|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
OP
|
$312.44
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
76100146
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$203.09 |
| Max. Negotiated Rate |
$1,063.61 |
| Rate for Payer: Aetna Commercial |
$281.20
|
| Rate for Payer: Aetna Medicare |
$686.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: ASR ASR |
$303.07
|
| Rate for Payer: ASR Commercial |
$303.07
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$255.86
|
| Rate for Payer: BCN Commercial |
$242.23
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$249.95
|
| Rate for Payer: Cash Price |
$249.95
|
| Rate for Payer: Cofinity Commercial |
$293.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$312.44
|
| Rate for Payer: Healthscope Whirlpool |
$303.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$281.20
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.57
|
| Rate for Payer: Nomi Health Commercial |
$256.20
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$754.82
|
| Rate for Payer: PHP Medicaid |
$367.80
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$273.76
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$219.02
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$274.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,063.61
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP DNSP |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: VA VA |
$686.20
|
|
|
HC EXCISION/DESTRUCT LESION PHARYNX ANY METHOD
|
Facility
|
IP
|
$8,122.26
|
|
|
Service Code
|
CPT 42808
|
| Hospital Charge Code |
76100476
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,279.47 |
| Max. Negotiated Rate |
$8,122.26 |
| Rate for Payer: Aetna Commercial |
$7,310.03
|
| Rate for Payer: ASR ASR |
$7,878.59
|
| Rate for Payer: ASR Commercial |
$7,878.59
|
| Rate for Payer: BCBS Trust/PPO |
$6,618.83
|
| Rate for Payer: BCN Commercial |
$6,297.19
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cofinity Commercial |
$7,634.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,497.81
|
| Rate for Payer: Healthscope Commercial |
$8,122.26
|
| Rate for Payer: Healthscope Whirlpool |
$7,878.59
|
| Rate for Payer: Mclaren Commercial |
$7,310.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,903.92
|
| Rate for Payer: Nomi Health Commercial |
$6,660.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,279.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,147.59
|
|
|
HC EXCISION/DESTRUCT LESION PHARYNX ANY METHOD
|
Facility
|
OP
|
$8,122.26
|
|
|
Service Code
|
CPT 42808
|
| Hospital Charge Code |
76100476
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$8,122.26 |
| Rate for Payer: Aetna Commercial |
$7,310.03
|
| Rate for Payer: Aetna Medicare |
$3,162.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: ASR ASR |
$7,878.59
|
| Rate for Payer: ASR Commercial |
$7,878.59
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCBS Trust/PPO |
$6,651.32
|
| Rate for Payer: BCN Commercial |
$6,297.19
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cofinity Commercial |
$7,634.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,497.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$8,122.26
|
| Rate for Payer: Healthscope Whirlpool |
$7,878.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,162.90
|
| Rate for Payer: Mclaren Commercial |
$7,310.03
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,903.92
|
| Rate for Payer: Nomi Health Commercial |
$6,660.25
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$3,479.19
|
| Rate for Payer: PHP Medicaid |
$1,695.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,279.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,116.72
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Priority Health Narrow Network |
$5,693.70
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,147.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Exchange |
$4,902.49
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP DNSP |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,695.31
|
| Rate for Payer: VA VA |
$3,162.90
|
|
|
HC EXCISION EXCESSIVE SKIN & SUBQ TISSUE
|
Facility
|
OP
|
$7,179.80
|
|
|
Service Code
|
CPT 15839
|
| Hospital Charge Code |
76100330
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$7,179.80 |
| Rate for Payer: Aetna Commercial |
$6,461.82
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$6,964.41
|
| Rate for Payer: ASR Commercial |
$6,964.41
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$5,879.54
|
| Rate for Payer: BCN Commercial |
$5,566.50
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$5,743.84
|
| Rate for Payer: Cash Price |
$5,743.84
|
| Rate for Payer: Cofinity Commercial |
$6,749.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,743.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$7,179.80
|
| Rate for Payer: Healthscope Whirlpool |
$6,964.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$6,461.82
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,102.83
|
| Rate for Payer: Nomi Health Commercial |
$5,887.44
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,666.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,290.94
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$5,033.04
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,318.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
HC EXCISION EXCESSIVE SKIN & SUBQ TISSUE
|
Facility
|
IP
|
$7,179.80
|
|
|
Service Code
|
CPT 15839
|
| Hospital Charge Code |
76100330
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,666.87 |
| Max. Negotiated Rate |
$7,179.80 |
| Rate for Payer: Aetna Commercial |
$6,461.82
|
| Rate for Payer: ASR ASR |
$6,964.41
|
| Rate for Payer: ASR Commercial |
$6,964.41
|
| Rate for Payer: BCBS Trust/PPO |
$5,850.82
|
| Rate for Payer: BCN Commercial |
$5,566.50
|
| Rate for Payer: Cash Price |
$5,743.84
|
| Rate for Payer: Cofinity Commercial |
$6,749.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,743.84
|
| Rate for Payer: Healthscope Commercial |
$7,179.80
|
| Rate for Payer: Healthscope Whirlpool |
$6,964.41
|
| Rate for Payer: Mclaren Commercial |
$6,461.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,102.83
|
| Rate for Payer: Nomi Health Commercial |
$5,887.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,666.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,318.22
|
|
|
HC EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Facility
|
IP
|
$7,344.00
|
|
|
Service Code
|
CPT 69110
|
| Hospital Charge Code |
76100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,773.60 |
| Max. Negotiated Rate |
$7,344.00 |
| Rate for Payer: Aetna Commercial |
$6,609.60
|
| Rate for Payer: ASR ASR |
$7,123.68
|
| Rate for Payer: ASR Commercial |
$7,123.68
|
| Rate for Payer: BCBS Trust/PPO |
$5,984.63
|
| Rate for Payer: BCN Commercial |
$5,693.80
|
| Rate for Payer: Cash Price |
$5,875.20
|
| Rate for Payer: Cofinity Commercial |
$6,903.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,875.20
|
| Rate for Payer: Healthscope Commercial |
$7,344.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,123.68
|
| Rate for Payer: Mclaren Commercial |
$6,609.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,242.40
|
| Rate for Payer: Nomi Health Commercial |
$6,022.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,773.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,462.72
|
|
|
HC EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Facility
|
OP
|
$7,344.00
|
|
|
Service Code
|
CPT 69110
|
| Hospital Charge Code |
76100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$7,344.00 |
| Rate for Payer: Aetna Commercial |
$6,609.60
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$7,123.68
|
| Rate for Payer: ASR Commercial |
$7,123.68
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$6,014.00
|
| Rate for Payer: BCN Commercial |
$5,693.80
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$5,875.20
|
| Rate for Payer: Cash Price |
$5,875.20
|
| Rate for Payer: Cofinity Commercial |
$6,903.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,875.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$7,344.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,123.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$6,609.60
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,242.40
|
| Rate for Payer: Nomi Health Commercial |
$6,022.08
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,773.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,434.81
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$5,148.14
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,462.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
HC EXCISION LESION TONGUE W/O CLOSURE
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
76100465
|
|
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 EXCISION LESION TONGUE W/O CLOSURE
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
76100465
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$8,058.00 |
| Rate for Payer: Aetna Commercial |
$7,252.20
|
| Rate for Payer: Aetna Medicare |
$3,162.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: ASR ASR |
$7,816.26
|
| Rate for Payer: ASR Commercial |
$7,816.26
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCBS Trust/PPO |
$6,598.70
|
| Rate for Payer: BCN Commercial |
$6,247.37
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| 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 |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$8,058.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,816.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,162.90
|
| Rate for Payer: Mclaren Commercial |
$7,252.20
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| 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 |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$3,479.19
|
| Rate for Payer: PHP Medicaid |
$1,695.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| 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 |
$3,162.90
|
| Rate for Payer: Priority Health Narrow Network |
$5,648.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,091.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Exchange |
$4,902.49
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP DNSP |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,695.31
|
| Rate for Payer: VA VA |
$3,162.90
|
|
|
HC EXCISION LINGUAL FRENUM FRENECTOMY
|
Facility
|
IP
|
$3,978.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
76100380
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,585.70 |
| Max. Negotiated Rate |
$3,978.00 |
| Rate for Payer: Aetna Commercial |
$3,580.20
|
| Rate for Payer: ASR ASR |
$3,858.66
|
| Rate for Payer: ASR Commercial |
$3,858.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,241.67
|
| Rate for Payer: BCN Commercial |
$3,084.14
|
| Rate for Payer: Cash Price |
$3,182.40
|
| Rate for Payer: Cofinity Commercial |
$3,739.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,182.40
|
| Rate for Payer: Healthscope Commercial |
$3,978.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,858.66
|
| Rate for Payer: Mclaren Commercial |
$3,580.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,381.30
|
| Rate for Payer: Nomi Health Commercial |
$3,261.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,585.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,500.64
|
|
|
HC EXCISION LINGUAL FRENUM FRENECTOMY
|
Facility
|
OP
|
$3,978.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
76100380
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$774.34 |
| Max. Negotiated Rate |
$3,978.00 |
| Rate for Payer: Aetna Commercial |
$3,580.20
|
| Rate for Payer: Aetna Medicare |
$1,444.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,805.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,805.83
|
| Rate for Payer: ASR ASR |
$3,858.66
|
| Rate for Payer: ASR Commercial |
$3,858.66
|
| Rate for Payer: BCBS Complete |
$813.05
|
| Rate for Payer: BCBS MAPPO |
$1,444.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,257.58
|
| Rate for Payer: BCN Commercial |
$3,084.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,444.66
|
| Rate for Payer: Cash Price |
$3,182.40
|
| Rate for Payer: Cash Price |
$3,182.40
|
| Rate for Payer: Cofinity Commercial |
$3,739.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,182.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,444.66
|
| Rate for Payer: Healthscope Commercial |
$3,978.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,858.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,444.66
|
| Rate for Payer: Mclaren Commercial |
$3,580.20
|
| Rate for Payer: Mclaren Medicaid |
$774.34
|
| Rate for Payer: Mclaren Medicare |
$1,444.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,516.89
|
| Rate for Payer: Meridian Medicaid |
$813.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,661.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,381.30
|
| Rate for Payer: Nomi Health Commercial |
$3,261.96
|
| Rate for Payer: PACE Medicare |
$1,372.43
|
| Rate for Payer: PACE SWMI |
$1,444.66
|
| Rate for Payer: PHP Commercial |
$1,589.13
|
| Rate for Payer: PHP Medicaid |
$774.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,444.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,585.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,485.52
|
| Rate for Payer: Priority Health Medicare |
$1,444.66
|
| Rate for Payer: Priority Health Narrow Network |
$2,788.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,444.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,500.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,444.66
|
| Rate for Payer: UHC Exchange |
$2,239.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,444.66
|
| Rate for Payer: UHCCP DNSP |
$1,444.66
|
| Rate for Payer: UHCCP Medicaid |
$774.34
|
| Rate for Payer: VA VA |
$1,444.66
|
|
|
HC EXCISION OF ANAL LESION(S)
|
Facility
|
IP
|
$7,527.94
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
76100350
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,893.16 |
| Max. Negotiated Rate |
$7,527.94 |
| Rate for Payer: Aetna Commercial |
$6,775.15
|
| Rate for Payer: ASR ASR |
$7,302.10
|
| Rate for Payer: ASR Commercial |
$7,302.10
|
| Rate for Payer: BCBS Trust/PPO |
$6,134.52
|
| Rate for Payer: BCN Commercial |
$5,836.41
|
| Rate for Payer: Cash Price |
$6,022.35
|
| Rate for Payer: Cofinity Commercial |
$7,076.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,022.35
|
| Rate for Payer: Healthscope Commercial |
$7,527.94
|
| Rate for Payer: Healthscope Whirlpool |
$7,302.10
|
| Rate for Payer: Mclaren Commercial |
$6,775.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,398.75
|
| Rate for Payer: Nomi Health Commercial |
$6,172.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,893.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,624.59
|
|
|
HC EXCISION OF ANAL LESION(S)
|
Facility
|
OP
|
$7,527.94
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
76100350
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,433.59 |
| Max. Negotiated Rate |
$7,527.94 |
| Rate for Payer: Aetna Commercial |
$6,775.15
|
| Rate for Payer: Aetna Medicare |
$2,674.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,343.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,343.25
|
| Rate for Payer: ASR ASR |
$7,302.10
|
| Rate for Payer: ASR Commercial |
$7,302.10
|
| Rate for Payer: BCBS Complete |
$1,505.26
|
| Rate for Payer: BCBS MAPPO |
$2,674.60
|
| Rate for Payer: BCBS Trust/PPO |
$6,164.63
|
| Rate for Payer: BCN Commercial |
$5,836.41
|
| Rate for Payer: BCN Medicare Advantage |
$2,674.60
|
| Rate for Payer: Cash Price |
$6,022.35
|
| Rate for Payer: Cash Price |
$6,022.35
|
| Rate for Payer: Cofinity Commercial |
$7,076.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,022.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,674.60
|
| Rate for Payer: Healthscope Commercial |
$7,527.94
|
| Rate for Payer: Healthscope Whirlpool |
$7,302.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,674.60
|
| Rate for Payer: Mclaren Commercial |
$6,775.15
|
| Rate for Payer: Mclaren Medicaid |
$1,433.59
|
| Rate for Payer: Mclaren Medicare |
$2,674.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,808.33
|
| Rate for Payer: Meridian Medicaid |
$1,505.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,075.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,398.75
|
| Rate for Payer: Nomi Health Commercial |
$6,172.91
|
| Rate for Payer: PACE Medicare |
$2,540.87
|
| Rate for Payer: PACE SWMI |
$2,674.60
|
| Rate for Payer: PHP Commercial |
$2,942.06
|
| Rate for Payer: PHP Medicaid |
$1,433.59
|
| Rate for Payer: PHP Medicare Advantage |
$2,674.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,433.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,893.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,595.98
|
| Rate for Payer: Priority Health Medicare |
$2,674.60
|
| Rate for Payer: Priority Health Narrow Network |
$5,277.09
|
| Rate for Payer: Railroad Medicare Medicare |
$2,674.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,624.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,674.60
|
| Rate for Payer: UHC Exchange |
$4,145.63
|
| Rate for Payer: UHC Medicare Advantage |
$2,674.60
|
| Rate for Payer: UHCCP DNSP |
$2,674.60
|
| Rate for Payer: UHCCP Medicaid |
$1,433.59
|
| Rate for Payer: VA VA |
$2,674.60
|
|
|
HC EXCISION OF NAIL OR NAIL MATRIX
|
Facility
|
IP
|
$395.79
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
76100077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$257.26 |
| Max. Negotiated Rate |
$395.79 |
| Rate for Payer: Aetna Commercial |
$356.21
|
| Rate for Payer: ASR ASR |
$383.92
|
| Rate for Payer: ASR Commercial |
$383.92
|
| Rate for Payer: BCBS Trust/PPO |
$322.53
|
| Rate for Payer: BCN Commercial |
$306.86
|
| Rate for Payer: Cash Price |
$316.63
|
| Rate for Payer: Cofinity Commercial |
$372.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.63
|
| Rate for Payer: Healthscope Commercial |
$395.79
|
| Rate for Payer: Healthscope Whirlpool |
$383.92
|
| Rate for Payer: Mclaren Commercial |
$356.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.42
|
| Rate for Payer: Nomi Health Commercial |
$324.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.30
|
|
|
HC EXCISION OF NAIL OR NAIL MATRIX
|
Facility
|
OP
|
$395.79
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
76100077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$603.96 |
| Rate for Payer: Aetna Commercial |
$356.21
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$383.92
|
| Rate for Payer: ASR Commercial |
$383.92
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$324.11
|
| Rate for Payer: BCN Commercial |
$306.86
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$316.63
|
| Rate for Payer: Cash Price |
$316.63
|
| Rate for Payer: Cofinity Commercial |
$372.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$395.79
|
| Rate for Payer: Healthscope Whirlpool |
$383.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$356.21
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.42
|
| Rate for Payer: Nomi Health Commercial |
$324.55
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$346.79
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$277.45
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
HC EXCISION OF PENIS LESION(S)
|
Facility
|
OP
|
$5,277.80
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
76100347
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$956.23 |
| Max. Negotiated Rate |
$5,277.80 |
| Rate for Payer: Aetna Commercial |
$4,750.02
|
| Rate for Payer: Aetna Medicare |
$1,784.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,230.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,230.01
|
| Rate for Payer: ASR ASR |
$5,119.47
|
| Rate for Payer: ASR Commercial |
$5,119.47
|
| Rate for Payer: BCBS Complete |
$1,004.04
|
| Rate for Payer: BCBS MAPPO |
$1,784.01
|
| Rate for Payer: BCBS Trust/PPO |
$4,321.99
|
| Rate for Payer: BCN Commercial |
$4,091.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,784.01
|
| Rate for Payer: Cash Price |
$4,222.24
|
| Rate for Payer: Cash Price |
$4,222.24
|
| Rate for Payer: Cofinity Commercial |
$4,961.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,222.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,784.01
|
| Rate for Payer: Healthscope Commercial |
$5,277.80
|
| Rate for Payer: Healthscope Whirlpool |
$5,119.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,784.01
|
| Rate for Payer: Mclaren Commercial |
$4,750.02
|
| Rate for Payer: Mclaren Medicaid |
$956.23
|
| Rate for Payer: Mclaren Medicare |
$1,784.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,873.21
|
| Rate for Payer: Meridian Medicaid |
$1,004.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,051.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,486.13
|
| Rate for Payer: Nomi Health Commercial |
$4,327.80
|
| Rate for Payer: PACE Medicare |
$1,694.81
|
| Rate for Payer: PACE SWMI |
$1,784.01
|
| Rate for Payer: PHP Commercial |
$1,962.41
|
| Rate for Payer: PHP Medicaid |
$956.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,784.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$956.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,430.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,624.41
|
| Rate for Payer: Priority Health Medicare |
$1,784.01
|
| Rate for Payer: Priority Health Narrow Network |
$3,699.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,784.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,644.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,784.01
|
| Rate for Payer: UHC Exchange |
$2,765.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,784.01
|
| Rate for Payer: UHCCP DNSP |
$1,784.01
|
| Rate for Payer: UHCCP Medicaid |
$956.23
|
| Rate for Payer: VA VA |
$1,784.01
|
|
|
HC EXCISION OF PENIS LESION(S)
|
Facility
|
IP
|
$5,277.80
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
76100347
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$3,430.57 |
| Max. Negotiated Rate |
$5,277.80 |
| Rate for Payer: Aetna Commercial |
$4,750.02
|
| Rate for Payer: ASR ASR |
$5,119.47
|
| Rate for Payer: ASR Commercial |
$5,119.47
|
| Rate for Payer: BCBS Trust/PPO |
$4,300.88
|
| Rate for Payer: BCN Commercial |
$4,091.88
|
| Rate for Payer: Cash Price |
$4,222.24
|
| Rate for Payer: Cofinity Commercial |
$4,961.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,222.24
|
| Rate for Payer: Healthscope Commercial |
$5,277.80
|
| Rate for Payer: Healthscope Whirlpool |
$5,119.47
|
| Rate for Payer: Mclaren Commercial |
$4,750.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,486.13
|
| Rate for Payer: Nomi Health Commercial |
$4,327.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,430.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,644.46
|
|
|
HC EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Facility
|
IP
|
$3,945.22
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
76100321
|
| Min. Negotiated Rate |
$2,564.39 |
| Max. Negotiated Rate |
$3,945.22 |
| Rate for Payer: Aetna Commercial |
$3,550.70
|
| Rate for Payer: ASR ASR |
$3,826.86
|
| Rate for Payer: ASR Commercial |
$3,826.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,214.96
|
| Rate for Payer: BCN Commercial |
$3,058.73
|
| Rate for Payer: Cash Price |
$3,156.18
|
| Rate for Payer: Cofinity Commercial |
$3,708.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,156.18
|
| Rate for Payer: Healthscope Commercial |
$3,945.22
|
| Rate for Payer: Healthscope Whirlpool |
$3,826.86
|
| Rate for Payer: Mclaren Commercial |
$3,550.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,353.44
|
| Rate for Payer: Nomi Health Commercial |
$3,235.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,564.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,471.79
|
|
|
HC EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Facility
|
OP
|
$3,945.22
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
76100321
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$3,550.70
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$3,826.86
|
| Rate for Payer: ASR Commercial |
$3,826.86
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,230.74
|
| Rate for Payer: BCN Commercial |
$3,058.73
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$3,156.18
|
| Rate for Payer: Cash Price |
$3,156.18
|
| Rate for Payer: Cofinity Commercial |
$3,708.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,156.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$3,945.22
|
| Rate for Payer: Healthscope Whirlpool |
$3,826.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$3,550.70
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,353.44
|
| Rate for Payer: Nomi Health Commercial |
$3,235.08
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,564.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,456.80
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,765.60
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,471.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
HC EXCISION SOFT TISSUE PELVIS HIP SUBQ <3CM
|
Facility
|
OP
|
$7,162.94
|
|
|
Service Code
|
CPT 27047
|
| Hospital Charge Code |
76100439
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$7,162.94 |
| Rate for Payer: Aetna Commercial |
$6,446.65
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$6,948.05
|
| Rate for Payer: ASR Commercial |
$6,948.05
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$5,865.73
|
| Rate for Payer: BCN Commercial |
$5,553.43
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$5,730.35
|
| Rate for Payer: Cash Price |
$5,730.35
|
| Rate for Payer: Cofinity Commercial |
$6,733.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,730.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$7,162.94
|
| Rate for Payer: Healthscope Whirlpool |
$6,948.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$6,446.65
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,088.50
|
| Rate for Payer: Nomi Health Commercial |
$5,873.61
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,655.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,276.17
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$5,021.22
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,303.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
HC EXCISION SOFT TISSUE PELVIS HIP SUBQ <3CM
|
Facility
|
IP
|
$7,162.94
|
|
|
Service Code
|
CPT 27047
|
| Hospital Charge Code |
76100439
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,655.91 |
| Max. Negotiated Rate |
$7,162.94 |
| Rate for Payer: Aetna Commercial |
$6,446.65
|
| Rate for Payer: ASR ASR |
$6,948.05
|
| Rate for Payer: ASR Commercial |
$6,948.05
|
| Rate for Payer: BCBS Trust/PPO |
$5,837.08
|
| Rate for Payer: BCN Commercial |
$5,553.43
|
| Rate for Payer: Cash Price |
$5,730.35
|
| Rate for Payer: Cofinity Commercial |
$6,733.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,730.35
|
| Rate for Payer: Healthscope Commercial |
$7,162.94
|
| Rate for Payer: Healthscope Whirlpool |
$6,948.05
|
| Rate for Payer: Mclaren Commercial |
$6,446.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,088.50
|
| Rate for Payer: Nomi Health Commercial |
$5,873.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,655.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,303.39
|
|
|
HC EXCISION TONSIL TAGS
|
Facility
|
IP
|
$8,122.26
|
|
|
Service Code
|
CPT 42860
|
| Hospital Charge Code |
76100477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,279.47 |
| Max. Negotiated Rate |
$8,122.26 |
| Rate for Payer: Aetna Commercial |
$7,310.03
|
| Rate for Payer: ASR ASR |
$7,878.59
|
| Rate for Payer: ASR Commercial |
$7,878.59
|
| Rate for Payer: BCBS Trust/PPO |
$6,618.83
|
| Rate for Payer: BCN Commercial |
$6,297.19
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cofinity Commercial |
$7,634.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,497.81
|
| Rate for Payer: Healthscope Commercial |
$8,122.26
|
| Rate for Payer: Healthscope Whirlpool |
$7,878.59
|
| Rate for Payer: Mclaren Commercial |
$7,310.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,903.92
|
| Rate for Payer: Nomi Health Commercial |
$6,660.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,279.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,147.59
|
|
|
HC EXCISION TONSIL TAGS
|
Facility
|
OP
|
$8,122.26
|
|
|
Service Code
|
CPT 42860
|
| Hospital Charge Code |
76100477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$8,122.26 |
| Rate for Payer: Aetna Commercial |
$7,310.03
|
| Rate for Payer: Aetna Medicare |
$3,162.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: ASR ASR |
$7,878.59
|
| Rate for Payer: ASR Commercial |
$7,878.59
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCBS Trust/PPO |
$6,651.32
|
| Rate for Payer: BCN Commercial |
$6,297.19
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cofinity Commercial |
$7,634.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,497.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$8,122.26
|
| Rate for Payer: Healthscope Whirlpool |
$7,878.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,162.90
|
| Rate for Payer: Mclaren Commercial |
$7,310.03
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,903.92
|
| Rate for Payer: Nomi Health Commercial |
$6,660.25
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$3,479.19
|
| Rate for Payer: PHP Medicaid |
$1,695.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,279.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,116.72
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Priority Health Narrow Network |
$5,693.70
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,147.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Exchange |
$4,902.49
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP DNSP |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,695.31
|
| Rate for Payer: VA VA |
$3,162.90
|
|
|
HC EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM
|
Facility
|
OP
|
$4,627.74
|
|
|
Service Code
|
CPT 23075
|
| Hospital Charge Code |
76100412
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,627.74 |
| Rate for Payer: Aetna Commercial |
$4,164.97
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$4,488.91
|
| Rate for Payer: ASR Commercial |
$4,488.91
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,789.66
|
| Rate for Payer: BCN Commercial |
$3,587.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$3,702.19
|
| Rate for Payer: Cash Price |
$3,702.19
|
| Rate for Payer: Cofinity Commercial |
$4,350.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,702.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$4,627.74
|
| Rate for Payer: Healthscope Whirlpool |
$4,488.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$4,164.97
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,933.58
|
| Rate for Payer: Nomi Health Commercial |
$3,794.75
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,008.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,054.83
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$3,244.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,072.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM
|
Facility
|
IP
|
$4,627.74
|
|
|
Service Code
|
CPT 23075
|
| Hospital Charge Code |
76100412
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,008.03 |
| Max. Negotiated Rate |
$4,627.74 |
| Rate for Payer: Aetna Commercial |
$4,164.97
|
| Rate for Payer: ASR ASR |
$4,488.91
|
| Rate for Payer: ASR Commercial |
$4,488.91
|
| Rate for Payer: BCBS Trust/PPO |
$3,771.15
|
| Rate for Payer: BCN Commercial |
$3,587.89
|
| Rate for Payer: Cash Price |
$3,702.19
|
| Rate for Payer: Cofinity Commercial |
$4,350.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,702.19
|
| Rate for Payer: Healthscope Commercial |
$4,627.74
|
| Rate for Payer: Healthscope Whirlpool |
$4,488.91
|
| Rate for Payer: Mclaren Commercial |
$4,164.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,933.58
|
| Rate for Payer: Nomi Health Commercial |
$3,794.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,008.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,072.41
|
|
