate for Payer: BCN Commercial |
$679.88
|
| Rate for Payer: BCN Medicare Advantage |
$206.75
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cofinity Commercial |
$711.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$661.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.75
|
| Rate for Payer: Healthscope Commercial |
$744.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$620.25
|
| Rate for Payer: Mclaren Medicaid |
$145.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$217.09
|
| Rate for Payer: Meridian Medicaid |
$153.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$237.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$227.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$702.95
|
| Rate for Payer: Nomi Health Commercial |
$678.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$620.25
|
| Rate for Payer: PACE Senior Care Partners |
$196.41
|
| Rate for Payer: PACE SWMI |
$206.75
|
| Rate for Payer: PHP Commercial |
$702.95
|
| Rate for Payer: PHP Medicare Advantage |
$206.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$719.49
|
| Rate for Payer: Priority Health Medicare |
$208.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$575.59
|
| Rate for Payer: Railroad Medicare Medicare |
$206.75
|
| Rate for Payer: UHC Core |
$690.54
|
| Rate for Payer: UHC Exchange |
$206.75
|
| Rate for Payer: UHC Medicaid |
$145.80
|
| Rate for Payer: UHC Medicare Advantage |
$206.75
|
| Rate for Payer: UHCCP Medicaid |
$145.80
|
| Rate for Payer: VA VA |
$206.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$620.25
|
|
