|
HC OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Facility
|
IP
|
$8,531.28
|
|
|
Service Code
|
CPT 28113
|
| Hospital Charge Code |
76100367
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,374.71 |
| Max. Negotiated Rate |
$7,678.15 |
| Rate for Payer: Aetna Commercial |
$7,251.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,545.33
|
| Rate for Payer: Cash Price |
$6,825.02
|
| Rate for Payer: Cofinity Advantage |
$5,971.90
|
| Rate for Payer: Cofinity Commercial |
$7,336.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,825.02
|
| Rate for Payer: Healthscope Commercial |
$7,678.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,251.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,398.46
|
| Rate for Payer: PHP Commercial |
$7,251.59
|
| Rate for Payer: Priority Health SBD |
$5,374.71
|
|
|
HC OSTEOCALCIN
|
Facility
|
IP
|
$105.06
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.19 |
| Max. Negotiated Rate |
$94.55 |
| Rate for Payer: Aetna Commercial |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.29
|
| Rate for Payer: Cash Price |
$84.05
|
| Rate for Payer: Cofinity Advantage |
$73.54
|
| Rate for Payer: Cofinity Commercial |
$90.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.05
|
| Rate for Payer: Healthscope Commercial |
$94.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.80
|
| Rate for Payer: PHP Commercial |
$89.30
|
| Rate for Payer: Priority Health SBD |
$66.19
|
|
|
HC OSTEOCALCIN
|
Facility
|
OP
|
$105.06
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.61 |
| Max. Negotiated Rate |
$94.55 |
| Rate for Payer: Aetna Commercial |
$89.30
|
| Rate for Payer: Aetna Medicare |
$31.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.29
|
| 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 |
$16.39
|
| Rate for Payer: BCBS MAPPO |
$29.85
|
| Rate for Payer: BCBS Trust/PPO |
$31.83
|
| Rate for Payer: BCN Commercial |
$31.83
|
| Rate for Payer: BCN Medicare Advantage |
$29.85
|
| Rate for Payer: Cash Price |
$84.05
|
| Rate for Payer: Cash Price |
$84.05
|
| Rate for Payer: Cofinity Advantage |
$73.54
|
| Rate for Payer: Cofinity Commercial |
$90.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.85
|
| Rate for Payer: Healthscope Commercial |
$94.55
|
| Rate for Payer: Mclaren Medicaid |
$15.61
|
| Rate for Payer: Mclaren Medicare |
$29.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.34
|
| Rate for Payer: Meridian Medicaid |
$31.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.30
|
| Rate for Payer: Nomi Health Commercial |
$44.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.80
|
| Rate for Payer: PACE Medicare |
$28.36
|
| Rate for Payer: PACE SWMI |
$29.85
|
| Rate for Payer: PHP Commercial |
$89.30
|
| Rate for Payer: PHP Medicare Advantage |
$29.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29.85
|
| Rate for Payer: Priority Health Medicare |
$29.85
|
| Rate for Payer: Priority Health SBD |
$66.19
|
| Rate for Payer: Priority Health Tiered Network |
$23.88
|
| Rate for Payer: Railroad Medicare Medicare |
$29.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.78
|
| Rate for Payer: UHC Core |
$44.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.85
|
| Rate for Payer: UHC Exchange |
$44.78
|
| Rate for Payer: UHC Medicaid |
$15.61
|
| Rate for Payer: UHCCP Medicaid |
$15.61
|
| Rate for Payer: VA VA |
$29.85
|
|
|
HC OSTEOPATHIC MANIPULATION 1-2 BODY REGIONS
|
Facility
|
OP
|
$37.82
|
|
|
Service Code
|
CPT 98925
|
| Hospital Charge Code |
53000001
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$69.57 |
| Rate for Payer: Aetna Commercial |
$32.15
|
| Rate for Payer: Aetna Medicare |
$22.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.89
|
| Rate for Payer: BCBS Complete |
$11.81
|
| Rate for Payer: BCBS MAPPO |
$21.51
|
| Rate for Payer: BCBS Trust/PPO |
$44.67
|
| Rate for Payer: BCN Commercial |
$44.67
|
| Rate for Payer: BCN Medicare Advantage |
$21.51
|
| Rate for Payer: Cash Price |
$30.26
|
| Rate for Payer: Cash Price |
$30.26
|
| Rate for Payer: Cofinity Advantage |
$26.47
|
| Rate for Payer: Cofinity Commercial |
$32.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.51
|
| Rate for Payer: Healthscope Commercial |
$34.04
|
| Rate for Payer: Mclaren Medicaid |
$11.25
|
| Rate for Payer: Mclaren Medicare |
$21.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.59
|
| Rate for Payer: Meridian Medicaid |
$22.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.15
|
| Rate for Payer: Nomi Health Commercial |
$64.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.36
|
| Rate for Payer: PACE Medicare |
$20.43
|
| Rate for Payer: PACE SWMI |
$21.51
|
| Rate for Payer: PHP Commercial |
$32.15
|
| Rate for Payer: PHP Medicare Advantage |
$21.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$69.57
|
| Rate for Payer: Priority Health Medicare |
$21.51
|
| Rate for Payer: Priority Health SBD |
$23.83
|
| Rate for Payer: Priority Health Tiered Network |
$55.66
|
| Rate for Payer: Railroad Medicare Medicare |
$21.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.58
|
| Rate for Payer: UHC Core |
$19.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.51
|
| Rate for Payer: UHC Exchange |
$14.86
|
| Rate for Payer: UHC Medicaid |
$11.25
|
| Rate for Payer: UHCCP Medicaid |
$11.25
|
| Rate for Payer: VA VA |
$21.51
|
|
|
HC OSTEOPATHIC MANIPULATION 1-2 BODY REGIONS
|
Facility
|
IP
|
$37.82
|
|
|
Service Code
|
CPT 98925
|
| Hospital Charge Code |
53000001
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$23.83 |
| Max. Negotiated Rate |
$34.04 |
| Rate for Payer: Aetna Commercial |
$32.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.58
|
| Rate for Payer: Cash Price |
$30.26
|
| Rate for Payer: Cofinity Advantage |
$26.47
|
| Rate for Payer: Cofinity Commercial |
$32.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.26
|
| Rate for Payer: Healthscope Commercial |
$34.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.36
|
| Rate for Payer: PHP Commercial |
$32.15
|
| Rate for Payer: Priority Health SBD |
$23.83
|
|
|
HC OSTEOPATHIC MANIPULATION 3-4 BODY REGIONS
|
Facility
|
OP
|
$32.15
|
|
|
Service Code
|
CPT 98926
|
| Hospital Charge Code |
53000002
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$69.57 |
| Rate for Payer: Aetna Commercial |
$27.33
|
| Rate for Payer: Aetna Medicare |
$22.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.89
|
| Rate for Payer: BCBS Complete |
$11.81
|
| Rate for Payer: BCBS MAPPO |
$21.51
|
| Rate for Payer: BCBS Trust/PPO |
$60.54
|
| Rate for Payer: BCN Commercial |
$60.54
|
| Rate for Payer: BCN Medicare Advantage |
$21.51
|
| Rate for Payer: Cash Price |
$25.72
|
| Rate for Payer: Cash Price |
$25.72
|
| Rate for Payer: Cofinity Advantage |
$22.50
|
| Rate for Payer: Cofinity Commercial |
$27.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.51
|
| Rate for Payer: Healthscope Commercial |
$28.93
|
| Rate for Payer: Mclaren Medicaid |
$11.25
|
| Rate for Payer: Mclaren Medicare |
$21.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.59
|
| Rate for Payer: Meridian Medicaid |
$22.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.33
|
| Rate for Payer: Nomi Health Commercial |
$64.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.11
|
| Rate for Payer: PACE Medicare |
$20.43
|
| Rate for Payer: PACE SWMI |
$21.51
|
| Rate for Payer: PHP Commercial |
$27.33
|
| Rate for Payer: PHP Medicare Advantage |
$21.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$69.57
|
| Rate for Payer: Priority Health Medicare |
$21.51
|
| Rate for Payer: Priority Health SBD |
$20.25
|
| Rate for Payer: Priority Health Tiered Network |
$55.66
|
| Rate for Payer: Railroad Medicare Medicare |
$21.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.90
|
| Rate for Payer: UHC Core |
$16.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.51
|
| Rate for Payer: UHC Exchange |
$12.63
|
| Rate for Payer: UHC Medicaid |
$11.25
|
| Rate for Payer: UHCCP Medicaid |
$11.25
|
| Rate for Payer: VA VA |
$21.51
|
|
|
HC OSTEOPATHIC MANIPULATION 3-4 BODY REGIONS
|
Facility
|
IP
|
$32.15
|
|
|
Service Code
|
CPT 98926
|
| Hospital Charge Code |
53000002
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$28.93 |
| Rate for Payer: Aetna Commercial |
$27.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.90
|
| Rate for Payer: Cash Price |
$25.72
|
| Rate for Payer: Cofinity Advantage |
$22.50
|
| Rate for Payer: Cofinity Commercial |
$27.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.72
|
| Rate for Payer: Healthscope Commercial |
$28.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.11
|
| Rate for Payer: PHP Commercial |
$27.33
|
| Rate for Payer: Priority Health SBD |
$20.25
|
|
|
HC OSTEOPATHIC MANIPULATION 5-6 BODY REGIONS
|
Facility
|
OP
|
$60.61
|
|
|
Service Code
|
CPT 98927
|
| Hospital Charge Code |
53000003
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$75.41 |
| Rate for Payer: Aetna Commercial |
$51.52
|
| Rate for Payer: Aetna Medicare |
$22.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.89
|
| Rate for Payer: BCBS Complete |
$11.81
|
| Rate for Payer: BCBS MAPPO |
$21.51
|
| Rate for Payer: BCBS Trust/PPO |
$75.41
|
| Rate for Payer: BCN Commercial |
$75.41
|
| Rate for Payer: BCN Medicare Advantage |
$21.51
|
| Rate for Payer: Cash Price |
$48.49
|
| Rate for Payer: Cash Price |
$48.49
|
| Rate for Payer: Cofinity Advantage |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$52.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.51
|
| Rate for Payer: Healthscope Commercial |
$54.55
|
| Rate for Payer: Mclaren Medicaid |
$11.25
|
| Rate for Payer: Mclaren Medicare |
$21.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.59
|
| Rate for Payer: Meridian Medicaid |
$22.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.52
|
| Rate for Payer: Nomi Health Commercial |
$64.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.46
|
| Rate for Payer: PACE Medicare |
$20.43
|
| Rate for Payer: PACE SWMI |
$21.51
|
| Rate for Payer: PHP Commercial |
$51.52
|
| Rate for Payer: PHP Medicare Advantage |
$21.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$69.57
|
| Rate for Payer: Priority Health Medicare |
$21.51
|
| Rate for Payer: Priority Health SBD |
$38.18
|
| Rate for Payer: Priority Health Tiered Network |
$55.66
|
| Rate for Payer: Railroad Medicare Medicare |
$21.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.40
|
| Rate for Payer: UHC Core |
$31.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.51
|
| Rate for Payer: UHC Exchange |
$23.82
|
| Rate for Payer: UHC Medicaid |
$11.25
|
| Rate for Payer: UHCCP Medicaid |
$11.25
|
| Rate for Payer: VA VA |
$21.51
|
|
|
HC OSTEOPATHIC MANIPULATION 5-6 BODY REGIONS
|
Facility
|
IP
|
$60.61
|
|
|
Service Code
|
CPT 98927
|
| Hospital Charge Code |
53000003
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$38.18 |
| Max. Negotiated Rate |
$54.55 |
| Rate for Payer: Aetna Commercial |
$51.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.40
|
| Rate for Payer: Cash Price |
$48.49
|
| Rate for Payer: Cofinity Advantage |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$52.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.49
|
| Rate for Payer: Healthscope Commercial |
$54.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.46
|
| Rate for Payer: PHP Commercial |
$51.52
|
| Rate for Payer: Priority Health SBD |
$38.18
|
|
|
HC OSTEOPATHIC MANIPULATION 7-8 BODY REGIONS
|
Facility
|
IP
|
$72.88
|
|
|
Service Code
|
CPT 98928
|
| Hospital Charge Code |
53000004
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$45.91 |
| Max. Negotiated Rate |
$65.59 |
| Rate for Payer: Aetna Commercial |
$61.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.37
|
| Rate for Payer: Cash Price |
$58.30
|
| Rate for Payer: Cofinity Advantage |
$51.02
|
| Rate for Payer: Cofinity Commercial |
$62.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.30
|
| Rate for Payer: Healthscope Commercial |
$65.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.66
|
| Rate for Payer: PHP Commercial |
$61.95
|
| Rate for Payer: Priority Health SBD |
$45.91
|
|
|
HC OSTEOPATHIC MANIPULATION 7-8 BODY REGIONS
|
Facility
|
OP
|
$72.88
|
|
|
Service Code
|
CPT 98928
|
| Hospital Charge Code |
53000004
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$87.34 |
| Rate for Payer: Aetna Commercial |
$61.95
|
| Rate for Payer: Aetna Medicare |
$22.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.89
|
| Rate for Payer: BCBS Complete |
$11.81
|
| Rate for Payer: BCBS MAPPO |
$21.51
|
| Rate for Payer: BCBS Trust/PPO |
$87.34
|
| Rate for Payer: BCN Commercial |
$87.34
|
| Rate for Payer: BCN Medicare Advantage |
$21.51
|
| Rate for Payer: Cash Price |
$58.30
|
| Rate for Payer: Cash Price |
$58.30
|
| Rate for Payer: Cofinity Advantage |
$51.02
|
| Rate for Payer: Cofinity Commercial |
$62.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.51
|
| Rate for Payer: Healthscope Commercial |
$65.59
|
| Rate for Payer: Mclaren Medicaid |
$11.25
|
| Rate for Payer: Mclaren Medicare |
$21.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.59
|
| Rate for Payer: Meridian Medicaid |
$22.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.95
|
| Rate for Payer: Nomi Health Commercial |
$64.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.66
|
| Rate for Payer: PACE Medicare |
$20.43
|
| Rate for Payer: PACE SWMI |
$21.51
|
| Rate for Payer: PHP Commercial |
$61.95
|
| Rate for Payer: PHP Medicare Advantage |
$21.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$69.57
|
| Rate for Payer: Priority Health Medicare |
$21.51
|
| Rate for Payer: Priority Health SBD |
$45.91
|
| Rate for Payer: Priority Health Tiered Network |
$55.66
|
| Rate for Payer: Railroad Medicare Medicare |
$21.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.37
|
| Rate for Payer: UHC Core |
$37.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.51
|
| Rate for Payer: UHC Exchange |
$28.64
|
| Rate for Payer: UHC Medicaid |
$11.25
|
| Rate for Payer: UHCCP Medicaid |
$11.25
|
| Rate for Payer: VA VA |
$21.51
|
|
|
HC OSTEOPATHIC MANIPULATION 9-10 BODY REGIONS
|
Facility
|
IP
|
$66.92
|
|
|
Service Code
|
CPT 98929
|
| Hospital Charge Code |
53000005
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$42.16 |
| Max. Negotiated Rate |
$60.23 |
| Rate for Payer: Aetna Commercial |
$56.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.50
|
| Rate for Payer: Cash Price |
$53.54
|
| Rate for Payer: Cofinity Advantage |
$46.84
|
| Rate for Payer: Cofinity Commercial |
$57.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.54
|
| Rate for Payer: Healthscope Commercial |
$60.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.19
|
| Rate for Payer: PHP Commercial |
$56.88
|
| Rate for Payer: Priority Health SBD |
$42.16
|
|
|
HC OSTEOPATHIC MANIPULATION 9-10 BODY REGIONS
|
Facility
|
OP
|
$66.92
|
|
|
Service Code
|
CPT 98929
|
| Hospital Charge Code |
53000005
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$99.24 |
| Rate for Payer: Aetna Commercial |
$56.88
|
| Rate for Payer: Aetna Medicare |
$22.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.89
|
| Rate for Payer: BCBS Complete |
$11.81
|
| Rate for Payer: BCBS MAPPO |
$21.51
|
| Rate for Payer: BCBS Trust/PPO |
$99.24
|
| Rate for Payer: BCN Commercial |
$99.24
|
| Rate for Payer: BCN Medicare Advantage |
$21.51
|
| Rate for Payer: Cash Price |
$53.54
|
| Rate for Payer: Cash Price |
$53.54
|
| Rate for Payer: Cofinity Advantage |
$46.84
|
| Rate for Payer: Cofinity Commercial |
$57.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.51
|
| Rate for Payer: Healthscope Commercial |
$60.23
|
| Rate for Payer: Mclaren Medicaid |
$11.25
|
| Rate for Payer: Mclaren Medicare |
$21.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.59
|
| Rate for Payer: Meridian Medicaid |
$22.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.88
|
| Rate for Payer: Nomi Health Commercial |
$64.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.19
|
| Rate for Payer: PACE Medicare |
$20.43
|
| Rate for Payer: PACE SWMI |
$21.51
|
| Rate for Payer: PHP Commercial |
$56.88
|
| Rate for Payer: PHP Medicare Advantage |
$21.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$69.57
|
| Rate for Payer: Priority Health Medicare |
$21.51
|
| Rate for Payer: Priority Health SBD |
$42.16
|
| Rate for Payer: Priority Health Tiered Network |
$55.66
|
| Rate for Payer: Railroad Medicare Medicare |
$21.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.50
|
| Rate for Payer: UHC Core |
$34.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.51
|
| Rate for Payer: UHC Exchange |
$26.30
|
| Rate for Payer: UHC Medicaid |
$11.25
|
| Rate for Payer: UHCCP Medicaid |
$11.25
|
| Rate for Payer: VA VA |
$21.51
|
|
|
HC OSTIAL PRO SYSTEM
|
Facility
|
OP
|
$2,028.41
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$797.17 |
| Max. Negotiated Rate |
$1,825.57 |
| Rate for Payer: Aetna Commercial |
$1,724.15
|
| Rate for Payer: Aetna Medicare |
$1,014.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,318.47
|
| Rate for Payer: BCBS Complete |
$811.36
|
| Rate for Payer: Cash Price |
$1,622.73
|
| Rate for Payer: Cofinity Advantage |
$1,419.89
|
| Rate for Payer: Cofinity Commercial |
$1,744.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,622.73
|
| Rate for Payer: Healthscope Commercial |
$1,825.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,622.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,724.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,521.31
|
| Rate for Payer: PHP Commercial |
$1,724.15
|
| Rate for Payer: Priority Health SBD |
$1,277.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,318.47
|
| Rate for Payer: UHC Core |
$1,056.80
|
| Rate for Payer: UHC Exchange |
$797.17
|
|
|
HC OSTIAL PRO SYSTEM
|
Facility
|
IP
|
$2,028.41
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,277.90 |
| Max. Negotiated Rate |
$1,825.57 |
| Rate for Payer: Aetna Commercial |
$1,724.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,318.47
|
| Rate for Payer: Cash Price |
$1,622.73
|
| Rate for Payer: Cofinity Advantage |
$1,419.89
|
| Rate for Payer: Cofinity Commercial |
$1,744.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,622.73
|
| Rate for Payer: Healthscope Commercial |
$1,825.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,724.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,521.31
|
| Rate for Payer: PHP Commercial |
$1,724.15
|
| Rate for Payer: Priority Health SBD |
$1,277.90
|
|
|
HC OSTO-ZYME
|
Facility
|
OP
|
$43.96
|
|
| Hospital Charge Code |
27000129
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.28 |
| Max. Negotiated Rate |
$39.56 |
| Rate for Payer: Aetna Commercial |
$37.37
|
| Rate for Payer: Aetna Medicare |
$21.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.57
|
| Rate for Payer: BCBS Complete |
$17.58
|
| Rate for Payer: Cash Price |
$35.17
|
| Rate for Payer: Cofinity Advantage |
$30.77
|
| Rate for Payer: Cofinity Commercial |
$37.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.17
|
| Rate for Payer: Healthscope Commercial |
$39.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.97
|
| Rate for Payer: PHP Commercial |
$37.37
|
| Rate for Payer: Priority Health SBD |
$27.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.57
|
| Rate for Payer: UHC Core |
$22.90
|
| Rate for Payer: UHC Exchange |
$17.28
|
|
|
HC OSTO-ZYME
|
Facility
|
IP
|
$43.96
|
|
| Hospital Charge Code |
27000129
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.69 |
| Max. Negotiated Rate |
$39.56 |
| Rate for Payer: Aetna Commercial |
$37.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.57
|
| Rate for Payer: Cash Price |
$35.17
|
| Rate for Payer: Cofinity Advantage |
$30.77
|
| Rate for Payer: Cofinity Commercial |
$37.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.17
|
| Rate for Payer: Healthscope Commercial |
$39.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.97
|
| Rate for Payer: PHP Commercial |
$37.37
|
| Rate for Payer: Priority Health SBD |
$27.69
|
|
|
HC OSU OBSERVATION PER HOUR
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200009
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$100.80 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Advantage |
$112.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health SBD |
$100.80
|
|
|
HC OSU OBSERVATION PER HOUR
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200009
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$64.00 |
| Max. Negotiated Rate |
$1,608.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna Medicare |
$80.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.00
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: BCBS Trust/PPO |
$112.58
|
| Rate for Payer: BCN Commercial |
$112.58
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Advantage |
$112.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health SBD |
$100.80
|
| Rate for Payer: UHC Medicaid |
$1,608.00
|
| Rate for Payer: UHCCP Medicaid |
$810.00
|
|
|
HC OT EVAL HIGH COMPLEXITY
|
Facility
|
OP
|
$284.84
|
|
|
Service Code
|
CPT 97167
|
| Hospital Charge Code |
43400009
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$60.80 |
| Max. Negotiated Rate |
$256.36 |
| Rate for Payer: Aetna Commercial |
$242.11
|
| Rate for Payer: Aetna Medicare |
$142.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.15
|
| Rate for Payer: BCBS Complete |
$113.94
|
| Rate for Payer: BCBS Trust/PPO |
$84.71
|
| Rate for Payer: BCN Commercial |
$84.71
|
| Rate for Payer: Cash Price |
$227.87
|
| Rate for Payer: Cash Price |
$227.87
|
| Rate for Payer: Cash Price |
$227.87
|
| Rate for Payer: Cofinity Advantage |
$199.39
|
| Rate for Payer: Cofinity Commercial |
$244.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.87
|
| Rate for Payer: Healthscope Commercial |
$256.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$227.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.11
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.63
|
| Rate for Payer: PHP Commercial |
$242.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$76.00
|
| Rate for Payer: Priority Health SBD |
$179.45
|
| Rate for Payer: Priority Health Tiered Network |
$60.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.15
|
| Rate for Payer: UHC Core |
$148.40
|
| Rate for Payer: UHC Exchange |
$111.94
|
|
|
HC OT EVAL HIGH COMPLEXITY
|
Facility
|
IP
|
$284.84
|
|
|
Service Code
|
CPT 97167
|
| Hospital Charge Code |
43400009
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$179.45 |
| Max. Negotiated Rate |
$256.36 |
| Rate for Payer: Aetna Commercial |
$242.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.15
|
| Rate for Payer: Cash Price |
$227.87
|
| Rate for Payer: Cofinity Advantage |
$199.39
|
| Rate for Payer: Cofinity Commercial |
$244.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.87
|
| Rate for Payer: Healthscope Commercial |
$256.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.63
|
| Rate for Payer: PHP Commercial |
$242.11
|
| Rate for Payer: Priority Health SBD |
$179.45
|
|
|
HC OT EVAL LOW COMPLEXITY
|
Facility
|
OP
|
$233.04
|
|
|
Service Code
|
CPT 97165
|
| Hospital Charge Code |
43400007
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$60.80 |
| Max. Negotiated Rate |
$209.74 |
| Rate for Payer: Aetna Commercial |
$198.08
|
| Rate for Payer: Aetna Medicare |
$116.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.48
|
| Rate for Payer: BCBS Complete |
$93.22
|
| Rate for Payer: BCBS Trust/PPO |
$85.03
|
| Rate for Payer: BCN Commercial |
$85.03
|
| Rate for Payer: Cash Price |
$186.43
|
| Rate for Payer: Cash Price |
$186.43
|
| Rate for Payer: Cash Price |
$186.43
|
| Rate for Payer: Cofinity Advantage |
$163.13
|
| Rate for Payer: Cofinity Commercial |
$200.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.43
|
| Rate for Payer: Healthscope Commercial |
$209.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.08
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.78
|
| Rate for Payer: PHP Commercial |
$198.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$76.00
|
| Rate for Payer: Priority Health SBD |
$146.82
|
| Rate for Payer: Priority Health Tiered Network |
$60.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.48
|
| Rate for Payer: UHC Core |
$121.41
|
| Rate for Payer: UHC Exchange |
$91.58
|
|
|
HC OT EVAL LOW COMPLEXITY
|
Facility
|
IP
|
$233.04
|
|
|
Service Code
|
CPT 97165
|
| Hospital Charge Code |
43400007
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$146.82 |
| Max. Negotiated Rate |
$209.74 |
| Rate for Payer: Aetna Commercial |
$198.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.48
|
| Rate for Payer: Cash Price |
$186.43
|
| Rate for Payer: Cofinity Advantage |
$163.13
|
| Rate for Payer: Cofinity Commercial |
$200.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.43
|
| Rate for Payer: Healthscope Commercial |
$209.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.78
|
| Rate for Payer: PHP Commercial |
$198.08
|
| Rate for Payer: Priority Health SBD |
$146.82
|
|
|
HC OT EVAL MODERATE COMPLEXITY
|
Facility
|
IP
|
$258.94
|
|
|
Service Code
|
CPT 97166
|
| Hospital Charge Code |
43400008
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$163.13 |
| Max. Negotiated Rate |
$233.05 |
| Rate for Payer: Aetna Commercial |
$220.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.31
|
| Rate for Payer: Cash Price |
$207.15
|
| Rate for Payer: Cofinity Advantage |
$181.26
|
| Rate for Payer: Cofinity Commercial |
$222.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.15
|
| Rate for Payer: Healthscope Commercial |
$233.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.21
|
| Rate for Payer: PHP Commercial |
$220.10
|
| Rate for Payer: Priority Health SBD |
$163.13
|
|
|
HC OT EVAL MODERATE COMPLEXITY
|
Facility
|
OP
|
$258.94
|
|
|
Service Code
|
CPT 97166
|
| Hospital Charge Code |
43400008
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$60.80 |
| Max. Negotiated Rate |
$233.05 |
| Rate for Payer: Aetna Commercial |
$220.10
|
| Rate for Payer: Aetna Medicare |
$129.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.31
|
| Rate for Payer: BCBS Complete |
$103.58
|
| Rate for Payer: BCBS Trust/PPO |
$84.71
|
| Rate for Payer: BCN Commercial |
$84.71
|
| Rate for Payer: Cash Price |
$207.15
|
| Rate for Payer: Cash Price |
$207.15
|
| Rate for Payer: Cash Price |
$207.15
|
| Rate for Payer: Cofinity Advantage |
$181.26
|
| Rate for Payer: Cofinity Commercial |
$222.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.15
|
| Rate for Payer: Healthscope Commercial |
$233.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$207.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.10
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.21
|
| Rate for Payer: PHP Commercial |
$220.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$76.00
|
| Rate for Payer: Priority Health SBD |
$163.13
|
| Rate for Payer: Priority Health Tiered Network |
$60.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.31
|
| Rate for Payer: UHC Core |
$134.91
|
| Rate for Payer: UHC Exchange |
$101.76
|
|
