|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM
|
Facility
|
OP
|
$285.00
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
11422
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$199.50 |
| Max. Negotiated Rate |
$1,801.41 |
| Rate for Payer: Aetna Commercial |
$256.50
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$276.45
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$220.96
|
| Rate for Payer: BCN Commercial |
$220.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$267.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$285.00
|
| Rate for Payer: Healthscope Whirlpool |
$276.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$256.50
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$242.25
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$259.35
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$202.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$250.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM
|
Professional
|
Both
|
$285.00
|
|
|
Service Code
|
HCPCS 11422
|
| Hospital Charge Code |
11422
|
| Min. Negotiated Rate |
$32.57 |
| Max. Negotiated Rate |
$211.65 |
| Rate for Payer: Aetna Commercial |
$175.98
|
| Rate for Payer: Aetna Medicare |
$131.33
|
| Rate for Payer: BCBS Complete |
$91.70
|
| Rate for Payer: BCBS MAPPO |
$131.33
|
| Rate for Payer: BCBS Trust/PPO |
$32.57
|
| Rate for Payer: BCN Commercial |
$211.65
|
| Rate for Payer: BCN Medicare Advantage |
$131.33
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$175.98
|
| Rate for Payer: Cofinity Commercial |
$189.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.33
|
| Rate for Payer: Healthscope Commercial |
$157.60
|
| Rate for Payer: Healthscope Whirlpool |
$157.60
|
| Rate for Payer: Meridian Medicaid |
$91.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.90
|
| Rate for Payer: PACE SWMI |
$131.33
|
| Rate for Payer: PHP Medicare Advantage |
$131.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.47
|
| Rate for Payer: Priority Health Medicare |
$131.33
|
| Rate for Payer: Priority Health Narrow Network |
$166.47
|
| Rate for Payer: UHC Medicare Advantage |
$135.27
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM
|
Facility
|
IP
|
$285.00
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
11422
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$199.50 |
| Max. Negotiated Rate |
$285.00 |
| Rate for Payer: Aetna Commercial |
$256.50
|
| Rate for Payer: ASR ASR |
$276.45
|
| Rate for Payer: BCBS Trust/PPO |
$220.96
|
| Rate for Payer: BCN Commercial |
$220.96
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$267.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.00
|
| Rate for Payer: Healthscope Commercial |
$285.00
|
| Rate for Payer: Healthscope Whirlpool |
$276.45
|
| Rate for Payer: Mclaren Commercial |
$256.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$242.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$250.80
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM
|
Professional
|
Both
|
$285.00
|
|
|
Service Code
|
HCPCS 11422
|
| Min. Negotiated Rate |
$32.57 |
| Max. Negotiated Rate |
$211.65 |
| Rate for Payer: Aetna Commercial |
$175.98
|
| Rate for Payer: Aetna Medicare |
$131.33
|
| Rate for Payer: BCBS Complete |
$91.70
|
| Rate for Payer: BCBS MAPPO |
$131.33
|
| Rate for Payer: BCBS Trust/PPO |
$32.57
|
| Rate for Payer: BCN Commercial |
$211.65
|
| Rate for Payer: BCN Medicare Advantage |
$131.33
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$175.98
|
| Rate for Payer: Cofinity Commercial |
$189.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.33
|
| Rate for Payer: Healthscope Commercial |
$157.60
|
| Rate for Payer: Healthscope Whirlpool |
$157.60
|
| Rate for Payer: Meridian Medicaid |
$91.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.90
|
| Rate for Payer: PACE SWMI |
$131.33
|
| Rate for Payer: PHP Medicare Advantage |
$131.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.47
|
| Rate for Payer: Priority Health Medicare |
$131.33
|
| Rate for Payer: Priority Health Narrow Network |
$166.47
|
| Rate for Payer: UHC Medicare Advantage |
$135.27
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Facility
|
OP
|
$393.00
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
11423
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$275.10 |
| Max. Negotiated Rate |
$1,801.41 |
| Rate for Payer: Aetna Commercial |
$353.70
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$381.21
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$304.69
|
| Rate for Payer: BCN Commercial |
$304.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$314.40
|
| Rate for Payer: Cash Price |
$314.40
|
| Rate for Payer: Cofinity Commercial |
$369.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$314.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$393.00
|
| Rate for Payer: Healthscope Whirlpool |
$381.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$353.70
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$334.05
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.63
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$279.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$345.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Professional
|
Both
|
$393.00
|
|
|
Service Code
|
HCPCS 11423
|
| Hospital Charge Code |
11423
|
| Min. Negotiated Rate |
$100.96 |
| Max. Negotiated Rate |
$338.18 |
| Rate for Payer: Aetna Commercial |
$203.12
|
| Rate for Payer: Aetna Medicare |
$151.58
|
| Rate for Payer: BCBS Complete |
$106.01
|
| Rate for Payer: BCBS MAPPO |
$151.58
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$241.09
|
| Rate for Payer: BCN Medicare Advantage |
$151.58
|
| Rate for Payer: Cash Price |
$314.40
|
| Rate for Payer: Cash Price |
$314.40
|
| Rate for Payer: Cofinity Commercial |
$203.12
|
| Rate for Payer: Cofinity Commercial |
$218.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.58
|
| Rate for Payer: Healthscope Commercial |
$181.90
|
| Rate for Payer: Healthscope Whirlpool |
$181.90
|
| Rate for Payer: Meridian Medicaid |
$106.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$159.16
|
| Rate for Payer: PACE SWMI |
$151.58
|
| Rate for Payer: PHP Medicare Advantage |
$151.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$191.54
|
| Rate for Payer: Priority Health Medicare |
$151.58
|
| Rate for Payer: Priority Health Narrow Network |
$191.54
|
| Rate for Payer: UHC Medicare Advantage |
$156.13
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Professional
|
Both
|
$393.00
|
|
|
Service Code
|
HCPCS 11423
|
| Min. Negotiated Rate |
$100.96 |
| Max. Negotiated Rate |
$338.18 |
| Rate for Payer: Aetna Commercial |
$203.12
|
| Rate for Payer: Aetna Medicare |
$151.58
|
| Rate for Payer: BCBS Complete |
$106.01
|
| Rate for Payer: BCBS MAPPO |
$151.58
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$241.09
|
| Rate for Payer: BCN Medicare Advantage |
$151.58
|
| Rate for Payer: Cash Price |
$314.40
|
| Rate for Payer: Cash Price |
$314.40
|
| Rate for Payer: Cofinity Commercial |
$218.28
|
| Rate for Payer: Cofinity Commercial |
$203.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.58
|
| Rate for Payer: Healthscope Commercial |
$181.90
|
| Rate for Payer: Healthscope Whirlpool |
$181.90
|
| Rate for Payer: Meridian Medicaid |
$106.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$159.16
|
| Rate for Payer: PACE SWMI |
$151.58
|
| Rate for Payer: PHP Medicare Advantage |
$151.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$191.54
|
| Rate for Payer: Priority Health Medicare |
$151.58
|
| Rate for Payer: Priority Health Narrow Network |
$191.54
|
| Rate for Payer: UHC Medicare Advantage |
$156.13
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Facility
|
IP
|
$393.00
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
11423
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$275.10 |
| Max. Negotiated Rate |
$393.00 |
| Rate for Payer: Aetna Commercial |
$353.70
|
| Rate for Payer: ASR ASR |
$381.21
|
| Rate for Payer: BCBS Trust/PPO |
$304.69
|
| Rate for Payer: BCN Commercial |
$304.69
|
| Rate for Payer: Cash Price |
$314.40
|
| Rate for Payer: Cofinity Commercial |
$369.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$314.40
|
| Rate for Payer: Healthscope Commercial |
$393.00
|
| Rate for Payer: Healthscope Whirlpool |
$381.21
|
| Rate for Payer: Mclaren Commercial |
$353.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$334.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$345.84
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Facility
|
OP
|
$503.00
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
11424
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$352.10 |
| Max. Negotiated Rate |
$1,801.41 |
| Rate for Payer: Aetna Commercial |
$452.70
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$487.91
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$389.98
|
| Rate for Payer: BCN Commercial |
$389.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$402.40
|
| Rate for Payer: Cash Price |
$402.40
|
| Rate for Payer: Cofinity Commercial |
$472.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$402.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$503.00
|
| Rate for Payer: Healthscope Whirlpool |
$487.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$452.70
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$427.55
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$457.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$357.13
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$442.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Professional
|
Both
|
$503.00
|
|
|
Service Code
|
HCPCS 11424
|
| Min. Negotiated Rate |
$116.30 |
| Max. Negotiated Rate |
$2,640.00 |
| Rate for Payer: Aetna Commercial |
$232.72
|
| Rate for Payer: Aetna Medicare |
$173.67
|
| Rate for Payer: BCBS Complete |
$122.12
|
| Rate for Payer: BCBS MAPPO |
$173.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,640.00
|
| Rate for Payer: BCN Commercial |
$277.61
|
| Rate for Payer: BCN Medicare Advantage |
$173.67
|
| Rate for Payer: Cash Price |
$402.40
|
| Rate for Payer: Cash Price |
$402.40
|
| Rate for Payer: Cofinity Commercial |
$250.08
|
| Rate for Payer: Cofinity Commercial |
$232.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.67
|
| Rate for Payer: Healthscope Commercial |
$208.40
|
| Rate for Payer: Healthscope Whirlpool |
$208.40
|
| Rate for Payer: Meridian Medicaid |
$122.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$182.35
|
| Rate for Payer: PACE SWMI |
$173.67
|
| Rate for Payer: PHP Medicare Advantage |
$173.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.67
|
| Rate for Payer: Priority Health Medicare |
$173.67
|
| Rate for Payer: Priority Health Narrow Network |
$218.67
|
| Rate for Payer: UHC Medicare Advantage |
$178.88
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Professional
|
Both
|
$503.00
|
|
|
Service Code
|
HCPCS 11424
|
| Hospital Charge Code |
11424
|
| Min. Negotiated Rate |
$116.30 |
| Max. Negotiated Rate |
$2,640.00 |
| Rate for Payer: Aetna Commercial |
$232.72
|
| Rate for Payer: Aetna Medicare |
$173.67
|
| Rate for Payer: BCBS Complete |
$122.12
|
| Rate for Payer: BCBS MAPPO |
$173.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,640.00
|
| Rate for Payer: BCN Commercial |
$277.61
|
| Rate for Payer: BCN Medicare Advantage |
$173.67
|
| Rate for Payer: Cash Price |
$402.40
|
| Rate for Payer: Cash Price |
$402.40
|
| Rate for Payer: Cofinity Commercial |
$250.08
|
| Rate for Payer: Cofinity Commercial |
$232.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.67
|
| Rate for Payer: Healthscope Commercial |
$208.40
|
| Rate for Payer: Healthscope Whirlpool |
$208.40
|
| Rate for Payer: Meridian Medicaid |
$122.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$182.35
|
| Rate for Payer: PACE SWMI |
$173.67
|
| Rate for Payer: PHP Medicare Advantage |
$173.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.67
|
| Rate for Payer: Priority Health Medicare |
$173.67
|
| Rate for Payer: Priority Health Narrow Network |
$218.67
|
| Rate for Payer: UHC Medicare Advantage |
$178.88
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Facility
|
IP
|
$503.00
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
11424
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$352.10 |
| Max. Negotiated Rate |
$503.00 |
| Rate for Payer: Aetna Commercial |
$452.70
|
| Rate for Payer: ASR ASR |
$487.91
|
| Rate for Payer: BCBS Trust/PPO |
$389.98
|
| Rate for Payer: BCN Commercial |
$389.98
|
| Rate for Payer: Cash Price |
$402.40
|
| Rate for Payer: Cofinity Commercial |
$472.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$402.40
|
| Rate for Payer: Healthscope Commercial |
$503.00
|
| Rate for Payer: Healthscope Whirlpool |
$487.91
|
| Rate for Payer: Mclaren Commercial |
$452.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$427.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$442.64
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM
|
Facility
|
OP
|
$692.00
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
11426
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$484.40 |
| Max. Negotiated Rate |
$3,157.18 |
| Rate for Payer: Aetna Commercial |
$622.80
|
| Rate for Payer: Aetna Medicare |
$2,525.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: ASR ASR |
$671.24
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$536.51
|
| Rate for Payer: BCN Commercial |
$536.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$553.60
|
| Rate for Payer: Cash Price |
$553.60
|
| Rate for Payer: Cofinity Commercial |
$650.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$692.00
|
| Rate for Payer: Healthscope Whirlpool |
$671.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$622.80
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$588.20
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$2,778.31
|
| Rate for Payer: PHP Medicaid |
$1,381.58
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$629.72
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$491.32
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$608.96
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM
|
Professional
|
Both
|
$692.00
|
|
|
Service Code
|
HCPCS 11426
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$484.40 |
| Rate for Payer: Aetna Commercial |
$353.99
|
| Rate for Payer: Aetna Medicare |
$264.17
|
| Rate for Payer: BCBS Complete |
$180.26
|
| Rate for Payer: BCBS MAPPO |
$264.17
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$388.74
|
| Rate for Payer: BCN Medicare Advantage |
$264.17
|
| Rate for Payer: Cash Price |
$553.60
|
| Rate for Payer: Cash Price |
$553.60
|
| Rate for Payer: Cofinity Commercial |
$380.40
|
| Rate for Payer: Cofinity Commercial |
$353.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$264.17
|
| Rate for Payer: Healthscope Commercial |
$317.00
|
| Rate for Payer: Healthscope Whirlpool |
$317.00
|
| Rate for Payer: Meridian Medicaid |
$180.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$277.38
|
| Rate for Payer: PACE SWMI |
$264.17
|
| Rate for Payer: PHP Medicare Advantage |
$264.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.47
|
| Rate for Payer: Priority Health Medicare |
$264.17
|
| Rate for Payer: Priority Health Narrow Network |
$330.47
|
| Rate for Payer: UHC Medicare Advantage |
$272.10
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM
|
Facility
|
IP
|
$692.00
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
11426
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$484.40 |
| Max. Negotiated Rate |
$692.00 |
| Rate for Payer: Aetna Commercial |
$622.80
|
| Rate for Payer: ASR ASR |
$671.24
|
| Rate for Payer: BCBS Trust/PPO |
$536.51
|
| Rate for Payer: BCN Commercial |
$536.51
|
| Rate for Payer: Cash Price |
$553.60
|
| Rate for Payer: Cofinity Commercial |
$650.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.60
|
| Rate for Payer: Healthscope Commercial |
$692.00
|
| Rate for Payer: Healthscope Whirlpool |
$671.24
|
| Rate for Payer: Mclaren Commercial |
$622.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$588.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$608.96
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM
|
Professional
|
Both
|
$692.00
|
|
|
Service Code
|
HCPCS 11426
|
| Hospital Charge Code |
11426
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$484.40 |
| Rate for Payer: Aetna Commercial |
$353.99
|
| Rate for Payer: Aetna Medicare |
$264.17
|
| Rate for Payer: BCBS Complete |
$180.26
|
| Rate for Payer: BCBS MAPPO |
$264.17
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$388.74
|
| Rate for Payer: BCN Medicare Advantage |
$264.17
|
| Rate for Payer: Cash Price |
$553.60
|
| Rate for Payer: Cash Price |
$553.60
|
| Rate for Payer: Cofinity Commercial |
$380.40
|
| Rate for Payer: Cofinity Commercial |
$353.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$264.17
|
| Rate for Payer: Healthscope Commercial |
$317.00
|
| Rate for Payer: Healthscope Whirlpool |
$317.00
|
| Rate for Payer: Meridian Medicaid |
$180.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$277.38
|
| Rate for Payer: PACE SWMI |
$264.17
|
| Rate for Payer: PHP Medicare Advantage |
$264.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.47
|
| Rate for Payer: Priority Health Medicare |
$264.17
|
| Rate for Payer: Priority Health Narrow Network |
$330.47
|
| Rate for Payer: UHC Medicare Advantage |
$272.10
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
11400
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$200.00 |
| Rate for Payer: Aetna Commercial |
$180.00
|
| Rate for Payer: ASR ASR |
$194.00
|
| Rate for Payer: BCBS Trust/PPO |
$155.06
|
| Rate for Payer: BCN Commercial |
$155.06
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$188.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.00
|
| Rate for Payer: Healthscope Commercial |
$200.00
|
| Rate for Payer: Healthscope Whirlpool |
$194.00
|
| Rate for Payer: Mclaren Commercial |
$180.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.00
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
11400
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$781.74 |
| Rate for Payer: Aetna Commercial |
$180.00
|
| Rate for Payer: Aetna Medicare |
$625.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: ASR ASR |
$194.00
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$155.06
|
| Rate for Payer: BCN Commercial |
$155.06
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$188.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$200.00
|
| Rate for Payer: Healthscope Whirlpool |
$194.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.39
|
| Rate for Payer: Mclaren Commercial |
$180.00
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.00
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$687.93
|
| Rate for Payer: PHP Medicaid |
$342.09
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$719.35
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$575.48
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.00
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 11400
|
| Min. Negotiated Rate |
$54.32 |
| Max. Negotiated Rate |
$6,962.48 |
| Rate for Payer: Aetna Commercial |
$108.37
|
| Rate for Payer: Aetna Medicare |
$80.87
|
| Rate for Payer: BCBS Complete |
$57.04
|
| Rate for Payer: BCBS MAPPO |
$80.87
|
| Rate for Payer: BCBS Trust/PPO |
$6,962.48
|
| Rate for Payer: BCN Commercial |
$151.17
|
| Rate for Payer: BCN Medicare Advantage |
$80.87
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$116.45
|
| Rate for Payer: Cofinity Commercial |
$108.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.87
|
| Rate for Payer: Healthscope Commercial |
$97.04
|
| Rate for Payer: Healthscope Whirlpool |
$97.04
|
| Rate for Payer: Meridian Medicaid |
$57.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.91
|
| Rate for Payer: PACE SWMI |
$80.87
|
| Rate for Payer: PHP Medicare Advantage |
$80.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.17
|
| Rate for Payer: Priority Health Medicare |
$80.87
|
| Rate for Payer: Priority Health Narrow Network |
$103.17
|
| Rate for Payer: UHC Medicare Advantage |
$83.30
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 11400
|
| Hospital Charge Code |
11400
|
| Min. Negotiated Rate |
$54.32 |
| Max. Negotiated Rate |
$6,962.48 |
| Rate for Payer: Aetna Commercial |
$108.37
|
| Rate for Payer: Aetna Medicare |
$80.87
|
| Rate for Payer: BCBS Complete |
$57.04
|
| Rate for Payer: BCBS MAPPO |
$80.87
|
| Rate for Payer: BCBS Trust/PPO |
$6,962.48
|
| Rate for Payer: BCN Commercial |
$151.17
|
| Rate for Payer: BCN Medicare Advantage |
$80.87
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$108.37
|
| Rate for Payer: Cofinity Commercial |
$116.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.87
|
| Rate for Payer: Healthscope Commercial |
$97.04
|
| Rate for Payer: Healthscope Whirlpool |
$97.04
|
| Rate for Payer: Meridian Medicaid |
$57.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.91
|
| Rate for Payer: PACE SWMI |
$80.87
|
| Rate for Payer: PHP Medicare Advantage |
$80.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.17
|
| Rate for Payer: Priority Health Medicare |
$80.87
|
| Rate for Payer: Priority Health Narrow Network |
$103.17
|
| Rate for Payer: UHC Medicare Advantage |
$83.30
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 11401
|
| Hospital Charge Code |
11401
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$5,569.98 |
| Rate for Payer: Aetna Commercial |
$137.66
|
| Rate for Payer: Aetna Medicare |
$102.73
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$102.73
|
| Rate for Payer: BCBS Trust/PPO |
$5,569.98
|
| Rate for Payer: BCN Commercial |
$184.56
|
| Rate for Payer: BCN Medicare Advantage |
$102.73
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$147.93
|
| Rate for Payer: Cofinity Commercial |
$137.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.73
|
| Rate for Payer: Healthscope Commercial |
$123.28
|
| Rate for Payer: Healthscope Whirlpool |
$123.28
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$107.87
|
| Rate for Payer: PACE SWMI |
$102.73
|
| Rate for Payer: PHP Medicare Advantage |
$102.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.30
|
| Rate for Payer: Priority Health Medicare |
$102.73
|
| Rate for Payer: Priority Health Narrow Network |
$130.30
|
| Rate for Payer: UHC Medicare Advantage |
$105.81
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Facility
|
OP
|
$242.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
11401
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$169.40 |
| Max. Negotiated Rate |
$719.35 |
| Rate for Payer: Aetna Commercial |
$217.80
|
| Rate for Payer: Aetna Medicare |
$354.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: ASR ASR |
$234.74
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$187.62
|
| Rate for Payer: BCN Commercial |
$187.62
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$227.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$242.00
|
| Rate for Payer: Healthscope Whirlpool |
$234.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.43
|
| Rate for Payer: Mclaren Commercial |
$217.80
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$205.70
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$389.87
|
| Rate for Payer: PHP Medicaid |
$193.87
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$719.35
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$575.48
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$212.96
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: VA VA |
$354.43
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 11401
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$5,569.98 |
| Rate for Payer: Aetna Commercial |
$137.66
|
| Rate for Payer: Aetna Medicare |
$102.73
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$102.73
|
| Rate for Payer: BCBS Trust/PPO |
$5,569.98
|
| Rate for Payer: BCN Commercial |
$184.56
|
| Rate for Payer: BCN Medicare Advantage |
$102.73
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$137.66
|
| Rate for Payer: Cofinity Commercial |
$147.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.73
|
| Rate for Payer: Healthscope Commercial |
$123.28
|
| Rate for Payer: Healthscope Whirlpool |
$123.28
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$107.87
|
| Rate for Payer: PACE SWMI |
$102.73
|
| Rate for Payer: PHP Medicare Advantage |
$102.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.30
|
| Rate for Payer: Priority Health Medicare |
$102.73
|
| Rate for Payer: Priority Health Narrow Network |
$130.30
|
| Rate for Payer: UHC Medicare Advantage |
$105.81
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Facility
|
IP
|
$242.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
11401
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$169.40 |
| Max. Negotiated Rate |
$242.00 |
| Rate for Payer: Aetna Commercial |
$217.80
|
| Rate for Payer: ASR ASR |
$234.74
|
| Rate for Payer: BCBS Trust/PPO |
$187.62
|
| Rate for Payer: BCN Commercial |
$187.62
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$227.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.60
|
| Rate for Payer: Healthscope Commercial |
$242.00
|
| Rate for Payer: Healthscope Whirlpool |
$234.74
|
| Rate for Payer: Mclaren Commercial |
$217.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$205.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$212.96
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM
|
Facility
|
OP
|
$269.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
11402
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$188.30 |
| Max. Negotiated Rate |
$781.74 |
| Rate for Payer: Aetna Commercial |
$242.10
|
| Rate for Payer: Aetna Medicare |
$625.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: ASR ASR |
$260.93
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$208.56
|
| Rate for Payer: BCN Commercial |
$208.56
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$252.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$269.00
|
| Rate for Payer: Healthscope Whirlpool |
$260.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$625.39
|
| Rate for Payer: Mclaren Commercial |
$242.10
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$228.65
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$687.93
|
| Rate for Payer: PHP Medicaid |
$342.09
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$244.79
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$190.99
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.72
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: VA VA |
$625.39
|
|
