|
HC EXCISION TONSIL TAGS
|
Facility
|
IP
|
$8,122.26
|
|
|
Service Code
|
CPT 42860
|
| Hospital Charge Code |
76100477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,573.79 |
| Max. Negotiated Rate |
$7,310.03 |
| Rate for Payer: Aetna American Axle |
$5,279.47
|
| Rate for Payer: Aetna Commercial |
$6,903.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,279.47
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cofinity Commercial |
$5,685.58
|
| Rate for Payer: Cofinity Commercial |
$6,985.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,685.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,497.81
|
| Rate for Payer: Healthscope Commercial |
$7,310.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,685.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,091.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,903.92
|
| Rate for Payer: PHP Commercial |
$6,903.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,279.47
|
| Rate for Payer: Priority Health SBD |
$5,117.02
|
| Rate for Payer: UMR Bronson Commercial |
$3,573.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,091.70
|
|
|
HC EXCISION TONSIL TAGS
|
Facility
|
OP
|
$8,122.26
|
|
|
Service Code
|
CPT 42860
|
| Hospital Charge Code |
76100477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$186.51 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna American Axle |
$5,279.47
|
| Rate for Payer: Aetna Commercial |
$6,903.92
|
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,279.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,026.66
|
| Rate for Payer: BCN Commercial |
$3,026.66
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cofinity Commercial |
$6,985.14
|
| Rate for Payer: Cofinity Commercial |
$5,685.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,685.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,497.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$7,310.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,685.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,091.70
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,903.92
|
| Rate for Payer: Nomi Health Commercial |
$6,672.75
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Commercial |
$6,903.92
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,279.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Priority Health SBD |
$5,117.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.16
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$186.51
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,703.14
|
| Rate for Payer: UMR Bronson Commercial |
$3,005.24
|
| Rate for Payer: VA VA |
$3,177.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,091.70
|
|
|
HC EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM
|
Facility
|
IP
|
$4,627.74
|
|
|
Service Code
|
CPT 23075
|
| Hospital Charge Code |
76100412
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,036.21 |
| Max. Negotiated Rate |
$4,164.97 |
| Rate for Payer: Aetna American Axle |
$3,008.03
|
| Rate for Payer: Aetna Commercial |
$3,933.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,008.03
|
| Rate for Payer: Cash Price |
$3,702.19
|
| Rate for Payer: Cofinity Commercial |
$3,239.42
|
| Rate for Payer: Cofinity Commercial |
$3,979.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,239.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,702.19
|
| Rate for Payer: Healthscope Commercial |
$4,164.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,239.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,470.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,933.58
|
| Rate for Payer: PHP Commercial |
$3,933.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,008.03
|
| Rate for Payer: Priority Health SBD |
$2,915.48
|
| Rate for Payer: UMR Bronson Commercial |
$2,036.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,470.80
|
|
|
HC EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM
|
Facility
|
OP
|
$4,627.74
|
|
|
Service Code
|
CPT 23075
|
| Hospital Charge Code |
76100412
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$319.57 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$3,008.03
|
| Rate for Payer: Aetna Commercial |
$3,933.58
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,008.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,107.96
|
| Rate for Payer: BCN Commercial |
$1,107.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$3,702.19
|
| Rate for Payer: Cash Price |
$3,702.19
|
| Rate for Payer: Cash Price |
$3,702.19
|
| Rate for Payer: Cofinity Commercial |
$3,979.86
|
| Rate for Payer: Cofinity Commercial |
$3,239.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,239.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,702.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$4,164.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,239.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,470.80
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,933.58
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$3,933.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,008.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$2,915.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.53
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$319.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,712.26
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,470.80
|
|
|
HC EXCISION VAGINAL CYST/TUMOR
|
Facility
|
OP
|
$7,945.53
|
|
|
Service Code
|
CPT 57135
|
| Hospital Charge Code |
76100333
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$181.38 |
| Max. Negotiated Rate |
$9,791.14 |
| Rate for Payer: Aetna American Axle |
$5,164.59
|
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: Aetna Medicare |
$3,239.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,164.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,537.06
|
| Rate for Payer: BCN Commercial |
$2,537.06
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Cofinity Commercial |
$5,561.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,561.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,561.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,542.00
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,791.14
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$7,832.91
|
| Rate for Payer: Priority Health SBD |
$5,005.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.52
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$181.38
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: UMR Bronson Commercial |
$2,939.85
|
| Rate for Payer: VA VA |
$3,115.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC EXCISION VAGINAL CYST/TUMOR
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 57135
|
| Hospital Charge Code |
76100333
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,496.03 |
| Max. Negotiated Rate |
$7,150.98 |
| Rate for Payer: Aetna American Axle |
$5,164.59
|
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,164.59
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$5,561.87
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,561.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,561.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health SBD |
$5,005.68
|
| Rate for Payer: UMR Bronson Commercial |
$3,496.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC EXC LEG/ANKLE TUM < 3 CM
|
Facility
|
OP
|
$2,927.69
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
76100309
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$296.08 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$1,903.00
|
| Rate for Payer: Aetna Commercial |
$2,488.54
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,903.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,338.80
|
| Rate for Payer: BCN Commercial |
$1,338.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$2,342.15
|
| Rate for Payer: Cash Price |
$2,342.15
|
| Rate for Payer: Cash Price |
$2,342.15
|
| Rate for Payer: Cofinity Commercial |
$2,517.81
|
| Rate for Payer: Cofinity Commercial |
$2,049.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,049.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,342.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$2,634.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,049.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,195.77
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,488.54
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$2,488.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,903.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$1,844.44
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$325.69
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$296.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,083.25
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,195.77
|
|
|
HC EXC LEG/ANKLE TUM < 3 CM
|
Facility
|
IP
|
$2,927.69
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
76100309
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,288.18 |
| Max. Negotiated Rate |
$2,634.92 |
| Rate for Payer: Aetna American Axle |
$1,903.00
|
| Rate for Payer: Aetna Commercial |
$2,488.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,903.00
|
| Rate for Payer: Cash Price |
$2,342.15
|
| Rate for Payer: Cofinity Commercial |
$2,049.38
|
| Rate for Payer: Cofinity Commercial |
$2,517.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,049.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,342.15
|
| Rate for Payer: Healthscope Commercial |
$2,634.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,049.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,195.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,488.54
|
| Rate for Payer: PHP Commercial |
$2,488.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,903.00
|
| Rate for Payer: Priority Health SBD |
$1,844.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,288.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,195.77
|
|
|
HC EXC LESION MUCOSA SBMCSL VESTIBULE SMPL RPR
|
Facility
|
IP
|
$4,268.00
|
|
|
Service Code
|
CPT 40812
|
| Hospital Charge Code |
76100430
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,877.92 |
| Max. Negotiated Rate |
$3,841.20 |
| Rate for Payer: Aetna American Axle |
$2,774.20
|
| Rate for Payer: Aetna Commercial |
$3,627.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,774.20
|
| Rate for Payer: Cash Price |
$3,414.40
|
| Rate for Payer: Cofinity Commercial |
$2,987.60
|
| Rate for Payer: Cofinity Commercial |
$3,670.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,987.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,414.40
|
| Rate for Payer: Healthscope Commercial |
$3,841.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,987.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,201.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,627.80
|
| Rate for Payer: PHP Commercial |
$3,627.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,774.20
|
| Rate for Payer: Priority Health SBD |
$2,688.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,877.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,201.00
|
|
|
HC EXC LESION MUCOSA SBMCSL VESTIBULE SMPL RPR
|
Facility
|
OP
|
$4,268.00
|
|
|
Service Code
|
CPT 40812
|
| Hospital Charge Code |
76100430
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$172.61 |
| Max. Negotiated Rate |
$4,561.52 |
| Rate for Payer: Aetna American Axle |
$2,774.20
|
| Rate for Payer: Aetna Commercial |
$3,627.80
|
| Rate for Payer: Aetna Medicare |
$1,509.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,774.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,814.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,814.16
|
| Rate for Payer: BCBS Complete |
$816.81
|
| Rate for Payer: BCBS MAPPO |
$1,451.33
|
| Rate for Payer: BCBS Trust/PPO |
$266.86
|
| Rate for Payer: BCN Commercial |
$266.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,451.33
|
| Rate for Payer: Cash Price |
$3,414.40
|
| Rate for Payer: Cash Price |
$3,414.40
|
| Rate for Payer: Cash Price |
$3,414.40
|
| Rate for Payer: Cofinity Commercial |
$3,670.48
|
| Rate for Payer: Cofinity Commercial |
$2,987.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,987.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,414.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,451.33
|
| Rate for Payer: Healthscope Commercial |
$3,841.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,987.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,201.00
|
| Rate for Payer: Mclaren Medicaid |
$777.91
|
| Rate for Payer: Mclaren Medicare |
$1,451.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,523.90
|
| Rate for Payer: Meridian Medicaid |
$816.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,669.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,627.80
|
| Rate for Payer: Nomi Health Commercial |
$3,047.79
|
| Rate for Payer: PACE Medicare |
$1,378.76
|
| Rate for Payer: PACE SWMI |
$1,451.33
|
| Rate for Payer: PHP Commercial |
$3,627.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,451.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$777.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,774.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,561.52
|
| Rate for Payer: Priority Health Medicare |
$1,451.33
|
| Rate for Payer: Priority Health Narrow Network |
$3,649.22
|
| Rate for Payer: Priority Health SBD |
$2,688.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,451.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.87
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,451.33
|
| Rate for Payer: UHC Exchange |
$172.61
|
| Rate for Payer: UHC Medicare Advantage |
$1,451.33
|
| Rate for Payer: UHCCP Medicaid |
$777.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,579.16
|
| Rate for Payer: VA VA |
$1,451.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,201.00
|
|
|
HC EXC LESION PALATE UVULA W/O CLOSURE
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 42104
|
| Hospital Charge Code |
76100467
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,545.52 |
| Max. Negotiated Rate |
$7,252.20 |
| Rate for Payer: Aetna American Axle |
$5,237.70
|
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.70
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$5,640.60
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,640.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,640.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,043.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health SBD |
$5,076.54
|
| Rate for Payer: UMR Bronson Commercial |
$3,545.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
|
HC EXC LESION PALATE UVULA W/O CLOSURE
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 42104
|
| Hospital Charge Code |
76100467
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.60 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna American Axle |
$5,237.70
|
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$203.22
|
| Rate for Payer: BCN Commercial |
$203.22
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Cofinity Commercial |
$5,640.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,640.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,640.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,043.50
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,672.75
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Priority Health SBD |
$5,076.54
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.46
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$128.60
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,703.14
|
| Rate for Payer: UMR Bronson Commercial |
$2,981.46
|
| Rate for Payer: VA VA |
$3,177.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
|
HC EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 40510
|
| Hospital Charge Code |
76100457
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,545.52 |
| Max. Negotiated Rate |
$7,252.20 |
| Rate for Payer: Aetna American Axle |
$5,237.70
|
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.70
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$5,640.60
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,640.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,640.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,043.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health SBD |
$5,076.54
|
| Rate for Payer: UMR Bronson Commercial |
$3,545.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
|
HC EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 40510
|
| Hospital Charge Code |
76100457
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$335.18 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna American Axle |
$5,237.70
|
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,708.82
|
| Rate for Payer: BCN Commercial |
$1,708.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Cofinity Commercial |
$5,640.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,640.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,640.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,043.50
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,672.75
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Priority Health SBD |
$5,076.54
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$368.70
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$335.18
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,703.14
|
| Rate for Payer: UMR Bronson Commercial |
$2,981.46
|
| Rate for Payer: VA VA |
$3,177.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
|
HC EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11620
|
| Hospital Charge Code |
76100107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$117.42 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$764.43
|
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$764.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$171.90
|
| Rate for Payer: BCN Commercial |
$171.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$823.24
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$823.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$823.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$740.91
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.16
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$117.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$435.14
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11620
|
| Hospital Charge Code |
76100107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$517.46 |
| Max. Negotiated Rate |
$1,058.44 |
| Rate for Payer: Aetna American Axle |
$764.43
|
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$764.43
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Cofinity Commercial |
$823.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$823.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$823.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health SBD |
$740.91
|
| Rate for Payer: UMR Bronson Commercial |
$517.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 TO 1.0 CM
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
76100108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$141.63 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna American Axle |
$764.43
|
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$764.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$196.57
|
| Rate for Payer: BCN Commercial |
$196.57
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$823.24
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$823.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$823.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$740.91
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.79
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$141.63
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: UMR Bronson Commercial |
$435.14
|
| Rate for Payer: VA VA |
$689.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 TO 1.0 CM
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
76100108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$517.46 |
| Max. Negotiated Rate |
$1,058.44 |
| Rate for Payer: Aetna American Axle |
$764.43
|
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$764.43
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Cofinity Commercial |
$823.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$823.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$823.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health SBD |
$740.91
|
| Rate for Payer: UMR Bronson Commercial |
$517.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.0 TO 2.0 CM
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
76100109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$160.75 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna American Axle |
$764.43
|
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$764.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$214.18
|
| Rate for Payer: BCN Commercial |
$214.18
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$823.24
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$823.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$823.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$740.91
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.82
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: UMR Bronson Commercial |
$435.14
|
| Rate for Payer: VA VA |
$689.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.0 TO 2.0 CM
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
76100109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$517.46 |
| Max. Negotiated Rate |
$1,058.44 |
| Rate for Payer: Aetna American Axle |
$764.43
|
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$764.43
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Cofinity Commercial |
$823.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$823.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$823.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health SBD |
$740.91
|
| Rate for Payer: UMR Bronson Commercial |
$517.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXC SINGLE EXTERNAL PAPILLA OR TAG, ANUS
|
Facility
|
IP
|
$1,567.19
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
76100280
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$689.56 |
| Max. Negotiated Rate |
$1,410.47 |
| Rate for Payer: Aetna American Axle |
$1,018.67
|
| Rate for Payer: Aetna Commercial |
$1,332.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,018.67
|
| Rate for Payer: Cash Price |
$1,253.75
|
| Rate for Payer: Cofinity Commercial |
$1,097.03
|
| Rate for Payer: Cofinity Commercial |
$1,347.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,097.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,253.75
|
| Rate for Payer: Healthscope Commercial |
$1,410.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,097.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,175.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.11
|
| Rate for Payer: PHP Commercial |
$1,332.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,018.67
|
| Rate for Payer: Priority Health SBD |
$987.33
|
| Rate for Payer: UMR Bronson Commercial |
$689.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,175.39
|
|
|
HC EXC SINGLE EXTERNAL PAPILLA OR TAG, ANUS
|
Facility
|
OP
|
$1,567.19
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
76100280
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$117.04 |
| Max. Negotiated Rate |
$3,630.90 |
| Rate for Payer: Aetna American Axle |
$1,018.67
|
| Rate for Payer: Aetna Commercial |
$1,332.11
|
| Rate for Payer: Aetna Medicare |
$1,201.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,018.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,193.16
|
| Rate for Payer: BCN Commercial |
$1,193.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$1,253.75
|
| Rate for Payer: Cash Price |
$1,253.75
|
| Rate for Payer: Cash Price |
$1,253.75
|
| Rate for Payer: Cofinity Commercial |
$1,347.78
|
| Rate for Payer: Cofinity Commercial |
$1,097.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,097.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,253.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,410.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,097.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,175.39
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.11
|
| Rate for Payer: Nomi Health Commercial |
$2,426.00
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$1,332.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,018.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,630.90
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,904.72
|
| Rate for Payer: Priority Health SBD |
$987.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.74
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Exchange |
$117.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$619.21
|
| Rate for Payer: UMR Bronson Commercial |
$579.86
|
| Rate for Payer: VA VA |
$1,155.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,175.39
|
|
|
HC EXC SKIN MALIG 2.1-3CM FACE, FACIAL
|
Facility
|
OP
|
$2,146.61
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
76100215
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$216.46 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$1,395.30
|
| Rate for Payer: Aetna Commercial |
$1,824.62
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,395.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,681.90
|
| Rate for Payer: BCN Commercial |
$1,681.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,717.29
|
| 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 |
$1,587.48
|
| 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 |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.62
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,824.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$1,352.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.11
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$216.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$794.25
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.96
|
|
|
HC EXC SKIN MALIG 2.1-3CM FACE, FACIAL
|
Facility
|
IP
|
$2,146.61
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
76100215
|
|
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 2.1-3 CM REMAINDER BODY
|
Facility
|
IP
|
$2,146.61
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
76100212
|
|
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
|
|
