|
HC APPLY HC SKIN SUB 1ST 25 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
IP
|
$2,553.43
|
|
|
Service Code
|
CPT 15275
|
| Hospital Charge Code |
76100061
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,557.34 |
| Max. Negotiated Rate |
$2,298.09 |
| Rate for Payer: Aetna Commercial |
$2,170.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,973.29
|
| Rate for Payer: BCN Commercial |
$1,973.29
|
| Rate for Payer: Cash Price |
$2,042.74
|
| Rate for Payer: Cofinity Commercial |
$2,195.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,042.74
|
| Rate for Payer: Healthscope Commercial |
$2,298.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,915.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,170.42
|
| Rate for Payer: PHP Commercial |
$2,170.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,787.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,221.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,557.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,247.02
|
| Rate for Payer: UHC Core |
$2,132.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,915.07
|
|
|
HC APPLY HC SKIN SUB 1ST 25 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
OP
|
$2,340.63
|
|
|
Service Code
|
CPT 15271
|
| Hospital Charge Code |
76100057
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$555.90 |
| Max. Negotiated Rate |
$2,106.57 |
| Rate for Payer: Aetna Commercial |
$1,989.54
|
| Rate for Payer: Aetna Medicare |
$608.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$731.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$731.45
|
| Rate for Payer: BCBS Complete |
$1,256.10
|
| Rate for Payer: BCBS MAPPO |
$585.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,819.84
|
| Rate for Payer: BCN Commercial |
$1,819.84
|
| Rate for Payer: BCN Medicare Advantage |
$585.16
|
| Rate for Payer: Cash Price |
$1,872.50
|
| Rate for Payer: Cash Price |
$1,872.50
|
| Rate for Payer: Cofinity Commercial |
$2,012.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,872.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.16
|
| Rate for Payer: Healthscope Commercial |
$2,106.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,755.47
|
| Rate for Payer: Mclaren Medicaid |
$1,196.28
|
| Rate for Payer: Meridian Medicaid |
$1,256.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$614.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$672.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,989.54
|
| Rate for Payer: PACE Senior Care Partners |
$555.90
|
| Rate for Payer: PACE SWMI |
$585.16
|
| Rate for Payer: PHP Commercial |
$1,989.54
|
| Rate for Payer: PHP Medicare Advantage |
$585.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,196.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,638.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,036.35
|
| Rate for Payer: Priority Health Medicare |
$585.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,427.55
|
| Rate for Payer: Railroad Medicare Medicare |
$585.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,059.75
|
| Rate for Payer: UHC Core |
$1,954.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.16
|
| Rate for Payer: UHC Medicare Advantage |
$602.71
|
| Rate for Payer: VA VA |
$585.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,755.47
|
|
|
HC APPLY HC SKIN SUB 1ST 25 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
IP
|
$2,340.63
|
|
|
Service Code
|
CPT 15271
|
| Hospital Charge Code |
76100057
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,427.55 |
| Max. Negotiated Rate |
$2,106.57 |
| Rate for Payer: Aetna Commercial |
$1,989.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,808.84
|
| Rate for Payer: BCN Commercial |
$1,808.84
|
| Rate for Payer: Cash Price |
$1,872.50
|
| Rate for Payer: Cofinity Commercial |
$2,012.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,872.50
|
| Rate for Payer: Healthscope Commercial |
$2,106.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,755.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,989.54
|
| Rate for Payer: PHP Commercial |
$1,989.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,638.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,036.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,427.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,059.75
|
| Rate for Payer: UHC Core |
$1,954.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,755.47
|
|
|
HC APPLY HC SKIN SUB ADDL 100 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
IP
|
$909.21
|
|
|
Service Code
|
CPT 15278
|
| Hospital Charge Code |
76100064
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$554.53 |
| Max. Negotiated Rate |
$818.29 |
| Rate for Payer: Aetna Commercial |
$772.83
|
| Rate for Payer: BCBS Trust/PPO |
$702.64
|
| Rate for Payer: BCN Commercial |
$702.64
|
| Rate for Payer: Cash Price |
$727.37
|
| Rate for Payer: Cofinity Commercial |
$781.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$727.37
|
| Rate for Payer: Healthscope Commercial |
$818.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$772.83
|
| Rate for Payer: PHP Commercial |
$772.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$636.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$791.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$554.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$800.10
|
| Rate for Payer: UHC Core |
$759.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.91
|
|
|
HC APPLY HC SKIN SUB ADDL 100 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
OP
|
$909.21
|
|
|
Service Code
|
CPT 15278
|
| Hospital Charge Code |
76100064
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$215.94 |
| Max. Negotiated Rate |
$818.29 |
| Rate for Payer: Aetna Commercial |
$772.83
|
| Rate for Payer: Aetna Medicare |
$236.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$284.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$284.13
|
| Rate for Payer: BCBS Complete |
$363.68
|
| Rate for Payer: BCBS MAPPO |
$227.30
|
| Rate for Payer: BCBS Trust/PPO |
$706.91
|
| Rate for Payer: BCN Commercial |
$706.91
|
| Rate for Payer: BCN Medicare Advantage |
$227.30
|
| Rate for Payer: Cash Price |
$727.37
|
| Rate for Payer: Cofinity Commercial |
$781.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$727.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.30
|
| Rate for Payer: Healthscope Commercial |
$818.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$238.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$772.83
|
| Rate for Payer: PACE Senior Care Partners |
$215.94
|
| Rate for Payer: PACE SWMI |
$227.30
|
| Rate for Payer: PHP Commercial |
$772.83
|
| Rate for Payer: PHP Medicare Advantage |
$227.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$636.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$791.01
|
| Rate for Payer: Priority Health Medicare |
$227.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$554.53
|
| Rate for Payer: Railroad Medicare Medicare |
$227.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$800.10
|
| Rate for Payer: UHC Core |
$759.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.30
|
| Rate for Payer: UHC Medicare Advantage |
$234.12
|
| Rate for Payer: VA VA |
$227.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.91
|
|
|
HC APPLY HC SKIN SUB ADDL 100 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
OP
|
$909.21
|
|
|
Service Code
|
CPT 15274
|
| Hospital Charge Code |
76100060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$215.94 |
| Max. Negotiated Rate |
$818.29 |
| Rate for Payer: Aetna Commercial |
$772.83
|
| Rate for Payer: Aetna Medicare |
$236.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$284.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$284.13
|
| Rate for Payer: BCBS Complete |
$363.68
|
| Rate for Payer: BCBS MAPPO |
$227.30
|
| Rate for Payer: BCBS Trust/PPO |
$706.91
|
| Rate for Payer: BCN Commercial |
$706.91
|
| Rate for Payer: BCN Medicare Advantage |
$227.30
|
| Rate for Payer: Cash Price |
$727.37
|
| Rate for Payer: Cofinity Commercial |
$781.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$727.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.30
|
| Rate for Payer: Healthscope Commercial |
$818.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$238.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$772.83
|
| Rate for Payer: PACE Senior Care Partners |
$215.94
|
| Rate for Payer: PACE SWMI |
$227.30
|
| Rate for Payer: PHP Commercial |
$772.83
|
| Rate for Payer: PHP Medicare Advantage |
$227.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$636.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$791.01
|
| Rate for Payer: Priority Health Medicare |
$227.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$554.53
|
| Rate for Payer: Railroad Medicare Medicare |
$227.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$800.10
|
| Rate for Payer: UHC Core |
$759.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.30
|
| Rate for Payer: UHC Medicare Advantage |
$234.12
|
| Rate for Payer: VA VA |
$227.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.91
|
|
|
HC APPLY HC SKIN SUB ADDL 100 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
IP
|
$909.21
|
|
|
Service Code
|
CPT 15274
|
| Hospital Charge Code |
76100060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$554.53 |
| Max. Negotiated Rate |
$818.29 |
| Rate for Payer: Aetna Commercial |
$772.83
|
| Rate for Payer: BCBS Trust/PPO |
$702.64
|
| Rate for Payer: BCN Commercial |
$702.64
|
| Rate for Payer: Cash Price |
$727.37
|
| Rate for Payer: Cofinity Commercial |
$781.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$727.37
|
| Rate for Payer: Healthscope Commercial |
$818.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$772.83
|
| Rate for Payer: PHP Commercial |
$772.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$636.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$791.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$554.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$800.10
|
| Rate for Payer: UHC Core |
$759.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.91
|
|
|
HC APPLY HC SKIN SUB ADDL 25 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
IP
|
$696.66
|
|
|
Service Code
|
CPT 15276
|
| Hospital Charge Code |
76100062
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$424.89 |
| Max. Negotiated Rate |
$626.99 |
| Rate for Payer: Aetna Commercial |
$592.16
|
| Rate for Payer: BCBS Trust/PPO |
$538.38
|
| Rate for Payer: BCN Commercial |
$538.38
|
| Rate for Payer: Cash Price |
$557.33
|
| Rate for Payer: Cofinity Commercial |
$599.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.33
|
| Rate for Payer: Healthscope Commercial |
$626.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$592.16
|
| Rate for Payer: PHP Commercial |
$592.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$424.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.06
|
| Rate for Payer: UHC Core |
$581.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.50
|
|
|
HC APPLY HC SKIN SUB ADDL 25 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
OP
|
$696.66
|
|
|
Service Code
|
CPT 15276
|
| Hospital Charge Code |
76100062
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$165.46 |
| Max. Negotiated Rate |
$626.99 |
| Rate for Payer: Aetna Commercial |
$592.16
|
| Rate for Payer: Aetna Medicare |
$181.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.71
|
| Rate for Payer: BCBS Complete |
$278.66
|
| Rate for Payer: BCBS MAPPO |
$174.16
|
| Rate for Payer: BCBS Trust/PPO |
$541.65
|
| Rate for Payer: BCN Commercial |
$541.65
|
| Rate for Payer: BCN Medicare Advantage |
$174.16
|
| Rate for Payer: Cash Price |
$557.33
|
| Rate for Payer: Cofinity Commercial |
$599.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.16
|
| Rate for Payer: Healthscope Commercial |
$626.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$182.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$592.16
|
| Rate for Payer: PACE Senior Care Partners |
$165.46
|
| Rate for Payer: PACE SWMI |
$174.16
|
| Rate for Payer: PHP Commercial |
$592.16
|
| Rate for Payer: PHP Medicare Advantage |
$174.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.09
|
| Rate for Payer: Priority Health Medicare |
$174.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$424.89
|
| Rate for Payer: Railroad Medicare Medicare |
$174.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.06
|
| Rate for Payer: UHC Core |
$581.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.16
|
| Rate for Payer: UHC Medicare Advantage |
$179.39
|
| Rate for Payer: VA VA |
$174.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.50
|
|
|
HC APPLY HC SKIN SUB ADDL 25 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
IP
|
$696.66
|
|
|
Service Code
|
CPT 15272
|
| Hospital Charge Code |
76100058
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$424.89 |
| Max. Negotiated Rate |
$626.99 |
| Rate for Payer: Aetna Commercial |
$592.16
|
| Rate for Payer: BCBS Trust/PPO |
$538.38
|
| Rate for Payer: BCN Commercial |
$538.38
|
| Rate for Payer: Cash Price |
$557.33
|
| Rate for Payer: Cofinity Commercial |
$599.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.33
|
| Rate for Payer: Healthscope Commercial |
$626.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$592.16
|
| Rate for Payer: PHP Commercial |
$592.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$424.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.06
|
| Rate for Payer: UHC Core |
$581.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.50
|
|
|
HC APPLY HC SKIN SUB ADDL 25 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
OP
|
$696.66
|
|
|
Service Code
|
CPT 15272
|
| Hospital Charge Code |
76100058
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$165.46 |
| Max. Negotiated Rate |
$626.99 |
| Rate for Payer: Aetna Commercial |
$592.16
|
| Rate for Payer: Aetna Medicare |
$181.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.71
|
| Rate for Payer: BCBS Complete |
$278.66
|
| Rate for Payer: BCBS MAPPO |
$174.16
|
| Rate for Payer: BCBS Trust/PPO |
$541.65
|
| Rate for Payer: BCN Commercial |
$541.65
|
| Rate for Payer: BCN Medicare Advantage |
$174.16
|
| Rate for Payer: Cash Price |
$557.33
|
| Rate for Payer: Cofinity Commercial |
$599.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.16
|
| Rate for Payer: Healthscope Commercial |
$626.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$182.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$592.16
|
| Rate for Payer: PACE Senior Care Partners |
$165.46
|
| Rate for Payer: PACE SWMI |
$174.16
|
| Rate for Payer: PHP Commercial |
$592.16
|
| Rate for Payer: PHP Medicare Advantage |
$174.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.09
|
| Rate for Payer: Priority Health Medicare |
$174.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$424.89
|
| Rate for Payer: Railroad Medicare Medicare |
$174.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.06
|
| Rate for Payer: UHC Core |
$581.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.16
|
| Rate for Payer: UHC Medicare Advantage |
$179.39
|
| Rate for Payer: VA VA |
$174.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.50
|
|
|
HC APPLY LC SKIN SUB 100 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
OP
|
$1,909.32
|
|
|
Service Code
|
HCPCS 15277
|
| Hospital Charge Code |
76100055
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$453.46 |
| Max. Negotiated Rate |
$1,718.39 |
| Rate for Payer: Aetna Commercial |
$1,622.92
|
| Rate for Payer: Aetna Medicare |
$496.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$596.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$596.66
|
| Rate for Payer: BCBS Complete |
$1,256.10
|
| Rate for Payer: BCBS MAPPO |
$477.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,484.50
|
| Rate for Payer: BCN Commercial |
$1,484.50
|
| Rate for Payer: BCN Medicare Advantage |
$477.33
|
| Rate for Payer: Cash Price |
$1,527.46
|
| Rate for Payer: Cash Price |
$1,527.46
|
| Rate for Payer: Cofinity Commercial |
$1,642.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,527.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.33
|
| Rate for Payer: Healthscope Commercial |
$1,718.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,431.99
|
| Rate for Payer: Mclaren Medicaid |
$1,196.28
|
| Rate for Payer: Meridian Medicaid |
$1,256.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$501.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$548.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,622.92
|
| Rate for Payer: PACE Senior Care Partners |
$453.46
|
| Rate for Payer: PACE SWMI |
$477.33
|
| Rate for Payer: PHP Commercial |
$1,622.92
|
| Rate for Payer: PHP Medicare Advantage |
$477.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,196.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,661.11
|
| Rate for Payer: Priority Health Medicare |
$477.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,164.49
|
| Rate for Payer: Railroad Medicare Medicare |
$477.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,680.20
|
| Rate for Payer: UHC Core |
$1,594.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$477.33
|
| Rate for Payer: UHC Medicare Advantage |
$491.65
|
| Rate for Payer: VA VA |
$477.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,431.99
|
|
|
HC APPLY LC SKIN SUB 100 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
IP
|
$1,909.32
|
|
|
Service Code
|
HCPCS 15277
|
| Hospital Charge Code |
76100055
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,164.49 |
| Max. Negotiated Rate |
$1,718.39 |
| Rate for Payer: Aetna Commercial |
$1,622.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,475.52
|
| Rate for Payer: BCN Commercial |
$1,475.52
|
| Rate for Payer: Cash Price |
$1,527.46
|
| Rate for Payer: Cofinity Commercial |
$1,642.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,527.46
|
| Rate for Payer: Healthscope Commercial |
$1,718.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,431.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,622.92
|
| Rate for Payer: PHP Commercial |
$1,622.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,661.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,164.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,680.20
|
| Rate for Payer: UHC Core |
$1,594.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,431.99
|
|
|
HC APPLY LC SKIN SUB 1ST 100 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
OP
|
$2,520.30
|
|
|
Service Code
|
HCPCS 15273
|
| Hospital Charge Code |
76100051
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$598.57 |
| Max. Negotiated Rate |
$2,471.13 |
| Rate for Payer: Aetna Commercial |
$2,142.26
|
| Rate for Payer: Aetna Medicare |
$655.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$787.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$787.59
|
| Rate for Payer: BCBS Complete |
$2,471.13
|
| Rate for Payer: BCBS MAPPO |
$630.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,959.53
|
| Rate for Payer: BCN Commercial |
$1,959.53
|
| Rate for Payer: BCN Medicare Advantage |
$630.08
|
| Rate for Payer: Cash Price |
$2,016.24
|
| Rate for Payer: Cash Price |
$2,016.24
|
| Rate for Payer: Cofinity Commercial |
$2,167.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,016.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$630.08
|
| Rate for Payer: Healthscope Commercial |
$2,268.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,890.22
|
| Rate for Payer: Mclaren Medicaid |
$2,353.45
|
| Rate for Payer: Meridian Medicaid |
$2,471.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$661.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$724.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,142.26
|
| Rate for Payer: PACE Senior Care Partners |
$598.57
|
| Rate for Payer: PACE SWMI |
$630.08
|
| Rate for Payer: PHP Commercial |
$2,142.26
|
| Rate for Payer: PHP Medicare Advantage |
$630.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,353.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,192.66
|
| Rate for Payer: Priority Health Medicare |
$630.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,537.13
|
| Rate for Payer: Railroad Medicare Medicare |
$630.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,217.86
|
| Rate for Payer: UHC Core |
$2,104.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$630.08
|
| Rate for Payer: UHC Medicare Advantage |
$648.98
|
| Rate for Payer: VA VA |
$630.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,890.22
|
|
|
HC APPLY LC SKIN SUB 1ST 100 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
IP
|
$2,520.30
|
|
|
Service Code
|
HCPCS 15273
|
| Hospital Charge Code |
76100051
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,537.13 |
| Max. Negotiated Rate |
$2,268.27 |
| Rate for Payer: Aetna Commercial |
$2,142.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,947.69
|
| Rate for Payer: BCN Commercial |
$1,947.69
|
| Rate for Payer: Cash Price |
$2,016.24
|
| Rate for Payer: Cofinity Commercial |
$2,167.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,016.24
|
| Rate for Payer: Healthscope Commercial |
$2,268.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,890.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,142.26
|
| Rate for Payer: PHP Commercial |
$2,142.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,192.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,537.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,217.86
|
| Rate for Payer: UHC Core |
$2,104.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,890.22
|
|
|
HC APPLY LC SKIN SUB 1ST 25 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
IP
|
$2,553.43
|
|
|
Service Code
|
HCPCS 15275
|
| Hospital Charge Code |
76100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,557.34 |
| Max. Negotiated Rate |
$2,298.09 |
| Rate for Payer: Aetna Commercial |
$2,170.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,973.29
|
| Rate for Payer: BCN Commercial |
$1,973.29
|
| Rate for Payer: Cash Price |
$2,042.74
|
| Rate for Payer: Cofinity Commercial |
$2,195.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,042.74
|
| Rate for Payer: Healthscope Commercial |
$2,298.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,915.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,170.42
|
| Rate for Payer: PHP Commercial |
$2,170.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,787.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,221.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,557.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,247.02
|
| Rate for Payer: UHC Core |
$2,132.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,915.07
|
|
|
HC APPLY LC SKIN SUB 1ST 25 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
OP
|
$2,553.43
|
|
|
Service Code
|
HCPCS 15275
|
| Hospital Charge Code |
76100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$606.44 |
| Max. Negotiated Rate |
$2,298.09 |
| Rate for Payer: Aetna Commercial |
$2,170.42
|
| Rate for Payer: Aetna Medicare |
$663.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$797.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$797.95
|
| Rate for Payer: BCBS Complete |
$1,256.10
|
| Rate for Payer: BCBS MAPPO |
$638.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,985.29
|
| Rate for Payer: BCN Commercial |
$1,985.29
|
| Rate for Payer: BCN Medicare Advantage |
$638.36
|
| Rate for Payer: Cash Price |
$2,042.74
|
| Rate for Payer: Cash Price |
$2,042.74
|
| Rate for Payer: Cofinity Commercial |
$2,195.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,042.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$638.36
|
| Rate for Payer: Healthscope Commercial |
$2,298.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,915.07
|
| Rate for Payer: Mclaren Medicaid |
$1,196.28
|
| Rate for Payer: Meridian Medicaid |
$1,256.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$670.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$734.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,170.42
|
| Rate for Payer: PACE Senior Care Partners |
$606.44
|
| Rate for Payer: PACE SWMI |
$638.36
|
| Rate for Payer: PHP Commercial |
$2,170.42
|
| Rate for Payer: PHP Medicare Advantage |
$638.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,196.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,787.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,221.48
|
| Rate for Payer: Priority Health Medicare |
$638.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,557.34
|
| Rate for Payer: Railroad Medicare Medicare |
$638.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,247.02
|
| Rate for Payer: UHC Core |
$2,132.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$638.36
|
| Rate for Payer: UHC Medicare Advantage |
$657.51
|
| Rate for Payer: VA VA |
$638.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,915.07
|
|
|
HC APPLY LC SKIN SUB 1ST 25 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
OP
|
$2,340.63
|
|
|
Service Code
|
HCPCS 15271
|
| Hospital Charge Code |
76100049
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$555.90 |
| Max. Negotiated Rate |
$2,106.57 |
| Rate for Payer: Aetna Commercial |
$1,989.54
|
| Rate for Payer: Aetna Medicare |
$608.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$731.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$731.45
|
| Rate for Payer: BCBS Complete |
$1,256.10
|
| Rate for Payer: BCBS MAPPO |
$585.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,819.84
|
| Rate for Payer: BCN Commercial |
$1,819.84
|
| Rate for Payer: BCN Medicare Advantage |
$585.16
|
| Rate for Payer: Cash Price |
$1,872.50
|
| Rate for Payer: Cash Price |
$1,872.50
|
| Rate for Payer: Cofinity Commercial |
$2,012.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,872.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.16
|
| Rate for Payer: Healthscope Commercial |
$2,106.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,755.47
|
| Rate for Payer: Mclaren Medicaid |
$1,196.28
|
| Rate for Payer: Meridian Medicaid |
$1,256.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$614.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$672.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,989.54
|
| Rate for Payer: PACE Senior Care Partners |
$555.90
|
| Rate for Payer: PACE SWMI |
$585.16
|
| Rate for Payer: PHP Commercial |
$1,989.54
|
| Rate for Payer: PHP Medicare Advantage |
$585.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,196.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,638.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,036.35
|
| Rate for Payer: Priority Health Medicare |
$585.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,427.55
|
| Rate for Payer: Railroad Medicare Medicare |
$585.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,059.75
|
| Rate for Payer: UHC Core |
$1,954.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.16
|
| Rate for Payer: UHC Medicare Advantage |
$602.71
|
| Rate for Payer: VA VA |
$585.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,755.47
|
|
|
HC APPLY LC SKIN SUB 1ST 25 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
IP
|
$2,340.63
|
|
|
Service Code
|
HCPCS 15271
|
| Hospital Charge Code |
76100049
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,427.55 |
| Max. Negotiated Rate |
$2,106.57 |
| Rate for Payer: Aetna Commercial |
$1,989.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,808.84
|
| Rate for Payer: BCN Commercial |
$1,808.84
|
| Rate for Payer: Cash Price |
$1,872.50
|
| Rate for Payer: Cofinity Commercial |
$2,012.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,872.50
|
| Rate for Payer: Healthscope Commercial |
$2,106.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,755.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,989.54
|
| Rate for Payer: PHP Commercial |
$1,989.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,638.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,036.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,427.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,059.75
|
| Rate for Payer: UHC Core |
$1,954.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,755.47
|
|
|
HC APPLY LC SKIN SUB ADDL 100 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
OP
|
$909.21
|
|
|
Service Code
|
HCPCS 15278
|
| Hospital Charge Code |
76100056
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$215.94 |
| Max. Negotiated Rate |
$818.29 |
| Rate for Payer: Aetna Commercial |
$772.83
|
| Rate for Payer: Aetna Medicare |
$236.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$284.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$284.13
|
| Rate for Payer: BCBS Complete |
$363.68
|
| Rate for Payer: BCBS MAPPO |
$227.30
|
| Rate for Payer: BCBS Trust/PPO |
$706.91
|
| Rate for Payer: BCN Commercial |
$706.91
|
| Rate for Payer: BCN Medicare Advantage |
$227.30
|
| Rate for Payer: Cash Price |
$727.37
|
| Rate for Payer: Cofinity Commercial |
$781.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$727.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.30
|
| Rate for Payer: Healthscope Commercial |
$818.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$238.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$772.83
|
| Rate for Payer: PACE Senior Care Partners |
$215.94
|
| Rate for Payer: PACE SWMI |
$227.30
|
| Rate for Payer: PHP Commercial |
$772.83
|
| Rate for Payer: PHP Medicare Advantage |
$227.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$636.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$791.01
|
| Rate for Payer: Priority Health Medicare |
$227.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$554.53
|
| Rate for Payer: Railroad Medicare Medicare |
$227.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$800.10
|
| Rate for Payer: UHC Core |
$759.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.30
|
| Rate for Payer: UHC Medicare Advantage |
$234.12
|
| Rate for Payer: VA VA |
$227.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.91
|
|
|
HC APPLY LC SKIN SUB ADDL 100 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
IP
|
$909.21
|
|
|
Service Code
|
HCPCS 15278
|
| Hospital Charge Code |
76100056
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$554.53 |
| Max. Negotiated Rate |
$818.29 |
| Rate for Payer: Aetna Commercial |
$772.83
|
| Rate for Payer: BCBS Trust/PPO |
$702.64
|
| Rate for Payer: BCN Commercial |
$702.64
|
| Rate for Payer: Cash Price |
$727.37
|
| Rate for Payer: Cofinity Commercial |
$781.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$727.37
|
| Rate for Payer: Healthscope Commercial |
$818.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$772.83
|
| Rate for Payer: PHP Commercial |
$772.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$636.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$791.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$554.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$800.10
|
| Rate for Payer: UHC Core |
$759.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.91
|
|
|
HC APPLY LC SKIN SUB ADDL 100 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
OP
|
$909.21
|
|
|
Service Code
|
HCPCS 15274
|
| Hospital Charge Code |
76100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$215.94 |
| Max. Negotiated Rate |
$818.29 |
| Rate for Payer: Aetna Commercial |
$772.83
|
| Rate for Payer: Aetna Medicare |
$236.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$284.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$284.13
|
| Rate for Payer: BCBS Complete |
$363.68
|
| Rate for Payer: BCBS MAPPO |
$227.30
|
| Rate for Payer: BCBS Trust/PPO |
$706.91
|
| Rate for Payer: BCN Commercial |
$706.91
|
| Rate for Payer: BCN Medicare Advantage |
$227.30
|
| Rate for Payer: Cash Price |
$727.37
|
| Rate for Payer: Cofinity Commercial |
$781.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$727.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.30
|
| Rate for Payer: Healthscope Commercial |
$818.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$238.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$772.83
|
| Rate for Payer: PACE Senior Care Partners |
$215.94
|
| Rate for Payer: PACE SWMI |
$227.30
|
| Rate for Payer: PHP Commercial |
$772.83
|
| Rate for Payer: PHP Medicare Advantage |
$227.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$636.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$791.01
|
| Rate for Payer: Priority Health Medicare |
$227.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$554.53
|
| Rate for Payer: Railroad Medicare Medicare |
$227.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$800.10
|
| Rate for Payer: UHC Core |
$759.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.30
|
| Rate for Payer: UHC Medicare Advantage |
$234.12
|
| Rate for Payer: VA VA |
$227.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.91
|
|
|
HC APPLY LC SKIN SUB ADDL 100 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
IP
|
$909.21
|
|
|
Service Code
|
HCPCS 15274
|
| Hospital Charge Code |
76100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$554.53 |
| Max. Negotiated Rate |
$818.29 |
| Rate for Payer: Aetna Commercial |
$772.83
|
| Rate for Payer: BCBS Trust/PPO |
$702.64
|
| Rate for Payer: BCN Commercial |
$702.64
|
| Rate for Payer: Cash Price |
$727.37
|
| Rate for Payer: Cofinity Commercial |
$781.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$727.37
|
| Rate for Payer: Healthscope Commercial |
$818.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$772.83
|
| Rate for Payer: PHP Commercial |
$772.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$636.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$791.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$554.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$800.10
|
| Rate for Payer: UHC Core |
$759.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.91
|
|
|
HC APPLY LC SKIN SUB ADDL 25 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
IP
|
$696.66
|
|
|
Service Code
|
HCPCS 15276
|
| Hospital Charge Code |
76100054
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$424.89 |
| Max. Negotiated Rate |
$626.99 |
| Rate for Payer: Aetna Commercial |
$592.16
|
| Rate for Payer: BCBS Trust/PPO |
$538.38
|
| Rate for Payer: BCN Commercial |
$538.38
|
| Rate for Payer: Cash Price |
$557.33
|
| Rate for Payer: Cofinity Commercial |
$599.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.33
|
| Rate for Payer: Healthscope Commercial |
$626.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$592.16
|
| Rate for Payer: PHP Commercial |
$592.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$424.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.06
|
| Rate for Payer: UHC Core |
$581.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.50
|
|
|
HC APPLY LC SKIN SUB ADDL 25 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
OP
|
$696.66
|
|
|
Service Code
|
HCPCS 15276
|
| Hospital Charge Code |
76100054
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$165.46 |
| Max. Negotiated Rate |
$626.99 |
| Rate for Payer: Aetna Commercial |
$592.16
|
| Rate for Payer: Aetna Medicare |
$181.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.71
|
| Rate for Payer: BCBS Complete |
$278.66
|
| Rate for Payer: BCBS MAPPO |
$174.16
|
| Rate for Payer: BCBS Trust/PPO |
$541.65
|
| Rate for Payer: BCN Commercial |
$541.65
|
| Rate for Payer: BCN Medicare Advantage |
$174.16
|
| Rate for Payer: Cash Price |
$557.33
|
| Rate for Payer: Cofinity Commercial |
$599.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.16
|
| Rate for Payer: Healthscope Commercial |
$626.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$182.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$592.16
|
| Rate for Payer: PACE Senior Care Partners |
$165.46
|
| Rate for Payer: PACE SWMI |
$174.16
|
| Rate for Payer: PHP Commercial |
$592.16
|
| Rate for Payer: PHP Medicare Advantage |
$174.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.09
|
| Rate for Payer: Priority Health Medicare |
$174.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$424.89
|
| Rate for Payer: Railroad Medicare Medicare |
$174.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.06
|
| Rate for Payer: UHC Core |
$581.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.16
|
| Rate for Payer: UHC Medicare Advantage |
$179.39
|
| Rate for Payer: VA VA |
$174.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.50
|
|
