|
HC EXCISE LESION MUCOSA & SBMCSL VESTIB CPLX RPR
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 40814
|
| Hospital Charge Code |
76100490
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$8,219.16 |
| Rate for Payer: Aetna Commercial |
$7,397.24
|
| Rate for Payer: Aetna Medicare |
$3,303.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: ASR ASR |
$7,972.59
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$6,776.70
|
| Rate for Payer: BCN Commercial |
$6,776.70
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,575.33
|
| 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: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$7,972.59
|
| Rate for Payer: Healthscope Whirlpool |
$8,219.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,303.54
|
| Rate for Payer: Mclaren Commercial |
$7,397.24
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$1,814.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$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: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$3,633.89
|
| Rate for Payer: PHP Medicaid |
$1,770.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,201.63
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Narrow Network |
$5,761.63
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,232.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$5,120.49
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP DNSP |
$3,303.54
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
HC EXCISE LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
76100461
|
|
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
|
|
|
HC EXCISE LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
76100461
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$8,219.16 |
| Rate for Payer: Aetna Commercial |
$7,397.24
|
| Rate for Payer: Aetna Medicare |
$3,303.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: ASR ASR |
$7,972.59
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$6,776.70
|
| Rate for Payer: BCN Commercial |
$6,776.70
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,575.33
|
| 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: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$7,972.59
|
| Rate for Payer: Healthscope Whirlpool |
$8,219.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,303.54
|
| Rate for Payer: Mclaren Commercial |
$7,397.24
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$1,814.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$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: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$3,633.89
|
| Rate for Payer: PHP Medicaid |
$1,770.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,201.63
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Narrow Network |
$5,761.63
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,232.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$5,120.49
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP DNSP |
$3,303.54
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
HC EXCISE LIP OR CHEEK FOLD
|
Facility
|
OP
|
$4,043.82
|
|
|
Service Code
|
CPT 40819
|
| Hospital Charge Code |
76100517
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$808.56 |
| Max. Negotiated Rate |
$4,043.82 |
| Rate for Payer: Aetna Commercial |
$3,639.44
|
| Rate for Payer: Aetna Medicare |
$1,546.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,932.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,932.50
|
| Rate for Payer: ASR ASR |
$3,922.51
|
| Rate for Payer: BCBS Complete |
$849.06
|
| Rate for Payer: BCBS MAPPO |
$1,546.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,334.13
|
| Rate for Payer: BCN Commercial |
$3,334.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,546.00
|
| Rate for Payer: Cash Price |
$3,235.06
|
| Rate for Payer: Cash Price |
$3,235.06
|
| Rate for Payer: Cofinity Commercial |
$3,801.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,235.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.00
|
| Rate for Payer: Healthscope Commercial |
$3,922.51
|
| Rate for Payer: Healthscope Whirlpool |
$4,043.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,546.00
|
| Rate for Payer: Mclaren Commercial |
$3,639.44
|
| Rate for Payer: Mclaren Medicaid |
$1,546.00
|
| Rate for Payer: Mclaren Medicare |
$1,546.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,623.30
|
| Rate for Payer: Meridian Medicaid |
$849.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,777.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,700.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,437.25
|
| Rate for Payer: Nomi Health Commercial |
$3,315.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,032.86
|
| Rate for Payer: PACE Medicare |
$1,468.70
|
| Rate for Payer: PACE SWMI |
$1,546.00
|
| Rate for Payer: PHP Commercial |
$1,700.60
|
| Rate for Payer: PHP Medicaid |
$828.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,546.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,543.20
|
| Rate for Payer: Priority Health Medicare |
$1,546.00
|
| Rate for Payer: Priority Health Narrow Network |
$2,834.72
|
| Rate for Payer: Railroad Medicare Medicare |
$1,546.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,558.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,546.00
|
| Rate for Payer: UHC Exchange |
$2,396.30
|
| Rate for Payer: UHC Medicaid |
$808.56
|
| Rate for Payer: UHCCP DNSP |
$1,546.00
|
| Rate for Payer: UHCCP Medicaid |
$808.56
|
| Rate for Payer: VA VA |
$1,546.00
|
|
|
HC EXCISE LIP OR CHEEK FOLD
|
Facility
|
IP
|
$4,043.82
|
|
|
Service Code
|
CPT 40819
|
| Hospital Charge Code |
76100517
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,032.86 |
| Max. Negotiated Rate |
$4,043.82 |
| Rate for Payer: Aetna Commercial |
$3,639.44
|
| Rate for Payer: ASR ASR |
$3,922.51
|
| Rate for Payer: BCBS Trust/PPO |
$3,320.78
|
| Rate for Payer: BCN Commercial |
$3,320.78
|
| Rate for Payer: Cash Price |
$3,235.06
|
| Rate for Payer: Cofinity Commercial |
$3,801.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,235.06
|
| Rate for Payer: Healthscope Commercial |
$3,922.51
|
| Rate for Payer: Healthscope Whirlpool |
$4,043.82
|
| Rate for Payer: Mclaren Commercial |
$3,639.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,437.25
|
| Rate for Payer: Nomi Health Commercial |
$3,315.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,032.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,558.56
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.5 CM OR LESS
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
76100110
|
|
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 MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.5 CM OR LESS
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
76100110
|
|
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 MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
76100111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$1,093.66 |
| Rate for Payer: Aetna Commercial |
$550.87
|
| 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 |
$593.72
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$504.66
|
| Rate for Payer: BCN Commercial |
$504.66
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| 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 |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$593.72
|
| Rate for Payer: Healthscope Whirlpool |
$612.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$550.87
|
| 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 |
$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 |
$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 |
$536.30
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$429.07
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.63
|
| 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 MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
76100111
|
|
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 MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
76100112
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$1,093.66 |
| Rate for Payer: Aetna Commercial |
$550.87
|
| 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 |
$593.72
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$504.66
|
| Rate for Payer: BCN Commercial |
$504.66
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| 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 |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$593.72
|
| Rate for Payer: Healthscope Whirlpool |
$612.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$550.87
|
| 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 |
$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 |
$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 |
$536.30
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$429.07
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.63
|
| 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 MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
76100112
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS <=0.5 CM
|
Facility
|
IP
|
$193.14
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
76100145
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.85 |
| Max. Negotiated Rate |
$193.14 |
| Rate for Payer: Aetna Commercial |
$173.83
|
| Rate for Payer: ASR ASR |
$187.35
|
| Rate for Payer: BCBS Trust/PPO |
$158.61
|
| Rate for Payer: BCN Commercial |
$158.61
|
| Rate for Payer: Cash Price |
$154.51
|
| Rate for Payer: Cofinity Commercial |
$181.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.51
|
| Rate for Payer: Healthscope Commercial |
$187.35
|
| Rate for Payer: Healthscope Whirlpool |
$193.14
|
| Rate for Payer: Mclaren Commercial |
$173.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.17
|
| Rate for Payer: Nomi Health Commercial |
$158.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$144.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$169.96
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS <=0.5 CM
|
Facility
|
OP
|
$193.14
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
76100145
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$135.39 |
| Max. Negotiated Rate |
$1,093.66 |
| Rate for Payer: Aetna Commercial |
$173.83
|
| 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 |
$187.35
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$159.24
|
| Rate for Payer: BCN Commercial |
$159.24
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$154.51
|
| Rate for Payer: Cash Price |
$154.51
|
| Rate for Payer: Cofinity Commercial |
$181.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$187.35
|
| Rate for Payer: Healthscope Whirlpool |
$193.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$173.83
|
| 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 |
$164.17
|
| Rate for Payer: Nomi Health Commercial |
$158.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$144.85
|
| 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 |
$169.23
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$135.39
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$169.96
|
| 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 MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11601
|
| Hospital Charge Code |
76100104
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11601
|
| Hospital Charge Code |
76100104
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$1,093.66 |
| Rate for Payer: Aetna Commercial |
$550.87
|
| 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 |
$593.72
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$504.66
|
| Rate for Payer: BCN Commercial |
$504.66
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| 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 |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$593.72
|
| Rate for Payer: Healthscope Whirlpool |
$612.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$550.87
|
| 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 |
$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 |
$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 |
$536.30
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$429.07
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.63
|
| 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 MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
76100105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$627.83 |
| 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 |
$536.30
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$429.07
|
| 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 MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
76100105
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
76100106
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
76100106
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
IP
|
$318.69
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
76100146
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$239.02 |
| Max. Negotiated Rate |
$318.69 |
| Rate for Payer: Aetna Commercial |
$286.82
|
| Rate for Payer: ASR ASR |
$309.13
|
| Rate for Payer: BCBS Trust/PPO |
$261.71
|
| Rate for Payer: BCN Commercial |
$261.71
|
| Rate for Payer: Cash Price |
$254.95
|
| Rate for Payer: Cofinity Commercial |
$299.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.95
|
| Rate for Payer: Healthscope Commercial |
$309.13
|
| Rate for Payer: Healthscope Whirlpool |
$318.69
|
| Rate for Payer: Mclaren Commercial |
$286.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$270.89
|
| Rate for Payer: Nomi Health Commercial |
$261.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$239.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$280.45
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
OP
|
$318.69
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
76100146
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$223.40 |
| Max. Negotiated Rate |
$1,093.66 |
| Rate for Payer: Aetna Commercial |
$286.82
|
| 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 |
$309.13
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$262.76
|
| Rate for Payer: BCN Commercial |
$262.76
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$254.95
|
| Rate for Payer: Cash Price |
$254.95
|
| Rate for Payer: Cofinity Commercial |
$299.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$309.13
|
| Rate for Payer: Healthscope Whirlpool |
$318.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$286.82
|
| 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 |
$270.89
|
| Rate for Payer: Nomi Health Commercial |
$261.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$239.02
|
| 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 |
$279.24
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$223.40
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$280.45
|
| 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 EXCISION/DESTRUCT LESION PHARYNX ANY METHOD
|
Facility
|
OP
|
$8,284.71
|
|
|
Service Code
|
CPT 42808
|
| Hospital Charge Code |
76100476
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$8,284.71 |
| Rate for Payer: Aetna Commercial |
$7,456.24
|
| Rate for Payer: Aetna Medicare |
$3,303.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: ASR ASR |
$8,036.17
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$6,830.74
|
| Rate for Payer: BCN Commercial |
$6,830.74
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,627.77
|
| Rate for Payer: Cash Price |
$6,627.77
|
| Rate for Payer: Cofinity Commercial |
$7,787.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,627.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$8,036.17
|
| Rate for Payer: Healthscope Whirlpool |
$8,284.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,303.54
|
| Rate for Payer: Mclaren Commercial |
$7,456.24
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$1,814.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,042.00
|
| Rate for Payer: Nomi Health Commercial |
$6,793.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,213.53
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$3,633.89
|
| Rate for Payer: PHP Medicaid |
$1,770.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,259.06
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Narrow Network |
$5,807.58
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,290.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$5,120.49
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP DNSP |
$3,303.54
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
HC EXCISION/DESTRUCT LESION PHARYNX ANY METHOD
|
Facility
|
IP
|
$8,284.71
|
|
|
Service Code
|
CPT 42808
|
| Hospital Charge Code |
76100476
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,213.53 |
| Max. Negotiated Rate |
$8,284.71 |
| Rate for Payer: Aetna Commercial |
$7,456.24
|
| Rate for Payer: ASR ASR |
$8,036.17
|
| Rate for Payer: BCBS Trust/PPO |
$6,803.40
|
| Rate for Payer: BCN Commercial |
$6,803.40
|
| Rate for Payer: Cash Price |
$6,627.77
|
| Rate for Payer: Cofinity Commercial |
$7,787.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,627.77
|
| Rate for Payer: Healthscope Commercial |
$8,036.17
|
| Rate for Payer: Healthscope Whirlpool |
$8,284.71
|
| Rate for Payer: Mclaren Commercial |
$7,456.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,042.00
|
| Rate for Payer: Nomi Health Commercial |
$6,793.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,213.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,290.54
|
|
|
HC EXCISION EXCESSIVE SKIN & SUBQ TISSUE
|
Facility
|
IP
|
$7,323.40
|
|
|
Service Code
|
CPT 15839
|
| Hospital Charge Code |
76100330
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,492.55 |
| Max. Negotiated Rate |
$7,323.40 |
| Rate for Payer: Aetna Commercial |
$6,591.06
|
| Rate for Payer: ASR ASR |
$7,103.70
|
| Rate for Payer: BCBS Trust/PPO |
$6,013.98
|
| Rate for Payer: BCN Commercial |
$6,013.98
|
| Rate for Payer: Cash Price |
$5,858.72
|
| Rate for Payer: Cofinity Commercial |
$6,884.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,858.72
|
| Rate for Payer: Healthscope Commercial |
$7,103.70
|
| Rate for Payer: Healthscope Whirlpool |
$7,323.40
|
| Rate for Payer: Mclaren Commercial |
$6,591.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,224.89
|
| Rate for Payer: Nomi Health Commercial |
$6,005.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,492.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,444.59
|
|
|
HC EXCISION EXCESSIVE SKIN & SUBQ TISSUE
|
Facility
|
OP
|
$7,323.40
|
|
|
Service Code
|
CPT 15839
|
| Hospital Charge Code |
76100330
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$7,323.40 |
| Rate for Payer: Aetna Commercial |
$6,591.06
|
| 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 |
$7,103.70
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$6,038.14
|
| Rate for Payer: BCN Commercial |
$6,038.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$5,858.72
|
| Rate for Payer: Cash Price |
$5,858.72
|
| Rate for Payer: Cofinity Commercial |
$6,884.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,858.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$7,103.70
|
| Rate for Payer: Healthscope Whirlpool |
$7,323.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$6,591.06
|
| 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 |
$6,224.89
|
| Rate for Payer: Nomi Health Commercial |
$6,005.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,492.55
|
| 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 |
$6,416.76
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$5,133.70
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,444.59
|
| 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
|
|
