|
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
|
|
|
HC EXC LESION TONGUE W/CLOSURE
|
Facility
|
IP
|
$9,995.00
|
|
|
Service Code
|
CPT 41112
|
| Hospital Charge Code |
76100540
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7,496.25 |
| Max. Negotiated Rate |
$9,995.00 |
| Rate for Payer: Aetna Commercial |
$8,995.50
|
| Rate for Payer: ASR ASR |
$9,695.15
|
| Rate for Payer: BCBS Trust/PPO |
$8,207.89
|
| Rate for Payer: BCN Commercial |
$8,207.89
|
| Rate for Payer: Cash Price |
$7,996.00
|
| Rate for Payer: Cofinity Commercial |
$9,395.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,996.00
|
| Rate for Payer: Healthscope Commercial |
$9,695.15
|
| Rate for Payer: Healthscope Whirlpool |
$9,995.00
|
| Rate for Payer: Mclaren Commercial |
$8,995.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,495.75
|
| Rate for Payer: Nomi Health Commercial |
$8,195.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,496.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,795.60
|
|
|
HC EXC LESION TONGUE W/CLOSURE
|
Facility
|
OP
|
$9,995.00
|
|
|
Service Code
|
CPT 41112
|
| Hospital Charge Code |
76100540
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$9,995.00 |
| Rate for Payer: Aetna Commercial |
$8,995.50
|
| 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 |
$9,695.15
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$8,240.88
|
| Rate for Payer: BCN Commercial |
$8,240.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$7,996.00
|
| Rate for Payer: Cash Price |
$7,996.00
|
| Rate for Payer: Cofinity Commercial |
$9,395.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,996.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$9,695.15
|
| Rate for Payer: Healthscope Whirlpool |
$9,995.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,303.54
|
| Rate for Payer: Mclaren Commercial |
$8,995.50
|
| 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 |
$8,495.75
|
| Rate for Payer: Nomi Health Commercial |
$8,195.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,496.25
|
| 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 |
$8,757.62
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Narrow Network |
$7,006.49
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,795.60
|
| 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 EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 40510
|
| Hospital Charge Code |
76100457
|
|
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 EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 40510
|
| Hospital Charge Code |
76100457
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11620
|
| Hospital Charge Code |
76100107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$840.90 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,079.61
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$1,163.58
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$989.05
|
| Rate for Payer: BCN Commercial |
$989.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,127.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,163.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,199.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,079.61
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,051.06
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$840.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,055.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11620
|
| Hospital Charge Code |
76100107
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 TO 1.0 CM
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
76100108
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 TO 1.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
76100108
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.0 TO 2.0 CM
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
76100109
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.0 TO 2.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
76100109
|
|
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 EXC SINGLE EXTERNAL PAPILLA OR TAG, ANUS
|
Facility
|
OP
|
$1,598.53
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
76100280
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$1,848.13 |
| Rate for Payer: Aetna Commercial |
$1,438.68
|
| Rate for Payer: Aetna Medicare |
$1,192.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: ASR ASR |
$1,550.57
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.99
|
| Rate for Payer: BCN Commercial |
$1,317.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Cash Price |
$1,278.82
|
| Rate for Payer: Cash Price |
$1,278.82
|
| Rate for Payer: Cofinity Commercial |
$1,502.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,278.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Healthscope Commercial |
$1,550.57
|
| Rate for Payer: Healthscope Whirlpool |
$1,598.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,192.34
|
| Rate for Payer: Mclaren Commercial |
$1,438.68
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$654.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,358.75
|
| Rate for Payer: Nomi Health Commercial |
$1,310.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,198.90
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Commercial |
$1,311.57
|
| Rate for Payer: PHP Medicaid |
$639.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,400.63
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,120.57
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,406.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Exchange |
$1,848.13
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP DNSP |
$1,192.34
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
HC EXC SINGLE EXTERNAL PAPILLA OR TAG, ANUS
|
Facility
|
IP
|
$1,598.53
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
76100280
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,198.90 |
| Max. Negotiated Rate |
$1,598.53 |
| Rate for Payer: Aetna Commercial |
$1,438.68
|
| Rate for Payer: ASR ASR |
$1,550.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,312.71
|
| Rate for Payer: BCN Commercial |
$1,312.71
|
| Rate for Payer: Cash Price |
$1,278.82
|
| Rate for Payer: Cofinity Commercial |
$1,502.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,278.82
|
| Rate for Payer: Healthscope Commercial |
$1,550.57
|
| Rate for Payer: Healthscope Whirlpool |
$1,598.53
|
| Rate for Payer: Mclaren Commercial |
$1,438.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,358.75
|
| Rate for Payer: Nomi Health Commercial |
$1,310.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,198.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,406.71
|
|
|
HC EXC SKIN MALIG 2.1-3CM FACE, FACIAL
|
Facility
|
OP
|
$2,189.54
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
76100215
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,970.59
|
| 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 |
$2,123.85
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,805.28
|
| Rate for Payer: BCN Commercial |
$1,805.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Commercial |
$2,058.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,123.85
|
| Rate for Payer: Healthscope Whirlpool |
$2,189.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,970.59
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.11
|
| Rate for Payer: Nomi Health Commercial |
$1,795.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,918.47
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,534.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,926.80
|
| 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 SKIN MALIG 2.1-3CM FACE, FACIAL
|
Facility
|
IP
|
$2,189.54
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
76100215
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,642.15 |
| Max. Negotiated Rate |
$2,189.54 |
| Rate for Payer: Aetna Commercial |
$1,970.59
|
| Rate for Payer: ASR ASR |
$2,123.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,798.05
|
| Rate for Payer: BCN Commercial |
$1,798.05
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Commercial |
$2,058.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Healthscope Commercial |
$2,123.85
|
| Rate for Payer: Healthscope Whirlpool |
$2,189.54
|
| Rate for Payer: Mclaren Commercial |
$1,970.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.11
|
| Rate for Payer: Nomi Health Commercial |
$1,795.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,926.80
|
|
|
HC EXC SKIN MALIG 2.1-3 CM REMAINDER BODY
|
Facility
|
OP
|
$2,189.54
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
76100212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,970.59
|
| 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 |
$2,123.85
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,805.28
|
| Rate for Payer: BCN Commercial |
$1,805.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Commercial |
$2,058.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,123.85
|
| Rate for Payer: Healthscope Whirlpool |
$2,189.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,970.59
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.11
|
| Rate for Payer: Nomi Health Commercial |
$1,795.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,918.47
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,534.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,926.80
|
| 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 SKIN MALIG 2.1-3 CM REMAINDER BODY
|
Facility
|
IP
|
$2,189.54
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
76100212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,642.15 |
| Max. Negotiated Rate |
$2,189.54 |
| Rate for Payer: Aetna Commercial |
$1,970.59
|
| Rate for Payer: ASR ASR |
$2,123.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,798.05
|
| Rate for Payer: BCN Commercial |
$1,798.05
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Commercial |
$2,058.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Healthscope Commercial |
$2,123.85
|
| Rate for Payer: Healthscope Whirlpool |
$2,189.54
|
| Rate for Payer: Mclaren Commercial |
$1,970.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.11
|
| Rate for Payer: Nomi Health Commercial |
$1,795.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,926.80
|
|
|
HC EXC SKIN MALIG 3.1-4CM FACE, FACIAL
|
Facility
|
OP
|
$2,189.54
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
76100216
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,970.59
|
| 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 |
$2,123.85
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,805.28
|
| Rate for Payer: BCN Commercial |
$1,805.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Commercial |
$2,058.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,123.85
|
| Rate for Payer: Healthscope Whirlpool |
$2,189.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,970.59
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.11
|
| Rate for Payer: Nomi Health Commercial |
$1,795.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,918.47
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,534.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,926.80
|
| 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 SKIN MALIG 3.1-4CM FACE, FACIAL
|
Facility
|
IP
|
$2,189.54
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
76100216
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,642.15 |
| Max. Negotiated Rate |
$2,189.54 |
| Rate for Payer: Aetna Commercial |
$1,970.59
|
| Rate for Payer: ASR ASR |
$2,123.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,798.05
|
| Rate for Payer: BCN Commercial |
$1,798.05
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Commercial |
$2,058.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Healthscope Commercial |
$2,123.85
|
| Rate for Payer: Healthscope Whirlpool |
$2,189.54
|
| Rate for Payer: Mclaren Commercial |
$1,970.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.11
|
| Rate for Payer: Nomi Health Commercial |
$1,795.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,926.80
|
|
|
HC EXC SKIN MALIG 3.1-4 CM REMAINDER BODY
|
Facility
|
IP
|
$2,189.54
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
76100213
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,642.15 |
| Max. Negotiated Rate |
$2,189.54 |
| Rate for Payer: Aetna Commercial |
$1,970.59
|
| Rate for Payer: ASR ASR |
$2,123.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,798.05
|
| Rate for Payer: BCN Commercial |
$1,798.05
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Commercial |
$2,058.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Healthscope Commercial |
$2,123.85
|
| Rate for Payer: Healthscope Whirlpool |
$2,189.54
|
| Rate for Payer: Mclaren Commercial |
$1,970.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.11
|
| Rate for Payer: Nomi Health Commercial |
$1,795.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,926.80
|
|
|
HC EXC SKIN MALIG 3.1-4 CM REMAINDER BODY
|
Facility
|
OP
|
$2,189.54
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
76100213
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,970.59
|
| 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 |
$2,123.85
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,805.28
|
| Rate for Payer: BCN Commercial |
$1,805.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Commercial |
$2,058.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,123.85
|
| Rate for Payer: Healthscope Whirlpool |
$2,189.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,970.59
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.11
|
| Rate for Payer: Nomi Health Commercial |
$1,795.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,918.47
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,534.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,926.80
|
| 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 SKIN MALIG >4CM FACE, FACIAL
|
Facility
|
OP
|
$3,785.86
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
76100217
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$4,486.12 |
| Rate for Payer: Aetna Commercial |
$3,407.27
|
| 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 |
$3,672.28
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,121.44
|
| Rate for Payer: BCN Commercial |
$3,121.44
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$3,028.69
|
| Rate for Payer: Cash Price |
$3,028.69
|
| Rate for Payer: Cofinity Commercial |
$3,558.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,028.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$3,672.28
|
| Rate for Payer: Healthscope Whirlpool |
$3,785.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$3,407.27
|
| 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 |
$3,217.98
|
| Rate for Payer: Nomi Health Commercial |
$3,104.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,839.39
|
| 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 |
$3,317.17
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$2,653.89
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,331.56
|
| 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 EXC SKIN MALIG >4CM FACE, FACIAL
|
Facility
|
IP
|
$3,785.86
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
76100217
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,839.39 |
| Max. Negotiated Rate |
$3,785.86 |
| Rate for Payer: Aetna Commercial |
$3,407.27
|
| Rate for Payer: ASR ASR |
$3,672.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,108.95
|
| Rate for Payer: BCN Commercial |
$3,108.95
|
| Rate for Payer: Cash Price |
$3,028.69
|
| Rate for Payer: Cofinity Commercial |
$3,558.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,028.69
|
| Rate for Payer: Healthscope Commercial |
$3,672.28
|
| Rate for Payer: Healthscope Whirlpool |
$3,785.86
|
| Rate for Payer: Mclaren Commercial |
$3,407.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,217.98
|
| Rate for Payer: Nomi Health Commercial |
$3,104.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,839.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,331.56
|
|
|
HC EXC SKIN MALIG >4 CM TRUNK, ARM, LEG
|
Facility
|
IP
|
$2,189.54
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
76100211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,642.15 |
| Max. Negotiated Rate |
$2,189.54 |
| Rate for Payer: Aetna Commercial |
$1,970.59
|
| Rate for Payer: ASR ASR |
$2,123.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,798.05
|
| Rate for Payer: BCN Commercial |
$1,798.05
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Commercial |
$2,058.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Healthscope Commercial |
$2,123.85
|
| Rate for Payer: Healthscope Whirlpool |
$2,189.54
|
| Rate for Payer: Mclaren Commercial |
$1,970.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.11
|
| Rate for Payer: Nomi Health Commercial |
$1,795.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,926.80
|
|
|
HC EXC SKIN MALIG >4 CM TRUNK, ARM, LEG
|
Facility
|
OP
|
$2,189.54
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
76100211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,970.59
|
| 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 |
$2,123.85
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,805.28
|
| Rate for Payer: BCN Commercial |
$1,805.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Commercial |
$2,058.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,123.85
|
| Rate for Payer: Healthscope Whirlpool |
$2,189.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,970.59
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.11
|
| Rate for Payer: Nomi Health Commercial |
$1,795.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,918.47
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,534.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,926.80
|
| 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
|
|
