|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Facility
|
IP
|
$596.00
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
11642
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$387.40 |
| Max. Negotiated Rate |
$596.00 |
| Rate for Payer: Aetna Commercial |
$536.40
|
| Rate for Payer: ASR ASR |
$578.12
|
| Rate for Payer: ASR Commercial |
$578.12
|
| Rate for Payer: BCBS Trust/PPO |
$485.68
|
| Rate for Payer: BCN Commercial |
$462.08
|
| 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: Healthscope Commercial |
$596.00
|
| Rate for Payer: Healthscope Whirlpool |
$578.12
|
| Rate for Payer: Mclaren Commercial |
$536.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.60
|
| Rate for Payer: Nomi Health Commercial |
$488.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$524.48
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 11642
|
| Hospital Charge Code |
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 2.1-3.0 CM
|
Facility
|
OP
|
$745.00
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
11643
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$484.25 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$670.50
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$722.65
|
| Rate for Payer: ASR Commercial |
$722.65
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$610.08
|
| Rate for Payer: BCN Commercial |
$577.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$700.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$745.00
|
| Rate for Payer: Healthscope Whirlpool |
$722.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$670.50
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$633.25
|
| Rate for Payer: Nomi Health Commercial |
$610.90
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$652.77
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$522.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$655.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Professional
|
Both
|
$745.00
|
|
|
Service Code
|
HCPCS 11643
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$484.25 |
| Rate for Payer: Aetna Commercial |
$243.96
|
| Rate for Payer: Aetna Medicare |
$372.50
|
| Rate for Payer: BCBS Complete |
$153.43
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$370.68
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Meridian Medicaid |
$153.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$306.58
|
| Rate for Payer: Priority Health Narrow Network |
$306.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$244.46
|
| Rate for Payer: UHC Exchange |
$244.46
|
| Rate for Payer: UHCCP Medicaid |
$146.12
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Professional
|
Both
|
$745.00
|
|
|
Service Code
|
HCPCS 11643
|
| Hospital Charge Code |
11643
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$484.25 |
| Rate for Payer: Aetna Commercial |
$243.96
|
| Rate for Payer: Aetna Medicare |
$372.50
|
| Rate for Payer: BCBS Complete |
$153.43
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$370.68
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Meridian Medicaid |
$153.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$306.58
|
| Rate for Payer: Priority Health Narrow Network |
$306.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$244.46
|
| Rate for Payer: UHC Exchange |
$244.46
|
| Rate for Payer: UHCCP Medicaid |
$146.12
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Facility
|
IP
|
$745.00
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
11643
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$484.25 |
| Max. Negotiated Rate |
$745.00 |
| Rate for Payer: Aetna Commercial |
$670.50
|
| Rate for Payer: ASR ASR |
$722.65
|
| Rate for Payer: ASR Commercial |
$722.65
|
| Rate for Payer: BCBS Trust/PPO |
$607.10
|
| Rate for Payer: BCN Commercial |
$577.60
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$700.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.00
|
| Rate for Payer: Healthscope Commercial |
$745.00
|
| Rate for Payer: Healthscope Whirlpool |
$722.65
|
| Rate for Payer: Mclaren Commercial |
$670.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$633.25
|
| Rate for Payer: Nomi Health Commercial |
$610.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$655.60
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Facility
|
OP
|
$922.00
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
11644
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$599.30 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$829.80
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$894.34
|
| Rate for Payer: ASR Commercial |
$894.34
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$755.03
|
| Rate for Payer: BCN Commercial |
$714.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$866.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$922.00
|
| Rate for Payer: Healthscope Whirlpool |
$894.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$829.80
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.70
|
| Rate for Payer: Nomi Health Commercial |
$756.04
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$807.86
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$646.32
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$811.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 11644
|
| Hospital Charge Code |
11644
|
| Min. Negotiated Rate |
$180.41 |
| Max. Negotiated Rate |
$655.87 |
| Rate for Payer: Aetna Commercial |
$303.84
|
| Rate for Payer: Aetna Medicare |
$461.00
|
| Rate for Payer: BCBS Complete |
$189.43
|
| Rate for Payer: BCBS Trust/PPO |
$655.87
|
| Rate for Payer: BCN Commercial |
$457.06
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Meridian Medicaid |
$189.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$180.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$379.73
|
| Rate for Payer: Priority Health Narrow Network |
$379.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.83
|
| Rate for Payer: UHC Exchange |
$303.83
|
| Rate for Payer: UHCCP Medicaid |
$180.41
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 11644
|
| Min. Negotiated Rate |
$180.41 |
| Max. Negotiated Rate |
$655.87 |
| Rate for Payer: Aetna Commercial |
$303.84
|
| Rate for Payer: Aetna Medicare |
$461.00
|
| Rate for Payer: BCBS Complete |
$189.43
|
| Rate for Payer: BCBS Trust/PPO |
$655.87
|
| Rate for Payer: BCN Commercial |
$457.06
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Meridian Medicaid |
$189.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$180.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$379.73
|
| Rate for Payer: Priority Health Narrow Network |
$379.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$303.83
|
| Rate for Payer: UHC Exchange |
$303.83
|
| Rate for Payer: UHCCP Medicaid |
$180.41
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM
|
Facility
|
IP
|
$922.00
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
11644
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$599.30 |
| Max. Negotiated Rate |
$922.00 |
| Rate for Payer: Aetna Commercial |
$829.80
|
| Rate for Payer: ASR ASR |
$894.34
|
| Rate for Payer: ASR Commercial |
$894.34
|
| Rate for Payer: BCBS Trust/PPO |
$751.34
|
| Rate for Payer: BCN Commercial |
$714.83
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$866.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.60
|
| Rate for Payer: Healthscope Commercial |
$922.00
|
| Rate for Payer: Healthscope Whirlpool |
$894.34
|
| Rate for Payer: Mclaren Commercial |
$829.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.70
|
| Rate for Payer: Nomi Health Commercial |
$756.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$811.36
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Facility
|
OP
|
$922.00
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
11646
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$599.30 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Priority Health Narrow Network |
$646.32
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: Aetna Commercial |
$829.80
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$894.34
|
| Rate for Payer: ASR Commercial |
$894.34
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$755.03
|
| Rate for Payer: BCN Commercial |
$714.83
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$866.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$922.00
|
| Rate for Payer: Healthscope Whirlpool |
$894.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$829.80
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.70
|
| Rate for Payer: Nomi Health Commercial |
$756.04
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$807.86
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$811.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 11646
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$599.30 |
| Rate for Payer: Aetna Commercial |
$422.43
|
| Rate for Payer: Aetna Medicare |
$461.00
|
| Rate for Payer: BCBS Complete |
$261.00
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$594.10
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Meridian Medicaid |
$261.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$524.21
|
| Rate for Payer: Priority Health Narrow Network |
$524.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$425.47
|
| Rate for Payer: UHC Exchange |
$425.47
|
| Rate for Payer: UHCCP Medicaid |
$248.57
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Facility
|
IP
|
$922.00
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
11646
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$599.30 |
| Max. Negotiated Rate |
$922.00 |
| Rate for Payer: Aetna Commercial |
$829.80
|
| Rate for Payer: ASR ASR |
$894.34
|
| Rate for Payer: ASR Commercial |
$894.34
|
| Rate for Payer: BCBS Trust/PPO |
$751.34
|
| Rate for Payer: BCN Commercial |
$714.83
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$866.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.60
|
| Rate for Payer: Healthscope Commercial |
$922.00
|
| Rate for Payer: Healthscope Whirlpool |
$894.34
|
| Rate for Payer: Mclaren Commercial |
$829.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.70
|
| Rate for Payer: Nomi Health Commercial |
$756.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$811.36
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 11646
|
| Hospital Charge Code |
11646
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$599.30 |
| Rate for Payer: Aetna Commercial |
$422.43
|
| Rate for Payer: Aetna Medicare |
$461.00
|
| Rate for Payer: BCBS Complete |
$261.00
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$594.10
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Meridian Medicaid |
$261.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$524.21
|
| Rate for Payer: Priority Health Narrow Network |
$524.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$425.47
|
| Rate for Payer: UHC Exchange |
$425.47
|
| Rate for Payer: UHCCP Medicaid |
$248.57
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 11620
|
| Min. Negotiated Rate |
$79.24 |
| Max. Negotiated Rate |
$578.99 |
| Rate for Payer: Aetna Commercial |
$131.33
|
| Rate for Payer: Aetna Medicare |
$161.00
|
| Rate for Payer: BCBS Complete |
$83.20
|
| Rate for Payer: BCBS Trust/PPO |
$578.99
|
| Rate for Payer: BCN Commercial |
$291.75
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Meridian Medicaid |
$83.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.52
|
| Rate for Payer: Priority Health Narrow Network |
$167.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$123.24
|
| Rate for Payer: UHC Exchange |
$123.24
|
| Rate for Payer: UHCCP Medicaid |
$79.24
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM
|
Professional
|
Both
|
$380.00
|
|
|
Service Code
|
HCPCS 11621
|
| Min. Negotiated Rate |
$26.32 |
| Max. Negotiated Rate |
$337.19 |
| Rate for Payer: Aetna Commercial |
$158.81
|
| Rate for Payer: Aetna Medicare |
$190.00
|
| Rate for Payer: BCBS Complete |
$101.09
|
| Rate for Payer: BCBS Trust/PPO |
$26.32
|
| Rate for Payer: BCN Commercial |
$337.19
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Meridian Medicaid |
$101.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$201.83
|
| Rate for Payer: Priority Health Narrow Network |
$201.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$156.51
|
| Rate for Payer: UHC Exchange |
$156.51
|
| Rate for Payer: UHCCP Medicaid |
$96.28
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Facility
|
OP
|
$424.00
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
11622
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$275.60 |
| Max. Negotiated Rate |
$1,068.51 |
| Rate for Payer: Aetna Commercial |
$381.60
|
| 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 |
$411.28
|
| Rate for Payer: ASR Commercial |
$411.28
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$347.21
|
| Rate for Payer: BCN Commercial |
$328.73
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$398.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$424.00
|
| Rate for Payer: Healthscope Whirlpool |
$411.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$381.60
|
| 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 |
$360.40
|
| Rate for Payer: Nomi Health Commercial |
$347.68
|
| 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 |
$275.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$371.51
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$297.22
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$373.12
|
| 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 S/N/H/F/G 1.1-2.0 CM
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 11622
|
| Min. Negotiated Rate |
$108.63 |
| Max. Negotiated Rate |
$156,313.01 |
| Rate for Payer: Aetna Commercial |
$179.90
|
| Rate for Payer: Aetna Medicare |
$212.00
|
| Rate for Payer: BCBS Complete |
$114.06
|
| Rate for Payer: BCBS Trust/PPO |
$156,313.01
|
| Rate for Payer: BCN Commercial |
$370.42
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Meridian Medicaid |
$114.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.92
|
| Rate for Payer: Priority Health Narrow Network |
$228.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.24
|
| Rate for Payer: UHC Exchange |
$180.24
|
| Rate for Payer: UHCCP Medicaid |
$108.63
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Facility
|
IP
|
$424.00
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
11622
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$275.60 |
| Max. Negotiated Rate |
$424.00 |
| Rate for Payer: Aetna Commercial |
$381.60
|
| Rate for Payer: ASR ASR |
$411.28
|
| Rate for Payer: ASR Commercial |
$411.28
|
| Rate for Payer: BCBS Trust/PPO |
$345.52
|
| Rate for Payer: BCN Commercial |
$328.73
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$398.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.20
|
| Rate for Payer: Healthscope Commercial |
$424.00
|
| Rate for Payer: Healthscope Whirlpool |
$411.28
|
| Rate for Payer: Mclaren Commercial |
$381.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.40
|
| Rate for Payer: Nomi Health Commercial |
$347.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$373.12
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 11622
|
| Hospital Charge Code |
11622
|
| Min. Negotiated Rate |
$108.63 |
| Max. Negotiated Rate |
$156,313.01 |
| Rate for Payer: Aetna Commercial |
$179.90
|
| Rate for Payer: Aetna Medicare |
$212.00
|
| Rate for Payer: BCBS Complete |
$114.06
|
| Rate for Payer: BCBS Trust/PPO |
$156,313.01
|
| Rate for Payer: BCN Commercial |
$370.42
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Meridian Medicaid |
$114.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.92
|
| Rate for Payer: Priority Health Narrow Network |
$228.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.24
|
| Rate for Payer: UHC Exchange |
$180.24
|
| Rate for Payer: UHCCP Medicaid |
$108.63
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Facility
|
OP
|
$527.00
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
11623
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$342.55 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$474.30
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$511.19
|
| Rate for Payer: ASR Commercial |
$511.19
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$431.56
|
| Rate for Payer: BCN Commercial |
$408.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cofinity Commercial |
$495.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$421.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$527.00
|
| Rate for Payer: Healthscope Whirlpool |
$511.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$474.30
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$447.95
|
| Rate for Payer: Nomi Health Commercial |
$432.14
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$461.76
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$369.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$463.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Professional
|
Both
|
$527.00
|
|
|
Service Code
|
HCPCS 11623
|
| Min. Negotiated Rate |
$134.19 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$224.21
|
| Rate for Payer: Aetna Medicare |
$263.50
|
| Rate for Payer: BCBS Complete |
$140.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: BCN Commercial |
$433.95
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Meridian Medicaid |
$140.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.20
|
| Rate for Payer: Priority Health Narrow Network |
$282.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$222.33
|
| Rate for Payer: UHC Exchange |
$222.33
|
| Rate for Payer: UHCCP Medicaid |
$134.19
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Facility
|
IP
|
$527.00
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
11623
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$342.55 |
| Max. Negotiated Rate |
$527.00 |
| Rate for Payer: Aetna Commercial |
$474.30
|
| Rate for Payer: ASR ASR |
$511.19
|
| Rate for Payer: ASR Commercial |
$511.19
|
| Rate for Payer: BCBS Trust/PPO |
$429.45
|
| Rate for Payer: BCN Commercial |
$408.58
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cofinity Commercial |
$495.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$421.60
|
| Rate for Payer: Healthscope Commercial |
$527.00
|
| Rate for Payer: Healthscope Whirlpool |
$511.19
|
| Rate for Payer: Mclaren Commercial |
$474.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$447.95
|
| Rate for Payer: Nomi Health Commercial |
$432.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$463.76
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM
|
Professional
|
Both
|
$527.00
|
|
|
Service Code
|
HCPCS 11623
|
| Hospital Charge Code |
11623
|
| Min. Negotiated Rate |
$134.19 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$224.21
|
| Rate for Payer: Aetna Medicare |
$263.50
|
| Rate for Payer: BCBS Complete |
$140.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: BCN Commercial |
$433.95
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Meridian Medicaid |
$140.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.20
|
| Rate for Payer: Priority Health Narrow Network |
$282.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$222.33
|
| Rate for Payer: UHC Exchange |
$222.33
|
| Rate for Payer: UHCCP Medicaid |
$134.19
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Professional
|
Both
|
$595.00
|
|
|
Service Code
|
HCPCS 11624
|
| Min. Negotiated Rate |
$152.30 |
| Max. Negotiated Rate |
$1,307.96 |
| Rate for Payer: Aetna Commercial |
$254.89
|
| Rate for Payer: Aetna Medicare |
$297.50
|
| Rate for Payer: BCBS Complete |
$159.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.96
|
| Rate for Payer: BCN Commercial |
$494.05
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Meridian Medicaid |
$159.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$321.02
|
| Rate for Payer: Priority Health Narrow Network |
$321.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.78
|
| Rate for Payer: UHC Exchange |
$252.78
|
| Rate for Payer: UHCCP Medicaid |
$152.30
|
|
