|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
11421
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$169.65 |
| Max. Negotiated Rate |
$261.00 |
| Rate for Payer: Aetna Commercial |
$234.90
|
| Rate for Payer: ASR ASR |
$253.17
|
| Rate for Payer: ASR Commercial |
$253.17
|
| Rate for Payer: BCBS Trust/PPO |
$212.69
|
| Rate for Payer: BCN Commercial |
$202.35
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$245.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.80
|
| Rate for Payer: Healthscope Commercial |
$261.00
|
| Rate for Payer: Healthscope Whirlpool |
$253.17
|
| Rate for Payer: Mclaren Commercial |
$234.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.85
|
| Rate for Payer: Nomi Health Commercial |
$214.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.68
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 11421
|
| Min. Negotiated Rate |
$103.13 |
| Max. Negotiated Rate |
$169.65 |
| Rate for Payer: Aetna Commercial |
$138.19
|
| Rate for Payer: Aetna Medicare |
$103.13
|
| Rate for Payer: BCBS Complete |
$104.40
|
| Rate for Payer: BCBS MAPPO |
$103.13
|
| Rate for Payer: BCN Medicare Advantage |
$103.13
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$148.51
|
| Rate for Payer: Cofinity Commercial |
$138.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.13
|
| Rate for Payer: Healthscope Commercial |
$123.76
|
| Rate for Payer: Healthscope Whirlpool |
$123.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.29
|
| Rate for Payer: Nomi Health Commercial |
$123.76
|
| Rate for Payer: PACE SWMI |
$103.13
|
| Rate for Payer: PHP Medicare Advantage |
$103.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
| Rate for Payer: Priority Health Medicare |
$103.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.13
|
| Rate for Payer: UHC Medicare Advantage |
$103.13
|
| Rate for Payer: UHCCP DNSP |
$103.13
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 11421
|
| Hospital Charge Code |
11421
|
| Min. Negotiated Rate |
$103.13 |
| Max. Negotiated Rate |
$169.65 |
| Rate for Payer: Aetna Commercial |
$138.19
|
| Rate for Payer: Aetna Medicare |
$103.13
|
| Rate for Payer: BCBS Complete |
$104.40
|
| Rate for Payer: BCBS MAPPO |
$103.13
|
| Rate for Payer: BCN Medicare Advantage |
$103.13
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$148.51
|
| Rate for Payer: Cofinity Commercial |
$138.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.13
|
| Rate for Payer: Healthscope Commercial |
$123.76
|
| Rate for Payer: Healthscope Whirlpool |
$123.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.29
|
| Rate for Payer: Nomi Health Commercial |
$123.76
|
| Rate for Payer: PACE SWMI |
$103.13
|
| Rate for Payer: PHP Medicare Advantage |
$103.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
| Rate for Payer: Priority Health Medicare |
$103.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.13
|
| Rate for Payer: UHC Medicare Advantage |
$103.13
|
| Rate for Payer: UHCCP DNSP |
$103.13
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
11421
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$169.65 |
| Max. Negotiated Rate |
$1,063.61 |
| Rate for Payer: Aetna Commercial |
$234.90
|
| 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 |
$253.17
|
| Rate for Payer: ASR Commercial |
$253.17
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$213.73
|
| Rate for Payer: BCN Commercial |
$202.35
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$245.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$261.00
|
| Rate for Payer: Healthscope Whirlpool |
$253.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$234.90
|
| 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 |
$221.85
|
| Rate for Payer: Nomi Health Commercial |
$214.02
|
| 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 |
$169.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.69
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$182.96
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.68
|
| 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
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM
|
Facility
|
OP
|
$291.00
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
11422
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$189.15 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$261.90
|
| 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 |
$282.27
|
| Rate for Payer: ASR Commercial |
$282.27
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$238.30
|
| Rate for Payer: BCN Commercial |
$225.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$273.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$291.00
|
| Rate for Payer: Healthscope Whirlpool |
$282.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$261.90
|
| 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 |
$247.35
|
| Rate for Payer: Nomi Health Commercial |
$238.62
|
| 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 |
$189.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.97
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$203.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$256.08
|
| 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
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 11422
|
| Hospital Charge Code |
11422
|
| Min. Negotiated Rate |
$116.40 |
| Max. Negotiated Rate |
$189.15 |
| Rate for Payer: Aetna Commercial |
$172.74
|
| Rate for Payer: Aetna Medicare |
$128.91
|
| Rate for Payer: BCBS Complete |
$116.40
|
| Rate for Payer: BCBS MAPPO |
$128.91
|
| Rate for Payer: BCN Medicare Advantage |
$128.91
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$185.63
|
| Rate for Payer: Cofinity Commercial |
$172.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.91
|
| Rate for Payer: Healthscope Commercial |
$154.69
|
| Rate for Payer: Healthscope Whirlpool |
$154.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.36
|
| Rate for Payer: Nomi Health Commercial |
$154.69
|
| Rate for Payer: PACE SWMI |
$128.91
|
| Rate for Payer: PHP Medicare Advantage |
$128.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.15
|
| Rate for Payer: Priority Health Medicare |
$128.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.91
|
| Rate for Payer: UHC Medicare Advantage |
$128.91
|
| Rate for Payer: UHCCP DNSP |
$128.91
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 11422
|
| Min. Negotiated Rate |
$116.40 |
| Max. Negotiated Rate |
$189.15 |
| Rate for Payer: Aetna Commercial |
$172.74
|
| Rate for Payer: Aetna Medicare |
$128.91
|
| Rate for Payer: BCBS Complete |
$116.40
|
| Rate for Payer: BCBS MAPPO |
$128.91
|
| Rate for Payer: BCN Medicare Advantage |
$128.91
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$185.63
|
| Rate for Payer: Cofinity Commercial |
$172.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.91
|
| Rate for Payer: Healthscope Commercial |
$154.69
|
| Rate for Payer: Healthscope Whirlpool |
$154.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.36
|
| Rate for Payer: Nomi Health Commercial |
$154.69
|
| Rate for Payer: PACE SWMI |
$128.91
|
| Rate for Payer: PHP Medicare Advantage |
$128.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.15
|
| Rate for Payer: Priority Health Medicare |
$128.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.91
|
| Rate for Payer: UHC Medicare Advantage |
$128.91
|
| Rate for Payer: UHCCP DNSP |
$128.91
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM
|
Facility
|
IP
|
$291.00
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
11422
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$189.15 |
| Max. Negotiated Rate |
$291.00 |
| Rate for Payer: Aetna Commercial |
$261.90
|
| Rate for Payer: ASR ASR |
$282.27
|
| Rate for Payer: ASR Commercial |
$282.27
|
| Rate for Payer: BCBS Trust/PPO |
$237.14
|
| Rate for Payer: BCN Commercial |
$225.61
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$273.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.80
|
| Rate for Payer: Healthscope Commercial |
$291.00
|
| Rate for Payer: Healthscope Whirlpool |
$282.27
|
| Rate for Payer: Mclaren Commercial |
$261.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.35
|
| Rate for Payer: Nomi Health Commercial |
$238.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$256.08
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Professional
|
Both
|
$401.00
|
|
|
Service Code
|
HCPCS 11423
|
| Hospital Charge Code |
11423
|
| Min. Negotiated Rate |
$150.04 |
| Max. Negotiated Rate |
$260.65 |
| Rate for Payer: Aetna Commercial |
$201.05
|
| Rate for Payer: Aetna Medicare |
$150.04
|
| Rate for Payer: BCBS Complete |
$160.40
|
| Rate for Payer: BCBS MAPPO |
$150.04
|
| Rate for Payer: BCN Medicare Advantage |
$150.04
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cofinity Commercial |
$216.06
|
| Rate for Payer: Cofinity Commercial |
$201.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.04
|
| Rate for Payer: Healthscope Commercial |
$180.05
|
| Rate for Payer: Healthscope Whirlpool |
$180.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.54
|
| Rate for Payer: Nomi Health Commercial |
$180.05
|
| Rate for Payer: PACE SWMI |
$150.04
|
| Rate for Payer: PHP Medicare Advantage |
$150.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.65
|
| Rate for Payer: Priority Health Medicare |
$150.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.04
|
| Rate for Payer: UHC Medicare Advantage |
$150.04
|
| Rate for Payer: UHCCP DNSP |
$150.04
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Professional
|
Both
|
$401.00
|
|
|
Service Code
|
HCPCS 11423
|
| Min. Negotiated Rate |
$150.04 |
| Max. Negotiated Rate |
$260.65 |
| Rate for Payer: Aetna Commercial |
$201.05
|
| Rate for Payer: Aetna Medicare |
$150.04
|
| Rate for Payer: BCBS Complete |
$160.40
|
| Rate for Payer: BCBS MAPPO |
$150.04
|
| Rate for Payer: BCN Medicare Advantage |
$150.04
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cofinity Commercial |
$216.06
|
| Rate for Payer: Cofinity Commercial |
$201.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.04
|
| Rate for Payer: Healthscope Commercial |
$180.05
|
| Rate for Payer: Healthscope Whirlpool |
$180.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.54
|
| Rate for Payer: Nomi Health Commercial |
$180.05
|
| Rate for Payer: PACE SWMI |
$150.04
|
| Rate for Payer: PHP Medicare Advantage |
$150.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.65
|
| Rate for Payer: Priority Health Medicare |
$150.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.04
|
| Rate for Payer: UHC Medicare Advantage |
$150.04
|
| Rate for Payer: UHCCP DNSP |
$150.04
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Facility
|
IP
|
$401.00
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
11423
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$260.65 |
| Max. Negotiated Rate |
$401.00 |
| Rate for Payer: Aetna Commercial |
$360.90
|
| Rate for Payer: ASR ASR |
$388.97
|
| Rate for Payer: ASR Commercial |
$388.97
|
| Rate for Payer: BCBS Trust/PPO |
$326.77
|
| Rate for Payer: BCN Commercial |
$310.90
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cofinity Commercial |
$376.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.80
|
| Rate for Payer: Healthscope Commercial |
$401.00
|
| Rate for Payer: Healthscope Whirlpool |
$388.97
|
| Rate for Payer: Mclaren Commercial |
$360.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.85
|
| Rate for Payer: Nomi Health Commercial |
$328.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$352.88
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Facility
|
OP
|
$401.00
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
11423
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$260.65 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$360.90
|
| 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 |
$388.97
|
| Rate for Payer: ASR Commercial |
$388.97
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$328.38
|
| Rate for Payer: BCN Commercial |
$310.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cofinity Commercial |
$376.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$401.00
|
| Rate for Payer: Healthscope Whirlpool |
$388.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$360.90
|
| 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 |
$340.85
|
| Rate for Payer: Nomi Health Commercial |
$328.82
|
| 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 |
$260.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$351.36
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$281.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$352.88
|
| 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
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Facility
|
OP
|
$513.00
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
11424
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$333.45 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$461.70
|
| 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 |
$497.61
|
| Rate for Payer: ASR Commercial |
$497.61
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$420.10
|
| Rate for Payer: BCN Commercial |
$397.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cofinity Commercial |
$482.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$410.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$513.00
|
| Rate for Payer: Healthscope Whirlpool |
$497.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$461.70
|
| 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 |
$436.05
|
| Rate for Payer: Nomi Health Commercial |
$420.66
|
| 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 |
$333.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$449.49
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$359.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$451.44
|
| 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
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Professional
|
Both
|
$513.00
|
|
|
Service Code
|
HCPCS 11424
|
| Hospital Charge Code |
11424
|
| Min. Negotiated Rate |
$173.40 |
| Max. Negotiated Rate |
$333.45 |
| Rate for Payer: Aetna Commercial |
$232.36
|
| Rate for Payer: Aetna Medicare |
$173.40
|
| Rate for Payer: BCBS Complete |
$205.20
|
| Rate for Payer: BCBS MAPPO |
$173.40
|
| Rate for Payer: BCN Medicare Advantage |
$173.40
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cofinity Commercial |
$249.70
|
| Rate for Payer: Cofinity Commercial |
$232.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.40
|
| Rate for Payer: Healthscope Commercial |
$208.08
|
| Rate for Payer: Healthscope Whirlpool |
$208.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.07
|
| Rate for Payer: Nomi Health Commercial |
$208.08
|
| Rate for Payer: PACE SWMI |
$173.40
|
| Rate for Payer: PHP Medicare Advantage |
$173.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.45
|
| Rate for Payer: Priority Health Medicare |
$173.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.40
|
| Rate for Payer: UHC Medicare Advantage |
$173.40
|
| Rate for Payer: UHCCP DNSP |
$173.40
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Facility
|
IP
|
$513.00
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
11424
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$333.45 |
| Max. Negotiated Rate |
$513.00 |
| Rate for Payer: Aetna Commercial |
$461.70
|
| Rate for Payer: ASR ASR |
$497.61
|
| Rate for Payer: ASR Commercial |
$497.61
|
| Rate for Payer: BCBS Trust/PPO |
$418.04
|
| Rate for Payer: BCN Commercial |
$397.73
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cofinity Commercial |
$482.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$410.40
|
| Rate for Payer: Healthscope Commercial |
$513.00
|
| Rate for Payer: Healthscope Whirlpool |
$497.61
|
| Rate for Payer: Mclaren Commercial |
$461.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$436.05
|
| Rate for Payer: Nomi Health Commercial |
$420.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$451.44
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Professional
|
Both
|
$513.00
|
|
|
Service Code
|
HCPCS 11424
|
| Min. Negotiated Rate |
$173.40 |
| Max. Negotiated Rate |
$333.45 |
| Rate for Payer: Aetna Commercial |
$232.36
|
| Rate for Payer: Aetna Medicare |
$173.40
|
| Rate for Payer: BCBS Complete |
$205.20
|
| Rate for Payer: BCBS MAPPO |
$173.40
|
| Rate for Payer: BCN Medicare Advantage |
$173.40
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cofinity Commercial |
$249.70
|
| Rate for Payer: Cofinity Commercial |
$232.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.40
|
| Rate for Payer: Healthscope Commercial |
$208.08
|
| Rate for Payer: Healthscope Whirlpool |
$208.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.07
|
| Rate for Payer: Nomi Health Commercial |
$208.08
|
| Rate for Payer: PACE SWMI |
$173.40
|
| Rate for Payer: PHP Medicare Advantage |
$173.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.45
|
| Rate for Payer: Priority Health Medicare |
$173.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.40
|
| Rate for Payer: UHC Medicare Advantage |
$173.40
|
| Rate for Payer: UHCCP DNSP |
$173.40
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM
|
Facility
|
IP
|
$706.00
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
11426
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$458.90 |
| Max. Negotiated Rate |
$706.00 |
| Rate for Payer: Aetna Commercial |
$635.40
|
| Rate for Payer: ASR ASR |
$684.82
|
| Rate for Payer: ASR Commercial |
$684.82
|
| Rate for Payer: BCBS Trust/PPO |
$575.32
|
| Rate for Payer: BCN Commercial |
$547.36
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cofinity Commercial |
$663.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.80
|
| Rate for Payer: Healthscope Commercial |
$706.00
|
| Rate for Payer: Healthscope Whirlpool |
$684.82
|
| Rate for Payer: Mclaren Commercial |
$635.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$600.10
|
| Rate for Payer: Nomi Health Commercial |
$578.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$621.28
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM
|
Professional
|
Both
|
$706.00
|
|
|
Service Code
|
HCPCS 11426
|
| Min. Negotiated Rate |
$257.95 |
| Max. Negotiated Rate |
$458.90 |
| Rate for Payer: Aetna Commercial |
$345.65
|
| Rate for Payer: Aetna Medicare |
$257.95
|
| Rate for Payer: BCBS Complete |
$282.40
|
| Rate for Payer: BCBS MAPPO |
$257.95
|
| Rate for Payer: BCN Medicare Advantage |
$257.95
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cofinity Commercial |
$371.45
|
| Rate for Payer: Cofinity Commercial |
$345.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.95
|
| Rate for Payer: Healthscope Commercial |
$309.54
|
| Rate for Payer: Healthscope Whirlpool |
$309.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.85
|
| Rate for Payer: Nomi Health Commercial |
$309.54
|
| Rate for Payer: PACE SWMI |
$257.95
|
| Rate for Payer: PHP Medicare Advantage |
$257.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.90
|
| Rate for Payer: Priority Health Medicare |
$257.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.95
|
| Rate for Payer: UHC Medicare Advantage |
$257.95
|
| Rate for Payer: UHCCP DNSP |
$257.95
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM
|
Professional
|
Both
|
$706.00
|
|
|
Service Code
|
HCPCS 11426
|
| Hospital Charge Code |
11426
|
| Min. Negotiated Rate |
$257.95 |
| Max. Negotiated Rate |
$458.90 |
| Rate for Payer: Aetna Commercial |
$345.65
|
| Rate for Payer: Aetna Medicare |
$257.95
|
| Rate for Payer: BCBS Complete |
$282.40
|
| Rate for Payer: BCBS MAPPO |
$257.95
|
| Rate for Payer: BCN Medicare Advantage |
$257.95
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cofinity Commercial |
$371.45
|
| Rate for Payer: Cofinity Commercial |
$345.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.95
|
| Rate for Payer: Healthscope Commercial |
$309.54
|
| Rate for Payer: Healthscope Whirlpool |
$309.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.85
|
| Rate for Payer: Nomi Health Commercial |
$309.54
|
| Rate for Payer: PACE SWMI |
$257.95
|
| Rate for Payer: PHP Medicare Advantage |
$257.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.90
|
| Rate for Payer: Priority Health Medicare |
$257.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.95
|
| Rate for Payer: UHC Medicare Advantage |
$257.95
|
| Rate for Payer: UHCCP DNSP |
$257.95
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM
|
Facility
|
OP
|
$706.00
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
11426
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$458.90 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$635.40
|
| 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 |
$684.82
|
| Rate for Payer: ASR Commercial |
$684.82
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$578.14
|
| Rate for Payer: BCN Commercial |
$547.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cofinity Commercial |
$663.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$706.00
|
| Rate for Payer: Healthscope Whirlpool |
$684.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$635.40
|
| 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 |
$600.10
|
| Rate for Payer: Nomi Health Commercial |
$578.92
|
| 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 |
$458.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$618.60
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$494.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$621.28
|
| 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
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 11400
|
| Min. Negotiated Rate |
$79.42 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Aetna Commercial |
$106.42
|
| Rate for Payer: Aetna Medicare |
$79.42
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCBS MAPPO |
$79.42
|
| Rate for Payer: BCN Medicare Advantage |
$79.42
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$114.36
|
| Rate for Payer: Cofinity Commercial |
$106.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.42
|
| Rate for Payer: Healthscope Commercial |
$95.30
|
| Rate for Payer: Healthscope Whirlpool |
$95.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.39
|
| Rate for Payer: Nomi Health Commercial |
$95.30
|
| Rate for Payer: PACE SWMI |
$79.42
|
| Rate for Payer: PHP Medicare Advantage |
$79.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health Medicare |
$79.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.42
|
| Rate for Payer: UHC Medicare Advantage |
$79.42
|
| Rate for Payer: UHCCP DNSP |
$79.42
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Facility
|
OP
|
$204.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
11400
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$132.60 |
| Max. Negotiated Rate |
$1,063.61 |
| Rate for Payer: Aetna Commercial |
$183.60
|
| 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 |
$197.88
|
| Rate for Payer: ASR Commercial |
$197.88
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$167.06
|
| Rate for Payer: BCN Commercial |
$158.16
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$191.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$204.00
|
| Rate for Payer: Healthscope Whirlpool |
$197.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$183.60
|
| 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 |
$173.40
|
| Rate for Payer: Nomi Health Commercial |
$167.28
|
| 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 |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.74
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$143.00
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.52
|
| 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
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 11400
|
| Hospital Charge Code |
11400
|
| Min. Negotiated Rate |
$79.42 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Aetna Commercial |
$106.42
|
| Rate for Payer: Aetna Medicare |
$79.42
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCBS MAPPO |
$79.42
|
| Rate for Payer: BCN Medicare Advantage |
$79.42
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$114.36
|
| Rate for Payer: Cofinity Commercial |
$106.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.42
|
| Rate for Payer: Healthscope Commercial |
$95.30
|
| Rate for Payer: Healthscope Whirlpool |
$95.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.39
|
| Rate for Payer: Nomi Health Commercial |
$95.30
|
| Rate for Payer: PACE SWMI |
$79.42
|
| Rate for Payer: PHP Medicare Advantage |
$79.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health Medicare |
$79.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.42
|
| Rate for Payer: UHC Medicare Advantage |
$79.42
|
| Rate for Payer: UHCCP DNSP |
$79.42
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<
|
Facility
|
IP
|
$204.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
11400
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$132.60 |
| Max. Negotiated Rate |
$204.00 |
| Rate for Payer: Aetna Commercial |
$183.60
|
| Rate for Payer: ASR ASR |
$197.88
|
| Rate for Payer: ASR Commercial |
$197.88
|
| Rate for Payer: BCBS Trust/PPO |
$166.24
|
| Rate for Payer: BCN Commercial |
$158.16
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$191.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Healthscope Commercial |
$204.00
|
| Rate for Payer: Healthscope Whirlpool |
$197.88
|
| Rate for Payer: Mclaren Commercial |
$183.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.40
|
| Rate for Payer: Nomi Health Commercial |
$167.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.52
|
|
|
PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM
|
Facility
|
OP
|
$247.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
11401
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$160.55 |
| Max. Negotiated Rate |
$603.96 |
| Rate for Payer: Aetna Commercial |
$222.30
|
| 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 |
$239.59
|
| Rate for Payer: ASR Commercial |
$239.59
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$202.27
|
| Rate for Payer: BCN Commercial |
$191.50
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cofinity Commercial |
$232.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$247.00
|
| Rate for Payer: Healthscope Whirlpool |
$239.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$222.30
|
| 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 |
$209.95
|
| Rate for Payer: Nomi Health Commercial |
$202.54
|
| 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 |
$160.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$216.42
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$173.15
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$217.36
|
| 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
|
|
