|
HC DESTRUCT BY NEURO AGENT SUP HYPOGAST PLEXUS
|
Facility
|
OP
|
$1,435.75
|
|
|
Service Code
|
CPT 64681
|
| Hospital Charge Code |
36100606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$465.40 |
| Max. Negotiated Rate |
$2,444.12 |
| Rate for Payer: Aetna American Axle |
$933.24
|
| Rate for Payer: Aetna Commercial |
$1,220.39
|
| Rate for Payer: Aetna Medicare |
$903.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$933.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,085.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,085.35
|
| Rate for Payer: BCBS Complete |
$488.67
|
| Rate for Payer: BCBS MAPPO |
$868.28
|
| Rate for Payer: BCN Medicare Advantage |
$868.28
|
| Rate for Payer: Cash Price |
$1,148.60
|
| Rate for Payer: Cash Price |
$1,148.60
|
| Rate for Payer: Cofinity Commercial |
$1,234.74
|
| Rate for Payer: Cofinity Commercial |
$1,005.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,005.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,148.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.28
|
| Rate for Payer: Healthscope Commercial |
$1,292.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,005.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,076.81
|
| Rate for Payer: Mclaren Medicaid |
$465.40
|
| Rate for Payer: Mclaren Medicare |
$868.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.69
|
| Rate for Payer: Meridian Medicaid |
$488.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,220.39
|
| Rate for Payer: PACE Medicare |
$824.87
|
| Rate for Payer: PACE SWMI |
$868.28
|
| Rate for Payer: PHP Commercial |
$1,220.39
|
| Rate for Payer: PHP Medicare Advantage |
$868.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.24
|
| Rate for Payer: Priority Health Medicare |
$868.28
|
| Rate for Payer: Priority Health SBD |
$904.52
|
| Rate for Payer: Railroad Medicare Medicare |
$868.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,444.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.28
|
| Rate for Payer: UHC Exchange |
$1,659.37
|
| Rate for Payer: UHC Medicare Advantage |
$868.28
|
| Rate for Payer: UHCCP Medicaid |
$465.40
|
| Rate for Payer: UMR Bronson Commercial |
$531.23
|
| Rate for Payer: VA VA |
$868.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,076.81
|
|
|
HC DESTRUCT BY NEURO AGENT SUP HYPOGAST PLEXUS
|
Facility
|
IP
|
$1,435.75
|
|
|
Service Code
|
CPT 64681
|
| Hospital Charge Code |
36100606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$631.73 |
| Max. Negotiated Rate |
$1,292.17 |
| Rate for Payer: Aetna American Axle |
$933.24
|
| Rate for Payer: Aetna Commercial |
$1,220.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$933.24
|
| Rate for Payer: Cash Price |
$1,148.60
|
| Rate for Payer: Cofinity Commercial |
$1,005.02
|
| Rate for Payer: Cofinity Commercial |
$1,234.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,005.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,148.60
|
| Rate for Payer: Healthscope Commercial |
$1,292.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,005.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,076.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,220.39
|
| Rate for Payer: PHP Commercial |
$1,220.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.24
|
| Rate for Payer: Priority Health SBD |
$904.52
|
| Rate for Payer: UMR Bronson Commercial |
$631.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,076.81
|
|
|
HC DESTRUCT BY NEURO AGENT TRIGEM NRVE
|
Facility
|
OP
|
$2,683.19
|
|
|
Service Code
|
CPT 64610
|
| Hospital Charge Code |
36100607
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$992.78 |
| Max. Negotiated Rate |
$5,360.98 |
| Rate for Payer: Aetna American Axle |
$1,744.07
|
| Rate for Payer: Aetna Commercial |
$2,280.71
|
| Rate for Payer: Aetna Medicare |
$1,980.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,744.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,380.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,380.62
|
| Rate for Payer: BCBS Complete |
$1,071.85
|
| Rate for Payer: BCBS MAPPO |
$1,904.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,904.50
|
| Rate for Payer: Cash Price |
$2,146.55
|
| Rate for Payer: Cash Price |
$2,146.55
|
| Rate for Payer: Cofinity Commercial |
$2,307.54
|
| Rate for Payer: Cofinity Commercial |
$1,878.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,878.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,904.50
|
| Rate for Payer: Healthscope Commercial |
$2,414.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,878.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,012.39
|
| Rate for Payer: Mclaren Medicaid |
$1,020.81
|
| Rate for Payer: Mclaren Medicare |
$1,904.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,999.72
|
| Rate for Payer: Meridian Medicaid |
$1,071.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,190.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.71
|
| Rate for Payer: PACE Medicare |
$1,809.28
|
| Rate for Payer: PACE SWMI |
$1,904.50
|
| Rate for Payer: PHP Commercial |
$2,280.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,904.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,020.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.07
|
| Rate for Payer: Priority Health Medicare |
$1,904.50
|
| Rate for Payer: Priority Health SBD |
$1,690.41
|
| Rate for Payer: Railroad Medicare Medicare |
$1,904.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,360.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,904.50
|
| Rate for Payer: UHC Exchange |
$3,639.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,904.50
|
| Rate for Payer: UHCCP Medicaid |
$1,020.81
|
| Rate for Payer: UMR Bronson Commercial |
$992.78
|
| Rate for Payer: VA VA |
$1,904.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.39
|
|
|
HC DESTRUCT BY NEURO AGENT TRIGEM NRVE
|
Facility
|
IP
|
$2,683.19
|
|
|
Service Code
|
CPT 64610
|
| Hospital Charge Code |
36100607
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,180.60 |
| Max. Negotiated Rate |
$2,414.87 |
| Rate for Payer: Aetna American Axle |
$1,744.07
|
| Rate for Payer: Aetna Commercial |
$2,280.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,744.07
|
| Rate for Payer: Cash Price |
$2,146.55
|
| Rate for Payer: Cofinity Commercial |
$1,878.23
|
| Rate for Payer: Cofinity Commercial |
$2,307.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,878.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.55
|
| Rate for Payer: Healthscope Commercial |
$2,414.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,878.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,012.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.71
|
| Rate for Payer: PHP Commercial |
$2,280.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.07
|
| Rate for Payer: Priority Health SBD |
$1,690.41
|
| Rate for Payer: UMR Bronson Commercial |
$1,180.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.39
|
|
|
HC DESTRUCTION LESION(S) VULVA, EXTENSIVE
|
Facility
|
OP
|
$2,532.45
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
76100235
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$937.01 |
| Max. Negotiated Rate |
$5,021.81 |
| Rate for Payer: Aetna American Axle |
$1,646.09
|
| Rate for Payer: Aetna Commercial |
$2,152.58
|
| Rate for Payer: Aetna Medicare |
$1,855.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,646.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,230.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,230.01
|
| Rate for Payer: BCBS Complete |
$1,004.04
|
| Rate for Payer: BCBS MAPPO |
$1,784.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,784.01
|
| Rate for Payer: Cash Price |
$2,025.96
|
| Rate for Payer: Cash Price |
$2,025.96
|
| Rate for Payer: Cofinity Commercial |
$2,177.91
|
| Rate for Payer: Cofinity Commercial |
$1,772.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,772.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,025.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,784.01
|
| Rate for Payer: Healthscope Commercial |
$2,279.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,772.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,899.34
|
| Rate for Payer: Mclaren Medicaid |
$956.23
|
| Rate for Payer: Mclaren Medicare |
$1,784.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,873.21
|
| Rate for Payer: Meridian Medicaid |
$1,004.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,051.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,152.58
|
| Rate for Payer: PACE Medicare |
$1,694.81
|
| Rate for Payer: PACE SWMI |
$1,784.01
|
| Rate for Payer: PHP Commercial |
$2,152.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,784.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$956.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.09
|
| Rate for Payer: Priority Health Medicare |
$1,784.01
|
| Rate for Payer: Priority Health SBD |
$1,595.44
|
| Rate for Payer: Railroad Medicare Medicare |
$1,784.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,021.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,784.01
|
| Rate for Payer: UHC Exchange |
$3,409.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,784.01
|
| Rate for Payer: UHCCP Medicaid |
$956.23
|
| Rate for Payer: UMR Bronson Commercial |
$937.01
|
| Rate for Payer: VA VA |
$1,784.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,899.34
|
|
|
HC DESTRUCTION LESION(S) VULVA, EXTENSIVE
|
Facility
|
IP
|
$2,532.45
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
76100235
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,114.28 |
| Max. Negotiated Rate |
$2,279.20 |
| Rate for Payer: Aetna American Axle |
$1,646.09
|
| Rate for Payer: Aetna Commercial |
$2,152.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,646.09
|
| Rate for Payer: Cash Price |
$2,025.96
|
| Rate for Payer: Cofinity Commercial |
$1,772.71
|
| Rate for Payer: Cofinity Commercial |
$2,177.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,772.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,025.96
|
| Rate for Payer: Healthscope Commercial |
$2,279.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,772.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,899.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,152.58
|
| Rate for Payer: PHP Commercial |
$2,152.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.09
|
| Rate for Payer: Priority Health SBD |
$1,595.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,114.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,899.34
|
|
|
HC DESTRUCTION LESION(S) VULVA, SIMPLE
|
Facility
|
OP
|
$2,532.45
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
76100233
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$937.01 |
| Max. Negotiated Rate |
$5,021.81 |
| Rate for Payer: Aetna American Axle |
$1,646.09
|
| Rate for Payer: Aetna Commercial |
$2,152.58
|
| Rate for Payer: Aetna Medicare |
$1,855.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,646.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,230.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,230.01
|
| Rate for Payer: BCBS Complete |
$1,004.04
|
| Rate for Payer: BCBS MAPPO |
$1,784.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,784.01
|
| Rate for Payer: Cash Price |
$2,025.96
|
| Rate for Payer: Cash Price |
$2,025.96
|
| Rate for Payer: Cofinity Commercial |
$2,177.91
|
| Rate for Payer: Cofinity Commercial |
$1,772.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,772.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,025.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,784.01
|
| Rate for Payer: Healthscope Commercial |
$2,279.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,772.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,899.34
|
| Rate for Payer: Mclaren Medicaid |
$956.23
|
| Rate for Payer: Mclaren Medicare |
$1,784.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,873.21
|
| Rate for Payer: Meridian Medicaid |
$1,004.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,051.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,152.58
|
| Rate for Payer: PACE Medicare |
$1,694.81
|
| Rate for Payer: PACE SWMI |
$1,784.01
|
| Rate for Payer: PHP Commercial |
$2,152.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,784.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$956.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.09
|
| Rate for Payer: Priority Health Medicare |
$1,784.01
|
| Rate for Payer: Priority Health SBD |
$1,595.44
|
| Rate for Payer: Railroad Medicare Medicare |
$1,784.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,021.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,784.01
|
| Rate for Payer: UHC Exchange |
$3,409.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,784.01
|
| Rate for Payer: UHCCP Medicaid |
$956.23
|
| Rate for Payer: UMR Bronson Commercial |
$937.01
|
| Rate for Payer: VA VA |
$1,784.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,899.34
|
|
|
HC DESTRUCTION LESION(S) VULVA, SIMPLE
|
Facility
|
IP
|
$2,532.45
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
76100233
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,114.28 |
| Max. Negotiated Rate |
$2,279.20 |
| Rate for Payer: Aetna American Axle |
$1,646.09
|
| Rate for Payer: Aetna Commercial |
$2,152.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,646.09
|
| Rate for Payer: Cash Price |
$2,025.96
|
| Rate for Payer: Cofinity Commercial |
$1,772.71
|
| Rate for Payer: Cofinity Commercial |
$2,177.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,772.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,025.96
|
| Rate for Payer: Healthscope Commercial |
$2,279.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,772.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,899.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,152.58
|
| Rate for Payer: PHP Commercial |
$2,152.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.09
|
| Rate for Payer: Priority Health SBD |
$1,595.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,114.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,899.34
|
|
|
HC DESTRUCTION PENIS LESION(S) CHEMICAL
|
Facility
|
IP
|
$1,065.05
|
|
|
Service Code
|
CPT 54050
|
| Hospital Charge Code |
76100346
|
| Min. Negotiated Rate |
$468.62 |
| Max. Negotiated Rate |
$958.54 |
| Rate for Payer: Aetna American Axle |
$692.28
|
| Rate for Payer: Aetna Commercial |
$905.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$692.28
|
| Rate for Payer: Cash Price |
$852.04
|
| Rate for Payer: Cofinity Commercial |
$745.53
|
| Rate for Payer: Cofinity Commercial |
$915.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$745.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.04
|
| Rate for Payer: Healthscope Commercial |
$958.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$745.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.29
|
| Rate for Payer: PHP Commercial |
$905.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.28
|
| Rate for Payer: Priority Health SBD |
$670.98
|
| Rate for Payer: UMR Bronson Commercial |
$468.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.79
|
|
|
HC DESTRUCTION PENIS LESION(S) CHEMICAL
|
Facility
|
OP
|
$1,065.05
|
|
|
Service Code
|
CPT 54050
|
| Hospital Charge Code |
76100346
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna American Axle |
$692.28
|
| Rate for Payer: Aetna Commercial |
$905.29
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$692.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$852.04
|
| Rate for Payer: Cash Price |
$852.04
|
| Rate for Payer: Cofinity Commercial |
$915.94
|
| Rate for Payer: Cofinity Commercial |
$745.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$745.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$958.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$745.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.79
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.29
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$905.29
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.28
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$670.98
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$744.66
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: UMR Bronson Commercial |
$394.07
|
| Rate for Payer: VA VA |
$389.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.79
|
|
|
HC DESTRUCT MALIG LESION FACE,EAR,EYELID,NOSE,LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
IP
|
$392.23
|
|
|
Service Code
|
CPT 17282
|
| Hospital Charge Code |
76100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$172.58 |
| Max. Negotiated Rate |
$353.01 |
| Rate for Payer: Aetna American Axle |
$254.95
|
| Rate for Payer: Aetna Commercial |
$333.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.95
|
| Rate for Payer: Cash Price |
$313.78
|
| Rate for Payer: Cofinity Commercial |
$274.56
|
| Rate for Payer: Cofinity Commercial |
$337.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$274.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.78
|
| Rate for Payer: Healthscope Commercial |
$353.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$274.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.40
|
| Rate for Payer: PHP Commercial |
$333.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.95
|
| Rate for Payer: Priority Health SBD |
$247.10
|
| Rate for Payer: UMR Bronson Commercial |
$172.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.17
|
|
|
HC DESTRUCT MALIG LESION FACE,EAR,EYELID,NOSE,LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
OP
|
$392.23
|
|
|
Service Code
|
CPT 17282
|
| Hospital Charge Code |
76100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna American Axle |
$254.95
|
| Rate for Payer: Aetna Commercial |
$333.40
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$313.78
|
| Rate for Payer: Cash Price |
$313.78
|
| Rate for Payer: Cofinity Commercial |
$337.32
|
| Rate for Payer: Cofinity Commercial |
$274.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$274.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$353.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$274.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.17
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.40
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$333.40
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.95
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$247.10
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$370.35
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: UMR Bronson Commercial |
$145.13
|
| Rate for Payer: VA VA |
$193.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.17
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA <0.6 CM
|
Facility
|
IP
|
$219.52
|
|
|
Service Code
|
CPT 17270
|
| Hospital Charge Code |
76100154
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.59 |
| Max. Negotiated Rate |
$197.57 |
| Rate for Payer: Aetna American Axle |
$142.69
|
| Rate for Payer: Aetna Commercial |
$186.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.69
|
| Rate for Payer: Cash Price |
$175.62
|
| Rate for Payer: Cofinity Commercial |
$153.66
|
| Rate for Payer: Cofinity Commercial |
$188.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$153.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.62
|
| Rate for Payer: Healthscope Commercial |
$197.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$153.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.59
|
| Rate for Payer: PHP Commercial |
$186.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.69
|
| Rate for Payer: Priority Health SBD |
$138.30
|
| Rate for Payer: UMR Bronson Commercial |
$96.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.64
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA <0.6 CM
|
Facility
|
OP
|
$219.52
|
|
|
Service Code
|
CPT 17270
|
| Hospital Charge Code |
76100154
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.22 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna American Axle |
$142.69
|
| Rate for Payer: Aetna Commercial |
$186.59
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$175.62
|
| Rate for Payer: Cash Price |
$175.62
|
| Rate for Payer: Cofinity Commercial |
$188.79
|
| Rate for Payer: Cofinity Commercial |
$153.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$153.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$197.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$153.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.64
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.59
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$186.59
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.69
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$138.30
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$370.35
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: UMR Bronson Commercial |
$81.22
|
| Rate for Payer: VA VA |
$193.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.64
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
OP
|
$281.59
|
|
|
Service Code
|
CPT 17271
|
| Hospital Charge Code |
76100128
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna American Axle |
$183.03
|
| Rate for Payer: Aetna Commercial |
$239.35
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$242.17
|
| Rate for Payer: Cofinity Commercial |
$197.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$197.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$253.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$197.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.19
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$239.35
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$177.40
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$370.35
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: UMR Bronson Commercial |
$104.19
|
| Rate for Payer: VA VA |
$193.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.19
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
IP
|
$281.59
|
|
|
Service Code
|
CPT 17271
|
| Hospital Charge Code |
76100128
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.90 |
| Max. Negotiated Rate |
$253.43 |
| Rate for Payer: Aetna American Axle |
$183.03
|
| Rate for Payer: Aetna Commercial |
$239.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.03
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$197.11
|
| Rate for Payer: Cofinity Commercial |
$242.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$197.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Healthscope Commercial |
$253.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$197.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: PHP Commercial |
$239.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health SBD |
$177.40
|
| Rate for Payer: UMR Bronson Commercial |
$123.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.19
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 17272
|
| Hospital Charge Code |
76100129
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$71.20 |
| Max. Negotiated Rate |
$145.64 |
| Rate for Payer: Aetna American Axle |
$105.18
|
| Rate for Payer: Aetna Commercial |
$137.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.18
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$113.27
|
| Rate for Payer: Cofinity Commercial |
$139.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$113.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Healthscope Commercial |
$145.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: PHP Commercial |
$137.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health SBD |
$101.95
|
| Rate for Payer: UMR Bronson Commercial |
$71.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.36
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
OP
|
$161.82
|
|
|
Service Code
|
CPT 17272
|
| Hospital Charge Code |
76100129
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$59.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna American Axle |
$105.18
|
| Rate for Payer: Aetna Commercial |
$137.55
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$139.17
|
| Rate for Payer: Cofinity Commercial |
$113.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$113.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$145.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.36
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$137.55
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$101.95
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$370.35
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: UMR Bronson Commercial |
$59.87
|
| Rate for Payer: VA VA |
$193.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.36
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
IP
|
$309.75
|
|
|
Service Code
|
CPT 17273
|
| Hospital Charge Code |
76100130
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$136.29 |
| Max. Negotiated Rate |
$278.77 |
| Rate for Payer: Aetna American Axle |
$201.34
|
| Rate for Payer: Aetna Commercial |
$263.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.34
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cofinity Commercial |
$216.82
|
| Rate for Payer: Cofinity Commercial |
$266.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$216.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.80
|
| Rate for Payer: Healthscope Commercial |
$278.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.29
|
| Rate for Payer: PHP Commercial |
$263.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.34
|
| Rate for Payer: Priority Health SBD |
$195.14
|
| Rate for Payer: UMR Bronson Commercial |
$136.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.31
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
OP
|
$309.75
|
|
|
Service Code
|
CPT 17273
|
| Hospital Charge Code |
76100130
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.61 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna American Axle |
$201.34
|
| Rate for Payer: Aetna Commercial |
$263.29
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cofinity Commercial |
$266.38
|
| Rate for Payer: Cofinity Commercial |
$216.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$216.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$278.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.31
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.29
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$263.29
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.34
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$195.14
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$744.66
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: UMR Bronson Commercial |
$114.61
|
| Rate for Payer: VA VA |
$389.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.31
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 17260
|
| Hospital Charge Code |
76100125
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$71.20 |
| Max. Negotiated Rate |
$145.64 |
| Rate for Payer: Aetna American Axle |
$105.18
|
| Rate for Payer: Aetna Commercial |
$137.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.18
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$113.27
|
| Rate for Payer: Cofinity Commercial |
$139.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$113.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Healthscope Commercial |
$145.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: PHP Commercial |
$137.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health SBD |
$101.95
|
| Rate for Payer: UMR Bronson Commercial |
$71.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.36
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
OP
|
$161.82
|
|
|
Service Code
|
CPT 17260
|
| Hospital Charge Code |
76100125
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$59.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna American Axle |
$105.18
|
| Rate for Payer: Aetna Commercial |
$137.55
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$139.17
|
| Rate for Payer: Cofinity Commercial |
$113.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$113.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$145.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.36
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$137.55
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$101.95
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$370.35
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: UMR Bronson Commercial |
$59.87
|
| Rate for Payer: VA VA |
$193.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.36
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$161.82
|
|
|
Service Code
|
CPT 17261
|
| Hospital Charge Code |
76100126
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$59.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna American Axle |
$105.18
|
| Rate for Payer: Aetna Commercial |
$137.55
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$139.17
|
| Rate for Payer: Cofinity Commercial |
$113.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$113.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$145.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.36
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$137.55
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$101.95
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$370.35
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: UMR Bronson Commercial |
$59.87
|
| Rate for Payer: VA VA |
$193.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.36
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 17261
|
| Hospital Charge Code |
76100126
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$71.20 |
| Max. Negotiated Rate |
$145.64 |
| Rate for Payer: Aetna American Axle |
$105.18
|
| Rate for Payer: Aetna Commercial |
$137.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.18
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$113.27
|
| Rate for Payer: Cofinity Commercial |
$139.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$113.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Healthscope Commercial |
$145.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: PHP Commercial |
$137.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health SBD |
$101.95
|
| Rate for Payer: UMR Bronson Commercial |
$71.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.36
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 17262
|
| Hospital Charge Code |
76100127
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$71.20 |
| Max. Negotiated Rate |
$145.64 |
| Rate for Payer: Aetna American Axle |
$105.18
|
| Rate for Payer: Aetna Commercial |
$137.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.18
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$113.27
|
| Rate for Payer: Cofinity Commercial |
$139.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$113.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Healthscope Commercial |
$145.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: PHP Commercial |
$137.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health SBD |
$101.95
|
| Rate for Payer: UMR Bronson Commercial |
$71.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.36
|
|
