|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
76100097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$899.68 |
| Max. Negotiated Rate |
$1,199.57 |
| Rate for Payer: Aetna Commercial |
$1,079.61
|
| Rate for Payer: ASR ASR |
$1,163.58
|
| Rate for Payer: BCBS Trust/PPO |
$985.09
|
| Rate for Payer: BCN Commercial |
$985.09
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,127.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Healthscope Commercial |
$1,163.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,199.57
|
| Rate for Payer: Mclaren Commercial |
$1,079.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,055.62
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
76100097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$840.90 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,079.61
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$1,163.58
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$989.05
|
| Rate for Payer: BCN Commercial |
$989.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,127.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,163.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,199.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,079.61
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,051.06
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$840.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,055.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
76100098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$899.68 |
| Max. Negotiated Rate |
$1,199.57 |
| Rate for Payer: Aetna Commercial |
$1,079.61
|
| Rate for Payer: ASR ASR |
$1,163.58
|
| Rate for Payer: BCBS Trust/PPO |
$985.09
|
| Rate for Payer: BCN Commercial |
$985.09
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,127.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Healthscope Commercial |
$1,163.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,199.57
|
| Rate for Payer: Mclaren Commercial |
$1,079.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,055.62
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
76100098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$840.90 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,079.61
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$1,163.58
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$989.05
|
| Rate for Payer: BCN Commercial |
$989.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,127.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,163.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,199.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,079.61
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,051.06
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$840.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,055.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 3.1 TO 4.0 CM
|
Facility
|
OP
|
$1,981.12
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
76100099
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,783.01
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$1,921.69
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,633.43
|
| Rate for Payer: BCN Commercial |
$1,633.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cofinity Commercial |
$1,862.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,584.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,921.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,981.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,783.01
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,683.95
|
| Rate for Payer: Nomi Health Commercial |
$1,624.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.84
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,735.86
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,388.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,743.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 3.1 TO 4.0 CM
|
Facility
|
IP
|
$1,981.12
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
76100099
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,485.84 |
| Max. Negotiated Rate |
$1,981.12 |
| Rate for Payer: Aetna Commercial |
$1,783.01
|
| Rate for Payer: ASR ASR |
$1,921.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,626.90
|
| Rate for Payer: BCN Commercial |
$1,626.90
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cofinity Commercial |
$1,862.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,584.90
|
| Rate for Payer: Healthscope Commercial |
$1,921.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,981.12
|
| Rate for Payer: Mclaren Commercial |
$1,783.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,683.95
|
| Rate for Payer: Nomi Health Commercial |
$1,624.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,743.39
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA OVER 4.0 CM
|
Facility
|
OP
|
$1,981.12
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
76100100
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,388.77 |
| Max. Negotiated Rate |
$4,486.12 |
| Rate for Payer: Aetna Commercial |
$1,783.01
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: ASR ASR |
$1,921.69
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,633.43
|
| Rate for Payer: BCN Commercial |
$1,633.43
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cofinity Commercial |
$1,862.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,584.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$1,921.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,981.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$1,783.01
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,683.95
|
| Rate for Payer: Nomi Health Commercial |
$1,624.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.84
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,735.86
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,388.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,743.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$4,486.12
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA OVER 4.0 CM
|
Facility
|
IP
|
$1,981.12
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
76100100
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,485.84 |
| Max. Negotiated Rate |
$1,981.12 |
| Rate for Payer: Aetna Commercial |
$1,783.01
|
| Rate for Payer: ASR ASR |
$1,921.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,626.90
|
| Rate for Payer: BCN Commercial |
$1,626.90
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cofinity Commercial |
$1,862.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,584.90
|
| Rate for Payer: Healthscope Commercial |
$1,921.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,981.12
|
| Rate for Payer: Mclaren Commercial |
$1,783.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,683.95
|
| Rate for Payer: Nomi Health Commercial |
$1,624.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,743.39
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
IP
|
$855.50
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
76100089
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$641.62 |
| Max. Negotiated Rate |
$855.50 |
| Rate for Payer: Aetna Commercial |
$769.95
|
| Rate for Payer: ASR ASR |
$829.84
|
| Rate for Payer: BCBS Trust/PPO |
$702.54
|
| Rate for Payer: BCN Commercial |
$702.54
|
| Rate for Payer: Cash Price |
$684.40
|
| Rate for Payer: Cofinity Commercial |
$804.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.40
|
| Rate for Payer: Healthscope Commercial |
$829.84
|
| Rate for Payer: Healthscope Whirlpool |
$855.50
|
| Rate for Payer: Mclaren Commercial |
$769.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$727.17
|
| Rate for Payer: Nomi Health Commercial |
$701.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$641.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$752.84
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
OP
|
$855.50
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
76100089
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$1,093.66 |
| Rate for Payer: Aetna Commercial |
$769.95
|
| Rate for Payer: Aetna Medicare |
$705.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: ASR ASR |
$829.84
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$705.36
|
| Rate for Payer: BCN Commercial |
$705.36
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$684.40
|
| Rate for Payer: Cash Price |
$684.40
|
| Rate for Payer: Cofinity Commercial |
$804.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$829.84
|
| Rate for Payer: Healthscope Whirlpool |
$855.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$769.95
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$387.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$727.17
|
| Rate for Payer: Nomi Health Commercial |
$701.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$641.62
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$776.15
|
| Rate for Payer: PHP Medicaid |
$378.20
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$848.60
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$678.88
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$752.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$1,093.66
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP DNSP |
$705.59
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.6 CM TO 1.0 CM
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
76100090
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$848.60 |
| Rate for Payer: Aetna Commercial |
$550.87
|
| 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 |
$593.72
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$504.66
|
| Rate for Payer: BCN Commercial |
$504.66
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Commercial |
$575.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$593.72
|
| Rate for Payer: Healthscope Whirlpool |
$612.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$550.87
|
| 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 |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$501.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| 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 |
$848.60
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$678.88
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.63
|
| 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 EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.6 CM TO 1.0 CM
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
76100090
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$459.06 |
| Max. Negotiated Rate |
$612.08 |
| Rate for Payer: Aetna Commercial |
$550.87
|
| Rate for Payer: ASR ASR |
$593.72
|
| Rate for Payer: BCBS Trust/PPO |
$502.64
|
| Rate for Payer: BCN Commercial |
$502.64
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Commercial |
$575.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Healthscope Commercial |
$593.72
|
| Rate for Payer: Healthscope Whirlpool |
$612.08
|
| Rate for Payer: Mclaren Commercial |
$550.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$501.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.63
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 1.1 CM TO 2.0 CM
|
Facility
|
OP
|
$1,320.15
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
76100091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$1,320.15 |
| Rate for Payer: Aetna Commercial |
$1,188.13
|
| Rate for Payer: Aetna Medicare |
$705.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: ASR ASR |
$1,280.55
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,088.46
|
| Rate for Payer: BCN Commercial |
$1,088.46
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$1,056.12
|
| Rate for Payer: Cash Price |
$1,056.12
|
| Rate for Payer: Cofinity Commercial |
$1,240.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$1,280.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,320.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$1,188.13
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$387.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,122.13
|
| Rate for Payer: Nomi Health Commercial |
$1,082.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$990.11
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$776.15
|
| Rate for Payer: PHP Medicaid |
$378.20
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,156.72
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$925.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,161.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$1,093.66
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP DNSP |
$705.59
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 1.1 CM TO 2.0 CM
|
Facility
|
IP
|
$1,320.15
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
76100091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$990.11 |
| Max. Negotiated Rate |
$1,320.15 |
| Rate for Payer: Aetna Commercial |
$1,188.13
|
| Rate for Payer: ASR ASR |
$1,280.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,084.11
|
| Rate for Payer: BCN Commercial |
$1,084.11
|
| Rate for Payer: Cash Price |
$1,056.12
|
| Rate for Payer: Cofinity Commercial |
$1,240.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.12
|
| Rate for Payer: Healthscope Commercial |
$1,280.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,320.15
|
| Rate for Payer: Mclaren Commercial |
$1,188.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,122.13
|
| Rate for Payer: Nomi Health Commercial |
$1,082.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$990.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,161.73
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
76100092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$899.68 |
| Max. Negotiated Rate |
$1,199.57 |
| Rate for Payer: Aetna Commercial |
$1,079.61
|
| Rate for Payer: ASR ASR |
$1,163.58
|
| Rate for Payer: BCBS Trust/PPO |
$985.09
|
| Rate for Payer: BCN Commercial |
$985.09
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,127.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Healthscope Commercial |
$1,163.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,199.57
|
| Rate for Payer: Mclaren Commercial |
$1,079.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,055.62
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
76100092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$1,199.57 |
| Rate for Payer: Aetna Commercial |
$1,079.61
|
| Rate for Payer: Aetna Medicare |
$705.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: ASR ASR |
$1,163.58
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$989.05
|
| Rate for Payer: BCN Commercial |
$989.05
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,127.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$1,163.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,199.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$1,079.61
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$387.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$776.15
|
| Rate for Payer: PHP Medicaid |
$378.20
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,051.06
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$840.90
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,055.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$1,093.66
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP DNSP |
$705.59
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
IP
|
$1,439.49
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
76100093
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,079.62 |
| Max. Negotiated Rate |
$1,439.49 |
| Rate for Payer: Aetna Commercial |
$1,295.54
|
| Rate for Payer: ASR ASR |
$1,396.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.11
|
| Rate for Payer: BCN Commercial |
$1,182.11
|
| Rate for Payer: Cash Price |
$1,151.59
|
| Rate for Payer: Cofinity Commercial |
$1,353.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,151.59
|
| Rate for Payer: Healthscope Commercial |
$1,396.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,439.49
|
| Rate for Payer: Mclaren Commercial |
$1,295.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,223.57
|
| Rate for Payer: Nomi Health Commercial |
$1,180.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,079.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,266.75
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
OP
|
$1,439.49
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
76100093
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,295.54
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$1,396.31
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.86
|
| Rate for Payer: BCN Commercial |
$1,186.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,151.59
|
| Rate for Payer: Cash Price |
$1,151.59
|
| Rate for Payer: Cofinity Commercial |
$1,353.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,151.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,396.31
|
| Rate for Payer: Healthscope Whirlpool |
$1,439.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,295.54
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,223.57
|
| Rate for Payer: Nomi Health Commercial |
$1,180.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,079.62
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,261.28
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,009.08
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,266.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
IP
|
$2,161.23
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,620.92 |
| Max. Negotiated Rate |
$2,161.23 |
| Rate for Payer: Aetna Commercial |
$1,945.11
|
| Rate for Payer: ASR ASR |
$2,096.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,774.80
|
| Rate for Payer: BCN Commercial |
$1,774.80
|
| Rate for Payer: Cash Price |
$1,728.98
|
| Rate for Payer: Cofinity Commercial |
$2,031.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,728.98
|
| Rate for Payer: Healthscope Commercial |
$2,096.39
|
| Rate for Payer: Healthscope Whirlpool |
$2,161.23
|
| Rate for Payer: Mclaren Commercial |
$1,945.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,837.05
|
| Rate for Payer: Nomi Health Commercial |
$1,772.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,620.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,901.88
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
OP
|
$2,161.23
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,945.11
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$2,096.39
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,781.93
|
| Rate for Payer: BCN Commercial |
$1,781.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,728.98
|
| Rate for Payer: Cash Price |
$1,728.98
|
| Rate for Payer: Cofinity Commercial |
$2,031.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,728.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,096.39
|
| Rate for Payer: Healthscope Whirlpool |
$2,161.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,945.11
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,837.05
|
| Rate for Payer: Nomi Health Commercial |
$1,772.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,620.92
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,893.67
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,515.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,901.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXCISE CYST/BREAST LESION
|
Facility
|
OP
|
$4,822.48
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$515.37 |
| Max. Negotiated Rate |
$6,047.09 |
| Rate for Payer: Aetna Commercial |
$4,340.23
|
| Rate for Payer: Aetna Medicare |
$3,901.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: ASR ASR |
$4,677.81
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,976.13
|
| Rate for Payer: BCCCP Commercial |
$515.37
|
| Rate for Payer: BCN Commercial |
$3,976.13
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Cash Price |
$3,857.98
|
| Rate for Payer: Cash Price |
$3,857.98
|
| Rate for Payer: Cofinity Commercial |
$4,533.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,857.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Healthscope Commercial |
$4,677.81
|
| Rate for Payer: Healthscope Whirlpool |
$4,822.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,901.35
|
| Rate for Payer: Mclaren Commercial |
$4,340.23
|
| Rate for Payer: Mclaren Medicaid |
$3,901.35
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$2,142.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,099.11
|
| Rate for Payer: Nomi Health Commercial |
$3,954.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,616.86
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Commercial |
$4,291.48
|
| Rate for Payer: PHP Medicaid |
$2,091.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,267.20
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health Narrow Network |
$3,413.76
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,243.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,901.35
|
| Rate for Payer: UHC Exchange |
$6,047.09
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP DNSP |
$3,901.35
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
HC EXCISE CYST/BREAST LESION
|
Facility
|
IP
|
$4,822.48
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,616.86 |
| Max. Negotiated Rate |
$4,822.48 |
| Rate for Payer: Aetna Commercial |
$4,340.23
|
| Rate for Payer: ASR ASR |
$4,677.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,960.22
|
| Rate for Payer: BCN Commercial |
$3,960.22
|
| Rate for Payer: Cash Price |
$3,857.98
|
| Rate for Payer: Cofinity Commercial |
$4,533.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,857.98
|
| Rate for Payer: Healthscope Commercial |
$4,677.81
|
| Rate for Payer: Healthscope Whirlpool |
$4,822.48
|
| Rate for Payer: Mclaren Commercial |
$4,340.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,099.11
|
| Rate for Payer: Nomi Health Commercial |
$3,954.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,616.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,243.78
|
|
|
HC EXCISE LESION EYELID WITHOUT CLOSURE
|
Facility
|
IP
|
$887.23
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
36100521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$665.42 |
| Max. Negotiated Rate |
$887.23 |
| Rate for Payer: Aetna Commercial |
$798.51
|
| Rate for Payer: ASR ASR |
$860.61
|
| Rate for Payer: BCBS Trust/PPO |
$728.59
|
| Rate for Payer: BCN Commercial |
$728.59
|
| Rate for Payer: Cash Price |
$709.78
|
| Rate for Payer: Cofinity Commercial |
$834.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.78
|
| Rate for Payer: Healthscope Commercial |
$860.61
|
| Rate for Payer: Healthscope Whirlpool |
$887.23
|
| Rate for Payer: Mclaren Commercial |
$798.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.15
|
| Rate for Payer: Nomi Health Commercial |
$727.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$665.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$780.76
|
|
|
HC EXCISE LESION EYELID WITHOUT CLOSURE
|
Facility
|
OP
|
$887.23
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
36100521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$519.49 |
| Max. Negotiated Rate |
$1,539.60 |
| Rate for Payer: Aetna Commercial |
$798.51
|
| Rate for Payer: Aetna Medicare |
$993.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,241.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,241.61
|
| Rate for Payer: ASR ASR |
$860.61
|
| Rate for Payer: BCBS Complete |
$545.51
|
| Rate for Payer: BCBS MAPPO |
$993.29
|
| Rate for Payer: BCBS Trust/PPO |
$731.52
|
| Rate for Payer: BCN Commercial |
$731.52
|
| Rate for Payer: BCN Medicare Advantage |
$993.29
|
| Rate for Payer: Cash Price |
$709.78
|
| Rate for Payer: Cash Price |
$709.78
|
| Rate for Payer: Cofinity Commercial |
$834.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$993.29
|
| Rate for Payer: Healthscope Commercial |
$860.61
|
| Rate for Payer: Healthscope Whirlpool |
$887.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$993.29
|
| Rate for Payer: Mclaren Commercial |
$798.51
|
| Rate for Payer: Mclaren Medicaid |
$993.29
|
| Rate for Payer: Mclaren Medicare |
$993.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,042.95
|
| Rate for Payer: Meridian Medicaid |
$545.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,142.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,092.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.15
|
| Rate for Payer: Nomi Health Commercial |
$727.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$665.42
|
| Rate for Payer: PACE Medicare |
$943.63
|
| Rate for Payer: PACE SWMI |
$993.29
|
| Rate for Payer: PHP Commercial |
$1,092.62
|
| Rate for Payer: PHP Medicaid |
$532.40
|
| Rate for Payer: PHP Medicare Advantage |
$993.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$519.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$777.39
|
| Rate for Payer: Priority Health Medicare |
$993.29
|
| Rate for Payer: Priority Health Narrow Network |
$621.95
|
| Rate for Payer: Railroad Medicare Medicare |
$993.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$780.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$993.29
|
| Rate for Payer: UHC Exchange |
$1,539.60
|
| Rate for Payer: UHC Medicaid |
$519.49
|
| Rate for Payer: UHCCP DNSP |
$993.29
|
| Rate for Payer: UHCCP Medicaid |
$519.49
|
| Rate for Payer: VA VA |
$993.29
|
|
|
HC EXCISE LESION MUCOSA & SBMCSL VESTIB CPLX RPR
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 40814
|
| Hospital Charge Code |
76100490
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,164.37 |
| Max. Negotiated Rate |
$8,219.16 |
| Rate for Payer: Aetna Commercial |
$7,397.24
|
| Rate for Payer: ASR ASR |
$7,972.59
|
| Rate for Payer: BCBS Trust/PPO |
$6,749.57
|
| Rate for Payer: BCN Commercial |
$6,749.57
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Commercial |
$7,726.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Healthscope Commercial |
$7,972.59
|
| Rate for Payer: Healthscope Whirlpool |
$8,219.16
|
| Rate for Payer: Mclaren Commercial |
$7,397.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$6,739.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,232.86
|
|
