|
EXCISION OR DESTRUCTION (EG, LASER), INTRANASAL LESION; INTERNAL APPROACH
|
Facility
|
OP
|
$9,986.81
|
|
|
Service Code
|
CPT 30117
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$389.07 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,708.82
|
| Rate for Payer: BCN Commercial |
$1,708.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Nomi Health Commercial |
$6,672.75
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$427.98
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$389.07
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,703.14
|
| Rate for Payer: VA VA |
$3,177.50
|
|
|
EXCISION OR DESTRUCTION LINGUAL TONSIL, ANY METHOD (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$18,216.88
|
|
|
Service Code
|
CPT 42870
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$551.84 |
| Max. Negotiated Rate |
$18,216.88 |
| Rate for Payer: Aetna Medicare |
$6,027.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,245.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,245.06
|
| Rate for Payer: BCBS Complete |
$3,262.02
|
| Rate for Payer: BCBS MAPPO |
$5,796.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,935.22
|
| Rate for Payer: BCN Commercial |
$1,935.22
|
| Rate for Payer: BCN Medicare Advantage |
$5,796.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,796.05
|
| Rate for Payer: Mclaren Medicaid |
$3,106.68
|
| Rate for Payer: Mclaren Medicare |
$5,796.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,085.85
|
| Rate for Payer: Meridian Medicaid |
$3,262.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,665.46
|
| Rate for Payer: Nomi Health Commercial |
$12,171.70
|
| Rate for Payer: PACE Medicare |
$5,506.25
|
| Rate for Payer: PACE SWMI |
$5,796.05
|
| Rate for Payer: PHP Medicare Advantage |
$5,796.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,106.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,216.88
|
| Rate for Payer: Priority Health Medicare |
$5,796.05
|
| Rate for Payer: Priority Health Narrow Network |
$14,573.50
|
| Rate for Payer: Railroad Medicare Medicare |
$5,796.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.02
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,796.05
|
| Rate for Payer: UHC Exchange |
$551.84
|
| Rate for Payer: UHC Medicare Advantage |
$5,796.05
|
| Rate for Payer: UHCCP Medicaid |
$3,106.68
|
| Rate for Payer: VA VA |
$5,796.05
|
|
|
EXCISION OR DESTRUCTION OF LESION OF PHARYNX, ANY METHOD
|
Facility
|
OP
|
$9,986.81
|
|
|
Service Code
|
CPT 42808
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$159.81 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,708.82
|
| Rate for Payer: BCN Commercial |
$1,708.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Nomi Health Commercial |
$6,672.75
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.79
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$159.81
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,703.14
|
| Rate for Payer: VA VA |
$3,177.50
|
|
|
EXCISION OR FULGURATION; SKENE'S GLANDS
|
Facility
|
OP
|
$10,620.87
|
|
|
Service Code
|
CPT 53270
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$177.97 |
| Max. Negotiated Rate |
$10,620.87 |
| Rate for Payer: Aetna Medicare |
$3,514.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,224.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,224.04
|
| Rate for Payer: BCBS Complete |
$1,901.83
|
| Rate for Payer: BCBS MAPPO |
$3,379.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,839.21
|
| Rate for Payer: BCN Commercial |
$1,839.21
|
| Rate for Payer: BCN Medicare Advantage |
$3,379.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,379.23
|
| Rate for Payer: Mclaren Medicaid |
$1,811.27
|
| Rate for Payer: Mclaren Medicare |
$3,379.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,548.19
|
| Rate for Payer: Meridian Medicaid |
$1,901.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,886.11
|
| Rate for Payer: Nomi Health Commercial |
$7,096.38
|
| Rate for Payer: PACE Medicare |
$3,210.27
|
| Rate for Payer: PACE SWMI |
$3,379.23
|
| Rate for Payer: PHP Medicare Advantage |
$3,379.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,811.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,620.87
|
| Rate for Payer: Priority Health Medicare |
$3,379.23
|
| Rate for Payer: Priority Health Narrow Network |
$8,496.70
|
| Rate for Payer: Railroad Medicare Medicare |
$3,379.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.77
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,379.23
|
| Rate for Payer: UHC Exchange |
$177.97
|
| Rate for Payer: UHC Medicare Advantage |
$3,379.23
|
| Rate for Payer: UHCCP Medicaid |
$1,811.27
|
| Rate for Payer: VA VA |
$3,379.23
|
|
|
EXCISION OR FULGURATION; URETHRAL CARUNCLE
|
Facility
|
OP
|
$6,308.24
|
|
|
Service Code
|
CPT 53265
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$182.23 |
| Max. Negotiated Rate |
$6,308.24 |
| Rate for Payer: Aetna Medicare |
$2,087.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,439.79
|
| Rate for Payer: BCN Commercial |
$1,439.79
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Mclaren Medicaid |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Nomi Health Commercial |
$4,214.89
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,308.24
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$5,046.59
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.45
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$182.23
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: VA VA |
$2,007.09
|
|
|
EXCISION OR FULGURATION; URETHRAL PROLAPSE
|
Facility
|
OP
|
$10,620.87
|
|
|
Service Code
|
CPT 53275
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$253.31 |
| Max. Negotiated Rate |
$10,620.87 |
| Rate for Payer: Aetna Medicare |
$3,514.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,224.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,224.04
|
| Rate for Payer: BCBS Complete |
$1,901.83
|
| Rate for Payer: BCBS MAPPO |
$3,379.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,594.02
|
| Rate for Payer: BCN Commercial |
$1,594.02
|
| Rate for Payer: BCN Medicare Advantage |
$3,379.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,379.23
|
| Rate for Payer: Mclaren Medicaid |
$1,811.27
|
| Rate for Payer: Mclaren Medicare |
$3,379.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,548.19
|
| Rate for Payer: Meridian Medicaid |
$1,901.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,886.11
|
| Rate for Payer: Nomi Health Commercial |
$7,096.38
|
| Rate for Payer: PACE Medicare |
$3,210.27
|
| Rate for Payer: PACE SWMI |
$3,379.23
|
| Rate for Payer: PHP Medicare Advantage |
$3,379.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,811.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,620.87
|
| Rate for Payer: Priority Health Medicare |
$3,379.23
|
| Rate for Payer: Priority Health Narrow Network |
$8,496.70
|
| Rate for Payer: Railroad Medicare Medicare |
$3,379.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.64
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,379.23
|
| Rate for Payer: UHC Exchange |
$253.31
|
| Rate for Payer: UHC Medicare Advantage |
$3,379.23
|
| Rate for Payer: UHCCP Medicaid |
$1,811.27
|
| Rate for Payer: VA VA |
$3,379.23
|
|
|
EXCISION OR SURGICAL PLANING OF SKIN OF NOSE FOR RHINOPHYMA
|
Facility
|
OP
|
$9,986.81
|
|
|
Service Code
|
CPT 30120
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$400.73 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,708.82
|
| Rate for Payer: BCN Commercial |
$1,708.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Nomi Health Commercial |
$6,672.75
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.80
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$400.73
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,703.14
|
| Rate for Payer: VA VA |
$3,177.50
|
|
|
EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER 0.5 CM OR LESS
|
Facility
|
OP
|
$2,166.65
|
|
|
Service Code
|
CPT 11440
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$100.65 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Medicare |
$716.93
|
| 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: Health Alliance Plan Medicare Advantage |
$689.36
|
| 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: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| 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: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.72
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$100.65
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER 0.6 TO 1.0 CM
|
Facility
|
OP
|
$2,166.65
|
|
|
Service Code
|
CPT 11441
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$126.39 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Medicare |
$716.93
|
| 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: Health Alliance Plan Medicare Advantage |
$689.36
|
| 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: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| 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: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.03
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$126.39
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER 1.1 TO 2.0 CM
|
Facility
|
OP
|
$2,166.65
|
|
|
Service Code
|
CPT 11442
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$139.66 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Medicare |
$716.93
|
| 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: Health Alliance Plan Medicare Advantage |
$689.36
|
| 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: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| 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: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.63
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$139.66
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER 2.1 TO 3.0 CM
|
Facility
|
OP
|
$4,989.41
|
|
|
Service Code
|
CPT 11443
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$170.65 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| 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: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| 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: 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 Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| 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: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.72
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$170.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER 3.1 TO 4.0 CM
|
Facility
|
OP
|
$4,989.41
|
|
|
Service Code
|
CPT 11444
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$215.62 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| 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 |
$947.36
|
| Rate for Payer: BCN Commercial |
$947.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| 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: 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 Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| 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: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.18
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$215.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER OVER 4.0 CM
|
Facility
|
OP
|
$8,813.49
|
|
|
Service Code
|
CPT 11446
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$304.10 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| 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: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| 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: 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 Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.51
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$304.10
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
EXCISION, PREPATELLAR BURSA
|
Facility
|
OP
|
$9,991.56
|
|
|
Service Code
|
CPT 27340
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$364.68 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,898.39
|
| Rate for Payer: BCN Commercial |
$1,898.39
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$401.15
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$364.68
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
EXCISION, RADIAL HEAD
|
Facility
|
OP
|
$9,991.56
|
|
|
Service Code
|
CPT 24130
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$496.10 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,214.78
|
| Rate for Payer: BCN Commercial |
$2,214.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.71
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$496.10
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
EXCISION SOFT TISSUE LESION, EXTERNAL AUDITORY CANAL
|
Facility
|
OP
|
$8,813.49
|
|
|
Service Code
|
CPT 69145
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$244.27 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| 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: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| 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: 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 Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.70
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$244.27
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
EXCISION, TUMOR OR VASCULAR MALFORMATION, SOFT TISSUE OF HAND OR FINGER, SUBCUTANEOUS; 1.5 CM OR GREATER
|
Facility
|
OP
|
$4,989.41
|
|
|
Service Code
|
CPT 26111
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$403.94 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| 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 |
$1,523.44
|
| Rate for Payer: BCN Commercial |
$1,523.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| 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: 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 Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| 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: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$444.33
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$403.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
EXCISION, TUMOR OR VASCULAR MALFORMATION, SOFT TISSUE OF HAND OR FINGER, SUBCUTANEOUS; LESS THAN 1.5 CM
|
Facility
|
OP
|
$4,989.41
|
|
|
Service Code
|
CPT 26115
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$322.24 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| 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 |
$1,523.44
|
| Rate for Payer: BCN Commercial |
$1,523.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| 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: 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 Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| 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: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$354.46
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$322.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBCUTANEOUS; 3 CM OR GREATER
|
Facility
|
OP
|
$8,813.49
|
|
|
Service Code
|
CPT 22903
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$430.24 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| 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 |
$2,648.39
|
| Rate for Payer: BCN Commercial |
$2,648.39
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| 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: 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 Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.26
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$430.24
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBCUTANEOUS; LESS THAN 3 CM
|
Facility
|
OP
|
$4,989.41
|
|
|
Service Code
|
CPT 22902
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$325.05 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| 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 |
$2,106.79
|
| Rate for Payer: BCN Commercial |
$2,106.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| 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: 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 Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| 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: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$357.56
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$325.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER
|
Facility
|
OP
|
$8,813.49
|
|
|
Service Code
|
CPT 22901
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$651.21 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| 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: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| 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: 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 Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$716.33
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$651.21
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM
|
Facility
|
OP
|
$8,813.49
|
|
|
Service Code
|
CPT 22900
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$552.56 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| 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: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| 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: 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 Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.82
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$552.56
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK, SUBCUTANEOUS; 3 CM OR GREATER
|
Facility
|
OP
|
$4,989.41
|
|
|
Service Code
|
CPT 21931
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$458.90 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| 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 |
$2,463.00
|
| Rate for Payer: BCN Commercial |
$2,463.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| 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: 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 Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| 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: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.79
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$458.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK, SUBCUTANEOUS; LESS THAN 3 CM
|
Facility
|
OP
|
$4,989.41
|
|
|
Service Code
|
CPT 21930
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$354.77 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| 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 |
$2,562.77
|
| Rate for Payer: BCN Commercial |
$2,562.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| 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: 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 Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| 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: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$390.25
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$354.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER
|
Facility
|
OP
|
$8,813.49
|
|
|
Service Code
|
CPT 21933
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$719.82 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| 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 |
$2,689.54
|
| Rate for Payer: BCN Commercial |
$2,689.54
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| 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: 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 Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$791.80
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$719.82
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
