|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM <0.6 CM
|
Facility
|
IP
|
$247.47
|
|
|
Service Code
|
CPT 17280
|
| Hospital Charge Code |
76100155
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$108.89 |
| Max. Negotiated Rate |
$222.72 |
| Rate for Payer: Aetna American Axle |
$160.86
|
| Rate for Payer: Aetna Commercial |
$210.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.86
|
| Rate for Payer: Cash Price |
$197.98
|
| Rate for Payer: Cofinity Advantage |
$173.23
|
| Rate for Payer: Cofinity Commercial |
$212.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.98
|
| Rate for Payer: Healthscope Commercial |
$222.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.60
|
| Rate for Payer: PHP Commercial |
$210.35
|
| Rate for Payer: Priority Health SBD |
$155.91
|
| Rate for Payer: UMR Bronson Commercial |
$108.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.60
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 0.6 TO 1.0 CM
|
Facility
|
OP
|
$400.07
|
|
|
Service Code
|
CPT 17281
|
| Hospital Charge Code |
76100147
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna American Axle |
$260.05
|
| Rate for Payer: Aetna Commercial |
$340.06
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$173.24
|
| Rate for Payer: BCN Commercial |
$173.24
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cofinity Advantage |
$280.05
|
| Rate for Payer: Cofinity Commercial |
$344.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$360.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$280.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.05
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.06
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$300.05
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$340.06
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health SBD |
$252.04
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$260.05
|
| Rate for Payer: UHC Core |
$208.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$157.23
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: UMR Bronson Commercial |
$148.03
|
| Rate for Payer: VA VA |
$199.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.05
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 0.6 TO 1.0 CM
|
Facility
|
IP
|
$400.07
|
|
|
Service Code
|
CPT 17281
|
| Hospital Charge Code |
76100147
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$176.03 |
| Max. Negotiated Rate |
$360.06 |
| Rate for Payer: Aetna American Axle |
$260.05
|
| Rate for Payer: Aetna Commercial |
$340.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.05
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cofinity Advantage |
$280.05
|
| Rate for Payer: Cofinity Commercial |
$344.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.06
|
| Rate for Payer: Healthscope Commercial |
$360.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$280.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$300.05
|
| Rate for Payer: PHP Commercial |
$340.06
|
| Rate for Payer: Priority Health SBD |
$252.04
|
| Rate for Payer: UMR Bronson Commercial |
$176.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.05
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 2.1-3 CM
|
Facility
|
IP
|
$400.07
|
|
|
Service Code
|
CPT 17283
|
| Hospital Charge Code |
76100156
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$176.03 |
| Max. Negotiated Rate |
$360.06 |
| Rate for Payer: Aetna American Axle |
$260.05
|
| Rate for Payer: Aetna Commercial |
$340.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.05
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cofinity Advantage |
$280.05
|
| Rate for Payer: Cofinity Commercial |
$344.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.06
|
| Rate for Payer: Healthscope Commercial |
$360.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$280.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$300.05
|
| Rate for Payer: PHP Commercial |
$340.06
|
| Rate for Payer: Priority Health SBD |
$252.04
|
| Rate for Payer: UMR Bronson Commercial |
$176.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.05
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 2.1-3 CM
|
Facility
|
OP
|
$400.07
|
|
|
Service Code
|
CPT 17283
|
| Hospital Charge Code |
76100156
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$148.03 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$260.05
|
| Rate for Payer: Aetna Commercial |
$340.06
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$222.02
|
| Rate for Payer: BCN Commercial |
$222.02
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cofinity Advantage |
$280.05
|
| Rate for Payer: Cofinity Commercial |
$344.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$360.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$280.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.05
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.06
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$300.05
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$340.06
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$252.04
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$260.05
|
| Rate for Payer: UHC Core |
$208.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$157.23
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$148.03
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.05
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 3.1-4 CM
|
Facility
|
IP
|
$614.44
|
|
|
Service Code
|
CPT 17284
|
| Hospital Charge Code |
76100157
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$270.35 |
| Max. Negotiated Rate |
$553.00 |
| Rate for Payer: Aetna American Axle |
$399.39
|
| Rate for Payer: Aetna Commercial |
$522.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.39
|
| Rate for Payer: Cash Price |
$491.55
|
| Rate for Payer: Cofinity Advantage |
$430.11
|
| Rate for Payer: Cofinity Commercial |
$528.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.55
|
| Rate for Payer: Healthscope Commercial |
$553.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$430.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$522.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.83
|
| Rate for Payer: PHP Commercial |
$522.27
|
| Rate for Payer: Priority Health SBD |
$387.10
|
| Rate for Payer: UMR Bronson Commercial |
$270.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.83
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 3.1-4 CM
|
Facility
|
OP
|
$614.44
|
|
|
Service Code
|
CPT 17284
|
| Hospital Charge Code |
76100157
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$227.34 |
| Max. Negotiated Rate |
$2,381.49 |
| Rate for Payer: Aetna American Axle |
$399.39
|
| Rate for Payer: Aetna Commercial |
$522.27
|
| Rate for Payer: Aetna Medicare |
$765.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$920.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$920.51
|
| Rate for Payer: BCBS Complete |
$404.44
|
| Rate for Payer: BCBS MAPPO |
$736.41
|
| Rate for Payer: BCBS Trust/PPO |
$245.51
|
| Rate for Payer: BCN Commercial |
$245.51
|
| Rate for Payer: BCN Medicare Advantage |
$736.41
|
| Rate for Payer: Cash Price |
$491.55
|
| Rate for Payer: Cash Price |
$491.55
|
| Rate for Payer: Cash Price |
$491.55
|
| Rate for Payer: Cofinity Advantage |
$430.11
|
| Rate for Payer: Cofinity Commercial |
$528.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.41
|
| Rate for Payer: Healthscope Commercial |
$553.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$430.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.83
|
| Rate for Payer: Mclaren Medicaid |
$736.41
|
| Rate for Payer: Mclaren Medicare |
$736.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.23
|
| Rate for Payer: Meridian Medicaid |
$773.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$846.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$810.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$522.27
|
| Rate for Payer: Nomi Health Commercial |
$2,209.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.83
|
| Rate for Payer: PACE Medicare |
$699.59
|
| Rate for Payer: PACE SWMI |
$736.41
|
| Rate for Payer: PHP Commercial |
$522.27
|
| Rate for Payer: PHP Medicare Advantage |
$736.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,381.49
|
| Rate for Payer: Priority Health Medicare |
$736.41
|
| Rate for Payer: Priority Health SBD |
$387.10
|
| Rate for Payer: Priority Health Tiered Network |
$1,905.19
|
| Rate for Payer: Railroad Medicare Medicare |
$736.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.39
|
| Rate for Payer: UHC Core |
$320.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$736.41
|
| Rate for Payer: UHC Exchange |
$241.47
|
| Rate for Payer: UHC Medicaid |
$385.14
|
| Rate for Payer: UHCCP Medicaid |
$385.14
|
| Rate for Payer: UMR Bronson Commercial |
$227.34
|
| Rate for Payer: VA VA |
$736.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.83
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM >4 CM
|
Facility
|
OP
|
$614.44
|
|
|
Service Code
|
CPT 17286
|
| Hospital Charge Code |
76100158
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$227.34 |
| Max. Negotiated Rate |
$2,381.49 |
| Rate for Payer: Aetna American Axle |
$399.39
|
| Rate for Payer: Aetna Commercial |
$522.27
|
| Rate for Payer: Aetna Medicare |
$765.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$920.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$920.51
|
| Rate for Payer: BCBS Complete |
$404.44
|
| Rate for Payer: BCBS MAPPO |
$736.41
|
| Rate for Payer: BCBS Trust/PPO |
$288.55
|
| Rate for Payer: BCN Commercial |
$288.55
|
| Rate for Payer: BCN Medicare Advantage |
$736.41
|
| Rate for Payer: Cash Price |
$491.55
|
| Rate for Payer: Cash Price |
$491.55
|
| Rate for Payer: Cash Price |
$491.55
|
| Rate for Payer: Cofinity Advantage |
$430.11
|
| Rate for Payer: Cofinity Commercial |
$528.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.41
|
| Rate for Payer: Healthscope Commercial |
$553.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$430.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.83
|
| Rate for Payer: Mclaren Medicaid |
$736.41
|
| Rate for Payer: Mclaren Medicare |
$736.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.23
|
| Rate for Payer: Meridian Medicaid |
$773.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$846.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$810.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$522.27
|
| Rate for Payer: Nomi Health Commercial |
$2,209.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.83
|
| Rate for Payer: PACE Medicare |
$699.59
|
| Rate for Payer: PACE SWMI |
$736.41
|
| Rate for Payer: PHP Commercial |
$522.27
|
| Rate for Payer: PHP Medicare Advantage |
$736.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,381.49
|
| Rate for Payer: Priority Health Medicare |
$736.41
|
| Rate for Payer: Priority Health SBD |
$387.10
|
| Rate for Payer: Priority Health Tiered Network |
$1,905.19
|
| Rate for Payer: Railroad Medicare Medicare |
$736.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.39
|
| Rate for Payer: UHC Core |
$320.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$736.41
|
| Rate for Payer: UHC Exchange |
$241.47
|
| Rate for Payer: UHC Medicaid |
$385.14
|
| Rate for Payer: UHCCP Medicaid |
$385.14
|
| Rate for Payer: UMR Bronson Commercial |
$227.34
|
| Rate for Payer: VA VA |
$736.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.83
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM >4 CM
|
Facility
|
IP
|
$614.44
|
|
|
Service Code
|
CPT 17286
|
| Hospital Charge Code |
76100158
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$270.35 |
| Max. Negotiated Rate |
$553.00 |
| Rate for Payer: Aetna American Axle |
$399.39
|
| Rate for Payer: Aetna Commercial |
$522.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.39
|
| Rate for Payer: Cash Price |
$491.55
|
| Rate for Payer: Cofinity Advantage |
$430.11
|
| Rate for Payer: Cofinity Commercial |
$528.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.55
|
| Rate for Payer: Healthscope Commercial |
$553.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$430.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$522.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.83
|
| Rate for Payer: PHP Commercial |
$522.27
|
| Rate for Payer: Priority Health SBD |
$387.10
|
| Rate for Payer: UMR Bronson Commercial |
$270.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.83
|
|
|
HC DESTR PENIS LESION, SIMPLE, CRYO
|
Facility
|
IP
|
$180.41
|
|
|
Service Code
|
CPT 54056
|
| Hospital Charge Code |
76100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$79.38 |
| Max. Negotiated Rate |
$162.37 |
| Rate for Payer: Aetna American Axle |
$117.27
|
| Rate for Payer: Aetna Commercial |
$153.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.27
|
| Rate for Payer: Cash Price |
$144.33
|
| Rate for Payer: Cofinity Advantage |
$126.29
|
| Rate for Payer: Cofinity Commercial |
$155.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.33
|
| Rate for Payer: Healthscope Commercial |
$162.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.31
|
| Rate for Payer: PHP Commercial |
$153.35
|
| Rate for Payer: Priority Health SBD |
$113.66
|
| Rate for Payer: UMR Bronson Commercial |
$79.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.31
|
|
|
HC DESTR PENIS LESION, SIMPLE, CRYO
|
Facility
|
OP
|
$180.41
|
|
|
Service Code
|
CPT 54056
|
| Hospital Charge Code |
76100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.75 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna American Axle |
$117.27
|
| Rate for Payer: Aetna Commercial |
$153.35
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$138.20
|
| Rate for Payer: BCN Commercial |
$138.20
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$144.33
|
| Rate for Payer: Cash Price |
$144.33
|
| Rate for Payer: Cash Price |
$144.33
|
| Rate for Payer: Cofinity Advantage |
$126.29
|
| Rate for Payer: Cofinity Commercial |
$155.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$162.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.31
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.35
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.31
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$153.35
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health SBD |
$113.66
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.27
|
| Rate for Payer: UHC Core |
$93.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$70.90
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: UMR Bronson Commercial |
$66.75
|
| Rate for Payer: VA VA |
$199.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.31
|
|
|
HC DESTRUCT ANAL LESN(S) SIMPLE CHEM
|
Facility
|
OP
|
$499.83
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
76100219
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$184.94 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$324.89
|
| Rate for Payer: Aetna Commercial |
$424.86
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$252.90
|
| Rate for Payer: BCN Commercial |
$252.90
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$399.86
|
| Rate for Payer: Cash Price |
$399.86
|
| Rate for Payer: Cash Price |
$399.86
|
| Rate for Payer: Cofinity Advantage |
$349.88
|
| Rate for Payer: Cofinity Commercial |
$429.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$449.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$349.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.87
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.86
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.87
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$424.86
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$314.89
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.89
|
| Rate for Payer: UHC Core |
$260.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$196.43
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$184.94
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.87
|
|
|
HC DESTRUCT ANAL LESN(S) SIMPLE CHEM
|
Facility
|
IP
|
$499.83
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
76100219
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$219.93 |
| Max. Negotiated Rate |
$449.85 |
| Rate for Payer: Aetna American Axle |
$324.89
|
| Rate for Payer: Aetna Commercial |
$424.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.89
|
| Rate for Payer: Cash Price |
$399.86
|
| Rate for Payer: Cofinity Advantage |
$349.88
|
| Rate for Payer: Cofinity Commercial |
$429.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.86
|
| Rate for Payer: Healthscope Commercial |
$449.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$349.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.87
|
| Rate for Payer: PHP Commercial |
$424.86
|
| Rate for Payer: Priority Health SBD |
$314.89
|
| Rate for Payer: UMR Bronson Commercial |
$219.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.87
|
|
|
HC DESTRUCT BENIGN LESIONS 15 OR MORE
|
Facility
|
OP
|
$165.06
|
|
|
Service Code
|
CPT 17111
|
| Hospital Charge Code |
76100124
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$61.07 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna American Axle |
$107.29
|
| Rate for Payer: Aetna Commercial |
$140.30
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$373.07
|
| Rate for Payer: BCN Commercial |
$373.07
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Advantage |
$115.54
|
| Rate for Payer: Cofinity Commercial |
$141.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$148.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.80
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$140.30
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health SBD |
$103.99
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.29
|
| Rate for Payer: UHC Core |
$86.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$64.87
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: UMR Bronson Commercial |
$61.07
|
| Rate for Payer: VA VA |
$199.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.80
|
|
|
HC DESTRUCT BENIGN LESIONS 15 OR MORE
|
Facility
|
IP
|
$165.06
|
|
|
Service Code
|
CPT 17111
|
| Hospital Charge Code |
76100124
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.63 |
| Max. Negotiated Rate |
$148.55 |
| Rate for Payer: Aetna American Axle |
$107.29
|
| Rate for Payer: Aetna Commercial |
$140.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.29
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Advantage |
$115.54
|
| Rate for Payer: Cofinity Commercial |
$141.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Healthscope Commercial |
$148.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: PHP Commercial |
$140.30
|
| Rate for Payer: Priority Health SBD |
$103.99
|
| Rate for Payer: UMR Bronson Commercial |
$72.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.80
|
|
|
HC DESTRUCT BENIGN LESIONS UP TO 14 LESIONS
|
Facility
|
IP
|
$180.06
|
|
|
Service Code
|
CPT 17110
|
| Hospital Charge Code |
76100123
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$79.23 |
| Max. Negotiated Rate |
$162.05 |
| Rate for Payer: Aetna American Axle |
$117.04
|
| Rate for Payer: Aetna Commercial |
$153.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.04
|
| Rate for Payer: Cash Price |
$144.05
|
| Rate for Payer: Cofinity Advantage |
$126.04
|
| Rate for Payer: Cofinity Commercial |
$154.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.05
|
| Rate for Payer: Healthscope Commercial |
$162.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.04
|
| Rate for Payer: PHP Commercial |
$153.05
|
| Rate for Payer: Priority Health SBD |
$113.44
|
| Rate for Payer: UMR Bronson Commercial |
$79.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.04
|
|
|
HC DESTRUCT BENIGN LESIONS UP TO 14 LESIONS
|
Facility
|
OP
|
$180.06
|
|
|
Service Code
|
CPT 17110
|
| Hospital Charge Code |
76100123
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.62 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna American Axle |
$117.04
|
| Rate for Payer: Aetna Commercial |
$153.05
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$126.14
|
| Rate for Payer: BCN Commercial |
$126.14
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$144.05
|
| Rate for Payer: Cash Price |
$144.05
|
| Rate for Payer: Cash Price |
$144.05
|
| Rate for Payer: Cofinity Advantage |
$126.04
|
| Rate for Payer: Cofinity Commercial |
$154.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$162.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.04
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.05
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.04
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$153.05
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health SBD |
$113.44
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.04
|
| Rate for Payer: UHC Core |
$93.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$70.76
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: UMR Bronson Commercial |
$66.62
|
| Rate for Payer: VA VA |
$199.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.04
|
|
|
HC DESTRUCT BY NEURO AGENT SUP HYPOGAST PLEXUS
|
Facility
|
IP
|
$1,464.47
|
|
|
Service Code
|
CPT 64681
|
| Hospital Charge Code |
36100606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$644.37 |
| Max. Negotiated Rate |
$1,318.02 |
| Rate for Payer: Aetna American Axle |
$951.91
|
| Rate for Payer: Aetna Commercial |
$1,244.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$951.91
|
| Rate for Payer: Cash Price |
$1,171.58
|
| Rate for Payer: Cofinity Advantage |
$1,025.13
|
| Rate for Payer: Cofinity Commercial |
$1,259.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,171.58
|
| Rate for Payer: Healthscope Commercial |
$1,318.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,025.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,098.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,244.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,098.35
|
| Rate for Payer: PHP Commercial |
$1,244.80
|
| Rate for Payer: Priority Health SBD |
$922.62
|
| Rate for Payer: UMR Bronson Commercial |
$644.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,098.35
|
|
|
HC DESTRUCT BY NEURO AGENT SUP HYPOGAST PLEXUS
|
Facility
|
OP
|
$1,464.47
|
|
|
Service Code
|
CPT 64681
|
| Hospital Charge Code |
36100606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.91 |
| Max. Negotiated Rate |
$2,850.01 |
| Rate for Payer: Aetna American Axle |
$951.91
|
| Rate for Payer: Aetna Commercial |
$1,244.80
|
| Rate for Payer: Aetna Medicare |
$916.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$951.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$907.73
|
| Rate for Payer: BCN Commercial |
$907.73
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$1,171.58
|
| Rate for Payer: Cash Price |
$1,171.58
|
| Rate for Payer: Cash Price |
$1,171.58
|
| Rate for Payer: Cofinity Advantage |
$1,025.13
|
| Rate for Payer: Cofinity Commercial |
$1,259.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,171.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,318.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,025.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,098.35
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$925.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,244.80
|
| Rate for Payer: Nomi Health Commercial |
$2,643.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,098.35
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$1,244.80
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,850.01
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health SBD |
$922.62
|
| Rate for Payer: Priority Health Tiered Network |
$2,280.01
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: UMR Bronson Commercial |
$541.85
|
| Rate for Payer: VA VA |
$881.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,098.35
|
|
|
HC DESTRUCT BY NEURO AGENT TRIGEM NRVE
|
Facility
|
OP
|
$2,736.85
|
|
|
Service Code
|
CPT 64610
|
| Hospital Charge Code |
36100607
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,012.63 |
| Max. Negotiated Rate |
$6,292.24 |
| Rate for Payer: Aetna American Axle |
$1,778.95
|
| Rate for Payer: Aetna Commercial |
$2,326.32
|
| Rate for Payer: Aetna Medicare |
$2,023.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,778.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,432.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,432.12
|
| Rate for Payer: BCBS Complete |
$1,068.58
|
| Rate for Payer: BCBS MAPPO |
$1,945.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,731.83
|
| Rate for Payer: BCN Commercial |
$1,731.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,945.70
|
| Rate for Payer: Cash Price |
$2,189.48
|
| Rate for Payer: Cash Price |
$2,189.48
|
| Rate for Payer: Cash Price |
$2,189.48
|
| Rate for Payer: Cofinity Advantage |
$1,915.80
|
| Rate for Payer: Cofinity Commercial |
$2,353.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,945.70
|
| Rate for Payer: Healthscope Commercial |
$2,463.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,915.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,052.64
|
| Rate for Payer: Mclaren Medicaid |
$1,945.70
|
| Rate for Payer: Mclaren Medicare |
$1,945.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,042.98
|
| Rate for Payer: Meridian Medicaid |
$2,042.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,237.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,140.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.32
|
| Rate for Payer: Nomi Health Commercial |
$5,837.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.64
|
| Rate for Payer: PACE Medicare |
$1,848.41
|
| Rate for Payer: PACE SWMI |
$1,945.70
|
| Rate for Payer: PHP Commercial |
$2,326.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,945.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,017.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,292.24
|
| Rate for Payer: Priority Health Medicare |
$1,945.70
|
| Rate for Payer: Priority Health SBD |
$1,724.22
|
| Rate for Payer: Priority Health Tiered Network |
$5,033.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,945.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,945.70
|
| Rate for Payer: UHC Medicaid |
$1,017.60
|
| Rate for Payer: UHCCP Medicaid |
$1,017.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,012.63
|
| Rate for Payer: VA VA |
$1,945.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,052.64
|
|
|
HC DESTRUCT BY NEURO AGENT TRIGEM NRVE
|
Facility
|
IP
|
$2,736.85
|
|
|
Service Code
|
CPT 64610
|
| Hospital Charge Code |
36100607
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,204.21 |
| Max. Negotiated Rate |
$2,463.16 |
| Rate for Payer: Aetna American Axle |
$1,778.95
|
| Rate for Payer: Aetna Commercial |
$2,326.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,778.95
|
| Rate for Payer: Cash Price |
$2,189.48
|
| Rate for Payer: Cofinity Advantage |
$1,915.80
|
| Rate for Payer: Cofinity Commercial |
$2,353.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.48
|
| Rate for Payer: Healthscope Commercial |
$2,463.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,915.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,052.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.64
|
| Rate for Payer: PHP Commercial |
$2,326.32
|
| Rate for Payer: Priority Health SBD |
$1,724.22
|
| Rate for Payer: UMR Bronson Commercial |
$1,204.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,052.64
|
|
|
HC DESTRUCTION LESION(S) VULVA, EXTENSIVE
|
Facility
|
OP
|
$2,583.10
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
76100235
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$955.75 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna American Axle |
$1,679.02
|
| Rate for Payer: Aetna Commercial |
$2,195.64
|
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,679.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,534.69
|
| Rate for Payer: BCN Commercial |
$3,534.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Cash Price |
$2,066.48
|
| Rate for Payer: Cash Price |
$2,066.48
|
| Rate for Payer: Cash Price |
$2,066.48
|
| Rate for Payer: Cofinity Advantage |
$1,808.17
|
| Rate for Payer: Cofinity Commercial |
$2,221.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,066.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Healthscope Commercial |
$2,324.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,808.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,937.33
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$2,158.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,195.64
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,937.33
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Commercial |
$2,195.64
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,648.46
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health SBD |
$1,627.35
|
| Rate for Payer: Priority Health Tiered Network |
$5,318.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,679.02
|
| Rate for Payer: UHC Core |
$1,345.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Exchange |
$1,015.16
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: UMR Bronson Commercial |
$955.75
|
| Rate for Payer: VA VA |
$2,055.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,937.33
|
|
|
HC DESTRUCTION LESION(S) VULVA, EXTENSIVE
|
Facility
|
IP
|
$2,583.10
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
76100235
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,136.56 |
| Max. Negotiated Rate |
$2,324.79 |
| Rate for Payer: Aetna American Axle |
$1,679.02
|
| Rate for Payer: Aetna Commercial |
$2,195.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,679.02
|
| Rate for Payer: Cash Price |
$2,066.48
|
| Rate for Payer: Cofinity Advantage |
$1,808.17
|
| Rate for Payer: Cofinity Commercial |
$2,221.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,066.48
|
| Rate for Payer: Healthscope Commercial |
$2,324.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,808.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,937.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,195.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,937.33
|
| Rate for Payer: PHP Commercial |
$2,195.64
|
| Rate for Payer: Priority Health SBD |
$1,627.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,136.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,937.33
|
|
|
HC DESTRUCTION LESION(S) VULVA, SIMPLE
|
Facility
|
IP
|
$2,583.10
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
76100233
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,136.56 |
| Max. Negotiated Rate |
$2,324.79 |
| Rate for Payer: Aetna American Axle |
$1,679.02
|
| Rate for Payer: Aetna Commercial |
$2,195.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,679.02
|
| Rate for Payer: Cash Price |
$2,066.48
|
| Rate for Payer: Cofinity Advantage |
$1,808.17
|
| Rate for Payer: Cofinity Commercial |
$2,221.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,066.48
|
| Rate for Payer: Healthscope Commercial |
$2,324.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,808.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,937.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,195.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,937.33
|
| Rate for Payer: PHP Commercial |
$2,195.64
|
| Rate for Payer: Priority Health SBD |
$1,627.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,136.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,937.33
|
|
|
HC DESTRUCTION LESION(S) VULVA, SIMPLE
|
Facility
|
OP
|
$2,583.10
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
76100233
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$955.75 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna American Axle |
$1,679.02
|
| Rate for Payer: Aetna Commercial |
$2,195.64
|
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,679.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,338.54
|
| Rate for Payer: BCN Commercial |
$2,338.54
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Cash Price |
$2,066.48
|
| Rate for Payer: Cash Price |
$2,066.48
|
| Rate for Payer: Cash Price |
$2,066.48
|
| Rate for Payer: Cofinity Advantage |
$1,808.17
|
| Rate for Payer: Cofinity Commercial |
$2,221.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,066.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Healthscope Commercial |
$2,324.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,808.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,937.33
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$2,158.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,195.64
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,937.33
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Commercial |
$2,195.64
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,648.46
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health SBD |
$1,627.35
|
| Rate for Payer: Priority Health Tiered Network |
$5,318.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,679.02
|
| Rate for Payer: UHC Core |
$1,345.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Exchange |
$1,015.16
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: UMR Bronson Commercial |
$955.75
|
| Rate for Payer: VA VA |
$2,055.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,937.33
|
|
