Reddenda · Rate Intelligence · Philadelphia-Camden-Wilmington, PA-NJ-DE-MD

11306 under Centene in Philadelphia-Camden-Wilmington, PA-NJ-DE-MD: a flat fee schedule

Shaving lesion, scalp/neck/hands/feet, 0.6-1cm · No dispersion to score. Flat fee schedule

• Centene pays exactly $201.93 for CPT 11306 (Shaving lesion, scalp/neck/hands/feet, 0.6-1cm) to 91.4% of the 4454 providers indexed in Philadelphia-Camden-Wilmington, PA-NJ-DE-MD.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate
• This cell has 4454 individual rate records and 4454 distinct providers, all converging on one number.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate
• Because the rate is flat, there is no local percentile to claim here: every peer is paid the same, so "below median" is not a meaningful complaint against this specific file.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate
• A rate change here would have to come from a fee-schedule renegotiation with Centene directly, not a peer-comparison argument, since 91.4% of the local market already sits at the identical number.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate
• Medicare's national non-facility rate for CPT 11306 is $117.91; Centene's flat $201.93 is 171% of that Medicare rate.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Centene to publish this rate
• A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute (45 CFR §149.510(c)(4)(iii)(B)).Source: 45 CFR §149.510(c)(4)(iii)(B) (No Surprises Act IDR)

Modeled from Centene's own published in-network rates, not guaranteed. Peer basis: same CPT, same payer file, same metro (CBSA); never a pooled payer family, never a national average. Page generated 2026-09-21 13:45 UTC.