|
HC EXC SKIN MALIG >4 CM TRUNK, ARM, LEG
|
Facility
|
OP
|
$2,104.52
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
76100211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$2,104.52 |
| Rate for Payer: Aetna Commercial |
$1,894.07
|
| 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 |
$2,041.38
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,631.63
|
| Rate for Payer: BCN Commercial |
$1,631.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,978.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$2,104.52
|
| Rate for Payer: Healthscope Whirlpool |
$2,041.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,894.07
|
| 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 |
$1,788.84
|
| 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 |
$1,473.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,915.11
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,494.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,851.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC EXC SKIN MALIG >4 CM TRUNK, ARM, LEG
|
Facility
|
IP
|
$2,104.52
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
76100211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,473.16 |
| Max. Negotiated Rate |
$2,104.52 |
| Rate for Payer: Aetna Commercial |
$1,894.07
|
| Rate for Payer: ASR ASR |
$2,041.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,631.63
|
| Rate for Payer: BCN Commercial |
$1,631.63
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,978.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Healthscope Commercial |
$2,104.52
|
| Rate for Payer: Healthscope Whirlpool |
$2,041.38
|
| Rate for Payer: Mclaren Commercial |
$1,894.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,851.98
|
|
|
HC EXC SKIN MALIG >4 REMAINDER BODY
|
Facility
|
IP
|
$3,638.85
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
76100214
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,547.20 |
| Max. Negotiated Rate |
$3,638.85 |
| Rate for Payer: Aetna Commercial |
$3,274.96
|
| Rate for Payer: ASR ASR |
$3,529.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,821.20
|
| Rate for Payer: BCN Commercial |
$2,821.20
|
| Rate for Payer: Cash Price |
$2,911.08
|
| Rate for Payer: Cofinity Commercial |
$3,420.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,911.08
|
| Rate for Payer: Healthscope Commercial |
$3,638.85
|
| Rate for Payer: Healthscope Whirlpool |
$3,529.68
|
| Rate for Payer: Mclaren Commercial |
$3,274.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,093.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,547.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,202.19
|
|
|
HC EXC SKIN MALIG >4 REMAINDER BODY
|
Facility
|
OP
|
$3,638.85
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
76100214
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,381.58 |
| Max. Negotiated Rate |
$3,638.85 |
| Rate for Payer: Aetna Commercial |
$3,274.96
|
| 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 |
$3,529.68
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,821.20
|
| Rate for Payer: BCN Commercial |
$2,821.20
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$2,911.08
|
| Rate for Payer: Cash Price |
$2,911.08
|
| Rate for Payer: Cofinity Commercial |
$3,420.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,911.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$3,638.85
|
| Rate for Payer: Healthscope Whirlpool |
$3,529.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$3,274.96
|
| 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 |
$3,093.02
|
| 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 |
$2,547.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,311.35
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,583.58
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,202.19
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
HC EXC THROMBOSED HEMORRHOID EXTERN
|
Facility
|
IP
|
$3,173.10
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
36000106
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,221.17 |
| Max. Negotiated Rate |
$3,173.10 |
| Rate for Payer: Aetna Commercial |
$2,855.79
|
| Rate for Payer: ASR ASR |
$3,077.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,460.10
|
| Rate for Payer: BCN Commercial |
$2,460.10
|
| Rate for Payer: Cash Price |
$2,538.48
|
| Rate for Payer: Cofinity Commercial |
$2,982.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,538.48
|
| Rate for Payer: Healthscope Commercial |
$3,173.10
|
| Rate for Payer: Healthscope Whirlpool |
$3,077.91
|
| Rate for Payer: Mclaren Commercial |
$2,855.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,697.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,221.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,792.33
|
|
|
HC EXC THROMBOSED HEMORRHOID EXTERN
|
Facility
|
OP
|
$3,173.10
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
36000106
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$573.77 |
| Max. Negotiated Rate |
$3,441.80 |
| Rate for Payer: Aetna Commercial |
$2,855.79
|
| Rate for Payer: Aetna Medicare |
$1,048.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
| Rate for Payer: ASR ASR |
$3,077.91
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,460.10
|
| Rate for Payer: BCN Commercial |
$2,460.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$2,538.48
|
| Rate for Payer: Cash Price |
$2,538.48
|
| Rate for Payer: Cofinity Commercial |
$2,982.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,538.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$3,173.10
|
| Rate for Payer: Healthscope Whirlpool |
$3,077.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,048.94
|
| Rate for Payer: Mclaren Commercial |
$2,855.79
|
| Rate for Payer: Mclaren Medicaid |
$573.77
|
| Rate for Payer: Mclaren Medicare |
$1,048.94
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,697.14
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$1,153.83
|
| Rate for Payer: PHP Medicaid |
$573.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,221.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,441.80
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,753.44
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,792.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: VA VA |
$1,048.94
|
|
|
HC EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ >3CM
|
Facility
|
IP
|
$3,547.91
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
76100245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,483.54 |
| Max. Negotiated Rate |
$3,547.91 |
| Rate for Payer: Aetna Commercial |
$3,193.12
|
| Rate for Payer: ASR ASR |
$3,441.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,750.69
|
| Rate for Payer: BCN Commercial |
$2,750.69
|
| Rate for Payer: Cash Price |
$2,838.33
|
| Rate for Payer: Cofinity Commercial |
$3,335.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,838.33
|
| Rate for Payer: Healthscope Commercial |
$3,547.91
|
| Rate for Payer: Healthscope Whirlpool |
$3,441.47
|
| Rate for Payer: Mclaren Commercial |
$3,193.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,015.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,483.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,122.16
|
|
|
HC EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ >3CM
|
Facility
|
OP
|
$3,547.91
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
76100245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,381.58 |
| Max. Negotiated Rate |
$3,547.91 |
| Rate for Payer: Aetna Commercial |
$3,193.12
|
| 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 |
$3,441.47
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,750.69
|
| Rate for Payer: BCN Commercial |
$2,750.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$2,838.33
|
| Rate for Payer: Cash Price |
$2,838.33
|
| Rate for Payer: Cofinity Commercial |
$3,335.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,838.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$3,547.91
|
| Rate for Payer: Healthscope Whirlpool |
$3,441.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$3,193.12
|
| 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 |
$3,015.72
|
| 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 |
$2,483.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,228.60
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,519.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,122.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <3CM
|
Facility
|
OP
|
$2,100.08
|
|
|
Service Code
|
CPT 22902
|
| Hospital Charge Code |
76100277
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$2,100.08 |
| Rate for Payer: Aetna Commercial |
$1,890.07
|
| 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 |
$2,037.08
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.19
|
| Rate for Payer: BCN Commercial |
$1,628.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,974.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$2,100.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,037.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,890.07
|
| 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 |
$1,785.07
|
| 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 |
$1,470.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,911.07
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,491.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,848.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <3CM
|
Facility
|
IP
|
$2,100.08
|
|
|
Service Code
|
CPT 22902
|
| Hospital Charge Code |
76100277
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,470.06 |
| Max. Negotiated Rate |
$2,100.08 |
| Rate for Payer: Aetna Commercial |
$1,890.07
|
| Rate for Payer: ASR ASR |
$2,037.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.19
|
| Rate for Payer: BCN Commercial |
$1,628.19
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,974.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Healthscope Commercial |
$2,100.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,037.08
|
| Rate for Payer: Mclaren Commercial |
$1,890.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,785.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,848.07
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <5CM
|
Facility
|
OP
|
$3,500.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
76100398
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,381.58 |
| Max. Negotiated Rate |
$3,500.00 |
| Rate for Payer: Aetna Commercial |
$3,150.00
|
| 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 |
$3,395.00
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,713.55
|
| Rate for Payer: BCN Commercial |
$2,713.55
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$2,800.00
|
| Rate for Payer: Cash Price |
$2,800.00
|
| Rate for Payer: Cofinity Commercial |
$3,290.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,800.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$3,500.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,395.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$3,150.00
|
| 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 |
$2,975.00
|
| 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 |
$2,450.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,185.00
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,485.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,080.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <5CM
|
Facility
|
IP
|
$3,500.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
76100398
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,450.00 |
| Max. Negotiated Rate |
$3,500.00 |
| Rate for Payer: Aetna Commercial |
$3,150.00
|
| Rate for Payer: ASR ASR |
$3,395.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,713.55
|
| Rate for Payer: BCN Commercial |
$2,713.55
|
| Rate for Payer: Cash Price |
$2,800.00
|
| Rate for Payer: Cofinity Commercial |
$3,290.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,800.00
|
| Rate for Payer: Healthscope Commercial |
$3,500.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,395.00
|
| Rate for Payer: Mclaren Commercial |
$3,150.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,975.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,450.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,080.00
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SQ < 3CM
|
Facility
|
OP
|
$2,100.08
|
|
|
Service Code
|
CPT 21930
|
| Hospital Charge Code |
76100227
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$2,100.08 |
| Rate for Payer: Aetna Commercial |
$1,890.07
|
| 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 |
$2,037.08
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.19
|
| Rate for Payer: BCN Commercial |
$1,628.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,974.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$2,100.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,037.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,890.07
|
| 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 |
$1,785.07
|
| 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 |
$1,470.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,911.07
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,491.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,848.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SQ < 3CM
|
Facility
|
IP
|
$2,100.08
|
|
|
Service Code
|
CPT 21930
|
| Hospital Charge Code |
76100227
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,470.06 |
| Max. Negotiated Rate |
$2,100.08 |
| Rate for Payer: Aetna Commercial |
$1,890.07
|
| Rate for Payer: ASR ASR |
$2,037.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.19
|
| Rate for Payer: BCN Commercial |
$1,628.19
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,974.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Healthscope Commercial |
$2,100.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,037.08
|
| Rate for Payer: Mclaren Commercial |
$1,890.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,785.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,848.07
|
|
|
HC EXC TUMOR SOFT TISSUE, BACK/FLANK, SUBFASCIAL <5CM
|
Facility
|
OP
|
$3,547.91
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
76100268
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,381.58 |
| Max. Negotiated Rate |
$3,547.91 |
| Rate for Payer: Aetna Commercial |
$3,193.12
|
| 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 |
$3,441.47
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,750.69
|
| Rate for Payer: BCN Commercial |
$2,750.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$2,838.33
|
| Rate for Payer: Cash Price |
$2,838.33
|
| Rate for Payer: Cofinity Commercial |
$3,335.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,838.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$3,547.91
|
| Rate for Payer: Healthscope Whirlpool |
$3,441.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$3,193.12
|
| 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 |
$3,015.72
|
| 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 |
$2,483.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,228.60
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,519.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,122.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
HC EXC TUMOR SOFT TISSUE, BACK/FLANK, SUBFASCIAL <5CM
|
Facility
|
IP
|
$3,547.91
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
76100268
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,483.54 |
| Max. Negotiated Rate |
$3,547.91 |
| Rate for Payer: Aetna Commercial |
$3,193.12
|
| Rate for Payer: ASR ASR |
$3,441.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,750.69
|
| Rate for Payer: BCN Commercial |
$2,750.69
|
| Rate for Payer: Cash Price |
$2,838.33
|
| Rate for Payer: Cofinity Commercial |
$3,335.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,838.33
|
| Rate for Payer: Healthscope Commercial |
$3,547.91
|
| Rate for Payer: Healthscope Whirlpool |
$3,441.47
|
| Rate for Payer: Mclaren Commercial |
$3,193.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,015.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,483.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,122.16
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SUBQ >3CM
|
Facility
|
IP
|
$2,380.09
|
|
|
Service Code
|
CPT 21931
|
| Hospital Charge Code |
76100244
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,666.06 |
| Max. Negotiated Rate |
$2,380.09 |
| Rate for Payer: Aetna Commercial |
$2,142.08
|
| Rate for Payer: ASR ASR |
$2,308.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,845.28
|
| Rate for Payer: BCN Commercial |
$1,845.28
|
| Rate for Payer: Cash Price |
$1,904.07
|
| Rate for Payer: Cofinity Commercial |
$2,237.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,904.07
|
| Rate for Payer: Healthscope Commercial |
$2,380.09
|
| Rate for Payer: Healthscope Whirlpool |
$2,308.69
|
| Rate for Payer: Mclaren Commercial |
$2,142.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,023.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,666.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,094.48
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SUBQ >3CM
|
Facility
|
OP
|
$2,380.09
|
|
|
Service Code
|
CPT 21931
|
| Hospital Charge Code |
76100244
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$2,380.09 |
| Rate for Payer: Aetna Commercial |
$2,142.08
|
| 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 |
$2,308.69
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,845.28
|
| Rate for Payer: BCN Commercial |
$1,845.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,904.07
|
| Rate for Payer: Cash Price |
$1,904.07
|
| Rate for Payer: Cofinity Commercial |
$2,237.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,904.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$2,380.09
|
| Rate for Payer: Healthscope Whirlpool |
$2,308.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$2,142.08
|
| 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 |
$2,023.08
|
| 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 |
$1,666.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,165.88
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,689.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,094.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC EXC TUMOR SOFT TISSUE FACE SCALP SUBQ <2CM
|
Facility
|
IP
|
$4,351.32
|
|
|
Service Code
|
CPT 21011
|
| Hospital Charge Code |
76100323
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,045.92 |
| Max. Negotiated Rate |
$4,351.32 |
| Rate for Payer: Aetna Commercial |
$3,916.19
|
| Rate for Payer: ASR ASR |
$4,220.78
|
| Rate for Payer: BCBS Trust/PPO |
$3,373.58
|
| Rate for Payer: BCN Commercial |
$3,373.58
|
| Rate for Payer: Cash Price |
$3,481.06
|
| Rate for Payer: Cofinity Commercial |
$4,090.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,481.06
|
| Rate for Payer: Healthscope Commercial |
$4,351.32
|
| Rate for Payer: Healthscope Whirlpool |
$4,220.78
|
| Rate for Payer: Mclaren Commercial |
$3,916.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,698.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,045.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,829.16
|
|
|
HC EXC TUMOR SOFT TISSUE FACE SCALP SUBQ <2CM
|
Facility
|
OP
|
$4,351.32
|
|
|
Service Code
|
CPT 21011
|
| Hospital Charge Code |
76100323
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$4,351.32 |
| Rate for Payer: Aetna Commercial |
$3,916.19
|
| 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 |
$4,220.78
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,373.58
|
| Rate for Payer: BCN Commercial |
$3,373.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$3,481.06
|
| Rate for Payer: Cash Price |
$3,481.06
|
| Rate for Payer: Cofinity Commercial |
$4,090.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,481.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$4,351.32
|
| Rate for Payer: Healthscope Whirlpool |
$4,220.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$3,916.19
|
| 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 |
$3,698.62
|
| 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 |
$3,045.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,959.70
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,089.44
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,829.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC EXC TUMOR SOFT TISSUE FACE/SCALP, SUBQ 2CM OR >
|
Facility
|
OP
|
$2,100.08
|
|
|
Service Code
|
CPT 21012
|
| Hospital Charge Code |
76100246
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$2,100.08 |
| Rate for Payer: Aetna Commercial |
$1,890.07
|
| 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 |
$2,037.08
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.19
|
| Rate for Payer: BCN Commercial |
$1,628.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,974.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$2,100.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,037.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,890.07
|
| 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 |
$1,785.07
|
| 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 |
$1,470.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,911.07
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,491.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,848.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC EXC TUMOR SOFT TISSUE FACE/SCALP, SUBQ 2CM OR >
|
Facility
|
IP
|
$2,100.08
|
|
|
Service Code
|
CPT 21012
|
| Hospital Charge Code |
76100246
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,470.06 |
| Max. Negotiated Rate |
$2,100.08 |
| Rate for Payer: Aetna Commercial |
$1,890.07
|
| Rate for Payer: ASR ASR |
$2,037.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.19
|
| Rate for Payer: BCN Commercial |
$1,628.19
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,974.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Healthscope Commercial |
$2,100.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,037.08
|
| Rate for Payer: Mclaren Commercial |
$1,890.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,785.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,848.07
|
|
|
HC EXC TUMOR SOFT TISSUE FOREARM DEEP<3CM
|
Facility
|
IP
|
$4,198.00
|
|
|
Service Code
|
CPT 25076
|
| Hospital Charge Code |
76100515
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,938.60 |
| Max. Negotiated Rate |
$4,198.00 |
| Rate for Payer: Aetna Commercial |
$3,778.20
|
| Rate for Payer: ASR ASR |
$4,072.06
|
| Rate for Payer: BCBS Trust/PPO |
$3,254.71
|
| Rate for Payer: BCN Commercial |
$3,254.71
|
| Rate for Payer: Cash Price |
$3,358.40
|
| Rate for Payer: Cofinity Commercial |
$3,946.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,358.40
|
| Rate for Payer: Healthscope Commercial |
$4,198.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,072.06
|
| Rate for Payer: Mclaren Commercial |
$3,778.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,568.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,938.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,694.24
|
|
|
HC EXC TUMOR SOFT TISSUE FOREARM DEEP<3CM
|
Facility
|
OP
|
$4,198.00
|
|
|
Service Code
|
CPT 25076
|
| Hospital Charge Code |
76100515
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$4,198.00 |
| Rate for Payer: Aetna Commercial |
$3,778.20
|
| 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 |
$4,072.06
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,254.71
|
| Rate for Payer: BCN Commercial |
$3,254.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$3,358.40
|
| Rate for Payer: Cash Price |
$3,358.40
|
| Rate for Payer: Cofinity Commercial |
$3,946.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,358.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$4,198.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,072.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$3,778.20
|
| 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 |
$3,568.30
|
| 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 |
$2,938.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,820.18
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,980.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,694.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC EXC TUMOR SOFT TISSUE FOREARM/WRIST, SQ <3CM
|
Facility
|
OP
|
$2,100.08
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
76100255
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$2,100.08 |
| Rate for Payer: Aetna Commercial |
$1,890.07
|
| 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 |
$2,037.08
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.19
|
| Rate for Payer: BCN Commercial |
$1,628.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,974.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$2,100.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,037.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,890.07
|
| 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 |
$1,785.07
|
| 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 |
$1,470.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,911.07
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,491.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,848.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
