|
HC EXC SKIN MALIG 3.1-4 CM REMAINDER BODY
|
Facility
|
OP
|
$2,146.61
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
76100213
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$794.25 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$1,395.30
|
| Rate for Payer: Aetna Commercial |
$1,824.62
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,395.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cofinity Commercial |
$1,846.08
|
| Rate for Payer: Cofinity Commercial |
$1,502.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,502.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$1,931.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,502.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.96
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.62
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,824.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.30
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$1,352.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$3,019.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: UMR Bronson Commercial |
$794.25
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.96
|
|
|
HC EXC SKIN MALIG >4CM FACE, FACIAL
|
Facility
|
IP
|
$3,711.63
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
76100217
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,633.12 |
| Max. Negotiated Rate |
$3,340.47 |
| Rate for Payer: Aetna American Axle |
$2,412.56
|
| Rate for Payer: Aetna Commercial |
$3,154.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,412.56
|
| Rate for Payer: Cash Price |
$2,969.30
|
| Rate for Payer: Cofinity Commercial |
$2,598.14
|
| Rate for Payer: Cofinity Commercial |
$3,192.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,598.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,969.30
|
| Rate for Payer: Healthscope Commercial |
$3,340.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,598.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,783.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,154.89
|
| Rate for Payer: PHP Commercial |
$3,154.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,412.56
|
| Rate for Payer: Priority Health SBD |
$2,338.33
|
| Rate for Payer: UMR Bronson Commercial |
$1,633.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,783.72
|
|
|
HC EXC SKIN MALIG >4CM FACE, FACIAL
|
Facility
|
OP
|
$3,711.63
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
76100217
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,373.30 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$2,412.56
|
| Rate for Payer: Aetna Commercial |
$3,154.89
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,412.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$2,969.30
|
| Rate for Payer: Cash Price |
$2,969.30
|
| Rate for Payer: Cofinity Commercial |
$3,192.00
|
| Rate for Payer: Cofinity Commercial |
$2,598.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,598.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,969.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$3,340.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,598.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,783.72
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,154.89
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,154.89
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,412.56
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$2,338.33
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$5,334.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,373.30
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,783.72
|
|
|
HC EXC SKIN MALIG >4 CM TRUNK, ARM, LEG
|
Facility
|
OP
|
$2,146.61
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
76100211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$794.25 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$1,395.30
|
| Rate for Payer: Aetna Commercial |
$1,824.62
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,395.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cofinity Commercial |
$1,846.08
|
| Rate for Payer: Cofinity Commercial |
$1,502.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,502.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$1,931.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,502.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.96
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.62
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,824.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.30
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$1,352.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$3,019.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: UMR Bronson Commercial |
$794.25
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.96
|
|
|
HC EXC SKIN MALIG >4 CM TRUNK, ARM, LEG
|
Facility
|
IP
|
$2,146.61
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
76100211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$944.51 |
| Max. Negotiated Rate |
$1,931.95 |
| Rate for Payer: Aetna American Axle |
$1,395.30
|
| Rate for Payer: Aetna Commercial |
$1,824.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,395.30
|
| Rate for Payer: Cash Price |
$1,717.29
|
| Rate for Payer: Cofinity Commercial |
$1,502.63
|
| Rate for Payer: Cofinity Commercial |
$1,846.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,502.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.29
|
| Rate for Payer: Healthscope Commercial |
$1,931.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,502.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.62
|
| Rate for Payer: PHP Commercial |
$1,824.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.30
|
| Rate for Payer: Priority Health SBD |
$1,352.36
|
| Rate for Payer: UMR Bronson Commercial |
$944.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.96
|
|
|
HC EXC SKIN MALIG >4 REMAINDER BODY
|
Facility
|
IP
|
$3,711.63
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
76100214
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,633.12 |
| Max. Negotiated Rate |
$3,340.47 |
| Rate for Payer: Aetna American Axle |
$2,412.56
|
| Rate for Payer: Aetna Commercial |
$3,154.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,412.56
|
| Rate for Payer: Cash Price |
$2,969.30
|
| Rate for Payer: Cofinity Commercial |
$2,598.14
|
| Rate for Payer: Cofinity Commercial |
$3,192.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,598.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,969.30
|
| Rate for Payer: Healthscope Commercial |
$3,340.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,598.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,783.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,154.89
|
| Rate for Payer: PHP Commercial |
$3,154.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,412.56
|
| Rate for Payer: Priority Health SBD |
$2,338.33
|
| Rate for Payer: UMR Bronson Commercial |
$1,633.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,783.72
|
|
|
HC EXC SKIN MALIG >4 REMAINDER BODY
|
Facility
|
OP
|
$3,711.63
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
76100214
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,373.30 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$2,412.56
|
| Rate for Payer: Aetna Commercial |
$3,154.89
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,412.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$2,969.30
|
| Rate for Payer: Cash Price |
$2,969.30
|
| Rate for Payer: Cofinity Commercial |
$3,192.00
|
| Rate for Payer: Cofinity Commercial |
$2,598.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,598.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,969.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$3,340.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,598.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,783.72
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,154.89
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,154.89
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,412.56
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$2,338.33
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$5,334.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,373.30
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,783.72
|
|
|
HC EXC THROMBOSED HEMORRHOID EXTERN
|
Facility
|
OP
|
$3,236.56
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
36000106
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$616.36 |
| Max. Negotiated Rate |
$3,236.94 |
| Rate for Payer: Aetna American Axle |
$2,103.76
|
| Rate for Payer: Aetna Commercial |
$2,751.08
|
| Rate for Payer: Aetna Medicare |
$1,195.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,103.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,437.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,437.41
|
| Rate for Payer: BCBS Complete |
$647.18
|
| Rate for Payer: BCBS MAPPO |
$1,149.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,149.93
|
| Rate for Payer: Cash Price |
$2,589.25
|
| Rate for Payer: Cash Price |
$2,589.25
|
| Rate for Payer: Cofinity Commercial |
$2,783.44
|
| Rate for Payer: Cofinity Commercial |
$2,265.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,265.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,589.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,149.93
|
| Rate for Payer: Healthscope Commercial |
$2,912.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,265.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,427.42
|
| Rate for Payer: Mclaren Medicaid |
$616.36
|
| Rate for Payer: Mclaren Medicare |
$1,149.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,207.43
|
| Rate for Payer: Meridian Medicaid |
$647.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,322.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,751.08
|
| Rate for Payer: PACE Medicare |
$1,092.43
|
| Rate for Payer: PACE SWMI |
$1,149.93
|
| Rate for Payer: PHP Commercial |
$2,751.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,149.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$616.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,103.76
|
| Rate for Payer: Priority Health Medicare |
$1,149.93
|
| Rate for Payer: Priority Health SBD |
$2,039.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,149.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,236.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,149.93
|
| Rate for Payer: UHC Exchange |
$2,197.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,149.93
|
| Rate for Payer: UHCCP Medicaid |
$616.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,197.53
|
| Rate for Payer: VA VA |
$1,149.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,427.42
|
|
|
HC EXC THROMBOSED HEMORRHOID EXTERN
|
Facility
|
IP
|
$3,236.56
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
36000106
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,424.09 |
| Max. Negotiated Rate |
$2,912.90 |
| Rate for Payer: Aetna American Axle |
$2,103.76
|
| Rate for Payer: Aetna Commercial |
$2,751.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,103.76
|
| Rate for Payer: Cash Price |
$2,589.25
|
| Rate for Payer: Cofinity Commercial |
$2,265.59
|
| Rate for Payer: Cofinity Commercial |
$2,783.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,265.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,589.25
|
| Rate for Payer: Healthscope Commercial |
$2,912.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,265.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,427.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,751.08
|
| Rate for Payer: PHP Commercial |
$2,751.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,103.76
|
| Rate for Payer: Priority Health SBD |
$2,039.03
|
| Rate for Payer: UMR Bronson Commercial |
$1,424.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,427.42
|
|
|
HC EXC TUMOR SOFT TISS FACE AND SCALP SUBFASCIAL <2CM
|
Facility
|
IP
|
$4,540.00
|
|
|
Service Code
|
CPT 21013
|
| Hospital Charge Code |
76100526
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,997.60 |
| Max. Negotiated Rate |
$4,086.00 |
| Rate for Payer: Aetna American Axle |
$2,951.00
|
| Rate for Payer: Aetna Commercial |
$3,859.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,951.00
|
| Rate for Payer: Cash Price |
$3,632.00
|
| Rate for Payer: Cofinity Commercial |
$3,178.00
|
| Rate for Payer: Cofinity Commercial |
$3,904.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,178.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,632.00
|
| Rate for Payer: Healthscope Commercial |
$4,086.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,178.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,405.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,859.00
|
| Rate for Payer: PHP Commercial |
$3,859.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,951.00
|
| Rate for Payer: Priority Health SBD |
$2,860.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,997.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,405.00
|
|
|
HC EXC TUMOR SOFT TISS FACE AND SCALP SUBFASCIAL <2CM
|
Facility
|
OP
|
$4,540.00
|
|
|
Service Code
|
CPT 21013
|
| Hospital Charge Code |
76100526
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$2,951.00
|
| Rate for Payer: Aetna Commercial |
$3,859.00
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,951.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$3,632.00
|
| Rate for Payer: Cash Price |
$3,632.00
|
| Rate for Payer: Cofinity Commercial |
$3,904.40
|
| Rate for Payer: Cofinity Commercial |
$3,178.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,178.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,632.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$4,086.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,178.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,405.00
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,859.00
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$3,859.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,951.00
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$2,860.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$3,019.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,679.80
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,405.00
|
|
|
HC EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>
|
Facility
|
IP
|
$4,540.00
|
|
|
Service Code
|
CPT 25071
|
| Hospital Charge Code |
76100431
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,997.60 |
| Max. Negotiated Rate |
$4,086.00 |
| Rate for Payer: Aetna American Axle |
$2,951.00
|
| Rate for Payer: Aetna Commercial |
$3,859.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,951.00
|
| Rate for Payer: Cash Price |
$3,632.00
|
| Rate for Payer: Cofinity Commercial |
$3,178.00
|
| Rate for Payer: Cofinity Commercial |
$3,904.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,178.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,632.00
|
| Rate for Payer: Healthscope Commercial |
$4,086.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,178.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,405.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,859.00
|
| Rate for Payer: PHP Commercial |
$3,859.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,951.00
|
| Rate for Payer: Priority Health SBD |
$2,860.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,997.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,405.00
|
|
|
HC EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>
|
Facility
|
OP
|
$4,540.00
|
|
|
Service Code
|
CPT 25071
|
| Hospital Charge Code |
76100431
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$2,951.00
|
| Rate for Payer: Aetna Commercial |
$3,859.00
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,951.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$3,632.00
|
| Rate for Payer: Cash Price |
$3,632.00
|
| Rate for Payer: Cofinity Commercial |
$3,904.40
|
| Rate for Payer: Cofinity Commercial |
$3,178.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,178.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,632.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$4,086.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,178.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,405.00
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,859.00
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$3,859.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,951.00
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$2,860.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$3,019.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,679.80
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,405.00
|
|
|
HC EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
OP
|
$8,111.04
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
76100413
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$5,272.18
|
| Rate for Payer: Aetna Commercial |
$6,894.38
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,272.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$6,488.83
|
| Rate for Payer: Cash Price |
$6,488.83
|
| Rate for Payer: Cofinity Commercial |
$6,975.49
|
| Rate for Payer: Cofinity Commercial |
$5,677.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,677.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,488.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$7,299.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,677.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,083.28
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,894.38
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$6,894.38
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,272.18
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$5,109.96
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$5,334.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: UMR Bronson Commercial |
$3,001.08
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,083.28
|
|
|
HC EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
IP
|
$8,111.04
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
76100413
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,568.86 |
| Max. Negotiated Rate |
$7,299.94 |
| Rate for Payer: Aetna American Axle |
$5,272.18
|
| Rate for Payer: Aetna Commercial |
$6,894.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,272.18
|
| Rate for Payer: Cash Price |
$6,488.83
|
| Rate for Payer: Cofinity Commercial |
$5,677.73
|
| Rate for Payer: Cofinity Commercial |
$6,975.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,677.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,488.83
|
| Rate for Payer: Healthscope Commercial |
$7,299.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,677.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,083.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,894.38
|
| Rate for Payer: PHP Commercial |
$6,894.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,272.18
|
| Rate for Payer: Priority Health SBD |
$5,109.96
|
| Rate for Payer: UMR Bronson Commercial |
$3,568.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,083.28
|
|
|
HC EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ >3CM
|
Facility
|
OP
|
$3,618.87
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
76100245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,338.98 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$2,352.27
|
| Rate for Payer: Aetna Commercial |
$3,076.04
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,352.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cofinity Commercial |
$3,112.23
|
| Rate for Payer: Cofinity Commercial |
$2,533.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,533.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,895.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$3,256.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,533.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,714.15
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,076.04
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,076.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.27
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$2,279.89
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$5,334.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,338.98
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,714.15
|
|
|
HC EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ >3CM
|
Facility
|
IP
|
$3,618.87
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
76100245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,592.30 |
| Max. Negotiated Rate |
$3,256.98 |
| Rate for Payer: Aetna American Axle |
$2,352.27
|
| Rate for Payer: Aetna Commercial |
$3,076.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,352.27
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cofinity Commercial |
$2,533.21
|
| Rate for Payer: Cofinity Commercial |
$3,112.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,533.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,895.10
|
| Rate for Payer: Healthscope Commercial |
$3,256.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,533.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,714.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,076.04
|
| Rate for Payer: PHP Commercial |
$3,076.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.27
|
| Rate for Payer: Priority Health SBD |
$2,279.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,592.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,714.15
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <3CM
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 22902
|
| Hospital Charge Code |
76100277
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$942.52 |
| Max. Negotiated Rate |
$1,927.87 |
| Rate for Payer: Aetna American Axle |
$1,392.35
|
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.35
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,499.46
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,499.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,499.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health SBD |
$1,349.51
|
| Rate for Payer: UMR Bronson Commercial |
$942.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.56
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <3CM
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 22902
|
| Hospital Charge Code |
76100277
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$792.57 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$1,392.35
|
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Cofinity Commercial |
$1,499.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,499.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,499.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.56
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$1,349.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$3,019.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: UMR Bronson Commercial |
$792.57
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.56
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <5CM
|
Facility
|
IP
|
$3,570.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
76100398
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,570.80 |
| Max. Negotiated Rate |
$3,213.00 |
| Rate for Payer: Aetna American Axle |
$2,320.50
|
| Rate for Payer: Aetna Commercial |
$3,034.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.50
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cofinity Commercial |
$2,499.00
|
| Rate for Payer: Cofinity Commercial |
$3,070.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,499.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.00
|
| Rate for Payer: Healthscope Commercial |
$3,213.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,499.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.50
|
| Rate for Payer: PHP Commercial |
$3,034.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.50
|
| Rate for Payer: Priority Health SBD |
$2,249.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,570.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.50
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <5CM
|
Facility
|
OP
|
$3,570.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
76100398
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,320.90 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$2,320.50
|
| Rate for Payer: Aetna Commercial |
$3,034.50
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cofinity Commercial |
$3,070.20
|
| Rate for Payer: Cofinity Commercial |
$2,499.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,499.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$3,213.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,499.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.50
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.50
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,034.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.50
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$2,249.10
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$5,334.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,320.90
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.50
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SQ < 3CM
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 21930
|
| Hospital Charge Code |
76100227
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$792.57 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$1,392.35
|
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Cofinity Commercial |
$1,499.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,499.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,499.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.56
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$1,349.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$3,019.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: UMR Bronson Commercial |
$792.57
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.56
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SQ < 3CM
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 21930
|
| Hospital Charge Code |
76100227
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$942.52 |
| Max. Negotiated Rate |
$1,927.87 |
| Rate for Payer: Aetna American Axle |
$1,392.35
|
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.35
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,499.46
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,499.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,499.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health SBD |
$1,349.51
|
| Rate for Payer: UMR Bronson Commercial |
$942.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.56
|
|
|
HC EXC TUMOR SOFT TISSUE, BACK/FLANK, SUBFASCIAL <5CM
|
Facility
|
IP
|
$3,618.87
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
76100268
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,592.30 |
| Max. Negotiated Rate |
$3,256.98 |
| Rate for Payer: Aetna American Axle |
$2,352.27
|
| Rate for Payer: Aetna Commercial |
$3,076.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,352.27
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cofinity Commercial |
$2,533.21
|
| Rate for Payer: Cofinity Commercial |
$3,112.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,533.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,895.10
|
| Rate for Payer: Healthscope Commercial |
$3,256.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,533.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,714.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,076.04
|
| Rate for Payer: PHP Commercial |
$3,076.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.27
|
| Rate for Payer: Priority Health SBD |
$2,279.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,592.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,714.15
|
|
|
HC EXC TUMOR SOFT TISSUE, BACK/FLANK, SUBFASCIAL <5CM
|
Facility
|
OP
|
$3,618.87
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
76100268
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,338.98 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$2,352.27
|
| Rate for Payer: Aetna Commercial |
$3,076.04
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,352.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cofinity Commercial |
$3,112.23
|
| Rate for Payer: Cofinity Commercial |
$2,533.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,533.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,895.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$3,256.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,533.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,714.15
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,076.04
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,076.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.27
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$2,279.89
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$5,334.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,338.98
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,714.15
|
|
