|
HC EXCIS/DESTRUCT INTRANASAL LESION INT APPR
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
76100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,530.00 |
| Max. Negotiated Rate |
$7,900.00 |
| Rate for Payer: Aetna Commercial |
$7,110.00
|
| Rate for Payer: ASR ASR |
$7,663.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,124.87
|
| Rate for Payer: BCN Commercial |
$6,124.87
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$7,426.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Healthscope Commercial |
$7,900.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,663.00
|
| Rate for Payer: Mclaren Commercial |
$7,110.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,952.00
|
|
|
HC EXCIS/DESTRUCT INTRANASAL LESION INT APPR
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
76100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,565.43 |
| Max. Negotiated Rate |
$7,900.00 |
| Rate for Payer: Aetna Commercial |
$7,110.00
|
| Rate for Payer: Aetna Medicare |
$2,861.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: ASR ASR |
$7,663.00
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$6,124.87
|
| Rate for Payer: BCN Commercial |
$6,124.87
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$7,426.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Healthscope Commercial |
$7,900.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,663.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,861.84
|
| Rate for Payer: Mclaren Commercial |
$7,110.00
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Commercial |
$3,148.02
|
| Rate for Payer: PHP Medicaid |
$1,565.43
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,189.00
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$5,609.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,952.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: VA VA |
$2,861.84
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
76100095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$807.09 |
| Max. Negotiated Rate |
$1,152.99 |
| Rate for Payer: Aetna Commercial |
$1,037.69
|
| Rate for Payer: ASR ASR |
$1,118.40
|
| Rate for Payer: BCBS Trust/PPO |
$893.91
|
| Rate for Payer: BCN Commercial |
$893.91
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$1,083.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Healthscope Commercial |
$1,152.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,118.40
|
| Rate for Payer: Mclaren Commercial |
$1,037.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,014.63
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
76100095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$1,801.41 |
| Rate for Payer: Aetna Commercial |
$1,037.69
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| 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: ASR ASR |
$1,118.40
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$893.91
|
| Rate for Payer: BCN Commercial |
$893.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$1,083.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,152.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,118.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,037.69
|
| 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 |
$980.04
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| 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 |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,049.22
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$818.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,014.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
76100096
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$807.09 |
| Max. Negotiated Rate |
$1,152.99 |
| Rate for Payer: Aetna Commercial |
$1,037.69
|
| Rate for Payer: ASR ASR |
$1,118.40
|
| Rate for Payer: BCBS Trust/PPO |
$893.91
|
| Rate for Payer: BCN Commercial |
$893.91
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$1,083.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Healthscope Commercial |
$1,152.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,118.40
|
| Rate for Payer: Mclaren Commercial |
$1,037.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,014.63
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
76100096
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$342.09 |
| Max. Negotiated Rate |
$1,152.99 |
| Rate for Payer: Aetna Commercial |
$1,037.69
|
| Rate for Payer: Aetna Medicare |
$625.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: ASR ASR |
$1,118.40
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$893.91
|
| Rate for Payer: BCN Commercial |
$893.91
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$1,083.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$1,152.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,118.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.39
|
| Rate for Payer: Mclaren Commercial |
$1,037.69
|
| 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 |
$980.04
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$687.93
|
| Rate for Payer: PHP Medicaid |
$342.09
|
| 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 |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,049.22
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$818.62
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,014.63
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
76100097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$807.09 |
| Max. Negotiated Rate |
$1,152.99 |
| Rate for Payer: Aetna Commercial |
$1,037.69
|
| Rate for Payer: ASR ASR |
$1,118.40
|
| Rate for Payer: BCBS Trust/PPO |
$893.91
|
| Rate for Payer: BCN Commercial |
$893.91
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$1,083.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Healthscope Commercial |
$1,152.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,118.40
|
| Rate for Payer: Mclaren Commercial |
$1,037.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,014.63
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
76100097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$1,801.41 |
| Rate for Payer: Aetna Commercial |
$1,037.69
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| 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: ASR ASR |
$1,118.40
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$893.91
|
| Rate for Payer: BCN Commercial |
$893.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$1,083.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,152.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,118.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,037.69
|
| 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 |
$980.04
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| 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 |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,049.22
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$818.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,014.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
76100098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$807.09 |
| Max. Negotiated Rate |
$1,152.99 |
| Rate for Payer: Aetna Commercial |
$1,037.69
|
| Rate for Payer: ASR ASR |
$1,118.40
|
| Rate for Payer: BCBS Trust/PPO |
$893.91
|
| Rate for Payer: BCN Commercial |
$893.91
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$1,083.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Healthscope Commercial |
$1,152.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,118.40
|
| Rate for Payer: Mclaren Commercial |
$1,037.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,014.63
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
76100098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$1,801.41 |
| Rate for Payer: Aetna Commercial |
$1,037.69
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| 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: ASR ASR |
$1,118.40
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$893.91
|
| Rate for Payer: BCN Commercial |
$893.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$1,083.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,152.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,118.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,037.69
|
| 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 |
$980.04
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| 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 |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,049.22
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$818.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,014.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 3.1 TO 4.0 CM
|
Facility
|
OP
|
$1,904.19
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
76100099
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$1,904.19 |
| Rate for Payer: Aetna Commercial |
$1,713.77
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| 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: ASR ASR |
$1,847.06
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.32
|
| Rate for Payer: BCN Commercial |
$1,476.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cofinity Commercial |
$1,789.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,523.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,904.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,847.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,713.77
|
| 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 |
$1,618.56
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| 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 |
$1,332.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,732.81
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,351.97
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,675.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 3.1 TO 4.0 CM
|
Facility
|
IP
|
$1,904.19
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
76100099
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,332.93 |
| Max. Negotiated Rate |
$1,904.19 |
| Rate for Payer: Aetna Commercial |
$1,713.77
|
| Rate for Payer: ASR ASR |
$1,847.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.32
|
| Rate for Payer: BCN Commercial |
$1,476.32
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cofinity Commercial |
$1,789.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,523.35
|
| Rate for Payer: Healthscope Commercial |
$1,904.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,847.06
|
| Rate for Payer: Mclaren Commercial |
$1,713.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,618.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,675.69
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA OVER 4.0 CM
|
Facility
|
OP
|
$1,904.19
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
76100100
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,332.93 |
| Max. Negotiated Rate |
$3,157.18 |
| Rate for Payer: Aetna Commercial |
$1,713.77
|
| Rate for Payer: Aetna Medicare |
$2,525.74
|
| 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: ASR ASR |
$1,847.06
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.32
|
| Rate for Payer: BCN Commercial |
$1,476.32
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cofinity Commercial |
$1,789.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,523.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$1,904.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,847.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$1,713.77
|
| 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 |
$1,618.56
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$2,778.31
|
| Rate for Payer: PHP Medicaid |
$1,381.58
|
| 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 |
$1,332.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,732.81
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,351.97
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,675.69
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA OVER 4.0 CM
|
Facility
|
IP
|
$1,904.19
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
76100100
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,332.93 |
| Max. Negotiated Rate |
$1,904.19 |
| Rate for Payer: Aetna Commercial |
$1,713.77
|
| Rate for Payer: ASR ASR |
$1,847.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.32
|
| Rate for Payer: BCN Commercial |
$1,476.32
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cofinity Commercial |
$1,789.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,523.35
|
| Rate for Payer: Healthscope Commercial |
$1,904.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,847.06
|
| Rate for Payer: Mclaren Commercial |
$1,713.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,618.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,675.69
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
OP
|
$822.28
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
76100089
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$342.09 |
| Max. Negotiated Rate |
$822.28 |
| Rate for Payer: Aetna Commercial |
$740.05
|
| Rate for Payer: Aetna Medicare |
$625.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: ASR ASR |
$797.61
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$637.51
|
| Rate for Payer: BCN Commercial |
$637.51
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$657.82
|
| Rate for Payer: Cash Price |
$657.82
|
| Rate for Payer: Cofinity Commercial |
$772.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$657.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$822.28
|
| Rate for Payer: Healthscope Whirlpool |
$797.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.39
|
| Rate for Payer: Mclaren Commercial |
$740.05
|
| 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 |
$698.94
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$687.93
|
| Rate for Payer: PHP Medicaid |
$342.09
|
| 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 |
$575.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$719.35
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$575.48
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$723.61
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
IP
|
$822.28
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
76100089
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$575.60 |
| Max. Negotiated Rate |
$822.28 |
| Rate for Payer: Aetna Commercial |
$740.05
|
| Rate for Payer: ASR ASR |
$797.61
|
| Rate for Payer: BCBS Trust/PPO |
$637.51
|
| Rate for Payer: BCN Commercial |
$637.51
|
| Rate for Payer: Cash Price |
$657.82
|
| Rate for Payer: Cofinity Commercial |
$772.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$657.82
|
| Rate for Payer: Healthscope Commercial |
$822.28
|
| Rate for Payer: Healthscope Whirlpool |
$797.61
|
| Rate for Payer: Mclaren Commercial |
$740.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$698.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$723.61
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.6 CM TO 1.0 CM
|
Facility
|
IP
|
$588.31
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
76100090
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$411.82 |
| Max. Negotiated Rate |
$588.31 |
| Rate for Payer: Aetna Commercial |
$529.48
|
| Rate for Payer: ASR ASR |
$570.66
|
| Rate for Payer: BCBS Trust/PPO |
$456.12
|
| Rate for Payer: BCN Commercial |
$456.12
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$553.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Healthscope Commercial |
$588.31
|
| Rate for Payer: Healthscope Whirlpool |
$570.66
|
| Rate for Payer: Mclaren Commercial |
$529.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$517.71
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.6 CM TO 1.0 CM
|
Facility
|
OP
|
$588.31
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
76100090
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.87 |
| Max. Negotiated Rate |
$719.35 |
| Rate for Payer: Aetna Commercial |
$529.48
|
| Rate for Payer: Aetna Medicare |
$354.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: ASR ASR |
$570.66
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$456.12
|
| Rate for Payer: BCN Commercial |
$456.12
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$553.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$588.31
|
| Rate for Payer: Healthscope Whirlpool |
$570.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.43
|
| Rate for Payer: Mclaren Commercial |
$529.48
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$389.87
|
| Rate for Payer: PHP Medicaid |
$193.87
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$719.35
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$575.48
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$517.71
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: VA VA |
$354.43
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 1.1 CM TO 2.0 CM
|
Facility
|
IP
|
$1,268.88
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
76100091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$888.22 |
| Max. Negotiated Rate |
$1,268.88 |
| Rate for Payer: Aetna Commercial |
$1,141.99
|
| Rate for Payer: ASR ASR |
$1,230.81
|
| Rate for Payer: BCBS Trust/PPO |
$983.76
|
| Rate for Payer: BCN Commercial |
$983.76
|
| Rate for Payer: Cash Price |
$1,015.10
|
| Rate for Payer: Cofinity Commercial |
$1,192.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,015.10
|
| Rate for Payer: Healthscope Commercial |
$1,268.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,230.81
|
| Rate for Payer: Mclaren Commercial |
$1,141.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,078.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,116.61
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 1.1 CM TO 2.0 CM
|
Facility
|
OP
|
$1,268.88
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
76100091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$342.09 |
| Max. Negotiated Rate |
$1,268.88 |
| Rate for Payer: Aetna Commercial |
$1,141.99
|
| Rate for Payer: Aetna Medicare |
$625.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: ASR ASR |
$1,230.81
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$983.76
|
| Rate for Payer: BCN Commercial |
$983.76
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$1,015.10
|
| Rate for Payer: Cash Price |
$1,015.10
|
| Rate for Payer: Cofinity Commercial |
$1,192.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,015.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$1,268.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,230.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.39
|
| Rate for Payer: Mclaren Commercial |
$1,141.99
|
| 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 |
$1,078.55
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$687.93
|
| Rate for Payer: PHP Medicaid |
$342.09
|
| 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 |
$888.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.68
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$900.90
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,116.61
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
76100092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$342.09 |
| Max. Negotiated Rate |
$1,152.99 |
| Rate for Payer: Aetna Commercial |
$1,037.69
|
| Rate for Payer: Aetna Medicare |
$625.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: ASR ASR |
$1,118.40
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$893.91
|
| Rate for Payer: BCN Commercial |
$893.91
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$1,083.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$1,152.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,118.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.39
|
| Rate for Payer: Mclaren Commercial |
$1,037.69
|
| 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 |
$980.04
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$687.93
|
| Rate for Payer: PHP Medicaid |
$342.09
|
| 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 |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,049.22
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$818.62
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,014.63
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
76100092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$807.09 |
| Max. Negotiated Rate |
$1,152.99 |
| Rate for Payer: Aetna Commercial |
$1,037.69
|
| Rate for Payer: ASR ASR |
$1,118.40
|
| Rate for Payer: BCBS Trust/PPO |
$893.91
|
| Rate for Payer: BCN Commercial |
$893.91
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$1,083.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Healthscope Commercial |
$1,152.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,118.40
|
| Rate for Payer: Mclaren Commercial |
$1,037.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,014.63
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
IP
|
$1,383.59
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
76100093
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$968.51 |
| Max. Negotiated Rate |
$1,383.59 |
| Rate for Payer: Aetna Commercial |
$1,245.23
|
| Rate for Payer: ASR ASR |
$1,342.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,072.70
|
| Rate for Payer: BCN Commercial |
$1,072.70
|
| Rate for Payer: Cash Price |
$1,106.87
|
| Rate for Payer: Cofinity Commercial |
$1,300.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.87
|
| Rate for Payer: Healthscope Commercial |
$1,383.59
|
| Rate for Payer: Healthscope Whirlpool |
$1,342.08
|
| Rate for Payer: Mclaren Commercial |
$1,245.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,176.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$968.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,217.56
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
OP
|
$1,383.59
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
76100093
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$1,801.41 |
| Rate for Payer: Aetna Commercial |
$1,245.23
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| 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: ASR ASR |
$1,342.08
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,072.70
|
| Rate for Payer: BCN Commercial |
$1,072.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,106.87
|
| Rate for Payer: Cash Price |
$1,106.87
|
| Rate for Payer: Cofinity Commercial |
$1,300.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,383.59
|
| Rate for Payer: Healthscope Whirlpool |
$1,342.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,245.23
|
| 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 |
$1,176.05
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| 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 |
$968.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,259.07
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$982.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,217.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
OP
|
$2,077.30
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$2,077.30 |
| Rate for Payer: Aetna Commercial |
$1,869.57
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| 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: ASR ASR |
$2,014.98
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,610.53
|
| Rate for Payer: BCN Commercial |
$1,610.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,661.84
|
| Rate for Payer: Cash Price |
$1,661.84
|
| Rate for Payer: Cofinity Commercial |
$1,952.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,661.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$2,077.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,014.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,869.57
|
| 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 |
$1,765.70
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| 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 |
$1,454.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,890.34
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,474.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,828.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
