|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Facility
|
OP
|
$904.00
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
11644
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$275.38 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$587.60
|
| Rate for Payer: Aetna Commercial |
$768.40
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,021.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Cofinity Commercial |
$632.80
|
| Rate for Payer: Cofinity Commercial |
$777.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$813.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$632.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.00
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$768.40
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$768.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$569.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$275.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$334.48
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.00
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Professional
|
Both
|
$904.00
|
|
|
Service Code
|
HCPCS 11646
|
| Hospital Charge Code |
11646
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$632.80 |
| Rate for Payer: Aetna Commercial |
$422.43
|
| Rate for Payer: BCBS Complete |
$259.65
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Meridian Medicaid |
$259.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$475.57
|
| Rate for Payer: Priority Health Narrow Network |
$475.57
|
| Rate for Payer: Priority Health SBD |
$475.57
|
| Rate for Payer: UMR Bronson Commercial |
$415.84
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Facility
|
IP
|
$904.00
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
11646
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$397.76 |
| Max. Negotiated Rate |
$813.60 |
| Rate for Payer: Aetna American Axle |
$587.60
|
| Rate for Payer: Aetna Commercial |
$768.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.60
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Cofinity Commercial |
$632.80
|
| Rate for Payer: Cofinity Commercial |
$777.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.20
|
| Rate for Payer: Healthscope Commercial |
$813.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$632.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$768.40
|
| Rate for Payer: PHP Commercial |
$768.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.80
|
| Rate for Payer: Priority Health SBD |
$569.52
|
| Rate for Payer: UMR Bronson Commercial |
$397.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.00
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Professional
|
Both
|
$904.00
|
|
|
Service Code
|
HCPCS 11646
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$632.80 |
| Rate for Payer: Aetna Commercial |
$422.43
|
| Rate for Payer: BCBS Complete |
$259.65
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Meridian Medicaid |
$259.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$475.57
|
| Rate for Payer: Priority Health Narrow Network |
$475.57
|
| Rate for Payer: Priority Health SBD |
$475.57
|
| Rate for Payer: UMR Bronson Commercial |
$415.84
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Facility
|
OP
|
$904.00
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
11646
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$334.48 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$587.60
|
| Rate for Payer: Aetna Commercial |
$768.40
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,787.02
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Cofinity Commercial |
$632.80
|
| Rate for Payer: Cofinity Commercial |
$777.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$813.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$632.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.00
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$768.40
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$768.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Priority Health SBD |
$569.52
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$418.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$380.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$334.48
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.00
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 11620
|
| Min. Negotiated Rate |
$79.02 |
| Max. Negotiated Rate |
$578.99 |
| Rate for Payer: Aetna Commercial |
$131.33
|
| Rate for Payer: BCBS Complete |
$82.97
|
| Rate for Payer: BCBS Trust/PPO |
$578.99
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Meridian Medicaid |
$82.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.44
|
| Rate for Payer: Priority Health Narrow Network |
$150.44
|
| Rate for Payer: Priority Health SBD |
$150.44
|
| Rate for Payer: UMR Bronson Commercial |
$145.36
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM
|
Professional
|
Both
|
$373.00
|
|
|
Service Code
|
HCPCS 11621
|
| Min. Negotiated Rate |
$26.32 |
| Max. Negotiated Rate |
$261.10 |
| Rate for Payer: Aetna Commercial |
$158.81
|
| Rate for Payer: BCBS Complete |
$99.97
|
| Rate for Payer: BCBS Trust/PPO |
$26.32
|
| Rate for Payer: Cash Price |
$298.40
|
| Rate for Payer: Cash Price |
$298.40
|
| Rate for Payer: Meridian Medicaid |
$99.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.50
|
| Rate for Payer: Priority Health Narrow Network |
$182.50
|
| Rate for Payer: Priority Health SBD |
$182.50
|
| Rate for Payer: UMR Bronson Commercial |
$171.58
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Facility
|
IP
|
$416.00
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
11622
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$183.04 |
| Max. Negotiated Rate |
$374.40 |
| Rate for Payer: Aetna American Axle |
$270.40
|
| Rate for Payer: Aetna Commercial |
$353.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.40
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Cofinity Commercial |
$291.20
|
| Rate for Payer: Cofinity Commercial |
$357.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.80
|
| Rate for Payer: Healthscope Commercial |
$374.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$353.60
|
| Rate for Payer: PHP Commercial |
$353.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.20
|
| Rate for Payer: Priority Health SBD |
$262.08
|
| Rate for Payer: UMR Bronson Commercial |
$183.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.00
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Professional
|
Both
|
$416.00
|
|
|
Service Code
|
HCPCS 11622
|
| Min. Negotiated Rate |
$107.99 |
| Max. Negotiated Rate |
$156,313.01 |
| Rate for Payer: Aetna Commercial |
$179.90
|
| Rate for Payer: BCBS Complete |
$113.39
|
| Rate for Payer: BCBS Trust/PPO |
$156,313.01
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Meridian Medicaid |
$113.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$206.34
|
| Rate for Payer: Priority Health Narrow Network |
$206.34
|
| Rate for Payer: Priority Health SBD |
$206.34
|
| Rate for Payer: UMR Bronson Commercial |
$191.36
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Professional
|
Both
|
$416.00
|
|
|
Service Code
|
HCPCS 11622
|
| Hospital Charge Code |
11622
|
| Min. Negotiated Rate |
$107.99 |
| Max. Negotiated Rate |
$156,313.01 |
| Rate for Payer: Aetna Commercial |
$179.90
|
| Rate for Payer: BCBS Complete |
$113.39
|
| Rate for Payer: BCBS Trust/PPO |
$156,313.01
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Meridian Medicaid |
$113.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$206.34
|
| Rate for Payer: Priority Health Narrow Network |
$206.34
|
| Rate for Payer: Priority Health SBD |
$206.34
|
| Rate for Payer: UMR Bronson Commercial |
$191.36
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Facility
|
OP
|
$416.00
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
11622
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$153.92 |
| Max. Negotiated Rate |
$1,968.76 |
| Rate for Payer: Aetna American Axle |
$270.40
|
| Rate for Payer: Aetna Commercial |
$353.60
|
| Rate for Payer: Aetna Medicare |
$650.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$204.21
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Cofinity Commercial |
$357.76
|
| Rate for Payer: Cofinity Commercial |
$291.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$374.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.00
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$353.60
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$353.60
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.76
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.01
|
| Rate for Payer: Priority Health SBD |
$262.08
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.39
|
| Rate for Payer: UHC Exchange |
$166.01
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: UMR Bronson Commercial |
$153.92
|
| Rate for Payer: VA VA |
$625.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.00
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Professional
|
Both
|
$517.00
|
|
|
Service Code
|
HCPCS 11623
|
| Hospital Charge Code |
11623
|
| Min. Negotiated Rate |
$133.13 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$224.21
|
| Rate for Payer: BCBS Complete |
$139.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Meridian Medicaid |
$139.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.67
|
| Rate for Payer: Priority Health Narrow Network |
$255.67
|
| Rate for Payer: Priority Health SBD |
$255.67
|
| Rate for Payer: UMR Bronson Commercial |
$237.82
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Facility
|
OP
|
$517.00
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
11623
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$191.29 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$336.05
|
| Rate for Payer: Aetna Commercial |
$439.45
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$224.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cofinity Commercial |
$361.90
|
| Rate for Payer: Cofinity Commercial |
$444.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$465.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$361.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$387.75
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$439.45
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$439.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$325.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$204.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$191.29
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$387.75
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Facility
|
IP
|
$517.00
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
11623
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$227.48 |
| Max. Negotiated Rate |
$465.30 |
| Rate for Payer: Aetna American Axle |
$336.05
|
| Rate for Payer: Aetna Commercial |
$439.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.05
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cofinity Commercial |
$361.90
|
| Rate for Payer: Cofinity Commercial |
$444.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.60
|
| Rate for Payer: Healthscope Commercial |
$465.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$361.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$387.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$439.45
|
| Rate for Payer: PHP Commercial |
$439.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.90
|
| Rate for Payer: Priority Health SBD |
$325.71
|
| Rate for Payer: UMR Bronson Commercial |
$227.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$387.75
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Professional
|
Both
|
$517.00
|
|
|
Service Code
|
HCPCS 11623
|
| Min. Negotiated Rate |
$133.13 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$224.21
|
| Rate for Payer: BCBS Complete |
$139.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Meridian Medicaid |
$139.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.67
|
| Rate for Payer: Priority Health Narrow Network |
$255.67
|
| Rate for Payer: Priority Health SBD |
$255.67
|
| Rate for Payer: UMR Bronson Commercial |
$237.82
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Professional
|
Both
|
$583.00
|
|
|
Service Code
|
HCPCS 11624
|
| Hospital Charge Code |
11624
|
| Min. Negotiated Rate |
$151.44 |
| Max. Negotiated Rate |
$1,307.96 |
| Rate for Payer: Aetna Commercial |
$254.89
|
| Rate for Payer: BCBS Complete |
$159.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.96
|
| Rate for Payer: Cash Price |
$466.40
|
| Rate for Payer: Cash Price |
$466.40
|
| Rate for Payer: Meridian Medicaid |
$159.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$151.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$290.19
|
| Rate for Payer: Priority Health Narrow Network |
$290.19
|
| Rate for Payer: Priority Health SBD |
$290.19
|
| Rate for Payer: UMR Bronson Commercial |
$268.18
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Facility
|
OP
|
$583.00
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$215.71 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$378.95
|
| Rate for Payer: Aetna Commercial |
$495.55
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,056.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$466.40
|
| Rate for Payer: Cash Price |
$466.40
|
| Rate for Payer: Cofinity Commercial |
$408.10
|
| Rate for Payer: Cofinity Commercial |
$501.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$524.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$408.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.25
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$495.55
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$495.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$367.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$232.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$215.71
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.25
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Facility
|
IP
|
$583.00
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$256.52 |
| Max. Negotiated Rate |
$524.70 |
| Rate for Payer: Aetna American Axle |
$378.95
|
| Rate for Payer: Aetna Commercial |
$495.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.95
|
| Rate for Payer: Cash Price |
$466.40
|
| Rate for Payer: Cofinity Commercial |
$408.10
|
| Rate for Payer: Cofinity Commercial |
$501.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.40
|
| Rate for Payer: Healthscope Commercial |
$524.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$408.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$495.55
|
| Rate for Payer: PHP Commercial |
$495.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.10
|
| Rate for Payer: Priority Health SBD |
$367.29
|
| Rate for Payer: UMR Bronson Commercial |
$256.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.25
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Professional
|
Both
|
$583.00
|
|
|
Service Code
|
HCPCS 11624
|
| Min. Negotiated Rate |
$151.44 |
| Max. Negotiated Rate |
$1,307.96 |
| Rate for Payer: Aetna Commercial |
$254.89
|
| Rate for Payer: BCBS Complete |
$159.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.96
|
| Rate for Payer: Cash Price |
$466.40
|
| Rate for Payer: Cash Price |
$466.40
|
| Rate for Payer: Meridian Medicaid |
$159.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$151.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$290.19
|
| Rate for Payer: Priority Health Narrow Network |
$290.19
|
| Rate for Payer: Priority Health SBD |
$290.19
|
| Rate for Payer: UMR Bronson Commercial |
$268.18
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Facility
|
OP
|
$912.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
11626
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$284.55 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$592.80
|
| Rate for Payer: Aetna Commercial |
$775.20
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$592.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,531.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cofinity Commercial |
$784.32
|
| Rate for Payer: Cofinity Commercial |
$638.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$729.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$820.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$638.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$684.00
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$775.20
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$775.20
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$638.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Priority Health SBD |
$574.56
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$284.55
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$337.44
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$684.00
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Professional
|
Both
|
$912.00
|
|
|
Service Code
|
HCPCS 11626
|
| Hospital Charge Code |
11626
|
| Min. Negotiated Rate |
$185.10 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$315.59
|
| Rate for Payer: BCBS Complete |
$194.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Meridian Medicaid |
$194.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$638.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$355.96
|
| Rate for Payer: Priority Health Narrow Network |
$355.96
|
| Rate for Payer: Priority Health SBD |
$355.96
|
| Rate for Payer: UMR Bronson Commercial |
$419.52
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Facility
|
IP
|
$912.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
11626
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$401.28 |
| Max. Negotiated Rate |
$820.80 |
| Rate for Payer: Aetna American Axle |
$592.80
|
| Rate for Payer: Aetna Commercial |
$775.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$592.80
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cofinity Commercial |
$638.40
|
| Rate for Payer: Cofinity Commercial |
$784.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$729.60
|
| Rate for Payer: Healthscope Commercial |
$820.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$638.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$684.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$775.20
|
| Rate for Payer: PHP Commercial |
$775.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$638.40
|
| Rate for Payer: Priority Health SBD |
$574.56
|
| Rate for Payer: UMR Bronson Commercial |
$401.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$684.00
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Professional
|
Both
|
$912.00
|
|
|
Service Code
|
HCPCS 11626
|
| Min. Negotiated Rate |
$185.10 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$315.59
|
| Rate for Payer: BCBS Complete |
$194.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Meridian Medicaid |
$194.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$638.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$355.96
|
| Rate for Payer: Priority Health Narrow Network |
$355.96
|
| Rate for Payer: Priority Health SBD |
$355.96
|
| Rate for Payer: UMR Bronson Commercial |
$419.52
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Professional
|
Both
|
$787.00
|
|
|
Service Code
|
HCPCS 11606
|
| Hospital Charge Code |
11606
|
| Min. Negotiated Rate |
$201.50 |
| Max. Negotiated Rate |
$592.45 |
| Rate for Payer: Aetna Commercial |
$341.92
|
| Rate for Payer: BCBS Complete |
$211.58
|
| Rate for Payer: BCBS Trust/PPO |
$592.45
|
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Meridian Medicaid |
$211.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$550.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$385.96
|
| Rate for Payer: Priority Health Narrow Network |
$385.96
|
| Rate for Payer: Priority Health SBD |
$385.96
|
| Rate for Payer: UMR Bronson Commercial |
$362.02
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Facility
|
IP
|
$787.00
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
11606
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$346.28 |
| Max. Negotiated Rate |
$708.30 |
| Rate for Payer: Aetna American Axle |
$511.55
|
| Rate for Payer: Aetna Commercial |
$668.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.55
|
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Cofinity Commercial |
$550.90
|
| Rate for Payer: Cofinity Commercial |
$676.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$629.60
|
| Rate for Payer: Healthscope Commercial |
$708.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$550.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$668.95
|
| Rate for Payer: PHP Commercial |
$668.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$550.90
|
| Rate for Payer: Priority Health SBD |
$495.81
|
| Rate for Payer: UMR Bronson Commercial |
$346.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.25
|
|
