|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
OP
|
$306.31
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
76100146
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$214.42 |
| Max. Negotiated Rate |
$781.74 |
| Rate for Payer: Aetna Commercial |
$275.68
|
| 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 |
$297.12
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$237.48
|
| Rate for Payer: BCN Commercial |
$237.48
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$245.05
|
| Rate for Payer: Cash Price |
$245.05
|
| Rate for Payer: Cofinity Commercial |
$287.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Healthscope Whirlpool |
$297.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.39
|
| Rate for Payer: Mclaren Commercial |
$275.68
|
| 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 |
$260.36
|
| 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 |
$214.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$278.74
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$217.48
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.55
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
IP
|
$306.31
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
76100146
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$214.42 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna Commercial |
$275.68
|
| Rate for Payer: ASR ASR |
$297.12
|
| Rate for Payer: BCBS Trust/PPO |
$237.48
|
| Rate for Payer: BCN Commercial |
$237.48
|
| Rate for Payer: Cash Price |
$245.05
|
| Rate for Payer: Cofinity Commercial |
$287.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.05
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Healthscope Whirlpool |
$297.12
|
| Rate for Payer: Mclaren Commercial |
$275.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$260.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.55
|
|
|
HC EXCISION/DESTRUCT LESION PHARYNX ANY METHOD
|
Facility
|
IP
|
$7,963.00
|
|
|
Service Code
|
CPT 42808
|
| Hospital Charge Code |
76100476
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,574.10 |
| Max. Negotiated Rate |
$7,963.00 |
| Rate for Payer: Aetna Commercial |
$7,166.70
|
| Rate for Payer: ASR ASR |
$7,724.11
|
| Rate for Payer: BCBS Trust/PPO |
$6,173.71
|
| Rate for Payer: BCN Commercial |
$6,173.71
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cofinity Commercial |
$7,485.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,370.40
|
| Rate for Payer: Healthscope Commercial |
$7,963.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,724.11
|
| Rate for Payer: Mclaren Commercial |
$7,166.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,768.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,574.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,007.44
|
|
|
HC EXCISION/DESTRUCT LESION PHARYNX ANY METHOD
|
Facility
|
OP
|
$7,963.00
|
|
|
Service Code
|
CPT 42808
|
| Hospital Charge Code |
76100476
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,565.43 |
| Max. Negotiated Rate |
$7,963.00 |
| Rate for Payer: Aetna Commercial |
$7,166.70
|
| 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 |
$7,724.11
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$6,173.71
|
| Rate for Payer: BCN Commercial |
$6,173.71
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cofinity Commercial |
$7,485.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,370.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Healthscope Commercial |
$7,963.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,724.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,861.84
|
| Rate for Payer: Mclaren Commercial |
$7,166.70
|
| 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 |
$6,768.55
|
| 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 |
$5,574.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,246.33
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$5,653.73
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,007.44
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: VA VA |
$2,861.84
|
|
|
HC EXCISION EXCESSIVE SKIN & SUBQ TISSUE
|
Facility
|
IP
|
$7,039.02
|
|
|
Service Code
|
CPT 15839
|
| Hospital Charge Code |
76100330
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,927.31 |
| Max. Negotiated Rate |
$7,039.02 |
| Rate for Payer: Aetna Commercial |
$6,335.12
|
| Rate for Payer: ASR ASR |
$6,827.85
|
| Rate for Payer: BCBS Trust/PPO |
$5,457.35
|
| Rate for Payer: BCN Commercial |
$5,457.35
|
| Rate for Payer: Cash Price |
$5,631.22
|
| Rate for Payer: Cofinity Commercial |
$6,616.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,631.22
|
| Rate for Payer: Healthscope Commercial |
$7,039.02
|
| Rate for Payer: Healthscope Whirlpool |
$6,827.85
|
| Rate for Payer: Mclaren Commercial |
$6,335.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,983.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,927.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,194.34
|
|
|
HC EXCISION EXCESSIVE SKIN & SUBQ TISSUE
|
Facility
|
OP
|
$7,039.02
|
|
|
Service Code
|
CPT 15839
|
| Hospital Charge Code |
76100330
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,381.58 |
| Max. Negotiated Rate |
$7,039.02 |
| Rate for Payer: Aetna Commercial |
$6,335.12
|
| 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 |
$6,827.85
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$5,457.35
|
| Rate for Payer: BCN Commercial |
$5,457.35
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$5,631.22
|
| Rate for Payer: Cash Price |
$5,631.22
|
| Rate for Payer: Cofinity Commercial |
$6,616.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,631.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$7,039.02
|
| Rate for Payer: Healthscope Whirlpool |
$6,827.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$6,335.12
|
| 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 |
$5,983.17
|
| 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 |
$4,927.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,405.51
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$4,997.70
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,194.34
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
HC EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Facility
|
OP
|
$7,200.00
|
|
|
Service Code
|
CPT 69110
|
| Hospital Charge Code |
76100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,381.58 |
| Max. Negotiated Rate |
$7,200.00 |
| Rate for Payer: Aetna Commercial |
$6,480.00
|
| 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 |
$6,984.00
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$5,582.16
|
| Rate for Payer: BCN Commercial |
$5,582.16
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$5,760.00
|
| Rate for Payer: Cash Price |
$5,760.00
|
| Rate for Payer: Cofinity Commercial |
$6,768.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,760.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$7,200.00
|
| Rate for Payer: Healthscope Whirlpool |
$6,984.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$6,480.00
|
| 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 |
$6,120.00
|
| 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 |
$5,040.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,552.00
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$5,112.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,336.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
HC EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Facility
|
IP
|
$7,200.00
|
|
|
Service Code
|
CPT 69110
|
| Hospital Charge Code |
76100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,040.00 |
| Max. Negotiated Rate |
$7,200.00 |
| Rate for Payer: Aetna Commercial |
$6,480.00
|
| Rate for Payer: ASR ASR |
$6,984.00
|
| Rate for Payer: BCBS Trust/PPO |
$5,582.16
|
| Rate for Payer: BCN Commercial |
$5,582.16
|
| Rate for Payer: Cash Price |
$5,760.00
|
| Rate for Payer: Cofinity Commercial |
$6,768.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,760.00
|
| Rate for Payer: Healthscope Commercial |
$7,200.00
|
| Rate for Payer: Healthscope Whirlpool |
$6,984.00
|
| Rate for Payer: Mclaren Commercial |
$6,480.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,120.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,040.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,336.00
|
|
|
HC EXCISION LESION TONGUE W/O CLOSURE
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
76100465
|
|
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 EXCISION LESION TONGUE W/O CLOSURE
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
76100465
|
|
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 EXCISION LINGUAL FRENUM FRENECTOMY
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
76100380
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$741.50 |
| Max. Negotiated Rate |
$3,900.00 |
| Rate for Payer: Aetna Commercial |
$3,510.00
|
| Rate for Payer: Aetna Medicare |
$1,355.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,694.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,694.48
|
| Rate for Payer: ASR ASR |
$3,783.00
|
| Rate for Payer: BCBS Complete |
$778.65
|
| Rate for Payer: BCBS MAPPO |
$1,355.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,023.67
|
| Rate for Payer: BCN Commercial |
$3,023.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,355.58
|
| Rate for Payer: Cash Price |
$3,120.00
|
| Rate for Payer: Cash Price |
$3,120.00
|
| Rate for Payer: Cofinity Commercial |
$3,666.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,120.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,355.58
|
| Rate for Payer: Healthscope Commercial |
$3,900.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,783.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,355.58
|
| Rate for Payer: Mclaren Commercial |
$3,510.00
|
| Rate for Payer: Mclaren Medicaid |
$741.50
|
| Rate for Payer: Mclaren Medicare |
$1,355.58
|
| Rate for Payer: Meridian Medicaid |
$778.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,423.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,558.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,315.00
|
| Rate for Payer: PACE Medicare |
$1,287.80
|
| Rate for Payer: PACE SWMI |
$1,355.58
|
| Rate for Payer: PHP Commercial |
$1,491.14
|
| Rate for Payer: PHP Medicaid |
$741.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,355.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$741.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,730.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,549.00
|
| Rate for Payer: Priority Health Medicare |
$1,355.58
|
| Rate for Payer: Priority Health Narrow Network |
$2,769.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,355.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,432.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,396.25
|
| Rate for Payer: VA VA |
$1,355.58
|
|
|
HC EXCISION LINGUAL FRENUM FRENECTOMY
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
76100380
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,730.00 |
| Max. Negotiated Rate |
$3,900.00 |
| Rate for Payer: Aetna Commercial |
$3,510.00
|
| Rate for Payer: ASR ASR |
$3,783.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,023.67
|
| Rate for Payer: BCN Commercial |
$3,023.67
|
| Rate for Payer: Cash Price |
$3,120.00
|
| Rate for Payer: Cofinity Commercial |
$3,666.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,120.00
|
| Rate for Payer: Healthscope Commercial |
$3,900.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,783.00
|
| Rate for Payer: Mclaren Commercial |
$3,510.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,315.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,730.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,432.00
|
|
|
HC EXCISION OF ANAL LESION(S)
|
Facility
|
IP
|
$7,380.33
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
76100350
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,166.23 |
| Max. Negotiated Rate |
$7,380.33 |
| Rate for Payer: Aetna Commercial |
$6,642.30
|
| Rate for Payer: ASR ASR |
$7,158.92
|
| Rate for Payer: BCBS Trust/PPO |
$5,721.97
|
| Rate for Payer: BCN Commercial |
$5,721.97
|
| Rate for Payer: Cash Price |
$5,904.26
|
| Rate for Payer: Cofinity Commercial |
$6,937.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,904.26
|
| Rate for Payer: Healthscope Commercial |
$7,380.33
|
| Rate for Payer: Healthscope Whirlpool |
$7,158.92
|
| Rate for Payer: Mclaren Commercial |
$6,642.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,273.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,166.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,494.69
|
|
|
HC EXCISION OF ANAL LESION(S)
|
Facility
|
OP
|
$7,380.33
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
76100350
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,365.19 |
| Max. Negotiated Rate |
$7,380.33 |
| Rate for Payer: Aetna Commercial |
$6,642.30
|
| Rate for Payer: Aetna Medicare |
$2,495.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,119.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,119.72
|
| Rate for Payer: ASR ASR |
$7,158.92
|
| Rate for Payer: BCBS Complete |
$1,433.58
|
| Rate for Payer: BCBS MAPPO |
$2,495.78
|
| Rate for Payer: BCBS Trust/PPO |
$5,721.97
|
| Rate for Payer: BCN Commercial |
$5,721.97
|
| Rate for Payer: BCN Medicare Advantage |
$2,495.78
|
| Rate for Payer: Cash Price |
$5,904.26
|
| Rate for Payer: Cash Price |
$5,904.26
|
| Rate for Payer: Cofinity Commercial |
$6,937.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,904.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,495.78
|
| Rate for Payer: Healthscope Commercial |
$7,380.33
|
| Rate for Payer: Healthscope Whirlpool |
$7,158.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,495.78
|
| Rate for Payer: Mclaren Commercial |
$6,642.30
|
| Rate for Payer: Mclaren Medicaid |
$1,365.19
|
| Rate for Payer: Mclaren Medicare |
$2,495.78
|
| Rate for Payer: Meridian Medicaid |
$1,433.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,620.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,870.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,273.28
|
| Rate for Payer: PACE Medicare |
$2,370.99
|
| Rate for Payer: PACE SWMI |
$2,495.78
|
| Rate for Payer: PHP Commercial |
$2,745.36
|
| Rate for Payer: PHP Medicaid |
$1,365.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,495.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,365.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,166.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,716.10
|
| Rate for Payer: Priority Health Medicare |
$2,495.78
|
| Rate for Payer: Priority Health Narrow Network |
$5,240.03
|
| Rate for Payer: Railroad Medicare Medicare |
$2,495.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,494.69
|
| Rate for Payer: UHC Medicare Advantage |
$2,570.65
|
| Rate for Payer: VA VA |
$2,495.78
|
|
|
HC EXCISION OF NAIL OR NAIL MATRIX
|
Facility
|
IP
|
$388.03
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
76100077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$271.62 |
| Max. Negotiated Rate |
$388.03 |
| Rate for Payer: Aetna Commercial |
$349.23
|
| Rate for Payer: ASR ASR |
$376.39
|
| Rate for Payer: BCBS Trust/PPO |
$300.84
|
| Rate for Payer: BCN Commercial |
$300.84
|
| Rate for Payer: Cash Price |
$310.42
|
| Rate for Payer: Cofinity Commercial |
$364.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.42
|
| Rate for Payer: Healthscope Commercial |
$388.03
|
| Rate for Payer: Healthscope Whirlpool |
$376.39
|
| Rate for Payer: Mclaren Commercial |
$349.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$329.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$271.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$341.47
|
|
|
HC EXCISION OF NAIL OR NAIL MATRIX
|
Facility
|
OP
|
$388.03
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
76100077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.87 |
| Max. Negotiated Rate |
$719.35 |
| Rate for Payer: Aetna Commercial |
$349.23
|
| 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 |
$376.39
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$300.84
|
| Rate for Payer: BCN Commercial |
$300.84
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$310.42
|
| Rate for Payer: Cash Price |
$310.42
|
| Rate for Payer: Cofinity Commercial |
$364.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$388.03
|
| Rate for Payer: Healthscope Whirlpool |
$376.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.43
|
| Rate for Payer: Mclaren Commercial |
$349.23
|
| 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 |
$329.83
|
| 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 |
$271.62
|
| 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 |
$341.47
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: VA VA |
$354.43
|
|
|
HC EXCISION OF PENIS LESION(S)
|
Facility
|
IP
|
$5,174.31
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
76100347
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$3,622.02 |
| Max. Negotiated Rate |
$5,174.31 |
| Rate for Payer: Aetna Commercial |
$4,656.88
|
| Rate for Payer: ASR ASR |
$5,019.08
|
| Rate for Payer: BCBS Trust/PPO |
$4,011.64
|
| Rate for Payer: BCN Commercial |
$4,011.64
|
| Rate for Payer: Cash Price |
$4,139.45
|
| Rate for Payer: Cofinity Commercial |
$4,863.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,139.45
|
| Rate for Payer: Healthscope Commercial |
$5,174.31
|
| Rate for Payer: Healthscope Whirlpool |
$5,019.08
|
| Rate for Payer: Mclaren Commercial |
$4,656.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,398.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,622.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,553.39
|
|
|
HC EXCISION OF PENIS LESION(S)
|
Facility
|
OP
|
$5,174.31
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
76100347
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$886.68 |
| Max. Negotiated Rate |
$5,174.31 |
| Rate for Payer: Aetna Commercial |
$4,656.88
|
| Rate for Payer: Aetna Medicare |
$1,620.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: ASR ASR |
$5,019.08
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$4,011.64
|
| Rate for Payer: BCN Commercial |
$4,011.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Cash Price |
$4,139.45
|
| Rate for Payer: Cash Price |
$4,139.45
|
| Rate for Payer: Cofinity Commercial |
$4,863.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,139.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Healthscope Commercial |
$5,174.31
|
| Rate for Payer: Healthscope Whirlpool |
$5,019.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,620.98
|
| Rate for Payer: Mclaren Commercial |
$4,656.88
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,398.16
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Commercial |
$1,783.08
|
| Rate for Payer: PHP Medicaid |
$886.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,622.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,708.62
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$3,673.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,553.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: VA VA |
$1,620.98
|
|
|
HC EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Facility
|
IP
|
$3,867.86
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
76100321
|
| Min. Negotiated Rate |
$2,707.50 |
| Max. Negotiated Rate |
$3,867.86 |
| Rate for Payer: Aetna Commercial |
$3,481.07
|
| Rate for Payer: ASR ASR |
$3,751.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,998.75
|
| Rate for Payer: BCN Commercial |
$2,998.75
|
| Rate for Payer: Cash Price |
$3,094.29
|
| Rate for Payer: Cofinity Commercial |
$3,635.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,094.29
|
| Rate for Payer: Healthscope Commercial |
$3,867.86
|
| Rate for Payer: Healthscope Whirlpool |
$3,751.82
|
| Rate for Payer: Mclaren Commercial |
$3,481.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,287.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,707.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,403.72
|
|
|
HC EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Facility
|
OP
|
$3,867.86
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
76100321
|
| Min. Negotiated Rate |
$1,381.58 |
| Max. Negotiated Rate |
$3,867.86 |
| Rate for Payer: Aetna Commercial |
$3,481.07
|
| 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 |
$3,751.82
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,998.75
|
| Rate for Payer: BCN Commercial |
$2,998.75
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$3,094.29
|
| Rate for Payer: Cash Price |
$3,094.29
|
| Rate for Payer: Cofinity Commercial |
$3,635.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,094.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$3,867.86
|
| Rate for Payer: Healthscope Whirlpool |
$3,751.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$3,481.07
|
| 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 |
$3,287.68
|
| 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 |
$2,707.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,519.75
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,746.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,403.72
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
HC EXCISION SOFT TISSUE PELVIS HIP SUBQ <3CM
|
Facility
|
IP
|
$7,022.49
|
|
|
Service Code
|
CPT 27047
|
| Hospital Charge Code |
76100439
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,915.74 |
| Max. Negotiated Rate |
$7,022.49 |
| Rate for Payer: Aetna Commercial |
$6,320.24
|
| Rate for Payer: ASR ASR |
$6,811.82
|
| Rate for Payer: BCBS Trust/PPO |
$5,444.54
|
| Rate for Payer: BCN Commercial |
$5,444.54
|
| Rate for Payer: Cash Price |
$5,617.99
|
| Rate for Payer: Cofinity Commercial |
$6,601.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,617.99
|
| Rate for Payer: Healthscope Commercial |
$7,022.49
|
| Rate for Payer: Healthscope Whirlpool |
$6,811.82
|
| Rate for Payer: Mclaren Commercial |
$6,320.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,969.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,915.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,179.79
|
|
|
HC EXCISION SOFT TISSUE PELVIS HIP SUBQ <3CM
|
Facility
|
OP
|
$7,022.49
|
|
|
Service Code
|
CPT 27047
|
| Hospital Charge Code |
76100439
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,381.58 |
| Max. Negotiated Rate |
$7,022.49 |
| Rate for Payer: Aetna Commercial |
$6,320.24
|
| 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 |
$6,811.82
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$5,444.54
|
| Rate for Payer: BCN Commercial |
$5,444.54
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$5,617.99
|
| Rate for Payer: Cash Price |
$5,617.99
|
| Rate for Payer: Cofinity Commercial |
$6,601.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,617.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$7,022.49
|
| Rate for Payer: Healthscope Whirlpool |
$6,811.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$6,320.24
|
| 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 |
$5,969.12
|
| 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 |
$4,915.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,390.47
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$4,985.97
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,179.79
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
HC EXCISION TONSIL TAGS
|
Facility
|
IP
|
$7,963.00
|
|
|
Service Code
|
CPT 42860
|
| Hospital Charge Code |
76100477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,574.10 |
| Max. Negotiated Rate |
$7,963.00 |
| Rate for Payer: Aetna Commercial |
$7,166.70
|
| Rate for Payer: ASR ASR |
$7,724.11
|
| Rate for Payer: BCBS Trust/PPO |
$6,173.71
|
| Rate for Payer: BCN Commercial |
$6,173.71
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cofinity Commercial |
$7,485.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,370.40
|
| Rate for Payer: Healthscope Commercial |
$7,963.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,724.11
|
| Rate for Payer: Mclaren Commercial |
$7,166.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,768.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,574.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,007.44
|
|
|
HC EXCISION TONSIL TAGS
|
Facility
|
OP
|
$7,963.00
|
|
|
Service Code
|
CPT 42860
|
| Hospital Charge Code |
76100477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,565.43 |
| Max. Negotiated Rate |
$7,963.00 |
| Rate for Payer: Aetna Commercial |
$7,166.70
|
| 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 |
$7,724.11
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$6,173.71
|
| Rate for Payer: BCN Commercial |
$6,173.71
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cofinity Commercial |
$7,485.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,370.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Healthscope Commercial |
$7,963.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,724.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,861.84
|
| Rate for Payer: Mclaren Commercial |
$7,166.70
|
| 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 |
$6,768.55
|
| 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 |
$5,574.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,246.33
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$5,653.73
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,007.44
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: VA VA |
$2,861.84
|
|
|
HC EXCISION VAGINAL CYST/TUMOR
|
Facility
|
IP
|
$7,789.74
|
|
|
Service Code
|
CPT 57135
|
| Hospital Charge Code |
76100333
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,452.82 |
| Max. Negotiated Rate |
$7,789.74 |
| Rate for Payer: Aetna Commercial |
$7,010.77
|
| Rate for Payer: ASR ASR |
$7,556.05
|
| Rate for Payer: BCBS Trust/PPO |
$6,039.39
|
| Rate for Payer: BCN Commercial |
$6,039.39
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$7,322.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Healthscope Commercial |
$7,789.74
|
| Rate for Payer: Healthscope Whirlpool |
$7,556.05
|
| Rate for Payer: Mclaren Commercial |
$7,010.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,854.97
|
|
