|
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
|
|
|
HC EXC SKIN MALIG 3.1-4CM FACE, FACIAL
|
Facility
|
IP
|
$2,146.61
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
76100216
|
|
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 3.1-4CM FACE, FACIAL
|
Facility
|
OP
|
$2,146.61
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
76100216
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$268.84 |
| 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 |
$1,071.04
|
| Rate for Payer: BCN Commercial |
$1,071.04
|
| 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) |
$295.72
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$268.84
|
| 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 3.1-4 CM REMAINDER BODY
|
Facility
|
IP
|
$2,146.61
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
76100213
|
|
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 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 |
$227.10 |
| 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 |
$1,107.96
|
| Rate for Payer: BCN Commercial |
$1,107.96
|
| 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) |
$249.81
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$227.10
|
| 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 >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 |
$373.06 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna American Axle |
$2,412.56
|
| Rate for Payer: Aetna Commercial |
$3,154.89
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,412.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,874.25
|
| Rate for Payer: BCN Commercial |
$1,874.25
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$2,969.30
|
| 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 |
$2,804.18
|
| 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 |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,154.89
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,154.89
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,412.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$2,338.33
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.37
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$373.06
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,373.30
|
| Rate for Payer: VA VA |
$2,804.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,783.72
|
|
|
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 CM TRUNK, ARM, LEG
|
Facility
|
OP
|
$2,146.61
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
76100211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$304.28 |
| 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 |
$2,360.01
|
| Rate for Payer: BCN Commercial |
$2,360.01
|
| 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) |
$334.71
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$304.28
|
| 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 >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 |
$279.26 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna American Axle |
$2,412.56
|
| Rate for Payer: Aetna Commercial |
$3,154.89
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,412.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,606.51
|
| Rate for Payer: BCN Commercial |
$1,606.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$2,969.30
|
| 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 |
$2,804.18
|
| 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 |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,154.89
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,154.89
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,412.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$2,338.33
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.19
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$279.26
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,373.30
|
| Rate for Payer: VA VA |
$2,804.18
|
| 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 |
$109.58 |
| Max. Negotiated Rate |
$3,630.90 |
| Rate for Payer: Aetna American Axle |
$2,103.76
|
| Rate for Payer: Aetna Commercial |
$2,751.08
|
| Rate for Payer: Aetna Medicare |
$1,201.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,103.76
|
| 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 |
$157.17
|
| Rate for Payer: BCN Commercial |
$157.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$2,589.25
|
| 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 |
$1,155.24
|
| 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 |
$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 |
$2,751.08
|
| 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 |
$2,751.08
|
| 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 |
$2,103.76
|
| 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 |
$2,039.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.54
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Exchange |
$109.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$619.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,197.53
|
| Rate for Payer: VA VA |
$1,155.24
|
| 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 |
$387.06 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$2,951.00
|
| Rate for Payer: Aetna Commercial |
$3,859.00
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,951.00
|
| 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 |
$1,681.90
|
| Rate for Payer: BCN Commercial |
$1,681.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$3,632.00
|
| 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 |
$1,587.48
|
| 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 |
$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 |
$3,859.00
|
| 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 |
$3,859.00
|
| 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 |
$2,951.00
|
| 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 |
$2,860.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$425.77
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$387.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,679.80
|
| Rate for Payer: VA VA |
$1,587.48
|
| 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 |
$413.22 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$2,951.00
|
| Rate for Payer: Aetna Commercial |
$3,859.00
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,951.00
|
| 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 |
$1,477.29
|
| Rate for Payer: BCN Commercial |
$1,477.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$3,632.00
|
| 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 |
$1,587.48
|
| 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 |
$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 |
$3,859.00
|
| 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 |
$3,859.00
|
| 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 |
$2,951.00
|
| 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 |
$2,860.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$454.54
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$413.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,679.80
|
| Rate for Payer: VA VA |
$1,587.48
|
| 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 |
$528.16 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna American Axle |
$5,272.18
|
| Rate for Payer: Aetna Commercial |
$6,894.38
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,272.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,606.51
|
| Rate for Payer: BCN Commercial |
$1,606.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$6,488.83
|
| 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 |
$2,804.18
|
| 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 |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,894.38
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$6,894.38
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,272.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$5,109.96
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$580.98
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$528.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$3,001.08
|
| Rate for Payer: VA VA |
$2,804.18
|
| 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
|
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 ABDOMINAL WALL SUBQ >3CM
|
Facility
|
OP
|
$3,618.87
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
76100245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$430.24 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna American Axle |
$2,352.27
|
| Rate for Payer: Aetna Commercial |
$3,076.04
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,352.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,648.39
|
| Rate for Payer: BCN Commercial |
$2,648.39
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$2,895.10
|
| 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 |
$2,804.18
|
| 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 |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,076.04
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,076.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$2,279.89
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.26
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$430.24
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,338.98
|
| Rate for Payer: VA VA |
$2,804.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,714.15
|
|
|
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 |
$325.05 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$1,392.35
|
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.35
|
| 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 |
$2,106.79
|
| Rate for Payer: BCN Commercial |
$2,106.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,713.66
|
| 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 |
$1,587.48
|
| 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 |
$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 |
$1,820.77
|
| 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 |
$1,820.77
|
| 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 |
$1,392.35
|
| 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 |
$1,349.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$357.56
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$325.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$792.57
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.56
|
|
|
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 <5CM
|
Facility
|
OP
|
$3,570.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
76100398
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$552.56 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna American Axle |
$2,320.50
|
| Rate for Payer: Aetna Commercial |
$3,034.50
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,606.51
|
| Rate for Payer: BCN Commercial |
$1,606.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$2,856.00
|
| 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 |
$2,804.18
|
| 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 |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.50
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,034.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$2,249.10
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.82
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$552.56
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,320.90
|
| Rate for Payer: VA VA |
$2,804.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.50
|
|
|
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
|
|
