|
HC EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 TO 1.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
76100108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$146.37 |
| Max. Negotiated Rate |
$1,968.76 |
| Rate for Payer: Aetna American Axle |
$749.44
|
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$650.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$187.42
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$807.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.76
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.01
|
| Rate for Payer: Priority Health SBD |
$726.38
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.39
|
| Rate for Payer: UHC Exchange |
$146.37
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: UMR Bronson Commercial |
$426.61
|
| Rate for Payer: VA VA |
$625.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.0 TO 2.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
76100109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$166.01 |
| Max. Negotiated Rate |
$1,968.76 |
| Rate for Payer: Aetna American Axle |
$749.44
|
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$650.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$204.21
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$807.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.76
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.01
|
| Rate for Payer: Priority Health SBD |
$726.38
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.39
|
| Rate for Payer: UHC Exchange |
$166.01
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: UMR Bronson Commercial |
$426.61
|
| Rate for Payer: VA VA |
$625.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.0 TO 2.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
76100109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$507.32 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna American Axle |
$749.44
|
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$807.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health SBD |
$726.38
|
| Rate for Payer: UMR Bronson Commercial |
$507.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXC SINGLE EXTERNAL PAPILLA OR TAG, ANUS
|
Facility
|
OP
|
$1,536.46
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
76100280
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$120.50 |
| Max. Negotiated Rate |
$3,302.11 |
| Rate for Payer: Aetna American Axle |
$998.70
|
| Rate for Payer: Aetna Commercial |
$1,305.99
|
| Rate for Payer: Aetna Medicare |
$1,090.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$998.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,137.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$1,229.17
|
| Rate for Payer: Cash Price |
$1,229.17
|
| Rate for Payer: Cofinity Commercial |
$1,075.52
|
| Rate for Payer: Cofinity Commercial |
$1,321.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$1,382.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,075.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.34
|
| Rate for Payer: Mclaren Medicaid |
$573.77
|
| Rate for Payer: Mclaren Medicare |
$1,048.94
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,305.99
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$1,305.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,302.11
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,641.69
|
| Rate for Payer: Priority Health SBD |
$967.97
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.94
|
| Rate for Payer: UHC Exchange |
$120.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: UMR Bronson Commercial |
$568.49
|
| Rate for Payer: VA VA |
$1,048.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.34
|
|
|
HC EXC SINGLE EXTERNAL PAPILLA OR TAG, ANUS
|
Facility
|
IP
|
$1,536.46
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
76100280
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$676.04 |
| Max. Negotiated Rate |
$1,382.81 |
| Rate for Payer: Aetna American Axle |
$998.70
|
| Rate for Payer: Aetna Commercial |
$1,305.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$998.70
|
| Rate for Payer: Cash Price |
$1,229.17
|
| Rate for Payer: Cofinity Commercial |
$1,075.52
|
| Rate for Payer: Cofinity Commercial |
$1,321.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.17
|
| Rate for Payer: Healthscope Commercial |
$1,382.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,075.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,305.99
|
| Rate for Payer: PHP Commercial |
$1,305.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.52
|
| Rate for Payer: Priority Health SBD |
$967.97
|
| Rate for Payer: UMR Bronson Commercial |
$676.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.34
|
|
|
HC EXC SKIN MALIG 2.1-3CM FACE, FACIAL
|
Facility
|
IP
|
$2,104.52
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
76100215
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$925.99 |
| Max. Negotiated Rate |
$1,894.07 |
| Rate for Payer: Aetna American Axle |
$1,367.94
|
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.94
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,473.16
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,473.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health SBD |
$1,325.85
|
| Rate for Payer: UMR Bronson Commercial |
$925.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG 2.1-3CM FACE, FACIAL
|
Facility
|
OP
|
$2,104.52
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
76100215
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$222.33 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$1,367.94
|
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,603.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,473.16
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,473.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$1,325.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$222.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$778.67
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG 2.1-3 CM REMAINDER BODY
|
Facility
|
OP
|
$2,104.52
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
76100212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$204.65 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$1,367.94
|
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$224.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,473.16
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,473.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$1,325.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$204.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$778.67
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG 2.1-3 CM REMAINDER BODY
|
Facility
|
IP
|
$2,104.52
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
76100212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$925.99 |
| Max. Negotiated Rate |
$1,894.07 |
| Rate for Payer: Aetna American Axle |
$1,367.94
|
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.94
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,473.16
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,473.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health SBD |
$1,325.85
|
| Rate for Payer: UMR Bronson Commercial |
$925.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG 3.1-4CM FACE, FACIAL
|
Facility
|
IP
|
$2,104.52
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
76100216
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$925.99 |
| Max. Negotiated Rate |
$1,894.07 |
| Rate for Payer: Aetna American Axle |
$1,367.94
|
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.94
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Cofinity Commercial |
$1,473.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,473.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health SBD |
$1,325.85
|
| Rate for Payer: UMR Bronson Commercial |
$925.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG 3.1-4CM FACE, FACIAL
|
Facility
|
OP
|
$2,104.52
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
76100216
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$275.38 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$1,367.94
|
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,021.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Cofinity Commercial |
$1,473.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,473.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$1,325.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$275.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$778.67
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG 3.1-4 CM REMAINDER BODY
|
Facility
|
IP
|
$2,104.52
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
76100213
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$925.99 |
| Max. Negotiated Rate |
$1,894.07 |
| Rate for Payer: Aetna American Axle |
$1,367.94
|
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.94
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,473.16
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,473.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health SBD |
$1,325.85
|
| Rate for Payer: UMR Bronson Commercial |
$925.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG 3.1-4 CM REMAINDER BODY
|
Facility
|
OP
|
$2,104.52
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
76100213
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$232.81 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$1,367.94
|
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,056.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,473.16
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,473.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$1,325.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$232.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$778.67
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG >4CM FACE, FACIAL
|
Facility
|
IP
|
$3,638.85
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
76100217
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,601.09 |
| Max. Negotiated Rate |
$3,274.96 |
| Rate for Payer: Aetna American Axle |
$2,365.25
|
| Rate for Payer: Aetna Commercial |
$3,093.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,365.25
|
| Rate for Payer: Cash Price |
$2,911.08
|
| Rate for Payer: Cofinity Commercial |
$2,547.20
|
| Rate for Payer: Cofinity Commercial |
$3,129.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,911.08
|
| Rate for Payer: Healthscope Commercial |
$3,274.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,547.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,729.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,093.02
|
| Rate for Payer: PHP Commercial |
$3,093.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,547.20
|
| Rate for Payer: Priority Health SBD |
$2,292.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,601.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,729.14
|
|
|
HC EXC SKIN MALIG >4CM FACE, FACIAL
|
Facility
|
OP
|
$3,638.85
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
76100217
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$380.16 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$2,365.25
|
| Rate for Payer: Aetna Commercial |
$3,093.02
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,365.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,787.02
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$2,911.08
|
| Rate for Payer: Cash Price |
$2,911.08
|
| Rate for Payer: Cofinity Commercial |
$3,129.41
|
| Rate for Payer: Cofinity Commercial |
$2,547.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,911.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$3,274.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,547.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,729.14
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,093.02
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$3,093.02
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,547.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Priority Health SBD |
$2,292.48
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$418.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$380.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,346.37
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,729.14
|
|
|
HC EXC SKIN MALIG >4 CM TRUNK, ARM, LEG
|
Facility
|
OP
|
$2,104.52
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
76100211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$309.76 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$1,367.94
|
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,250.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,473.16
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,473.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$1,325.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$340.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$309.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$778.67
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG >4 CM TRUNK, ARM, LEG
|
Facility
|
IP
|
$2,104.52
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
76100211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$925.99 |
| Max. Negotiated Rate |
$1,894.07 |
| Rate for Payer: Aetna American Axle |
$1,367.94
|
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.94
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,473.16
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,473.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health SBD |
$1,325.85
|
| Rate for Payer: UMR Bronson Commercial |
$925.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG >4 REMAINDER BODY
|
Facility
|
OP
|
$3,638.85
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
76100214
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$284.55 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$2,365.25
|
| Rate for Payer: Aetna Commercial |
$3,093.02
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,365.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,531.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$2,911.08
|
| Rate for Payer: Cash Price |
$2,911.08
|
| Rate for Payer: Cofinity Commercial |
$3,129.41
|
| Rate for Payer: Cofinity Commercial |
$2,547.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,911.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$3,274.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,547.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,729.14
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,093.02
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$3,093.02
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,547.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Priority Health SBD |
$2,292.48
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$284.55
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,346.37
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,729.14
|
|
|
HC EXC SKIN MALIG >4 REMAINDER BODY
|
Facility
|
IP
|
$3,638.85
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
76100214
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,601.09 |
| Max. Negotiated Rate |
$3,274.96 |
| Rate for Payer: Aetna American Axle |
$2,365.25
|
| Rate for Payer: Aetna Commercial |
$3,093.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,365.25
|
| Rate for Payer: Cash Price |
$2,911.08
|
| Rate for Payer: Cofinity Commercial |
$2,547.20
|
| Rate for Payer: Cofinity Commercial |
$3,129.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,911.08
|
| Rate for Payer: Healthscope Commercial |
$3,274.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,547.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,729.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,093.02
|
| Rate for Payer: PHP Commercial |
$3,093.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,547.20
|
| Rate for Payer: Priority Health SBD |
$2,292.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,601.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,729.14
|
|
|
HC EXC THROMBOSED HEMORRHOID EXTERN
|
Facility
|
IP
|
$3,173.10
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
36000106
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,396.16 |
| Max. Negotiated Rate |
$2,855.79 |
| Rate for Payer: Aetna American Axle |
$2,062.52
|
| Rate for Payer: Aetna Commercial |
$2,697.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,062.52
|
| Rate for Payer: Cash Price |
$2,538.48
|
| Rate for Payer: Cofinity Commercial |
$2,221.17
|
| Rate for Payer: Cofinity Commercial |
$2,728.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,538.48
|
| Rate for Payer: Healthscope Commercial |
$2,855.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,221.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,379.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,697.14
|
| Rate for Payer: PHP Commercial |
$2,697.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,221.17
|
| Rate for Payer: Priority Health SBD |
$1,999.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,396.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,379.82
|
|
|
HC EXC THROMBOSED HEMORRHOID EXTERN
|
Facility
|
OP
|
$3,173.10
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
36000106
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$112.31 |
| Max. Negotiated Rate |
$3,302.11 |
| Rate for Payer: Aetna American Axle |
$2,062.52
|
| Rate for Payer: Aetna Commercial |
$2,697.14
|
| Rate for Payer: Aetna Medicare |
$1,090.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,062.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$149.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$2,538.48
|
| Rate for Payer: Cash Price |
$2,538.48
|
| Rate for Payer: Cofinity Commercial |
$2,221.17
|
| Rate for Payer: Cofinity Commercial |
$2,728.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,538.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$2,855.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,221.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,379.82
|
| Rate for Payer: Mclaren Medicaid |
$573.77
|
| Rate for Payer: Mclaren Medicare |
$1,048.94
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,697.14
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$2,697.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,221.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,302.11
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,641.69
|
| Rate for Payer: Priority Health SBD |
$1,999.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.54
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.94
|
| Rate for Payer: UHC Exchange |
$112.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: UMR Bronson Commercial |
$1,174.05
|
| Rate for Payer: VA VA |
$1,048.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,379.82
|
|
|
HC EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ >3CM
|
Facility
|
IP
|
$3,547.91
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
76100245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,561.08 |
| Max. Negotiated Rate |
$3,193.12 |
| Rate for Payer: Aetna American Axle |
$2,306.14
|
| Rate for Payer: Aetna Commercial |
$3,015.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,306.14
|
| Rate for Payer: Cash Price |
$2,838.33
|
| Rate for Payer: Cofinity Commercial |
$2,483.54
|
| Rate for Payer: Cofinity Commercial |
$3,051.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,838.33
|
| Rate for Payer: Healthscope Commercial |
$3,193.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,483.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,660.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,015.72
|
| Rate for Payer: PHP Commercial |
$3,015.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,483.54
|
| Rate for Payer: Priority Health SBD |
$2,235.18
|
| Rate for Payer: UMR Bronson Commercial |
$1,561.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,660.93
|
|
|
HC EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ >3CM
|
Facility
|
OP
|
$3,547.91
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
76100245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$437.14 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$2,306.14
|
| Rate for Payer: Aetna Commercial |
$3,015.72
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,306.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,525.13
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$2,838.33
|
| Rate for Payer: Cash Price |
$2,838.33
|
| Rate for Payer: Cofinity Commercial |
$2,483.54
|
| Rate for Payer: Cofinity Commercial |
$3,051.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,838.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$3,193.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,483.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,660.93
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,015.72
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$3,015.72
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,483.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Priority Health SBD |
$2,235.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$437.14
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,312.73
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,660.93
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <3CM
|
Facility
|
OP
|
$2,100.08
|
|
|
Service Code
|
CPT 22902
|
| Hospital Charge Code |
76100277
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$332.68 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$1,365.05
|
| Rate for Payer: Aetna Commercial |
$1,785.07
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,365.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,008.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,470.06
|
| Rate for Payer: Cofinity Commercial |
$1,806.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,890.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,470.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,575.06
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,785.07
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,785.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$1,323.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$365.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$332.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$777.03
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,575.06
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <3CM
|
Facility
|
IP
|
$2,100.08
|
|
|
Service Code
|
CPT 22902
|
| Hospital Charge Code |
76100277
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$924.04 |
| Max. Negotiated Rate |
$1,890.07 |
| Rate for Payer: Aetna American Axle |
$1,365.05
|
| Rate for Payer: Aetna Commercial |
$1,785.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,365.05
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,470.06
|
| Rate for Payer: Cofinity Commercial |
$1,806.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Healthscope Commercial |
$1,890.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,470.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,575.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,785.07
|
| Rate for Payer: PHP Commercial |
$1,785.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.06
|
| Rate for Payer: Priority Health SBD |
$1,323.05
|
| Rate for Payer: UMR Bronson Commercial |
$924.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,575.06
|
|
