|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
IP
|
$281.59
|
|
|
Service Code
|
CPT 17271
|
| Hospital Charge Code |
76100128
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.03 |
| Max. Negotiated Rate |
$281.59 |
| Rate for Payer: Aetna Commercial |
$253.43
|
| Rate for Payer: ASR ASR |
$273.14
|
| Rate for Payer: ASR Commercial |
$273.14
|
| Rate for Payer: BCBS Trust/PPO |
$229.47
|
| Rate for Payer: BCN Commercial |
$218.32
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$264.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Healthscope Commercial |
$281.59
|
| Rate for Payer: Healthscope Whirlpool |
$273.14
|
| Rate for Payer: Mclaren Commercial |
$253.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.80
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
OP
|
$161.82
|
|
|
Service Code
|
CPT 17272
|
| Hospital Charge Code |
76100129
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.35 |
| Max. Negotiated Rate |
$301.75 |
| Rate for Payer: Aetna Commercial |
$145.64
|
| Rate for Payer: Aetna Medicare |
$194.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: ASR ASR |
$156.97
|
| Rate for Payer: ASR Commercial |
$156.97
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$132.51
|
| Rate for Payer: BCN Commercial |
$125.46
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$161.82
|
| Rate for Payer: Healthscope Whirlpool |
$156.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$194.68
|
| Rate for Payer: Mclaren Commercial |
$145.64
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$214.15
|
| Rate for Payer: PHP Medicaid |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.79
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$113.44
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$301.75
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP DNSP |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: VA VA |
$194.68
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 17272
|
| Hospital Charge Code |
76100129
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.18 |
| Max. Negotiated Rate |
$161.82 |
| Rate for Payer: Aetna Commercial |
$145.64
|
| Rate for Payer: ASR ASR |
$156.97
|
| Rate for Payer: ASR Commercial |
$156.97
|
| Rate for Payer: BCBS Trust/PPO |
$131.87
|
| Rate for Payer: BCN Commercial |
$125.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Healthscope Commercial |
$161.82
|
| Rate for Payer: Healthscope Whirlpool |
$156.97
|
| Rate for Payer: Mclaren Commercial |
$145.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.40
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
IP
|
$309.75
|
|
|
Service Code
|
CPT 17273
|
| Hospital Charge Code |
76100130
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.34 |
| Max. Negotiated Rate |
$309.75 |
| Rate for Payer: Aetna Commercial |
$278.78
|
| Rate for Payer: ASR ASR |
$300.46
|
| Rate for Payer: ASR Commercial |
$300.46
|
| Rate for Payer: BCBS Trust/PPO |
$252.42
|
| Rate for Payer: BCN Commercial |
$240.15
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cofinity Commercial |
$291.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.80
|
| Rate for Payer: Healthscope Commercial |
$309.75
|
| Rate for Payer: Healthscope Whirlpool |
$300.46
|
| Rate for Payer: Mclaren Commercial |
$278.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.29
|
| Rate for Payer: Nomi Health Commercial |
$254.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.58
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
OP
|
$309.75
|
|
|
Service Code
|
CPT 17273
|
| Hospital Charge Code |
76100130
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.34 |
| Max. Negotiated Rate |
$606.75 |
| Rate for Payer: Aetna Commercial |
$278.78
|
| Rate for Payer: Aetna Medicare |
$391.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: ASR ASR |
$300.46
|
| Rate for Payer: ASR Commercial |
$300.46
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$253.65
|
| Rate for Payer: BCN Commercial |
$240.15
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cofinity Commercial |
$291.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$309.75
|
| Rate for Payer: Healthscope Whirlpool |
$300.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$391.45
|
| Rate for Payer: Mclaren Commercial |
$278.78
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.29
|
| Rate for Payer: Nomi Health Commercial |
$254.00
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$430.60
|
| Rate for Payer: PHP Medicaid |
$209.82
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.40
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$217.13
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$606.75
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP DNSP |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: VA VA |
$391.45
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
OP
|
$161.82
|
|
|
Service Code
|
CPT 17260
|
| Hospital Charge Code |
76100125
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.35 |
| Max. Negotiated Rate |
$301.75 |
| Rate for Payer: Aetna Commercial |
$145.64
|
| Rate for Payer: Aetna Medicare |
$194.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: ASR ASR |
$156.97
|
| Rate for Payer: ASR Commercial |
$156.97
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$132.51
|
| Rate for Payer: BCN Commercial |
$125.46
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$161.82
|
| Rate for Payer: Healthscope Whirlpool |
$156.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$194.68
|
| Rate for Payer: Mclaren Commercial |
$145.64
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$214.15
|
| Rate for Payer: PHP Medicaid |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.79
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$113.44
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$301.75
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP DNSP |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: VA VA |
$194.68
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 17260
|
| Hospital Charge Code |
76100125
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.18 |
| Max. Negotiated Rate |
$161.82 |
| Rate for Payer: Aetna Commercial |
$145.64
|
| Rate for Payer: ASR ASR |
$156.97
|
| Rate for Payer: ASR Commercial |
$156.97
|
| Rate for Payer: BCBS Trust/PPO |
$131.87
|
| Rate for Payer: BCN Commercial |
$125.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Healthscope Commercial |
$161.82
|
| Rate for Payer: Healthscope Whirlpool |
$156.97
|
| Rate for Payer: Mclaren Commercial |
$145.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.40
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 17261
|
| Hospital Charge Code |
76100126
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.18 |
| Max. Negotiated Rate |
$161.82 |
| Rate for Payer: Aetna Commercial |
$145.64
|
| Rate for Payer: ASR ASR |
$156.97
|
| Rate for Payer: ASR Commercial |
$156.97
|
| Rate for Payer: BCBS Trust/PPO |
$131.87
|
| Rate for Payer: BCN Commercial |
$125.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Healthscope Commercial |
$161.82
|
| Rate for Payer: Healthscope Whirlpool |
$156.97
|
| Rate for Payer: Mclaren Commercial |
$145.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.40
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$161.82
|
|
|
Service Code
|
CPT 17261
|
| Hospital Charge Code |
76100126
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.35 |
| Max. Negotiated Rate |
$301.75 |
| Rate for Payer: Aetna Commercial |
$145.64
|
| Rate for Payer: Aetna Medicare |
$194.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: ASR ASR |
$156.97
|
| Rate for Payer: ASR Commercial |
$156.97
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$132.51
|
| Rate for Payer: BCN Commercial |
$125.46
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$161.82
|
| Rate for Payer: Healthscope Whirlpool |
$156.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$194.68
|
| Rate for Payer: Mclaren Commercial |
$145.64
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$214.15
|
| Rate for Payer: PHP Medicaid |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.79
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$113.44
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$301.75
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP DNSP |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: VA VA |
$194.68
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 17262
|
| Hospital Charge Code |
76100127
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.18 |
| Max. Negotiated Rate |
$161.82 |
| Rate for Payer: Aetna Commercial |
$145.64
|
| Rate for Payer: ASR ASR |
$156.97
|
| Rate for Payer: ASR Commercial |
$156.97
|
| Rate for Payer: BCBS Trust/PPO |
$131.87
|
| Rate for Payer: BCN Commercial |
$125.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Healthscope Commercial |
$161.82
|
| Rate for Payer: Healthscope Whirlpool |
$156.97
|
| Rate for Payer: Mclaren Commercial |
$145.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.40
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$161.82
|
|
|
Service Code
|
CPT 17262
|
| Hospital Charge Code |
76100127
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.35 |
| Max. Negotiated Rate |
$301.75 |
| Rate for Payer: Aetna Commercial |
$145.64
|
| Rate for Payer: Aetna Medicare |
$194.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: ASR ASR |
$156.97
|
| Rate for Payer: ASR Commercial |
$156.97
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$132.51
|
| Rate for Payer: BCN Commercial |
$125.46
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$161.82
|
| Rate for Payer: Healthscope Whirlpool |
$156.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$194.68
|
| Rate for Payer: Mclaren Commercial |
$145.64
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$214.15
|
| Rate for Payer: PHP Medicaid |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.79
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$113.44
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$301.75
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP DNSP |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: VA VA |
$194.68
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$532.44
|
|
|
Service Code
|
CPT 17263
|
| Hospital Charge Code |
76100372
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$346.09 |
| Max. Negotiated Rate |
$532.44 |
| Rate for Payer: Aetna Commercial |
$479.20
|
| Rate for Payer: ASR ASR |
$516.47
|
| Rate for Payer: ASR Commercial |
$516.47
|
| Rate for Payer: BCBS Trust/PPO |
$433.89
|
| Rate for Payer: BCN Commercial |
$412.80
|
| Rate for Payer: Cash Price |
$425.95
|
| Rate for Payer: Cofinity Commercial |
$500.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.95
|
| Rate for Payer: Healthscope Commercial |
$532.44
|
| Rate for Payer: Healthscope Whirlpool |
$516.47
|
| Rate for Payer: Mclaren Commercial |
$479.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.57
|
| Rate for Payer: Nomi Health Commercial |
$436.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$468.55
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$532.44
|
|
|
Service Code
|
CPT 17263
|
| Hospital Charge Code |
76100372
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.35 |
| Max. Negotiated Rate |
$532.44 |
| Rate for Payer: Aetna Commercial |
$479.20
|
| Rate for Payer: Aetna Medicare |
$194.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: ASR ASR |
$516.47
|
| Rate for Payer: ASR Commercial |
$516.47
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$436.02
|
| Rate for Payer: BCN Commercial |
$412.80
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$425.95
|
| Rate for Payer: Cash Price |
$425.95
|
| Rate for Payer: Cofinity Commercial |
$500.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$532.44
|
| Rate for Payer: Healthscope Whirlpool |
$516.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$194.68
|
| Rate for Payer: Mclaren Commercial |
$479.20
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.57
|
| Rate for Payer: Nomi Health Commercial |
$436.60
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$214.15
|
| Rate for Payer: PHP Medicaid |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$466.52
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$373.24
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$468.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$301.75
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP DNSP |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: VA VA |
$194.68
|
|
|
HC DESTRUCT NEURO AGENT PLANTAR DIGITAL NRV
|
Facility
|
OP
|
$408.88
|
|
|
Service Code
|
CPT 64632
|
| Hospital Charge Code |
36100608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.02 |
| Max. Negotiated Rate |
$448.29 |
| Rate for Payer: Aetna Commercial |
$367.99
|
| Rate for Payer: Aetna Medicare |
$289.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.52
|
| Rate for Payer: ASR ASR |
$396.61
|
| Rate for Payer: ASR Commercial |
$396.61
|
| Rate for Payer: BCBS Complete |
$162.77
|
| Rate for Payer: BCBS MAPPO |
$289.22
|
| Rate for Payer: BCBS Trust/PPO |
$334.83
|
| Rate for Payer: BCN Commercial |
$317.00
|
| Rate for Payer: BCN Medicare Advantage |
$289.22
|
| Rate for Payer: Cash Price |
$327.10
|
| Rate for Payer: Cash Price |
$327.10
|
| Rate for Payer: Cofinity Commercial |
$384.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$327.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.22
|
| Rate for Payer: Healthscope Commercial |
$408.88
|
| Rate for Payer: Healthscope Whirlpool |
$396.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$289.22
|
| Rate for Payer: Mclaren Commercial |
$367.99
|
| Rate for Payer: Mclaren Medicaid |
$155.02
|
| Rate for Payer: Mclaren Medicare |
$289.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.68
|
| Rate for Payer: Meridian Medicaid |
$162.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.55
|
| Rate for Payer: Nomi Health Commercial |
$335.28
|
| Rate for Payer: PACE Medicare |
$274.76
|
| Rate for Payer: PACE SWMI |
$289.22
|
| Rate for Payer: PHP Commercial |
$318.14
|
| Rate for Payer: PHP Medicaid |
$155.02
|
| Rate for Payer: PHP Medicare Advantage |
$289.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$358.26
|
| Rate for Payer: Priority Health Medicare |
$289.22
|
| Rate for Payer: Priority Health Narrow Network |
$286.62
|
| Rate for Payer: Railroad Medicare Medicare |
$289.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$359.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$289.22
|
| Rate for Payer: UHC Exchange |
$448.29
|
| Rate for Payer: UHC Medicare Advantage |
$289.22
|
| Rate for Payer: UHCCP DNSP |
$289.22
|
| Rate for Payer: UHCCP Medicaid |
$155.02
|
| Rate for Payer: VA VA |
$289.22
|
|
|
HC DESTRUCT NEURO AGENT PLANTAR DIGITAL NRV
|
Facility
|
IP
|
$408.88
|
|
|
Service Code
|
CPT 64632
|
| Hospital Charge Code |
36100608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$265.77 |
| Max. Negotiated Rate |
$408.88 |
| Rate for Payer: Aetna Commercial |
$367.99
|
| Rate for Payer: ASR ASR |
$396.61
|
| Rate for Payer: ASR Commercial |
$396.61
|
| Rate for Payer: BCBS Trust/PPO |
$333.20
|
| Rate for Payer: BCN Commercial |
$317.00
|
| Rate for Payer: Cash Price |
$327.10
|
| Rate for Payer: Cofinity Commercial |
$384.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$327.10
|
| Rate for Payer: Healthscope Commercial |
$408.88
|
| Rate for Payer: Healthscope Whirlpool |
$396.61
|
| Rate for Payer: Mclaren Commercial |
$367.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.55
|
| Rate for Payer: Nomi Health Commercial |
$335.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$359.81
|
|
|
HC DESTRUCT PREMALIGNANT LESIONS 15 OR MORE LESIONS
|
Facility
|
OP
|
$281.59
|
|
|
Service Code
|
CPT 17004
|
| Hospital Charge Code |
76100122
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.03 |
| Max. Negotiated Rate |
$606.75 |
| Rate for Payer: Aetna Commercial |
$253.43
|
| Rate for Payer: Aetna Medicare |
$391.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: ASR ASR |
$273.14
|
| Rate for Payer: ASR Commercial |
$273.14
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$230.59
|
| Rate for Payer: BCN Commercial |
$218.32
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$264.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$281.59
|
| Rate for Payer: Healthscope Whirlpool |
$273.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$391.45
|
| Rate for Payer: Mclaren Commercial |
$253.43
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$430.60
|
| Rate for Payer: PHP Medicaid |
$209.82
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.73
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$197.39
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$606.75
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP DNSP |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: VA VA |
$391.45
|
|
|
HC DESTRUCT PREMALIGNANT LESIONS 15 OR MORE LESIONS
|
Facility
|
IP
|
$281.59
|
|
|
Service Code
|
CPT 17004
|
| Hospital Charge Code |
76100122
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.03 |
| Max. Negotiated Rate |
$281.59 |
| Rate for Payer: Aetna Commercial |
$253.43
|
| Rate for Payer: ASR ASR |
$273.14
|
| Rate for Payer: ASR Commercial |
$273.14
|
| Rate for Payer: BCBS Trust/PPO |
$229.47
|
| Rate for Payer: BCN Commercial |
$218.32
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$264.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Healthscope Commercial |
$281.59
|
| Rate for Payer: Healthscope Whirlpool |
$273.14
|
| Rate for Payer: Mclaren Commercial |
$253.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.80
|
|
|
HC DESTRUCT PREMALIGNANT LESIONS FIRST LESION
|
Facility
|
OP
|
$176.53
|
|
|
Service Code
|
CPT 17000
|
| Hospital Charge Code |
76100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.35 |
| Max. Negotiated Rate |
$301.75 |
| Rate for Payer: Aetna Commercial |
$158.88
|
| Rate for Payer: Aetna Medicare |
$194.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: ASR ASR |
$171.23
|
| Rate for Payer: ASR Commercial |
$171.23
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$144.56
|
| Rate for Payer: BCN Commercial |
$136.86
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$141.22
|
| Rate for Payer: Cash Price |
$141.22
|
| Rate for Payer: Cofinity Commercial |
$165.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$176.53
|
| Rate for Payer: Healthscope Whirlpool |
$171.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$194.68
|
| Rate for Payer: Mclaren Commercial |
$158.88
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.05
|
| Rate for Payer: Nomi Health Commercial |
$144.75
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$214.15
|
| Rate for Payer: PHP Medicaid |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.68
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$123.75
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$301.75
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP DNSP |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: VA VA |
$194.68
|
|
|
HC DESTRUCT PREMALIGNANT LESIONS FIRST LESION
|
Facility
|
IP
|
$176.53
|
|
|
Service Code
|
CPT 17000
|
| Hospital Charge Code |
76100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.74 |
| Max. Negotiated Rate |
$176.53 |
| Rate for Payer: Aetna Commercial |
$158.88
|
| Rate for Payer: ASR ASR |
$171.23
|
| Rate for Payer: ASR Commercial |
$171.23
|
| Rate for Payer: BCBS Trust/PPO |
$143.85
|
| Rate for Payer: BCN Commercial |
$136.86
|
| Rate for Payer: Cash Price |
$141.22
|
| Rate for Payer: Cofinity Commercial |
$165.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.22
|
| Rate for Payer: Healthscope Commercial |
$176.53
|
| Rate for Payer: Healthscope Whirlpool |
$171.23
|
| Rate for Payer: Mclaren Commercial |
$158.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.05
|
| Rate for Payer: Nomi Health Commercial |
$144.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.35
|
|
|
HC DESTRUCT PREMALIGNANT LESIONS SECOND THRU 14 LESIONS EACH
|
Facility
|
IP
|
$35.48
|
|
|
Service Code
|
CPT 17003
|
| Hospital Charge Code |
76100121
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$23.06 |
| Max. Negotiated Rate |
$35.48 |
| Rate for Payer: Aetna Commercial |
$31.93
|
| Rate for Payer: ASR ASR |
$34.42
|
| Rate for Payer: ASR Commercial |
$34.42
|
| Rate for Payer: BCBS Trust/PPO |
$28.91
|
| Rate for Payer: BCN Commercial |
$27.51
|
| Rate for Payer: Cash Price |
$28.38
|
| Rate for Payer: Cofinity Commercial |
$33.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.38
|
| Rate for Payer: Healthscope Commercial |
$35.48
|
| Rate for Payer: Healthscope Whirlpool |
$34.42
|
| Rate for Payer: Mclaren Commercial |
$31.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.16
|
| Rate for Payer: Nomi Health Commercial |
$29.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.22
|
|
|
HC DESTRUCT PREMALIGNANT LESIONS SECOND THRU 14 LESIONS EACH
|
Facility
|
OP
|
$35.48
|
|
|
Service Code
|
CPT 17003
|
| Hospital Charge Code |
76100121
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$14.19 |
| Max. Negotiated Rate |
$35.48 |
| Rate for Payer: Aetna Commercial |
$31.93
|
| Rate for Payer: Aetna Medicare |
$17.74
|
| Rate for Payer: ASR ASR |
$34.42
|
| Rate for Payer: ASR Commercial |
$34.42
|
| Rate for Payer: BCBS Complete |
$14.19
|
| Rate for Payer: BCBS Trust/PPO |
$29.05
|
| Rate for Payer: BCN Commercial |
$27.51
|
| Rate for Payer: Cash Price |
$28.38
|
| Rate for Payer: Cofinity Commercial |
$33.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.38
|
| Rate for Payer: Healthscope Commercial |
$35.48
|
| Rate for Payer: Healthscope Whirlpool |
$34.42
|
| Rate for Payer: Mclaren Commercial |
$31.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.16
|
| Rate for Payer: Nomi Health Commercial |
$29.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.09
|
| Rate for Payer: Priority Health Narrow Network |
$24.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.22
|
|
|
HC DESTRUCT VAGINAL LESION(S) SIMPLE
|
Facility
|
OP
|
$3,898.53
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
36100583
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,669.77 |
| Max. Negotiated Rate |
$4,828.62 |
| Rate for Payer: Aetna Commercial |
$3,508.68
|
| Rate for Payer: Aetna Medicare |
$3,115.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: ASR ASR |
$3,781.57
|
| Rate for Payer: ASR Commercial |
$3,781.57
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$3,192.51
|
| Rate for Payer: BCN Commercial |
$3,022.53
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$3,118.82
|
| Rate for Payer: Cash Price |
$3,118.82
|
| Rate for Payer: Cofinity Commercial |
$3,664.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,118.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$3,898.53
|
| Rate for Payer: Healthscope Whirlpool |
$3,781.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,115.24
|
| Rate for Payer: Mclaren Commercial |
$3,508.68
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,313.75
|
| Rate for Payer: Nomi Health Commercial |
$3,196.79
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$3,426.76
|
| Rate for Payer: PHP Medicaid |
$1,669.77
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,534.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,641.95
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,913.56
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,430.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$4,828.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP DNSP |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: VA VA |
$3,115.24
|
|
|
HC DESTRUCT VAGINAL LESION(S) SIMPLE
|
Facility
|
IP
|
$3,898.53
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
36100583
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,534.04 |
| Max. Negotiated Rate |
$3,898.53 |
| Rate for Payer: Aetna Commercial |
$3,508.68
|
| Rate for Payer: ASR ASR |
$3,781.57
|
| Rate for Payer: ASR Commercial |
$3,781.57
|
| Rate for Payer: BCBS Trust/PPO |
$3,176.91
|
| Rate for Payer: BCN Commercial |
$3,022.53
|
| Rate for Payer: Cash Price |
$3,118.82
|
| Rate for Payer: Cofinity Commercial |
$3,664.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,118.82
|
| Rate for Payer: Healthscope Commercial |
$3,898.53
|
| Rate for Payer: Healthscope Whirlpool |
$3,781.57
|
| Rate for Payer: Mclaren Commercial |
$3,508.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,313.75
|
| Rate for Payer: Nomi Health Commercial |
$3,196.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,534.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,430.71
|
|
|
HC DES VESSEL/BRANCH
|
Facility
|
OP
|
$24,667.58
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
48100075
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,955.64 |
| Max. Negotiated Rate |
$24,667.58 |
| Rate for Payer: Aetna Commercial |
$22,200.82
|
| Rate for Payer: Aetna Medicare |
$11,111.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: ASR ASR |
$23,927.55
|
| Rate for Payer: ASR Commercial |
$23,927.55
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$20,200.28
|
| Rate for Payer: BCN Commercial |
$19,124.77
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$19,734.06
|
| Rate for Payer: Cash Price |
$19,734.06
|
| Rate for Payer: Cofinity Commercial |
$23,187.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,734.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$24,667.58
|
| Rate for Payer: Healthscope Whirlpool |
$23,927.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,111.26
|
| Rate for Payer: Mclaren Commercial |
$22,200.82
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,967.44
|
| Rate for Payer: Nomi Health Commercial |
$20,227.42
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$12,222.39
|
| Rate for Payer: PHP Medicaid |
$5,955.64
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16,033.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,888.06
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$7,110.45
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21,707.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$17,222.45
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP DNSP |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: VA VA |
$11,111.26
|
|
|
HC DES VESSEL/BRANCH
|
Facility
|
IP
|
$24,667.58
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
48100075
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$16,033.93 |
| Max. Negotiated Rate |
$24,667.58 |
| Rate for Payer: Aetna Commercial |
$22,200.82
|
| Rate for Payer: ASR ASR |
$23,927.55
|
| Rate for Payer: ASR Commercial |
$23,927.55
|
| Rate for Payer: BCBS Trust/PPO |
$20,101.61
|
| Rate for Payer: BCN Commercial |
$19,124.77
|
| Rate for Payer: Cash Price |
$19,734.06
|
| Rate for Payer: Cofinity Commercial |
$23,187.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,734.06
|
| Rate for Payer: Healthscope Commercial |
$24,667.58
|
| Rate for Payer: Healthscope Whirlpool |
$23,927.55
|
| Rate for Payer: Mclaren Commercial |
$22,200.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,967.44
|
| Rate for Payer: Nomi Health Commercial |
$20,227.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16,033.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21,707.47
|
|
