Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC

Facility

$53,599.72

Service Code	MS-DRG 939
Min. Negotiated Rate	$22,466.23
Max. Negotiated Rate	$53,599.72
Rate for Payer: Aetna Medicare	$24,594.61
Rate for Payer: Allen County Amish Medical Aid Commercial	$29,560.82
Rate for Payer: Amish Plain Church Group Commercial	$29,560.82
Rate for Payer: BCBS MAPPO	$23,648.66
Rate for Payer: BCBS Trust/PPO	$53,599.72
Rate for Payer: BCN Medicare Advantage	$23,648.66
Rate for Payer: Health Alliance Plan Medicare Advantage	$23,648.66
Rate for Payer: Mclaren Medicare	$23,648.66
Rate for Payer: Meridian Wellcare - Medicare Advantage	$24,831.09
Rate for Payer: MI Amish Medical Board Commercial	$27,195.96
Rate for Payer: PACE Medicare	$22,466.23
Rate for Payer: PACE SWMI	$23,648.66
Rate for Payer: PHP Medicare Advantage	$23,648.66
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$46,139.30
Rate for Payer: Priority Health Medicare	$23,648.66
Rate for Payer: Priority Health Narrow Network	$36,911.44
Rate for Payer: Railroad Medicare Medicare	$23,648.66
Rate for Payer: UHC All Payor (Choice/PPO)	$49,046.19
Rate for Payer: UHC Core	$30,095.21
Rate for Payer: UHC Dual Complete DSNP	$23,648.66
Rate for Payer: UHC Exchange	$32,233.38
Rate for Payer: UHC Medicare Advantage	$24,358.12
Rate for Payer: VA VA	$23,648.66

O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC

Facility

$30,290.24

Service Code	MS-DRG 941
Min. Negotiated Rate	$13,166.31
Max. Negotiated Rate	$30,290.24
Rate for Payer: Aetna Medicare	$14,413.64
Rate for Payer: Allen County Amish Medical Aid Commercial	$17,324.09
Rate for Payer: Amish Plain Church Group Commercial	$17,324.09
Rate for Payer: BCBS MAPPO	$13,859.27
Rate for Payer: BCBS Trust/PPO	$30,290.24
Rate for Payer: BCN Medicare Advantage	$13,859.27
Rate for Payer: Health Alliance Plan Medicare Advantage	$13,859.27
Rate for Payer: Mclaren Medicare	$13,859.27
Rate for Payer: Meridian Wellcare - Medicare Advantage	$14,552.23
Rate for Payer: MI Amish Medical Board Commercial	$15,938.16
Rate for Payer: PACE Medicare	$13,166.31
Rate for Payer: PACE SWMI	$13,859.27
Rate for Payer: PHP Medicare Advantage	$13,859.27
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$26,633.45
Rate for Payer: Priority Health Medicare	$13,859.27
Rate for Payer: Priority Health Narrow Network	$21,306.76
Rate for Payer: Railroad Medicare Medicare	$13,859.27
Rate for Payer: UHC All Payor (Choice/PPO)	$28,311.42
Rate for Payer: UHC Core	$17,372.16
Rate for Payer: UHC Dual Complete DSNP	$13,859.27
Rate for Payer: UHC Exchange	$18,606.40
Rate for Payer: UHC Medicare Advantage	$14,275.05
Rate for Payer: VA VA	$13,859.27

O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS

Facility

$56,920.30

Service Code	MS-DRG 876
Min. Negotiated Rate	$25,997.91
Max. Negotiated Rate	$56,920.30
Rate for Payer: Aetna Medicare	$28,460.87
Rate for Payer: Allen County Amish Medical Aid Commercial	$34,207.78
Rate for Payer: Amish Plain Church Group Commercial	$34,207.78
Rate for Payer: BCBS MAPPO	$27,366.22
Rate for Payer: BCBS Trust/PPO	$43,621.55
Rate for Payer: BCN Medicare Advantage	$27,366.22
Rate for Payer: Health Alliance Plan Medicare Advantage	$27,366.22
Rate for Payer: Mclaren Medicare	$27,366.22
Rate for Payer: Meridian Wellcare - Medicare Advantage	$28,734.53
Rate for Payer: MI Amish Medical Board Commercial	$31,471.15
Rate for Payer: PACE Medicare	$25,997.91
Rate for Payer: PACE SWMI	$27,366.22
Rate for Payer: PHP Medicare Advantage	$27,366.22
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$53,546.73
Rate for Payer: Priority Health Medicare	$27,366.22
Rate for Payer: Priority Health Narrow Network	$42,837.38
Rate for Payer: Railroad Medicare Medicare	$27,366.22
Rate for Payer: UHC All Payor (Choice/PPO)	$56,920.30
Rate for Payer: UHC Core	$34,926.84
Rate for Payer: UHC Dual Complete DSNP	$27,366.22
Rate for Payer: UHC Exchange	$37,408.29
Rate for Payer: UHC Medicare Advantage	$28,187.21
Rate for Payer: VA VA	$27,366.22

ORTHOVISC INJ PER DOSE

Professional

Both

$185.00

Service Code	HCPCS J7324
Min. Negotiated Rate	$74.00
Max. Negotiated Rate	$134.56
Rate for Payer: Aetna Commercial	$134.56
Rate for Payer: BCBS Complete	$74.00
Rate for Payer: BCBS Trust/PPO	$133.10
Rate for Payer: Cash Price	$148.00
Rate for Payer: Cash Price	$148.00
Rate for Payer: Priority Health Cigna Priority Health	$129.50

OSELTAMIVIR 30 MG CAPSULE

Facility

$479.49

Service Code	NDC 0004-0802-85
Hospital Charge Code	88704
Hospital Revenue Code	637
Min. Negotiated Rate	$302.08
Max. Negotiated Rate	$431.54
Rate for Payer: Aetna Commercial	$407.57
Rate for Payer: Aetna New Business (MI Preferred)	$311.67
Rate for Payer: Cash Price	$383.59
Rate for Payer: Cofinity Commercial	$335.64
Rate for Payer: Cofinity Commercial	$412.36
Rate for Payer: Healthscope Commercial	$431.54
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$407.57
Rate for Payer: PHP Commercial	$407.57
Rate for Payer: Priority Health Cigna Priority Health	$335.64
Rate for Payer: Priority Health SBD	$302.08

OSELTAMIVIR 30 MG CAPSULE

Facility

$38.74

Service Code	NDC 68180-675-11
Hospital Charge Code	88704
Hospital Revenue Code	637
Min. Negotiated Rate	$24.41
Max. Negotiated Rate	$34.87
Rate for Payer: Aetna Commercial	$32.93
Rate for Payer: Aetna New Business (MI Preferred)	$25.18
Rate for Payer: Cash Price	$30.99
Rate for Payer: Cofinity Commercial	$27.12
Rate for Payer: Cofinity Commercial	$33.32
Rate for Payer: Healthscope Commercial	$34.87
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$32.93
Rate for Payer: PHP Commercial	$32.93
Rate for Payer: Priority Health Cigna Priority Health	$27.12
Rate for Payer: Priority Health SBD	$24.41

OSELTAMIVIR 30 MG CAPSULE

Facility

$322.05

Service Code	NDC 47781-468-13
Hospital Charge Code	88704
Hospital Revenue Code	637
Min. Negotiated Rate	$202.89
Max. Negotiated Rate	$289.84
Rate for Payer: Aetna Commercial	$273.74
Rate for Payer: Aetna New Business (MI Preferred)	$209.33
Rate for Payer: Cash Price	$257.64
Rate for Payer: Cofinity Commercial	$225.44
Rate for Payer: Cofinity Commercial	$276.96
Rate for Payer: Healthscope Commercial	$289.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$273.74
Rate for Payer: PHP Commercial	$273.74
Rate for Payer: Priority Health Cigna Priority Health	$225.44
Rate for Payer: Priority Health SBD	$202.89

OSELTAMIVIR 30 MG CAPSULE

Facility

$73.68

Service Code	NDC 72205-042-11
Hospital Charge Code	88704
Hospital Revenue Code	637
Min. Negotiated Rate	$46.42
Max. Negotiated Rate	$66.31
Rate for Payer: Aetna Commercial	$62.63
Rate for Payer: Aetna New Business (MI Preferred)	$47.89
Rate for Payer: Cash Price	$58.94
Rate for Payer: Cofinity Commercial	$51.58
Rate for Payer: Cofinity Commercial	$63.36
Rate for Payer: Healthscope Commercial	$66.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$62.63
Rate for Payer: PHP Commercial	$62.63
Rate for Payer: Priority Health Cigna Priority Health	$51.58
Rate for Payer: Priority Health SBD	$46.42

OSELTAMIVIR 6 MG/ML ORAL SUSPENSION

Facility

$522.59

Service Code	NDC 0004-0822-05
Hospital Charge Code	153071
Hospital Revenue Code	637
Min. Negotiated Rate	$329.23
Max. Negotiated Rate	$470.33
Rate for Payer: Aetna Commercial	$444.20
Rate for Payer: Aetna New Business (MI Preferred)	$339.68
Rate for Payer: Cash Price	$418.07
Rate for Payer: Cofinity Commercial	$365.81
Rate for Payer: Cofinity Commercial	$449.43
Rate for Payer: Healthscope Commercial	$470.33
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$444.20
Rate for Payer: PHP Commercial	$444.20
Rate for Payer: Priority Health Cigna Priority Health	$365.81
Rate for Payer: Priority Health SBD	$329.23

OSELTAMIVIR 6 MG/ML ORAL SUSPENSION

Facility

$447.56

Service Code	NDC 47781-384-26
Hospital Charge Code	153071
Hospital Revenue Code	637
Min. Negotiated Rate	$281.96
Max. Negotiated Rate	$402.80
Rate for Payer: Aetna Commercial	$380.43
Rate for Payer: Aetna New Business (MI Preferred)	$290.91
Rate for Payer: Cash Price	$358.05
Rate for Payer: Cofinity Commercial	$313.29
Rate for Payer: Cofinity Commercial	$384.90
Rate for Payer: Healthscope Commercial	$402.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$380.43
Rate for Payer: PHP Commercial	$380.43
Rate for Payer: Priority Health Cigna Priority Health	$313.29
Rate for Payer: Priority Health SBD	$281.96

OSELTAMIVIR 75 MG CAPSULE

Facility

$522.63

Service Code	NDC 0004-0800-85
Hospital Charge Code	26546
Hospital Revenue Code	637
Min. Negotiated Rate	$329.26
Max. Negotiated Rate	$470.37
Rate for Payer: Aetna Commercial	$444.24
Rate for Payer: Aetna New Business (MI Preferred)	$339.71
Rate for Payer: Cash Price	$418.10
Rate for Payer: Cofinity Commercial	$365.84
Rate for Payer: Cofinity Commercial	$449.46
Rate for Payer: Healthscope Commercial	$470.37
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$444.24
Rate for Payer: PHP Commercial	$444.24
Rate for Payer: Priority Health Cigna Priority Health	$365.84
Rate for Payer: Priority Health SBD	$329.26

OSELTAMIVIR 75 MG CAPSULE

Facility

$276.21

Service Code	NDC 70710-1010-2
Hospital Charge Code	26546
Hospital Revenue Code	637
Min. Negotiated Rate	$174.01
Max. Negotiated Rate	$248.59
Rate for Payer: Aetna Commercial	$234.78
Rate for Payer: Aetna New Business (MI Preferred)	$179.54
Rate for Payer: Cash Price	$220.97
Rate for Payer: Cofinity Commercial	$193.35
Rate for Payer: Cofinity Commercial	$237.54
Rate for Payer: Healthscope Commercial	$248.59
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$234.78
Rate for Payer: PHP Commercial	$234.78
Rate for Payer: Priority Health Cigna Priority Health	$193.35
Rate for Payer: Priority Health SBD	$174.01

OSELTAMIVIR 75 MG CAPSULE

Facility

$82.61

Service Code	NDC 72205-044-11
Hospital Charge Code	26546
Hospital Revenue Code	637
Min. Negotiated Rate	$52.04
Max. Negotiated Rate	$74.35
Rate for Payer: Aetna Commercial	$70.22
Rate for Payer: Aetna New Business (MI Preferred)	$53.70
Rate for Payer: Cash Price	$66.09
Rate for Payer: Cofinity Commercial	$57.83
Rate for Payer: Cofinity Commercial	$71.04
Rate for Payer: Healthscope Commercial	$74.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$70.22
Rate for Payer: PHP Commercial	$70.22
Rate for Payer: Priority Health Cigna Priority Health	$57.83
Rate for Payer: Priority Health SBD	$52.04

OSELTAMIVIR 75 MG CAPSULE

Facility

$351.02

Service Code	NDC 47781-470-13
Hospital Charge Code	26546
Hospital Revenue Code	637
Min. Negotiated Rate	$221.14
Max. Negotiated Rate	$315.92
Rate for Payer: Aetna Commercial	$298.37
Rate for Payer: Aetna New Business (MI Preferred)	$228.16
Rate for Payer: Cash Price	$280.82
Rate for Payer: Cofinity Commercial	$245.71
Rate for Payer: Cofinity Commercial	$301.88
Rate for Payer: Healthscope Commercial	$315.92
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$298.37
Rate for Payer: PHP Commercial	$298.37
Rate for Payer: Priority Health Cigna Priority Health	$245.71
Rate for Payer: Priority Health SBD	$221.14

OSELTAMIVIR 75 MG CAPSULE

Facility

$82.61

Service Code	NDC 64380-799-01
Hospital Charge Code	26546
Hospital Revenue Code	637
Min. Negotiated Rate	$52.04
Max. Negotiated Rate	$74.35
Rate for Payer: Aetna Commercial	$70.22
Rate for Payer: Aetna New Business (MI Preferred)	$53.70
Rate for Payer: Cash Price	$66.09
Rate for Payer: Cofinity Commercial	$57.83
Rate for Payer: Cofinity Commercial	$71.04
Rate for Payer: Healthscope Commercial	$74.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$70.22
Rate for Payer: PHP Commercial	$70.22
Rate for Payer: Priority Health Cigna Priority Health	$57.83
Rate for Payer: Priority Health SBD	$52.04

OSELTAMIVIR 75 MG CAPSULE

Facility

$52.42

Service Code	NDC 68180-677-11
Hospital Charge Code	26546
Hospital Revenue Code	637
Min. Negotiated Rate	$33.02
Max. Negotiated Rate	$47.18
Rate for Payer: Aetna Commercial	$44.56
Rate for Payer: Aetna New Business (MI Preferred)	$34.07
Rate for Payer: Cash Price	$41.94
Rate for Payer: Cofinity Commercial	$36.69
Rate for Payer: Cofinity Commercial	$45.08
Rate for Payer: Healthscope Commercial	$47.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$44.56
Rate for Payer: PHP Commercial	$44.56
Rate for Payer: Priority Health Cigna Priority Health	$36.69
Rate for Payer: Priority Health SBD	$33.02

OSMOLITE 1.2 CONTINUOUS FEED

Facility

$9.60

Service Code	NDC 7007462698
Hospital Charge Code	301611
Hospital Revenue Code	637
Min. Negotiated Rate	$6.05
Max. Negotiated Rate	$8.64
Rate for Payer: Aetna Commercial	$8.16
Rate for Payer: Aetna New Business (MI Preferred)	$6.24
Rate for Payer: Cash Price	$7.68
Rate for Payer: Cofinity Commercial	$6.72
Rate for Payer: Cofinity Commercial	$8.26
Rate for Payer: Healthscope Commercial	$8.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$8.16
Rate for Payer: PHP Commercial	$8.16
Rate for Payer: Priority Health Cigna Priority Health	$6.72
Rate for Payer: Priority Health SBD	$6.05

OSTECTOMY, CALCANEUS;

Facility

$8,925.64

Service Code	CPT 28118
Hospital Revenue Code	360
Min. Negotiated Rate	$419.78
Max. Negotiated Rate	$8,925.64
Rate for Payer: Aetna Medicare	$2,995.31
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: Health Alliance Plan Medicare Advantage	$2,880.11
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: PACE Medicare	$2,736.10
Rate for Payer: PACE SWMI	$2,880.11
Rate for Payer: PHP Medicare Advantage	$2,880.11
Rate for Payer: Priority Health Choice Medicaid	$1,575.42
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: Railroad Medicare Medicare	$2,880.11
Rate for Payer: UHC All Payor (Choice/PPO)	$461.76
Rate for Payer: UHC Core	$4,155.00
Rate for Payer: UHC Dual Complete DSNP	$2,880.11
Rate for Payer: UHC Exchange	$419.78
Rate for Payer: UHC Medicare Advantage	$2,966.51
Rate for Payer: VA VA	$2,880.11

OSTECTOMY, CALCANEUS; FOR SPUR, WITH OR WITHOUT PLANTAR FASCIAL RELEASE

Facility

$8,925.64

Service Code	CPT 28119
Hospital Revenue Code	360
Min. Negotiated Rate	$361.82
Max. Negotiated Rate	$8,925.64
Rate for Payer: Aetna Medicare	$2,995.31
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	$1,752.48
Rate for Payer: BCN Medicare Advantage	$2,880.11
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,880.11
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: PACE Medicare	$2,736.10
Rate for Payer: PACE SWMI	$2,880.11
Rate for Payer: PHP Medicare Advantage	$2,880.11
Rate for Payer: Priority Health Choice Medicaid	$1,575.42
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: Railroad Medicare Medicare	$2,880.11
Rate for Payer: UHC All Payor (Choice/PPO)	$398.00
Rate for Payer: UHC Core	$4,155.00
Rate for Payer: UHC Dual Complete DSNP	$2,880.11
Rate for Payer: UHC Exchange	$361.82
Rate for Payer: UHC Medicare Advantage	$2,966.51
Rate for Payer: VA VA	$2,880.11

OSTECTOMY, COMPLETE EXCISION; FIRST METATARSAL HEAD

Facility

$8,925.64

Service Code	CPT 28111
Hospital Revenue Code	360
Min. Negotiated Rate	$315.65
Max. Negotiated Rate	$8,925.64
Rate for Payer: Aetna Medicare	$2,995.31
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: Health Alliance Plan Medicare Advantage	$2,880.11
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: PACE Medicare	$2,736.10
Rate for Payer: PACE SWMI	$2,880.11
Rate for Payer: PHP Medicare Advantage	$2,880.11
Rate for Payer: Priority Health Choice Medicaid	$1,575.42
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: Railroad Medicare Medicare	$2,880.11
Rate for Payer: UHC All Payor (Choice/PPO)	$347.22
Rate for Payer: UHC Core	$4,155.00
Rate for Payer: UHC Dual Complete DSNP	$2,880.11
Rate for Payer: UHC Exchange	$315.65
Rate for Payer: UHC Medicare Advantage	$2,966.51
Rate for Payer: VA VA	$2,880.11

OSTECTOMY, COMPLETE EXCISION; OTHER METATARSAL HEAD (SECOND, THIRD OR FOURTH)

Facility

$8,925.64

Service Code	CPT 28112
Hospital Revenue Code	360
Min. Negotiated Rate	$310.74
Max. Negotiated Rate	$8,925.64
Rate for Payer: Aetna Medicare	$2,995.31
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: Health Alliance Plan Medicare Advantage	$2,880.11
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: PACE Medicare	$2,736.10
Rate for Payer: PACE SWMI	$2,880.11
Rate for Payer: PHP Medicare Advantage	$2,880.11
Rate for Payer: Priority Health Choice Medicaid	$1,575.42
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: Railroad Medicare Medicare	$2,880.11
Rate for Payer: UHC All Payor (Choice/PPO)	$341.81
Rate for Payer: UHC Core	$4,155.00
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

OSTECTOMY, PARTIAL EXCISION, FIFTH METATARSAL HEAD (BUNIONETTE) (SEPARATE PROCEDURE)

Facility

$8,925.64

Service Code	CPT 28110
Hospital Revenue Code	360
Min. Negotiated Rate	$291.75
Max. Negotiated Rate	$8,925.64
Rate for Payer: Aetna Medicare	$2,995.31
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	$1,560.94
Rate for Payer: BCN Medicare Advantage	$2,880.11
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,880.11
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: PACE Medicare	$2,736.10
Rate for Payer: PACE SWMI	$2,880.11
Rate for Payer: PHP Medicare Advantage	$2,880.11
Rate for Payer: Priority Health Choice Medicaid	$1,575.42
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: Railroad Medicare Medicare	$2,880.11
Rate for Payer: UHC All Payor (Choice/PPO)	$320.92
Rate for Payer: UHC Core	$4,155.00
Rate for Payer: UHC Dual Complete DSNP	$2,880.11
Rate for Payer: UHC Exchange	$291.75
Rate for Payer: UHC Medicare Advantage	$2,966.51
Rate for Payer: VA VA	$2,880.11

OSTECTOMY, PARTIAL, EXOSTECTOMY OR CONDYLECTOMY, METATARSAL HEAD, EACH METATARSAL HEAD

Facility

$4,155.00

Service Code	CPT 28288
Hospital Revenue Code	360
Min. Negotiated Rate	$432.55
Max. Negotiated Rate	$4,155.00
Rate for Payer: Aetna Medicare	$2,995.31
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: Health Alliance Plan Medicare Advantage	$2,880.11
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: PACE Medicare	$2,736.10
Rate for Payer: PACE SWMI	$2,880.11
Rate for Payer: PHP Medicare Advantage	$2,880.11
Rate for Payer: Priority Health Choice Medicaid	$1,575.42
Rate for Payer: Priority Health Medicare	$2,880.11
Rate for Payer: Railroad Medicare Medicare	$2,880.11
Rate for Payer: UHC All Payor (Choice/PPO)	$475.80
Rate for Payer: UHC Core	$4,155.00
Rate for Payer: UHC Dual Complete DSNP	$2,880.11
Rate for Payer: UHC Exchange	$432.55
Rate for Payer: UHC Medicare Advantage	$2,966.51
Rate for Payer: VA VA	$2,880.11

OSTEOMYELITIS WITH CC

Facility

$19,802.74

Service Code	MS-DRG 540
Min. Negotiated Rate	$9,350.00
Max. Negotiated Rate	$19,802.74
Rate for Payer: Aetna Medicare	$10,235.78
Rate for Payer: Allen County Amish Medical Aid Commercial	$12,302.62
Rate for Payer: Amish Plain Church Group Commercial	$12,302.62
Rate for Payer: BCBS MAPPO	$9,842.10
Rate for Payer: BCBS Trust/PPO	$17,193.90
Rate for Payer: BCN Medicare Advantage	$9,842.10
Rate for Payer: Health Alliance Plan Medicare Advantage	$9,842.10
Rate for Payer: Mclaren Medicare	$9,842.10
Rate for Payer: Meridian Wellcare - Medicare Advantage	$10,334.20
Rate for Payer: MI Amish Medical Board Commercial	$11,318.42
Rate for Payer: PACE Medicare	$9,350.00
Rate for Payer: PACE SWMI	$9,842.10
Rate for Payer: PHP Medicare Advantage	$9,842.10
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$18,629.07
Rate for Payer: Priority Health Medicare	$9,842.10
Rate for Payer: Priority Health Narrow Network	$14,903.26
Rate for Payer: Railroad Medicare Medicare	$9,842.10
Rate for Payer: UHC All Payor (Choice/PPO)	$19,802.74
Rate for Payer: UHC Core	$12,151.15
Rate for Payer: UHC Dual Complete DSNP	$9,842.10
Rate for Payer: UHC Exchange	$13,014.46
Rate for Payer: UHC Medicare Advantage	$10,137.36
Rate for Payer: VA VA	$9,842.10

OSTEOMYELITIS WITH MCC

Facility

$30,270.04

Service Code	MS-DRG 539
Min. Negotiated Rate	$14,044.77
Max. Negotiated Rate	$30,270.04
Rate for Payer: Aetna Medicare	$15,375.33
Rate for Payer: Allen County Amish Medical Aid Commercial	$18,479.96
Rate for Payer: Amish Plain Church Group Commercial	$18,479.96
Rate for Payer: BCBS MAPPO	$14,783.97
Rate for Payer: BCBS Trust/PPO	$23,724.50
Rate for Payer: BCN Medicare Advantage	$14,783.97
Rate for Payer: Health Alliance Plan Medicare Advantage	$14,783.97
Rate for Payer: Mclaren Medicare	$14,783.97
Rate for Payer: Meridian Wellcare - Medicare Advantage	$15,523.17
Rate for Payer: MI Amish Medical Board Commercial	$17,001.57
Rate for Payer: PACE Medicare	$14,044.77
Rate for Payer: PACE SWMI	$14,783.97
Rate for Payer: PHP Medicare Advantage	$14,783.97
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$28,475.98
Rate for Payer: Priority Health Medicare	$14,783.97
Rate for Payer: Priority Health Narrow Network	$22,780.78
Rate for Payer: Railroad Medicare Medicare	$14,783.97
Rate for Payer: UHC All Payor (Choice/PPO)	$30,270.04
Rate for Payer: UHC Core	$18,573.98
Rate for Payer: UHC Dual Complete DSNP	$14,783.97
Rate for Payer: UHC Exchange	$19,893.61
Rate for Payer: UHC Medicare Advantage	$15,227.49
Rate for Payer: VA VA	$14,783.97

Know your out-of-pocket cost for care.

All Charges