|
Remove Lesion, Scalp/Neck/Hand/Foot < .5 cm Charge
|
Facility
|
OP
|
$331.00
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
713707
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$46.85 |
| Max. Negotiated Rate |
$2,555.47 |
| Rate for Payer: Aetna of AZ Commercial |
$297.90
|
| Rate for Payer: Arizona Complete Health Allwell |
$52.96
|
| Rate for Payer: Banner UC Health Medicare |
$52.96
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$225.08
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$46.85
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$52.96
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$52.96
|
| Rate for Payer: Cash Price |
$264.80
|
| Rate for Payer: Cash Price |
$264.80
|
| Rate for Payer: Cigna of AZ Commercial |
$231.70
|
| Rate for Payer: Devoted Health Medicare |
$59.58
|
| Rate for Payer: Humana of AZ Medicare |
$52.96
|
| Rate for Payer: Mercy Care Medicaid |
$46.85
|
| Rate for Payer: NaphCare Correctional Healthcare |
$46.85
|
| Rate for Payer: Seven Corners Travel Insurance |
$2,555.47
|
| Rate for Payer: Southwest Service Administrators UFCW |
$225.08
|
| Rate for Payer: TriWest Medicare |
$52.96
|
| Rate for Payer: United Healthcare Commercial |
$189.33
|
| Rate for Payer: United Healthcare Medicare |
$52.96
|
| Rate for Payer: Veterans Affairs TRICARE |
$52.43
|
|
|
Remove Lesion, Scalp/Neck/Hand/Foot < .5 cm Charge
|
Facility
|
IP
|
$331.00
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
713707
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$297.90 |
| Max. Negotiated Rate |
$297.90 |
| Rate for Payer: Aetna of AZ Commercial |
$297.90
|
| Rate for Payer: Cash Price |
$264.80
|
|
|
Remove Lesion, Scalp/Neck/Hand/Foot .6 to 1.0 cm Charge
|
Facility
|
IP
|
$515.00
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
713709
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$463.50 |
| Max. Negotiated Rate |
$463.50 |
| Rate for Payer: Aetna of AZ Commercial |
$463.50
|
| Rate for Payer: Cash Price |
$412.00
|
|
|
Remove Lesion, Scalp/Neck/Hand/Foot .6 to 1.0 cm Charge
|
Facility
|
OP
|
$515.00
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
713709
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$53.65 |
| Max. Negotiated Rate |
$1,095.68 |
| Rate for Payer: Aetna of AZ Commercial |
$463.50
|
| Rate for Payer: Arizona Complete Health Allwell |
$82.40
|
| Rate for Payer: Banner UC Health Medicare |
$82.40
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$350.20
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$53.65
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$82.40
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$82.40
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cigna of AZ Commercial |
$360.50
|
| Rate for Payer: Devoted Health Medicare |
$92.70
|
| Rate for Payer: Humana of AZ Medicare |
$82.40
|
| Rate for Payer: Mercy Care Medicaid |
$53.65
|
| Rate for Payer: NaphCare Correctional Healthcare |
$53.65
|
| Rate for Payer: Seven Corners Travel Insurance |
$1,095.68
|
| Rate for Payer: Southwest Service Administrators UFCW |
$350.20
|
| Rate for Payer: TriWest Medicare |
$82.40
|
| Rate for Payer: United Healthcare Commercial |
$294.58
|
| Rate for Payer: United Healthcare Medicare |
$82.40
|
| Rate for Payer: Veterans Affairs TRICARE |
$81.58
|
|
|
Remove Lesion, Trunk/Arm/Leg 1.1 to 2.0 cm Charge
|
Facility
|
OP
|
$585.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
713699
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$59.00 |
| Max. Negotiated Rate |
$1,095.68 |
| Rate for Payer: Aetna of AZ Commercial |
$526.50
|
| Rate for Payer: Arizona Complete Health Allwell |
$93.60
|
| Rate for Payer: Banner UC Health Medicare |
$93.60
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$397.80
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$59.00
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$93.60
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$93.60
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Cigna of AZ Commercial |
$409.50
|
| Rate for Payer: Devoted Health Medicare |
$105.30
|
| Rate for Payer: Humana of AZ Medicare |
$93.60
|
| Rate for Payer: Mercy Care Medicaid |
$59.00
|
| Rate for Payer: NaphCare Correctional Healthcare |
$59.00
|
| Rate for Payer: Seven Corners Travel Insurance |
$1,095.68
|
| Rate for Payer: Southwest Service Administrators UFCW |
$397.80
|
| Rate for Payer: TriWest Medicare |
$93.60
|
| Rate for Payer: United Healthcare Commercial |
$334.62
|
| Rate for Payer: United Healthcare Medicare |
$93.60
|
| Rate for Payer: Veterans Affairs TRICARE |
$92.66
|
|
|
Remove Lesion, Trunk/Arm/Leg 1.1 to 2.0 cm Charge
|
Facility
|
IP
|
$585.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
713699
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$526.50 |
| Max. Negotiated Rate |
$526.50 |
| Rate for Payer: Aetna of AZ Commercial |
$526.50
|
| Rate for Payer: Cash Price |
$468.00
|
|
|
Remove Lesion, Trunk/Arm/Leg 2.1 to 3.0 cm Charge
|
Facility
|
IP
|
$738.00
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
713701
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$664.20 |
| Max. Negotiated Rate |
$664.20 |
| Rate for Payer: Aetna of AZ Commercial |
$664.20
|
| Rate for Payer: Cash Price |
$590.40
|
|
|
Remove Lesion, Trunk/Arm/Leg 2.1 to 3.0 cm Charge
|
Facility
|
OP
|
$738.00
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
713701
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$50.78 |
| Max. Negotiated Rate |
$1,095.68 |
| Rate for Payer: Aetna of AZ Commercial |
$664.20
|
| Rate for Payer: Arizona Complete Health Allwell |
$118.08
|
| Rate for Payer: Banner UC Health Medicare |
$118.08
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$501.84
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$50.78
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$118.08
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$118.08
|
| Rate for Payer: Cash Price |
$590.40
|
| Rate for Payer: Cash Price |
$590.40
|
| Rate for Payer: Cigna of AZ Commercial |
$516.60
|
| Rate for Payer: Devoted Health Medicare |
$132.84
|
| Rate for Payer: Humana of AZ Medicare |
$118.08
|
| Rate for Payer: Mercy Care Medicaid |
$50.78
|
| Rate for Payer: NaphCare Correctional Healthcare |
$50.78
|
| Rate for Payer: Seven Corners Travel Insurance |
$1,095.68
|
| Rate for Payer: Southwest Service Administrators UFCW |
$501.84
|
| Rate for Payer: TriWest Medicare |
$118.08
|
| Rate for Payer: United Healthcare Commercial |
$422.14
|
| Rate for Payer: United Healthcare Medicare |
$118.08
|
| Rate for Payer: Veterans Affairs TRICARE |
$116.90
|
|
|
Remove Lesion, Trunk/Arm/Leg 3.1 to 4.0 cm Charge
|
Facility
|
IP
|
$619.00
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
713703
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$557.10 |
| Max. Negotiated Rate |
$557.10 |
| Rate for Payer: Aetna of AZ Commercial |
$557.10
|
| Rate for Payer: Cash Price |
$495.20
|
|
|
Remove Lesion, Trunk/Arm/Leg 3.1 to 4.0 cm Charge
|
Facility
|
OP
|
$619.00
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
713703
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$62.58 |
| Max. Negotiated Rate |
$2,555.47 |
| Rate for Payer: Aetna of AZ Commercial |
$557.10
|
| Rate for Payer: Arizona Complete Health Allwell |
$99.04
|
| Rate for Payer: Banner UC Health Medicare |
$99.04
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$420.92
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$62.58
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$99.04
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$99.04
|
| Rate for Payer: Cash Price |
$495.20
|
| Rate for Payer: Cash Price |
$495.20
|
| Rate for Payer: Cigna of AZ Commercial |
$433.30
|
| Rate for Payer: Devoted Health Medicare |
$111.42
|
| Rate for Payer: Humana of AZ Medicare |
$99.04
|
| Rate for Payer: Mercy Care Medicaid |
$62.58
|
| Rate for Payer: NaphCare Correctional Healthcare |
$62.58
|
| Rate for Payer: Seven Corners Travel Insurance |
$2,555.47
|
| Rate for Payer: Southwest Service Administrators UFCW |
$420.92
|
| Rate for Payer: TriWest Medicare |
$99.04
|
| Rate for Payer: United Healthcare Commercial |
$354.07
|
| Rate for Payer: United Healthcare Medicare |
$99.04
|
| Rate for Payer: Veterans Affairs TRICARE |
$98.05
|
|
|
Remove Lesion, Trunk/Arm/Leg >4.0 cm Charge
|
Facility
|
IP
|
$730.00
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
713705
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$657.00 |
| Max. Negotiated Rate |
$657.00 |
| Rate for Payer: Aetna of AZ Commercial |
$657.00
|
| Rate for Payer: Cash Price |
$584.00
|
|
|
Remove Lesion, Trunk/Arm/Leg >4.0 cm Charge
|
Facility
|
OP
|
$730.00
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
713705
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$74.74 |
| Max. Negotiated Rate |
$2,555.47 |
| Rate for Payer: Aetna of AZ Commercial |
$657.00
|
| Rate for Payer: Arizona Complete Health Allwell |
$116.80
|
| Rate for Payer: Banner UC Health Medicare |
$116.80
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$496.40
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$74.74
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$116.80
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$116.80
|
| Rate for Payer: Cash Price |
$584.00
|
| Rate for Payer: Cash Price |
$584.00
|
| Rate for Payer: Cigna of AZ Commercial |
$511.00
|
| Rate for Payer: Devoted Health Medicare |
$131.40
|
| Rate for Payer: Humana of AZ Medicare |
$116.80
|
| Rate for Payer: Mercy Care Medicaid |
$74.74
|
| Rate for Payer: NaphCare Correctional Healthcare |
$74.74
|
| Rate for Payer: Seven Corners Travel Insurance |
$2,555.47
|
| Rate for Payer: Southwest Service Administrators UFCW |
$496.40
|
| Rate for Payer: TriWest Medicare |
$116.80
|
| Rate for Payer: United Healthcare Commercial |
$417.56
|
| Rate for Payer: United Healthcare Medicare |
$116.80
|
| Rate for Payer: Veterans Affairs TRICARE |
$115.63
|
|
|
Remove Lesion, Trunk/Arm/Leg <.5 cm Charge
|
Facility
|
IP
|
$352.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
713695
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$316.80 |
| Max. Negotiated Rate |
$316.80 |
| Rate for Payer: Aetna of AZ Commercial |
$316.80
|
| Rate for Payer: Cash Price |
$281.60
|
|
|
Remove Lesion, Trunk/Arm/Leg <.5 cm Charge
|
Facility
|
OP
|
$352.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
713695
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$46.13 |
| Max. Negotiated Rate |
$1,095.68 |
| Rate for Payer: Aetna of AZ Commercial |
$316.80
|
| Rate for Payer: Arizona Complete Health Allwell |
$56.32
|
| Rate for Payer: Banner UC Health Medicare |
$56.32
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$239.36
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$46.13
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$56.32
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$56.32
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cigna of AZ Commercial |
$246.40
|
| Rate for Payer: Devoted Health Medicare |
$63.36
|
| Rate for Payer: Humana of AZ Medicare |
$56.32
|
| Rate for Payer: Mercy Care Medicaid |
$46.13
|
| Rate for Payer: NaphCare Correctional Healthcare |
$46.13
|
| Rate for Payer: Seven Corners Travel Insurance |
$1,095.68
|
| Rate for Payer: Southwest Service Administrators UFCW |
$239.36
|
| Rate for Payer: TriWest Medicare |
$56.32
|
| Rate for Payer: United Healthcare Commercial |
$201.34
|
| Rate for Payer: United Healthcare Medicare |
$56.32
|
| Rate for Payer: Veterans Affairs TRICARE |
$55.76
|
|
|
Remove Lesion, Trunk/Arm/Leg .6 to 1.0 cm Charge
|
Facility
|
IP
|
$508.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
713697
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$457.20 |
| Max. Negotiated Rate |
$457.20 |
| Rate for Payer: Aetna of AZ Commercial |
$457.20
|
| Rate for Payer: Cash Price |
$406.40
|
|
|
Remove Lesion, Trunk/Arm/Leg .6 to 1.0 cm Charge
|
Facility
|
OP
|
$508.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
713697
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$52.92 |
| Max. Negotiated Rate |
$629.00 |
| Rate for Payer: Aetna of AZ Commercial |
$457.20
|
| Rate for Payer: Arizona Complete Health Allwell |
$81.28
|
| Rate for Payer: Banner UC Health Medicare |
$81.28
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$345.44
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$52.92
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$81.28
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$81.28
|
| Rate for Payer: Cash Price |
$406.40
|
| Rate for Payer: Cash Price |
$406.40
|
| Rate for Payer: Cigna of AZ Commercial |
$355.60
|
| Rate for Payer: Devoted Health Medicare |
$91.44
|
| Rate for Payer: Humana of AZ Medicare |
$81.28
|
| Rate for Payer: Mercy Care Medicaid |
$52.92
|
| Rate for Payer: NaphCare Correctional Healthcare |
$52.92
|
| Rate for Payer: Seven Corners Travel Insurance |
$629.00
|
| Rate for Payer: Southwest Service Administrators UFCW |
$345.44
|
| Rate for Payer: TriWest Medicare |
$81.28
|
| Rate for Payer: United Healthcare Commercial |
$290.58
|
| Rate for Payer: United Healthcare Medicare |
$81.28
|
| Rate for Payer: Veterans Affairs TRICARE |
$80.47
|
|
|
Remove Malig Lesion w/Margins, Face, Ears, Eyelids, Nose, Lips; Diam 3.1 to 4.0
|
Facility
|
IP
|
$1,194.00
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
713863
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$1,074.60 |
| Max. Negotiated Rate |
$1,074.60 |
| Rate for Payer: Aetna of AZ Commercial |
$1,074.60
|
| Rate for Payer: Cash Price |
$955.20
|
|
|
Remove Malig Lesion w/Margins, Face, Ears, Eyelids, Nose, Lips; Diam 3.1 to 4.0
|
Facility
|
OP
|
$1,194.00
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
713863
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$114.79 |
| Max. Negotiated Rate |
$2,555.47 |
| Rate for Payer: Aetna of AZ Commercial |
$1,074.60
|
| Rate for Payer: Arizona Complete Health Allwell |
$191.04
|
| Rate for Payer: Banner UC Health Medicare |
$191.04
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$811.92
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$114.79
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$191.04
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$191.04
|
| Rate for Payer: Cash Price |
$955.20
|
| Rate for Payer: Cash Price |
$955.20
|
| Rate for Payer: Cigna of AZ Commercial |
$835.80
|
| Rate for Payer: Devoted Health Medicare |
$214.92
|
| Rate for Payer: Humana of AZ Medicare |
$191.04
|
| Rate for Payer: Mercy Care Medicaid |
$114.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$114.79
|
| Rate for Payer: Seven Corners Travel Insurance |
$2,555.47
|
| Rate for Payer: Southwest Service Administrators UFCW |
$811.92
|
| Rate for Payer: TriWest Medicare |
$191.04
|
| Rate for Payer: United Healthcare Commercial |
$682.97
|
| Rate for Payer: United Healthcare Medicare |
$191.04
|
| Rate for Payer: Veterans Affairs TRICARE |
$189.13
|
|
|
Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 0.5 cm >
|
Facility
|
OP
|
$481.00
|
|
|
Service Code
|
CPT 11620
|
| Hospital Charge Code |
713843
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$76.19 |
| Max. Negotiated Rate |
$2,555.47 |
| Rate for Payer: Aetna of AZ Commercial |
$432.90
|
| Rate for Payer: Arizona Complete Health Allwell |
$76.96
|
| Rate for Payer: Banner UC Health Medicare |
$76.96
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$327.08
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$79.04
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$76.96
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$76.96
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cigna of AZ Commercial |
$336.70
|
| Rate for Payer: Devoted Health Medicare |
$86.58
|
| Rate for Payer: Humana of AZ Medicare |
$76.96
|
| Rate for Payer: Mercy Care Medicaid |
$79.04
|
| Rate for Payer: NaphCare Correctional Healthcare |
$79.04
|
| Rate for Payer: Seven Corners Travel Insurance |
$2,555.47
|
| Rate for Payer: Southwest Service Administrators UFCW |
$327.08
|
| Rate for Payer: TriWest Medicare |
$76.96
|
| Rate for Payer: United Healthcare Commercial |
$275.13
|
| Rate for Payer: United Healthcare Medicare |
$76.96
|
| Rate for Payer: Veterans Affairs TRICARE |
$76.19
|
|
|
Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 0.5 cm >
|
Facility
|
IP
|
$481.00
|
|
|
Service Code
|
CPT 11620
|
| Hospital Charge Code |
713843
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$432.90 |
| Max. Negotiated Rate |
$432.90 |
| Rate for Payer: Aetna of AZ Commercial |
$432.90
|
| Rate for Payer: Cash Price |
$384.80
|
|
|
Remove Other Benign Lesion w/Margins , Face/Ears/Eyelids/Nose/Lips; Diam 3.1 to
|
Facility
|
OP
|
$873.00
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
713827
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$60.79 |
| Max. Negotiated Rate |
$2,555.47 |
| Rate for Payer: Aetna of AZ Commercial |
$785.70
|
| Rate for Payer: Arizona Complete Health Allwell |
$139.68
|
| Rate for Payer: Banner UC Health Medicare |
$139.68
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$593.64
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$60.79
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$139.68
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$139.68
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cigna of AZ Commercial |
$611.10
|
| Rate for Payer: Devoted Health Medicare |
$157.14
|
| Rate for Payer: Humana of AZ Medicare |
$139.68
|
| Rate for Payer: Mercy Care Medicaid |
$60.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$60.79
|
| Rate for Payer: Seven Corners Travel Insurance |
$2,555.47
|
| Rate for Payer: Southwest Service Administrators UFCW |
$593.64
|
| Rate for Payer: TriWest Medicare |
$139.68
|
| Rate for Payer: United Healthcare Commercial |
$499.36
|
| Rate for Payer: United Healthcare Medicare |
$139.68
|
| Rate for Payer: Veterans Affairs TRICARE |
$138.28
|
|
|
Remove Other Benign Lesion w/Margins , Face/Ears/Eyelids/Nose/Lips; Diam 3.1 to
|
Facility
|
IP
|
$873.00
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
713827
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$785.70 |
| Max. Negotiated Rate |
$785.70 |
| Rate for Payer: Aetna of AZ Commercial |
$785.70
|
| Rate for Payer: Cash Price |
$698.40
|
|
|
REMOVER STAPLE PRECISE 3M
|
Facility
|
OP
|
$16.00
|
|
| Hospital Charge Code |
22540633
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$14.40 |
| Rate for Payer: Aetna of AZ Commercial |
$14.40
|
| Rate for Payer: Arizona Complete Health Allwell |
$2.56
|
| Rate for Payer: Banner UC Health Medicare |
$2.56
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Commercial |
$10.88
|
| Rate for Payer: Blue Cross Blue Shield of Arizona Medicare |
$2.56
|
| Rate for Payer: Care1st Health Plan Arizona Medicare |
$2.56
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cigna of AZ Commercial |
$11.20
|
| Rate for Payer: Devoted Health Medicare |
$2.88
|
| Rate for Payer: Humana of AZ Medicare |
$2.56
|
| Rate for Payer: Southwest Service Administrators UFCW |
$10.88
|
| Rate for Payer: TriWest Medicare |
$2.56
|
| Rate for Payer: United Healthcare Commercial |
$9.15
|
| Rate for Payer: United Healthcare Medicare |
$2.56
|
| Rate for Payer: Veterans Affairs TRICARE |
$2.53
|
|
|
REMOVER STAPLE PRECISE 3M
|
Facility
|
IP
|
$16.00
|
|
| Hospital Charge Code |
22540633
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$14.40 |
| Rate for Payer: Aetna of AZ Commercial |
$14.40
|
| Rate for Payer: Cash Price |
$12.80
|
|
|
REMOVER STAPLE PROXIMATE
|
Facility
|
IP
|
$37.00
|
|
| Hospital Charge Code |
22355173
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$33.30 |
| Max. Negotiated Rate |
$33.30 |
| Rate for Payer: Aetna of AZ Commercial |
$33.30
|
| Rate for Payer: Cash Price |
$29.60
|
|
