|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Facility
|
OP
|
$422.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
11602
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$506.31 |
| Rate for Payer: Aetna Commercial |
$379.80
|
| 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 |
$409.34
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$347.94
|
| Rate for Payer: BCN Commercial |
$347.94
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cofinity Commercial |
$396.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$409.34
|
| Rate for Payer: Healthscope Whirlpool |
$422.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$405.05
|
| Rate for Payer: Mclaren Commercial |
$379.80
|
| 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 |
$358.70
|
| Rate for Payer: Nomi Health Commercial |
$346.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$316.50
|
| 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 |
$369.76
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Narrow Network |
$295.82
|
| 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 EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Facility
|
IP
|
$422.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
11602
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$316.50 |
| Max. Negotiated Rate |
$422.00 |
| Rate for Payer: Aetna Commercial |
$379.80
|
| Rate for Payer: ASR ASR |
$409.34
|
| Rate for Payer: BCBS Trust/PPO |
$346.55
|
| Rate for Payer: BCN Commercial |
$346.55
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cofinity Commercial |
$396.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.60
|
| Rate for Payer: Healthscope Commercial |
$409.34
|
| Rate for Payer: Healthscope Whirlpool |
$422.00
|
| Rate for Payer: Mclaren Commercial |
$379.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.70
|
| Rate for Payer: Nomi Health Commercial |
$346.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$316.50
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Professional
|
Both
|
$422.00
|
|
|
Service Code
|
HCPCS 11602
|
| Hospital Charge Code |
11602
|
| Min. Negotiated Rate |
$87.12 |
| Max. Negotiated Rate |
$316.50 |
| Rate for Payer: Aetna Commercial |
$177.97
|
| Rate for Payer: Aetna Medicare |
$132.81
|
| Rate for Payer: BCBS Complete |
$91.48
|
| Rate for Payer: BCBS MAPPO |
$132.81
|
| Rate for Payer: BCN Commercial |
$191.24
|
| Rate for Payer: BCN Medicare Advantage |
$132.81
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cofinity Commercial |
$191.25
|
| Rate for Payer: Cofinity Commercial |
$177.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.81
|
| Rate for Payer: Healthscope Commercial |
$159.37
|
| Rate for Payer: Healthscope Whirlpool |
$159.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.45
|
| Rate for Payer: Meridian Medicaid |
$91.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$146.09
|
| Rate for Payer: Nomi Health Commercial |
$159.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$316.50
|
| Rate for Payer: PACE SWMI |
$132.81
|
| Rate for Payer: PHP Medicare Advantage |
$132.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$221.97
|
| Rate for Payer: Priority Health Medicare |
$132.81
|
| Rate for Payer: Priority Health Narrow Network |
$221.97
|
| Rate for Payer: Railroad Medicare Medicare |
$132.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$279.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.81
|
| Rate for Payer: UHC Exchange |
$279.46
|
| Rate for Payer: UHC Medicaid |
$87.12
|
| Rate for Payer: UHCCP DNSP |
$132.81
|
| Rate for Payer: UHCCP Medicaid |
$87.12
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Facility
|
IP
|
$481.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
11603
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$360.75 |
| Max. Negotiated Rate |
$481.00 |
| Rate for Payer: Aetna Commercial |
$432.90
|
| Rate for Payer: ASR ASR |
$466.57
|
| Rate for Payer: BCBS Trust/PPO |
$395.00
|
| Rate for Payer: BCN Commercial |
$395.00
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cofinity Commercial |
$452.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.80
|
| Rate for Payer: Healthscope Commercial |
$466.57
|
| Rate for Payer: Healthscope Whirlpool |
$481.00
|
| Rate for Payer: Mclaren Commercial |
$432.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$408.85
|
| Rate for Payer: Nomi Health Commercial |
$394.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$360.75
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Facility
|
OP
|
$481.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
11603
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$337.18 |
| Max. Negotiated Rate |
$881.99 |
| Rate for Payer: Aetna Commercial |
$432.90
|
| 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 |
$466.57
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$396.58
|
| Rate for Payer: BCN Commercial |
$396.58
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cofinity Commercial |
$452.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$466.57
|
| Rate for Payer: Healthscope Whirlpool |
$481.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$432.90
|
| 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 |
$408.85
|
| Rate for Payer: Nomi Health Commercial |
$394.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$360.75
|
| 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 |
$421.45
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$337.18
|
| 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 EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Professional
|
Both
|
$481.00
|
|
|
Service Code
|
HCPCS 11603
|
| Min. Negotiated Rate |
$104.16 |
| Max. Negotiated Rate |
$360.75 |
| Rate for Payer: Aetna Commercial |
$213.72
|
| Rate for Payer: Aetna Medicare |
$159.49
|
| Rate for Payer: BCBS Complete |
$109.37
|
| Rate for Payer: BCBS MAPPO |
$159.49
|
| Rate for Payer: BCN Commercial |
$289.82
|
| Rate for Payer: BCN Medicare Advantage |
$159.49
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cofinity Commercial |
$229.67
|
| Rate for Payer: Cofinity Commercial |
$213.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.49
|
| Rate for Payer: Healthscope Commercial |
$191.39
|
| Rate for Payer: Healthscope Whirlpool |
$191.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.46
|
| Rate for Payer: Meridian Medicaid |
$109.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$175.44
|
| Rate for Payer: Nomi Health Commercial |
$191.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$360.75
|
| Rate for Payer: PACE SWMI |
$159.49
|
| Rate for Payer: PHP Medicare Advantage |
$159.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$265.27
|
| Rate for Payer: Priority Health Medicare |
$159.49
|
| Rate for Payer: Priority Health Narrow Network |
$265.27
|
| Rate for Payer: Railroad Medicare Medicare |
$159.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$335.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$159.49
|
| Rate for Payer: UHC Exchange |
$335.05
|
| Rate for Payer: UHC Medicaid |
$104.16
|
| Rate for Payer: UHCCP DNSP |
$159.49
|
| Rate for Payer: UHCCP Medicaid |
$104.16
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Professional
|
Both
|
$481.00
|
|
|
Service Code
|
HCPCS 11603
|
| Hospital Charge Code |
11603
|
| Min. Negotiated Rate |
$104.16 |
| Max. Negotiated Rate |
$360.75 |
| Rate for Payer: Aetna Commercial |
$213.72
|
| Rate for Payer: Aetna Medicare |
$159.49
|
| Rate for Payer: BCBS Complete |
$109.37
|
| Rate for Payer: BCBS MAPPO |
$159.49
|
| Rate for Payer: BCN Commercial |
$289.82
|
| Rate for Payer: BCN Medicare Advantage |
$159.49
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cofinity Commercial |
$229.67
|
| Rate for Payer: Cofinity Commercial |
$213.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.49
|
| Rate for Payer: Healthscope Commercial |
$191.39
|
| Rate for Payer: Healthscope Whirlpool |
$191.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.46
|
| Rate for Payer: Meridian Medicaid |
$109.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$175.44
|
| Rate for Payer: Nomi Health Commercial |
$191.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$360.75
|
| Rate for Payer: PACE SWMI |
$159.49
|
| Rate for Payer: PHP Medicare Advantage |
$159.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$265.27
|
| Rate for Payer: Priority Health Medicare |
$159.49
|
| Rate for Payer: Priority Health Narrow Network |
$265.27
|
| Rate for Payer: Railroad Medicare Medicare |
$159.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$335.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$159.49
|
| Rate for Payer: UHC Exchange |
$335.05
|
| Rate for Payer: UHC Medicaid |
$104.16
|
| Rate for Payer: UHCCP DNSP |
$159.49
|
| Rate for Payer: UHCCP Medicaid |
$104.16
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 11604
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$402.75 |
| Rate for Payer: Aetna Commercial |
$237.38
|
| Rate for Payer: Aetna Medicare |
$177.15
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCBS MAPPO |
$177.15
|
| Rate for Payer: BCN Commercial |
$319.21
|
| Rate for Payer: BCN Medicare Advantage |
$177.15
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Commercial |
$255.10
|
| Rate for Payer: Cofinity Commercial |
$237.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.15
|
| Rate for Payer: Healthscope Commercial |
$212.58
|
| Rate for Payer: Healthscope Whirlpool |
$212.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.01
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.87
|
| Rate for Payer: Nomi Health Commercial |
$212.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.75
|
| Rate for Payer: PACE SWMI |
$177.15
|
| Rate for Payer: PHP Medicare Advantage |
$177.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$292.15
|
| Rate for Payer: Priority Health Medicare |
$177.15
|
| Rate for Payer: Priority Health Narrow Network |
$292.15
|
| Rate for Payer: Railroad Medicare Medicare |
$177.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$370.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.15
|
| Rate for Payer: UHC Exchange |
$370.72
|
| Rate for Payer: UHC Medicaid |
$115.45
|
| Rate for Payer: UHCCP DNSP |
$177.15
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Facility
|
OP
|
$537.00
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
11604
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$881.99 |
| Rate for Payer: Aetna Commercial |
$483.30
|
| 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 |
$520.89
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$442.76
|
| Rate for Payer: BCN Commercial |
$442.76
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Commercial |
$504.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$520.89
|
| Rate for Payer: Healthscope Whirlpool |
$537.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$705.59
|
| Rate for Payer: Mclaren Commercial |
$483.30
|
| 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 |
$456.45
|
| Rate for Payer: Nomi Health Commercial |
$440.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.75
|
| 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 |
$470.52
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Narrow Network |
$376.44
|
| 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 EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Facility
|
IP
|
$537.00
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
11604
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$402.75 |
| Max. Negotiated Rate |
$537.00 |
| Rate for Payer: Aetna Commercial |
$483.30
|
| Rate for Payer: ASR ASR |
$520.89
|
| Rate for Payer: BCBS Trust/PPO |
$440.98
|
| Rate for Payer: BCN Commercial |
$440.98
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Commercial |
$504.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.60
|
| Rate for Payer: Healthscope Commercial |
$520.89
|
| Rate for Payer: Healthscope Whirlpool |
$537.00
|
| Rate for Payer: Mclaren Commercial |
$483.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$456.45
|
| Rate for Payer: Nomi Health Commercial |
$440.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.75
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 11604
|
| Hospital Charge Code |
11604
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$402.75 |
| Rate for Payer: Aetna Commercial |
$237.38
|
| Rate for Payer: Aetna Medicare |
$177.15
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCBS MAPPO |
$177.15
|
| Rate for Payer: BCN Commercial |
$319.21
|
| Rate for Payer: BCN Medicare Advantage |
$177.15
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Commercial |
$255.10
|
| Rate for Payer: Cofinity Commercial |
$237.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.15
|
| Rate for Payer: Healthscope Commercial |
$212.58
|
| Rate for Payer: Healthscope Whirlpool |
$212.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.01
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.87
|
| Rate for Payer: Nomi Health Commercial |
$212.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.75
|
| Rate for Payer: PACE SWMI |
$177.15
|
| Rate for Payer: PHP Medicare Advantage |
$177.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$292.15
|
| Rate for Payer: Priority Health Medicare |
$177.15
|
| Rate for Payer: Priority Health Narrow Network |
$292.15
|
| Rate for Payer: Railroad Medicare Medicare |
$177.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$370.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.15
|
| Rate for Payer: UHC Exchange |
$370.72
|
| Rate for Payer: UHC Medicaid |
$115.45
|
| Rate for Payer: UHCCP DNSP |
$177.15
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
|
|
PR EXCISION MAXILLARY TORUS PALATINUS
|
Professional
|
Both
|
$817.00
|
|
|
Service Code
|
HCPCS 21032
|
| Min. Negotiated Rate |
$155.70 |
| Max. Negotiated Rate |
$612.75 |
| Rate for Payer: Aetna Commercial |
$315.56
|
| Rate for Payer: Aetna Medicare |
$235.49
|
| Rate for Payer: BCBS Complete |
$163.49
|
| Rate for Payer: BCBS MAPPO |
$235.49
|
| Rate for Payer: BCN Commercial |
$397.38
|
| Rate for Payer: BCN Medicare Advantage |
$235.49
|
| Rate for Payer: Cash Price |
$653.60
|
| Rate for Payer: Cash Price |
$653.60
|
| Rate for Payer: Cofinity Commercial |
$339.11
|
| Rate for Payer: Cofinity Commercial |
$315.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.49
|
| Rate for Payer: Healthscope Commercial |
$282.59
|
| Rate for Payer: Healthscope Whirlpool |
$282.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.26
|
| Rate for Payer: Meridian Medicaid |
$163.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.04
|
| Rate for Payer: Nomi Health Commercial |
$282.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$612.75
|
| Rate for Payer: PACE SWMI |
$235.49
|
| Rate for Payer: PHP Medicare Advantage |
$235.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$424.81
|
| Rate for Payer: Priority Health Medicare |
$235.49
|
| Rate for Payer: Priority Health Narrow Network |
$424.81
|
| Rate for Payer: Railroad Medicare Medicare |
$235.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$472.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$235.49
|
| Rate for Payer: UHC Exchange |
$472.29
|
| Rate for Payer: UHC Medicaid |
$155.70
|
| Rate for Payer: UHCCP DNSP |
$235.49
|
| Rate for Payer: UHCCP Medicaid |
$155.70
|
|
|
PR EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS
|
Professional
|
Both
|
$699.00
|
|
|
Service Code
|
HCPCS 46230
|
| Min. Negotiated Rate |
$106.07 |
| Max. Negotiated Rate |
$524.25 |
| Rate for Payer: Aetna Commercial |
$218.07
|
| Rate for Payer: Aetna Medicare |
$162.74
|
| Rate for Payer: BCBS Complete |
$111.37
|
| Rate for Payer: BCBS MAPPO |
$162.74
|
| Rate for Payer: BCN Commercial |
$263.44
|
| Rate for Payer: BCN Medicare Advantage |
$162.74
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cofinity Commercial |
$234.35
|
| Rate for Payer: Cofinity Commercial |
$218.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.74
|
| Rate for Payer: Healthscope Commercial |
$195.29
|
| Rate for Payer: Healthscope Whirlpool |
$195.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.88
|
| Rate for Payer: Meridian Medicaid |
$111.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$179.01
|
| Rate for Payer: Nomi Health Commercial |
$195.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$524.25
|
| Rate for Payer: PACE SWMI |
$162.74
|
| Rate for Payer: PHP Medicare Advantage |
$162.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$320.97
|
| Rate for Payer: Priority Health Medicare |
$162.74
|
| Rate for Payer: Priority Health Narrow Network |
$320.97
|
| Rate for Payer: Railroad Medicare Medicare |
$162.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$162.74
|
| Rate for Payer: UHC Exchange |
$303.70
|
| Rate for Payer: UHC Medicaid |
$106.07
|
| Rate for Payer: UHCCP DNSP |
$162.74
|
| Rate for Payer: UHCCP Medicaid |
$106.07
|
|
|
PR EXCISION NAIL&NAIL MATRIX PRTL/COMPL PERM RMVL
|
Professional
|
Both
|
$497.00
|
|
|
Service Code
|
HCPCS 11750
|
| Min. Negotiated Rate |
$60.07 |
| Max. Negotiated Rate |
$372.75 |
| Rate for Payer: Aetna Commercial |
$122.58
|
| Rate for Payer: Aetna Medicare |
$91.48
|
| Rate for Payer: BCBS Complete |
$63.07
|
| Rate for Payer: BCBS MAPPO |
$91.48
|
| Rate for Payer: BCN Commercial |
$120.56
|
| Rate for Payer: BCN Medicare Advantage |
$91.48
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cofinity Commercial |
$131.73
|
| Rate for Payer: Cofinity Commercial |
$122.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.48
|
| Rate for Payer: Healthscope Commercial |
$109.78
|
| Rate for Payer: Healthscope Whirlpool |
$109.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.05
|
| Rate for Payer: Meridian Medicaid |
$63.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.63
|
| Rate for Payer: Nomi Health Commercial |
$109.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$372.75
|
| Rate for Payer: PACE SWMI |
$91.48
|
| Rate for Payer: PHP Medicare Advantage |
$91.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$139.92
|
| Rate for Payer: Priority Health Medicare |
$91.48
|
| Rate for Payer: Priority Health Narrow Network |
$139.92
|
| Rate for Payer: Railroad Medicare Medicare |
$91.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.48
|
| Rate for Payer: UHC Exchange |
$176.26
|
| Rate for Payer: UHC Medicaid |
$60.07
|
| Rate for Payer: UHCCP DNSP |
$91.48
|
| Rate for Payer: UHCCP Medicaid |
$60.07
|
|
|
PR EXCISION NASAL POLYP EXTENSIVE
|
Professional
|
Both
|
$837.00
|
|
|
Service Code
|
HCPCS 30115
|
| Min. Negotiated Rate |
$276.47 |
| Max. Negotiated Rate |
$756.59 |
| Rate for Payer: Aetna Commercial |
$553.26
|
| Rate for Payer: Aetna Medicare |
$412.88
|
| Rate for Payer: BCBS Complete |
$290.29
|
| Rate for Payer: BCBS MAPPO |
$412.88
|
| Rate for Payer: BCN Commercial |
$697.67
|
| Rate for Payer: BCN Medicare Advantage |
$412.88
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cofinity Commercial |
$594.55
|
| Rate for Payer: Cofinity Commercial |
$553.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.88
|
| Rate for Payer: Healthscope Commercial |
$495.46
|
| Rate for Payer: Healthscope Whirlpool |
$495.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$433.52
|
| Rate for Payer: Meridian Medicaid |
$290.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$454.17
|
| Rate for Payer: Nomi Health Commercial |
$495.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$627.75
|
| Rate for Payer: PACE SWMI |
$412.88
|
| Rate for Payer: PHP Medicare Advantage |
$412.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$656.99
|
| Rate for Payer: Priority Health Medicare |
$412.88
|
| Rate for Payer: Priority Health Narrow Network |
$656.99
|
| Rate for Payer: Railroad Medicare Medicare |
$412.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$756.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$412.88
|
| Rate for Payer: UHC Exchange |
$756.59
|
| Rate for Payer: UHC Medicaid |
$276.47
|
| Rate for Payer: UHCCP DNSP |
$412.88
|
| Rate for Payer: UHCCP Medicaid |
$276.47
|
|
|
PR EXCISION NASAL POLYP SIMPLE
|
Professional
|
Both
|
$512.00
|
|
|
Service Code
|
HCPCS 30110
|
| Min. Negotiated Rate |
$76.47 |
| Max. Negotiated Rate |
$384.00 |
| Rate for Payer: Aetna Commercial |
$155.31
|
| Rate for Payer: Aetna Medicare |
$115.90
|
| Rate for Payer: BCBS Complete |
$80.29
|
| Rate for Payer: BCBS MAPPO |
$115.90
|
| Rate for Payer: BCN Commercial |
$201.68
|
| Rate for Payer: BCN Medicare Advantage |
$115.90
|
| Rate for Payer: Cash Price |
$409.60
|
| Rate for Payer: Cash Price |
$409.60
|
| Rate for Payer: Cofinity Commercial |
$166.90
|
| Rate for Payer: Cofinity Commercial |
$155.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.90
|
| Rate for Payer: Healthscope Commercial |
$139.08
|
| Rate for Payer: Healthscope Whirlpool |
$139.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.69
|
| Rate for Payer: Meridian Medicaid |
$80.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$127.49
|
| Rate for Payer: Nomi Health Commercial |
$139.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$384.00
|
| Rate for Payer: PACE SWMI |
$115.90
|
| Rate for Payer: PHP Medicare Advantage |
$115.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$189.92
|
| Rate for Payer: Priority Health Medicare |
$115.90
|
| Rate for Payer: Priority Health Narrow Network |
$189.92
|
| Rate for Payer: Railroad Medicare Medicare |
$115.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$222.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$115.90
|
| Rate for Payer: UHC Exchange |
$222.82
|
| Rate for Payer: UHC Medicaid |
$76.47
|
| Rate for Payer: UHCCP DNSP |
$115.90
|
| Rate for Payer: UHCCP Medicaid |
$76.47
|
|
|
PR EXCISION NEUROMA DIGITAL NRV EA ADDL DIGIT
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 64778
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$323.83 |
| Rate for Payer: Aetna Commercial |
$207.59
|
| Rate for Payer: Aetna Medicare |
$154.92
|
| Rate for Payer: BCBS Complete |
$103.77
|
| Rate for Payer: BCBS MAPPO |
$154.92
|
| Rate for Payer: BCN Commercial |
$267.91
|
| Rate for Payer: BCN Medicare Advantage |
$154.92
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$223.08
|
| Rate for Payer: Cofinity Commercial |
$207.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.92
|
| Rate for Payer: Healthscope Commercial |
$185.90
|
| Rate for Payer: Healthscope Whirlpool |
$185.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.67
|
| Rate for Payer: Meridian Medicaid |
$103.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$170.41
|
| Rate for Payer: Nomi Health Commercial |
$185.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.25
|
| Rate for Payer: PACE SWMI |
$154.92
|
| Rate for Payer: PHP Medicare Advantage |
$154.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$311.17
|
| Rate for Payer: Priority Health Medicare |
$154.92
|
| Rate for Payer: Priority Health Narrow Network |
$311.17
|
| Rate for Payer: Railroad Medicare Medicare |
$154.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$323.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$154.92
|
| Rate for Payer: UHC Exchange |
$323.83
|
| Rate for Payer: UHC Medicaid |
$98.83
|
| Rate for Payer: UHCCP DNSP |
$154.92
|
| Rate for Payer: UHCCP Medicaid |
$98.83
|
|
|
PR EXCISION NEUROMA SCIATIC NERVE
|
Professional
|
Both
|
$3,654.00
|
|
|
Service Code
|
HCPCS 64786
|
| Min. Negotiated Rate |
$606.62 |
| Max. Negotiated Rate |
$2,740.50 |
| Rate for Payer: Aetna Commercial |
$1,266.37
|
| Rate for Payer: Aetna Medicare |
$945.05
|
| Rate for Payer: BCBS Complete |
$636.95
|
| Rate for Payer: BCBS MAPPO |
$945.05
|
| Rate for Payer: BCN Commercial |
$1,514.86
|
| Rate for Payer: BCN Medicare Advantage |
$945.05
|
| Rate for Payer: Cash Price |
$2,923.20
|
| Rate for Payer: Cash Price |
$2,923.20
|
| Rate for Payer: Cofinity Commercial |
$1,360.87
|
| Rate for Payer: Cofinity Commercial |
$1,266.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$945.05
|
| Rate for Payer: Healthscope Commercial |
$1,134.06
|
| Rate for Payer: Healthscope Whirlpool |
$1,134.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$992.30
|
| Rate for Payer: Meridian Medicaid |
$636.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,039.56
|
| Rate for Payer: Nomi Health Commercial |
$1,134.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,740.50
|
| Rate for Payer: PACE SWMI |
$945.05
|
| Rate for Payer: PHP Medicare Advantage |
$945.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$606.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,759.48
|
| Rate for Payer: Priority Health Medicare |
$945.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,759.48
|
| Rate for Payer: Railroad Medicare Medicare |
$945.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,786.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$945.05
|
| Rate for Payer: UHC Exchange |
$1,786.46
|
| Rate for Payer: UHC Medicaid |
$606.62
|
| Rate for Payer: UHCCP DNSP |
$945.05
|
| Rate for Payer: UHCCP Medicaid |
$606.62
|
|
|
PR EXCISION OF BULBOURETHRAL GLAND
|
Professional
|
Both
|
$1,171.00
|
|
|
Service Code
|
HCPCS 53250
|
| Min. Negotiated Rate |
$234.30 |
| Max. Negotiated Rate |
$878.25 |
| Rate for Payer: Aetna Commercial |
$482.19
|
| Rate for Payer: Aetna Medicare |
$359.84
|
| Rate for Payer: BCBS Complete |
$246.01
|
| Rate for Payer: BCBS MAPPO |
$359.84
|
| Rate for Payer: BCN Commercial |
$599.07
|
| Rate for Payer: BCN Medicare Advantage |
$359.84
|
| Rate for Payer: Cash Price |
$936.80
|
| Rate for Payer: Cash Price |
$936.80
|
| Rate for Payer: Cofinity Commercial |
$518.17
|
| Rate for Payer: Cofinity Commercial |
$482.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$359.84
|
| Rate for Payer: Healthscope Commercial |
$431.81
|
| Rate for Payer: Healthscope Whirlpool |
$431.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$377.83
|
| Rate for Payer: Meridian Medicaid |
$246.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$395.82
|
| Rate for Payer: Nomi Health Commercial |
$431.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$878.25
|
| Rate for Payer: PACE SWMI |
$359.84
|
| Rate for Payer: PHP Medicare Advantage |
$359.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$652.59
|
| Rate for Payer: Priority Health Medicare |
$359.84
|
| Rate for Payer: Priority Health Narrow Network |
$652.59
|
| Rate for Payer: Railroad Medicare Medicare |
$359.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$694.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$359.84
|
| Rate for Payer: UHC Exchange |
$694.99
|
| Rate for Payer: UHC Medicaid |
$234.30
|
| Rate for Payer: UHCCP DNSP |
$359.84
|
| Rate for Payer: UHCCP Medicaid |
$234.30
|
|
|
PR EXCISION OF PENILE PLAQUE
|
Professional
|
Both
|
$1,222.00
|
|
|
Service Code
|
HCPCS 54110
|
| Min. Negotiated Rate |
$362.53 |
| Max. Negotiated Rate |
$1,100.27 |
| Rate for Payer: Aetna Commercial |
$750.11
|
| Rate for Payer: Aetna Medicare |
$559.78
|
| Rate for Payer: BCBS Complete |
$380.66
|
| Rate for Payer: BCBS MAPPO |
$559.78
|
| Rate for Payer: BCN Commercial |
$937.20
|
| Rate for Payer: BCN Medicare Advantage |
$559.78
|
| Rate for Payer: Cash Price |
$977.60
|
| Rate for Payer: Cash Price |
$977.60
|
| Rate for Payer: Cofinity Commercial |
$806.08
|
| Rate for Payer: Cofinity Commercial |
$750.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$559.78
|
| Rate for Payer: Healthscope Commercial |
$671.74
|
| Rate for Payer: Healthscope Whirlpool |
$671.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$587.77
|
| Rate for Payer: Meridian Medicaid |
$380.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$615.76
|
| Rate for Payer: Nomi Health Commercial |
$671.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$916.50
|
| Rate for Payer: PACE SWMI |
$559.78
|
| Rate for Payer: PHP Medicare Advantage |
$559.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,020.91
|
| Rate for Payer: Priority Health Medicare |
$559.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,020.91
|
| Rate for Payer: Railroad Medicare Medicare |
$559.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,100.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$559.78
|
| Rate for Payer: UHC Exchange |
$1,100.27
|
| Rate for Payer: UHC Medicaid |
$362.53
|
| Rate for Payer: UHCCP DNSP |
$559.78
|
| Rate for Payer: UHCCP Medicaid |
$362.53
|
|
|
PR EXCISION OLECRANON BURSA
|
Professional
|
Both
|
$630.00
|
|
|
Service Code
|
HCPCS 24105
|
| Min. Negotiated Rate |
$228.34 |
| Max. Negotiated Rate |
$608.95 |
| Rate for Payer: Aetna Commercial |
$459.67
|
| Rate for Payer: Aetna Medicare |
$343.04
|
| Rate for Payer: BCBS Complete |
$239.76
|
| Rate for Payer: BCBS MAPPO |
$343.04
|
| Rate for Payer: BCN Commercial |
$559.23
|
| Rate for Payer: BCN Medicare Advantage |
$343.04
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cofinity Commercial |
$493.98
|
| Rate for Payer: Cofinity Commercial |
$459.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.04
|
| Rate for Payer: Healthscope Commercial |
$411.65
|
| Rate for Payer: Healthscope Whirlpool |
$411.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.19
|
| Rate for Payer: Meridian Medicaid |
$239.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$377.34
|
| Rate for Payer: Nomi Health Commercial |
$411.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$472.50
|
| Rate for Payer: PACE SWMI |
$343.04
|
| Rate for Payer: PHP Medicare Advantage |
$343.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$597.80
|
| Rate for Payer: Priority Health Medicare |
$343.04
|
| Rate for Payer: Priority Health Narrow Network |
$597.80
|
| Rate for Payer: Railroad Medicare Medicare |
$343.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$608.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$343.04
|
| Rate for Payer: UHC Exchange |
$608.95
|
| Rate for Payer: UHC Medicaid |
$228.34
|
| Rate for Payer: UHCCP DNSP |
$343.04
|
| Rate for Payer: UHCCP Medicaid |
$228.34
|
|
|
PR EXCISION OR FULGURATION SKENES GLANDS
|
Professional
|
Both
|
$414.00
|
|
|
Service Code
|
HCPCS 53270
|
| Min. Negotiated Rate |
$107.99 |
| Max. Negotiated Rate |
$323.14 |
| Rate for Payer: Aetna Commercial |
$222.96
|
| Rate for Payer: Aetna Medicare |
$166.39
|
| Rate for Payer: BCBS Complete |
$113.39
|
| Rate for Payer: BCBS MAPPO |
$166.39
|
| Rate for Payer: BCN Commercial |
$279.37
|
| Rate for Payer: BCN Medicare Advantage |
$166.39
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cofinity Commercial |
$239.60
|
| Rate for Payer: Cofinity Commercial |
$222.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.39
|
| Rate for Payer: Healthscope Commercial |
$199.67
|
| Rate for Payer: Healthscope Whirlpool |
$199.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.71
|
| Rate for Payer: Meridian Medicaid |
$113.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$183.03
|
| Rate for Payer: Nomi Health Commercial |
$199.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.50
|
| Rate for Payer: PACE SWMI |
$166.39
|
| Rate for Payer: PHP Medicare Advantage |
$166.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$304.32
|
| Rate for Payer: Priority Health Medicare |
$166.39
|
| Rate for Payer: Priority Health Narrow Network |
$304.32
|
| Rate for Payer: Railroad Medicare Medicare |
$166.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$323.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$166.39
|
| Rate for Payer: UHC Exchange |
$323.14
|
| Rate for Payer: UHC Medicaid |
$107.99
|
| Rate for Payer: UHCCP DNSP |
$166.39
|
| Rate for Payer: UHCCP Medicaid |
$107.99
|
|
|
PR EXCISION PILONIDAL CYST/SINUS COMPLICATED
|
Professional
|
Both
|
$1,189.00
|
|
|
Service Code
|
HCPCS 11772
|
| Min. Negotiated Rate |
$365.72 |
| Max. Negotiated Rate |
$1,006.12 |
| Rate for Payer: Aetna Commercial |
$745.98
|
| Rate for Payer: Aetna Medicare |
$556.70
|
| Rate for Payer: BCBS Complete |
$384.01
|
| Rate for Payer: BCBS MAPPO |
$556.70
|
| Rate for Payer: BCN Commercial |
$876.45
|
| Rate for Payer: BCN Medicare Advantage |
$556.70
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cash Price |
$951.20
|
| Rate for Payer: Cofinity Commercial |
$801.65
|
| Rate for Payer: Cofinity Commercial |
$745.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$556.70
|
| Rate for Payer: Healthscope Commercial |
$668.04
|
| Rate for Payer: Healthscope Whirlpool |
$668.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$584.53
|
| Rate for Payer: Meridian Medicaid |
$384.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$612.37
|
| Rate for Payer: Nomi Health Commercial |
$668.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$891.75
|
| Rate for Payer: PACE SWMI |
$556.70
|
| Rate for Payer: PHP Medicare Advantage |
$556.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$802.18
|
| Rate for Payer: Priority Health Medicare |
$556.70
|
| Rate for Payer: Priority Health Narrow Network |
$802.18
|
| Rate for Payer: Railroad Medicare Medicare |
$556.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,006.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$556.70
|
| Rate for Payer: UHC Exchange |
$1,006.12
|
| Rate for Payer: UHC Medicaid |
$365.72
|
| Rate for Payer: UHCCP DNSP |
$556.70
|
| Rate for Payer: UHCCP Medicaid |
$365.72
|
|
|
PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE
|
Facility
|
IP
|
$1,383.00
|
|
|
Service Code
|
CPT 11771
|
| Hospital Charge Code |
11771
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,037.25 |
| Max. Negotiated Rate |
$1,383.00 |
| Rate for Payer: Aetna Commercial |
$1,244.70
|
| Rate for Payer: ASR ASR |
$1,341.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,135.72
|
| Rate for Payer: BCN Commercial |
$1,135.72
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cofinity Commercial |
$1,300.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.40
|
| Rate for Payer: Healthscope Commercial |
$1,341.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,383.00
|
| Rate for Payer: Mclaren Commercial |
$1,244.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,175.55
|
| Rate for Payer: Nomi Health Commercial |
$1,134.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,037.25
|
|
|
PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE
|
Professional
|
Both
|
$1,383.00
|
|
|
Service Code
|
HCPCS 11771
|
| Min. Negotiated Rate |
$281.80 |
| Max. Negotiated Rate |
$1,037.25 |
| Rate for Payer: Aetna Commercial |
$577.58
|
| Rate for Payer: Aetna Medicare |
$431.03
|
| Rate for Payer: BCBS Complete |
$295.89
|
| Rate for Payer: BCBS MAPPO |
$431.03
|
| Rate for Payer: BCN Commercial |
$682.23
|
| Rate for Payer: BCN Medicare Advantage |
$431.03
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cofinity Commercial |
$620.68
|
| Rate for Payer: Cofinity Commercial |
$577.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$431.03
|
| Rate for Payer: Healthscope Commercial |
$517.24
|
| Rate for Payer: Healthscope Whirlpool |
$517.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$452.58
|
| Rate for Payer: Meridian Medicaid |
$295.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$474.13
|
| Rate for Payer: Nomi Health Commercial |
$517.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,037.25
|
| Rate for Payer: PACE SWMI |
$431.03
|
| Rate for Payer: PHP Medicare Advantage |
$431.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$624.42
|
| Rate for Payer: Priority Health Medicare |
$431.03
|
| Rate for Payer: Priority Health Narrow Network |
$624.42
|
| Rate for Payer: Railroad Medicare Medicare |
$431.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$771.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$431.03
|
| Rate for Payer: UHC Exchange |
$771.69
|
| Rate for Payer: UHC Medicaid |
$281.80
|
| Rate for Payer: UHCCP DNSP |
$431.03
|
| Rate for Payer: UHCCP Medicaid |
$281.80
|
|
