|
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 |
$1,063.61 |
| Rate for Payer: Aetna Commercial |
$381.60
|
| Rate for Payer: Aetna Medicare |
$686.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: ASR ASR |
$411.28
|
| Rate for Payer: ASR Commercial |
$411.28
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCBS Trust/PPO |
$347.21
|
| Rate for Payer: BCN Commercial |
$328.73
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| 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 |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$424.00
|
| Rate for Payer: Healthscope Whirlpool |
$411.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$686.20
|
| Rate for Payer: Mclaren Commercial |
$381.60
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.40
|
| Rate for Payer: Nomi Health Commercial |
$347.68
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$754.82
|
| Rate for Payer: PHP Medicaid |
$367.80
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$371.51
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health Narrow Network |
$297.22
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$373.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,063.61
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP DNSP |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: VA VA |
$686.20
|
|
|
PR 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
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$275.60 |
| Rate for Payer: Aetna Commercial |
$213.86
|
| Rate for Payer: Aetna Medicare |
$159.60
|
| Rate for Payer: BCBS Complete |
$169.60
|
| Rate for Payer: BCBS MAPPO |
$159.60
|
| Rate for Payer: BCN Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$229.82
|
| Rate for Payer: Cofinity Commercial |
$213.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.60
|
| Rate for Payer: Healthscope Commercial |
$191.52
|
| Rate for Payer: Healthscope Whirlpool |
$191.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.58
|
| Rate for Payer: Nomi Health Commercial |
$191.52
|
| Rate for Payer: PACE SWMI |
$159.60
|
| Rate for Payer: PHP Medicare Advantage |
$159.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.60
|
| Rate for Payer: Priority Health Medicare |
$159.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.60
|
| Rate for Payer: UHC Medicare Advantage |
$159.60
|
| Rate for Payer: UHCCP DNSP |
$159.60
|
|
|
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 |
$197.99 |
| Max. Negotiated Rate |
$342.55 |
| Rate for Payer: Aetna Commercial |
$265.31
|
| Rate for Payer: Aetna Medicare |
$197.99
|
| Rate for Payer: BCBS Complete |
$210.80
|
| Rate for Payer: BCBS MAPPO |
$197.99
|
| Rate for Payer: BCN Medicare Advantage |
$197.99
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cofinity Commercial |
$285.11
|
| Rate for Payer: Cofinity Commercial |
$265.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.99
|
| Rate for Payer: Healthscope Commercial |
$237.59
|
| Rate for Payer: Healthscope Whirlpool |
$237.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.89
|
| Rate for Payer: Nomi Health Commercial |
$237.59
|
| Rate for Payer: PACE SWMI |
$197.99
|
| Rate for Payer: PHP Medicare Advantage |
$197.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.55
|
| Rate for Payer: Priority Health Medicare |
$197.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.99
|
| Rate for Payer: UHC Medicare Advantage |
$197.99
|
| Rate for Payer: UHCCP DNSP |
$197.99
|
|
|
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
|
Facility
|
OP
|
$527.00
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
11623
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$342.55 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$474.30
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$511.19
|
| Rate for Payer: ASR Commercial |
$511.19
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$431.56
|
| Rate for Payer: BCN Commercial |
$408.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| 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 |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$527.00
|
| Rate for Payer: Healthscope Whirlpool |
$511.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$474.30
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$447.95
|
| Rate for Payer: Nomi Health Commercial |
$432.14
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$461.76
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$369.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$463.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
PR 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 |
$197.99 |
| Max. Negotiated Rate |
$342.55 |
| Rate for Payer: Aetna Commercial |
$265.31
|
| Rate for Payer: Aetna Medicare |
$197.99
|
| Rate for Payer: BCBS Complete |
$210.80
|
| Rate for Payer: BCBS MAPPO |
$197.99
|
| Rate for Payer: BCN Medicare Advantage |
$197.99
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cofinity Commercial |
$285.11
|
| Rate for Payer: Cofinity Commercial |
$265.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.99
|
| Rate for Payer: Healthscope Commercial |
$237.59
|
| Rate for Payer: Healthscope Whirlpool |
$237.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.89
|
| Rate for Payer: Nomi Health Commercial |
$237.59
|
| Rate for Payer: PACE SWMI |
$197.99
|
| Rate for Payer: PHP Medicare Advantage |
$197.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.55
|
| Rate for Payer: Priority Health Medicare |
$197.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.99
|
| Rate for Payer: UHC Medicare Advantage |
$197.99
|
| Rate for Payer: UHCCP DNSP |
$197.99
|
|
|
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 |
$225.44 |
| Max. Negotiated Rate |
$386.75 |
| Rate for Payer: Aetna Commercial |
$302.09
|
| Rate for Payer: Aetna Medicare |
$225.44
|
| Rate for Payer: BCBS Complete |
$238.00
|
| Rate for Payer: BCBS MAPPO |
$225.44
|
| Rate for Payer: BCN Medicare Advantage |
$225.44
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cofinity Commercial |
$324.63
|
| Rate for Payer: Cofinity Commercial |
$302.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.44
|
| Rate for Payer: Healthscope Commercial |
$270.53
|
| Rate for Payer: Healthscope Whirlpool |
$270.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.71
|
| Rate for Payer: Nomi Health Commercial |
$270.53
|
| Rate for Payer: PACE SWMI |
$225.44
|
| Rate for Payer: PHP Medicare Advantage |
$225.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.75
|
| Rate for Payer: Priority Health Medicare |
$225.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.44
|
| Rate for Payer: UHC Medicare Advantage |
$225.44
|
| Rate for Payer: UHCCP DNSP |
$225.44
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Professional
|
Both
|
$595.00
|
|
|
Service Code
|
HCPCS 11624
|
| Hospital Charge Code |
11624
|
| Min. Negotiated Rate |
$225.44 |
| Max. Negotiated Rate |
$386.75 |
| Rate for Payer: Aetna Commercial |
$302.09
|
| Rate for Payer: Aetna Medicare |
$225.44
|
| Rate for Payer: BCBS Complete |
$238.00
|
| Rate for Payer: BCBS MAPPO |
$225.44
|
| Rate for Payer: BCN Medicare Advantage |
$225.44
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cofinity Commercial |
$324.63
|
| Rate for Payer: Cofinity Commercial |
$302.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.44
|
| Rate for Payer: Healthscope Commercial |
$270.53
|
| Rate for Payer: Healthscope Whirlpool |
$270.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.71
|
| Rate for Payer: Nomi Health Commercial |
$270.53
|
| Rate for Payer: PACE SWMI |
$225.44
|
| Rate for Payer: PHP Medicare Advantage |
$225.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.75
|
| Rate for Payer: Priority Health Medicare |
$225.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.44
|
| Rate for Payer: UHC Medicare Advantage |
$225.44
|
| Rate for Payer: UHCCP DNSP |
$225.44
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Facility
|
OP
|
$595.00
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$386.75 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$535.50
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$577.15
|
| Rate for Payer: ASR Commercial |
$577.15
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$487.25
|
| Rate for Payer: BCN Commercial |
$461.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cofinity Commercial |
$559.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$595.00
|
| Rate for Payer: Healthscope Whirlpool |
$577.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$535.50
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.75
|
| Rate for Payer: Nomi Health Commercial |
$487.90
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$521.34
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$417.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$523.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Facility
|
IP
|
$595.00
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$386.75 |
| Max. Negotiated Rate |
$595.00 |
| Rate for Payer: Aetna Commercial |
$535.50
|
| Rate for Payer: ASR ASR |
$577.15
|
| Rate for Payer: ASR Commercial |
$577.15
|
| Rate for Payer: BCBS Trust/PPO |
$484.87
|
| Rate for Payer: BCN Commercial |
$461.30
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cofinity Commercial |
$559.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.00
|
| Rate for Payer: Healthscope Commercial |
$595.00
|
| Rate for Payer: Healthscope Whirlpool |
$577.15
|
| Rate for Payer: Mclaren Commercial |
$535.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.75
|
| Rate for Payer: Nomi Health Commercial |
$487.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$523.60
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Facility
|
IP
|
$930.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
11626
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$604.50 |
| Max. Negotiated Rate |
$930.00 |
| Rate for Payer: Aetna Commercial |
$837.00
|
| Rate for Payer: ASR ASR |
$902.10
|
| Rate for Payer: ASR Commercial |
$902.10
|
| Rate for Payer: BCBS Trust/PPO |
$757.86
|
| Rate for Payer: BCN Commercial |
$721.03
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$874.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$744.00
|
| Rate for Payer: Healthscope Commercial |
$930.00
|
| Rate for Payer: Healthscope Whirlpool |
$902.10
|
| Rate for Payer: Mclaren Commercial |
$837.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$790.50
|
| Rate for Payer: Nomi Health Commercial |
$762.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$818.40
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Facility
|
OP
|
$930.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
11626
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$604.50 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$837.00
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$902.10
|
| Rate for Payer: ASR Commercial |
$902.10
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$761.58
|
| Rate for Payer: BCN Commercial |
$721.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$874.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$744.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$930.00
|
| Rate for Payer: Healthscope Whirlpool |
$902.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$837.00
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$790.50
|
| Rate for Payer: Nomi Health Commercial |
$762.60
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$814.87
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$651.93
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$818.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Professional
|
Both
|
$930.00
|
|
|
Service Code
|
HCPCS 11626
|
| Min. Negotiated Rate |
$277.64 |
| Max. Negotiated Rate |
$604.50 |
| Rate for Payer: Aetna Commercial |
$372.04
|
| Rate for Payer: Aetna Medicare |
$277.64
|
| Rate for Payer: BCBS Complete |
$372.00
|
| Rate for Payer: BCBS MAPPO |
$277.64
|
| Rate for Payer: BCN Medicare Advantage |
$277.64
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$399.80
|
| Rate for Payer: Cofinity Commercial |
$372.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$277.64
|
| Rate for Payer: Healthscope Commercial |
$333.17
|
| Rate for Payer: Healthscope Whirlpool |
$333.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$291.52
|
| Rate for Payer: Nomi Health Commercial |
$333.17
|
| Rate for Payer: PACE SWMI |
$277.64
|
| Rate for Payer: PHP Medicare Advantage |
$277.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health Medicare |
$277.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$277.64
|
| Rate for Payer: UHC Medicare Advantage |
$277.64
|
| Rate for Payer: UHCCP DNSP |
$277.64
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Professional
|
Both
|
$930.00
|
|
|
Service Code
|
HCPCS 11626
|
| Hospital Charge Code |
11626
|
| Min. Negotiated Rate |
$277.64 |
| Max. Negotiated Rate |
$604.50 |
| Rate for Payer: Aetna Commercial |
$372.04
|
| Rate for Payer: Aetna Medicare |
$277.64
|
| Rate for Payer: BCBS Complete |
$372.00
|
| Rate for Payer: BCBS MAPPO |
$277.64
|
| Rate for Payer: BCN Medicare Advantage |
$277.64
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$399.80
|
| Rate for Payer: Cofinity Commercial |
$372.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$277.64
|
| Rate for Payer: Healthscope Commercial |
$333.17
|
| Rate for Payer: Healthscope Whirlpool |
$333.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$291.52
|
| Rate for Payer: Nomi Health Commercial |
$333.17
|
| Rate for Payer: PACE SWMI |
$277.64
|
| Rate for Payer: PHP Medicare Advantage |
$277.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health Medicare |
$277.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$277.64
|
| Rate for Payer: UHC Medicare Advantage |
$277.64
|
| Rate for Payer: UHCCP DNSP |
$277.64
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Professional
|
Both
|
$803.00
|
|
|
Service Code
|
HCPCS 11606
|
| Hospital Charge Code |
11606
|
| Min. Negotiated Rate |
$301.60 |
| Max. Negotiated Rate |
$521.95 |
| Rate for Payer: Aetna Commercial |
$404.14
|
| Rate for Payer: Aetna Medicare |
$301.60
|
| Rate for Payer: BCBS Complete |
$321.20
|
| Rate for Payer: BCBS MAPPO |
$301.60
|
| Rate for Payer: BCN Medicare Advantage |
$301.60
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$434.30
|
| Rate for Payer: Cofinity Commercial |
$404.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.60
|
| Rate for Payer: Healthscope Commercial |
$361.92
|
| Rate for Payer: Healthscope Whirlpool |
$361.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.68
|
| Rate for Payer: Nomi Health Commercial |
$361.92
|
| Rate for Payer: PACE SWMI |
$301.60
|
| Rate for Payer: PHP Medicare Advantage |
$301.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health Medicare |
$301.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.60
|
| Rate for Payer: UHC Medicare Advantage |
$301.60
|
| Rate for Payer: UHCCP DNSP |
$301.60
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Facility
|
IP
|
$803.00
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
11606
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$521.95 |
| Max. Negotiated Rate |
$803.00 |
| Rate for Payer: Aetna Commercial |
$722.70
|
| Rate for Payer: ASR ASR |
$778.91
|
| Rate for Payer: ASR Commercial |
$778.91
|
| Rate for Payer: BCBS Trust/PPO |
$654.36
|
| Rate for Payer: BCN Commercial |
$622.57
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$754.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$642.40
|
| Rate for Payer: Healthscope Commercial |
$803.00
|
| Rate for Payer: Healthscope Whirlpool |
$778.91
|
| Rate for Payer: Mclaren Commercial |
$722.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$682.55
|
| Rate for Payer: Nomi Health Commercial |
$658.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$706.64
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Professional
|
Both
|
$803.00
|
|
|
Service Code
|
HCPCS 11606
|
| Min. Negotiated Rate |
$301.60 |
| Max. Negotiated Rate |
$521.95 |
| Rate for Payer: Aetna Commercial |
$404.14
|
| Rate for Payer: Aetna Medicare |
$301.60
|
| Rate for Payer: BCBS Complete |
$321.20
|
| Rate for Payer: BCBS MAPPO |
$301.60
|
| Rate for Payer: BCN Medicare Advantage |
$301.60
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$434.30
|
| Rate for Payer: Cofinity Commercial |
$404.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.60
|
| Rate for Payer: Healthscope Commercial |
$361.92
|
| Rate for Payer: Healthscope Whirlpool |
$361.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.68
|
| Rate for Payer: Nomi Health Commercial |
$361.92
|
| Rate for Payer: PACE SWMI |
$301.60
|
| Rate for Payer: PHP Medicare Advantage |
$301.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health Medicare |
$301.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.60
|
| Rate for Payer: UHC Medicare Advantage |
$301.60
|
| Rate for Payer: UHCCP DNSP |
$301.60
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Facility
|
OP
|
$803.00
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
11606
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$521.95 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$722.70
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$778.91
|
| Rate for Payer: ASR Commercial |
$778.91
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$657.58
|
| Rate for Payer: BCN Commercial |
$622.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$754.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$642.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$803.00
|
| Rate for Payer: Healthscope Whirlpool |
$778.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$722.70
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$682.55
|
| Rate for Payer: Nomi Health Commercial |
$658.46
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$703.59
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$562.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$706.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
PR EXCISION MALIGNANT TUMOR MANDIBLE RADICAL
|
Professional
|
Both
|
$2,220.00
|
|
|
Service Code
|
HCPCS 21045
|
| Min. Negotiated Rate |
$888.00 |
| Max. Negotiated Rate |
$1,641.48 |
| Rate for Payer: Aetna Commercial |
$1,527.49
|
| Rate for Payer: Aetna Medicare |
$1,139.92
|
| Rate for Payer: BCBS Complete |
$888.00
|
| Rate for Payer: BCBS MAPPO |
$1,139.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,139.92
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cofinity Commercial |
$1,641.48
|
| Rate for Payer: Cofinity Commercial |
$1,527.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,139.92
|
| Rate for Payer: Healthscope Commercial |
$1,367.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,367.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,196.92
|
| Rate for Payer: Nomi Health Commercial |
$1,367.90
|
| Rate for Payer: PACE SWMI |
$1,139.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,139.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,443.00
|
| Rate for Payer: Priority Health Medicare |
$1,139.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,139.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,139.92
|
| Rate for Payer: UHCCP DNSP |
$1,139.92
|
|
|
PR EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA
|
Professional
|
Both
|
$2,754.00
|
|
|
Service Code
|
HCPCS 21034
|
| Min. Negotiated Rate |
$1,069.88 |
| Max. Negotiated Rate |
$1,790.10 |
| Rate for Payer: Aetna Commercial |
$1,433.64
|
| Rate for Payer: Aetna Medicare |
$1,069.88
|
| Rate for Payer: BCBS Complete |
$1,101.60
|
| Rate for Payer: BCBS MAPPO |
$1,069.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,069.88
|
| Rate for Payer: Cash Price |
$2,203.20
|
| Rate for Payer: Cash Price |
$2,203.20
|
| Rate for Payer: Cofinity Commercial |
$1,540.63
|
| Rate for Payer: Cofinity Commercial |
$1,433.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,069.88
|
| Rate for Payer: Healthscope Commercial |
$1,283.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,283.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,123.37
|
| Rate for Payer: Nomi Health Commercial |
$1,283.86
|
| Rate for Payer: PACE SWMI |
$1,069.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,069.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,790.10
|
| Rate for Payer: Priority Health Medicare |
$1,069.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,069.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,069.88
|
| Rate for Payer: UHCCP DNSP |
$1,069.88
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<
|
Professional
|
Both
|
$318.00
|
|
|
Service Code
|
HCPCS 11600
|
| Min. Negotiated Rate |
$115.21 |
| Max. Negotiated Rate |
$206.70 |
| Rate for Payer: Aetna Commercial |
$154.38
|
| Rate for Payer: Aetna Medicare |
$115.21
|
| Rate for Payer: BCBS Complete |
$127.20
|
| Rate for Payer: BCBS MAPPO |
$115.21
|
| Rate for Payer: BCN Medicare Advantage |
$115.21
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cofinity Commercial |
$165.90
|
| Rate for Payer: Cofinity Commercial |
$154.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.21
|
| Rate for Payer: Healthscope Commercial |
$138.25
|
| Rate for Payer: Healthscope Whirlpool |
$138.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.97
|
| Rate for Payer: Nomi Health Commercial |
$138.25
|
| Rate for Payer: PACE SWMI |
$115.21
|
| Rate for Payer: PHP Medicare Advantage |
$115.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.70
|
| Rate for Payer: Priority Health Medicare |
$115.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.21
|
| Rate for Payer: UHC Medicare Advantage |
$115.21
|
| Rate for Payer: UHCCP DNSP |
$115.21
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 11601
|
| Min. Negotiated Rate |
$140.09 |
| Max. Negotiated Rate |
$245.05 |
| Rate for Payer: Aetna Commercial |
$187.72
|
| Rate for Payer: Aetna Medicare |
$140.09
|
| Rate for Payer: BCBS Complete |
$150.80
|
| Rate for Payer: BCBS MAPPO |
$140.09
|
| Rate for Payer: BCN Medicare Advantage |
$140.09
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cofinity Commercial |
$201.73
|
| Rate for Payer: Cofinity Commercial |
$187.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.09
|
| Rate for Payer: Healthscope Commercial |
$168.11
|
| Rate for Payer: Healthscope Whirlpool |
$168.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.09
|
| Rate for Payer: Nomi Health Commercial |
$168.11
|
| Rate for Payer: PACE SWMI |
$140.09
|
| Rate for Payer: PHP Medicare Advantage |
$140.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.05
|
| Rate for Payer: Priority Health Medicare |
$140.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.09
|
| Rate for Payer: UHC Medicare Advantage |
$140.09
|
| Rate for Payer: UHCCP DNSP |
$140.09
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 11602
|
| Min. Negotiated Rate |
$152.16 |
| Max. Negotiated Rate |
$266.50 |
| Rate for Payer: Aetna Commercial |
$203.89
|
| Rate for Payer: Aetna Medicare |
$152.16
|
| Rate for Payer: BCBS Complete |
$164.00
|
| Rate for Payer: BCBS MAPPO |
$152.16
|
| Rate for Payer: BCN Medicare Advantage |
$152.16
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$219.11
|
| Rate for Payer: Cofinity Commercial |
$203.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.16
|
| Rate for Payer: Healthscope Commercial |
$182.59
|
| Rate for Payer: Healthscope Whirlpool |
$182.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.77
|
| Rate for Payer: Nomi Health Commercial |
$182.59
|
| Rate for Payer: PACE SWMI |
$152.16
|
| Rate for Payer: PHP Medicare Advantage |
$152.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health Medicare |
$152.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.16
|
| Rate for Payer: UHC Medicare Advantage |
$152.16
|
| Rate for Payer: UHCCP DNSP |
$152.16
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Facility
|
OP
|
$410.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
11602
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$603.96 |
| Rate for Payer: Aetna Commercial |
$369.00
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$397.70
|
| Rate for Payer: ASR Commercial |
$397.70
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$335.75
|
| Rate for Payer: BCN Commercial |
$317.87
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$385.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$328.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$410.00
|
| Rate for Payer: Healthscope Whirlpool |
$397.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$369.00
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.50
|
| Rate for Payer: Nomi Health Commercial |
$336.20
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$359.24
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$287.41
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$360.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
