|
HC EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Facility
|
OP
|
$11,236.32
|
|
|
Service Code
|
CPT 69110
|
| Hospital Charge Code |
76100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$11,236.32 |
| Rate for Payer: Aetna Commercial |
$10,112.69
|
| Rate for Payer: Aetna Commercial |
$6,741.79
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| 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: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: ASR ASR |
$7,266.15
|
| Rate for Payer: ASR ASR |
$10,899.23
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$6,176.23
|
| Rate for Payer: BCBS Trust/PPO |
$9,264.35
|
| Rate for Payer: BCN Commercial |
$9,264.35
|
| Rate for Payer: BCN Commercial |
$6,176.23
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$8,989.06
|
| Rate for Payer: Cash Price |
$8,989.06
|
| Rate for Payer: Cash Price |
$5,992.70
|
| Rate for Payer: Cash Price |
$5,992.70
|
| Rate for Payer: Cofinity Commercial |
$10,562.14
|
| Rate for Payer: Cofinity Commercial |
$7,041.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,989.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,992.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$10,899.23
|
| Rate for Payer: Healthscope Commercial |
$7,266.15
|
| Rate for Payer: Healthscope Whirlpool |
$7,490.88
|
| Rate for Payer: Healthscope Whirlpool |
$11,236.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$6,741.79
|
| Rate for Payer: Mclaren Commercial |
$10,112.69
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,367.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,550.87
|
| Rate for Payer: Nomi Health Commercial |
$9,213.78
|
| Rate for Payer: Nomi Health Commercial |
$6,142.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,618.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,427.24
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,845.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,563.51
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$7,876.66
|
| Rate for Payer: Priority Health Narrow Network |
$5,251.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,887.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,591.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$4,486.12
|
| Rate for Payer: UHC Exchange |
$4,486.12
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Facility
|
IP
|
$11,236.32
|
|
|
Service Code
|
CPT 69110
|
| Hospital Charge Code |
76100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8,427.24 |
| Max. Negotiated Rate |
$11,236.32 |
| Rate for Payer: Aetna Commercial |
$10,112.69
|
| Rate for Payer: Aetna Commercial |
$6,741.79
|
| Rate for Payer: ASR ASR |
$10,899.23
|
| Rate for Payer: ASR ASR |
$7,266.15
|
| Rate for Payer: BCBS Trust/PPO |
$9,227.27
|
| Rate for Payer: BCBS Trust/PPO |
$6,151.51
|
| Rate for Payer: BCN Commercial |
$9,227.27
|
| Rate for Payer: BCN Commercial |
$6,151.51
|
| Rate for Payer: Cash Price |
$5,992.70
|
| Rate for Payer: Cash Price |
$8,989.06
|
| Rate for Payer: Cofinity Commercial |
$7,041.43
|
| Rate for Payer: Cofinity Commercial |
$10,562.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,989.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,992.70
|
| Rate for Payer: Healthscope Commercial |
$10,899.23
|
| Rate for Payer: Healthscope Commercial |
$7,266.15
|
| Rate for Payer: Healthscope Whirlpool |
$7,490.88
|
| Rate for Payer: Healthscope Whirlpool |
$11,236.32
|
| Rate for Payer: Mclaren Commercial |
$6,741.79
|
| Rate for Payer: Mclaren Commercial |
$10,112.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,367.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,550.87
|
| Rate for Payer: Nomi Health Commercial |
$6,142.52
|
| Rate for Payer: Nomi Health Commercial |
$9,213.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,427.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,618.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,591.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,887.96
|
|
|
HC EXCISION LESION TONGUE W/O CLOSURE
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
76100465
|
|
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 EXCISION LESION TONGUE W/O CLOSURE
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
76100465
|
|
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 EXCISION LINGUAL FRENUM FRENECTOMY
|
Facility
|
IP
|
$4,057.56
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
76100380
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,043.17 |
| Max. Negotiated Rate |
$4,057.56 |
| Rate for Payer: Aetna Commercial |
$3,651.80
|
| Rate for Payer: ASR ASR |
$3,935.83
|
| Rate for Payer: BCBS Trust/PPO |
$3,332.07
|
| Rate for Payer: BCN Commercial |
$3,332.07
|
| Rate for Payer: Cash Price |
$3,246.05
|
| Rate for Payer: Cofinity Commercial |
$3,814.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,246.05
|
| Rate for Payer: Healthscope Commercial |
$3,935.83
|
| Rate for Payer: Healthscope Whirlpool |
$4,057.56
|
| Rate for Payer: Mclaren Commercial |
$3,651.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,448.93
|
| Rate for Payer: Nomi Health Commercial |
$3,327.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,043.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,570.65
|
|
|
HC EXCISION LINGUAL FRENUM FRENECTOMY
|
Facility
|
OP
|
$4,057.56
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
76100380
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$808.56 |
| Max. Negotiated Rate |
$4,057.56 |
| Rate for Payer: Aetna Commercial |
$3,651.80
|
| 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 |
$3,935.83
|
| Rate for Payer: BCBS Complete |
$849.06
|
| Rate for Payer: BCBS MAPPO |
$1,546.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,345.46
|
| Rate for Payer: BCN Commercial |
$3,345.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,546.00
|
| Rate for Payer: Cash Price |
$3,246.05
|
| Rate for Payer: Cash Price |
$3,246.05
|
| Rate for Payer: Cofinity Commercial |
$3,814.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,246.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.00
|
| Rate for Payer: Healthscope Commercial |
$3,935.83
|
| Rate for Payer: Healthscope Whirlpool |
$4,057.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,546.00
|
| Rate for Payer: Mclaren Commercial |
$3,651.80
|
| 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 |
$3,448.93
|
| Rate for Payer: Nomi Health Commercial |
$3,327.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,043.17
|
| 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 |
$3,555.23
|
| Rate for Payer: Priority Health Medicare |
$1,546.00
|
| Rate for Payer: Priority Health Narrow Network |
$2,844.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,546.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,570.65
|
| 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 EXCISION OF ANAL LESION(S)
|
Facility
|
OP
|
$7,678.50
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
76100350
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,446.45 |
| Max. Negotiated Rate |
$7,678.50 |
| Rate for Payer: Aetna Commercial |
$6,910.65
|
| Rate for Payer: Aetna Medicare |
$2,765.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: ASR ASR |
$7,448.15
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$6,330.92
|
| Rate for Payer: BCN Commercial |
$6,330.92
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Cash Price |
$6,142.80
|
| Rate for Payer: Cash Price |
$6,142.80
|
| Rate for Payer: Cofinity Commercial |
$7,217.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,142.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Healthscope Commercial |
$7,448.15
|
| Rate for Payer: Healthscope Whirlpool |
$7,678.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,765.68
|
| Rate for Payer: Mclaren Commercial |
$6,910.65
|
| Rate for Payer: Mclaren Medicaid |
$2,765.68
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$1,518.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,526.73
|
| Rate for Payer: Nomi Health Commercial |
$6,296.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,758.88
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Commercial |
$3,042.25
|
| Rate for Payer: PHP Medicaid |
$1,482.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,727.90
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health Narrow Network |
$5,382.63
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,757.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,765.68
|
| Rate for Payer: UHC Exchange |
$4,286.80
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP DNSP |
$2,765.68
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
HC EXCISION OF ANAL LESION(S)
|
Facility
|
IP
|
$7,678.50
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
76100350
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,758.88 |
| Max. Negotiated Rate |
$7,678.50 |
| Rate for Payer: Aetna Commercial |
$6,910.65
|
| Rate for Payer: ASR ASR |
$7,448.15
|
| Rate for Payer: BCBS Trust/PPO |
$6,305.58
|
| Rate for Payer: BCN Commercial |
$6,305.58
|
| Rate for Payer: Cash Price |
$6,142.80
|
| Rate for Payer: Cofinity Commercial |
$7,217.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,142.80
|
| Rate for Payer: Healthscope Commercial |
$7,448.15
|
| Rate for Payer: Healthscope Whirlpool |
$7,678.50
|
| Rate for Payer: Mclaren Commercial |
$6,910.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,526.73
|
| Rate for Payer: Nomi Health Commercial |
$6,296.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,758.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,757.08
|
|
|
HC EXCISION OF NAIL OR NAIL MATRIX
|
Facility
|
IP
|
$403.71
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
76100077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$302.78 |
| Max. Negotiated Rate |
$403.71 |
| Rate for Payer: Aetna Commercial |
$363.34
|
| Rate for Payer: ASR ASR |
$391.60
|
| Rate for Payer: BCBS Trust/PPO |
$331.53
|
| Rate for Payer: BCN Commercial |
$331.53
|
| Rate for Payer: Cash Price |
$322.97
|
| Rate for Payer: Cofinity Commercial |
$379.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.97
|
| Rate for Payer: Healthscope Commercial |
$391.60
|
| Rate for Payer: Healthscope Whirlpool |
$403.71
|
| Rate for Payer: Mclaren Commercial |
$363.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.15
|
| Rate for Payer: Nomi Health Commercial |
$331.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$302.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$355.26
|
|
|
HC EXCISION OF NAIL OR NAIL MATRIX
|
Facility
|
OP
|
$403.71
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
76100077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$848.60 |
| Rate for Payer: Aetna Commercial |
$363.34
|
| 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 |
$391.60
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$332.86
|
| Rate for Payer: BCN Commercial |
$332.86
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$322.97
|
| Rate for Payer: Cash Price |
$322.97
|
| Rate for Payer: Cofinity Commercial |
$379.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$391.60
|
| Rate for Payer: Healthscope Whirlpool |
$403.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$363.34
|
| 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 |
$343.15
|
| Rate for Payer: Nomi Health Commercial |
$331.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$302.78
|
| 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 |
$355.26
|
| 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 EXCISION OF PENIS LESION(S)
|
Facility
|
IP
|
$5,383.36
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
76100347
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$4,037.52 |
| Max. Negotiated Rate |
$5,383.36 |
| Rate for Payer: Aetna Commercial |
$4,845.02
|
| Rate for Payer: ASR ASR |
$5,221.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,420.82
|
| Rate for Payer: BCN Commercial |
$4,420.82
|
| Rate for Payer: Cash Price |
$4,306.69
|
| Rate for Payer: Cofinity Commercial |
$5,060.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,306.69
|
| Rate for Payer: Healthscope Commercial |
$5,221.86
|
| Rate for Payer: Healthscope Whirlpool |
$5,383.36
|
| Rate for Payer: Mclaren Commercial |
$4,845.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,575.86
|
| Rate for Payer: Nomi Health Commercial |
$4,414.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,037.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,737.36
|
|
|
HC EXCISION OF PENIS LESION(S)
|
Facility
|
OP
|
$5,383.36
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
76100347
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$1,075.21 |
| Max. Negotiated Rate |
$5,383.36 |
| Rate for Payer: Aetna Commercial |
$4,845.02
|
| Rate for Payer: Aetna Medicare |
$2,055.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: ASR ASR |
$5,221.86
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,438.58
|
| Rate for Payer: BCN Commercial |
$4,438.58
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Cash Price |
$4,306.69
|
| Rate for Payer: Cash Price |
$4,306.69
|
| Rate for Payer: Cofinity Commercial |
$5,060.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,306.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Healthscope Commercial |
$5,221.86
|
| Rate for Payer: Healthscope Whirlpool |
$5,383.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,055.86
|
| Rate for Payer: Mclaren Commercial |
$4,845.02
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$1,129.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,575.86
|
| Rate for Payer: Nomi Health Commercial |
$4,414.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,037.52
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Commercial |
$2,261.45
|
| Rate for Payer: PHP Medicaid |
$1,101.94
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,716.90
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health Narrow Network |
$3,773.74
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,737.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Exchange |
$3,186.58
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP DNSP |
$2,055.86
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: VA VA |
$2,055.86
|
|
|
HC EXCISION SOFT TISSUE PELVIS HIP SUBQ <3CM
|
Facility
|
IP
|
$7,306.20
|
|
|
Service Code
|
CPT 27047
|
| Hospital Charge Code |
76100439
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,479.65 |
| Max. Negotiated Rate |
$7,306.20 |
| Rate for Payer: Aetna Commercial |
$6,575.58
|
| Rate for Payer: ASR ASR |
$7,087.01
|
| Rate for Payer: BCBS Trust/PPO |
$5,999.85
|
| Rate for Payer: BCN Commercial |
$5,999.85
|
| Rate for Payer: Cash Price |
$5,844.96
|
| Rate for Payer: Cofinity Commercial |
$6,867.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,844.96
|
| Rate for Payer: Healthscope Commercial |
$7,087.01
|
| Rate for Payer: Healthscope Whirlpool |
$7,306.20
|
| Rate for Payer: Mclaren Commercial |
$6,575.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,210.27
|
| Rate for Payer: Nomi Health Commercial |
$5,991.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,479.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,429.46
|
|
|
HC EXCISION SOFT TISSUE PELVIS HIP SUBQ <3CM
|
Facility
|
OP
|
$7,306.20
|
|
|
Service Code
|
CPT 27047
|
| Hospital Charge Code |
76100439
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$7,306.20 |
| Rate for Payer: Aetna Commercial |
$6,575.58
|
| 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 |
$7,087.01
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$6,023.96
|
| Rate for Payer: BCN Commercial |
$6,023.96
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$5,844.96
|
| Rate for Payer: Cash Price |
$5,844.96
|
| Rate for Payer: Cofinity Commercial |
$6,867.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,844.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$7,087.01
|
| Rate for Payer: Healthscope Whirlpool |
$7,306.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$6,575.58
|
| 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 |
$6,210.27
|
| Rate for Payer: Nomi Health Commercial |
$5,991.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,479.65
|
| 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 |
$6,401.69
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$5,121.65
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,429.46
|
| 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 EXCISION TONSIL TAGS
|
Facility
|
IP
|
$8,284.71
|
|
|
Service Code
|
CPT 42860
|
| Hospital Charge Code |
76100477
|
|
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 TONSIL TAGS
|
Facility
|
OP
|
$8,284.71
|
|
|
Service Code
|
CPT 42860
|
| Hospital Charge Code |
76100477
|
|
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 TUMOR SOFT TISSUE SHOULDER SUBQ <3CM
|
Facility
|
IP
|
$4,720.29
|
|
|
Service Code
|
CPT 23075
|
| Hospital Charge Code |
76100412
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,540.22 |
| Max. Negotiated Rate |
$4,720.29 |
| Rate for Payer: Aetna Commercial |
$4,248.26
|
| Rate for Payer: ASR ASR |
$4,578.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,876.30
|
| Rate for Payer: BCN Commercial |
$3,876.30
|
| Rate for Payer: Cash Price |
$3,776.23
|
| Rate for Payer: Cofinity Commercial |
$4,437.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,776.23
|
| Rate for Payer: Healthscope Commercial |
$4,578.68
|
| Rate for Payer: Healthscope Whirlpool |
$4,720.29
|
| Rate for Payer: Mclaren Commercial |
$4,248.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,012.25
|
| Rate for Payer: Nomi Health Commercial |
$3,870.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,540.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,153.86
|
|
|
HC EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM
|
Facility
|
OP
|
$4,720.29
|
|
|
Service Code
|
CPT 23075
|
| Hospital Charge Code |
76100412
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$4,720.29 |
| Rate for Payer: Aetna Commercial |
$4,248.26
|
| 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 |
$4,578.68
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,891.88
|
| Rate for Payer: BCN Commercial |
$3,891.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,776.23
|
| Rate for Payer: Cash Price |
$3,776.23
|
| Rate for Payer: Cofinity Commercial |
$4,437.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,776.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$4,578.68
|
| Rate for Payer: Healthscope Whirlpool |
$4,720.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$4,248.26
|
| 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 |
$4,012.25
|
| Rate for Payer: Nomi Health Commercial |
$3,870.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,540.22
|
| 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 |
$4,135.92
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$3,308.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,153.86
|
| 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 EXCISION VAGINAL CYST/TUMOR
|
Facility
|
OP
|
$8,104.44
|
|
|
Service Code
|
CPT 57135
|
| Hospital Charge Code |
76100333
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,686.93 |
| Max. Negotiated Rate |
$8,104.44 |
| Rate for Payer: Aetna Commercial |
$7,294.00
|
| Rate for Payer: Aetna Medicare |
$3,225.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: ASR ASR |
$7,861.31
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$6,682.11
|
| Rate for Payer: BCN Commercial |
$6,682.11
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$7,618.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$7,861.31
|
| Rate for Payer: Healthscope Whirlpool |
$8,104.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,225.49
|
| Rate for Payer: Mclaren Commercial |
$7,294.00
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$1,771.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$3,548.04
|
| Rate for Payer: PHP Medicaid |
$1,728.86
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,015.25
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health Narrow Network |
$3,212.20
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,131.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$4,999.51
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP DNSP |
$3,225.49
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: VA VA |
$3,225.49
|
|
|
HC EXCISION VAGINAL CYST/TUMOR
|
Facility
|
IP
|
$8,104.44
|
|
|
Service Code
|
CPT 57135
|
| Hospital Charge Code |
76100333
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,078.33 |
| Max. Negotiated Rate |
$8,104.44 |
| Rate for Payer: Aetna Commercial |
$7,294.00
|
| Rate for Payer: ASR ASR |
$7,861.31
|
| Rate for Payer: BCBS Trust/PPO |
$6,655.37
|
| Rate for Payer: BCN Commercial |
$6,655.37
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$7,618.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Healthscope Commercial |
$7,861.31
|
| Rate for Payer: Healthscope Whirlpool |
$8,104.44
|
| Rate for Payer: Mclaren Commercial |
$7,294.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,131.91
|
|
|
HC EXC LEG/ANKLE TUM < 3 CM
|
Facility
|
OP
|
$2,986.24
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
76100309
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$2,986.24 |
| Rate for Payer: Aetna Commercial |
$2,687.62
|
| 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 |
$2,896.65
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,462.15
|
| Rate for Payer: BCN Commercial |
$2,462.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$2,388.99
|
| Rate for Payer: Cash Price |
$2,388.99
|
| Rate for Payer: Cofinity Commercial |
$2,807.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,388.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,896.65
|
| Rate for Payer: Healthscope Whirlpool |
$2,986.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$2,687.62
|
| 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 |
$2,538.30
|
| Rate for Payer: Nomi Health Commercial |
$2,448.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,239.68
|
| 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 |
$2,616.54
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$2,093.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,627.89
|
| 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 EXC LEG/ANKLE TUM < 3 CM
|
Facility
|
IP
|
$2,986.24
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
76100309
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,239.68 |
| Max. Negotiated Rate |
$2,986.24 |
| Rate for Payer: Aetna Commercial |
$2,687.62
|
| Rate for Payer: ASR ASR |
$2,896.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,452.30
|
| Rate for Payer: BCN Commercial |
$2,452.30
|
| Rate for Payer: Cash Price |
$2,388.99
|
| Rate for Payer: Cofinity Commercial |
$2,807.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,388.99
|
| Rate for Payer: Healthscope Commercial |
$2,896.65
|
| Rate for Payer: Healthscope Whirlpool |
$2,986.24
|
| Rate for Payer: Mclaren Commercial |
$2,687.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,538.30
|
| Rate for Payer: Nomi Health Commercial |
$2,448.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,239.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,627.89
|
|
|
HC EXC LESION MUCOSA SBMCSL VESTIBULE SMPL RPR
|
Facility
|
IP
|
$4,353.36
|
|
|
Service Code
|
CPT 40812
|
| Hospital Charge Code |
76100430
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,265.02 |
| Max. Negotiated Rate |
$4,353.36 |
| Rate for Payer: Aetna Commercial |
$3,918.02
|
| Rate for Payer: ASR ASR |
$4,222.76
|
| Rate for Payer: BCBS Trust/PPO |
$3,574.98
|
| Rate for Payer: BCN Commercial |
$3,574.98
|
| Rate for Payer: Cash Price |
$3,482.69
|
| Rate for Payer: Cofinity Commercial |
$4,092.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,482.69
|
| Rate for Payer: Healthscope Commercial |
$4,222.76
|
| Rate for Payer: Healthscope Whirlpool |
$4,353.36
|
| Rate for Payer: Mclaren Commercial |
$3,918.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,700.36
|
| Rate for Payer: Nomi Health Commercial |
$3,569.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,265.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,830.96
|
|
|
HC EXC LESION MUCOSA SBMCSL VESTIBULE SMPL RPR
|
Facility
|
OP
|
$4,353.36
|
|
|
Service Code
|
CPT 40812
|
| Hospital Charge Code |
76100430
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$808.56 |
| Max. Negotiated Rate |
$4,353.36 |
| Rate for Payer: Aetna Commercial |
$3,918.02
|
| 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 |
$4,222.76
|
| Rate for Payer: BCBS Complete |
$849.06
|
| Rate for Payer: BCBS MAPPO |
$1,546.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,589.35
|
| Rate for Payer: BCN Commercial |
$3,589.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,546.00
|
| Rate for Payer: Cash Price |
$3,482.69
|
| Rate for Payer: Cash Price |
$3,482.69
|
| Rate for Payer: Cofinity Commercial |
$4,092.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,482.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.00
|
| Rate for Payer: Healthscope Commercial |
$4,222.76
|
| Rate for Payer: Healthscope Whirlpool |
$4,353.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,546.00
|
| Rate for Payer: Mclaren Commercial |
$3,918.02
|
| 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 |
$3,700.36
|
| Rate for Payer: Nomi Health Commercial |
$3,569.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,265.02
|
| 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 |
$3,814.41
|
| Rate for Payer: Priority Health Medicare |
$1,546.00
|
| Rate for Payer: Priority Health Narrow Network |
$3,051.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,546.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,830.96
|
| 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 EXC LESION PALATE UVULA W/O CLOSURE
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 42104
|
| Hospital Charge Code |
76100467
|
|
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
|
|
