|
HC EXCHANGE ABSCESS CYST DRAIN CATHETER
|
Facility
|
OP
|
$2,562.94
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
36100222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$996.23 |
| Max. Negotiated Rate |
$2,880.88 |
| Rate for Payer: Aetna Commercial |
$2,306.65
|
| Rate for Payer: Aetna Medicare |
$1,858.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,323.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,323.29
|
| Rate for Payer: ASR ASR |
$2,486.05
|
| Rate for Payer: ASR Commercial |
$2,486.05
|
| Rate for Payer: BCBS Complete |
$1,046.04
|
| Rate for Payer: BCBS MAPPO |
$1,858.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,098.79
|
| Rate for Payer: BCN Commercial |
$1,987.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,858.63
|
| Rate for Payer: Cash Price |
$2,050.35
|
| Rate for Payer: Cash Price |
$2,050.35
|
| Rate for Payer: Cofinity Commercial |
$2,409.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,050.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,858.63
|
| Rate for Payer: Healthscope Commercial |
$2,562.94
|
| Rate for Payer: Healthscope Whirlpool |
$2,486.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,858.63
|
| Rate for Payer: Mclaren Commercial |
$2,306.65
|
| Rate for Payer: Mclaren Medicaid |
$996.23
|
| Rate for Payer: Mclaren Medicare |
$1,858.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,951.56
|
| Rate for Payer: Meridian Medicaid |
$1,046.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,137.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,178.50
|
| Rate for Payer: Nomi Health Commercial |
$2,101.61
|
| Rate for Payer: PACE Medicare |
$1,765.70
|
| Rate for Payer: PACE SWMI |
$1,858.63
|
| Rate for Payer: PHP Commercial |
$2,044.49
|
| Rate for Payer: PHP Medicaid |
$996.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,858.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$996.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,665.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,245.65
|
| Rate for Payer: Priority Health Medicare |
$1,858.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,796.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,858.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,255.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,858.63
|
| Rate for Payer: UHC Exchange |
$2,880.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,858.63
|
| Rate for Payer: UHCCP DNSP |
$1,858.63
|
| Rate for Payer: UHCCP Medicaid |
$996.23
|
| Rate for Payer: VA VA |
$1,858.63
|
|
|
HC EXCHANGE BILIARY DRAIN CATH
|
Facility
|
IP
|
$4,333.80
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
36100493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,816.97 |
| Max. Negotiated Rate |
$4,333.80 |
| Rate for Payer: Aetna Commercial |
$3,900.42
|
| Rate for Payer: ASR ASR |
$4,203.79
|
| Rate for Payer: ASR Commercial |
$4,203.79
|
| Rate for Payer: BCBS Trust/PPO |
$3,531.61
|
| Rate for Payer: BCN Commercial |
$3,360.00
|
| Rate for Payer: Cash Price |
$3,467.04
|
| Rate for Payer: Cofinity Commercial |
$4,073.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,467.04
|
| Rate for Payer: Healthscope Commercial |
$4,333.80
|
| Rate for Payer: Healthscope Whirlpool |
$4,203.79
|
| Rate for Payer: Mclaren Commercial |
$3,900.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,683.73
|
| Rate for Payer: Nomi Health Commercial |
$3,553.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,816.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,813.74
|
|
|
HC EXCHANGE BILIARY DRAIN CATH
|
Facility
|
OP
|
$4,333.80
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
36100493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,853.33 |
| Max. Negotiated Rate |
$5,359.44 |
| Rate for Payer: Aetna Commercial |
$3,900.42
|
| Rate for Payer: Aetna Medicare |
$3,457.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: ASR ASR |
$4,203.79
|
| Rate for Payer: ASR Commercial |
$4,203.79
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,548.95
|
| Rate for Payer: BCN Commercial |
$3,360.00
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$3,467.04
|
| Rate for Payer: Cash Price |
$3,467.04
|
| Rate for Payer: Cofinity Commercial |
$4,073.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,467.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$4,333.80
|
| Rate for Payer: Healthscope Whirlpool |
$4,203.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,457.70
|
| Rate for Payer: Mclaren Commercial |
$3,900.42
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,683.73
|
| Rate for Payer: Nomi Health Commercial |
$3,553.72
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$3,803.47
|
| Rate for Payer: PHP Medicaid |
$1,853.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,816.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,797.28
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$3,037.99
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,813.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Exchange |
$5,359.44
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP DNSP |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,853.33
|
| Rate for Payer: VA VA |
$3,457.70
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER
|
Facility
|
IP
|
$3,542.33
|
|
|
Service Code
|
CPT 50435
|
| Hospital Charge Code |
36100507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,302.51 |
| Max. Negotiated Rate |
$3,542.33 |
| Rate for Payer: Aetna Commercial |
$3,188.10
|
| Rate for Payer: ASR ASR |
$3,436.06
|
| Rate for Payer: ASR Commercial |
$3,436.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,886.64
|
| Rate for Payer: BCN Commercial |
$2,746.37
|
| Rate for Payer: Cash Price |
$2,833.86
|
| Rate for Payer: Cofinity Commercial |
$3,329.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,833.86
|
| Rate for Payer: Healthscope Commercial |
$3,542.33
|
| Rate for Payer: Healthscope Whirlpool |
$3,436.06
|
| Rate for Payer: Mclaren Commercial |
$3,188.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,010.98
|
| Rate for Payer: Nomi Health Commercial |
$2,904.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,302.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,117.25
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER
|
Facility
|
OP
|
$3,542.33
|
|
|
Service Code
|
CPT 50435
|
| Hospital Charge Code |
36100507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,075.80 |
| Max. Negotiated Rate |
$3,542.33 |
| Rate for Payer: Aetna Commercial |
$3,188.10
|
| Rate for Payer: Aetna Medicare |
$2,007.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: ASR ASR |
$3,436.06
|
| Rate for Payer: ASR Commercial |
$3,436.06
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,900.81
|
| Rate for Payer: BCN Commercial |
$2,746.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$2,833.86
|
| Rate for Payer: Cash Price |
$2,833.86
|
| Rate for Payer: Cofinity Commercial |
$3,329.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,833.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$3,542.33
|
| Rate for Payer: Healthscope Whirlpool |
$3,436.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,007.09
|
| Rate for Payer: Mclaren Commercial |
$3,188.10
|
| Rate for Payer: Mclaren Medicaid |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,010.98
|
| Rate for Payer: Nomi Health Commercial |
$2,904.71
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Commercial |
$2,207.80
|
| Rate for Payer: PHP Medicaid |
$1,075.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,302.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,103.79
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$2,483.17
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,117.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$3,110.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP DNSP |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: VA VA |
$2,007.09
|
|
|
HC EXCHANGE TRANSFUSION NONINFANT
|
Facility
|
OP
|
$1,524.05
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
39100001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$229.59 |
| Max. Negotiated Rate |
$1,524.05 |
| Rate for Payer: Aetna Commercial |
$1,371.64
|
| Rate for Payer: Aetna Medicare |
$428.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$535.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$535.42
|
| Rate for Payer: ASR ASR |
$1,478.33
|
| Rate for Payer: ASR Commercial |
$1,478.33
|
| Rate for Payer: BCBS Complete |
$241.07
|
| Rate for Payer: BCBS MAPPO |
$428.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.04
|
| Rate for Payer: BCN Commercial |
$1,181.60
|
| Rate for Payer: BCN Medicare Advantage |
$428.34
|
| Rate for Payer: Cash Price |
$1,219.24
|
| Rate for Payer: Cash Price |
$1,219.24
|
| Rate for Payer: Cofinity Commercial |
$1,432.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,219.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.34
|
| Rate for Payer: Healthscope Commercial |
$1,524.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,478.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$428.34
|
| Rate for Payer: Mclaren Commercial |
$1,371.64
|
| Rate for Payer: Mclaren Medicaid |
$229.59
|
| Rate for Payer: Mclaren Medicare |
$428.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.76
|
| Rate for Payer: Meridian Medicaid |
$241.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$492.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,295.44
|
| Rate for Payer: Nomi Health Commercial |
$1,249.72
|
| Rate for Payer: PACE Medicare |
$406.92
|
| Rate for Payer: PACE SWMI |
$428.34
|
| Rate for Payer: PHP Commercial |
$471.17
|
| Rate for Payer: PHP Medicaid |
$229.59
|
| Rate for Payer: PHP Medicare Advantage |
$428.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$990.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,335.37
|
| Rate for Payer: Priority Health Medicare |
$428.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,068.36
|
| Rate for Payer: Railroad Medicare Medicare |
$428.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,341.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.34
|
| Rate for Payer: UHC Exchange |
$663.93
|
| Rate for Payer: UHC Medicare Advantage |
$428.34
|
| Rate for Payer: UHCCP DNSP |
$428.34
|
| Rate for Payer: UHCCP Medicaid |
$229.59
|
| Rate for Payer: VA VA |
$428.34
|
|
|
HC EXCHANGE TRANSFUSION NONINFANT
|
Facility
|
IP
|
$1,524.05
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
39100001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$990.63 |
| Max. Negotiated Rate |
$1,524.05 |
| Rate for Payer: Aetna Commercial |
$1,371.64
|
| Rate for Payer: ASR ASR |
$1,478.33
|
| Rate for Payer: ASR Commercial |
$1,478.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,241.95
|
| Rate for Payer: BCN Commercial |
$1,181.60
|
| Rate for Payer: Cash Price |
$1,219.24
|
| Rate for Payer: Cofinity Commercial |
$1,432.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,219.24
|
| Rate for Payer: Healthscope Commercial |
$1,524.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,478.33
|
| Rate for Payer: Mclaren Commercial |
$1,371.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,295.44
|
| Rate for Payer: Nomi Health Commercial |
$1,249.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$990.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,341.16
|
|
|
HC EXCHANGE WIRE PTCA
|
Facility
|
IP
|
$550.26
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$357.67 |
| Max. Negotiated Rate |
$550.26 |
| Rate for Payer: Aetna Commercial |
$495.23
|
| Rate for Payer: ASR ASR |
$533.75
|
| Rate for Payer: ASR Commercial |
$533.75
|
| Rate for Payer: BCBS Trust/PPO |
$448.41
|
| Rate for Payer: BCN Commercial |
$426.62
|
| Rate for Payer: Cash Price |
$440.21
|
| Rate for Payer: Cofinity Commercial |
$517.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.21
|
| Rate for Payer: Healthscope Commercial |
$550.26
|
| Rate for Payer: Healthscope Whirlpool |
$533.75
|
| Rate for Payer: Mclaren Commercial |
$495.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$467.72
|
| Rate for Payer: Nomi Health Commercial |
$451.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$484.23
|
|
|
HC EXCHANGE WIRE PTCA
|
Facility
|
OP
|
$550.26
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$220.10 |
| Max. Negotiated Rate |
$550.26 |
| Rate for Payer: Aetna Commercial |
$495.23
|
| Rate for Payer: Aetna Medicare |
$275.13
|
| Rate for Payer: ASR ASR |
$533.75
|
| Rate for Payer: ASR Commercial |
$533.75
|
| Rate for Payer: BCBS Complete |
$220.10
|
| Rate for Payer: BCBS Trust/PPO |
$450.61
|
| Rate for Payer: BCN Commercial |
$426.62
|
| Rate for Payer: Cash Price |
$440.21
|
| Rate for Payer: Cofinity Commercial |
$517.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.21
|
| Rate for Payer: Healthscope Commercial |
$550.26
|
| Rate for Payer: Healthscope Whirlpool |
$533.75
|
| Rate for Payer: Mclaren Commercial |
$495.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$467.72
|
| Rate for Payer: Nomi Health Commercial |
$451.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$482.14
|
| Rate for Payer: Priority Health Narrow Network |
$385.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$484.23
|
|
|
HC EXCIS/DESTRUCT INTRANASAL LESION INT APPR
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
76100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,703.14 |
| Max. Negotiated Rate |
$8,058.00 |
| Rate for Payer: Aetna Commercial |
$7,252.20
|
| Rate for Payer: Aetna Medicare |
$3,177.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: ASR ASR |
$7,816.26
|
| Rate for Payer: ASR Commercial |
$7,816.26
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$6,598.70
|
| Rate for Payer: BCN Commercial |
$6,247.37
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$7,574.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$8,058.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,816.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,177.50
|
| Rate for Payer: Mclaren Commercial |
$7,252.20
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,607.56
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Commercial |
$3,495.25
|
| Rate for Payer: PHP Medicaid |
$1,703.14
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,060.42
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$5,648.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,091.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$4,925.12
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP DNSP |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,703.14
|
| Rate for Payer: VA VA |
$3,177.50
|
|
|
HC EXCIS/DESTRUCT INTRANASAL LESION INT APPR
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
76100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,237.70 |
| Max. Negotiated Rate |
$8,058.00 |
| Rate for Payer: Aetna Commercial |
$7,252.20
|
| Rate for Payer: ASR ASR |
$7,816.26
|
| Rate for Payer: ASR Commercial |
$7,816.26
|
| Rate for Payer: BCBS Trust/PPO |
$6,566.46
|
| Rate for Payer: BCN Commercial |
$6,247.37
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$7,574.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Healthscope Commercial |
$8,058.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,816.26
|
| Rate for Payer: Mclaren Commercial |
$7,252.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,607.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,091.04
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
76100095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$1,176.05 |
| Rate for Payer: Aetna Commercial |
$1,058.44
|
| Rate for Payer: ASR ASR |
$1,140.77
|
| Rate for Payer: ASR Commercial |
$1,140.77
|
| Rate for Payer: BCBS Trust/PPO |
$958.36
|
| Rate for Payer: BCN Commercial |
$911.79
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,105.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,176.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,140.77
|
| Rate for Payer: Mclaren Commercial |
$1,058.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.92
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
76100095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$1,058.44
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$1,140.77
|
| Rate for Payer: ASR Commercial |
$1,140.77
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$963.07
|
| Rate for Payer: BCN Commercial |
$911.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,105.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,176.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,140.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,058.44
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,030.46
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$824.41
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
76100096
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.50 |
| Max. Negotiated Rate |
$1,176.05 |
| Rate for Payer: Aetna Commercial |
$1,058.44
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$1,140.77
|
| Rate for Payer: ASR Commercial |
$1,140.77
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$963.07
|
| Rate for Payer: BCN Commercial |
$911.79
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,105.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$1,176.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,140.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$1,058.44
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,030.46
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$824.41
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
76100096
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$1,176.05 |
| Rate for Payer: Aetna Commercial |
$1,058.44
|
| Rate for Payer: ASR ASR |
$1,140.77
|
| Rate for Payer: ASR Commercial |
$1,140.77
|
| Rate for Payer: BCBS Trust/PPO |
$958.36
|
| Rate for Payer: BCN Commercial |
$911.79
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,105.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,176.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,140.77
|
| Rate for Payer: Mclaren Commercial |
$1,058.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.92
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
76100097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$1,058.44
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$1,140.77
|
| Rate for Payer: ASR Commercial |
$1,140.77
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$963.07
|
| Rate for Payer: BCN Commercial |
$911.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,105.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,176.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,140.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,058.44
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,030.46
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$824.41
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
76100097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$1,176.05 |
| Rate for Payer: Aetna Commercial |
$1,058.44
|
| Rate for Payer: ASR ASR |
$1,140.77
|
| Rate for Payer: ASR Commercial |
$1,140.77
|
| Rate for Payer: BCBS Trust/PPO |
$958.36
|
| Rate for Payer: BCN Commercial |
$911.79
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,105.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,176.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,140.77
|
| Rate for Payer: Mclaren Commercial |
$1,058.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.92
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
76100098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$1,058.44
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$1,140.77
|
| Rate for Payer: ASR Commercial |
$1,140.77
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$963.07
|
| Rate for Payer: BCN Commercial |
$911.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,105.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,176.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,140.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,058.44
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,030.46
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$824.41
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
76100098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$1,176.05 |
| Rate for Payer: Aetna Commercial |
$1,058.44
|
| Rate for Payer: ASR ASR |
$1,140.77
|
| Rate for Payer: ASR Commercial |
$1,140.77
|
| Rate for Payer: BCBS Trust/PPO |
$958.36
|
| Rate for Payer: BCN Commercial |
$911.79
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,105.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,176.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,140.77
|
| Rate for Payer: Mclaren Commercial |
$1,058.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.92
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 3.1 TO 4.0 CM
|
Facility
|
IP
|
$1,942.27
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
76100099
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,262.48 |
| Max. Negotiated Rate |
$1,942.27 |
| Rate for Payer: Aetna Commercial |
$1,748.04
|
| Rate for Payer: ASR ASR |
$1,884.00
|
| Rate for Payer: ASR Commercial |
$1,884.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,582.76
|
| Rate for Payer: BCN Commercial |
$1,505.84
|
| Rate for Payer: Cash Price |
$1,553.82
|
| Rate for Payer: Cofinity Commercial |
$1,825.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,553.82
|
| Rate for Payer: Healthscope Commercial |
$1,942.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,884.00
|
| Rate for Payer: Mclaren Commercial |
$1,748.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,650.93
|
| Rate for Payer: Nomi Health Commercial |
$1,592.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,709.20
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 3.1 TO 4.0 CM
|
Facility
|
OP
|
$1,942.27
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
76100099
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$1,748.04
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$1,884.00
|
| Rate for Payer: ASR Commercial |
$1,884.00
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,590.52
|
| Rate for Payer: BCN Commercial |
$1,505.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,553.82
|
| Rate for Payer: Cash Price |
$1,553.82
|
| Rate for Payer: Cofinity Commercial |
$1,825.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,553.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,942.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,884.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,748.04
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,650.93
|
| Rate for Payer: Nomi Health Commercial |
$1,592.66
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,701.82
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,361.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,709.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA OVER 4.0 CM
|
Facility
|
OP
|
$1,942.27
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
76100100
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,262.48 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$1,748.04
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$1,884.00
|
| Rate for Payer: ASR Commercial |
$1,884.00
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,590.52
|
| Rate for Payer: BCN Commercial |
$1,505.84
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,553.82
|
| Rate for Payer: Cash Price |
$1,553.82
|
| Rate for Payer: Cofinity Commercial |
$1,825.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,553.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,942.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,884.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$1,748.04
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,650.93
|
| Rate for Payer: Nomi Health Commercial |
$1,592.66
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,701.82
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,361.53
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,709.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA OVER 4.0 CM
|
Facility
|
IP
|
$1,942.27
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
76100100
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,262.48 |
| Max. Negotiated Rate |
$1,942.27 |
| Rate for Payer: Aetna Commercial |
$1,748.04
|
| Rate for Payer: ASR ASR |
$1,884.00
|
| Rate for Payer: ASR Commercial |
$1,884.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,582.76
|
| Rate for Payer: BCN Commercial |
$1,505.84
|
| Rate for Payer: Cash Price |
$1,553.82
|
| Rate for Payer: Cofinity Commercial |
$1,825.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,553.82
|
| Rate for Payer: Healthscope Commercial |
$1,942.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,884.00
|
| Rate for Payer: Mclaren Commercial |
$1,748.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,650.93
|
| Rate for Payer: Nomi Health Commercial |
$1,592.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,709.20
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
IP
|
$838.73
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
76100089
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$545.17 |
| Max. Negotiated Rate |
$838.73 |
| Rate for Payer: Aetna Commercial |
$754.86
|
| Rate for Payer: ASR ASR |
$813.57
|
| Rate for Payer: ASR Commercial |
$813.57
|
| Rate for Payer: BCBS Trust/PPO |
$683.48
|
| Rate for Payer: BCN Commercial |
$650.27
|
| Rate for Payer: Cash Price |
$670.98
|
| Rate for Payer: Cofinity Commercial |
$788.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$670.98
|
| Rate for Payer: Healthscope Commercial |
$838.73
|
| Rate for Payer: Healthscope Whirlpool |
$813.57
|
| Rate for Payer: Mclaren Commercial |
$754.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$712.92
|
| Rate for Payer: Nomi Health Commercial |
$687.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$545.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$738.08
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
OP
|
$838.73
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
76100089
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.50 |
| Max. Negotiated Rate |
$1,068.51 |
| Rate for Payer: Aetna Commercial |
$754.86
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$813.57
|
| Rate for Payer: ASR Commercial |
$813.57
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$686.84
|
| Rate for Payer: BCN Commercial |
$650.27
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$670.98
|
| Rate for Payer: Cash Price |
$670.98
|
| Rate for Payer: Cofinity Commercial |
$788.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$670.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$838.73
|
| Rate for Payer: Healthscope Whirlpool |
$813.57
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$754.86
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$712.92
|
| Rate for Payer: Nomi Health Commercial |
$687.76
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$545.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$769.70
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$615.76
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$738.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
