|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
76100098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$527.81 |
| Max. Negotiated Rate |
$1,079.61 |
| Rate for Payer: Aetna American Axle |
$779.72
|
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.72
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Advantage |
$839.70
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$839.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: Priority Health SBD |
$755.73
|
| Rate for Payer: UMR Bronson Commercial |
$527.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.68
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 3.1 TO 4.0 CM
|
Facility
|
OP
|
$1,981.12
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
76100099
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$733.01 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$1,287.73
|
| Rate for Payer: Aetna Commercial |
$1,683.95
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,287.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,782.49
|
| Rate for Payer: BCN Commercial |
$2,782.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cofinity Advantage |
$1,386.78
|
| Rate for Payer: Cofinity Commercial |
$1,703.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,584.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,783.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,386.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,485.84
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,683.95
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.84
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,683.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,248.11
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,287.73
|
| Rate for Payer: UHC Core |
$1,032.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$778.58
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$733.01
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,485.84
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 3.1 TO 4.0 CM
|
Facility
|
IP
|
$1,981.12
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
76100099
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$871.69 |
| Max. Negotiated Rate |
$1,783.01 |
| Rate for Payer: Aetna American Axle |
$1,287.73
|
| Rate for Payer: Aetna Commercial |
$1,683.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,287.73
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cofinity Advantage |
$1,386.78
|
| Rate for Payer: Cofinity Commercial |
$1,703.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,584.90
|
| Rate for Payer: Healthscope Commercial |
$1,783.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,386.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,485.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,683.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.84
|
| Rate for Payer: PHP Commercial |
$1,683.95
|
| Rate for Payer: Priority Health SBD |
$1,248.11
|
| Rate for Payer: UMR Bronson Commercial |
$871.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,485.84
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA OVER 4.0 CM
|
Facility
|
OP
|
$1,981.12
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
76100100
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$733.01 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna American Axle |
$1,287.73
|
| Rate for Payer: Aetna Commercial |
$1,683.95
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,287.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,093.48
|
| Rate for Payer: BCN Commercial |
$3,093.48
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cofinity Advantage |
$1,386.78
|
| Rate for Payer: Cofinity Commercial |
$1,703.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,584.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$1,783.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,386.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,485.84
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,683.95
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.84
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$1,683.95
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$1,248.11
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,287.73
|
| Rate for Payer: UHC Core |
$1,032.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$778.58
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: UMR Bronson Commercial |
$733.01
|
| Rate for Payer: VA VA |
$2,894.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,485.84
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA OVER 4.0 CM
|
Facility
|
IP
|
$1,981.12
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
76100100
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$871.69 |
| Max. Negotiated Rate |
$1,783.01 |
| Rate for Payer: Aetna American Axle |
$1,287.73
|
| Rate for Payer: Aetna Commercial |
$1,683.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,287.73
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cofinity Advantage |
$1,386.78
|
| Rate for Payer: Cofinity Commercial |
$1,703.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,584.90
|
| Rate for Payer: Healthscope Commercial |
$1,783.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,386.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,485.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,683.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.84
|
| Rate for Payer: PHP Commercial |
$1,683.95
|
| Rate for Payer: Priority Health SBD |
$1,248.11
|
| Rate for Payer: UMR Bronson Commercial |
$871.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,485.84
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
OP
|
$855.50
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
76100089
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$316.54 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna American Axle |
$556.08
|
| Rate for Payer: Aetna Commercial |
$727.17
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$556.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$879.35
|
| Rate for Payer: BCN Commercial |
$879.35
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$684.40
|
| Rate for Payer: Cash Price |
$684.40
|
| Rate for Payer: Cash Price |
$684.40
|
| Rate for Payer: Cofinity Advantage |
$598.85
|
| Rate for Payer: Cofinity Commercial |
$735.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$769.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$598.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$641.62
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$727.17
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$641.62
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$727.17
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$538.97
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$556.08
|
| Rate for Payer: UHC Core |
$445.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$336.21
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UMR Bronson Commercial |
$316.54
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$641.62
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
IP
|
$855.50
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
76100089
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$376.42 |
| Max. Negotiated Rate |
$769.95 |
| Rate for Payer: Aetna American Axle |
$556.08
|
| Rate for Payer: Aetna Commercial |
$727.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$556.08
|
| Rate for Payer: Cash Price |
$684.40
|
| Rate for Payer: Cofinity Advantage |
$598.85
|
| Rate for Payer: Cofinity Commercial |
$735.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.40
|
| Rate for Payer: Healthscope Commercial |
$769.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$598.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$641.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$727.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$641.62
|
| Rate for Payer: PHP Commercial |
$727.17
|
| Rate for Payer: Priority Health SBD |
$538.97
|
| Rate for Payer: UMR Bronson Commercial |
$376.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$641.62
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.6 CM TO 1.0 CM
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
76100090
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$397.85
|
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.85
|
| 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 |
$505.51
|
| Rate for Payer: BCN Commercial |
$505.51
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Advantage |
$428.46
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.06
|
| 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 |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$520.27
|
| 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 |
$385.61
|
| 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) |
$397.85
|
| Rate for Payer: UHC Core |
$318.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$240.55
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$226.47
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.06
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.6 CM TO 1.0 CM
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
76100090
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$269.32 |
| Max. Negotiated Rate |
$550.87 |
| Rate for Payer: Aetna American Axle |
$397.85
|
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.85
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Advantage |
$428.46
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: Priority Health SBD |
$385.61
|
| Rate for Payer: UMR Bronson Commercial |
$269.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.06
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 1.1 CM TO 2.0 CM
|
Facility
|
IP
|
$1,320.15
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
76100091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$580.87 |
| Max. Negotiated Rate |
$1,188.13 |
| Rate for Payer: Aetna American Axle |
$858.10
|
| Rate for Payer: Aetna Commercial |
$1,122.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$858.10
|
| Rate for Payer: Cash Price |
$1,056.12
|
| Rate for Payer: Cofinity Advantage |
$924.11
|
| Rate for Payer: Cofinity Commercial |
$1,135.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.12
|
| Rate for Payer: Healthscope Commercial |
$1,188.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$924.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$990.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,122.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$990.11
|
| Rate for Payer: PHP Commercial |
$1,122.13
|
| Rate for Payer: Priority Health SBD |
$831.69
|
| Rate for Payer: UMR Bronson Commercial |
$580.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$990.11
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 1.1 CM TO 2.0 CM
|
Facility
|
OP
|
$1,320.15
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
76100091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna American Axle |
$858.10
|
| Rate for Payer: Aetna Commercial |
$1,122.13
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$858.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$879.35
|
| Rate for Payer: BCN Commercial |
$879.35
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$1,056.12
|
| Rate for Payer: Cash Price |
$1,056.12
|
| Rate for Payer: Cash Price |
$1,056.12
|
| Rate for Payer: Cofinity Advantage |
$924.11
|
| Rate for Payer: Cofinity Commercial |
$1,135.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$1,188.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$924.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$990.11
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,122.13
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$990.11
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$1,122.13
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$831.69
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$858.10
|
| Rate for Payer: UHC Core |
$687.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$518.82
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UMR Bronson Commercial |
$488.46
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$990.11
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
76100092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$527.81 |
| Max. Negotiated Rate |
$1,079.61 |
| Rate for Payer: Aetna American Axle |
$779.72
|
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.72
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Advantage |
$839.70
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$839.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: Priority Health SBD |
$755.73
|
| Rate for Payer: UMR Bronson Commercial |
$527.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.68
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
76100092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna American Axle |
$779.72
|
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$879.35
|
| Rate for Payer: BCN Commercial |
$879.35
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Advantage |
$839.70
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$839.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.68
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$755.73
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$779.72
|
| Rate for Payer: UHC Core |
$624.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$471.43
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UMR Bronson Commercial |
$443.84
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.68
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
IP
|
$1,439.49
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
76100093
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$633.38 |
| Max. Negotiated Rate |
$1,295.54 |
| Rate for Payer: Aetna American Axle |
$935.67
|
| Rate for Payer: Aetna Commercial |
$1,223.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$935.67
|
| Rate for Payer: Cash Price |
$1,151.59
|
| Rate for Payer: Cofinity Advantage |
$1,007.64
|
| Rate for Payer: Cofinity Commercial |
$1,237.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,151.59
|
| Rate for Payer: Healthscope Commercial |
$1,295.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,007.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,079.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,223.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,079.62
|
| Rate for Payer: PHP Commercial |
$1,223.57
|
| Rate for Payer: Priority Health SBD |
$906.88
|
| Rate for Payer: UMR Bronson Commercial |
$633.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,079.62
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
OP
|
$1,439.49
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
76100093
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$532.61 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$935.67
|
| Rate for Payer: Aetna Commercial |
$1,223.57
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$935.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,086.40
|
| Rate for Payer: BCN Commercial |
$2,086.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,151.59
|
| Rate for Payer: Cash Price |
$1,151.59
|
| Rate for Payer: Cash Price |
$1,151.59
|
| Rate for Payer: Cofinity Advantage |
$1,007.64
|
| Rate for Payer: Cofinity Commercial |
$1,237.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,151.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,295.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,007.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,079.62
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,223.57
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,079.62
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,223.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$906.88
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$935.67
|
| Rate for Payer: UHC Core |
$749.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$565.72
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$532.61
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,079.62
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
OP
|
$2,161.23
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$799.66 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$1,404.80
|
| Rate for Payer: Aetna Commercial |
$1,837.05
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,404.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,023.75
|
| Rate for Payer: BCN Commercial |
$3,023.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,728.98
|
| Rate for Payer: Cash Price |
$1,728.98
|
| Rate for Payer: Cash Price |
$1,728.98
|
| Rate for Payer: Cofinity Advantage |
$1,512.86
|
| Rate for Payer: Cofinity Commercial |
$1,858.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,728.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,945.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,512.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,620.92
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,837.05
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,620.92
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,837.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,361.57
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,404.80
|
| Rate for Payer: UHC Core |
$1,126.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$849.36
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$799.66
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,620.92
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
IP
|
$2,161.23
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$950.94 |
| Max. Negotiated Rate |
$1,945.11 |
| Rate for Payer: Aetna American Axle |
$1,404.80
|
| Rate for Payer: Aetna Commercial |
$1,837.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,404.80
|
| Rate for Payer: Cash Price |
$1,728.98
|
| Rate for Payer: Cofinity Advantage |
$1,512.86
|
| Rate for Payer: Cofinity Commercial |
$1,858.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,728.98
|
| Rate for Payer: Healthscope Commercial |
$1,945.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,512.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,620.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,837.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,620.92
|
| Rate for Payer: PHP Commercial |
$1,837.05
|
| Rate for Payer: Priority Health SBD |
$1,361.57
|
| Rate for Payer: UMR Bronson Commercial |
$950.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,620.92
|
|
|
HC EXCISE CYST/BREAST LESION
|
Facility
|
OP
|
$4,822.48
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$515.37 |
| Max. Negotiated Rate |
$12,616.62 |
| Rate for Payer: Aetna American Axle |
$3,134.61
|
| Rate for Payer: Aetna Commercial |
$4,099.11
|
| Rate for Payer: Aetna Medicare |
$4,057.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,134.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,367.78
|
| Rate for Payer: BCCCP Commercial |
$515.37
|
| Rate for Payer: BCN Commercial |
$3,367.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Cash Price |
$3,857.98
|
| Rate for Payer: Cash Price |
$3,857.98
|
| Rate for Payer: Cash Price |
$3,857.98
|
| Rate for Payer: Cofinity Advantage |
$3,375.74
|
| Rate for Payer: Cofinity Commercial |
$4,147.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,857.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Healthscope Commercial |
$4,340.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,375.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,616.86
|
| Rate for Payer: Mclaren Medicaid |
$3,901.35
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$4,096.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,099.11
|
| Rate for Payer: Nomi Health Commercial |
$11,704.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,616.86
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Commercial |
$4,099.11
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,616.62
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health SBD |
$3,038.16
|
| Rate for Payer: Priority Health Tiered Network |
$10,093.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,134.61
|
| Rate for Payer: UHC Core |
$2,512.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,901.35
|
| Rate for Payer: UHC Exchange |
$1,895.23
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: UMR Bronson Commercial |
$1,784.32
|
| Rate for Payer: VA VA |
$3,901.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,616.86
|
|
|
HC EXCISE CYST/BREAST LESION
|
Facility
|
IP
|
$4,822.48
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,121.89 |
| Max. Negotiated Rate |
$4,340.23 |
| Rate for Payer: Aetna American Axle |
$3,134.61
|
| Rate for Payer: Aetna Commercial |
$4,099.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,134.61
|
| Rate for Payer: Cash Price |
$3,857.98
|
| Rate for Payer: Cofinity Advantage |
$3,375.74
|
| Rate for Payer: Cofinity Commercial |
$4,147.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,857.98
|
| Rate for Payer: Healthscope Commercial |
$4,340.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,375.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,616.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,099.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,616.86
|
| Rate for Payer: PHP Commercial |
$4,099.11
|
| Rate for Payer: Priority Health SBD |
$3,038.16
|
| Rate for Payer: UMR Bronson Commercial |
$2,121.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,616.86
|
|
|
HC EXCISE LESION EYELID WITHOUT CLOSURE
|
Facility
|
IP
|
$887.23
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
36100521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$390.38 |
| Max. Negotiated Rate |
$798.51 |
| Rate for Payer: Aetna American Axle |
$576.70
|
| Rate for Payer: Aetna Commercial |
$754.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.70
|
| Rate for Payer: Cash Price |
$709.78
|
| Rate for Payer: Cofinity Advantage |
$621.06
|
| Rate for Payer: Cofinity Commercial |
$763.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.78
|
| Rate for Payer: Healthscope Commercial |
$798.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$621.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$665.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$665.42
|
| Rate for Payer: PHP Commercial |
$754.15
|
| Rate for Payer: Priority Health SBD |
$558.95
|
| Rate for Payer: UMR Bronson Commercial |
$390.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.42
|
|
|
HC EXCISE LESION EYELID WITHOUT CLOSURE
|
Facility
|
OP
|
$887.23
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
36100521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$316.12 |
| Max. Negotiated Rate |
$3,212.23 |
| Rate for Payer: Aetna American Axle |
$576.70
|
| Rate for Payer: Aetna Commercial |
$754.15
|
| Rate for Payer: Aetna Medicare |
$1,033.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,241.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,241.61
|
| Rate for Payer: BCBS Complete |
$545.51
|
| Rate for Payer: BCBS MAPPO |
$993.29
|
| Rate for Payer: BCBS Trust/PPO |
$316.12
|
| Rate for Payer: BCN Commercial |
$316.12
|
| Rate for Payer: BCN Medicare Advantage |
$993.29
|
| Rate for Payer: Cash Price |
$709.78
|
| Rate for Payer: Cash Price |
$709.78
|
| Rate for Payer: Cash Price |
$709.78
|
| Rate for Payer: Cofinity Advantage |
$621.06
|
| Rate for Payer: Cofinity Commercial |
$763.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$993.29
|
| Rate for Payer: Healthscope Commercial |
$798.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$621.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$665.42
|
| Rate for Payer: Mclaren Medicaid |
$993.29
|
| Rate for Payer: Mclaren Medicare |
$993.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,042.95
|
| Rate for Payer: Meridian Medicaid |
$1,042.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,142.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,092.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.15
|
| Rate for Payer: Nomi Health Commercial |
$2,979.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$665.42
|
| Rate for Payer: PACE Medicare |
$943.63
|
| Rate for Payer: PACE SWMI |
$993.29
|
| Rate for Payer: PHP Commercial |
$754.15
|
| Rate for Payer: PHP Medicare Advantage |
$993.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$519.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,212.23
|
| Rate for Payer: Priority Health Medicare |
$993.29
|
| Rate for Payer: Priority Health SBD |
$558.95
|
| Rate for Payer: Priority Health Tiered Network |
$2,569.78
|
| Rate for Payer: Railroad Medicare Medicare |
$993.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$576.70
|
| Rate for Payer: UHC Core |
$462.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$993.29
|
| Rate for Payer: UHC Exchange |
$348.68
|
| Rate for Payer: UHC Medicaid |
$519.49
|
| Rate for Payer: UHCCP Medicaid |
$519.49
|
| Rate for Payer: UMR Bronson Commercial |
$328.28
|
| Rate for Payer: VA VA |
$993.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.42
|
|
|
HC EXCISE LESION MUCOSA & SBMCSL VESTIB CPLX RPR
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 40814
|
| Hospital Charge Code |
76100490
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$10,683.35 |
| Rate for Payer: Aetna American Axle |
$5,342.45
|
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| 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 |
$1,769.51
|
| Rate for Payer: BCN Commercial |
$1,769.51
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,753.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| 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 |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| 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 |
$5,178.07
|
| 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) |
$5,342.45
|
| Rate for Payer: UHC Core |
$4,282.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$3,230.13
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: UMR Bronson Commercial |
$3,041.09
|
| Rate for Payer: VA VA |
$3,303.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC EXCISE LESION MUCOSA & SBMCSL VESTIB CPLX RPR
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 40814
|
| Hospital Charge Code |
76100490
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,616.43 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna American Axle |
$5,342.45
|
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,753.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: Priority Health SBD |
$5,178.07
|
| Rate for Payer: UMR Bronson Commercial |
$3,616.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC EXCISE LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
76100461
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,616.43 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna American Axle |
$5,342.45
|
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,753.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: Priority Health SBD |
$5,178.07
|
| Rate for Payer: UMR Bronson Commercial |
$3,616.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC EXCISE LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
76100461
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$252.41 |
| Max. Negotiated Rate |
$10,683.35 |
| Rate for Payer: Aetna American Axle |
$5,342.45
|
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| 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 |
$252.41
|
| Rate for Payer: BCN Commercial |
$252.41
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,753.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| 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 |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| 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 |
$5,178.07
|
| 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) |
$5,342.45
|
| Rate for Payer: UHC Core |
$4,282.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$3,230.13
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: UMR Bronson Commercial |
$3,041.09
|
| Rate for Payer: VA VA |
$3,303.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
