|
HC DESTRUCT BY NEURO AGENT SUP HYPOGAST PLEXUS
|
Facility
|
IP
|
$1,435.75
|
|
|
Service Code
|
CPT 64681
|
| Hospital Charge Code |
36100606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$933.24 |
| Max. Negotiated Rate |
$1,435.75 |
| Rate for Payer: Aetna Commercial |
$1,292.17
|
| Rate for Payer: ASR ASR |
$1,392.68
|
| Rate for Payer: ASR Commercial |
$1,392.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,169.99
|
| Rate for Payer: BCN Commercial |
$1,113.14
|
| Rate for Payer: Cash Price |
$1,148.60
|
| Rate for Payer: Cofinity Commercial |
$1,349.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,148.60
|
| Rate for Payer: Healthscope Commercial |
$1,435.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,392.68
|
| Rate for Payer: Mclaren Commercial |
$1,292.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,220.39
|
| Rate for Payer: Nomi Health Commercial |
$1,177.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,263.46
|
|
|
HC DESTRUCT BY NEURO AGENT SUP HYPOGAST PLEXUS
|
Facility
|
OP
|
$1,435.75
|
|
|
Service Code
|
CPT 64681
|
| Hospital Charge Code |
36100606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$465.40 |
| Max. Negotiated Rate |
$1,435.75 |
| Rate for Payer: Aetna Commercial |
$1,292.17
|
| Rate for Payer: Aetna Medicare |
$868.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,085.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,085.35
|
| Rate for Payer: ASR ASR |
$1,392.68
|
| Rate for Payer: ASR Commercial |
$1,392.68
|
| Rate for Payer: BCBS Complete |
$488.67
|
| Rate for Payer: BCBS MAPPO |
$868.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,175.74
|
| Rate for Payer: BCN Commercial |
$1,113.14
|
| Rate for Payer: BCN Medicare Advantage |
$868.28
|
| Rate for Payer: Cash Price |
$1,148.60
|
| Rate for Payer: Cash Price |
$1,148.60
|
| Rate for Payer: Cofinity Commercial |
$1,349.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,148.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.28
|
| Rate for Payer: Healthscope Commercial |
$1,435.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,392.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$868.28
|
| Rate for Payer: Mclaren Commercial |
$1,292.17
|
| Rate for Payer: Mclaren Medicaid |
$465.40
|
| Rate for Payer: Mclaren Medicare |
$868.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.69
|
| Rate for Payer: Meridian Medicaid |
$488.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,220.39
|
| Rate for Payer: Nomi Health Commercial |
$1,177.32
|
| Rate for Payer: PACE Medicare |
$824.87
|
| Rate for Payer: PACE SWMI |
$868.28
|
| Rate for Payer: PHP Commercial |
$955.11
|
| Rate for Payer: PHP Medicaid |
$465.40
|
| Rate for Payer: PHP Medicare Advantage |
$868.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,258.00
|
| Rate for Payer: Priority Health Medicare |
$868.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,006.46
|
| Rate for Payer: Railroad Medicare Medicare |
$868.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,263.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.28
|
| Rate for Payer: UHC Exchange |
$1,345.83
|
| Rate for Payer: UHC Medicare Advantage |
$868.28
|
| Rate for Payer: UHCCP DNSP |
$868.28
|
| Rate for Payer: UHCCP Medicaid |
$465.40
|
| Rate for Payer: VA VA |
$868.28
|
|
|
HC DESTRUCT BY NEURO AGENT TRIGEM NRVE
|
Facility
|
OP
|
$2,683.19
|
|
|
Service Code
|
CPT 64610
|
| Hospital Charge Code |
36100607
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,020.81 |
| Max. Negotiated Rate |
$2,951.97 |
| Rate for Payer: Aetna Commercial |
$2,414.87
|
| Rate for Payer: Aetna Medicare |
$1,904.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,380.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,380.62
|
| Rate for Payer: ASR ASR |
$2,602.69
|
| Rate for Payer: ASR Commercial |
$2,602.69
|
| Rate for Payer: BCBS Complete |
$1,071.85
|
| Rate for Payer: BCBS MAPPO |
$1,904.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,197.26
|
| Rate for Payer: BCN Commercial |
$2,080.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,904.50
|
| Rate for Payer: Cash Price |
$2,146.55
|
| Rate for Payer: Cash Price |
$2,146.55
|
| Rate for Payer: Cofinity Commercial |
$2,522.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,904.50
|
| Rate for Payer: Healthscope Commercial |
$2,683.19
|
| Rate for Payer: Healthscope Whirlpool |
$2,602.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,904.50
|
| Rate for Payer: Mclaren Commercial |
$2,414.87
|
| Rate for Payer: Mclaren Medicaid |
$1,020.81
|
| Rate for Payer: Mclaren Medicare |
$1,904.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,999.72
|
| Rate for Payer: Meridian Medicaid |
$1,071.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,190.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.71
|
| Rate for Payer: Nomi Health Commercial |
$2,200.22
|
| Rate for Payer: PACE Medicare |
$1,809.28
|
| Rate for Payer: PACE SWMI |
$1,904.50
|
| Rate for Payer: PHP Commercial |
$2,094.95
|
| Rate for Payer: PHP Medicaid |
$1,020.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,904.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,020.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,351.01
|
| Rate for Payer: Priority Health Medicare |
$1,904.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,880.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,904.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,361.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,904.50
|
| Rate for Payer: UHC Exchange |
$2,951.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,904.50
|
| Rate for Payer: UHCCP DNSP |
$1,904.50
|
| Rate for Payer: UHCCP Medicaid |
$1,020.81
|
| Rate for Payer: VA VA |
$1,904.50
|
|
|
HC DESTRUCT BY NEURO AGENT TRIGEM NRVE
|
Facility
|
IP
|
$2,683.19
|
|
|
Service Code
|
CPT 64610
|
| Hospital Charge Code |
36100607
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,744.07 |
| Max. Negotiated Rate |
$2,683.19 |
| Rate for Payer: Aetna Commercial |
$2,414.87
|
| Rate for Payer: ASR ASR |
$2,602.69
|
| Rate for Payer: ASR Commercial |
$2,602.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,186.53
|
| Rate for Payer: BCN Commercial |
$2,080.28
|
| Rate for Payer: Cash Price |
$2,146.55
|
| Rate for Payer: Cofinity Commercial |
$2,522.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.55
|
| Rate for Payer: Healthscope Commercial |
$2,683.19
|
| Rate for Payer: Healthscope Whirlpool |
$2,602.69
|
| Rate for Payer: Mclaren Commercial |
$2,414.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.71
|
| Rate for Payer: Nomi Health Commercial |
$2,200.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,361.21
|
|
|
HC DESTRUCTION LESION(S) VULVA, EXTENSIVE
|
Facility
|
OP
|
$2,532.45
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
76100235
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$956.23 |
| Max. Negotiated Rate |
$2,765.22 |
| Rate for Payer: Aetna Commercial |
$2,279.20
|
| Rate for Payer: Aetna Medicare |
$1,784.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,230.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,230.01
|
| Rate for Payer: ASR ASR |
$2,456.48
|
| Rate for Payer: ASR Commercial |
$2,456.48
|
| Rate for Payer: BCBS Complete |
$1,004.04
|
| Rate for Payer: BCBS MAPPO |
$1,784.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,073.82
|
| Rate for Payer: BCN Commercial |
$1,963.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,784.01
|
| Rate for Payer: Cash Price |
$2,025.96
|
| Rate for Payer: Cash Price |
$2,025.96
|
| Rate for Payer: Cofinity Commercial |
$2,380.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,025.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,784.01
|
| Rate for Payer: Healthscope Commercial |
$2,532.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,456.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,784.01
|
| Rate for Payer: Mclaren Commercial |
$2,279.20
|
| Rate for Payer: Mclaren Medicaid |
$956.23
|
| Rate for Payer: Mclaren Medicare |
$1,784.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,873.21
|
| Rate for Payer: Meridian Medicaid |
$1,004.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,051.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,152.58
|
| Rate for Payer: Nomi Health Commercial |
$2,076.61
|
| Rate for Payer: PACE Medicare |
$1,694.81
|
| Rate for Payer: PACE SWMI |
$1,784.01
|
| Rate for Payer: PHP Commercial |
$1,962.41
|
| Rate for Payer: PHP Medicaid |
$956.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,784.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$956.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,218.93
|
| Rate for Payer: Priority Health Medicare |
$1,784.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,775.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,784.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,228.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,784.01
|
| Rate for Payer: UHC Exchange |
$2,765.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,784.01
|
| Rate for Payer: UHCCP DNSP |
$1,784.01
|
| Rate for Payer: UHCCP Medicaid |
$956.23
|
| Rate for Payer: VA VA |
$1,784.01
|
|
|
HC DESTRUCTION LESION(S) VULVA, EXTENSIVE
|
Facility
|
IP
|
$2,532.45
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
76100235
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,646.09 |
| Max. Negotiated Rate |
$2,532.45 |
| Rate for Payer: Aetna Commercial |
$2,279.20
|
| Rate for Payer: ASR ASR |
$2,456.48
|
| Rate for Payer: ASR Commercial |
$2,456.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,063.69
|
| Rate for Payer: BCN Commercial |
$1,963.41
|
| Rate for Payer: Cash Price |
$2,025.96
|
| Rate for Payer: Cofinity Commercial |
$2,380.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,025.96
|
| Rate for Payer: Healthscope Commercial |
$2,532.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,456.48
|
| Rate for Payer: Mclaren Commercial |
$2,279.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,152.58
|
| Rate for Payer: Nomi Health Commercial |
$2,076.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,228.56
|
|
|
HC DESTRUCTION LESION(S) VULVA, SIMPLE
|
Facility
|
IP
|
$2,532.45
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
76100233
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,646.09 |
| Max. Negotiated Rate |
$2,532.45 |
| Rate for Payer: Aetna Commercial |
$2,279.20
|
| Rate for Payer: ASR ASR |
$2,456.48
|
| Rate for Payer: ASR Commercial |
$2,456.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,063.69
|
| Rate for Payer: BCN Commercial |
$1,963.41
|
| Rate for Payer: Cash Price |
$2,025.96
|
| Rate for Payer: Cofinity Commercial |
$2,380.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,025.96
|
| Rate for Payer: Healthscope Commercial |
$2,532.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,456.48
|
| Rate for Payer: Mclaren Commercial |
$2,279.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,152.58
|
| Rate for Payer: Nomi Health Commercial |
$2,076.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,228.56
|
|
|
HC DESTRUCTION LESION(S) VULVA, SIMPLE
|
Facility
|
OP
|
$2,532.45
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
76100233
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$956.23 |
| Max. Negotiated Rate |
$2,765.22 |
| Rate for Payer: Aetna Commercial |
$2,279.20
|
| Rate for Payer: Aetna Medicare |
$1,784.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,230.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,230.01
|
| Rate for Payer: ASR ASR |
$2,456.48
|
| Rate for Payer: ASR Commercial |
$2,456.48
|
| Rate for Payer: BCBS Complete |
$1,004.04
|
| Rate for Payer: BCBS MAPPO |
$1,784.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,073.82
|
| Rate for Payer: BCN Commercial |
$1,963.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,784.01
|
| Rate for Payer: Cash Price |
$2,025.96
|
| Rate for Payer: Cash Price |
$2,025.96
|
| Rate for Payer: Cofinity Commercial |
$2,380.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,025.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,784.01
|
| Rate for Payer: Healthscope Commercial |
$2,532.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,456.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,784.01
|
| Rate for Payer: Mclaren Commercial |
$2,279.20
|
| Rate for Payer: Mclaren Medicaid |
$956.23
|
| Rate for Payer: Mclaren Medicare |
$1,784.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,873.21
|
| Rate for Payer: Meridian Medicaid |
$1,004.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,051.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,152.58
|
| Rate for Payer: Nomi Health Commercial |
$2,076.61
|
| Rate for Payer: PACE Medicare |
$1,694.81
|
| Rate for Payer: PACE SWMI |
$1,784.01
|
| Rate for Payer: PHP Commercial |
$1,962.41
|
| Rate for Payer: PHP Medicaid |
$956.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,784.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$956.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,218.93
|
| Rate for Payer: Priority Health Medicare |
$1,784.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,775.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,784.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,228.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,784.01
|
| Rate for Payer: UHC Exchange |
$2,765.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,784.01
|
| Rate for Payer: UHCCP DNSP |
$1,784.01
|
| Rate for Payer: UHCCP Medicaid |
$956.23
|
| Rate for Payer: VA VA |
$1,784.01
|
|
|
HC DESTRUCTION PENIS LESION(S) CHEMICAL
|
Facility
|
OP
|
$1,065.05
|
|
|
Service Code
|
CPT 54050
|
| Hospital Charge Code |
76100346
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$1,065.05 |
| Rate for Payer: Aetna Commercial |
$958.54
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$1,033.10
|
| Rate for Payer: ASR Commercial |
$1,033.10
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$872.17
|
| Rate for Payer: BCN Commercial |
$825.73
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$852.04
|
| Rate for Payer: Cash Price |
$852.04
|
| Rate for Payer: Cofinity Commercial |
$1,001.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$1,065.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,033.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$958.54
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.29
|
| Rate for Payer: Nomi Health Commercial |
$873.34
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$933.20
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$746.60
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$937.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
HC DESTRUCTION PENIS LESION(S) CHEMICAL
|
Facility
|
IP
|
$1,065.05
|
|
|
Service Code
|
CPT 54050
|
| Hospital Charge Code |
76100346
|
| Min. Negotiated Rate |
$692.28 |
| Max. Negotiated Rate |
$1,065.05 |
| Rate for Payer: Aetna Commercial |
$958.54
|
| Rate for Payer: ASR ASR |
$1,033.10
|
| Rate for Payer: ASR Commercial |
$1,033.10
|
| Rate for Payer: BCBS Trust/PPO |
$867.91
|
| Rate for Payer: BCN Commercial |
$825.73
|
| Rate for Payer: Cash Price |
$852.04
|
| Rate for Payer: Cofinity Commercial |
$1,001.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.04
|
| Rate for Payer: Healthscope Commercial |
$1,065.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,033.10
|
| Rate for Payer: Mclaren Commercial |
$958.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.29
|
| Rate for Payer: Nomi Health Commercial |
$873.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$937.24
|
|
|
HC DESTRUCT MALIG LESION FACE,EAR,EYELID,NOSE,LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
OP
|
$392.23
|
|
|
Service Code
|
CPT 17282
|
| Hospital Charge Code |
76100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$392.23 |
| Rate for Payer: Aetna Commercial |
$353.01
|
| Rate for Payer: Aetna Medicare |
$193.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: ASR ASR |
$380.46
|
| Rate for Payer: ASR Commercial |
$380.46
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCBS Trust/PPO |
$321.20
|
| Rate for Payer: BCN Commercial |
$304.10
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$313.78
|
| Rate for Payer: Cash Price |
$313.78
|
| Rate for Payer: Cofinity Commercial |
$368.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$392.23
|
| Rate for Payer: Healthscope Whirlpool |
$380.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$193.79
|
| Rate for Payer: Mclaren Commercial |
$353.01
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.40
|
| Rate for Payer: Nomi Health Commercial |
$321.63
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$213.17
|
| Rate for Payer: PHP Medicaid |
$103.87
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$343.67
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health Narrow Network |
$274.95
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$345.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$300.37
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP DNSP |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: VA VA |
$193.79
|
|
|
HC DESTRUCT MALIG LESION FACE,EAR,EYELID,NOSE,LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
IP
|
$392.23
|
|
|
Service Code
|
CPT 17282
|
| Hospital Charge Code |
76100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$254.95 |
| Max. Negotiated Rate |
$392.23 |
| Rate for Payer: Aetna Commercial |
$353.01
|
| Rate for Payer: ASR ASR |
$380.46
|
| Rate for Payer: ASR Commercial |
$380.46
|
| Rate for Payer: BCBS Trust/PPO |
$319.63
|
| Rate for Payer: BCN Commercial |
$304.10
|
| Rate for Payer: Cash Price |
$313.78
|
| Rate for Payer: Cofinity Commercial |
$368.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.78
|
| Rate for Payer: Healthscope Commercial |
$392.23
|
| Rate for Payer: Healthscope Whirlpool |
$380.46
|
| Rate for Payer: Mclaren Commercial |
$353.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.40
|
| Rate for Payer: Nomi Health Commercial |
$321.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$345.16
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA <0.6 CM
|
Facility
|
IP
|
$219.52
|
|
|
Service Code
|
CPT 17270
|
| Hospital Charge Code |
76100154
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$142.69 |
| Max. Negotiated Rate |
$219.52 |
| Rate for Payer: Aetna Commercial |
$197.57
|
| Rate for Payer: ASR ASR |
$212.93
|
| Rate for Payer: ASR Commercial |
$212.93
|
| Rate for Payer: BCBS Trust/PPO |
$178.89
|
| Rate for Payer: BCN Commercial |
$170.19
|
| Rate for Payer: Cash Price |
$175.62
|
| Rate for Payer: Cofinity Commercial |
$206.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.62
|
| Rate for Payer: Healthscope Commercial |
$219.52
|
| Rate for Payer: Healthscope Whirlpool |
$212.93
|
| Rate for Payer: Mclaren Commercial |
$197.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.59
|
| Rate for Payer: Nomi Health Commercial |
$180.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$193.18
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA <0.6 CM
|
Facility
|
OP
|
$219.52
|
|
|
Service Code
|
CPT 17270
|
| Hospital Charge Code |
76100154
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$300.37 |
| Rate for Payer: Aetna Commercial |
$197.57
|
| Rate for Payer: Aetna Medicare |
$193.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: ASR ASR |
$212.93
|
| Rate for Payer: ASR Commercial |
$212.93
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCBS Trust/PPO |
$179.76
|
| Rate for Payer: BCN Commercial |
$170.19
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$175.62
|
| Rate for Payer: Cash Price |
$175.62
|
| Rate for Payer: Cofinity Commercial |
$206.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$219.52
|
| Rate for Payer: Healthscope Whirlpool |
$212.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$193.79
|
| Rate for Payer: Mclaren Commercial |
$197.57
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.59
|
| Rate for Payer: Nomi Health Commercial |
$180.01
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$213.17
|
| Rate for Payer: PHP Medicaid |
$103.87
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$192.34
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health Narrow Network |
$153.88
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$193.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$300.37
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP DNSP |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: VA VA |
$193.79
|
|
|
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 0.6 TO 1.0 CM
|
Facility
|
OP
|
$281.59
|
|
|
Service Code
|
CPT 17271
|
| Hospital Charge Code |
76100128
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$300.37 |
| Rate for Payer: Aetna Commercial |
$253.43
|
| Rate for Payer: Aetna Medicare |
$193.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: ASR ASR |
$273.14
|
| Rate for Payer: ASR Commercial |
$273.14
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCBS Trust/PPO |
$230.59
|
| Rate for Payer: BCN Commercial |
$218.32
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| 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 |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$281.59
|
| Rate for Payer: Healthscope Whirlpool |
$273.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$193.79
|
| Rate for Payer: Mclaren Commercial |
$253.43
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$213.17
|
| Rate for Payer: PHP Medicaid |
$103.87
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| 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 |
$193.79
|
| Rate for Payer: Priority Health Narrow Network |
$197.39
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$300.37
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP DNSP |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: VA VA |
$193.79
|
|
|
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 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 |
$103.87 |
| Max. Negotiated Rate |
$300.37 |
| Rate for Payer: Aetna Commercial |
$145.64
|
| Rate for Payer: Aetna Medicare |
$193.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: ASR ASR |
$156.97
|
| Rate for Payer: ASR Commercial |
$156.97
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCBS Trust/PPO |
$132.51
|
| Rate for Payer: BCN Commercial |
$125.46
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| 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 |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$161.82
|
| Rate for Payer: Healthscope Whirlpool |
$156.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$193.79
|
| Rate for Payer: Mclaren Commercial |
$145.64
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$213.17
|
| Rate for Payer: PHP Medicaid |
$103.87
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| 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 |
$193.79
|
| Rate for Payer: Priority Health Narrow Network |
$113.44
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$300.37
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP DNSP |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: VA VA |
$193.79
|
|
|
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 |
$603.96 |
| Rate for Payer: Aetna Commercial |
$278.77
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$300.46
|
| Rate for Payer: ASR Commercial |
$300.46
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$253.65
|
| Rate for Payer: BCN Commercial |
$240.15
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cofinity Commercial |
$291.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$309.75
|
| Rate for Payer: Healthscope Whirlpool |
$300.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$278.77
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.29
|
| Rate for Payer: Nomi Health Commercial |
$254.00
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| 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 |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$217.13
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
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 |
$278.77
|
| 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 |
$291.17
|
| 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 |
$278.77
|
| 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 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 |
$103.87 |
| Max. Negotiated Rate |
$300.37 |
| Rate for Payer: Aetna Commercial |
$145.64
|
| Rate for Payer: Aetna Medicare |
$193.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: ASR ASR |
$156.97
|
| Rate for Payer: ASR Commercial |
$156.97
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCBS Trust/PPO |
$132.51
|
| Rate for Payer: BCN Commercial |
$125.46
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| 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 |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$161.82
|
| Rate for Payer: Healthscope Whirlpool |
$156.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$193.79
|
| Rate for Payer: Mclaren Commercial |
$145.64
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$213.17
|
| Rate for Payer: PHP Medicaid |
$103.87
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| 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 |
$193.79
|
| Rate for Payer: Priority Health Narrow Network |
$113.44
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$300.37
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP DNSP |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: VA VA |
$193.79
|
|
|
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 |
$103.87 |
| Max. Negotiated Rate |
$300.37 |
| Rate for Payer: Aetna Commercial |
$145.64
|
| Rate for Payer: Aetna Medicare |
$193.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: ASR ASR |
$156.97
|
| Rate for Payer: ASR Commercial |
$156.97
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCBS Trust/PPO |
$132.51
|
| Rate for Payer: BCN Commercial |
$125.46
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| 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 |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$161.82
|
| Rate for Payer: Healthscope Whirlpool |
$156.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$193.79
|
| Rate for Payer: Mclaren Commercial |
$145.64
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$213.17
|
| Rate for Payer: PHP Medicaid |
$103.87
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| 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 |
$193.79
|
| Rate for Payer: Priority Health Narrow Network |
$113.44
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$300.37
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP DNSP |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: VA VA |
$193.79
|
|
|
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
|
|
