|
PR EXCISION LESION FLOOR MOUTH
|
Professional
|
Both
|
$606.00
|
|
|
Service Code
|
HCPCS 41116
|
| Min. Negotiated Rate |
$128.44 |
| Max. Negotiated Rate |
$454.50 |
| Rate for Payer: Aetna Commercial |
$259.46
|
| Rate for Payer: Aetna Medicare |
$201.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.83
|
| Rate for Payer: BCBS Complete |
$134.86
|
| Rate for Payer: BCBS MAPPO |
$193.63
|
| Rate for Payer: BCN Commercial |
$327.67
|
| Rate for Payer: BCN Medicare Advantage |
$193.63
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cofinity Commercial |
$259.46
|
| Rate for Payer: Cofinity Commercial |
$278.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.31
|
| Rate for Payer: Meridian Medicaid |
$134.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$212.99
|
| Rate for Payer: Nomi Health Commercial |
$232.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$454.50
|
| Rate for Payer: PACE SWMI |
$193.63
|
| Rate for Payer: PHP Commercial |
$271.08
|
| Rate for Payer: PHP Medicare Advantage |
$193.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$399.25
|
| Rate for Payer: Priority Health Medicare |
$193.63
|
| Rate for Payer: Priority Health SBD |
$399.25
|
| Rate for Payer: Priority Health Tiered Network |
$399.25
|
| Rate for Payer: Railroad Medicare Medicare |
$193.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.19
|
| Rate for Payer: UHC Core |
$370.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$193.63
|
| Rate for Payer: UHC Exchange |
$370.19
|
| Rate for Payer: UHC Medicaid |
$128.44
|
| Rate for Payer: UHCCP Medicaid |
$128.44
|
| Rate for Payer: UMR Bronson Commercial |
$278.76
|
|
|
PR EXCISION LESION MENISCUS/CAPSULE KNEE
|
Professional
|
Both
|
$2,410.00
|
|
|
Service Code
|
HCPCS 27347
|
| Min. Negotiated Rate |
$323.97 |
| Max. Negotiated Rate |
$1,807.50 |
| Rate for Payer: Aetna Commercial |
$660.03
|
| Rate for Payer: Aetna Medicare |
$512.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$660.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.29
|
| Rate for Payer: BCBS Complete |
$340.17
|
| Rate for Payer: BCBS MAPPO |
$492.56
|
| Rate for Payer: BCN Commercial |
$811.71
|
| Rate for Payer: BCN Medicare Advantage |
$492.56
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cash Price |
$1,928.00
|
| Rate for Payer: Cofinity Commercial |
$660.03
|
| Rate for Payer: Cofinity Commercial |
$709.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$517.19
|
| Rate for Payer: Meridian Medicaid |
$340.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$541.82
|
| Rate for Payer: Nomi Health Commercial |
$591.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,807.50
|
| Rate for Payer: PACE SWMI |
$492.56
|
| Rate for Payer: PHP Commercial |
$689.58
|
| Rate for Payer: PHP Medicare Advantage |
$492.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$867.70
|
| Rate for Payer: Priority Health Medicare |
$492.56
|
| Rate for Payer: Priority Health SBD |
$867.70
|
| Rate for Payer: Priority Health Tiered Network |
$867.70
|
| Rate for Payer: Railroad Medicare Medicare |
$492.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$915.57
|
| Rate for Payer: UHC Core |
$915.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$492.56
|
| Rate for Payer: UHC Exchange |
$915.57
|
| Rate for Payer: UHC Medicaid |
$323.97
|
| Rate for Payer: UHCCP Medicaid |
$323.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,108.60
|
|
|
PR EXCISION LESION MESENTERY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,553.00
|
|
|
Service Code
|
HCPCS 44820
|
| Min. Negotiated Rate |
$515.46 |
| Max. Negotiated Rate |
$1,564.83 |
| Rate for Payer: Aetna Commercial |
$1,075.64
|
| Rate for Payer: Aetna Medicare |
$834.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,075.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,155.92
|
| Rate for Payer: BCBS Complete |
$541.23
|
| Rate for Payer: BCBS MAPPO |
$802.72
|
| Rate for Payer: BCN Commercial |
$1,284.30
|
| Rate for Payer: BCN Medicare Advantage |
$802.72
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cofinity Commercial |
$1,075.64
|
| Rate for Payer: Cofinity Commercial |
$1,155.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$842.86
|
| Rate for Payer: Meridian Medicaid |
$541.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$882.99
|
| Rate for Payer: Nomi Health Commercial |
$963.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,164.75
|
| Rate for Payer: PACE SWMI |
$802.72
|
| Rate for Payer: PHP Commercial |
$1,123.81
|
| Rate for Payer: PHP Medicare Advantage |
$802.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,564.83
|
| Rate for Payer: Priority Health Medicare |
$802.72
|
| Rate for Payer: Priority Health SBD |
$1,564.83
|
| Rate for Payer: Priority Health Tiered Network |
$1,564.83
|
| Rate for Payer: Railroad Medicare Medicare |
$802.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,485.56
|
| Rate for Payer: UHC Core |
$1,485.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$802.72
|
| Rate for Payer: UHC Exchange |
$1,485.56
|
| Rate for Payer: UHC Medicaid |
$515.46
|
| Rate for Payer: UHCCP Medicaid |
$515.46
|
| Rate for Payer: UMR Bronson Commercial |
$714.38
|
|
|
PR EXCISION LESION PANCREAS
|
Professional
|
Both
|
$2,343.00
|
|
|
Service Code
|
HCPCS 48120
|
| Min. Negotiated Rate |
$667.76 |
| Max. Negotiated Rate |
$2,039.92 |
| Rate for Payer: Aetna Commercial |
$1,397.37
|
| Rate for Payer: Aetna Medicare |
$1,084.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,397.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,501.65
|
| Rate for Payer: BCBS Complete |
$701.15
|
| Rate for Payer: BCBS MAPPO |
$1,042.81
|
| Rate for Payer: BCN Commercial |
$1,674.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,042.81
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cash Price |
$1,874.40
|
| Rate for Payer: Cofinity Commercial |
$1,397.37
|
| Rate for Payer: Cofinity Commercial |
$1,501.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,042.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,094.95
|
| Rate for Payer: Meridian Medicaid |
$701.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,147.09
|
| Rate for Payer: Nomi Health Commercial |
$1,251.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,757.25
|
| Rate for Payer: PACE SWMI |
$1,042.81
|
| Rate for Payer: PHP Commercial |
$1,459.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,042.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$667.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,039.92
|
| Rate for Payer: Priority Health Medicare |
$1,042.81
|
| Rate for Payer: Priority Health SBD |
$2,039.92
|
| Rate for Payer: Priority Health Tiered Network |
$2,039.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,042.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,970.93
|
| Rate for Payer: UHC Core |
$1,970.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,042.81
|
| Rate for Payer: UHC Exchange |
$1,970.93
|
| Rate for Payer: UHC Medicaid |
$667.76
|
| Rate for Payer: UHCCP Medicaid |
$667.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,077.78
|
|
|
PR EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK
|
Professional
|
Both
|
$1,384.00
|
|
|
Service Code
|
HCPCS 27630
|
| Min. Negotiated Rate |
$221.09 |
| Max. Negotiated Rate |
$1,038.00 |
| Rate for Payer: Aetna Commercial |
$449.89
|
| Rate for Payer: Aetna Medicare |
$349.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$483.47
|
| Rate for Payer: BCBS Complete |
$232.14
|
| Rate for Payer: BCBS MAPPO |
$335.74
|
| Rate for Payer: BCN Commercial |
$549.28
|
| Rate for Payer: BCN Medicare Advantage |
$335.74
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cofinity Commercial |
$449.89
|
| Rate for Payer: Cofinity Commercial |
$483.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.53
|
| Rate for Payer: Meridian Medicaid |
$232.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$369.31
|
| Rate for Payer: Nomi Health Commercial |
$402.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,038.00
|
| Rate for Payer: PACE SWMI |
$335.74
|
| Rate for Payer: PHP Commercial |
$470.04
|
| Rate for Payer: PHP Medicare Advantage |
$335.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$587.15
|
| Rate for Payer: Priority Health Medicare |
$335.74
|
| Rate for Payer: Priority Health SBD |
$587.15
|
| Rate for Payer: Priority Health Tiered Network |
$587.15
|
| Rate for Payer: Railroad Medicare Medicare |
$335.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.32
|
| Rate for Payer: UHC Core |
$625.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$335.74
|
| Rate for Payer: UHC Exchange |
$625.32
|
| Rate for Payer: UHC Medicaid |
$221.09
|
| Rate for Payer: UHCCP Medicaid |
$221.09
|
| Rate for Payer: UMR Bronson Commercial |
$636.64
|
|
|
PR EXCISION LESION TENDON SHEATH FOREARM&/WRIST
|
Professional
|
Both
|
$1,190.00
|
|
|
Service Code
|
HCPCS 25110
|
| Min. Negotiated Rate |
$215.34 |
| Max. Negotiated Rate |
$892.50 |
| Rate for Payer: Aetna Commercial |
$436.01
|
| Rate for Payer: Aetna Medicare |
$338.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$468.55
|
| Rate for Payer: BCBS Complete |
$226.11
|
| Rate for Payer: BCBS MAPPO |
$325.38
|
| Rate for Payer: BCN Commercial |
$536.33
|
| Rate for Payer: BCN Medicare Advantage |
$325.38
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cofinity Commercial |
$436.01
|
| Rate for Payer: Cofinity Commercial |
$468.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$325.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.65
|
| Rate for Payer: Meridian Medicaid |
$226.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$357.92
|
| Rate for Payer: Nomi Health Commercial |
$390.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
| Rate for Payer: PACE SWMI |
$325.38
|
| Rate for Payer: PHP Commercial |
$455.53
|
| Rate for Payer: PHP Medicare Advantage |
$325.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$573.31
|
| Rate for Payer: Priority Health Medicare |
$325.38
|
| Rate for Payer: Priority Health SBD |
$573.31
|
| Rate for Payer: Priority Health Tiered Network |
$573.31
|
| Rate for Payer: Railroad Medicare Medicare |
$325.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$590.96
|
| Rate for Payer: UHC Core |
$590.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$325.38
|
| Rate for Payer: UHC Exchange |
$590.96
|
| Rate for Payer: UHC Medicaid |
$215.34
|
| Rate for Payer: UHCCP Medicaid |
$215.34
|
| Rate for Payer: UMR Bronson Commercial |
$547.40
|
|
|
PR EXCISION LESION TONGUE W/O CLOSURE
|
Professional
|
Both
|
$392.00
|
|
|
Service Code
|
HCPCS 41110
|
| Min. Negotiated Rate |
$75.83 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna Commercial |
$153.42
|
| Rate for Payer: Aetna Medicare |
$119.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.87
|
| Rate for Payer: BCBS Complete |
$79.62
|
| Rate for Payer: BCBS MAPPO |
$114.49
|
| Rate for Payer: BCN Commercial |
$195.21
|
| Rate for Payer: BCN Medicare Advantage |
$114.49
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cofinity Commercial |
$153.42
|
| Rate for Payer: Cofinity Commercial |
$164.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.21
|
| Rate for Payer: Meridian Medicaid |
$79.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$125.94
|
| Rate for Payer: Nomi Health Commercial |
$137.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$294.00
|
| Rate for Payer: PACE SWMI |
$114.49
|
| Rate for Payer: PHP Commercial |
$160.29
|
| Rate for Payer: PHP Medicare Advantage |
$114.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$237.85
|
| Rate for Payer: Priority Health Medicare |
$114.49
|
| Rate for Payer: Priority Health SBD |
$237.85
|
| Rate for Payer: Priority Health Tiered Network |
$237.85
|
| Rate for Payer: Railroad Medicare Medicare |
$114.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.75
|
| Rate for Payer: UHC Core |
$223.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$114.49
|
| Rate for Payer: UHC Exchange |
$223.75
|
| Rate for Payer: UHC Medicaid |
$75.83
|
| Rate for Payer: UHCCP Medicaid |
$75.83
|
| Rate for Payer: UMR Bronson Commercial |
$180.32
|
|
|
PR EXCISION LINGUAL FRENUM FRENECTOMY
|
Professional
|
Both
|
$460.00
|
|
|
Service Code
|
HCPCS 41115
|
| Min. Negotiated Rate |
$84.99 |
| Max. Negotiated Rate |
$345.00 |
| Rate for Payer: Aetna Commercial |
$172.27
|
| Rate for Payer: Aetna Medicare |
$133.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.13
|
| Rate for Payer: BCBS Complete |
$89.24
|
| Rate for Payer: BCBS MAPPO |
$128.56
|
| Rate for Payer: BCN Commercial |
$220.11
|
| Rate for Payer: BCN Medicare Advantage |
$128.56
|
| Rate for Payer: Cash Price |
$368.00
|
| Rate for Payer: Cash Price |
$368.00
|
| Rate for Payer: Cofinity Commercial |
$172.27
|
| Rate for Payer: Cofinity Commercial |
$185.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.99
|
| Rate for Payer: Meridian Medicaid |
$89.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.42
|
| Rate for Payer: Nomi Health Commercial |
$154.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.00
|
| Rate for Payer: PACE SWMI |
$128.56
|
| Rate for Payer: PHP Commercial |
$179.98
|
| Rate for Payer: PHP Medicare Advantage |
$128.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$268.18
|
| Rate for Payer: Priority Health Medicare |
$128.56
|
| Rate for Payer: Priority Health SBD |
$268.18
|
| Rate for Payer: Priority Health Tiered Network |
$268.18
|
| Rate for Payer: Railroad Medicare Medicare |
$128.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.90
|
| Rate for Payer: UHC Core |
$249.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.56
|
| Rate for Payer: UHC Exchange |
$249.90
|
| Rate for Payer: UHC Medicaid |
$84.99
|
| Rate for Payer: UHCCP Medicaid |
$84.99
|
| Rate for Payer: UMR Bronson Commercial |
$211.60
|
|
|
PR EXCISION LOCAL LESION EPIDIDYMIS
|
Professional
|
Both
|
$636.00
|
|
|
Service Code
|
HCPCS 54830
|
| Min. Negotiated Rate |
$221.73 |
| Max. Negotiated Rate |
$651.61 |
| Rate for Payer: Aetna Commercial |
$455.75
|
| Rate for Payer: Aetna Medicare |
$353.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.76
|
| Rate for Payer: BCBS Complete |
$232.82
|
| Rate for Payer: BCBS MAPPO |
$340.11
|
| Rate for Payer: BCN Commercial |
$562.72
|
| Rate for Payer: BCN Medicare Advantage |
$340.11
|
| Rate for Payer: Cash Price |
$508.80
|
| Rate for Payer: Cash Price |
$508.80
|
| Rate for Payer: Cofinity Commercial |
$455.75
|
| Rate for Payer: Cofinity Commercial |
$489.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.12
|
| Rate for Payer: Meridian Medicaid |
$232.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$374.12
|
| Rate for Payer: Nomi Health Commercial |
$408.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$477.00
|
| Rate for Payer: PACE SWMI |
$340.11
|
| Rate for Payer: PHP Commercial |
$476.15
|
| Rate for Payer: PHP Medicare Advantage |
$340.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$612.99
|
| Rate for Payer: Priority Health Medicare |
$340.11
|
| Rate for Payer: Priority Health SBD |
$612.99
|
| Rate for Payer: Priority Health Tiered Network |
$612.99
|
| Rate for Payer: Railroad Medicare Medicare |
$340.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$651.61
|
| Rate for Payer: UHC Core |
$651.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$340.11
|
| Rate for Payer: UHC Exchange |
$651.61
|
| Rate for Payer: UHC Medicaid |
$221.73
|
| Rate for Payer: UHCCP Medicaid |
$221.73
|
| Rate for Payer: UMR Bronson Commercial |
$292.56
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Facility
|
IP
|
$343.00
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$150.92 |
| Max. Negotiated Rate |
$308.70 |
| Rate for Payer: Aetna American Axle |
$222.95
|
| Rate for Payer: Aetna Commercial |
$291.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.95
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Advantage |
$240.10
|
| Rate for Payer: Cofinity Commercial |
$294.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.40
|
| Rate for Payer: Healthscope Commercial |
$308.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$240.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.25
|
| Rate for Payer: PHP Commercial |
$291.55
|
| Rate for Payer: Priority Health SBD |
$216.09
|
| Rate for Payer: UMR Bronson Commercial |
$150.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.25
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
11640
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$257.25 |
| Rate for Payer: Aetna Commercial |
$143.94
|
| Rate for Payer: Aetna Medicare |
$111.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.68
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCBS MAPPO |
$107.42
|
| Rate for Payer: BCN Commercial |
$150.40
|
| Rate for Payer: BCN Medicare Advantage |
$107.42
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$143.94
|
| Rate for Payer: Cofinity Commercial |
$154.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.79
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.16
|
| Rate for Payer: Nomi Health Commercial |
$128.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.25
|
| Rate for Payer: PACE SWMI |
$107.42
|
| Rate for Payer: PHP Commercial |
$150.39
|
| Rate for Payer: PHP Medicare Advantage |
$107.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$174.57
|
| Rate for Payer: Priority Health Medicare |
$107.42
|
| Rate for Payer: Priority Health SBD |
$174.57
|
| Rate for Payer: Priority Health Tiered Network |
$174.57
|
| Rate for Payer: Railroad Medicare Medicare |
$107.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.30
|
| Rate for Payer: UHC Core |
$216.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.42
|
| Rate for Payer: UHC Exchange |
$216.30
|
| Rate for Payer: UHC Medicaid |
$70.72
|
| Rate for Payer: UHCCP Medicaid |
$70.72
|
| Rate for Payer: UMR Bronson Commercial |
$157.78
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 11640
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$257.25 |
| Rate for Payer: Aetna Commercial |
$143.94
|
| Rate for Payer: Aetna Medicare |
$111.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.68
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCBS MAPPO |
$107.42
|
| Rate for Payer: BCN Commercial |
$150.40
|
| Rate for Payer: BCN Medicare Advantage |
$107.42
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$143.94
|
| Rate for Payer: Cofinity Commercial |
$154.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.79
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.16
|
| Rate for Payer: Nomi Health Commercial |
$128.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.25
|
| Rate for Payer: PACE SWMI |
$107.42
|
| Rate for Payer: PHP Commercial |
$150.39
|
| Rate for Payer: PHP Medicare Advantage |
$107.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$174.57
|
| Rate for Payer: Priority Health Medicare |
$107.42
|
| Rate for Payer: Priority Health SBD |
$174.57
|
| Rate for Payer: Priority Health Tiered Network |
$174.57
|
| Rate for Payer: Railroad Medicare Medicare |
$107.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.30
|
| Rate for Payer: UHC Core |
$216.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.42
|
| Rate for Payer: UHC Exchange |
$216.30
|
| Rate for Payer: UHC Medicaid |
$70.72
|
| Rate for Payer: UHCCP Medicaid |
$70.72
|
| Rate for Payer: UMR Bronson Commercial |
$157.78
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Facility
|
OP
|
$343.00
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$126.91 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna American Axle |
$222.95
|
| Rate for Payer: Aetna Commercial |
$291.55
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$216.30
|
| Rate for Payer: BCN Commercial |
$216.30
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Advantage |
$240.10
|
| Rate for Payer: Cofinity Commercial |
$294.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$308.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$240.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.25
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.55
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.25
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$291.55
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$216.09
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UMR Bronson Commercial |
$126.91
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.25
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Professional
|
Both
|
$406.00
|
|
|
Service Code
|
HCPCS 11641
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$304.50 |
| Rate for Payer: Aetna Commercial |
$175.45
|
| Rate for Payer: Aetna Medicare |
$136.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.54
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCBS MAPPO |
$130.93
|
| Rate for Payer: BCN Commercial |
$184.57
|
| Rate for Payer: BCN Medicare Advantage |
$130.93
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cofinity Commercial |
$175.45
|
| Rate for Payer: Cofinity Commercial |
$188.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.48
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$144.02
|
| Rate for Payer: Nomi Health Commercial |
$157.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.50
|
| Rate for Payer: PACE SWMI |
$130.93
|
| Rate for Payer: PHP Commercial |
$183.30
|
| Rate for Payer: PHP Medicare Advantage |
$130.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$214.22
|
| Rate for Payer: Priority Health Medicare |
$130.93
|
| Rate for Payer: Priority Health SBD |
$214.22
|
| Rate for Payer: Priority Health Tiered Network |
$214.22
|
| Rate for Payer: Railroad Medicare Medicare |
$130.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.69
|
| Rate for Payer: UHC Core |
$268.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$130.93
|
| Rate for Payer: UHC Exchange |
$268.69
|
| Rate for Payer: UHC Medicaid |
$85.84
|
| Rate for Payer: UHCCP Medicaid |
$85.84
|
| Rate for Payer: UMR Bronson Commercial |
$186.76
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Professional
|
Both
|
$406.00
|
|
|
Service Code
|
HCPCS 11641
|
| Hospital Charge Code |
11641
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$304.50 |
| Rate for Payer: Aetna Commercial |
$175.45
|
| Rate for Payer: Aetna Medicare |
$136.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.54
|
| Rate for Payer: BCBS Complete |
$90.13
|
| Rate for Payer: BCBS MAPPO |
$130.93
|
| Rate for Payer: BCN Commercial |
$184.57
|
| Rate for Payer: BCN Medicare Advantage |
$130.93
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cofinity Commercial |
$175.45
|
| Rate for Payer: Cofinity Commercial |
$188.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.48
|
| Rate for Payer: Meridian Medicaid |
$90.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$144.02
|
| Rate for Payer: Nomi Health Commercial |
$157.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.50
|
| Rate for Payer: PACE SWMI |
$130.93
|
| Rate for Payer: PHP Commercial |
$183.30
|
| Rate for Payer: PHP Medicare Advantage |
$130.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$214.22
|
| Rate for Payer: Priority Health Medicare |
$130.93
|
| Rate for Payer: Priority Health SBD |
$214.22
|
| Rate for Payer: Priority Health Tiered Network |
$214.22
|
| Rate for Payer: Railroad Medicare Medicare |
$130.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.69
|
| Rate for Payer: UHC Core |
$268.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$130.93
|
| Rate for Payer: UHC Exchange |
$268.69
|
| Rate for Payer: UHC Medicaid |
$85.84
|
| Rate for Payer: UHCCP Medicaid |
$85.84
|
| Rate for Payer: UMR Bronson Commercial |
$186.76
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Facility
|
IP
|
$406.00
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
11641
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$178.64 |
| Max. Negotiated Rate |
$365.40 |
| Rate for Payer: Aetna American Axle |
$263.90
|
| Rate for Payer: Aetna Commercial |
$345.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.90
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cofinity Advantage |
$284.20
|
| Rate for Payer: Cofinity Commercial |
$349.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.80
|
| Rate for Payer: Healthscope Commercial |
$365.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.50
|
| Rate for Payer: PHP Commercial |
$345.10
|
| Rate for Payer: Priority Health SBD |
$255.78
|
| Rate for Payer: UMR Bronson Commercial |
$178.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Facility
|
OP
|
$406.00
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
11641
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$150.22 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna American Axle |
$263.90
|
| Rate for Payer: Aetna Commercial |
$345.10
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$244.39
|
| Rate for Payer: BCN Commercial |
$244.39
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cofinity Advantage |
$284.20
|
| Rate for Payer: Cofinity Commercial |
$349.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$365.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.50
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.10
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.50
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$345.10
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$255.78
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UMR Bronson Commercial |
$150.22
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 11642
|
| Hospital Charge Code |
11642
|
| Min. Negotiated Rate |
$98.62 |
| Max. Negotiated Rate |
$460.50 |
| Rate for Payer: Aetna Commercial |
$202.03
|
| Rate for Payer: Aetna Medicare |
$156.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.11
|
| Rate for Payer: BCBS Complete |
$103.55
|
| Rate for Payer: BCBS MAPPO |
$150.77
|
| Rate for Payer: BCN Commercial |
$215.20
|
| Rate for Payer: BCN Medicare Advantage |
$150.77
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Commercial |
$202.03
|
| Rate for Payer: Cofinity Commercial |
$217.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.31
|
| Rate for Payer: Meridian Medicaid |
$103.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$165.85
|
| Rate for Payer: Nomi Health Commercial |
$180.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.50
|
| Rate for Payer: PACE SWMI |
$150.77
|
| Rate for Payer: PHP Commercial |
$211.08
|
| Rate for Payer: PHP Medicare Advantage |
$150.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$249.77
|
| Rate for Payer: Priority Health Medicare |
$150.77
|
| Rate for Payer: Priority Health SBD |
$249.77
|
| Rate for Payer: Priority Health Tiered Network |
$249.77
|
| Rate for Payer: Railroad Medicare Medicare |
$150.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.60
|
| Rate for Payer: UHC Core |
$315.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$150.77
|
| Rate for Payer: UHC Exchange |
$315.60
|
| Rate for Payer: UHC Medicaid |
$98.62
|
| Rate for Payer: UHCCP Medicaid |
$98.62
|
| Rate for Payer: UMR Bronson Commercial |
$282.44
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Facility
|
OP
|
$614.00
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
11642
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$227.18 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna American Axle |
$399.10
|
| Rate for Payer: Aetna Commercial |
$521.90
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$879.35
|
| Rate for Payer: BCN Commercial |
$879.35
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Advantage |
$429.80
|
| Rate for Payer: Cofinity Commercial |
$528.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$552.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$429.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.50
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$521.90
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.50
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$521.90
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$386.82
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UMR Bronson Commercial |
$227.18
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 11642
|
| Min. Negotiated Rate |
$98.62 |
| Max. Negotiated Rate |
$460.50 |
| Rate for Payer: Aetna Commercial |
$202.03
|
| Rate for Payer: Aetna Medicare |
$156.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.11
|
| Rate for Payer: BCBS Complete |
$103.55
|
| Rate for Payer: BCBS MAPPO |
$150.77
|
| Rate for Payer: BCN Commercial |
$215.20
|
| Rate for Payer: BCN Medicare Advantage |
$150.77
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Commercial |
$202.03
|
| Rate for Payer: Cofinity Commercial |
$217.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.31
|
| Rate for Payer: Meridian Medicaid |
$103.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$165.85
|
| Rate for Payer: Nomi Health Commercial |
$180.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.50
|
| Rate for Payer: PACE SWMI |
$150.77
|
| Rate for Payer: PHP Commercial |
$211.08
|
| Rate for Payer: PHP Medicare Advantage |
$150.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$249.77
|
| Rate for Payer: Priority Health Medicare |
$150.77
|
| Rate for Payer: Priority Health SBD |
$249.77
|
| Rate for Payer: Priority Health Tiered Network |
$249.77
|
| Rate for Payer: Railroad Medicare Medicare |
$150.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.60
|
| Rate for Payer: UHC Core |
$315.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$150.77
|
| Rate for Payer: UHC Exchange |
$315.60
|
| Rate for Payer: UHC Medicaid |
$98.62
|
| Rate for Payer: UHCCP Medicaid |
$98.62
|
| Rate for Payer: UMR Bronson Commercial |
$282.44
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Facility
|
IP
|
$614.00
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
11642
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$270.16 |
| Max. Negotiated Rate |
$552.60 |
| Rate for Payer: Aetna American Axle |
$399.10
|
| Rate for Payer: Aetna Commercial |
$521.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.10
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Advantage |
$429.80
|
| Rate for Payer: Cofinity Commercial |
$528.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.20
|
| Rate for Payer: Healthscope Commercial |
$552.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$429.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$521.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.50
|
| Rate for Payer: PHP Commercial |
$521.90
|
| Rate for Payer: Priority Health SBD |
$386.82
|
| Rate for Payer: UMR Bronson Commercial |
$270.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Facility
|
OP
|
$767.00
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
11643
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$283.79 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$498.55
|
| Rate for Payer: Aetna Commercial |
$651.95
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$498.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.89
|
| Rate for Payer: BCN Commercial |
$2,031.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cofinity Advantage |
$536.90
|
| Rate for Payer: Cofinity Commercial |
$659.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$613.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$690.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$536.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$575.25
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$651.95
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$575.25
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$651.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$483.21
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$283.79
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$575.25
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Facility
|
IP
|
$767.00
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
11643
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$337.48 |
| Max. Negotiated Rate |
$690.30 |
| Rate for Payer: Aetna American Axle |
$498.55
|
| Rate for Payer: Aetna Commercial |
$651.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$498.55
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cofinity Advantage |
$536.90
|
| Rate for Payer: Cofinity Commercial |
$659.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$613.60
|
| Rate for Payer: Healthscope Commercial |
$690.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$536.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$575.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$651.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$575.25
|
| Rate for Payer: PHP Commercial |
$651.95
|
| Rate for Payer: Priority Health SBD |
$483.21
|
| Rate for Payer: UMR Bronson Commercial |
$337.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$575.25
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Professional
|
Both
|
$767.00
|
|
|
Service Code
|
HCPCS 11643
|
| Min. Negotiated Rate |
$123.33 |
| Max. Negotiated Rate |
$575.25 |
| Rate for Payer: Aetna Commercial |
$253.73
|
| Rate for Payer: Aetna Medicare |
$196.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.66
|
| Rate for Payer: BCBS Complete |
$129.50
|
| Rate for Payer: BCBS MAPPO |
$189.35
|
| Rate for Payer: BCN Commercial |
$269.39
|
| Rate for Payer: BCN Medicare Advantage |
$189.35
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cofinity Commercial |
$253.73
|
| Rate for Payer: Cofinity Commercial |
$272.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.82
|
| Rate for Payer: Meridian Medicaid |
$129.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$208.28
|
| Rate for Payer: Nomi Health Commercial |
$227.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$575.25
|
| Rate for Payer: PACE SWMI |
$189.35
|
| Rate for Payer: PHP Commercial |
$265.09
|
| Rate for Payer: PHP Medicare Advantage |
$189.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$312.67
|
| Rate for Payer: Priority Health Medicare |
$189.35
|
| Rate for Payer: Priority Health SBD |
$312.67
|
| Rate for Payer: Priority Health Tiered Network |
$312.67
|
| Rate for Payer: Railroad Medicare Medicare |
$189.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.93
|
| Rate for Payer: UHC Core |
$396.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$189.35
|
| Rate for Payer: UHC Exchange |
$396.93
|
| Rate for Payer: UHC Medicaid |
$123.33
|
| Rate for Payer: UHCCP Medicaid |
$123.33
|
| Rate for Payer: UMR Bronson Commercial |
$352.82
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Professional
|
Both
|
$767.00
|
|
|
Service Code
|
HCPCS 11643
|
| Hospital Charge Code |
11643
|
| Min. Negotiated Rate |
$123.33 |
| Max. Negotiated Rate |
$575.25 |
| Rate for Payer: Aetna Commercial |
$253.73
|
| Rate for Payer: Aetna Medicare |
$196.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.66
|
| Rate for Payer: BCBS Complete |
$129.50
|
| Rate for Payer: BCBS MAPPO |
$189.35
|
| Rate for Payer: BCN Commercial |
$269.39
|
| Rate for Payer: BCN Medicare Advantage |
$189.35
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cofinity Commercial |
$253.73
|
| Rate for Payer: Cofinity Commercial |
$272.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.82
|
| Rate for Payer: Meridian Medicaid |
$129.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$208.28
|
| Rate for Payer: Nomi Health Commercial |
$227.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$575.25
|
| Rate for Payer: PACE SWMI |
$189.35
|
| Rate for Payer: PHP Commercial |
$265.09
|
| Rate for Payer: PHP Medicare Advantage |
$189.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$312.67
|
| Rate for Payer: Priority Health Medicare |
$189.35
|
| Rate for Payer: Priority Health SBD |
$312.67
|
| Rate for Payer: Priority Health Tiered Network |
$312.67
|
| Rate for Payer: Railroad Medicare Medicare |
$189.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.93
|
| Rate for Payer: UHC Core |
$396.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$189.35
|
| Rate for Payer: UHC Exchange |
$396.93
|
| Rate for Payer: UHC Medicaid |
$123.33
|
| Rate for Payer: UHCCP Medicaid |
$123.33
|
| Rate for Payer: UMR Bronson Commercial |
$352.82
|
|
