|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Professional
|
Both
|
$527.00
|
|
|
Service Code
|
HCPCS 11623
|
| Hospital Charge Code |
11623
|
| Min. Negotiated Rate |
$134.19 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$265.31
|
| Rate for Payer: Aetna Medicare |
$205.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.11
|
| Rate for Payer: BCBS Complete |
$140.90
|
| Rate for Payer: BCBS MAPPO |
$197.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: BCN Commercial |
$433.95
|
| Rate for Payer: BCN Medicare Advantage |
$197.99
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cofinity Commercial |
$285.11
|
| Rate for Payer: Cofinity Commercial |
$265.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.89
|
| Rate for Payer: Meridian Medicaid |
$140.90
|
| Rate for Payer: Nomi Health Commercial |
$237.59
|
| Rate for Payer: PACE SWMI |
$197.99
|
| Rate for Payer: PHP Commercial |
$277.19
|
| Rate for Payer: PHP Medicare Advantage |
$197.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.20
|
| Rate for Payer: Priority Health Medicare |
$197.99
|
| Rate for Payer: Priority Health Narrow Network |
$282.20
|
| Rate for Payer: Priority Health SBD |
$282.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.99
|
| Rate for Payer: UHC Medicare Advantage |
$197.99
|
| Rate for Payer: UHCCP Medicaid |
$134.19
|
| Rate for Payer: UMR Bronson Commercial |
$242.42
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Facility
|
OP
|
$527.00
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
11623
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$194.99 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$342.55
|
| Rate for Payer: Aetna Commercial |
$447.95
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$342.55
|
| 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 |
$235.05
|
| Rate for Payer: BCN Commercial |
$235.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cofinity Commercial |
$368.90
|
| Rate for Payer: Cofinity Commercial |
$453.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$368.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$421.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$474.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$368.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$395.25
|
| 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 |
$447.95
|
| 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 |
$447.95
|
| 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 |
$342.55
|
| 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 |
$332.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.82
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$198.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$194.99
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$395.25
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Facility
|
IP
|
$527.00
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
11623
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$231.88 |
| Max. Negotiated Rate |
$474.30 |
| Rate for Payer: Aetna American Axle |
$342.55
|
| Rate for Payer: Aetna Commercial |
$447.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$342.55
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cofinity Commercial |
$368.90
|
| Rate for Payer: Cofinity Commercial |
$453.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$368.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$421.60
|
| Rate for Payer: Healthscope Commercial |
$474.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$368.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$395.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$447.95
|
| Rate for Payer: PHP Commercial |
$447.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.55
|
| Rate for Payer: Priority Health SBD |
$332.01
|
| Rate for Payer: UMR Bronson Commercial |
$231.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$395.25
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Professional
|
Both
|
$527.00
|
|
|
Service Code
|
HCPCS 11623
|
| Min. Negotiated Rate |
$134.19 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$265.31
|
| Rate for Payer: Aetna Medicare |
$205.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.11
|
| Rate for Payer: BCBS Complete |
$140.90
|
| Rate for Payer: BCBS MAPPO |
$197.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: BCN Commercial |
$433.95
|
| Rate for Payer: BCN Medicare Advantage |
$197.99
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cofinity Commercial |
$265.31
|
| Rate for Payer: Cofinity Commercial |
$285.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.89
|
| Rate for Payer: Meridian Medicaid |
$140.90
|
| Rate for Payer: Nomi Health Commercial |
$237.59
|
| Rate for Payer: PACE SWMI |
$197.99
|
| Rate for Payer: PHP Commercial |
$277.19
|
| Rate for Payer: PHP Medicare Advantage |
$197.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.20
|
| Rate for Payer: Priority Health Medicare |
$197.99
|
| Rate for Payer: Priority Health Narrow Network |
$282.20
|
| Rate for Payer: Priority Health SBD |
$282.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.99
|
| Rate for Payer: UHC Medicare Advantage |
$197.99
|
| Rate for Payer: UHCCP Medicaid |
$134.19
|
| Rate for Payer: UMR Bronson Commercial |
$242.42
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Professional
|
Both
|
$595.00
|
|
|
Service Code
|
HCPCS 11624
|
| Min. Negotiated Rate |
$152.30 |
| Max. Negotiated Rate |
$1,307.96 |
| Rate for Payer: Aetna Commercial |
$302.09
|
| Rate for Payer: Aetna Medicare |
$234.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$302.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.63
|
| Rate for Payer: BCBS Complete |
$159.92
|
| Rate for Payer: BCBS MAPPO |
$225.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.96
|
| Rate for Payer: BCN Commercial |
$494.05
|
| Rate for Payer: BCN Medicare Advantage |
$225.44
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cofinity Commercial |
$302.09
|
| Rate for Payer: Cofinity Commercial |
$324.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.71
|
| Rate for Payer: Meridian Medicaid |
$159.92
|
| Rate for Payer: Nomi Health Commercial |
$270.53
|
| Rate for Payer: PACE SWMI |
$225.44
|
| Rate for Payer: PHP Commercial |
$315.62
|
| Rate for Payer: PHP Medicare Advantage |
$225.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$321.02
|
| Rate for Payer: Priority Health Medicare |
$225.44
|
| Rate for Payer: Priority Health Narrow Network |
$321.02
|
| Rate for Payer: Priority Health SBD |
$321.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.44
|
| Rate for Payer: UHC Medicare Advantage |
$225.44
|
| Rate for Payer: UHCCP Medicaid |
$152.30
|
| Rate for Payer: UMR Bronson Commercial |
$273.70
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Facility
|
IP
|
$595.00
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$261.80 |
| Max. Negotiated Rate |
$535.50 |
| Rate for Payer: Aetna American Axle |
$386.75
|
| Rate for Payer: Aetna Commercial |
$505.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.75
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cofinity Commercial |
$416.50
|
| Rate for Payer: Cofinity Commercial |
$511.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$416.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.00
|
| Rate for Payer: Healthscope Commercial |
$535.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$416.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.75
|
| Rate for Payer: PHP Commercial |
$505.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.75
|
| Rate for Payer: Priority Health SBD |
$374.85
|
| Rate for Payer: UMR Bronson Commercial |
$261.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.25
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Professional
|
Both
|
$595.00
|
|
|
Service Code
|
HCPCS 11624
|
| Hospital Charge Code |
11624
|
| Min. Negotiated Rate |
$152.30 |
| Max. Negotiated Rate |
$1,307.96 |
| Rate for Payer: Aetna Commercial |
$302.09
|
| Rate for Payer: Aetna Medicare |
$234.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$302.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.63
|
| Rate for Payer: BCBS Complete |
$159.92
|
| Rate for Payer: BCBS MAPPO |
$225.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.96
|
| Rate for Payer: BCN Commercial |
$494.05
|
| Rate for Payer: BCN Medicare Advantage |
$225.44
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cofinity Commercial |
$324.63
|
| Rate for Payer: Cofinity Commercial |
$302.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.71
|
| Rate for Payer: Meridian Medicaid |
$159.92
|
| Rate for Payer: Nomi Health Commercial |
$270.53
|
| Rate for Payer: PACE SWMI |
$225.44
|
| Rate for Payer: PHP Commercial |
$315.62
|
| Rate for Payer: PHP Medicare Advantage |
$225.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$321.02
|
| Rate for Payer: Priority Health Medicare |
$225.44
|
| Rate for Payer: Priority Health Narrow Network |
$321.02
|
| Rate for Payer: Priority Health SBD |
$321.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.44
|
| Rate for Payer: UHC Medicare Advantage |
$225.44
|
| Rate for Payer: UHCCP Medicaid |
$152.30
|
| Rate for Payer: UMR Bronson Commercial |
$273.70
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Facility
|
OP
|
$595.00
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$220.15 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$386.75
|
| Rate for Payer: Aetna Commercial |
$505.75
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.75
|
| 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 |
$1,107.96
|
| Rate for Payer: BCN Commercial |
$1,107.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cofinity Commercial |
$416.50
|
| Rate for Payer: Cofinity Commercial |
$511.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$416.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$535.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$416.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.25
|
| 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 |
$505.75
|
| 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 |
$505.75
|
| 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 |
$386.75
|
| 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 |
$374.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.81
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$227.10
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$220.15
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.25
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Professional
|
Both
|
$930.00
|
|
|
Service Code
|
HCPCS 11626
|
| Hospital Charge Code |
11626
|
| Min. Negotiated Rate |
$186.38 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$372.04
|
| Rate for Payer: Aetna Medicare |
$288.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.80
|
| Rate for Payer: BCBS Complete |
$195.70
|
| Rate for Payer: BCBS MAPPO |
$277.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: BCN Commercial |
$478.66
|
| Rate for Payer: BCN Medicare Advantage |
$277.64
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$399.80
|
| Rate for Payer: Cofinity Commercial |
$372.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$277.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$291.52
|
| Rate for Payer: Meridian Medicaid |
$195.70
|
| Rate for Payer: Nomi Health Commercial |
$333.17
|
| Rate for Payer: PACE SWMI |
$277.64
|
| Rate for Payer: PHP Commercial |
$388.70
|
| Rate for Payer: PHP Medicare Advantage |
$277.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.37
|
| Rate for Payer: Priority Health Medicare |
$277.64
|
| Rate for Payer: Priority Health Narrow Network |
$392.37
|
| Rate for Payer: Priority Health SBD |
$392.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$277.64
|
| Rate for Payer: UHC Medicare Advantage |
$277.64
|
| Rate for Payer: UHCCP Medicaid |
$186.38
|
| Rate for Payer: UMR Bronson Commercial |
$427.80
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Facility
|
OP
|
$930.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
11626
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$279.26 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna American Axle |
$604.50
|
| Rate for Payer: Aetna Commercial |
$790.50
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$604.50
|
| 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 |
$1,606.51
|
| Rate for Payer: BCN Commercial |
$1,606.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$651.00
|
| Rate for Payer: Cofinity Commercial |
$799.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$651.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$744.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$837.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$651.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$697.50
|
| 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 |
$790.50
|
| 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 |
$790.50
|
| 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 |
$604.50
|
| 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 |
$585.90
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.19
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$279.26
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$344.10
|
| Rate for Payer: VA VA |
$2,804.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$697.50
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Professional
|
Both
|
$930.00
|
|
|
Service Code
|
HCPCS 11626
|
| Min. Negotiated Rate |
$186.38 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$372.04
|
| Rate for Payer: Aetna Medicare |
$288.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.80
|
| Rate for Payer: BCBS Complete |
$195.70
|
| Rate for Payer: BCBS MAPPO |
$277.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: BCN Commercial |
$478.66
|
| Rate for Payer: BCN Medicare Advantage |
$277.64
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$372.04
|
| Rate for Payer: Cofinity Commercial |
$399.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$277.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$291.52
|
| Rate for Payer: Meridian Medicaid |
$195.70
|
| Rate for Payer: Nomi Health Commercial |
$333.17
|
| Rate for Payer: PACE SWMI |
$277.64
|
| Rate for Payer: PHP Commercial |
$388.70
|
| Rate for Payer: PHP Medicare Advantage |
$277.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.37
|
| Rate for Payer: Priority Health Medicare |
$277.64
|
| Rate for Payer: Priority Health Narrow Network |
$392.37
|
| Rate for Payer: Priority Health SBD |
$392.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$277.64
|
| Rate for Payer: UHC Medicare Advantage |
$277.64
|
| Rate for Payer: UHCCP Medicaid |
$186.38
|
| Rate for Payer: UMR Bronson Commercial |
$427.80
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Facility
|
IP
|
$930.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
11626
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$409.20 |
| Max. Negotiated Rate |
$837.00 |
| Rate for Payer: Aetna American Axle |
$604.50
|
| Rate for Payer: Aetna Commercial |
$790.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$604.50
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$651.00
|
| Rate for Payer: Cofinity Commercial |
$799.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$651.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$744.00
|
| Rate for Payer: Healthscope Commercial |
$837.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$651.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$697.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$790.50
|
| Rate for Payer: PHP Commercial |
$790.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health SBD |
$585.90
|
| Rate for Payer: UMR Bronson Commercial |
$409.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$697.50
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Facility
|
OP
|
$803.00
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
11606
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$297.11 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$521.95
|
| Rate for Payer: Aetna Commercial |
$682.55
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$521.95
|
| 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 |
$2,360.01
|
| Rate for Payer: BCN Commercial |
$2,360.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$562.10
|
| Rate for Payer: Cofinity Commercial |
$690.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$562.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$642.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$722.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$562.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$602.25
|
| 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 |
$682.55
|
| 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 |
$682.55
|
| 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 |
$521.95
|
| 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 |
$505.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.71
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$304.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$297.11
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$602.25
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Professional
|
Both
|
$803.00
|
|
|
Service Code
|
HCPCS 11606
|
| Hospital Charge Code |
11606
|
| Min. Negotiated Rate |
$202.35 |
| Max. Negotiated Rate |
$654.83 |
| Rate for Payer: Aetna Commercial |
$404.14
|
| Rate for Payer: Aetna Medicare |
$313.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.30
|
| Rate for Payer: BCBS Complete |
$212.47
|
| Rate for Payer: BCBS MAPPO |
$301.60
|
| Rate for Payer: BCBS Trust/PPO |
$592.45
|
| Rate for Payer: BCN Commercial |
$654.83
|
| Rate for Payer: BCN Medicare Advantage |
$301.60
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$434.30
|
| Rate for Payer: Cofinity Commercial |
$404.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.68
|
| Rate for Payer: Meridian Medicaid |
$212.47
|
| Rate for Payer: Nomi Health Commercial |
$361.92
|
| Rate for Payer: PACE SWMI |
$301.60
|
| Rate for Payer: PHP Commercial |
$422.24
|
| Rate for Payer: PHP Medicare Advantage |
$301.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$427.14
|
| Rate for Payer: Priority Health Medicare |
$301.60
|
| Rate for Payer: Priority Health Narrow Network |
$427.14
|
| Rate for Payer: Priority Health SBD |
$427.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.60
|
| Rate for Payer: UHC Medicare Advantage |
$301.60
|
| Rate for Payer: UHCCP Medicaid |
$202.35
|
| Rate for Payer: UMR Bronson Commercial |
$369.38
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Facility
|
IP
|
$803.00
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
11606
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$353.32 |
| Max. Negotiated Rate |
$722.70 |
| Rate for Payer: Aetna American Axle |
$521.95
|
| Rate for Payer: Aetna Commercial |
$682.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$521.95
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$562.10
|
| Rate for Payer: Cofinity Commercial |
$690.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$562.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$642.40
|
| Rate for Payer: Healthscope Commercial |
$722.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$562.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$602.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$682.55
|
| Rate for Payer: PHP Commercial |
$682.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health SBD |
$505.89
|
| Rate for Payer: UMR Bronson Commercial |
$353.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$602.25
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Professional
|
Both
|
$803.00
|
|
|
Service Code
|
HCPCS 11606
|
| Min. Negotiated Rate |
$202.35 |
| Max. Negotiated Rate |
$654.83 |
| Rate for Payer: Aetna Commercial |
$404.14
|
| Rate for Payer: Aetna Medicare |
$313.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.30
|
| Rate for Payer: BCBS Complete |
$212.47
|
| Rate for Payer: BCBS MAPPO |
$301.60
|
| Rate for Payer: BCBS Trust/PPO |
$592.45
|
| Rate for Payer: BCN Commercial |
$654.83
|
| Rate for Payer: BCN Medicare Advantage |
$301.60
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$404.14
|
| Rate for Payer: Cofinity Commercial |
$434.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.68
|
| Rate for Payer: Meridian Medicaid |
$212.47
|
| Rate for Payer: Nomi Health Commercial |
$361.92
|
| Rate for Payer: PACE SWMI |
$301.60
|
| Rate for Payer: PHP Commercial |
$422.24
|
| Rate for Payer: PHP Medicare Advantage |
$301.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$427.14
|
| Rate for Payer: Priority Health Medicare |
$301.60
|
| Rate for Payer: Priority Health Narrow Network |
$427.14
|
| Rate for Payer: Priority Health SBD |
$427.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.60
|
| Rate for Payer: UHC Medicare Advantage |
$301.60
|
| Rate for Payer: UHCCP Medicaid |
$202.35
|
| Rate for Payer: UMR Bronson Commercial |
$369.38
|
|
|
PR EXCISION MALIGNANT TUMOR MANDIBLE RADICAL
|
Professional
|
Both
|
$2,220.00
|
|
|
Service Code
|
HCPCS 21045
|
| Min. Negotiated Rate |
$99.81 |
| Max. Negotiated Rate |
$1,831.90 |
| Rate for Payer: Aetna Commercial |
$1,527.49
|
| Rate for Payer: Aetna Medicare |
$1,185.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,527.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,641.48
|
| Rate for Payer: BCBS Complete |
$808.50
|
| Rate for Payer: BCBS MAPPO |
$1,139.92
|
| Rate for Payer: BCBS Trust/PPO |
$99.81
|
| Rate for Payer: BCN Commercial |
$1,753.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,139.92
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cofinity Commercial |
$1,527.49
|
| Rate for Payer: Cofinity Commercial |
$1,641.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,139.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,196.92
|
| Rate for Payer: Meridian Medicaid |
$808.50
|
| Rate for Payer: Nomi Health Commercial |
$1,367.90
|
| Rate for Payer: PACE SWMI |
$1,139.92
|
| Rate for Payer: PHP Commercial |
$1,595.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,139.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$770.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,443.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,831.90
|
| Rate for Payer: Priority Health Medicare |
$1,139.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,831.90
|
| Rate for Payer: Priority Health SBD |
$1,831.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,139.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,139.92
|
| Rate for Payer: UHCCP Medicaid |
$770.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,021.20
|
|
|
PR EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA
|
Professional
|
Both
|
$2,754.00
|
|
|
Service Code
|
HCPCS 21034
|
| Min. Negotiated Rate |
$722.28 |
| Max. Negotiated Rate |
$1,900.96 |
| Rate for Payer: Aetna Commercial |
$1,433.64
|
| Rate for Payer: Aetna Medicare |
$1,112.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,433.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,540.63
|
| Rate for Payer: BCBS Complete |
$758.39
|
| Rate for Payer: BCBS MAPPO |
$1,069.88
|
| Rate for Payer: BCN Commercial |
$1,900.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,069.88
|
| Rate for Payer: Cash Price |
$2,203.20
|
| Rate for Payer: Cash Price |
$2,203.20
|
| Rate for Payer: Cofinity Commercial |
$1,433.64
|
| Rate for Payer: Cofinity Commercial |
$1,540.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,069.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,123.37
|
| Rate for Payer: Meridian Medicaid |
$758.39
|
| Rate for Payer: Nomi Health Commercial |
$1,283.86
|
| Rate for Payer: PACE SWMI |
$1,069.88
|
| Rate for Payer: PHP Commercial |
$1,497.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,069.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$722.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,790.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,719.43
|
| Rate for Payer: Priority Health Medicare |
$1,069.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,719.43
|
| Rate for Payer: Priority Health SBD |
$1,719.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,069.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,069.88
|
| Rate for Payer: UHCCP Medicaid |
$722.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,266.84
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<
|
Professional
|
Both
|
$318.00
|
|
|
Service Code
|
HCPCS 11600
|
| Min. Negotiated Rate |
$78.60 |
| Max. Negotiated Rate |
$1,866.00 |
| Rate for Payer: Aetna Commercial |
$154.38
|
| Rate for Payer: Aetna Medicare |
$119.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.90
|
| Rate for Payer: BCBS Complete |
$82.53
|
| Rate for Payer: BCBS MAPPO |
$115.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,866.00
|
| Rate for Payer: BCN Commercial |
$290.27
|
| Rate for Payer: BCN Medicare Advantage |
$115.21
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cofinity Commercial |
$154.38
|
| Rate for Payer: Cofinity Commercial |
$165.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.97
|
| Rate for Payer: Meridian Medicaid |
$82.53
|
| Rate for Payer: Nomi Health Commercial |
$138.25
|
| Rate for Payer: PACE SWMI |
$115.21
|
| Rate for Payer: PHP Commercial |
$161.29
|
| Rate for Payer: PHP Medicare Advantage |
$115.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.16
|
| Rate for Payer: Priority Health Medicare |
$115.21
|
| Rate for Payer: Priority Health Narrow Network |
$166.16
|
| Rate for Payer: Priority Health SBD |
$166.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.21
|
| Rate for Payer: UHC Medicare Advantage |
$115.21
|
| Rate for Payer: UHCCP Medicaid |
$78.60
|
| Rate for Payer: UMR Bronson Commercial |
$146.28
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 11601
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$269.37 |
| Rate for Payer: Aetna Commercial |
$187.72
|
| Rate for Payer: Aetna Medicare |
$145.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.73
|
| Rate for Payer: BCBS Complete |
$100.19
|
| Rate for Payer: BCBS MAPPO |
$140.09
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$269.37
|
| Rate for Payer: BCN Medicare Advantage |
$140.09
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cofinity Commercial |
$187.72
|
| Rate for Payer: Cofinity Commercial |
$201.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.09
|
| Rate for Payer: Meridian Medicaid |
$100.19
|
| Rate for Payer: Nomi Health Commercial |
$168.11
|
| Rate for Payer: PACE SWMI |
$140.09
|
| Rate for Payer: PHP Commercial |
$196.13
|
| Rate for Payer: PHP Medicare Advantage |
$140.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.93
|
| Rate for Payer: Priority Health Medicare |
$140.09
|
| Rate for Payer: Priority Health Narrow Network |
$200.93
|
| Rate for Payer: Priority Health SBD |
$200.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.09
|
| Rate for Payer: UHC Medicare Advantage |
$140.09
|
| Rate for Payer: UHCCP Medicaid |
$95.42
|
| Rate for Payer: UMR Bronson Commercial |
$173.42
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 11602
|
| Hospital Charge Code |
11602
|
| Min. Negotiated Rate |
$46.61 |
| Max. Negotiated Rate |
$288.21 |
| Rate for Payer: Aetna Commercial |
$203.89
|
| Rate for Payer: Aetna Medicare |
$158.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.11
|
| Rate for Payer: BCBS Complete |
$108.92
|
| Rate for Payer: BCBS MAPPO |
$152.16
|
| Rate for Payer: BCBS Trust/PPO |
$46.61
|
| Rate for Payer: BCN Commercial |
$288.21
|
| Rate for Payer: BCN Medicare Advantage |
$152.16
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$219.11
|
| Rate for Payer: Cofinity Commercial |
$203.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.77
|
| Rate for Payer: Meridian Medicaid |
$108.92
|
| Rate for Payer: Nomi Health Commercial |
$182.59
|
| Rate for Payer: PACE SWMI |
$152.16
|
| Rate for Payer: PHP Commercial |
$213.02
|
| Rate for Payer: PHP Medicare Advantage |
$152.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.08
|
| Rate for Payer: Priority Health Medicare |
$152.16
|
| Rate for Payer: Priority Health Narrow Network |
$218.08
|
| Rate for Payer: Priority Health SBD |
$218.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.16
|
| Rate for Payer: UHC Medicare Advantage |
$152.16
|
| Rate for Payer: UHCCP Medicaid |
$103.73
|
| Rate for Payer: UMR Bronson Commercial |
$188.60
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 11602
|
| Min. Negotiated Rate |
$46.61 |
| Max. Negotiated Rate |
$288.21 |
| Rate for Payer: Aetna Commercial |
$203.89
|
| Rate for Payer: Aetna Medicare |
$158.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.11
|
| Rate for Payer: BCBS Complete |
$108.92
|
| Rate for Payer: BCBS MAPPO |
$152.16
|
| Rate for Payer: BCBS Trust/PPO |
$46.61
|
| Rate for Payer: BCN Commercial |
$288.21
|
| Rate for Payer: BCN Medicare Advantage |
$152.16
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$203.89
|
| Rate for Payer: Cofinity Commercial |
$219.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.77
|
| Rate for Payer: Meridian Medicaid |
$108.92
|
| Rate for Payer: Nomi Health Commercial |
$182.59
|
| Rate for Payer: PACE SWMI |
$152.16
|
| Rate for Payer: PHP Commercial |
$213.02
|
| Rate for Payer: PHP Medicare Advantage |
$152.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.08
|
| Rate for Payer: Priority Health Medicare |
$152.16
|
| Rate for Payer: Priority Health Narrow Network |
$218.08
|
| Rate for Payer: Priority Health SBD |
$218.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.16
|
| Rate for Payer: UHC Medicare Advantage |
$152.16
|
| Rate for Payer: UHCCP Medicaid |
$103.73
|
| Rate for Payer: UMR Bronson Commercial |
$188.60
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Facility
|
IP
|
$410.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
11602
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$180.40 |
| Max. Negotiated Rate |
$369.00 |
| Rate for Payer: Aetna American Axle |
$266.50
|
| Rate for Payer: Aetna Commercial |
$348.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.50
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$287.00
|
| Rate for Payer: Cofinity Commercial |
$352.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$287.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$328.00
|
| Rate for Payer: Healthscope Commercial |
$369.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$287.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$307.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.50
|
| Rate for Payer: PHP Commercial |
$348.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health SBD |
$258.30
|
| Rate for Payer: UMR Bronson Commercial |
$180.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$307.50
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Facility
|
OP
|
$410.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
11602
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$151.70 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna American Axle |
$266.50
|
| Rate for Payer: Aetna Commercial |
$348.50
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$566.83
|
| Rate for Payer: BCN Commercial |
$566.83
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$287.00
|
| Rate for Payer: Cofinity Commercial |
$352.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$287.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$328.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$369.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$287.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$307.50
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.50
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$348.50
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$258.30
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.12
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$152.84
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: UMR Bronson Commercial |
$151.70
|
| Rate for Payer: VA VA |
$391.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$307.50
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Professional
|
Both
|
$467.00
|
|
|
Service Code
|
HCPCS 11603
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$409.03 |
| Rate for Payer: Aetna Commercial |
$244.55
|
| Rate for Payer: Aetna Medicare |
$189.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.80
|
| Rate for Payer: BCBS Complete |
$130.17
|
| Rate for Payer: BCBS MAPPO |
$182.50
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$409.03
|
| Rate for Payer: BCN Medicare Advantage |
$182.50
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cofinity Commercial |
$244.55
|
| Rate for Payer: Cofinity Commercial |
$262.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.62
|
| Rate for Payer: Meridian Medicaid |
$130.17
|
| Rate for Payer: Nomi Health Commercial |
$219.00
|
| Rate for Payer: PACE SWMI |
$182.50
|
| Rate for Payer: PHP Commercial |
$255.50
|
| Rate for Payer: PHP Medicare Advantage |
$182.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.53
|
| Rate for Payer: Priority Health Medicare |
$182.50
|
| Rate for Payer: Priority Health Narrow Network |
$260.53
|
| Rate for Payer: Priority Health SBD |
$260.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.50
|
| Rate for Payer: UHC Medicare Advantage |
$182.50
|
| Rate for Payer: UHCCP Medicaid |
$123.97
|
| Rate for Payer: UMR Bronson Commercial |
$214.82
|
|
