|
PR EXCISION HYDROCELE UNILATERAL
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 55040
|
| Min. Negotiated Rate |
$218.75 |
| Max. Negotiated Rate |
$1,183.92 |
| Rate for Payer: Aetna Commercial |
$433.14
|
| Rate for Payer: Aetna Medicare |
$628.00
|
| Rate for Payer: BCBS Complete |
$229.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.92
|
| Rate for Payer: BCN Commercial |
$490.14
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Meridian Medicaid |
$229.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$543.79
|
| Rate for Payer: Priority Health Narrow Network |
$543.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$403.51
|
| Rate for Payer: UHC Exchange |
$403.51
|
| Rate for Payer: UHCCP Medicaid |
$218.75
|
|
|
PR EXCISION INFECTED GRAFT ABDOMEN
|
Professional
|
Both
|
$4,043.00
|
|
|
Service Code
|
HCPCS 35907
|
| Min. Negotiated Rate |
$1,120.00 |
| Max. Negotiated Rate |
$2,971.84 |
| Rate for Payer: Aetna Commercial |
$2,561.49
|
| Rate for Payer: Aetna Medicare |
$2,021.50
|
| Rate for Payer: BCBS Complete |
$1,253.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,120.00
|
| Rate for Payer: BCN Commercial |
$2,709.71
|
| Rate for Payer: Cash Price |
$3,234.40
|
| Rate for Payer: Cash Price |
$3,234.40
|
| Rate for Payer: Meridian Medicaid |
$1,253.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,194.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,627.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,971.84
|
| Rate for Payer: Priority Health Narrow Network |
$2,971.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,593.25
|
| Rate for Payer: UHC Exchange |
$2,593.25
|
| Rate for Payer: UHCCP Medicaid |
$1,194.08
|
|
|
PR EXCISION INFECTED GRAFT EXTREMITY
|
Professional
|
Both
|
$2,005.00
|
|
|
Service Code
|
HCPCS 35903
|
| Min. Negotiated Rate |
$353.58 |
| Max. Negotiated Rate |
$1,303.25 |
| Rate for Payer: Aetna Commercial |
$757.47
|
| Rate for Payer: Aetna Medicare |
$1,002.50
|
| Rate for Payer: BCBS Complete |
$371.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,048.68
|
| Rate for Payer: BCN Commercial |
$810.72
|
| Rate for Payer: Cash Price |
$1,604.00
|
| Rate for Payer: Cash Price |
$1,604.00
|
| Rate for Payer: Meridian Medicaid |
$371.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,303.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$884.95
|
| Rate for Payer: Priority Health Narrow Network |
$884.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$750.01
|
| Rate for Payer: UHC Exchange |
$750.01
|
| Rate for Payer: UHCCP Medicaid |
$353.58
|
|
|
PR EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE
|
Professional
|
Both
|
$805.00
|
|
|
Service Code
|
HCPCS 30130
|
| Min. Negotiated Rate |
$266.68 |
| Max. Negotiated Rate |
$674.64 |
| Rate for Payer: Aetna Commercial |
$522.89
|
| Rate for Payer: Aetna Medicare |
$402.50
|
| Rate for Payer: BCBS Complete |
$280.01
|
| Rate for Payer: BCBS Trust/PPO |
$674.64
|
| Rate for Payer: BCN Commercial |
$619.16
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Meridian Medicaid |
$280.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$583.96
|
| Rate for Payer: Priority Health Narrow Network |
$583.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$401.29
|
| Rate for Payer: UHC Exchange |
$401.29
|
| Rate for Payer: UHCCP Medicaid |
$266.68
|
|
|
PR EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH
|
Professional
|
Both
|
$886.00
|
|
|
Service Code
|
HCPCS 28080
|
| Min. Negotiated Rate |
$249.21 |
| Max. Negotiated Rate |
$1,100.45 |
| Rate for Payer: Aetna Commercial |
$488.84
|
| Rate for Payer: Aetna Medicare |
$443.00
|
| Rate for Payer: BCBS Complete |
$261.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.45
|
| Rate for Payer: BCN Commercial |
$853.39
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Meridian Medicaid |
$261.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$584.68
|
| Rate for Payer: Priority Health Narrow Network |
$584.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$410.17
|
| Rate for Payer: UHC Exchange |
$410.17
|
| Rate for Payer: UHCCP Medicaid |
$249.21
|
|
|
PR EXCISION LACTIFEROUS DUCT FISTULA
|
Professional
|
Both
|
$794.00
|
|
|
Service Code
|
HCPCS 19112
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$678.77 |
| Rate for Payer: Aetna Commercial |
$346.57
|
| Rate for Payer: Aetna Medicare |
$397.00
|
| Rate for Payer: BCBS Complete |
$221.86
|
| Rate for Payer: BCBS Trust/PPO |
$12.95
|
| Rate for Payer: BCN Commercial |
$678.77
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Meridian Medicaid |
$221.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$516.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$443.39
|
| Rate for Payer: Priority Health Narrow Network |
$443.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$309.61
|
| Rate for Payer: UHC Exchange |
$309.61
|
| Rate for Payer: UHCCP Medicaid |
$211.30
|
|
|
PR EXCISION LESION FLOOR MOUTH
|
Professional
|
Both
|
$588.00
|
|
|
Service Code
|
HCPCS 41116
|
| Min. Negotiated Rate |
$140.15 |
| Max. Negotiated Rate |
$916.07 |
| Rate for Payer: Aetna Commercial |
$281.48
|
| Rate for Payer: Aetna Medicare |
$294.00
|
| Rate for Payer: BCBS Complete |
$147.16
|
| Rate for Payer: BCBS Trust/PPO |
$916.07
|
| Rate for Payer: BCN Commercial |
$494.05
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Meridian Medicaid |
$147.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$382.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$390.17
|
| Rate for Payer: Priority Health Narrow Network |
$390.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$259.88
|
| Rate for Payer: UHC Exchange |
$259.88
|
| Rate for Payer: UHCCP Medicaid |
$140.15
|
|
|
PR EXCISION LESION MENISCUS/CAPSULE KNEE
|
Professional
|
Both
|
$2,340.00
|
|
|
Service Code
|
HCPCS 27347
|
| Min. Negotiated Rate |
$347.19 |
| Max. Negotiated Rate |
$1,521.00 |
| Rate for Payer: Aetna Commercial |
$702.81
|
| Rate for Payer: Aetna Medicare |
$1,170.00
|
| Rate for Payer: BCBS Complete |
$364.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,496.67
|
| Rate for Payer: BCN Commercial |
$780.90
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Meridian Medicaid |
$364.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,521.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$821.30
|
| Rate for Payer: Priority Health Narrow Network |
$821.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$589.02
|
| Rate for Payer: UHC Exchange |
$589.02
|
| Rate for Payer: UHCCP Medicaid |
$347.19
|
|
|
PR EXCISION LESION MESENTERY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,508.00
|
|
|
Service Code
|
HCPCS 44820
|
| Min. Negotiated Rate |
$295.85 |
| Max. Negotiated Rate |
$1,529.66 |
| Rate for Payer: Aetna Commercial |
$1,133.59
|
| Rate for Payer: Aetna Medicare |
$754.00
|
| Rate for Payer: BCBS Complete |
$576.80
|
| Rate for Payer: BCBS Trust/PPO |
$295.85
|
| Rate for Payer: BCN Commercial |
$1,245.15
|
| Rate for Payer: Cash Price |
$1,206.40
|
| Rate for Payer: Cash Price |
$1,206.40
|
| Rate for Payer: Meridian Medicaid |
$576.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$549.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$980.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,529.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,529.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,011.56
|
| Rate for Payer: UHC Exchange |
$1,011.56
|
| Rate for Payer: UHCCP Medicaid |
$549.33
|
|
|
PR EXCISION LESION PANCREAS
|
Professional
|
Both
|
$2,275.00
|
|
|
Service Code
|
HCPCS 48120
|
| Min. Negotiated Rate |
$203.40 |
| Max. Negotiated Rate |
$1,995.61 |
| Rate for Payer: Aetna Commercial |
$1,496.65
|
| Rate for Payer: Aetna Medicare |
$1,137.50
|
| Rate for Payer: BCBS Complete |
$751.92
|
| Rate for Payer: BCBS Trust/PPO |
$203.40
|
| Rate for Payer: BCN Commercial |
$1,628.28
|
| Rate for Payer: Cash Price |
$1,820.00
|
| Rate for Payer: Cash Price |
$1,820.00
|
| Rate for Payer: Meridian Medicaid |
$751.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,478.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,995.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,995.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,333.66
|
| Rate for Payer: UHC Exchange |
$1,333.66
|
| Rate for Payer: UHCCP Medicaid |
$716.11
|
|
|
PR EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK
|
Professional
|
Both
|
$1,344.00
|
|
|
Service Code
|
HCPCS 27630
|
| Min. Negotiated Rate |
$234.94 |
| Max. Negotiated Rate |
$873.60 |
| Rate for Payer: Aetna Commercial |
$477.87
|
| Rate for Payer: Aetna Medicare |
$672.00
|
| Rate for Payer: BCBS Complete |
$246.69
|
| Rate for Payer: BCBS Trust/PPO |
$600.15
|
| Rate for Payer: BCN Commercial |
$785.31
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Meridian Medicaid |
$246.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$873.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$553.64
|
| Rate for Payer: Priority Health Narrow Network |
$553.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$419.99
|
| Rate for Payer: UHC Exchange |
$419.99
|
| Rate for Payer: UHCCP Medicaid |
$234.94
|
|
|
PR EXCISION LESION TENDON SHEATH FOREARM&/WRIST
|
Professional
|
Both
|
$1,155.00
|
|
|
Service Code
|
HCPCS 25110
|
| Min. Negotiated Rate |
$212.38 |
| Max. Negotiated Rate |
$750.75 |
| Rate for Payer: Aetna Commercial |
$456.59
|
| Rate for Payer: Aetna Medicare |
$577.50
|
| Rate for Payer: BCBS Complete |
$240.87
|
| Rate for Payer: BCBS Trust/PPO |
$212.38
|
| Rate for Payer: BCN Commercial |
$516.04
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Meridian Medicaid |
$240.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$750.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$542.44
|
| Rate for Payer: Priority Health Narrow Network |
$542.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$398.36
|
| Rate for Payer: UHC Exchange |
$398.36
|
| Rate for Payer: UHCCP Medicaid |
$229.40
|
|
|
PR EXCISION LESION TONGUE W/O CLOSURE
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 41110
|
| Min. Negotiated Rate |
$83.50 |
| Max. Negotiated Rate |
$569.51 |
| Rate for Payer: Aetna Commercial |
$170.28
|
| Rate for Payer: Aetna Medicare |
$190.50
|
| Rate for Payer: BCBS Complete |
$87.68
|
| Rate for Payer: BCBS Trust/PPO |
$569.51
|
| Rate for Payer: BCN Commercial |
$340.12
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Meridian Medicaid |
$87.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.46
|
| Rate for Payer: Priority Health Narrow Network |
$234.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.04
|
| Rate for Payer: UHC Exchange |
$157.04
|
| Rate for Payer: UHCCP Medicaid |
$83.50
|
|
|
PR EXCISION LINGUAL FRENUM FRENECTOMY
|
Professional
|
Both
|
$447.00
|
|
|
Service Code
|
HCPCS 41115
|
| Min. Negotiated Rate |
$94.15 |
| Max. Negotiated Rate |
$967.85 |
| Rate for Payer: Aetna Commercial |
$191.54
|
| Rate for Payer: Aetna Medicare |
$223.50
|
| Rate for Payer: BCBS Complete |
$98.86
|
| Rate for Payer: BCBS Trust/PPO |
$967.85
|
| Rate for Payer: BCN Commercial |
$387.03
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Meridian Medicaid |
$98.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$263.69
|
| Rate for Payer: Priority Health Narrow Network |
$263.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.56
|
| Rate for Payer: UHC Exchange |
$176.56
|
| Rate for Payer: UHCCP Medicaid |
$94.15
|
|
|
PR EXCISION LOCAL LESION EPIDIDYMIS
|
Professional
|
Both
|
$617.00
|
|
|
Service Code
|
HCPCS 54830
|
| Min. Negotiated Rate |
$240.69 |
| Max. Negotiated Rate |
$1,910.86 |
| Rate for Payer: Aetna Commercial |
$476.03
|
| Rate for Payer: Aetna Medicare |
$308.50
|
| Rate for Payer: BCBS Complete |
$252.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,910.86
|
| Rate for Payer: BCN Commercial |
$539.99
|
| Rate for Payer: Cash Price |
$493.60
|
| Rate for Payer: Cash Price |
$493.60
|
| Rate for Payer: Meridian Medicaid |
$252.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$598.11
|
| Rate for Payer: Priority Health Narrow Network |
$598.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$444.04
|
| Rate for Payer: UHC Exchange |
$444.04
|
| Rate for Payer: UHCCP Medicaid |
$240.69
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 11640
|
| Min. Negotiated Rate |
$81.58 |
| Max. Negotiated Rate |
$977.96 |
| Rate for Payer: Aetna Commercial |
$134.58
|
| Rate for Payer: Aetna Medicare |
$166.50
|
| Rate for Payer: BCBS Complete |
$85.66
|
| Rate for Payer: BCBS Trust/PPO |
$977.96
|
| Rate for Payer: BCN Commercial |
$239.53
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Meridian Medicaid |
$85.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.03
|
| Rate for Payer: Priority Health Narrow Network |
$172.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.37
|
| Rate for Payer: UHC Exchange |
$128.37
|
| Rate for Payer: UHCCP Medicaid |
$81.58
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
11640
|
| Min. Negotiated Rate |
$81.58 |
| Max. Negotiated Rate |
$977.96 |
| Rate for Payer: Aetna Commercial |
$134.58
|
| Rate for Payer: Aetna Medicare |
$166.50
|
| Rate for Payer: BCBS Complete |
$85.66
|
| Rate for Payer: BCBS Trust/PPO |
$977.96
|
| Rate for Payer: BCN Commercial |
$239.53
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Meridian Medicaid |
$85.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.03
|
| Rate for Payer: Priority Health Narrow Network |
$172.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.37
|
| Rate for Payer: UHC Exchange |
$128.37
|
| Rate for Payer: UHCCP Medicaid |
$81.58
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Facility
|
OP
|
$333.00
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$216.45 |
| Max. Negotiated Rate |
$1,068.51 |
| Rate for Payer: Aetna Commercial |
$299.70
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$323.01
|
| Rate for Payer: ASR Commercial |
$323.01
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$272.69
|
| Rate for Payer: BCN Commercial |
$258.17
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$313.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$333.00
|
| Rate for Payer: Healthscope Whirlpool |
$323.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$299.70
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.05
|
| Rate for Payer: Nomi Health Commercial |
$273.06
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.77
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$233.43
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$293.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Facility
|
IP
|
$333.00
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$216.45 |
| Max. Negotiated Rate |
$333.00 |
| Rate for Payer: Aetna Commercial |
$299.70
|
| Rate for Payer: ASR ASR |
$323.01
|
| Rate for Payer: ASR Commercial |
$323.01
|
| Rate for Payer: BCBS Trust/PPO |
$271.36
|
| Rate for Payer: BCN Commercial |
$258.17
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$313.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.40
|
| Rate for Payer: Healthscope Commercial |
$333.00
|
| Rate for Payer: Healthscope Whirlpool |
$323.01
|
| Rate for Payer: Mclaren Commercial |
$299.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.05
|
| Rate for Payer: Nomi Health Commercial |
$273.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$293.04
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 11641
|
| Hospital Charge Code |
11641
|
| Min. Negotiated Rate |
$100.11 |
| Max. Negotiated Rate |
$1,307.96 |
| Rate for Payer: Aetna Commercial |
$165.44
|
| Rate for Payer: Aetna Medicare |
$197.00
|
| Rate for Payer: BCBS Complete |
$105.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.96
|
| Rate for Payer: BCN Commercial |
$279.57
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Meridian Medicaid |
$105.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.41
|
| Rate for Payer: Priority Health Narrow Network |
$210.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.28
|
| Rate for Payer: UHC Exchange |
$165.28
|
| Rate for Payer: UHCCP Medicaid |
$100.11
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 11641
|
| Min. Negotiated Rate |
$100.11 |
| Max. Negotiated Rate |
$1,307.96 |
| Rate for Payer: Aetna Commercial |
$165.44
|
| Rate for Payer: Aetna Medicare |
$197.00
|
| Rate for Payer: BCBS Complete |
$105.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.96
|
| Rate for Payer: BCN Commercial |
$279.57
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Meridian Medicaid |
$105.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.41
|
| Rate for Payer: Priority Health Narrow Network |
$210.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.28
|
| Rate for Payer: UHC Exchange |
$165.28
|
| Rate for Payer: UHCCP Medicaid |
$100.11
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Facility
|
IP
|
$394.00
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
11641
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$256.10 |
| Max. Negotiated Rate |
$394.00 |
| Rate for Payer: Aetna Commercial |
$354.60
|
| Rate for Payer: ASR ASR |
$382.18
|
| Rate for Payer: ASR Commercial |
$382.18
|
| Rate for Payer: BCBS Trust/PPO |
$321.07
|
| Rate for Payer: BCN Commercial |
$305.47
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$370.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.20
|
| Rate for Payer: Healthscope Commercial |
$394.00
|
| Rate for Payer: Healthscope Whirlpool |
$382.18
|
| Rate for Payer: Mclaren Commercial |
$354.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$334.90
|
| Rate for Payer: Nomi Health Commercial |
$323.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$346.72
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Facility
|
OP
|
$394.00
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
11641
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$256.10 |
| Max. Negotiated Rate |
$1,068.51 |
| Rate for Payer: Aetna Commercial |
$354.60
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$382.18
|
| Rate for Payer: ASR Commercial |
$382.18
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$322.65
|
| Rate for Payer: BCN Commercial |
$305.47
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$370.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$394.00
|
| Rate for Payer: Healthscope Whirlpool |
$382.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$354.60
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$334.90
|
| Rate for Payer: Nomi Health Commercial |
$323.08
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$345.22
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$276.19
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$346.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 11642
|
| Min. Negotiated Rate |
$116.72 |
| Max. Negotiated Rate |
$712.50 |
| Rate for Payer: Aetna Commercial |
$194.03
|
| Rate for Payer: Aetna Medicare |
$298.00
|
| Rate for Payer: BCBS Complete |
$122.56
|
| Rate for Payer: BCBS Trust/PPO |
$712.50
|
| Rate for Payer: BCN Commercial |
$315.30
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Meridian Medicaid |
$122.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.08
|
| Rate for Payer: Priority Health Narrow Network |
$246.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.10
|
| Rate for Payer: UHC Exchange |
$195.10
|
| Rate for Payer: UHCCP Medicaid |
$116.72
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Facility
|
OP
|
$596.00
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
11642
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$369.50 |
| Max. Negotiated Rate |
$1,068.51 |
| Rate for Payer: Aetna Commercial |
$536.40
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$578.12
|
| Rate for Payer: ASR Commercial |
$578.12
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$488.06
|
| Rate for Payer: BCN Commercial |
$462.08
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$560.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$596.00
|
| Rate for Payer: Healthscope Whirlpool |
$578.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$536.40
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.60
|
| Rate for Payer: Nomi Health Commercial |
$488.72
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.22
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$417.80
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$524.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
