|
HC OSMOLALITY URINE
|
Facility
|
IP
|
$53.86
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
30100379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.93 |
| Max. Negotiated Rate |
$48.47 |
| Rate for Payer: Aetna Commercial |
$45.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.01
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$37.70
|
| Rate for Payer: Cofinity Commercial |
$46.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.09
|
| Rate for Payer: Healthscope Commercial |
$48.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.78
|
| Rate for Payer: PHP Commercial |
$45.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.01
|
| Rate for Payer: Priority Health SBD |
$33.93
|
|
|
HC OSMOTIC FRAGILITY RBC
|
Facility
|
OP
|
$131.42
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
30500052
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.16 |
| Max. Negotiated Rate |
$118.28 |
| Rate for Payer: Aetna Commercial |
$111.71
|
| Rate for Payer: Aetna Medicare |
$13.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.70
|
| Rate for Payer: BCBS Complete |
$7.52
|
| Rate for Payer: BCBS MAPPO |
$13.36
|
| Rate for Payer: BCN Medicare Advantage |
$13.36
|
| Rate for Payer: Cash Price |
$105.14
|
| Rate for Payer: Cash Price |
$105.14
|
| Rate for Payer: Cofinity Commercial |
$91.99
|
| Rate for Payer: Cofinity Commercial |
$113.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$118.28
|
| Rate for Payer: Mclaren Medicaid |
$7.16
|
| Rate for Payer: Mclaren Medicare |
$13.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.03
|
| Rate for Payer: Meridian Medicaid |
$7.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.71
|
| Rate for Payer: PACE Medicare |
$12.69
|
| Rate for Payer: PACE SWMI |
$13.36
|
| Rate for Payer: PHP Commercial |
$111.71
|
| Rate for Payer: PHP Medicare Advantage |
$13.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.42
|
| Rate for Payer: Priority Health Medicare |
$13.36
|
| Rate for Payer: Priority Health SBD |
$82.79
|
| Rate for Payer: Railroad Medicare Medicare |
$13.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.36
|
| Rate for Payer: UHC Medicare Advantage |
$13.36
|
| Rate for Payer: UHCCP Medicaid |
$7.52
|
| Rate for Payer: VA VA |
$13.36
|
|
|
HC OSMOTIC FRAGILITY RBC
|
Facility
|
IP
|
$131.42
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
30500052
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$82.79 |
| Max. Negotiated Rate |
$118.28 |
| Rate for Payer: Aetna Commercial |
$111.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.42
|
| Rate for Payer: Cash Price |
$105.14
|
| Rate for Payer: Cofinity Commercial |
$113.02
|
| Rate for Payer: Cofinity Commercial |
$91.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.14
|
| Rate for Payer: Healthscope Commercial |
$118.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.71
|
| Rate for Payer: PHP Commercial |
$111.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.42
|
| Rate for Payer: Priority Health SBD |
$82.79
|
|
|
HC OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Facility
|
OP
|
$8,364.00
|
|
|
Service Code
|
CPT 28111
|
| Hospital Charge Code |
76100365
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,436.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Cofinity Commercial |
$5,854.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,854.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$5,269.32
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,781.56
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
HC OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Facility
|
IP
|
$8,364.00
|
|
|
Service Code
|
CPT 28111
|
| Hospital Charge Code |
76100365
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,269.32 |
| Max. Negotiated Rate |
$7,527.60 |
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,436.60
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$5,854.80
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,854.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health SBD |
$5,269.32
|
|
|
HC OSTECTOMY COMPLETE 2,3 OR 4TH METATARSAL HEAD
|
Facility
|
OP
|
$8,364.00
|
|
|
Service Code
|
CPT 28112
|
| Hospital Charge Code |
76100366
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,436.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Cofinity Commercial |
$5,854.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,854.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$5,269.32
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,781.56
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
HC OSTECTOMY COMPLETE 2,3 OR 4TH METATARSAL HEAD
|
Facility
|
IP
|
$8,364.00
|
|
|
Service Code
|
CPT 28112
|
| Hospital Charge Code |
76100366
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,269.32 |
| Max. Negotiated Rate |
$7,527.60 |
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,436.60
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$5,854.80
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,854.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health SBD |
$5,269.32
|
|
|
HC OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Facility
|
IP
|
$8,364.00
|
|
|
Service Code
|
CPT 28113
|
| Hospital Charge Code |
76100367
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,269.32 |
| Max. Negotiated Rate |
$7,527.60 |
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,436.60
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$5,854.80
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,854.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health SBD |
$5,269.32
|
|
|
HC OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Facility
|
OP
|
$8,364.00
|
|
|
Service Code
|
CPT 28113
|
| Hospital Charge Code |
76100367
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,436.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Cofinity Commercial |
$5,854.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,854.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$5,269.32
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,781.56
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
HC OSTEOCALCIN
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$92.70 |
| Rate for Payer: Aetna Commercial |
$87.55
|
| Rate for Payer: Aetna Medicare |
$31.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.95
|
| 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 |
$16.80
|
| Rate for Payer: BCBS MAPPO |
$29.85
|
| Rate for Payer: BCN Medicare Advantage |
$29.85
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$88.58
|
| Rate for Payer: Cofinity Commercial |
$72.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.85
|
| Rate for Payer: Healthscope Commercial |
$92.70
|
| Rate for Payer: Mclaren Medicaid |
$16.00
|
| 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 |
$16.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.55
|
| Rate for Payer: PACE Medicare |
$28.36
|
| Rate for Payer: PACE SWMI |
$29.85
|
| Rate for Payer: PHP Commercial |
$87.55
|
| Rate for Payer: PHP Medicare Advantage |
$29.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health Medicare |
$29.85
|
| Rate for Payer: Priority Health SBD |
$64.89
|
| Rate for Payer: Railroad Medicare Medicare |
$29.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.85
|
| Rate for Payer: UHC Medicare Advantage |
$29.85
|
| Rate for Payer: UHCCP Medicaid |
$16.81
|
| Rate for Payer: VA VA |
$29.85
|
|
|
HC OSTEOCALCIN
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.89 |
| Max. Negotiated Rate |
$92.70 |
| Rate for Payer: Aetna Commercial |
$87.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.95
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$72.10
|
| Rate for Payer: Cofinity Commercial |
$88.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.40
|
| Rate for Payer: Healthscope Commercial |
$92.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.55
|
| Rate for Payer: PHP Commercial |
$87.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health SBD |
$64.89
|
|
|
HC OSTEOPATHIC MANIPULATION 1-2 BODY REGIONS
|
Facility
|
OP
|
$31.52
|
|
|
Service Code
|
CPT 98925
|
| Hospital Charge Code |
53000001
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$13.22 |
| Max. Negotiated Rate |
$69.44 |
| Rate for Payer: Aetna Commercial |
$26.79
|
| Rate for Payer: Aetna Medicare |
$25.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.84
|
| Rate for Payer: BCBS Complete |
$13.88
|
| Rate for Payer: BCBS MAPPO |
$24.67
|
| Rate for Payer: BCN Medicare Advantage |
$24.67
|
| Rate for Payer: Cash Price |
$25.22
|
| Rate for Payer: Cash Price |
$25.22
|
| Rate for Payer: Cofinity Commercial |
$27.11
|
| Rate for Payer: Cofinity Commercial |
$22.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.67
|
| Rate for Payer: Healthscope Commercial |
$28.37
|
| Rate for Payer: Mclaren Medicaid |
$13.22
|
| Rate for Payer: Mclaren Medicare |
$24.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$13.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.79
|
| Rate for Payer: PACE Medicare |
$23.44
|
| Rate for Payer: PACE SWMI |
$24.67
|
| Rate for Payer: PHP Commercial |
$26.79
|
| Rate for Payer: PHP Medicare Advantage |
$24.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.49
|
| Rate for Payer: Priority Health Medicare |
$24.67
|
| Rate for Payer: Priority Health SBD |
$19.86
|
| Rate for Payer: Railroad Medicare Medicare |
$24.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.67
|
| Rate for Payer: UHC Medicare Advantage |
$24.67
|
| Rate for Payer: UHCCP Medicaid |
$13.89
|
| Rate for Payer: VA VA |
$24.67
|
|
|
HC OSTEOPATHIC MANIPULATION 1-2 BODY REGIONS
|
Facility
|
IP
|
$31.52
|
|
|
Service Code
|
CPT 98925
|
| Hospital Charge Code |
53000001
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$19.86 |
| Max. Negotiated Rate |
$28.37 |
| Rate for Payer: Aetna Commercial |
$26.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.49
|
| Rate for Payer: Cash Price |
$25.22
|
| Rate for Payer: Cofinity Commercial |
$22.06
|
| Rate for Payer: Cofinity Commercial |
$27.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.22
|
| Rate for Payer: Healthscope Commercial |
$28.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.79
|
| Rate for Payer: PHP Commercial |
$26.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.49
|
| Rate for Payer: Priority Health SBD |
$19.86
|
|
|
HC OSTEOPATHIC MANIPULATION 3-4 BODY REGIONS
|
Facility
|
IP
|
$31.52
|
|
|
Service Code
|
CPT 98926
|
| Hospital Charge Code |
53000002
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$19.86 |
| Max. Negotiated Rate |
$28.37 |
| Rate for Payer: Aetna Commercial |
$26.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.49
|
| Rate for Payer: Cash Price |
$25.22
|
| Rate for Payer: Cofinity Commercial |
$22.06
|
| Rate for Payer: Cofinity Commercial |
$27.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.22
|
| Rate for Payer: Healthscope Commercial |
$28.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.79
|
| Rate for Payer: PHP Commercial |
$26.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.49
|
| Rate for Payer: Priority Health SBD |
$19.86
|
|
|
HC OSTEOPATHIC MANIPULATION 3-4 BODY REGIONS
|
Facility
|
OP
|
$31.52
|
|
|
Service Code
|
CPT 98926
|
| Hospital Charge Code |
53000002
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$13.22 |
| Max. Negotiated Rate |
$69.44 |
| Rate for Payer: Aetna Commercial |
$26.79
|
| Rate for Payer: Aetna Medicare |
$25.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.84
|
| Rate for Payer: BCBS Complete |
$13.88
|
| Rate for Payer: BCBS MAPPO |
$24.67
|
| Rate for Payer: BCN Medicare Advantage |
$24.67
|
| Rate for Payer: Cash Price |
$25.22
|
| Rate for Payer: Cash Price |
$25.22
|
| Rate for Payer: Cofinity Commercial |
$27.11
|
| Rate for Payer: Cofinity Commercial |
$22.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.67
|
| Rate for Payer: Healthscope Commercial |
$28.37
|
| Rate for Payer: Mclaren Medicaid |
$13.22
|
| Rate for Payer: Mclaren Medicare |
$24.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$13.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.79
|
| Rate for Payer: PACE Medicare |
$23.44
|
| Rate for Payer: PACE SWMI |
$24.67
|
| Rate for Payer: PHP Commercial |
$26.79
|
| Rate for Payer: PHP Medicare Advantage |
$24.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.49
|
| Rate for Payer: Priority Health Medicare |
$24.67
|
| Rate for Payer: Priority Health SBD |
$19.86
|
| Rate for Payer: Railroad Medicare Medicare |
$24.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.67
|
| Rate for Payer: UHC Medicare Advantage |
$24.67
|
| Rate for Payer: UHCCP Medicaid |
$13.89
|
| Rate for Payer: VA VA |
$24.67
|
|
|
HC OSTEOPATHIC MANIPULATION 5-6 BODY REGIONS
|
Facility
|
IP
|
$59.42
|
|
|
Service Code
|
CPT 98927
|
| Hospital Charge Code |
53000003
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$37.43 |
| Max. Negotiated Rate |
$53.48 |
| Rate for Payer: Aetna Commercial |
$50.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.62
|
| Rate for Payer: Cash Price |
$47.54
|
| Rate for Payer: Cofinity Commercial |
$41.59
|
| Rate for Payer: Cofinity Commercial |
$51.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.54
|
| Rate for Payer: Healthscope Commercial |
$53.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.51
|
| Rate for Payer: PHP Commercial |
$50.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.62
|
| Rate for Payer: Priority Health SBD |
$37.43
|
|
|
HC OSTEOPATHIC MANIPULATION 5-6 BODY REGIONS
|
Facility
|
OP
|
$59.42
|
|
|
Service Code
|
CPT 98927
|
| Hospital Charge Code |
53000003
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$13.22 |
| Max. Negotiated Rate |
$69.44 |
| Rate for Payer: Aetna Commercial |
$50.51
|
| Rate for Payer: Aetna Medicare |
$25.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.84
|
| Rate for Payer: BCBS Complete |
$13.88
|
| Rate for Payer: BCBS MAPPO |
$24.67
|
| Rate for Payer: BCN Medicare Advantage |
$24.67
|
| Rate for Payer: Cash Price |
$47.54
|
| Rate for Payer: Cash Price |
$47.54
|
| Rate for Payer: Cofinity Commercial |
$51.10
|
| Rate for Payer: Cofinity Commercial |
$41.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.67
|
| Rate for Payer: Healthscope Commercial |
$53.48
|
| Rate for Payer: Mclaren Medicaid |
$13.22
|
| Rate for Payer: Mclaren Medicare |
$24.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$13.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.51
|
| Rate for Payer: PACE Medicare |
$23.44
|
| Rate for Payer: PACE SWMI |
$24.67
|
| Rate for Payer: PHP Commercial |
$50.51
|
| Rate for Payer: PHP Medicare Advantage |
$24.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.62
|
| Rate for Payer: Priority Health Medicare |
$24.67
|
| Rate for Payer: Priority Health SBD |
$37.43
|
| Rate for Payer: Railroad Medicare Medicare |
$24.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.67
|
| Rate for Payer: UHC Medicare Advantage |
$24.67
|
| Rate for Payer: UHCCP Medicaid |
$13.89
|
| Rate for Payer: VA VA |
$24.67
|
|
|
HC OSTEOPATHIC MANIPULATION 7-8 BODY REGIONS
|
Facility
|
IP
|
$60.73
|
|
|
Service Code
|
CPT 98928
|
| Hospital Charge Code |
53000004
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$38.26 |
| Max. Negotiated Rate |
$54.66 |
| Rate for Payer: Aetna Commercial |
$51.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.47
|
| Rate for Payer: Cash Price |
$48.58
|
| Rate for Payer: Cofinity Commercial |
$42.51
|
| Rate for Payer: Cofinity Commercial |
$52.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.58
|
| Rate for Payer: Healthscope Commercial |
$54.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.62
|
| Rate for Payer: PHP Commercial |
$51.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.47
|
| Rate for Payer: Priority Health SBD |
$38.26
|
|
|
HC OSTEOPATHIC MANIPULATION 7-8 BODY REGIONS
|
Facility
|
OP
|
$60.73
|
|
|
Service Code
|
CPT 98928
|
| Hospital Charge Code |
53000004
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$13.22 |
| Max. Negotiated Rate |
$69.44 |
| Rate for Payer: Aetna Commercial |
$51.62
|
| Rate for Payer: Aetna Medicare |
$25.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.84
|
| Rate for Payer: BCBS Complete |
$13.88
|
| Rate for Payer: BCBS MAPPO |
$24.67
|
| Rate for Payer: BCN Medicare Advantage |
$24.67
|
| Rate for Payer: Cash Price |
$48.58
|
| Rate for Payer: Cash Price |
$48.58
|
| Rate for Payer: Cofinity Commercial |
$52.23
|
| Rate for Payer: Cofinity Commercial |
$42.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.67
|
| Rate for Payer: Healthscope Commercial |
$54.66
|
| Rate for Payer: Mclaren Medicaid |
$13.22
|
| Rate for Payer: Mclaren Medicare |
$24.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$13.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.62
|
| Rate for Payer: PACE Medicare |
$23.44
|
| Rate for Payer: PACE SWMI |
$24.67
|
| Rate for Payer: PHP Commercial |
$51.62
|
| Rate for Payer: PHP Medicare Advantage |
$24.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.47
|
| Rate for Payer: Priority Health Medicare |
$24.67
|
| Rate for Payer: Priority Health SBD |
$38.26
|
| Rate for Payer: Railroad Medicare Medicare |
$24.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.67
|
| Rate for Payer: UHC Medicare Advantage |
$24.67
|
| Rate for Payer: UHCCP Medicaid |
$13.89
|
| Rate for Payer: VA VA |
$24.67
|
|
|
HC OSTEOPATHIC MANIPULATION 9-10 BODY REGIONS
|
Facility
|
IP
|
$65.61
|
|
|
Service Code
|
CPT 98929
|
| Hospital Charge Code |
53000005
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$41.33 |
| Max. Negotiated Rate |
$59.05 |
| Rate for Payer: Aetna Commercial |
$55.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.65
|
| Rate for Payer: Cash Price |
$52.49
|
| Rate for Payer: Cofinity Commercial |
$45.93
|
| Rate for Payer: Cofinity Commercial |
$56.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.49
|
| Rate for Payer: Healthscope Commercial |
$59.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.77
|
| Rate for Payer: PHP Commercial |
$55.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.65
|
| Rate for Payer: Priority Health SBD |
$41.33
|
|
|
HC OSTEOPATHIC MANIPULATION 9-10 BODY REGIONS
|
Facility
|
OP
|
$65.61
|
|
|
Service Code
|
CPT 98929
|
| Hospital Charge Code |
53000005
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$13.22 |
| Max. Negotiated Rate |
$69.44 |
| Rate for Payer: Aetna Commercial |
$55.77
|
| Rate for Payer: Aetna Medicare |
$25.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.84
|
| Rate for Payer: BCBS Complete |
$13.88
|
| Rate for Payer: BCBS MAPPO |
$24.67
|
| Rate for Payer: BCN Medicare Advantage |
$24.67
|
| Rate for Payer: Cash Price |
$52.49
|
| Rate for Payer: Cash Price |
$52.49
|
| Rate for Payer: Cofinity Commercial |
$56.42
|
| Rate for Payer: Cofinity Commercial |
$45.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.67
|
| Rate for Payer: Healthscope Commercial |
$59.05
|
| Rate for Payer: Mclaren Medicaid |
$13.22
|
| Rate for Payer: Mclaren Medicare |
$24.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$13.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.77
|
| Rate for Payer: PACE Medicare |
$23.44
|
| Rate for Payer: PACE SWMI |
$24.67
|
| Rate for Payer: PHP Commercial |
$55.77
|
| Rate for Payer: PHP Medicare Advantage |
$24.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.65
|
| Rate for Payer: Priority Health Medicare |
$24.67
|
| Rate for Payer: Priority Health SBD |
$41.33
|
| Rate for Payer: Railroad Medicare Medicare |
$24.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.67
|
| Rate for Payer: UHC Medicare Advantage |
$24.67
|
| Rate for Payer: UHCCP Medicaid |
$13.89
|
| Rate for Payer: VA VA |
$24.67
|
|
|
HC OSTIAL PRO SYSTEM
|
Facility
|
IP
|
$1,988.64
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,252.84 |
| Max. Negotiated Rate |
$1,789.78 |
| Rate for Payer: Aetna Commercial |
$1,690.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,292.62
|
| Rate for Payer: Cash Price |
$1,590.91
|
| Rate for Payer: Cofinity Commercial |
$1,392.05
|
| Rate for Payer: Cofinity Commercial |
$1,710.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,392.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,590.91
|
| Rate for Payer: Healthscope Commercial |
$1,789.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,690.34
|
| Rate for Payer: PHP Commercial |
$1,690.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,292.62
|
| Rate for Payer: Priority Health SBD |
$1,252.84
|
|
|
HC OSTIAL PRO SYSTEM
|
Facility
|
OP
|
$1,988.64
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$795.46 |
| Max. Negotiated Rate |
$1,789.78 |
| Rate for Payer: Aetna Commercial |
$1,690.34
|
| Rate for Payer: Aetna Medicare |
$994.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,292.62
|
| Rate for Payer: BCBS Complete |
$795.46
|
| Rate for Payer: Cash Price |
$1,590.91
|
| Rate for Payer: Cofinity Commercial |
$1,392.05
|
| Rate for Payer: Cofinity Commercial |
$1,710.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,392.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,590.91
|
| Rate for Payer: Healthscope Commercial |
$1,789.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,690.34
|
| Rate for Payer: PHP Commercial |
$1,690.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,292.62
|
| Rate for Payer: Priority Health SBD |
$1,252.84
|
|
|
HC OSTO-ZYME
|
Facility
|
OP
|
$43.10
|
|
| Hospital Charge Code |
27000129
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.24 |
| Max. Negotiated Rate |
$38.79 |
| Rate for Payer: Aetna Commercial |
$36.63
|
| Rate for Payer: Aetna Medicare |
$21.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.02
|
| Rate for Payer: BCBS Complete |
$17.24
|
| Rate for Payer: Cash Price |
$34.48
|
| Rate for Payer: Cofinity Commercial |
$30.17
|
| Rate for Payer: Cofinity Commercial |
$37.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.48
|
| Rate for Payer: Healthscope Commercial |
$38.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.63
|
| Rate for Payer: PHP Commercial |
$36.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.02
|
| Rate for Payer: Priority Health SBD |
$27.15
|
|
|
HC OSTO-ZYME
|
Facility
|
IP
|
$43.10
|
|
| Hospital Charge Code |
27000129
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$38.79 |
| Rate for Payer: Aetna Commercial |
$36.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.02
|
| Rate for Payer: Cash Price |
$34.48
|
| Rate for Payer: Cofinity Commercial |
$30.17
|
| Rate for Payer: Cofinity Commercial |
$37.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.48
|
| Rate for Payer: Healthscope Commercial |
$38.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.63
|
| Rate for Payer: PHP Commercial |
$36.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.02
|
| Rate for Payer: Priority Health SBD |
$27.15
|
|
