|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Facility
|
IP
|
$394.00
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
11641
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$256.10 |
| Max. Negotiated Rate |
$354.60 |
| Rate for Payer: Aetna Commercial |
$334.90
|
| Rate for Payer: BCBS Trust/PPO |
$321.62
|
| Rate for Payer: BCN Commercial |
$304.48
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$338.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.20
|
| Rate for Payer: Healthscope Commercial |
$354.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$334.90
|
| Rate for Payer: Nomi Health Commercial |
$323.08
|
| Rate for Payer: PHP Commercial |
$334.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health HMO/PPO |
$342.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$263.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.72
|
| Rate for Payer: UHC Core |
$328.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 11641
|
| Min. Negotiated Rate |
$147.12 |
| Max. Negotiated Rate |
$256.10 |
| Rate for Payer: Aetna Commercial |
$197.14
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: BCBS Complete |
$157.60
|
| Rate for Payer: BCBS MAPPO |
$147.12
|
| Rate for Payer: BCN Medicare Advantage |
$147.12
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$211.85
|
| Rate for Payer: Cofinity Commercial |
$197.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.48
|
| Rate for Payer: Nomi Health Commercial |
$176.54
|
| Rate for Payer: PACE SWMI |
$147.12
|
| Rate for Payer: PHP Medicare Advantage |
$147.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health Medicare |
$148.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.12
|
| Rate for Payer: UHC Exchange |
$147.12
|
| Rate for Payer: UHC Medicare Advantage |
$147.12
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 11641
|
| Hospital Charge Code |
11641
|
| Min. Negotiated Rate |
$147.12 |
| Max. Negotiated Rate |
$256.10 |
| Rate for Payer: Aetna Commercial |
$197.14
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: BCBS Complete |
$157.60
|
| Rate for Payer: BCBS MAPPO |
$147.12
|
| Rate for Payer: BCN Medicare Advantage |
$147.12
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$211.85
|
| Rate for Payer: Cofinity Commercial |
$197.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.48
|
| Rate for Payer: Nomi Health Commercial |
$176.54
|
| Rate for Payer: PACE SWMI |
$147.12
|
| Rate for Payer: PHP Medicare Advantage |
$147.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health Medicare |
$148.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.12
|
| Rate for Payer: UHC Exchange |
$147.12
|
| Rate for Payer: UHC Medicare Advantage |
$147.12
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Facility
|
OP
|
$394.00
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
11641
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$93.58 |
| Max. Negotiated Rate |
$534.17 |
| Rate for Payer: Aetna Commercial |
$334.90
|
| Rate for Payer: Aetna Medicare |
$102.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.12
|
| Rate for Payer: BCBS Complete |
$534.17
|
| Rate for Payer: BCBS MAPPO |
$98.50
|
| Rate for Payer: BCBS Trust/PPO |
$323.91
|
| Rate for Payer: BCN Commercial |
$306.33
|
| Rate for Payer: BCN Medicare Advantage |
$98.50
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$338.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.50
|
| Rate for Payer: Healthscope Commercial |
$354.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.50
|
| Rate for Payer: Mclaren Medicaid |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.42
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$334.90
|
| Rate for Payer: Nomi Health Commercial |
$323.08
|
| Rate for Payer: PACE Senior Care Partners |
$93.58
|
| Rate for Payer: PACE SWMI |
$98.50
|
| Rate for Payer: PHP Commercial |
$334.90
|
| Rate for Payer: PHP Medicare Advantage |
$98.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health HMO/PPO |
$342.78
|
| Rate for Payer: Priority Health Medicare |
$99.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$263.98
|
| Rate for Payer: Railroad Medicare Medicare |
$98.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.72
|
| Rate for Payer: UHC Core |
$328.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.50
|
| Rate for Payer: UHC Exchange |
$98.50
|
| Rate for Payer: UHC Medicare Advantage |
$98.50
|
| Rate for Payer: UHCCP Medicaid |
$508.70
|
| Rate for Payer: VA VA |
$98.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 11642
|
| Hospital Charge Code |
11642
|
| Min. Negotiated Rate |
$171.82 |
| Max. Negotiated Rate |
$387.40 |
| Rate for Payer: Aetna Commercial |
$230.24
|
| Rate for Payer: Aetna Medicare |
$178.69
|
| Rate for Payer: BCBS Complete |
$238.40
|
| Rate for Payer: BCBS MAPPO |
$171.82
|
| Rate for Payer: BCN Medicare Advantage |
$171.82
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$247.42
|
| Rate for Payer: Cofinity Commercial |
$230.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.41
|
| Rate for Payer: Nomi Health Commercial |
$206.18
|
| Rate for Payer: PACE SWMI |
$171.82
|
| Rate for Payer: PHP Medicare Advantage |
$171.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health Medicare |
$173.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.82
|
| Rate for Payer: UHC Exchange |
$171.82
|
| Rate for Payer: UHC Medicare Advantage |
$171.82
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Facility
|
IP
|
$596.00
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
11642
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$387.40 |
| Max. Negotiated Rate |
$536.40 |
| Rate for Payer: Aetna Commercial |
$506.60
|
| Rate for Payer: BCBS Trust/PPO |
$486.51
|
| Rate for Payer: BCN Commercial |
$460.59
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$512.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.80
|
| Rate for Payer: Healthscope Commercial |
$536.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.60
|
| Rate for Payer: Nomi Health Commercial |
$488.72
|
| Rate for Payer: PHP Commercial |
$506.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health HMO/PPO |
$518.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$399.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$524.48
|
| Rate for Payer: UHC Core |
$497.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.00
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Facility
|
OP
|
$596.00
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
11642
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$141.55 |
| Max. Negotiated Rate |
$536.40 |
| Rate for Payer: Aetna Commercial |
$506.60
|
| Rate for Payer: Aetna Medicare |
$154.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$186.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$186.25
|
| Rate for Payer: BCBS Complete |
$534.17
|
| Rate for Payer: BCBS MAPPO |
$149.00
|
| Rate for Payer: BCBS Trust/PPO |
$489.97
|
| Rate for Payer: BCN Commercial |
$463.39
|
| Rate for Payer: BCN Medicare Advantage |
$149.00
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$512.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.00
|
| Rate for Payer: Healthscope Commercial |
$536.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.00
|
| Rate for Payer: Mclaren Medicaid |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.45
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$171.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.60
|
| Rate for Payer: Nomi Health Commercial |
$488.72
|
| Rate for Payer: PACE Senior Care Partners |
$141.55
|
| Rate for Payer: PACE SWMI |
$149.00
|
| Rate for Payer: PHP Commercial |
$506.60
|
| Rate for Payer: PHP Medicare Advantage |
$149.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health HMO/PPO |
$518.52
|
| Rate for Payer: Priority Health Medicare |
$150.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$399.32
|
| Rate for Payer: Railroad Medicare Medicare |
$149.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$524.48
|
| Rate for Payer: UHC Core |
$497.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$149.00
|
| Rate for Payer: UHC Exchange |
$149.00
|
| Rate for Payer: UHC Medicare Advantage |
$149.00
|
| Rate for Payer: UHCCP Medicaid |
$508.70
|
| Rate for Payer: VA VA |
$149.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.00
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 11642
|
| Min. Negotiated Rate |
$171.82 |
| Max. Negotiated Rate |
$387.40 |
| Rate for Payer: Aetna Commercial |
$230.24
|
| Rate for Payer: Aetna Medicare |
$178.69
|
| Rate for Payer: BCBS Complete |
$238.40
|
| Rate for Payer: BCBS MAPPO |
$171.82
|
| Rate for Payer: BCN Medicare Advantage |
$171.82
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$247.42
|
| Rate for Payer: Cofinity Commercial |
$230.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.41
|
| Rate for Payer: Nomi Health Commercial |
$206.18
|
| Rate for Payer: PACE SWMI |
$171.82
|
| Rate for Payer: PHP Medicare Advantage |
$171.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health Medicare |
$173.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.82
|
| Rate for Payer: UHC Exchange |
$171.82
|
| Rate for Payer: UHC Medicare Advantage |
$171.82
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Professional
|
Both
|
$745.00
|
|
|
Service Code
|
HCPCS 11643
|
| Min. Negotiated Rate |
$216.06 |
| Max. Negotiated Rate |
$484.25 |
| Rate for Payer: Aetna Commercial |
$289.52
|
| Rate for Payer: Aetna Medicare |
$224.70
|
| Rate for Payer: BCBS Complete |
$298.00
|
| Rate for Payer: BCBS MAPPO |
$216.06
|
| Rate for Payer: BCN Medicare Advantage |
$216.06
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$311.13
|
| Rate for Payer: Cofinity Commercial |
$289.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.86
|
| Rate for Payer: Nomi Health Commercial |
$259.27
|
| Rate for Payer: PACE SWMI |
$216.06
|
| Rate for Payer: PHP Medicare Advantage |
$216.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: Priority Health Medicare |
$218.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.06
|
| Rate for Payer: UHC Exchange |
$216.06
|
| Rate for Payer: UHC Medicare Advantage |
$216.06
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Facility
|
IP
|
$745.00
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
11643
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$484.25 |
| Max. Negotiated Rate |
$670.50 |
| Rate for Payer: Aetna Commercial |
$633.25
|
| Rate for Payer: BCBS Trust/PPO |
$608.14
|
| Rate for Payer: BCN Commercial |
$575.74
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$640.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.00
|
| Rate for Payer: Healthscope Commercial |
$670.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$558.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$633.25
|
| Rate for Payer: Nomi Health Commercial |
$610.90
|
| Rate for Payer: PHP Commercial |
$633.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: Priority Health HMO/PPO |
$648.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$499.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$655.60
|
| Rate for Payer: UHC Core |
$622.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$558.75
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Facility
|
OP
|
$745.00
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
11643
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$176.94 |
| Max. Negotiated Rate |
$1,230.09 |
| Rate for Payer: Aetna Commercial |
$633.25
|
| Rate for Payer: Aetna Medicare |
$193.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$232.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$232.81
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$186.25
|
| Rate for Payer: BCBS Trust/PPO |
$612.46
|
| Rate for Payer: BCN Commercial |
$579.24
|
| Rate for Payer: BCN Medicare Advantage |
$186.25
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$640.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.25
|
| Rate for Payer: Healthscope Commercial |
$670.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$558.75
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.56
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$214.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$633.25
|
| Rate for Payer: Nomi Health Commercial |
$610.90
|
| Rate for Payer: PACE Senior Care Partners |
$176.94
|
| Rate for Payer: PACE SWMI |
$186.25
|
| Rate for Payer: PHP Commercial |
$633.25
|
| Rate for Payer: PHP Medicare Advantage |
$186.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: Priority Health HMO/PPO |
$648.15
|
| Rate for Payer: Priority Health Medicare |
$188.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$499.15
|
| Rate for Payer: Railroad Medicare Medicare |
$186.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$655.60
|
| Rate for Payer: UHC Core |
$622.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.25
|
| Rate for Payer: UHC Exchange |
$186.25
|
| Rate for Payer: UHC Medicare Advantage |
$186.25
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$186.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$558.75
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Professional
|
Both
|
$745.00
|
|
|
Service Code
|
HCPCS 11643
|
| Hospital Charge Code |
11643
|
| Min. Negotiated Rate |
$216.06 |
| Max. Negotiated Rate |
$484.25 |
| Rate for Payer: Aetna Commercial |
$289.52
|
| Rate for Payer: Aetna Medicare |
$224.70
|
| Rate for Payer: BCBS Complete |
$298.00
|
| Rate for Payer: BCBS MAPPO |
$216.06
|
| Rate for Payer: BCN Medicare Advantage |
$216.06
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$311.13
|
| Rate for Payer: Cofinity Commercial |
$289.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.86
|
| Rate for Payer: Nomi Health Commercial |
$259.27
|
| Rate for Payer: PACE SWMI |
$216.06
|
| Rate for Payer: PHP Medicare Advantage |
$216.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: Priority Health Medicare |
$218.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.06
|
| Rate for Payer: UHC Exchange |
$216.06
|
| Rate for Payer: UHC Medicare Advantage |
$216.06
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 11644
|
| Hospital Charge Code |
11644
|
| Min. Negotiated Rate |
$267.42 |
| Max. Negotiated Rate |
$599.30 |
| Rate for Payer: Aetna Commercial |
$358.34
|
| Rate for Payer: Aetna Medicare |
$278.12
|
| Rate for Payer: BCBS Complete |
$368.80
|
| Rate for Payer: BCBS MAPPO |
$267.42
|
| Rate for Payer: BCN Medicare Advantage |
$267.42
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$385.08
|
| Rate for Payer: Cofinity Commercial |
$358.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.79
|
| Rate for Payer: Nomi Health Commercial |
$320.90
|
| Rate for Payer: PACE SWMI |
$267.42
|
| Rate for Payer: PHP Medicare Advantage |
$267.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health Medicare |
$270.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$267.42
|
| Rate for Payer: UHC Exchange |
$267.42
|
| Rate for Payer: UHC Medicare Advantage |
$267.42
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Facility
|
IP
|
$922.00
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
11644
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$599.30 |
| Max. Negotiated Rate |
$829.80 |
| Rate for Payer: Aetna Commercial |
$783.70
|
| Rate for Payer: BCBS Trust/PPO |
$752.63
|
| Rate for Payer: BCN Commercial |
$712.52
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$792.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.60
|
| Rate for Payer: Healthscope Commercial |
$829.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.70
|
| Rate for Payer: Nomi Health Commercial |
$756.04
|
| Rate for Payer: PHP Commercial |
$783.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO |
$802.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$811.36
|
| Rate for Payer: UHC Core |
$769.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Facility
|
OP
|
$922.00
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
11644
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$218.97 |
| Max. Negotiated Rate |
$1,230.09 |
| Rate for Payer: Aetna Commercial |
$783.70
|
| Rate for Payer: Aetna Medicare |
$239.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$288.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$288.12
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$230.50
|
| Rate for Payer: BCBS Trust/PPO |
$757.98
|
| Rate for Payer: BCN Commercial |
$716.86
|
| Rate for Payer: BCN Medicare Advantage |
$230.50
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$792.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.50
|
| Rate for Payer: Healthscope Commercial |
$829.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.50
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.03
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$265.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.70
|
| Rate for Payer: Nomi Health Commercial |
$756.04
|
| Rate for Payer: PACE Senior Care Partners |
$218.97
|
| Rate for Payer: PACE SWMI |
$230.50
|
| Rate for Payer: PHP Commercial |
$783.70
|
| Rate for Payer: PHP Medicare Advantage |
$230.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO |
$802.14
|
| Rate for Payer: Priority Health Medicare |
$232.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.74
|
| Rate for Payer: Railroad Medicare Medicare |
$230.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$811.36
|
| Rate for Payer: UHC Core |
$769.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$230.50
|
| Rate for Payer: UHC Exchange |
$230.50
|
| Rate for Payer: UHC Medicare Advantage |
$230.50
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$230.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 11644
|
| Min. Negotiated Rate |
$267.42 |
| Max. Negotiated Rate |
$599.30 |
| Rate for Payer: Aetna Commercial |
$358.34
|
| Rate for Payer: Aetna Medicare |
$278.12
|
| Rate for Payer: BCBS Complete |
$368.80
|
| Rate for Payer: BCBS MAPPO |
$267.42
|
| Rate for Payer: BCN Medicare Advantage |
$267.42
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$385.08
|
| Rate for Payer: Cofinity Commercial |
$358.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.79
|
| Rate for Payer: Nomi Health Commercial |
$320.90
|
| Rate for Payer: PACE SWMI |
$267.42
|
| Rate for Payer: PHP Medicare Advantage |
$267.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health Medicare |
$270.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$267.42
|
| Rate for Payer: UHC Exchange |
$267.42
|
| Rate for Payer: UHC Medicare Advantage |
$267.42
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 11646
|
| Hospital Charge Code |
11646
|
| Min. Negotiated Rate |
$368.80 |
| Max. Negotiated Rate |
$599.30 |
| Rate for Payer: Aetna Commercial |
$496.20
|
| Rate for Payer: Aetna Medicare |
$385.11
|
| Rate for Payer: BCBS Complete |
$368.80
|
| Rate for Payer: BCBS MAPPO |
$370.30
|
| Rate for Payer: BCN Medicare Advantage |
$370.30
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$533.23
|
| Rate for Payer: Cofinity Commercial |
$496.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$388.81
|
| Rate for Payer: Nomi Health Commercial |
$444.36
|
| Rate for Payer: PACE SWMI |
$370.30
|
| Rate for Payer: PHP Medicare Advantage |
$370.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health Medicare |
$374.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$370.30
|
| Rate for Payer: UHC Exchange |
$370.30
|
| Rate for Payer: UHC Medicare Advantage |
$370.30
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 11646
|
| Min. Negotiated Rate |
$368.80 |
| Max. Negotiated Rate |
$599.30 |
| Rate for Payer: Aetna Commercial |
$496.20
|
| Rate for Payer: Aetna Medicare |
$385.11
|
| Rate for Payer: BCBS Complete |
$368.80
|
| Rate for Payer: BCBS MAPPO |
$370.30
|
| Rate for Payer: BCN Medicare Advantage |
$370.30
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$533.23
|
| Rate for Payer: Cofinity Commercial |
$496.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$388.81
|
| Rate for Payer: Nomi Health Commercial |
$444.36
|
| Rate for Payer: PACE SWMI |
$370.30
|
| Rate for Payer: PHP Medicare Advantage |
$370.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health Medicare |
$374.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$370.30
|
| Rate for Payer: UHC Exchange |
$370.30
|
| Rate for Payer: UHC Medicare Advantage |
$370.30
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Facility
|
OP
|
$922.00
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
11646
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$218.97 |
| Max. Negotiated Rate |
$2,172.87 |
| Rate for Payer: Aetna Commercial |
$783.70
|
| Rate for Payer: Aetna Medicare |
$239.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$288.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$288.12
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$230.50
|
| Rate for Payer: BCBS Trust/PPO |
$757.98
|
| Rate for Payer: BCN Commercial |
$716.86
|
| Rate for Payer: BCN Medicare Advantage |
$230.50
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$792.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.50
|
| Rate for Payer: Healthscope Commercial |
$829.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.50
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.03
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$265.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.70
|
| Rate for Payer: Nomi Health Commercial |
$756.04
|
| Rate for Payer: PACE Senior Care Partners |
$218.97
|
| Rate for Payer: PACE SWMI |
$230.50
|
| Rate for Payer: PHP Commercial |
$783.70
|
| Rate for Payer: PHP Medicare Advantage |
$230.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO |
$802.14
|
| Rate for Payer: Priority Health Medicare |
$232.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.74
|
| Rate for Payer: Railroad Medicare Medicare |
$230.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$811.36
|
| Rate for Payer: UHC Core |
$769.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$230.50
|
| Rate for Payer: UHC Exchange |
$230.50
|
| Rate for Payer: UHC Medicare Advantage |
$230.50
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$230.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Facility
|
IP
|
$922.00
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
11646
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$599.30 |
| Max. Negotiated Rate |
$829.80 |
| Rate for Payer: Aetna Commercial |
$783.70
|
| Rate for Payer: BCBS Trust/PPO |
$752.63
|
| Rate for Payer: BCN Commercial |
$712.52
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$792.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.60
|
| Rate for Payer: Healthscope Commercial |
$829.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.70
|
| Rate for Payer: Nomi Health Commercial |
$756.04
|
| Rate for Payer: PHP Commercial |
$783.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO |
$802.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$811.36
|
| Rate for Payer: UHC Core |
$769.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.50
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 11620
|
| Min. Negotiated Rate |
$116.21 |
| Max. Negotiated Rate |
$209.30 |
| Rate for Payer: Aetna Commercial |
$155.72
|
| Rate for Payer: Aetna Medicare |
$120.86
|
| Rate for Payer: BCBS Complete |
$128.80
|
| Rate for Payer: BCBS MAPPO |
$116.21
|
| Rate for Payer: BCN Medicare Advantage |
$116.21
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$167.34
|
| Rate for Payer: Cofinity Commercial |
$155.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.02
|
| Rate for Payer: Nomi Health Commercial |
$139.45
|
| Rate for Payer: PACE SWMI |
$116.21
|
| Rate for Payer: PHP Medicare Advantage |
$116.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health Medicare |
$117.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.21
|
| Rate for Payer: UHC Exchange |
$116.21
|
| Rate for Payer: UHC Medicare Advantage |
$116.21
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM
|
Professional
|
Both
|
$380.00
|
|
|
Service Code
|
HCPCS 11621
|
| Min. Negotiated Rate |
$141.47 |
| Max. Negotiated Rate |
$247.00 |
| Rate for Payer: Aetna Commercial |
$189.57
|
| Rate for Payer: Aetna Medicare |
$147.13
|
| Rate for Payer: BCBS Complete |
$152.00
|
| Rate for Payer: BCBS MAPPO |
$141.47
|
| Rate for Payer: BCN Medicare Advantage |
$141.47
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cofinity Commercial |
$203.72
|
| Rate for Payer: Cofinity Commercial |
$189.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.54
|
| Rate for Payer: Nomi Health Commercial |
$169.76
|
| Rate for Payer: PACE SWMI |
$141.47
|
| Rate for Payer: PHP Medicare Advantage |
$141.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.00
|
| Rate for Payer: Priority Health Medicare |
$142.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.47
|
| Rate for Payer: UHC Exchange |
$141.47
|
| Rate for Payer: UHC Medicare Advantage |
$141.47
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 11622
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$275.60 |
| Rate for Payer: Aetna Commercial |
$213.86
|
| Rate for Payer: Aetna Medicare |
$165.98
|
| Rate for Payer: BCBS Complete |
$169.60
|
| Rate for Payer: BCBS MAPPO |
$159.60
|
| Rate for Payer: BCN Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$229.82
|
| Rate for Payer: Cofinity Commercial |
$213.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.58
|
| Rate for Payer: Nomi Health Commercial |
$191.52
|
| Rate for Payer: PACE SWMI |
$159.60
|
| Rate for Payer: PHP Medicare Advantage |
$159.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.60
|
| Rate for Payer: Priority Health Medicare |
$161.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.60
|
| Rate for Payer: UHC Exchange |
$159.60
|
| Rate for Payer: UHC Medicare Advantage |
$159.60
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Facility
|
IP
|
$424.00
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
11622
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$275.60 |
| Max. Negotiated Rate |
$381.60 |
| Rate for Payer: Aetna Commercial |
$360.40
|
| Rate for Payer: BCBS Trust/PPO |
$346.11
|
| Rate for Payer: BCN Commercial |
$327.67
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$364.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.20
|
| Rate for Payer: Healthscope Commercial |
$381.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.40
|
| Rate for Payer: Nomi Health Commercial |
$347.68
|
| Rate for Payer: PHP Commercial |
$360.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.60
|
| Rate for Payer: Priority Health HMO/PPO |
$368.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$284.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$373.12
|
| Rate for Payer: UHC Core |
$354.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.00
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 11622
|
| Hospital Charge Code |
11622
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$275.60 |
| Rate for Payer: Aetna Commercial |
$213.86
|
| Rate for Payer: Aetna Medicare |
$165.98
|
| Rate for Payer: BCBS Complete |
$169.60
|
| Rate for Payer: BCBS MAPPO |
$159.60
|
| Rate for Payer: BCN Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$229.82
|
| Rate for Payer: Cofinity Commercial |
$213.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.58
|
| Rate for Payer: Nomi Health Commercial |
$191.52
|
| Rate for Payer: PACE SWMI |
$159.60
|
| Rate for Payer: PHP Medicare Advantage |
$159.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.60
|
| Rate for Payer: Priority Health Medicare |
$161.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.60
|
| Rate for Payer: UHC Exchange |
$159.60
|
| Rate for Payer: UHC Medicare Advantage |
$159.60
|
|
