|
HC OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Facility
|
IP
|
$8,200.00
|
|
|
Service Code
|
CPT 28111
|
| Hospital Charge Code |
76100365
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,166.00 |
| Max. Negotiated Rate |
$7,380.00 |
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,330.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$5,740.00
|
| Rate for Payer: Cofinity Commercial |
$7,052.00
|
| Rate for Payer: Healthscope Commercial |
$7,380.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PHP Commercial |
$6,970.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health SBD |
$5,166.00
|
|
|
HC OSTECTOMY COMPLETE 2,3 OR 4TH METATARSAL HEAD
|
Facility
|
IP
|
$8,200.00
|
|
|
Service Code
|
CPT 28112
|
| Hospital Charge Code |
76100366
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,166.00 |
| Max. Negotiated Rate |
$7,380.00 |
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,330.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$5,740.00
|
| Rate for Payer: Cofinity Commercial |
$7,052.00
|
| Rate for Payer: Healthscope Commercial |
$7,380.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PHP Commercial |
$6,970.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health SBD |
$5,166.00
|
|
|
HC OSTECTOMY COMPLETE 2,3 OR 4TH METATARSAL HEAD
|
Facility
|
OP
|
$8,200.00
|
|
|
Service Code
|
CPT 28112
|
| Hospital Charge Code |
76100366
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$310.74 |
| Max. Negotiated Rate |
$8,925.64 |
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,330.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,600.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,600.14
|
| Rate for Payer: BCBS Complete |
$1,654.34
|
| Rate for Payer: BCBS MAPPO |
$2,880.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,058.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$5,740.00
|
| Rate for Payer: Cofinity Commercial |
$7,052.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Healthscope Commercial |
$7,380.00
|
| Rate for Payer: Mclaren Medicaid |
$1,575.42
|
| Rate for Payer: Mclaren Medicare |
$2,880.11
|
| Rate for Payer: Meridian Medicaid |
$1,654.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,024.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,312.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Commercial |
$6,970.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,880.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,575.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,925.64
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Priority Health Narrow Network |
$7,140.51
|
| Rate for Payer: Priority Health SBD |
$5,166.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$310.74
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
HC OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Facility
|
IP
|
$8,200.00
|
|
|
Service Code
|
CPT 28113
|
| Hospital Charge Code |
76100367
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,166.00 |
| Max. Negotiated Rate |
$7,380.00 |
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,330.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$5,740.00
|
| Rate for Payer: Cofinity Commercial |
$7,052.00
|
| Rate for Payer: Healthscope Commercial |
$7,380.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PHP Commercial |
$6,970.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health SBD |
$5,166.00
|
|
|
HC OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Facility
|
OP
|
$8,200.00
|
|
|
Service Code
|
CPT 28113
|
| Hospital Charge Code |
76100367
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$423.38 |
| Max. Negotiated Rate |
$8,925.64 |
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: Aetna Medicare |
$2,995.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,330.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,600.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,600.14
|
| Rate for Payer: BCBS Complete |
$1,654.34
|
| Rate for Payer: BCBS MAPPO |
$2,880.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,058.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,880.11
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$5,740.00
|
| Rate for Payer: Cofinity Commercial |
$7,052.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,880.11
|
| Rate for Payer: Healthscope Commercial |
$7,380.00
|
| Rate for Payer: Mclaren Medicaid |
$1,575.42
|
| Rate for Payer: Mclaren Medicare |
$2,880.11
|
| Rate for Payer: Meridian Medicaid |
$1,654.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,024.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,312.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PACE Medicare |
$2,736.10
|
| Rate for Payer: PACE SWMI |
$2,880.11
|
| Rate for Payer: PHP Commercial |
$6,970.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,880.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,575.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,925.64
|
| Rate for Payer: Priority Health Medicare |
$2,880.11
|
| Rate for Payer: Priority Health Narrow Network |
$7,140.51
|
| Rate for Payer: Priority Health SBD |
$5,166.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,880.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$465.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,880.11
|
| Rate for Payer: UHC Exchange |
$423.38
|
| Rate for Payer: UHC Medicare Advantage |
$2,966.51
|
| Rate for Payer: VA VA |
$2,880.11
|
|
|
HC OSTEOCALCIN
|
Facility
|
IP
|
$100.98
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$63.62 |
| Max. Negotiated Rate |
$90.88 |
| Rate for Payer: Aetna Commercial |
$85.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.64
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cofinity Commercial |
$70.69
|
| Rate for Payer: Cofinity Commercial |
$86.84
|
| Rate for Payer: Healthscope Commercial |
$90.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.83
|
| Rate for Payer: PHP Commercial |
$85.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.69
|
| Rate for Payer: Priority Health SBD |
$63.62
|
|
|
HC OSTEOCALCIN
|
Facility
|
OP
|
$100.98
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.33 |
| Max. Negotiated Rate |
$90.88 |
| Rate for Payer: Aetna Commercial |
$85.83
|
| Rate for Payer: Aetna Medicare |
$31.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.31
|
| Rate for Payer: BCBS Complete |
$17.15
|
| Rate for Payer: BCBS MAPPO |
$29.85
|
| Rate for Payer: BCBS Trust/PPO |
$23.38
|
| Rate for Payer: BCN Medicare Advantage |
$29.85
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cofinity Commercial |
$70.69
|
| Rate for Payer: Cofinity Commercial |
$86.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.85
|
| Rate for Payer: Healthscope Commercial |
$90.88
|
| Rate for Payer: Mclaren Medicaid |
$16.33
|
| Rate for Payer: Mclaren Medicare |
$29.85
|
| Rate for Payer: Meridian Medicaid |
$17.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.83
|
| Rate for Payer: PACE Medicare |
$28.36
|
| Rate for Payer: PACE SWMI |
$29.85
|
| Rate for Payer: PHP Commercial |
$85.83
|
| Rate for Payer: PHP Medicare Advantage |
$29.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.69
|
| Rate for Payer: Priority Health Medicare |
$29.85
|
| Rate for Payer: Priority Health SBD |
$63.62
|
| Rate for Payer: Railroad Medicare Medicare |
$29.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.82
|
| Rate for Payer: UHC Core |
$50.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.85
|
| Rate for Payer: UHC Exchange |
$29.85
|
| Rate for Payer: UHC Medicare Advantage |
$30.75
|
| Rate for Payer: VA VA |
$29.85
|
|
|
HC OSTEOPATHIC MANIPULATION 1-2 BODY REGIONS
|
Facility
|
IP
|
$30.90
|
|
|
Service Code
|
CPT 98925
|
| Hospital Charge Code |
53000001
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$27.81 |
| Rate for Payer: Aetna Commercial |
$26.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.08
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cofinity Commercial |
$21.63
|
| Rate for Payer: Cofinity Commercial |
$26.57
|
| Rate for Payer: Healthscope Commercial |
$27.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.26
|
| Rate for Payer: PHP Commercial |
$26.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: Priority Health SBD |
$19.47
|
|
|
HC OSTEOPATHIC MANIPULATION 1-2 BODY REGIONS
|
Facility
|
OP
|
$30.90
|
|
|
Service Code
|
CPT 98925
|
| Hospital Charge Code |
53000001
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna Commercial |
$26.26
|
| Rate for Payer: Aetna Medicare |
$24.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.86
|
| Rate for Payer: BCBS Complete |
$13.26
|
| Rate for Payer: BCBS MAPPO |
$23.09
|
| Rate for Payer: BCBS Trust/PPO |
$44.08
|
| Rate for Payer: BCN Medicare Advantage |
$23.09
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cofinity Commercial |
$21.63
|
| Rate for Payer: Cofinity Commercial |
$26.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.09
|
| Rate for Payer: Healthscope Commercial |
$27.81
|
| Rate for Payer: Mclaren Medicaid |
$12.63
|
| Rate for Payer: Mclaren Medicare |
$23.09
|
| Rate for Payer: Meridian Medicaid |
$13.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.26
|
| Rate for Payer: PACE Medicare |
$21.94
|
| Rate for Payer: PACE SWMI |
$23.09
|
| Rate for Payer: PHP Commercial |
$26.26
|
| Rate for Payer: PHP Medicare Advantage |
$23.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.91
|
| Rate for Payer: Priority Health Medicare |
$23.09
|
| Rate for Payer: Priority Health Narrow Network |
$59.93
|
| Rate for Payer: Priority Health SBD |
$19.47
|
| Rate for Payer: Railroad Medicare Medicare |
$23.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.09
|
| Rate for Payer: UHC Exchange |
$22.27
|
| Rate for Payer: UHC Medicare Advantage |
$23.78
|
| Rate for Payer: VA VA |
$23.09
|
|
|
HC OSTEOPATHIC MANIPULATION 3-4 BODY REGIONS
|
Facility
|
IP
|
$30.90
|
|
|
Service Code
|
CPT 98926
|
| Hospital Charge Code |
53000002
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$27.81 |
| Rate for Payer: Aetna Commercial |
$26.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.08
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cofinity Commercial |
$21.63
|
| Rate for Payer: Cofinity Commercial |
$26.57
|
| Rate for Payer: Healthscope Commercial |
$27.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.26
|
| Rate for Payer: PHP Commercial |
$26.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: Priority Health SBD |
$19.47
|
|
|
HC OSTEOPATHIC MANIPULATION 3-4 BODY REGIONS
|
Facility
|
OP
|
$30.90
|
|
|
Service Code
|
CPT 98926
|
| Hospital Charge Code |
53000002
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna Commercial |
$26.26
|
| Rate for Payer: Aetna Medicare |
$24.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.86
|
| Rate for Payer: BCBS Complete |
$13.26
|
| Rate for Payer: BCBS MAPPO |
$23.09
|
| Rate for Payer: BCBS Trust/PPO |
$59.45
|
| Rate for Payer: BCN Medicare Advantage |
$23.09
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cofinity Commercial |
$21.63
|
| Rate for Payer: Cofinity Commercial |
$26.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.09
|
| Rate for Payer: Healthscope Commercial |
$27.81
|
| Rate for Payer: Mclaren Medicaid |
$12.63
|
| Rate for Payer: Mclaren Medicare |
$23.09
|
| Rate for Payer: Meridian Medicaid |
$13.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.26
|
| Rate for Payer: PACE Medicare |
$21.94
|
| Rate for Payer: PACE SWMI |
$23.09
|
| Rate for Payer: PHP Commercial |
$26.26
|
| Rate for Payer: PHP Medicare Advantage |
$23.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.91
|
| Rate for Payer: Priority Health Medicare |
$23.09
|
| Rate for Payer: Priority Health Narrow Network |
$59.93
|
| Rate for Payer: Priority Health SBD |
$19.47
|
| Rate for Payer: Railroad Medicare Medicare |
$23.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.09
|
| Rate for Payer: UHC Exchange |
$33.73
|
| Rate for Payer: UHC Medicare Advantage |
$23.78
|
| Rate for Payer: VA VA |
$23.09
|
|
|
HC OSTEOPATHIC MANIPULATION 5-6 BODY REGIONS
|
Facility
|
OP
|
$58.25
|
|
|
Service Code
|
CPT 98927
|
| Hospital Charge Code |
53000003
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna Commercial |
$49.51
|
| Rate for Payer: Aetna Medicare |
$24.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.86
|
| Rate for Payer: BCBS Complete |
$13.26
|
| Rate for Payer: BCBS MAPPO |
$23.09
|
| Rate for Payer: BCBS Trust/PPO |
$73.78
|
| Rate for Payer: BCN Medicare Advantage |
$23.09
|
| Rate for Payer: Cash Price |
$46.60
|
| Rate for Payer: Cash Price |
$46.60
|
| Rate for Payer: Cofinity Commercial |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$50.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.09
|
| Rate for Payer: Healthscope Commercial |
$52.42
|
| Rate for Payer: Mclaren Medicaid |
$12.63
|
| Rate for Payer: Mclaren Medicare |
$23.09
|
| Rate for Payer: Meridian Medicaid |
$13.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.51
|
| Rate for Payer: PACE Medicare |
$21.94
|
| Rate for Payer: PACE SWMI |
$23.09
|
| Rate for Payer: PHP Commercial |
$49.51
|
| Rate for Payer: PHP Medicare Advantage |
$23.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.91
|
| Rate for Payer: Priority Health Medicare |
$23.09
|
| Rate for Payer: Priority Health Narrow Network |
$59.93
|
| Rate for Payer: Priority Health SBD |
$36.70
|
| Rate for Payer: Railroad Medicare Medicare |
$23.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.09
|
| Rate for Payer: UHC Exchange |
$44.86
|
| Rate for Payer: UHC Medicare Advantage |
$23.78
|
| Rate for Payer: VA VA |
$23.09
|
|
|
HC OSTEOPATHIC MANIPULATION 5-6 BODY REGIONS
|
Facility
|
IP
|
$58.25
|
|
|
Service Code
|
CPT 98927
|
| Hospital Charge Code |
53000003
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$36.70 |
| Max. Negotiated Rate |
$52.42 |
| Rate for Payer: Aetna Commercial |
$49.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.86
|
| Rate for Payer: Cash Price |
$46.60
|
| Rate for Payer: Cofinity Commercial |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$50.10
|
| Rate for Payer: Healthscope Commercial |
$52.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.51
|
| Rate for Payer: PHP Commercial |
$49.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.78
|
| Rate for Payer: Priority Health SBD |
$36.70
|
|
|
HC OSTEOPATHIC MANIPULATION 7-8 BODY REGIONS
|
Facility
|
IP
|
$59.54
|
|
|
Service Code
|
CPT 98928
|
| Hospital Charge Code |
53000004
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$37.51 |
| Max. Negotiated Rate |
$53.59 |
| Rate for Payer: Aetna Commercial |
$50.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.70
|
| Rate for Payer: Cash Price |
$47.63
|
| Rate for Payer: Cofinity Commercial |
$41.68
|
| Rate for Payer: Cofinity Commercial |
$51.20
|
| Rate for Payer: Healthscope Commercial |
$53.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.61
|
| Rate for Payer: PHP Commercial |
$50.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.68
|
| Rate for Payer: Priority Health SBD |
$37.51
|
|
|
HC OSTEOPATHIC MANIPULATION 7-8 BODY REGIONS
|
Facility
|
OP
|
$59.54
|
|
|
Service Code
|
CPT 98928
|
| Hospital Charge Code |
53000004
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$86.10 |
| Rate for Payer: Aetna Commercial |
$50.61
|
| Rate for Payer: Aetna Medicare |
$24.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.86
|
| Rate for Payer: BCBS Complete |
$13.26
|
| Rate for Payer: BCBS MAPPO |
$23.09
|
| Rate for Payer: BCBS Trust/PPO |
$86.10
|
| Rate for Payer: BCN Medicare Advantage |
$23.09
|
| Rate for Payer: Cash Price |
$47.63
|
| Rate for Payer: Cash Price |
$47.63
|
| Rate for Payer: Cofinity Commercial |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$41.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.09
|
| Rate for Payer: Healthscope Commercial |
$53.59
|
| Rate for Payer: Mclaren Medicaid |
$12.63
|
| Rate for Payer: Mclaren Medicare |
$23.09
|
| Rate for Payer: Meridian Medicaid |
$13.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.61
|
| Rate for Payer: PACE Medicare |
$21.94
|
| Rate for Payer: PACE SWMI |
$23.09
|
| Rate for Payer: PHP Commercial |
$50.61
|
| Rate for Payer: PHP Medicare Advantage |
$23.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.91
|
| Rate for Payer: Priority Health Medicare |
$23.09
|
| Rate for Payer: Priority Health Narrow Network |
$59.93
|
| Rate for Payer: Priority Health SBD |
$37.51
|
| Rate for Payer: Railroad Medicare Medicare |
$23.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.09
|
| Rate for Payer: UHC Exchange |
$56.65
|
| Rate for Payer: UHC Medicare Advantage |
$23.78
|
| Rate for Payer: VA VA |
$23.09
|
|
|
HC OSTEOPATHIC MANIPULATION 9-10 BODY REGIONS
|
Facility
|
IP
|
$64.32
|
|
|
Service Code
|
CPT 98929
|
| Hospital Charge Code |
53000005
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$40.52 |
| Max. Negotiated Rate |
$57.89 |
| Rate for Payer: Aetna Commercial |
$54.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.81
|
| Rate for Payer: Cash Price |
$51.46
|
| Rate for Payer: Cofinity Commercial |
$45.02
|
| Rate for Payer: Cofinity Commercial |
$55.32
|
| Rate for Payer: Healthscope Commercial |
$57.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.67
|
| Rate for Payer: PHP Commercial |
$54.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.02
|
| Rate for Payer: Priority Health SBD |
$40.52
|
|
|
HC OSTEOPATHIC MANIPULATION 9-10 BODY REGIONS
|
Facility
|
OP
|
$64.32
|
|
|
Service Code
|
CPT 98929
|
| Hospital Charge Code |
53000005
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$97.37 |
| Rate for Payer: Aetna Commercial |
$54.67
|
| Rate for Payer: Aetna Medicare |
$24.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.86
|
| Rate for Payer: BCBS Complete |
$13.26
|
| Rate for Payer: BCBS MAPPO |
$23.09
|
| Rate for Payer: BCBS Trust/PPO |
$97.37
|
| Rate for Payer: BCN Medicare Advantage |
$23.09
|
| Rate for Payer: Cash Price |
$51.46
|
| Rate for Payer: Cash Price |
$51.46
|
| Rate for Payer: Cofinity Commercial |
$45.02
|
| Rate for Payer: Cofinity Commercial |
$55.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.09
|
| Rate for Payer: Healthscope Commercial |
$57.89
|
| Rate for Payer: Mclaren Medicaid |
$12.63
|
| Rate for Payer: Mclaren Medicare |
$23.09
|
| Rate for Payer: Meridian Medicaid |
$13.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.67
|
| Rate for Payer: PACE Medicare |
$21.94
|
| Rate for Payer: PACE SWMI |
$23.09
|
| Rate for Payer: PHP Commercial |
$54.67
|
| Rate for Payer: PHP Medicare Advantage |
$23.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.91
|
| Rate for Payer: Priority Health Medicare |
$23.09
|
| Rate for Payer: Priority Health Narrow Network |
$59.93
|
| Rate for Payer: Priority Health SBD |
$40.52
|
| Rate for Payer: Railroad Medicare Medicare |
$23.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.09
|
| Rate for Payer: UHC Exchange |
$67.78
|
| Rate for Payer: UHC Medicare Advantage |
$23.78
|
| Rate for Payer: VA VA |
$23.09
|
|
|
HC OSTIAL PRO SYSTEM
|
Facility
|
IP
|
$1,949.65
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,228.28 |
| Max. Negotiated Rate |
$1,754.68 |
| Rate for Payer: Aetna Commercial |
$1,657.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,267.27
|
| Rate for Payer: Cash Price |
$1,559.72
|
| Rate for Payer: Cofinity Commercial |
$1,364.76
|
| Rate for Payer: Cofinity Commercial |
$1,676.70
|
| Rate for Payer: Healthscope Commercial |
$1,754.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,657.20
|
| Rate for Payer: PHP Commercial |
$1,657.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,364.76
|
| Rate for Payer: Priority Health SBD |
$1,228.28
|
|
|
HC OSTIAL PRO SYSTEM
|
Facility
|
OP
|
$1,949.65
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$779.86 |
| Max. Negotiated Rate |
$1,754.68 |
| Rate for Payer: Aetna Commercial |
$1,657.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,267.27
|
| Rate for Payer: BCBS Complete |
$779.86
|
| Rate for Payer: Cash Price |
$1,559.72
|
| Rate for Payer: Cofinity Commercial |
$1,364.76
|
| Rate for Payer: Cofinity Commercial |
$1,676.70
|
| Rate for Payer: Healthscope Commercial |
$1,754.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,657.20
|
| Rate for Payer: PHP Commercial |
$1,657.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,364.76
|
| Rate for Payer: Priority Health SBD |
$1,228.28
|
|
|
HC OSTO-ZYME
|
Facility
|
IP
|
$42.25
|
|
| Hospital Charge Code |
27000129
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.62 |
| Max. Negotiated Rate |
$38.02 |
| Rate for Payer: Aetna Commercial |
$35.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.46
|
| Rate for Payer: Cash Price |
$33.80
|
| Rate for Payer: Cofinity Commercial |
$29.58
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Healthscope Commercial |
$38.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.91
|
| Rate for Payer: PHP Commercial |
$35.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.58
|
| Rate for Payer: Priority Health SBD |
$26.62
|
|
|
HC OSTO-ZYME
|
Facility
|
OP
|
$42.25
|
|
| Hospital Charge Code |
27000129
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.90 |
| Max. Negotiated Rate |
$38.02 |
| Rate for Payer: Aetna Commercial |
$35.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.46
|
| Rate for Payer: BCBS Complete |
$16.90
|
| Rate for Payer: Cash Price |
$33.80
|
| Rate for Payer: Cofinity Commercial |
$29.58
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Healthscope Commercial |
$38.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.91
|
| Rate for Payer: PHP Commercial |
$35.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.58
|
| Rate for Payer: Priority Health SBD |
$26.62
|
|
|
HC OSU OBSERVATION PER HOUR
|
Facility
|
OP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200009
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$53.73 |
| Max. Negotiated Rate |
$1,000.00 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.31
|
| Rate for Payer: BCBS Complete |
$53.73
|
| Rate for Payer: BCBS Trust/PPO |
$108.91
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$94.03
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health SBD |
$84.63
|
|
|
HC OSU OBSERVATION PER HOUR
|
Facility
|
IP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200009
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$84.63 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.31
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$94.03
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health SBD |
$84.63
|
|
|
HC OT EVAL HIGH COMPLEXITY
|
Facility
|
IP
|
$273.77
|
|
|
Service Code
|
CPT 97167
|
| Hospital Charge Code |
43400009
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$172.48 |
| Max. Negotiated Rate |
$246.39 |
| Rate for Payer: Aetna Commercial |
$232.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.95
|
| Rate for Payer: Cash Price |
$219.02
|
| Rate for Payer: Cofinity Commercial |
$191.64
|
| Rate for Payer: Cofinity Commercial |
$235.44
|
| Rate for Payer: Healthscope Commercial |
$246.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$232.70
|
| Rate for Payer: PHP Commercial |
$232.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.64
|
| Rate for Payer: Priority Health SBD |
$172.48
|
|
|
HC OT EVAL HIGH COMPLEXITY
|
Facility
|
OP
|
$273.77
|
|
|
Service Code
|
CPT 97167
|
| Hospital Charge Code |
43400009
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$59.12 |
| Max. Negotiated Rate |
$246.39 |
| Rate for Payer: Aetna Commercial |
$232.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.95
|
| Rate for Payer: BCBS Complete |
$109.51
|
| Rate for Payer: BCBS Trust/PPO |
$59.12
|
| Rate for Payer: Cash Price |
$219.02
|
| Rate for Payer: Cash Price |
$219.02
|
| Rate for Payer: Cofinity Commercial |
$191.64
|
| Rate for Payer: Cofinity Commercial |
$235.44
|
| Rate for Payer: Healthscope Commercial |
$246.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$232.70
|
| Rate for Payer: PHP Commercial |
$232.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.64
|
| Rate for Payer: Priority Health SBD |
$172.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.49
|
| Rate for Payer: UHC Exchange |
$99.54
|
|
