|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Facility
|
OP
|
$413.00
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
11423
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$289.51 |
| Max. Negotiated Rate |
$2,057.07 |
| Rate for Payer: Aetna Commercial |
$371.70
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$400.61
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$340.52
|
| Rate for Payer: BCN Commercial |
$340.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$330.40
|
| Rate for Payer: Cash Price |
$330.40
|
| Rate for Payer: Cofinity Commercial |
$388.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$400.61
|
| Rate for Payer: Healthscope Whirlpool |
$413.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$371.70
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.05
|
| Rate for Payer: Nomi Health Commercial |
$338.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$309.75
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$361.87
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$289.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Professional
|
Both
|
$413.00
|
|
|
Service Code
|
HCPCS 11423
|
| Hospital Charge Code |
11423
|
| Min. Negotiated Rate |
$91.59 |
| Max. Negotiated Rate |
$309.75 |
| Rate for Payer: Aetna Commercial |
$186.15
|
| Rate for Payer: Aetna Medicare |
$138.92
|
| Rate for Payer: BCBS Complete |
$96.17
|
| Rate for Payer: BCBS MAPPO |
$138.92
|
| Rate for Payer: BCN Commercial |
$188.89
|
| Rate for Payer: BCN Medicare Advantage |
$138.92
|
| Rate for Payer: Cash Price |
$330.40
|
| Rate for Payer: Cash Price |
$330.40
|
| Rate for Payer: Cofinity Commercial |
$200.04
|
| Rate for Payer: Cofinity Commercial |
$186.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.92
|
| Rate for Payer: Healthscope Commercial |
$166.70
|
| Rate for Payer: Healthscope Whirlpool |
$166.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.87
|
| Rate for Payer: Meridian Medicaid |
$96.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$152.81
|
| Rate for Payer: Nomi Health Commercial |
$166.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$309.75
|
| Rate for Payer: PACE SWMI |
$138.92
|
| Rate for Payer: PHP Medicare Advantage |
$138.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$219.24
|
| Rate for Payer: Priority Health Medicare |
$138.92
|
| Rate for Payer: Priority Health Narrow Network |
$219.24
|
| Rate for Payer: Railroad Medicare Medicare |
$138.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$268.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$138.92
|
| Rate for Payer: UHC Exchange |
$268.17
|
| Rate for Payer: UHC Medicaid |
$91.59
|
| Rate for Payer: UHCCP DNSP |
$138.92
|
| Rate for Payer: UHCCP Medicaid |
$91.59
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Professional
|
Both
|
$413.00
|
|
|
Service Code
|
HCPCS 11423
|
| Min. Negotiated Rate |
$91.59 |
| Max. Negotiated Rate |
$309.75 |
| Rate for Payer: Aetna Commercial |
$186.15
|
| Rate for Payer: Aetna Medicare |
$138.92
|
| Rate for Payer: BCBS Complete |
$96.17
|
| Rate for Payer: BCBS MAPPO |
$138.92
|
| Rate for Payer: BCN Commercial |
$188.89
|
| Rate for Payer: BCN Medicare Advantage |
$138.92
|
| Rate for Payer: Cash Price |
$330.40
|
| Rate for Payer: Cash Price |
$330.40
|
| Rate for Payer: Cofinity Commercial |
$200.04
|
| Rate for Payer: Cofinity Commercial |
$186.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.92
|
| Rate for Payer: Healthscope Commercial |
$166.70
|
| Rate for Payer: Healthscope Whirlpool |
$166.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.87
|
| Rate for Payer: Meridian Medicaid |
$96.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$152.81
|
| Rate for Payer: Nomi Health Commercial |
$166.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$309.75
|
| Rate for Payer: PACE SWMI |
$138.92
|
| Rate for Payer: PHP Medicare Advantage |
$138.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$219.24
|
| Rate for Payer: Priority Health Medicare |
$138.92
|
| Rate for Payer: Priority Health Narrow Network |
$219.24
|
| Rate for Payer: Railroad Medicare Medicare |
$138.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$268.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$138.92
|
| Rate for Payer: UHC Exchange |
$268.17
|
| Rate for Payer: UHC Medicaid |
$91.59
|
| Rate for Payer: UHCCP DNSP |
$138.92
|
| Rate for Payer: UHCCP Medicaid |
$91.59
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Facility
|
IP
|
$413.00
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
11423
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$309.75 |
| Max. Negotiated Rate |
$413.00 |
| Rate for Payer: Aetna Commercial |
$371.70
|
| Rate for Payer: ASR ASR |
$400.61
|
| Rate for Payer: BCBS Trust/PPO |
$339.16
|
| Rate for Payer: BCN Commercial |
$339.16
|
| Rate for Payer: Cash Price |
$330.40
|
| Rate for Payer: Cofinity Commercial |
$388.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.40
|
| Rate for Payer: Healthscope Commercial |
$400.61
|
| Rate for Payer: Healthscope Whirlpool |
$413.00
|
| Rate for Payer: Mclaren Commercial |
$371.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.05
|
| Rate for Payer: Nomi Health Commercial |
$338.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$309.75
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Facility
|
IP
|
$528.00
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
11424
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$396.00 |
| Max. Negotiated Rate |
$528.00 |
| Rate for Payer: Aetna Commercial |
$475.20
|
| Rate for Payer: ASR ASR |
$512.16
|
| Rate for Payer: BCBS Trust/PPO |
$433.59
|
| Rate for Payer: BCN Commercial |
$433.59
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cofinity Commercial |
$496.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$422.40
|
| Rate for Payer: Healthscope Commercial |
$512.16
|
| Rate for Payer: Healthscope Whirlpool |
$528.00
|
| Rate for Payer: Mclaren Commercial |
$475.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$448.80
|
| Rate for Payer: Nomi Health Commercial |
$432.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.00
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Professional
|
Both
|
$528.00
|
|
|
Service Code
|
HCPCS 11424
|
| Min. Negotiated Rate |
$105.22 |
| Max. Negotiated Rate |
$396.00 |
| Rate for Payer: Aetna Commercial |
$214.87
|
| Rate for Payer: Aetna Medicare |
$160.35
|
| Rate for Payer: BCBS Complete |
$110.48
|
| Rate for Payer: BCBS MAPPO |
$160.35
|
| Rate for Payer: BCN Commercial |
$217.16
|
| Rate for Payer: BCN Medicare Advantage |
$160.35
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cofinity Commercial |
$230.90
|
| Rate for Payer: Cofinity Commercial |
$214.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.35
|
| Rate for Payer: Healthscope Commercial |
$192.42
|
| Rate for Payer: Healthscope Whirlpool |
$192.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.37
|
| Rate for Payer: Meridian Medicaid |
$110.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$176.38
|
| Rate for Payer: Nomi Health Commercial |
$192.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.00
|
| Rate for Payer: PACE SWMI |
$160.35
|
| Rate for Payer: PHP Medicare Advantage |
$160.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$252.05
|
| Rate for Payer: Priority Health Medicare |
$160.35
|
| Rate for Payer: Priority Health Narrow Network |
$252.05
|
| Rate for Payer: Railroad Medicare Medicare |
$160.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$160.35
|
| Rate for Payer: UHC Exchange |
$308.80
|
| Rate for Payer: UHC Medicaid |
$105.22
|
| Rate for Payer: UHCCP DNSP |
$160.35
|
| Rate for Payer: UHCCP Medicaid |
$105.22
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Professional
|
Both
|
$528.00
|
|
|
Service Code
|
HCPCS 11424
|
| Hospital Charge Code |
11424
|
| Min. Negotiated Rate |
$105.22 |
| Max. Negotiated Rate |
$396.00 |
| Rate for Payer: Aetna Commercial |
$214.87
|
| Rate for Payer: Aetna Medicare |
$160.35
|
| Rate for Payer: BCBS Complete |
$110.48
|
| Rate for Payer: BCBS MAPPO |
$160.35
|
| Rate for Payer: BCN Commercial |
$217.16
|
| Rate for Payer: BCN Medicare Advantage |
$160.35
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cofinity Commercial |
$230.90
|
| Rate for Payer: Cofinity Commercial |
$214.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.35
|
| Rate for Payer: Healthscope Commercial |
$192.42
|
| Rate for Payer: Healthscope Whirlpool |
$192.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.37
|
| Rate for Payer: Meridian Medicaid |
$110.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$176.38
|
| Rate for Payer: Nomi Health Commercial |
$192.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.00
|
| Rate for Payer: PACE SWMI |
$160.35
|
| Rate for Payer: PHP Medicare Advantage |
$160.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$252.05
|
| Rate for Payer: Priority Health Medicare |
$160.35
|
| Rate for Payer: Priority Health Narrow Network |
$252.05
|
| Rate for Payer: Railroad Medicare Medicare |
$160.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$160.35
|
| Rate for Payer: UHC Exchange |
$308.80
|
| Rate for Payer: UHC Medicaid |
$105.22
|
| Rate for Payer: UHCCP DNSP |
$160.35
|
| Rate for Payer: UHCCP Medicaid |
$105.22
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Facility
|
OP
|
$528.00
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
11424
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$370.13 |
| Max. Negotiated Rate |
$2,057.07 |
| Rate for Payer: Aetna Commercial |
$475.20
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$512.16
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$435.34
|
| Rate for Payer: BCN Commercial |
$435.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cofinity Commercial |
$496.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$422.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$512.16
|
| Rate for Payer: Healthscope Whirlpool |
$528.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$475.20
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$448.80
|
| Rate for Payer: Nomi Health Commercial |
$432.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.00
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$462.63
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$370.13
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM
|
Facility
|
OP
|
$727.00
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
11426
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$509.63 |
| Max. Negotiated Rate |
$3,617.84 |
| Rate for Payer: Aetna Commercial |
$654.30
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: ASR ASR |
$705.19
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$599.41
|
| Rate for Payer: BCN Commercial |
$599.41
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cofinity Commercial |
$683.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$581.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$705.19
|
| Rate for Payer: Healthscope Whirlpool |
$727.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$654.30
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$617.95
|
| Rate for Payer: Nomi Health Commercial |
$596.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$545.25
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$637.00
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$509.63
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM
|
Professional
|
Both
|
$727.00
|
|
|
Service Code
|
HCPCS 11426
|
| Hospital Charge Code |
11426
|
| Min. Negotiated Rate |
$156.13 |
| Max. Negotiated Rate |
$545.25 |
| Rate for Payer: Aetna Commercial |
$321.25
|
| Rate for Payer: Aetna Medicare |
$239.74
|
| Rate for Payer: BCBS Complete |
$163.94
|
| Rate for Payer: BCBS MAPPO |
$239.74
|
| Rate for Payer: BCN Commercial |
$320.84
|
| Rate for Payer: BCN Medicare Advantage |
$239.74
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cofinity Commercial |
$345.23
|
| Rate for Payer: Cofinity Commercial |
$321.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.74
|
| Rate for Payer: Healthscope Commercial |
$287.69
|
| Rate for Payer: Healthscope Whirlpool |
$287.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.73
|
| Rate for Payer: Meridian Medicaid |
$163.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$263.71
|
| Rate for Payer: Nomi Health Commercial |
$287.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$545.25
|
| Rate for Payer: PACE SWMI |
$239.74
|
| Rate for Payer: PHP Medicare Advantage |
$239.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$372.37
|
| Rate for Payer: Priority Health Medicare |
$239.74
|
| Rate for Payer: Priority Health Narrow Network |
$372.37
|
| Rate for Payer: Railroad Medicare Medicare |
$239.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$478.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$239.74
|
| Rate for Payer: UHC Exchange |
$478.76
|
| Rate for Payer: UHC Medicaid |
$156.13
|
| Rate for Payer: UHCCP DNSP |
$239.74
|
| Rate for Payer: UHCCP Medicaid |
$156.13
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM
|
Facility
|
IP
|
$727.00
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
11426
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$545.25 |
| Max. Negotiated Rate |
$727.00 |
| Rate for Payer: Aetna Commercial |
$654.30
|
| Rate for Payer: ASR ASR |
$705.19
|
| Rate for Payer: BCBS Trust/PPO |
$597.01
|
| Rate for Payer: BCN Commercial |
$597.01
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cofinity Commercial |
$683.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$581.60
|
| Rate for Payer: Healthscope Commercial |
$705.19
|
| Rate for Payer: Healthscope Whirlpool |
$727.00
|
| Rate for Payer: Mclaren Commercial |
$654.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$617.95
|
| Rate for Payer: Nomi Health Commercial |
$596.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$545.25
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM
|
Professional
|
Both
|
$727.00
|
|
|
Service Code
|
HCPCS 11426
|
| Min. Negotiated Rate |
$156.13 |
| Max. Negotiated Rate |
$545.25 |
| Rate for Payer: Aetna Commercial |
$321.25
|
| Rate for Payer: Aetna Medicare |
$239.74
|
| Rate for Payer: BCBS Complete |
$163.94
|
| Rate for Payer: BCBS MAPPO |
$239.74
|
| Rate for Payer: BCN Commercial |
$320.84
|
| Rate for Payer: BCN Medicare Advantage |
$239.74
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cash Price |
$581.60
|
| Rate for Payer: Cofinity Commercial |
$345.23
|
| Rate for Payer: Cofinity Commercial |
$321.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.74
|
| Rate for Payer: Healthscope Commercial |
$287.69
|
| Rate for Payer: Healthscope Whirlpool |
$287.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.73
|
| Rate for Payer: Meridian Medicaid |
$163.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$263.71
|
| Rate for Payer: Nomi Health Commercial |
$287.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$545.25
|
| Rate for Payer: PACE SWMI |
$239.74
|
| Rate for Payer: PHP Medicare Advantage |
$239.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$372.37
|
| Rate for Payer: Priority Health Medicare |
$239.74
|
| Rate for Payer: Priority Health Narrow Network |
$372.37
|
| Rate for Payer: Railroad Medicare Medicare |
$239.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$478.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$239.74
|
| Rate for Payer: UHC Exchange |
$478.76
|
| Rate for Payer: UHC Medicaid |
$156.13
|
| Rate for Payer: UHCCP DNSP |
$239.74
|
| Rate for Payer: UHCCP Medicaid |
$156.13
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
11400
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$881.99 |
| Rate for Payer: Aetna Commercial |
$189.00
|
| Rate for Payer: Aetna Medicare |
$705.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: ASR ASR |
$203.70
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$173.15
|
| Rate for Payer: BCN Commercial |
$173.15
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$197.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$203.70
|
| Rate for Payer: Healthscope Whirlpool |
$210.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$189.00
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$387.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.50
|
| Rate for Payer: Nomi Health Commercial |
$172.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$776.15
|
| Rate for Payer: PHP Medicaid |
$378.20
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$848.60
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$678.88
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP DNSP |
$705.59
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 11400
|
| Min. Negotiated Rate |
$48.78 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$98.06
|
| Rate for Payer: Aetna Medicare |
$73.18
|
| Rate for Payer: BCBS Complete |
$51.22
|
| Rate for Payer: BCBS MAPPO |
$73.18
|
| Rate for Payer: BCN Commercial |
$100.92
|
| Rate for Payer: BCN Medicare Advantage |
$73.18
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$98.06
|
| Rate for Payer: Cofinity Commercial |
$105.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.18
|
| Rate for Payer: Healthscope Commercial |
$87.82
|
| Rate for Payer: Healthscope Whirlpool |
$87.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.84
|
| Rate for Payer: Meridian Medicaid |
$51.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.50
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: PACE SWMI |
$73.18
|
| Rate for Payer: PHP Medicare Advantage |
$73.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$117.14
|
| Rate for Payer: Priority Health Medicare |
$73.18
|
| Rate for Payer: Priority Health Narrow Network |
$117.14
|
| Rate for Payer: Railroad Medicare Medicare |
$73.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$139.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$73.18
|
| Rate for Payer: UHC Exchange |
$139.27
|
| Rate for Payer: UHC Medicaid |
$48.78
|
| Rate for Payer: UHCCP DNSP |
$73.18
|
| Rate for Payer: UHCCP Medicaid |
$48.78
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
11400
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$189.00
|
| Rate for Payer: ASR ASR |
$203.70
|
| Rate for Payer: BCBS Trust/PPO |
$172.45
|
| Rate for Payer: BCN Commercial |
$172.45
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$197.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.00
|
| Rate for Payer: Healthscope Commercial |
$203.70
|
| Rate for Payer: Healthscope Whirlpool |
$210.00
|
| Rate for Payer: Mclaren Commercial |
$189.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.50
|
| Rate for Payer: Nomi Health Commercial |
$172.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 11400
|
| Hospital Charge Code |
11400
|
| Min. Negotiated Rate |
$48.78 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$98.06
|
| Rate for Payer: Aetna Medicare |
$73.18
|
| Rate for Payer: BCBS Complete |
$51.22
|
| Rate for Payer: BCBS MAPPO |
$73.18
|
| Rate for Payer: BCN Commercial |
$100.92
|
| Rate for Payer: BCN Medicare Advantage |
$73.18
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$98.06
|
| Rate for Payer: Cofinity Commercial |
$105.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.18
|
| Rate for Payer: Healthscope Commercial |
$87.82
|
| Rate for Payer: Healthscope Whirlpool |
$87.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.84
|
| Rate for Payer: Meridian Medicaid |
$51.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.50
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: PACE SWMI |
$73.18
|
| Rate for Payer: PHP Medicare Advantage |
$73.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$117.14
|
| Rate for Payer: Priority Health Medicare |
$73.18
|
| Rate for Payer: Priority Health Narrow Network |
$117.14
|
| Rate for Payer: Railroad Medicare Medicare |
$73.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$139.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$73.18
|
| Rate for Payer: UHC Exchange |
$139.27
|
| Rate for Payer: UHC Medicaid |
$48.78
|
| Rate for Payer: UHCCP DNSP |
$73.18
|
| Rate for Payer: UHCCP Medicaid |
$48.78
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 11401
|
| Min. Negotiated Rate |
$60.28 |
| Max. Negotiated Rate |
$190.50 |
| Rate for Payer: Aetna Commercial |
$122.06
|
| Rate for Payer: Aetna Medicare |
$91.09
|
| Rate for Payer: BCBS Complete |
$63.29
|
| Rate for Payer: BCBS MAPPO |
$91.09
|
| Rate for Payer: BCN Commercial |
$126.06
|
| Rate for Payer: BCN Medicare Advantage |
$91.09
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$131.17
|
| Rate for Payer: Cofinity Commercial |
$122.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.09
|
| Rate for Payer: Healthscope Commercial |
$109.31
|
| Rate for Payer: Healthscope Whirlpool |
$109.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.64
|
| Rate for Payer: Meridian Medicaid |
$63.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.20
|
| Rate for Payer: Nomi Health Commercial |
$109.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.50
|
| Rate for Payer: PACE SWMI |
$91.09
|
| Rate for Payer: PHP Medicare Advantage |
$91.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$146.30
|
| Rate for Payer: Priority Health Medicare |
$91.09
|
| Rate for Payer: Priority Health Narrow Network |
$146.30
|
| Rate for Payer: Railroad Medicare Medicare |
$91.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$177.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.09
|
| Rate for Payer: UHC Exchange |
$177.71
|
| Rate for Payer: UHC Medicaid |
$60.28
|
| Rate for Payer: UHCCP DNSP |
$91.09
|
| Rate for Payer: UHCCP Medicaid |
$60.28
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 11401
|
| Hospital Charge Code |
11401
|
| Min. Negotiated Rate |
$60.28 |
| Max. Negotiated Rate |
$190.50 |
| Rate for Payer: Aetna Commercial |
$122.06
|
| Rate for Payer: Aetna Medicare |
$91.09
|
| Rate for Payer: BCBS Complete |
$63.29
|
| Rate for Payer: BCBS MAPPO |
$91.09
|
| Rate for Payer: BCN Commercial |
$126.06
|
| Rate for Payer: BCN Medicare Advantage |
$91.09
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$131.17
|
| Rate for Payer: Cofinity Commercial |
$122.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.09
|
| Rate for Payer: Healthscope Commercial |
$109.31
|
| Rate for Payer: Healthscope Whirlpool |
$109.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.64
|
| Rate for Payer: Meridian Medicaid |
$63.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.20
|
| Rate for Payer: Nomi Health Commercial |
$109.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.50
|
| Rate for Payer: PACE SWMI |
$91.09
|
| Rate for Payer: PHP Medicare Advantage |
$91.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$146.30
|
| Rate for Payer: Priority Health Medicare |
$91.09
|
| Rate for Payer: Priority Health Narrow Network |
$146.30
|
| Rate for Payer: Railroad Medicare Medicare |
$91.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$177.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.09
|
| Rate for Payer: UHC Exchange |
$177.71
|
| Rate for Payer: UHC Medicaid |
$60.28
|
| Rate for Payer: UHCCP DNSP |
$91.09
|
| Rate for Payer: UHCCP Medicaid |
$60.28
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Facility
|
OP
|
$254.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
11401
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$190.50 |
| Max. Negotiated Rate |
$848.60 |
| Rate for Payer: Aetna Commercial |
$228.60
|
| Rate for Payer: Aetna Medicare |
$405.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: ASR ASR |
$246.38
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$209.42
|
| Rate for Payer: BCN Commercial |
$209.42
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$238.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$246.38
|
| Rate for Payer: Healthscope Whirlpool |
$254.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$228.60
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$222.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.90
|
| Rate for Payer: Nomi Health Commercial |
$208.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.50
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$445.56
|
| Rate for Payer: PHP Medicaid |
$217.11
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$848.60
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$678.88
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP DNSP |
$405.05
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Facility
|
IP
|
$254.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
11401
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$190.50 |
| Max. Negotiated Rate |
$254.00 |
| Rate for Payer: Aetna Commercial |
$228.60
|
| Rate for Payer: ASR ASR |
$246.38
|
| Rate for Payer: BCBS Trust/PPO |
$208.58
|
| Rate for Payer: BCN Commercial |
$208.58
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$238.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.20
|
| Rate for Payer: Healthscope Commercial |
$246.38
|
| Rate for Payer: Healthscope Whirlpool |
$254.00
|
| Rate for Payer: Mclaren Commercial |
$228.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.90
|
| Rate for Payer: Nomi Health Commercial |
$208.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.50
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM
|
Professional
|
Both
|
$282.00
|
|
|
Service Code
|
HCPCS 11402
|
| Min. Negotiated Rate |
$65.39 |
| Max. Negotiated Rate |
$211.50 |
| Rate for Payer: Aetna Commercial |
$132.69
|
| Rate for Payer: Aetna Medicare |
$99.02
|
| Rate for Payer: BCBS Complete |
$68.66
|
| Rate for Payer: BCBS MAPPO |
$99.02
|
| Rate for Payer: BCN Commercial |
$137.84
|
| Rate for Payer: BCN Medicare Advantage |
$99.02
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$142.59
|
| Rate for Payer: Cofinity Commercial |
$132.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.02
|
| Rate for Payer: Healthscope Commercial |
$118.82
|
| Rate for Payer: Healthscope Whirlpool |
$118.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.97
|
| Rate for Payer: Meridian Medicaid |
$68.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.92
|
| Rate for Payer: Nomi Health Commercial |
$118.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.50
|
| Rate for Payer: PACE SWMI |
$99.02
|
| Rate for Payer: PHP Medicare Advantage |
$99.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$159.98
|
| Rate for Payer: Priority Health Medicare |
$99.02
|
| Rate for Payer: Priority Health Narrow Network |
$159.98
|
| Rate for Payer: Railroad Medicare Medicare |
$99.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$196.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$99.02
|
| Rate for Payer: UHC Exchange |
$196.64
|
| Rate for Payer: UHC Medicaid |
$65.39
|
| Rate for Payer: UHCCP DNSP |
$99.02
|
| Rate for Payer: UHCCP Medicaid |
$65.39
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM
|
Facility
|
IP
|
$282.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
11402
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$211.50 |
| Max. Negotiated Rate |
$282.00 |
| Rate for Payer: Aetna Commercial |
$253.80
|
| Rate for Payer: ASR ASR |
$273.54
|
| Rate for Payer: BCBS Trust/PPO |
$231.58
|
| Rate for Payer: BCN Commercial |
$231.58
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$265.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.60
|
| Rate for Payer: Healthscope Commercial |
$273.54
|
| Rate for Payer: Healthscope Whirlpool |
$282.00
|
| Rate for Payer: Mclaren Commercial |
$253.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.70
|
| Rate for Payer: Nomi Health Commercial |
$231.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.50
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM
|
Facility
|
OP
|
$282.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
11402
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$197.68 |
| Max. Negotiated Rate |
$881.99 |
| Rate for Payer: Aetna Commercial |
$253.80
|
| Rate for Payer: Aetna Medicare |
$705.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: ASR ASR |
$273.54
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$232.51
|
| Rate for Payer: BCN Commercial |
$232.51
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$265.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$273.54
|
| Rate for Payer: Healthscope Whirlpool |
$282.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$253.80
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$387.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.70
|
| Rate for Payer: Nomi Health Commercial |
$231.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.50
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$776.15
|
| Rate for Payer: PHP Medicaid |
$378.20
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$247.09
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$197.68
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP DNSP |
$705.59
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM
|
Professional
|
Both
|
$282.00
|
|
|
Service Code
|
HCPCS 11402
|
| Hospital Charge Code |
11402
|
| Min. Negotiated Rate |
$65.39 |
| Max. Negotiated Rate |
$211.50 |
| Rate for Payer: Aetna Commercial |
$132.69
|
| Rate for Payer: Aetna Medicare |
$99.02
|
| Rate for Payer: BCBS Complete |
$68.66
|
| Rate for Payer: BCBS MAPPO |
$99.02
|
| Rate for Payer: BCN Commercial |
$137.84
|
| Rate for Payer: BCN Medicare Advantage |
$99.02
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$142.59
|
| Rate for Payer: Cofinity Commercial |
$132.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.02
|
| Rate for Payer: Healthscope Commercial |
$118.82
|
| Rate for Payer: Healthscope Whirlpool |
$118.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.97
|
| Rate for Payer: Meridian Medicaid |
$68.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.92
|
| Rate for Payer: Nomi Health Commercial |
$118.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.50
|
| Rate for Payer: PACE SWMI |
$99.02
|
| Rate for Payer: PHP Medicare Advantage |
$99.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$159.98
|
| Rate for Payer: Priority Health Medicare |
$99.02
|
| Rate for Payer: Priority Health Narrow Network |
$159.98
|
| Rate for Payer: Railroad Medicare Medicare |
$99.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$196.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$99.02
|
| Rate for Payer: UHC Exchange |
$196.64
|
| Rate for Payer: UHC Medicaid |
$65.39
|
| Rate for Payer: UHCCP DNSP |
$99.02
|
| Rate for Payer: UHCCP Medicaid |
$65.39
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 11403
|
| Min. Negotiated Rate |
$86.48 |
| Max. Negotiated Rate |
$254.35 |
| Rate for Payer: Aetna Commercial |
$175.29
|
| Rate for Payer: Aetna Medicare |
$130.81
|
| Rate for Payer: BCBS Complete |
$90.80
|
| Rate for Payer: BCBS MAPPO |
$130.81
|
| Rate for Payer: BCN Commercial |
$179.46
|
| Rate for Payer: BCN Medicare Advantage |
$130.81
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cofinity Commercial |
$188.37
|
| Rate for Payer: Cofinity Commercial |
$175.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.81
|
| Rate for Payer: Healthscope Commercial |
$156.97
|
| Rate for Payer: Healthscope Whirlpool |
$156.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.35
|
| Rate for Payer: Meridian Medicaid |
$90.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$143.89
|
| Rate for Payer: Nomi Health Commercial |
$156.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.50
|
| Rate for Payer: PACE SWMI |
$130.81
|
| Rate for Payer: PHP Medicare Advantage |
$130.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$208.29
|
| Rate for Payer: Priority Health Medicare |
$130.81
|
| Rate for Payer: Priority Health Narrow Network |
$208.29
|
| Rate for Payer: Railroad Medicare Medicare |
$130.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$254.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$130.81
|
| Rate for Payer: UHC Exchange |
$254.35
|
| Rate for Payer: UHC Medicaid |
$86.48
|
| Rate for Payer: UHCCP DNSP |
$130.81
|
| Rate for Payer: UHCCP Medicaid |
$86.48
|
|
