|
HC DESTRUCTION LESION(S) VULVA, EXTENSIVE
|
Facility
|
IP
|
$2,583.10
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
76100235
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,937.33 |
| Max. Negotiated Rate |
$2,583.10 |
| Rate for Payer: Aetna Commercial |
$2,324.79
|
| Rate for Payer: ASR ASR |
$2,505.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,121.24
|
| Rate for Payer: BCN Commercial |
$2,121.24
|
| Rate for Payer: Cash Price |
$2,066.48
|
| Rate for Payer: Cofinity Commercial |
$2,428.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,066.48
|
| Rate for Payer: Healthscope Commercial |
$2,505.61
|
| Rate for Payer: Healthscope Whirlpool |
$2,583.10
|
| Rate for Payer: Mclaren Commercial |
$2,324.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,195.64
|
| Rate for Payer: Nomi Health Commercial |
$2,118.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,937.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,273.13
|
|
|
HC DESTRUCTION LESION(S) VULVA, SIMPLE
|
Facility
|
OP
|
$2,583.10
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
76100233
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,075.21 |
| Max. Negotiated Rate |
$3,186.58 |
| Rate for Payer: Aetna Commercial |
$2,324.79
|
| Rate for Payer: Aetna Medicare |
$2,055.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: ASR ASR |
$2,505.61
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,129.77
|
| Rate for Payer: BCN Commercial |
$2,129.77
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Cash Price |
$2,066.48
|
| Rate for Payer: Cash Price |
$2,066.48
|
| Rate for Payer: Cofinity Commercial |
$2,428.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,066.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Healthscope Commercial |
$2,505.61
|
| Rate for Payer: Healthscope Whirlpool |
$2,583.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,055.86
|
| Rate for Payer: Mclaren Commercial |
$2,324.79
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$1,129.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,195.64
|
| Rate for Payer: Nomi Health Commercial |
$2,118.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,937.33
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Commercial |
$2,261.45
|
| Rate for Payer: PHP Medicaid |
$1,101.94
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,263.31
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,810.75
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,273.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Exchange |
$3,186.58
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP DNSP |
$2,055.86
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: VA VA |
$2,055.86
|
|
|
HC DESTRUCTION LESION(S) VULVA, SIMPLE
|
Facility
|
IP
|
$2,583.10
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
76100233
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,937.33 |
| Max. Negotiated Rate |
$2,583.10 |
| Rate for Payer: Aetna Commercial |
$2,324.79
|
| Rate for Payer: ASR ASR |
$2,505.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,121.24
|
| Rate for Payer: BCN Commercial |
$2,121.24
|
| Rate for Payer: Cash Price |
$2,066.48
|
| Rate for Payer: Cofinity Commercial |
$2,428.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,066.48
|
| Rate for Payer: Healthscope Commercial |
$2,505.61
|
| Rate for Payer: Healthscope Whirlpool |
$2,583.10
|
| Rate for Payer: Mclaren Commercial |
$2,324.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,195.64
|
| Rate for Payer: Nomi Health Commercial |
$2,118.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,937.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,273.13
|
|
|
HC DESTRUCT MALIG LESION FACE,EAR,EYELID,NOSE,LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
OP
|
$400.07
|
|
|
Service Code
|
CPT 17282
|
| Hospital Charge Code |
76100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$400.07 |
| Rate for Payer: Aetna Commercial |
$360.06
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$388.07
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$329.86
|
| Rate for Payer: BCN Commercial |
$329.86
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cofinity Commercial |
$376.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$388.07
|
| Rate for Payer: Healthscope Whirlpool |
$400.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$360.06
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.06
|
| Rate for Payer: Nomi Health Commercial |
$328.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$300.05
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$350.54
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$280.45
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$352.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$309.86
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
HC DESTRUCT MALIG LESION FACE,EAR,EYELID,NOSE,LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
IP
|
$400.07
|
|
|
Service Code
|
CPT 17282
|
| Hospital Charge Code |
76100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$300.05 |
| Max. Negotiated Rate |
$400.07 |
| Rate for Payer: Aetna Commercial |
$360.06
|
| Rate for Payer: ASR ASR |
$388.07
|
| Rate for Payer: BCBS Trust/PPO |
$328.54
|
| Rate for Payer: BCN Commercial |
$328.54
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cofinity Commercial |
$376.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.06
|
| Rate for Payer: Healthscope Commercial |
$388.07
|
| Rate for Payer: Healthscope Whirlpool |
$400.07
|
| Rate for Payer: Mclaren Commercial |
$360.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.06
|
| Rate for Payer: Nomi Health Commercial |
$328.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$300.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$352.06
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA <0.6 CM
|
Facility
|
IP
|
$223.91
|
|
|
Service Code
|
CPT 17270
|
| Hospital Charge Code |
76100154
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$167.93 |
| Max. Negotiated Rate |
$223.91 |
| Rate for Payer: Aetna Commercial |
$201.52
|
| Rate for Payer: ASR ASR |
$217.19
|
| Rate for Payer: BCBS Trust/PPO |
$183.87
|
| Rate for Payer: BCN Commercial |
$183.87
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cofinity Commercial |
$210.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.13
|
| Rate for Payer: Healthscope Commercial |
$217.19
|
| Rate for Payer: Healthscope Whirlpool |
$223.91
|
| Rate for Payer: Mclaren Commercial |
$201.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.32
|
| Rate for Payer: Nomi Health Commercial |
$183.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$197.04
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA <0.6 CM
|
Facility
|
OP
|
$223.91
|
|
|
Service Code
|
CPT 17270
|
| Hospital Charge Code |
76100154
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$309.86 |
| Rate for Payer: Aetna Commercial |
$201.52
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$217.19
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$184.61
|
| Rate for Payer: BCN Commercial |
$184.61
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cofinity Commercial |
$210.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$217.19
|
| Rate for Payer: Healthscope Whirlpool |
$223.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$201.52
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.32
|
| Rate for Payer: Nomi Health Commercial |
$183.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.93
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$196.19
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$156.96
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$197.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$309.86
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 17271
|
| Hospital Charge Code |
76100128
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$309.86 |
| Rate for Payer: Aetna Commercial |
$258.50
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$278.60
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$236.81
|
| Rate for Payer: BCN Commercial |
$236.81
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$269.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$278.60
|
| Rate for Payer: Healthscope Whirlpool |
$287.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$258.50
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$251.66
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$201.34
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$309.86
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
IP
|
$287.22
|
|
|
Service Code
|
CPT 17271
|
| Hospital Charge Code |
76100128
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$215.41 |
| Max. Negotiated Rate |
$287.22 |
| Rate for Payer: Aetna Commercial |
$258.50
|
| Rate for Payer: ASR ASR |
$278.60
|
| Rate for Payer: BCBS Trust/PPO |
$235.87
|
| Rate for Payer: BCN Commercial |
$235.87
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$269.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Healthscope Commercial |
$278.60
|
| Rate for Payer: Healthscope Whirlpool |
$287.22
|
| Rate for Payer: Mclaren Commercial |
$258.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.75
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
IP
|
$165.06
|
|
|
Service Code
|
CPT 17272
|
| Hospital Charge Code |
76100129
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.80 |
| Max. Negotiated Rate |
$165.06 |
| Rate for Payer: Aetna Commercial |
$148.55
|
| Rate for Payer: ASR ASR |
$160.11
|
| Rate for Payer: BCBS Trust/PPO |
$135.55
|
| Rate for Payer: BCN Commercial |
$135.55
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Commercial |
$155.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Healthscope Commercial |
$160.11
|
| Rate for Payer: Healthscope Whirlpool |
$165.06
|
| Rate for Payer: Mclaren Commercial |
$148.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Nomi Health Commercial |
$135.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.25
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
OP
|
$165.06
|
|
|
Service Code
|
CPT 17272
|
| Hospital Charge Code |
76100129
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$309.86 |
| Rate for Payer: Aetna Commercial |
$148.55
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$160.11
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$136.09
|
| Rate for Payer: BCN Commercial |
$136.09
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Commercial |
$155.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$160.11
|
| Rate for Payer: Healthscope Whirlpool |
$165.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$148.55
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Nomi Health Commercial |
$135.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$144.63
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$115.71
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$309.86
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
OP
|
$315.95
|
|
|
Service Code
|
CPT 17273
|
| Hospital Charge Code |
76100130
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$627.83 |
| Rate for Payer: Aetna Commercial |
$284.36
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$306.47
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$260.50
|
| Rate for Payer: BCN Commercial |
$260.50
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Commercial |
$296.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$306.47
|
| Rate for Payer: Healthscope Whirlpool |
$315.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$284.36
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Nomi Health Commercial |
$259.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$276.84
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$221.48
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$278.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$627.83
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
IP
|
$315.95
|
|
|
Service Code
|
CPT 17273
|
| Hospital Charge Code |
76100130
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$236.96 |
| Max. Negotiated Rate |
$315.95 |
| Rate for Payer: Aetna Commercial |
$284.36
|
| Rate for Payer: ASR ASR |
$306.47
|
| Rate for Payer: BCBS Trust/PPO |
$259.46
|
| Rate for Payer: BCN Commercial |
$259.46
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Commercial |
$296.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Healthscope Commercial |
$306.47
|
| Rate for Payer: Healthscope Whirlpool |
$315.95
|
| Rate for Payer: Mclaren Commercial |
$284.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Nomi Health Commercial |
$259.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$278.04
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
OP
|
$165.06
|
|
|
Service Code
|
CPT 17260
|
| Hospital Charge Code |
76100125
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$309.86 |
| Rate for Payer: Aetna Commercial |
$148.55
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$160.11
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$136.09
|
| Rate for Payer: BCN Commercial |
$136.09
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Commercial |
$155.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$160.11
|
| Rate for Payer: Healthscope Whirlpool |
$165.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$148.55
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Nomi Health Commercial |
$135.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$144.63
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$115.71
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$309.86
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
IP
|
$165.06
|
|
|
Service Code
|
CPT 17260
|
| Hospital Charge Code |
76100125
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.80 |
| Max. Negotiated Rate |
$165.06 |
| Rate for Payer: Aetna Commercial |
$148.55
|
| Rate for Payer: ASR ASR |
$160.11
|
| Rate for Payer: BCBS Trust/PPO |
$135.55
|
| Rate for Payer: BCN Commercial |
$135.55
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Commercial |
$155.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Healthscope Commercial |
$160.11
|
| Rate for Payer: Healthscope Whirlpool |
$165.06
|
| Rate for Payer: Mclaren Commercial |
$148.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Nomi Health Commercial |
$135.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.25
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$165.06
|
|
|
Service Code
|
CPT 17261
|
| Hospital Charge Code |
76100126
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$309.86 |
| Rate for Payer: Aetna Commercial |
$148.55
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$160.11
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$136.09
|
| Rate for Payer: BCN Commercial |
$136.09
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Commercial |
$155.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$160.11
|
| Rate for Payer: Healthscope Whirlpool |
$165.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$148.55
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Nomi Health Commercial |
$135.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$144.63
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$115.71
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$309.86
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$165.06
|
|
|
Service Code
|
CPT 17261
|
| Hospital Charge Code |
76100126
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.80 |
| Max. Negotiated Rate |
$165.06 |
| Rate for Payer: Aetna Commercial |
$148.55
|
| Rate for Payer: ASR ASR |
$160.11
|
| Rate for Payer: BCBS Trust/PPO |
$135.55
|
| Rate for Payer: BCN Commercial |
$135.55
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Commercial |
$155.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Healthscope Commercial |
$160.11
|
| Rate for Payer: Healthscope Whirlpool |
$165.06
|
| Rate for Payer: Mclaren Commercial |
$148.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Nomi Health Commercial |
$135.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.25
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$165.06
|
|
|
Service Code
|
CPT 17262
|
| Hospital Charge Code |
76100127
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$309.86 |
| Rate for Payer: Aetna Commercial |
$148.55
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$160.11
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$136.09
|
| Rate for Payer: BCN Commercial |
$136.09
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Commercial |
$155.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$160.11
|
| Rate for Payer: Healthscope Whirlpool |
$165.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$148.55
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Nomi Health Commercial |
$135.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$144.63
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$115.71
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$309.86
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$165.06
|
|
|
Service Code
|
CPT 17262
|
| Hospital Charge Code |
76100127
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.80 |
| Max. Negotiated Rate |
$165.06 |
| Rate for Payer: Aetna Commercial |
$148.55
|
| Rate for Payer: ASR ASR |
$160.11
|
| Rate for Payer: BCBS Trust/PPO |
$135.55
|
| Rate for Payer: BCN Commercial |
$135.55
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Commercial |
$155.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Healthscope Commercial |
$160.11
|
| Rate for Payer: Healthscope Whirlpool |
$165.06
|
| Rate for Payer: Mclaren Commercial |
$148.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Nomi Health Commercial |
$135.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.25
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$543.09
|
|
|
Service Code
|
CPT 17263
|
| Hospital Charge Code |
76100372
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$543.09 |
| Rate for Payer: Aetna Commercial |
$488.78
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$526.80
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$447.78
|
| Rate for Payer: BCN Commercial |
$447.78
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$434.47
|
| Rate for Payer: Cash Price |
$434.47
|
| Rate for Payer: Cofinity Commercial |
$510.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$526.80
|
| Rate for Payer: Healthscope Whirlpool |
$543.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$488.78
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.63
|
| Rate for Payer: Nomi Health Commercial |
$445.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$407.32
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$475.86
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$380.71
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$477.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$309.86
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$543.09
|
|
|
Service Code
|
CPT 17263
|
| Hospital Charge Code |
76100372
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$407.32 |
| Max. Negotiated Rate |
$543.09 |
| Rate for Payer: Aetna Commercial |
$488.78
|
| Rate for Payer: ASR ASR |
$526.80
|
| Rate for Payer: BCBS Trust/PPO |
$445.99
|
| Rate for Payer: BCN Commercial |
$445.99
|
| Rate for Payer: Cash Price |
$434.47
|
| Rate for Payer: Cofinity Commercial |
$510.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.47
|
| Rate for Payer: Healthscope Commercial |
$526.80
|
| Rate for Payer: Healthscope Whirlpool |
$543.09
|
| Rate for Payer: Mclaren Commercial |
$488.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.63
|
| Rate for Payer: Nomi Health Commercial |
$445.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$407.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$477.92
|
|
|
HC DESTRUCT MOUTH LESION
|
Facility
|
IP
|
$9,995.00
|
|
|
Service Code
|
CPT 40820
|
| Hospital Charge Code |
76100538
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7,496.25 |
| Max. Negotiated Rate |
$9,995.00 |
| Rate for Payer: Aetna Commercial |
$8,995.50
|
| Rate for Payer: ASR ASR |
$9,695.15
|
| Rate for Payer: BCBS Trust/PPO |
$8,207.89
|
| Rate for Payer: BCN Commercial |
$8,207.89
|
| Rate for Payer: Cash Price |
$7,996.00
|
| Rate for Payer: Cofinity Commercial |
$9,395.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,996.00
|
| Rate for Payer: Healthscope Commercial |
$9,695.15
|
| Rate for Payer: Healthscope Whirlpool |
$9,995.00
|
| Rate for Payer: Mclaren Commercial |
$8,995.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,495.75
|
| Rate for Payer: Nomi Health Commercial |
$8,195.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,496.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,795.60
|
|
|
HC DESTRUCT MOUTH LESION
|
Facility
|
OP
|
$9,995.00
|
|
|
Service Code
|
CPT 40820
|
| Hospital Charge Code |
76100538
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$9,995.00 |
| Rate for Payer: Aetna Commercial |
$8,995.50
|
| Rate for Payer: Aetna Medicare |
$3,303.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: ASR ASR |
$9,695.15
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$8,240.88
|
| Rate for Payer: BCN Commercial |
$8,240.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$7,996.00
|
| Rate for Payer: Cash Price |
$7,996.00
|
| Rate for Payer: Cofinity Commercial |
$9,395.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,996.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$9,695.15
|
| Rate for Payer: Healthscope Whirlpool |
$9,995.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,303.54
|
| Rate for Payer: Mclaren Commercial |
$8,995.50
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$1,814.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,495.75
|
| Rate for Payer: Nomi Health Commercial |
$8,195.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,496.25
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$3,633.89
|
| Rate for Payer: PHP Medicaid |
$1,770.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,757.62
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Narrow Network |
$7,006.49
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,795.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$5,120.49
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP DNSP |
$3,303.54
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
HC DESTRUCT NEURO AGENT PLANTAR DIGITAL NRV
|
Facility
|
OP
|
$417.06
|
|
|
Service Code
|
CPT 64632
|
| Hospital Charge Code |
36100608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$159.96 |
| Max. Negotiated Rate |
$474.07 |
| Rate for Payer: Aetna Commercial |
$375.35
|
| Rate for Payer: Aetna Medicare |
$305.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: ASR ASR |
$404.55
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$343.87
|
| Rate for Payer: BCN Commercial |
$343.87
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$333.65
|
| Rate for Payer: Cash Price |
$333.65
|
| Rate for Payer: Cofinity Commercial |
$392.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$404.55
|
| Rate for Payer: Healthscope Whirlpool |
$417.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$305.85
|
| Rate for Payer: Mclaren Commercial |
$375.35
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$167.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.50
|
| Rate for Payer: Nomi Health Commercial |
$341.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.80
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$336.44
|
| Rate for Payer: PHP Medicaid |
$163.94
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$365.43
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health Narrow Network |
$292.36
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$367.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$474.07
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP DNSP |
$305.85
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: VA VA |
$305.85
|
|
|
HC DESTRUCT NEURO AGENT PLANTAR DIGITAL NRV
|
Facility
|
IP
|
$417.06
|
|
|
Service Code
|
CPT 64632
|
| Hospital Charge Code |
36100608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$312.80 |
| Max. Negotiated Rate |
$417.06 |
| Rate for Payer: Aetna Commercial |
$375.35
|
| Rate for Payer: ASR ASR |
$404.55
|
| Rate for Payer: BCBS Trust/PPO |
$342.49
|
| Rate for Payer: BCN Commercial |
$342.49
|
| Rate for Payer: Cash Price |
$333.65
|
| Rate for Payer: Cofinity Commercial |
$392.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.65
|
| Rate for Payer: Healthscope Commercial |
$404.55
|
| Rate for Payer: Healthscope Whirlpool |
$417.06
|
| Rate for Payer: Mclaren Commercial |
$375.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.50
|
| Rate for Payer: Nomi Health Commercial |
$341.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$367.01
|
|
