|
HC DESTRUCT MALIG LESION FACE,EAR,EYELID,NOSE,LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
IP
|
$400.07
|
|
|
Service Code
|
CPT 17282
|
| Hospital Charge Code |
76100131
|
|
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 DESTRUCT MALIG LESION FACE,EAR,EYELID,NOSE,LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
OP
|
$400.07
|
|
|
Service Code
|
CPT 17282
|
| Hospital Charge Code |
76100131
|
|
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 |
$195.63
|
| Rate for Payer: BCN Commercial |
$195.63
|
| 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 DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA <0.6 CM
|
Facility
|
OP
|
$223.91
|
|
|
Service Code
|
CPT 17270
|
| Hospital Charge Code |
76100154
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$82.85 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna American Axle |
$145.54
|
| Rate for Payer: Aetna Commercial |
$190.32
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.54
|
| 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 |
$132.33
|
| Rate for Payer: BCN Commercial |
$132.33
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cofinity Advantage |
$156.74
|
| Rate for Payer: Cofinity Commercial |
$192.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$201.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.93
|
| 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 |
$190.32
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.93
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$190.32
|
| 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 |
$141.06
|
| 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) |
$145.54
|
| Rate for Payer: UHC Core |
$116.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$88.00
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: UMR Bronson Commercial |
$82.85
|
| Rate for Payer: VA VA |
$199.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.93
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA <0.6 CM
|
Facility
|
IP
|
$223.91
|
|
|
Service Code
|
CPT 17270
|
| Hospital Charge Code |
76100154
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$98.52 |
| Max. Negotiated Rate |
$201.52 |
| Rate for Payer: Aetna American Axle |
$145.54
|
| Rate for Payer: Aetna Commercial |
$190.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.54
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cofinity Advantage |
$156.74
|
| Rate for Payer: Cofinity Commercial |
$192.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.13
|
| Rate for Payer: Healthscope Commercial |
$201.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.93
|
| Rate for Payer: PHP Commercial |
$190.32
|
| Rate for Payer: Priority Health SBD |
$141.06
|
| Rate for Payer: UMR Bronson Commercial |
$98.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.93
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
IP
|
$287.22
|
|
|
Service Code
|
CPT 17271
|
| Hospital Charge Code |
76100128
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$126.38 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna American Axle |
$186.69
|
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.69
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Advantage |
$201.05
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: Priority Health SBD |
$180.95
|
| Rate for Payer: UMR Bronson Commercial |
$126.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 17271
|
| Hospital Charge Code |
76100128
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna American Axle |
$186.69
|
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.69
|
| 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 |
$132.33
|
| Rate for Payer: BCN Commercial |
$132.33
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Advantage |
$201.05
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| 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 |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$244.14
|
| 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 |
$180.95
|
| 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) |
$186.69
|
| Rate for Payer: UHC Core |
$149.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$112.88
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: UMR Bronson Commercial |
$106.27
|
| Rate for Payer: VA VA |
$199.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
IP
|
$165.06
|
|
|
Service Code
|
CPT 17272
|
| Hospital Charge Code |
76100129
|
|
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 MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
OP
|
$165.06
|
|
|
Service Code
|
CPT 17272
|
| Hospital Charge Code |
76100129
|
|
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 |
$172.78
|
| Rate for Payer: BCN Commercial |
$172.78
|
| 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 MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
OP
|
$315.95
|
|
|
Service Code
|
CPT 17273
|
| Hospital Charge Code |
76100130
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.90 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$205.37
|
| Rate for Payer: Aetna Commercial |
$268.56
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.37
|
| 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 |
$200.77
|
| Rate for Payer: BCN Commercial |
$200.77
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Advantage |
$221.16
|
| Rate for Payer: Cofinity Commercial |
$271.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$284.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$221.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.96
|
| 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 |
$268.56
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$268.56
|
| 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 |
$199.05
|
| 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) |
$205.37
|
| Rate for Payer: UHC Core |
$164.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$124.17
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$116.90
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.96
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
IP
|
$315.95
|
|
|
Service Code
|
CPT 17273
|
| Hospital Charge Code |
76100130
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$139.02 |
| Max. Negotiated Rate |
$284.36 |
| Rate for Payer: Aetna American Axle |
$205.37
|
| Rate for Payer: Aetna Commercial |
$268.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.37
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Advantage |
$221.16
|
| Rate for Payer: Cofinity Commercial |
$271.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Healthscope Commercial |
$284.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$221.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: PHP Commercial |
$268.56
|
| Rate for Payer: Priority Health SBD |
$199.05
|
| Rate for Payer: UMR Bronson Commercial |
$139.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.96
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
OP
|
$165.06
|
|
|
Service Code
|
CPT 17260
|
| Hospital Charge Code |
76100125
|
|
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 |
$172.78
|
| Rate for Payer: BCN Commercial |
$172.78
|
| 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 MALIGNANT LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
IP
|
$165.06
|
|
|
Service Code
|
CPT 17260
|
| Hospital Charge Code |
76100125
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$165.06
|
|
|
Service Code
|
CPT 17261
|
| Hospital Charge Code |
76100126
|
|
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 |
$189.08
|
| Rate for Payer: BCN Commercial |
$189.08
|
| 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 MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$165.06
|
|
|
Service Code
|
CPT 17261
|
| Hospital Charge Code |
76100126
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$165.06
|
|
|
Service Code
|
CPT 17262
|
| Hospital Charge Code |
76100127
|
|
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 |
$187.82
|
| Rate for Payer: BCN Commercial |
$187.82
|
| 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 MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$165.06
|
|
|
Service Code
|
CPT 17262
|
| Hospital Charge Code |
76100127
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$543.09
|
|
|
Service Code
|
CPT 17263
|
| Hospital Charge Code |
76100372
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna American Axle |
$353.01
|
| Rate for Payer: Aetna Commercial |
$461.63
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.01
|
| 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 |
$172.78
|
| Rate for Payer: BCN Commercial |
$172.78
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$434.47
|
| Rate for Payer: Cash Price |
$434.47
|
| Rate for Payer: Cash Price |
$434.47
|
| Rate for Payer: Cofinity Advantage |
$380.16
|
| Rate for Payer: Cofinity Commercial |
$467.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$488.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$380.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.32
|
| 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 |
$461.63
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$407.32
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$461.63
|
| 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 |
$342.15
|
| 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) |
$353.01
|
| Rate for Payer: UHC Core |
$282.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$213.43
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: UMR Bronson Commercial |
$200.94
|
| Rate for Payer: VA VA |
$199.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.32
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$543.09
|
|
|
Service Code
|
CPT 17263
|
| Hospital Charge Code |
76100372
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$238.96 |
| Max. Negotiated Rate |
$488.78 |
| Rate for Payer: Aetna American Axle |
$353.01
|
| Rate for Payer: Aetna Commercial |
$461.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.01
|
| Rate for Payer: Cash Price |
$434.47
|
| Rate for Payer: Cofinity Advantage |
$380.16
|
| Rate for Payer: Cofinity Commercial |
$467.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.47
|
| Rate for Payer: Healthscope Commercial |
$488.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$380.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$407.32
|
| Rate for Payer: PHP Commercial |
$461.63
|
| Rate for Payer: Priority Health SBD |
$342.15
|
| Rate for Payer: UMR Bronson Commercial |
$238.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.32
|
|
|
HC DESTRUCT MOUTH LESION
|
Facility
|
IP
|
$9,995.00
|
|
|
Service Code
|
CPT 40820
|
| Hospital Charge Code |
76100538
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,397.80 |
| Max. Negotiated Rate |
$8,995.50 |
| Rate for Payer: Aetna American Axle |
$6,496.75
|
| Rate for Payer: Aetna Commercial |
$8,495.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,496.75
|
| Rate for Payer: Cash Price |
$7,996.00
|
| Rate for Payer: Cofinity Advantage |
$6,996.50
|
| Rate for Payer: Cofinity Commercial |
$8,595.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,996.00
|
| Rate for Payer: Healthscope Commercial |
$8,995.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,996.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,496.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,495.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,496.25
|
| Rate for Payer: PHP Commercial |
$8,495.75
|
| Rate for Payer: Priority Health SBD |
$6,296.85
|
| Rate for Payer: UMR Bronson Commercial |
$4,397.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,496.25
|
|
|
HC DESTRUCT MOUTH LESION
|
Facility
|
OP
|
$9,995.00
|
|
|
Service Code
|
CPT 40820
|
| Hospital Charge Code |
76100538
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$352.26 |
| Max. Negotiated Rate |
$10,683.35 |
| Rate for Payer: Aetna American Axle |
$6,496.75
|
| Rate for Payer: Aetna Commercial |
$8,495.75
|
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,496.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$352.26
|
| Rate for Payer: BCN Commercial |
$352.26
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$7,996.00
|
| Rate for Payer: Cash Price |
$7,996.00
|
| Rate for Payer: Cash Price |
$7,996.00
|
| Rate for Payer: Cofinity Advantage |
$6,996.50
|
| Rate for Payer: Cofinity Commercial |
$8,595.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,996.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$8,995.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,996.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,496.25
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$3,468.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,495.75
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,496.25
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$8,495.75
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,683.35
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health SBD |
$6,296.85
|
| Rate for Payer: Priority Health Tiered Network |
$8,546.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,496.75
|
| Rate for Payer: UHC Core |
$5,207.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$3,928.03
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: UMR Bronson Commercial |
$3,698.15
|
| Rate for Payer: VA VA |
$3,303.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,496.25
|
|
|
HC DESTRUCT NEURO AGENT PLANTAR DIGITAL NRV
|
Facility
|
OP
|
$417.06
|
|
|
Service Code
|
CPT 64632
|
| Hospital Charge Code |
36100608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$64.24 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna American Axle |
$271.09
|
| Rate for Payer: Aetna Commercial |
$354.50
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$64.24
|
| Rate for Payer: BCN Commercial |
$64.24
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$333.65
|
| Rate for Payer: Cash Price |
$333.65
|
| Rate for Payer: Cash Price |
$333.65
|
| Rate for Payer: Cofinity Advantage |
$291.94
|
| Rate for Payer: Cofinity Commercial |
$358.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$375.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.80
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$321.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.50
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.80
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$354.50
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$989.08
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health SBD |
$262.75
|
| Rate for Payer: Priority Health Tiered Network |
$791.26
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$154.31
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.80
|
|
|
HC DESTRUCT NEURO AGENT PLANTAR DIGITAL NRV
|
Facility
|
IP
|
$417.06
|
|
|
Service Code
|
CPT 64632
|
| Hospital Charge Code |
36100608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$183.51 |
| Max. Negotiated Rate |
$375.35 |
| Rate for Payer: Aetna American Axle |
$271.09
|
| Rate for Payer: Aetna Commercial |
$354.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.09
|
| Rate for Payer: Cash Price |
$333.65
|
| Rate for Payer: Cofinity Advantage |
$291.94
|
| Rate for Payer: Cofinity Commercial |
$358.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.65
|
| Rate for Payer: Healthscope Commercial |
$375.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.80
|
| Rate for Payer: PHP Commercial |
$354.50
|
| Rate for Payer: Priority Health SBD |
$262.75
|
| Rate for Payer: UMR Bronson Commercial |
$183.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.80
|
|
|
HC DESTRUCT PREMALIGNANT LESIONS 15 OR MORE LESIONS
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 17004
|
| Hospital Charge Code |
76100122
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$106.27 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$186.69
|
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.69
|
| 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 |
$197.45
|
| Rate for Payer: BCN Commercial |
$197.45
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Advantage |
$201.05
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| 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 |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$244.14
|
| 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 |
$180.95
|
| 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) |
$186.69
|
| Rate for Payer: UHC Core |
$149.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$112.88
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$106.27
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC DESTRUCT PREMALIGNANT LESIONS 15 OR MORE LESIONS
|
Facility
|
IP
|
$287.22
|
|
|
Service Code
|
CPT 17004
|
| Hospital Charge Code |
76100122
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$126.38 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna American Axle |
$186.69
|
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.69
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Advantage |
$201.05
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: Priority Health SBD |
$180.95
|
| Rate for Payer: UMR Bronson Commercial |
$126.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC DESTRUCT PREMALIGNANT LESIONS FIRST LESION
|
Facility
|
IP
|
$180.06
|
|
|
Service Code
|
CPT 17000
|
| Hospital Charge Code |
76100120
|
|
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
|
|
