|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 11641
|
| Hospital Charge Code |
11641
|
| Min. Negotiated Rate |
$100.11 |
| Max. Negotiated Rate |
$1,307.96 |
| Rate for Payer: Aetna Commercial |
$197.14
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.85
|
| Rate for Payer: BCBS Complete |
$105.12
|
| Rate for Payer: BCBS MAPPO |
$147.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.96
|
| Rate for Payer: BCN Commercial |
$279.57
|
| Rate for Payer: BCN Medicare Advantage |
$147.12
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$211.85
|
| Rate for Payer: Cofinity Commercial |
$197.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.48
|
| Rate for Payer: Meridian Medicaid |
$105.12
|
| Rate for Payer: Nomi Health Commercial |
$176.54
|
| Rate for Payer: PACE SWMI |
$147.12
|
| Rate for Payer: PHP Commercial |
$205.97
|
| Rate for Payer: PHP Medicare Advantage |
$147.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.41
|
| Rate for Payer: Priority Health Medicare |
$147.12
|
| Rate for Payer: Priority Health Narrow Network |
$210.41
|
| Rate for Payer: Priority Health SBD |
$210.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.12
|
| Rate for Payer: UHC Medicare Advantage |
$147.12
|
| Rate for Payer: UHCCP Medicaid |
$100.11
|
| Rate for Payer: UMR Bronson Commercial |
$181.24
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Facility
|
IP
|
$394.00
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
11641
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$173.36 |
| Max. Negotiated Rate |
$354.60 |
| Rate for Payer: Aetna American Axle |
$256.10
|
| Rate for Payer: Aetna Commercial |
$334.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.10
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$275.80
|
| Rate for Payer: Cofinity Commercial |
$338.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$275.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.20
|
| Rate for Payer: Healthscope Commercial |
$354.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$275.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$334.90
|
| Rate for Payer: PHP Commercial |
$334.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health SBD |
$248.22
|
| Rate for Payer: UMR Bronson Commercial |
$173.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 11641
|
| Min. Negotiated Rate |
$100.11 |
| Max. Negotiated Rate |
$1,307.96 |
| Rate for Payer: Aetna Commercial |
$197.14
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.85
|
| Rate for Payer: BCBS Complete |
$105.12
|
| Rate for Payer: BCBS MAPPO |
$147.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.96
|
| Rate for Payer: BCN Commercial |
$279.57
|
| Rate for Payer: BCN Medicare Advantage |
$147.12
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$197.14
|
| Rate for Payer: Cofinity Commercial |
$211.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.48
|
| Rate for Payer: Meridian Medicaid |
$105.12
|
| Rate for Payer: Nomi Health Commercial |
$176.54
|
| Rate for Payer: PACE SWMI |
$147.12
|
| Rate for Payer: PHP Commercial |
$205.97
|
| Rate for Payer: PHP Medicare Advantage |
$147.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.41
|
| Rate for Payer: Priority Health Medicare |
$147.12
|
| Rate for Payer: Priority Health Narrow Network |
$210.41
|
| Rate for Payer: Priority Health SBD |
$210.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.12
|
| Rate for Payer: UHC Medicare Advantage |
$147.12
|
| Rate for Payer: UHCCP Medicaid |
$100.11
|
| Rate for Payer: UMR Bronson Commercial |
$181.24
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Facility
|
OP
|
$596.00
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
11642
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$173.13 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna American Axle |
$387.40
|
| Rate for Payer: Aetna Commercial |
$506.60
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$727.88
|
| Rate for Payer: BCN Commercial |
$727.88
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$417.20
|
| Rate for Payer: Cofinity Commercial |
$512.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$417.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$536.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$417.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.00
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.60
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$506.60
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$375.48
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.44
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$173.13
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: UMR Bronson Commercial |
$220.52
|
| Rate for Payer: VA VA |
$689.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.00
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Facility
|
IP
|
$596.00
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
11642
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$262.24 |
| Max. Negotiated Rate |
$536.40 |
| Rate for Payer: Aetna American Axle |
$387.40
|
| Rate for Payer: Aetna Commercial |
$506.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.40
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$417.20
|
| Rate for Payer: Cofinity Commercial |
$512.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$417.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.80
|
| Rate for Payer: Healthscope Commercial |
$536.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$417.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.60
|
| Rate for Payer: PHP Commercial |
$506.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health SBD |
$375.48
|
| Rate for Payer: UMR Bronson Commercial |
$262.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.00
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 11642
|
| Hospital Charge Code |
11642
|
| Min. Negotiated Rate |
$116.72 |
| Max. Negotiated Rate |
$712.50 |
| Rate for Payer: Aetna Commercial |
$230.24
|
| Rate for Payer: Aetna Medicare |
$178.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.42
|
| Rate for Payer: BCBS Complete |
$122.56
|
| Rate for Payer: BCBS MAPPO |
$171.82
|
| Rate for Payer: BCBS Trust/PPO |
$712.50
|
| Rate for Payer: BCN Commercial |
$315.30
|
| Rate for Payer: BCN Medicare Advantage |
$171.82
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$247.42
|
| Rate for Payer: Cofinity Commercial |
$230.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.41
|
| Rate for Payer: Meridian Medicaid |
$122.56
|
| Rate for Payer: Nomi Health Commercial |
$206.18
|
| Rate for Payer: PACE SWMI |
$171.82
|
| Rate for Payer: PHP Commercial |
$240.55
|
| Rate for Payer: PHP Medicare Advantage |
$171.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.08
|
| Rate for Payer: Priority Health Medicare |
$171.82
|
| Rate for Payer: Priority Health Narrow Network |
$246.08
|
| Rate for Payer: Priority Health SBD |
$246.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.82
|
| Rate for Payer: UHC Medicare Advantage |
$171.82
|
| Rate for Payer: UHCCP Medicaid |
$116.72
|
| Rate for Payer: UMR Bronson Commercial |
$274.16
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 11642
|
| Min. Negotiated Rate |
$116.72 |
| Max. Negotiated Rate |
$712.50 |
| Rate for Payer: Aetna Commercial |
$230.24
|
| Rate for Payer: Aetna Medicare |
$178.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.42
|
| Rate for Payer: BCBS Complete |
$122.56
|
| Rate for Payer: BCBS MAPPO |
$171.82
|
| Rate for Payer: BCBS Trust/PPO |
$712.50
|
| Rate for Payer: BCN Commercial |
$315.30
|
| Rate for Payer: BCN Medicare Advantage |
$171.82
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$230.24
|
| Rate for Payer: Cofinity Commercial |
$247.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.41
|
| Rate for Payer: Meridian Medicaid |
$122.56
|
| Rate for Payer: Nomi Health Commercial |
$206.18
|
| Rate for Payer: PACE SWMI |
$171.82
|
| Rate for Payer: PHP Commercial |
$240.55
|
| Rate for Payer: PHP Medicare Advantage |
$171.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.08
|
| Rate for Payer: Priority Health Medicare |
$171.82
|
| Rate for Payer: Priority Health Narrow Network |
$246.08
|
| Rate for Payer: Priority Health SBD |
$246.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.82
|
| Rate for Payer: UHC Medicare Advantage |
$171.82
|
| Rate for Payer: UHCCP Medicaid |
$116.72
|
| Rate for Payer: UMR Bronson Commercial |
$274.16
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Facility
|
OP
|
$745.00
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
11643
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$216.46 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$484.25
|
| Rate for Payer: Aetna Commercial |
$633.25
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$484.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,681.90
|
| Rate for Payer: BCN Commercial |
$1,681.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$521.50
|
| Rate for Payer: Cofinity Commercial |
$640.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$521.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$670.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$521.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$558.75
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$633.25
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$633.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$469.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.11
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$216.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$275.65
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$558.75
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Professional
|
Both
|
$745.00
|
|
|
Service Code
|
HCPCS 11643
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$484.25 |
| Rate for Payer: Aetna Commercial |
$289.52
|
| Rate for Payer: Aetna Medicare |
$224.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.13
|
| Rate for Payer: BCBS Complete |
$153.43
|
| Rate for Payer: BCBS MAPPO |
$216.06
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$370.68
|
| Rate for Payer: BCN Medicare Advantage |
$216.06
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$289.52
|
| Rate for Payer: Cofinity Commercial |
$311.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.86
|
| Rate for Payer: Meridian Medicaid |
$153.43
|
| Rate for Payer: Nomi Health Commercial |
$259.27
|
| Rate for Payer: PACE SWMI |
$216.06
|
| Rate for Payer: PHP Commercial |
$302.48
|
| Rate for Payer: PHP Medicare Advantage |
$216.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$306.58
|
| Rate for Payer: Priority Health Medicare |
$216.06
|
| Rate for Payer: Priority Health Narrow Network |
$306.58
|
| Rate for Payer: Priority Health SBD |
$306.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.06
|
| Rate for Payer: UHC Medicare Advantage |
$216.06
|
| Rate for Payer: UHCCP Medicaid |
$146.12
|
| Rate for Payer: UMR Bronson Commercial |
$342.70
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Facility
|
IP
|
$745.00
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
11643
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$327.80 |
| Max. Negotiated Rate |
$670.50 |
| Rate for Payer: Aetna American Axle |
$484.25
|
| Rate for Payer: Aetna Commercial |
$633.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$484.25
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$521.50
|
| Rate for Payer: Cofinity Commercial |
$640.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$521.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.00
|
| Rate for Payer: Healthscope Commercial |
$670.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$521.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$558.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$633.25
|
| Rate for Payer: PHP Commercial |
$633.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: Priority Health SBD |
$469.35
|
| Rate for Payer: UMR Bronson Commercial |
$327.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$558.75
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Professional
|
Both
|
$745.00
|
|
|
Service Code
|
HCPCS 11643
|
| Hospital Charge Code |
11643
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$484.25 |
| Rate for Payer: Aetna Commercial |
$289.52
|
| Rate for Payer: Aetna Medicare |
$224.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.13
|
| Rate for Payer: BCBS Complete |
$153.43
|
| Rate for Payer: BCBS MAPPO |
$216.06
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$370.68
|
| Rate for Payer: BCN Medicare Advantage |
$216.06
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$311.13
|
| Rate for Payer: Cofinity Commercial |
$289.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.86
|
| Rate for Payer: Meridian Medicaid |
$153.43
|
| Rate for Payer: Nomi Health Commercial |
$259.27
|
| Rate for Payer: PACE SWMI |
$216.06
|
| Rate for Payer: PHP Commercial |
$302.48
|
| Rate for Payer: PHP Medicare Advantage |
$216.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$306.58
|
| Rate for Payer: Priority Health Medicare |
$216.06
|
| Rate for Payer: Priority Health Narrow Network |
$306.58
|
| Rate for Payer: Priority Health SBD |
$306.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.06
|
| Rate for Payer: UHC Medicare Advantage |
$216.06
|
| Rate for Payer: UHCCP Medicaid |
$146.12
|
| Rate for Payer: UMR Bronson Commercial |
$342.70
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Facility
|
IP
|
$922.00
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
11644
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$405.68 |
| Max. Negotiated Rate |
$829.80 |
| Rate for Payer: Aetna American Axle |
$599.30
|
| Rate for Payer: Aetna Commercial |
$783.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$599.30
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$645.40
|
| Rate for Payer: Cofinity Commercial |
$792.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$645.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.60
|
| Rate for Payer: Healthscope Commercial |
$829.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$645.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.70
|
| Rate for Payer: PHP Commercial |
$783.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health SBD |
$580.86
|
| Rate for Payer: UMR Bronson Commercial |
$405.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Facility
|
OP
|
$922.00
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
11644
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$268.84 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$599.30
|
| Rate for Payer: Aetna Commercial |
$783.70
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$599.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,071.04
|
| Rate for Payer: BCN Commercial |
$1,071.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$645.40
|
| Rate for Payer: Cofinity Commercial |
$792.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$645.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$829.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$645.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.50
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.70
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$783.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$580.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.72
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$268.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$341.14
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 11644
|
| Min. Negotiated Rate |
$180.41 |
| Max. Negotiated Rate |
$655.87 |
| Rate for Payer: Aetna Commercial |
$358.34
|
| Rate for Payer: Aetna Medicare |
$278.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$358.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$385.08
|
| Rate for Payer: BCBS Complete |
$189.43
|
| Rate for Payer: BCBS MAPPO |
$267.42
|
| Rate for Payer: BCBS Trust/PPO |
$655.87
|
| Rate for Payer: BCN Commercial |
$457.06
|
| Rate for Payer: BCN Medicare Advantage |
$267.42
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$358.34
|
| Rate for Payer: Cofinity Commercial |
$385.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.79
|
| Rate for Payer: Meridian Medicaid |
$189.43
|
| Rate for Payer: Nomi Health Commercial |
$320.90
|
| Rate for Payer: PACE SWMI |
$267.42
|
| Rate for Payer: PHP Commercial |
$374.39
|
| Rate for Payer: PHP Medicare Advantage |
$267.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$180.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$379.73
|
| Rate for Payer: Priority Health Medicare |
$267.42
|
| Rate for Payer: Priority Health Narrow Network |
$379.73
|
| Rate for Payer: Priority Health SBD |
$379.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$267.42
|
| Rate for Payer: UHC Medicare Advantage |
$267.42
|
| Rate for Payer: UHCCP Medicaid |
$180.41
|
| Rate for Payer: UMR Bronson Commercial |
$424.12
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 11644
|
| Hospital Charge Code |
11644
|
| Min. Negotiated Rate |
$180.41 |
| Max. Negotiated Rate |
$655.87 |
| Rate for Payer: Aetna Commercial |
$358.34
|
| Rate for Payer: Aetna Medicare |
$278.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$358.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$385.08
|
| Rate for Payer: BCBS Complete |
$189.43
|
| Rate for Payer: BCBS MAPPO |
$267.42
|
| Rate for Payer: BCBS Trust/PPO |
$655.87
|
| Rate for Payer: BCN Commercial |
$457.06
|
| Rate for Payer: BCN Medicare Advantage |
$267.42
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$385.08
|
| Rate for Payer: Cofinity Commercial |
$358.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.79
|
| Rate for Payer: Meridian Medicaid |
$189.43
|
| Rate for Payer: Nomi Health Commercial |
$320.90
|
| Rate for Payer: PACE SWMI |
$267.42
|
| Rate for Payer: PHP Commercial |
$374.39
|
| Rate for Payer: PHP Medicare Advantage |
$267.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$180.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$379.73
|
| Rate for Payer: Priority Health Medicare |
$267.42
|
| Rate for Payer: Priority Health Narrow Network |
$379.73
|
| Rate for Payer: Priority Health SBD |
$379.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$267.42
|
| Rate for Payer: UHC Medicare Advantage |
$267.42
|
| Rate for Payer: UHCCP Medicaid |
$180.41
|
| Rate for Payer: UMR Bronson Commercial |
$424.12
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 11646
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$599.30 |
| Rate for Payer: Aetna Commercial |
$496.20
|
| Rate for Payer: Aetna Medicare |
$385.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$496.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.23
|
| Rate for Payer: BCBS Complete |
$261.00
|
| Rate for Payer: BCBS MAPPO |
$370.30
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$594.10
|
| Rate for Payer: BCN Medicare Advantage |
$370.30
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$496.20
|
| Rate for Payer: Cofinity Commercial |
$533.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$388.82
|
| Rate for Payer: Meridian Medicaid |
$261.00
|
| Rate for Payer: Nomi Health Commercial |
$444.36
|
| Rate for Payer: PACE SWMI |
$370.30
|
| Rate for Payer: PHP Commercial |
$518.42
|
| Rate for Payer: PHP Medicare Advantage |
$370.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$524.21
|
| Rate for Payer: Priority Health Medicare |
$370.30
|
| Rate for Payer: Priority Health Narrow Network |
$524.21
|
| Rate for Payer: Priority Health SBD |
$524.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$370.30
|
| Rate for Payer: UHC Medicare Advantage |
$370.30
|
| Rate for Payer: UHCCP Medicaid |
$248.57
|
| Rate for Payer: UMR Bronson Commercial |
$424.12
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 11646
|
| Hospital Charge Code |
11646
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$599.30 |
| Rate for Payer: Aetna Commercial |
$496.20
|
| Rate for Payer: Aetna Medicare |
$385.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$496.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.23
|
| Rate for Payer: BCBS Complete |
$261.00
|
| Rate for Payer: BCBS MAPPO |
$370.30
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$594.10
|
| Rate for Payer: BCN Medicare Advantage |
$370.30
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$533.23
|
| Rate for Payer: Cofinity Commercial |
$496.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$388.82
|
| Rate for Payer: Meridian Medicaid |
$261.00
|
| Rate for Payer: Nomi Health Commercial |
$444.36
|
| Rate for Payer: PACE SWMI |
$370.30
|
| Rate for Payer: PHP Commercial |
$518.42
|
| Rate for Payer: PHP Medicare Advantage |
$370.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$524.21
|
| Rate for Payer: Priority Health Medicare |
$370.30
|
| Rate for Payer: Priority Health Narrow Network |
$524.21
|
| Rate for Payer: Priority Health SBD |
$524.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$370.30
|
| Rate for Payer: UHC Medicare Advantage |
$370.30
|
| Rate for Payer: UHCCP Medicaid |
$248.57
|
| Rate for Payer: UMR Bronson Commercial |
$424.12
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Facility
|
IP
|
$922.00
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
11646
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$405.68 |
| Max. Negotiated Rate |
$829.80 |
| Rate for Payer: Aetna American Axle |
$599.30
|
| Rate for Payer: Aetna Commercial |
$783.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$599.30
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$645.40
|
| Rate for Payer: Cofinity Commercial |
$792.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$645.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.60
|
| Rate for Payer: Healthscope Commercial |
$829.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$645.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.70
|
| Rate for Payer: PHP Commercial |
$783.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health SBD |
$580.86
|
| Rate for Payer: UMR Bronson Commercial |
$405.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.50
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Facility
|
OP
|
$922.00
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
11646
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$341.14 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna American Axle |
$599.30
|
| Rate for Payer: Aetna Commercial |
$783.70
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$599.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,874.25
|
| Rate for Payer: BCN Commercial |
$1,874.25
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$645.40
|
| Rate for Payer: Cofinity Commercial |
$792.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$645.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$829.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$645.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.50
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.70
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$783.70
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$580.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.37
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$373.06
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$341.14
|
| Rate for Payer: VA VA |
$2,804.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.50
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 11620
|
| Min. Negotiated Rate |
$79.24 |
| Max. Negotiated Rate |
$578.99 |
| Rate for Payer: Aetna Commercial |
$155.72
|
| Rate for Payer: Aetna Medicare |
$120.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.34
|
| Rate for Payer: BCBS Complete |
$83.20
|
| Rate for Payer: BCBS MAPPO |
$116.21
|
| Rate for Payer: BCBS Trust/PPO |
$578.99
|
| Rate for Payer: BCN Commercial |
$291.75
|
| Rate for Payer: BCN Medicare Advantage |
$116.21
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$155.72
|
| Rate for Payer: Cofinity Commercial |
$167.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.02
|
| Rate for Payer: Meridian Medicaid |
$83.20
|
| Rate for Payer: Nomi Health Commercial |
$139.45
|
| Rate for Payer: PACE SWMI |
$116.21
|
| Rate for Payer: PHP Commercial |
$162.69
|
| Rate for Payer: PHP Medicare Advantage |
$116.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.52
|
| Rate for Payer: Priority Health Medicare |
$116.21
|
| Rate for Payer: Priority Health Narrow Network |
$167.52
|
| Rate for Payer: Priority Health SBD |
$167.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.21
|
| Rate for Payer: UHC Medicare Advantage |
$116.21
|
| Rate for Payer: UHCCP Medicaid |
$79.24
|
| Rate for Payer: UMR Bronson Commercial |
$148.12
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM
|
Professional
|
Both
|
$380.00
|
|
|
Service Code
|
HCPCS 11621
|
| Min. Negotiated Rate |
$26.32 |
| Max. Negotiated Rate |
$337.19 |
| Rate for Payer: Aetna Commercial |
$189.57
|
| Rate for Payer: Aetna Medicare |
$147.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.72
|
| Rate for Payer: BCBS Complete |
$101.09
|
| Rate for Payer: BCBS MAPPO |
$141.47
|
| Rate for Payer: BCBS Trust/PPO |
$26.32
|
| Rate for Payer: BCN Commercial |
$337.19
|
| Rate for Payer: BCN Medicare Advantage |
$141.47
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cofinity Commercial |
$189.57
|
| Rate for Payer: Cofinity Commercial |
$203.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.54
|
| Rate for Payer: Meridian Medicaid |
$101.09
|
| Rate for Payer: Nomi Health Commercial |
$169.76
|
| Rate for Payer: PACE SWMI |
$141.47
|
| Rate for Payer: PHP Commercial |
$198.06
|
| Rate for Payer: PHP Medicare Advantage |
$141.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$201.83
|
| Rate for Payer: Priority Health Medicare |
$141.47
|
| Rate for Payer: Priority Health Narrow Network |
$201.83
|
| Rate for Payer: Priority Health SBD |
$201.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.47
|
| Rate for Payer: UHC Medicare Advantage |
$141.47
|
| Rate for Payer: UHCCP Medicaid |
$96.28
|
| Rate for Payer: UMR Bronson Commercial |
$174.80
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Facility
|
OP
|
$424.00
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
11622
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$156.88 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna American Axle |
$275.60
|
| Rate for Payer: Aetna Commercial |
$360.40
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$214.18
|
| Rate for Payer: BCN Commercial |
$214.18
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$296.80
|
| Rate for Payer: Cofinity Commercial |
$364.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$296.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$381.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$296.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.00
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.40
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$360.40
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$267.12
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.82
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: UMR Bronson Commercial |
$156.88
|
| Rate for Payer: VA VA |
$689.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.00
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 11622
|
| Min. Negotiated Rate |
$108.63 |
| Max. Negotiated Rate |
$156,313.01 |
| Rate for Payer: Aetna Commercial |
$213.86
|
| Rate for Payer: Aetna Medicare |
$165.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.82
|
| Rate for Payer: BCBS Complete |
$114.06
|
| Rate for Payer: BCBS MAPPO |
$159.60
|
| Rate for Payer: BCBS Trust/PPO |
$156,313.01
|
| Rate for Payer: BCN Commercial |
$370.42
|
| Rate for Payer: BCN Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$213.86
|
| Rate for Payer: Cofinity Commercial |
$229.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.58
|
| Rate for Payer: Meridian Medicaid |
$114.06
|
| Rate for Payer: Nomi Health Commercial |
$191.52
|
| Rate for Payer: PACE SWMI |
$159.60
|
| Rate for Payer: PHP Commercial |
$223.44
|
| Rate for Payer: PHP Medicare Advantage |
$159.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.92
|
| Rate for Payer: Priority Health Medicare |
$159.60
|
| Rate for Payer: Priority Health Narrow Network |
$228.92
|
| Rate for Payer: Priority Health SBD |
$228.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.60
|
| Rate for Payer: UHC Medicare Advantage |
$159.60
|
| Rate for Payer: UHCCP Medicaid |
$108.63
|
| Rate for Payer: UMR Bronson Commercial |
$195.04
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Facility
|
IP
|
$424.00
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
11622
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$186.56 |
| Max. Negotiated Rate |
$381.60 |
| Rate for Payer: Aetna American Axle |
$275.60
|
| Rate for Payer: Aetna Commercial |
$360.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.60
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$296.80
|
| Rate for Payer: Cofinity Commercial |
$364.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$296.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.20
|
| Rate for Payer: Healthscope Commercial |
$381.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$296.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.40
|
| Rate for Payer: PHP Commercial |
$360.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.60
|
| Rate for Payer: Priority Health SBD |
$267.12
|
| Rate for Payer: UMR Bronson Commercial |
$186.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.00
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 11622
|
| Hospital Charge Code |
11622
|
| Min. Negotiated Rate |
$108.63 |
| Max. Negotiated Rate |
$156,313.01 |
| Rate for Payer: Aetna Commercial |
$213.86
|
| Rate for Payer: Aetna Medicare |
$165.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.82
|
| Rate for Payer: BCBS Complete |
$114.06
|
| Rate for Payer: BCBS MAPPO |
$159.60
|
| Rate for Payer: BCBS Trust/PPO |
$156,313.01
|
| Rate for Payer: BCN Commercial |
$370.42
|
| Rate for Payer: BCN Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$229.82
|
| Rate for Payer: Cofinity Commercial |
$213.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.58
|
| Rate for Payer: Meridian Medicaid |
$114.06
|
| Rate for Payer: Nomi Health Commercial |
$191.52
|
| Rate for Payer: PACE SWMI |
$159.60
|
| Rate for Payer: PHP Commercial |
$223.44
|
| Rate for Payer: PHP Medicare Advantage |
$159.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.92
|
| Rate for Payer: Priority Health Medicare |
$159.60
|
| Rate for Payer: Priority Health Narrow Network |
$228.92
|
| Rate for Payer: Priority Health SBD |
$228.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.60
|
| Rate for Payer: UHC Medicare Advantage |
$159.60
|
| Rate for Payer: UHCCP Medicaid |
$108.63
|
| Rate for Payer: UMR Bronson Commercial |
$195.04
|
|
