|
HC ORTHO/PROSTH MGMT SUBSEQ EA 15 MIN
|
Facility
|
OP
|
$126.91
|
|
|
Service Code
|
CPT 97763
|
| Hospital Charge Code |
42000056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$30.14 |
| Max. Negotiated Rate |
$114.22 |
| Rate for Payer: Aetna Commercial |
$107.87
|
| Rate for Payer: Aetna Medicare |
$33.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.66
|
| Rate for Payer: BCBS Complete |
$50.76
|
| Rate for Payer: BCBS MAPPO |
$31.73
|
| Rate for Payer: BCBS Trust/PPO |
$98.67
|
| Rate for Payer: BCN Commercial |
$98.67
|
| Rate for Payer: BCN Medicare Advantage |
$31.73
|
| Rate for Payer: Cash Price |
$101.53
|
| Rate for Payer: Cofinity Commercial |
$109.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.73
|
| Rate for Payer: Healthscope Commercial |
$114.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$107.87
|
| Rate for Payer: PACE Senior Care Partners |
$30.14
|
| Rate for Payer: PACE SWMI |
$31.73
|
| Rate for Payer: PHP Commercial |
$107.87
|
| Rate for Payer: PHP Medicare Advantage |
$31.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.41
|
| Rate for Payer: Priority Health Medicare |
$31.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.40
|
| Rate for Payer: Railroad Medicare Medicare |
$31.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.68
|
| Rate for Payer: UHC Core |
$105.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.73
|
| Rate for Payer: UHC Medicare Advantage |
$32.68
|
| Rate for Payer: VA VA |
$31.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.18
|
|
|
HC ORTHOTIC FIT/TRAIN INITIAL EA 15 MIN
|
Facility
|
OP
|
$122.43
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
42000039
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$29.08 |
| Max. Negotiated Rate |
$110.19 |
| Rate for Payer: Aetna Commercial |
$104.07
|
| Rate for Payer: Aetna Medicare |
$31.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.26
|
| Rate for Payer: BCBS Complete |
$48.97
|
| Rate for Payer: BCBS MAPPO |
$30.61
|
| Rate for Payer: BCBS Trust/PPO |
$95.19
|
| Rate for Payer: BCN Commercial |
$95.19
|
| Rate for Payer: BCN Medicare Advantage |
$30.61
|
| Rate for Payer: Cash Price |
$97.94
|
| Rate for Payer: Cofinity Commercial |
$105.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.61
|
| Rate for Payer: Healthscope Commercial |
$110.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.07
|
| Rate for Payer: PACE Senior Care Partners |
$29.08
|
| Rate for Payer: PACE SWMI |
$30.61
|
| Rate for Payer: PHP Commercial |
$104.07
|
| Rate for Payer: PHP Medicare Advantage |
$30.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.51
|
| Rate for Payer: Priority Health Medicare |
$30.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.67
|
| Rate for Payer: Railroad Medicare Medicare |
$30.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.74
|
| Rate for Payer: UHC Core |
$102.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.61
|
| Rate for Payer: UHC Medicare Advantage |
$31.53
|
| Rate for Payer: VA VA |
$30.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.82
|
|
|
HC ORTHOTIC FIT/TRAIN INITIAL EA 15 MIN
|
Facility
|
IP
|
$122.43
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
42000039
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$74.67 |
| Max. Negotiated Rate |
$110.19 |
| Rate for Payer: Aetna Commercial |
$104.07
|
| Rate for Payer: BCBS Trust/PPO |
$94.61
|
| Rate for Payer: BCN Commercial |
$94.61
|
| Rate for Payer: Cash Price |
$97.94
|
| Rate for Payer: Cofinity Commercial |
$105.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.94
|
| Rate for Payer: Healthscope Commercial |
$110.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.07
|
| Rate for Payer: PHP Commercial |
$104.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.74
|
| Rate for Payer: UHC Core |
$102.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.82
|
|
|
HC OSCILLATOR INIT DAY
|
Facility
|
OP
|
$2,363.12
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000039
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$411.09 |
| Max. Negotiated Rate |
$2,126.81 |
| Rate for Payer: Aetna Commercial |
$2,008.65
|
| Rate for Payer: Aetna Medicare |
$614.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$738.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$738.48
|
| Rate for Payer: BCBS Complete |
$431.64
|
| Rate for Payer: BCBS MAPPO |
$590.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,837.33
|
| Rate for Payer: BCN Commercial |
$1,837.33
|
| Rate for Payer: BCN Medicare Advantage |
$590.78
|
| Rate for Payer: Cash Price |
$1,890.50
|
| Rate for Payer: Cash Price |
$1,890.50
|
| Rate for Payer: Cofinity Commercial |
$2,032.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,890.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$590.78
|
| Rate for Payer: Healthscope Commercial |
$2,126.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,772.34
|
| Rate for Payer: Mclaren Medicaid |
$411.09
|
| Rate for Payer: Meridian Medicaid |
$431.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$620.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$679.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,008.65
|
| Rate for Payer: PACE Senior Care Partners |
$561.24
|
| Rate for Payer: PACE SWMI |
$590.78
|
| Rate for Payer: PHP Commercial |
$2,008.65
|
| Rate for Payer: PHP Medicare Advantage |
$590.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,055.91
|
| Rate for Payer: Priority Health Medicare |
$590.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,441.27
|
| Rate for Payer: Railroad Medicare Medicare |
$590.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,079.55
|
| Rate for Payer: UHC Core |
$1,973.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$590.78
|
| Rate for Payer: UHC Medicare Advantage |
$608.50
|
| Rate for Payer: VA VA |
$590.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,772.34
|
|
|
HC OSCILLATOR INIT DAY
|
Facility
|
IP
|
$2,363.12
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000039
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,441.27 |
| Max. Negotiated Rate |
$2,126.81 |
| Rate for Payer: Aetna Commercial |
$2,008.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,826.22
|
| Rate for Payer: BCN Commercial |
$1,826.22
|
| Rate for Payer: Cash Price |
$1,890.50
|
| Rate for Payer: Cofinity Commercial |
$2,032.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,890.50
|
| Rate for Payer: Healthscope Commercial |
$2,126.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,772.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,008.65
|
| Rate for Payer: PHP Commercial |
$2,008.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,055.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,441.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,079.55
|
| Rate for Payer: UHC Core |
$1,973.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,772.34
|
|
|
HC OSCILLATOR SUB DAY
|
Facility
|
IP
|
$1,321.84
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000040
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$806.19 |
| Max. Negotiated Rate |
$1,189.66 |
| Rate for Payer: Aetna Commercial |
$1,123.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,021.52
|
| Rate for Payer: BCN Commercial |
$1,021.52
|
| Rate for Payer: Cash Price |
$1,057.47
|
| Rate for Payer: Cofinity Commercial |
$1,136.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,057.47
|
| Rate for Payer: Healthscope Commercial |
$1,189.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$991.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,123.56
|
| Rate for Payer: PHP Commercial |
$1,123.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$806.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,163.22
|
| Rate for Payer: UHC Core |
$1,103.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$991.38
|
|
|
HC OSCILLATOR SUB DAY
|
Facility
|
OP
|
$1,321.84
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000040
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$313.94 |
| Max. Negotiated Rate |
$1,189.66 |
| Rate for Payer: Aetna Commercial |
$1,123.56
|
| Rate for Payer: Aetna Medicare |
$343.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$413.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$413.08
|
| Rate for Payer: BCBS Complete |
$431.64
|
| Rate for Payer: BCBS MAPPO |
$330.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,027.73
|
| Rate for Payer: BCN Commercial |
$1,027.73
|
| Rate for Payer: BCN Medicare Advantage |
$330.46
|
| Rate for Payer: Cash Price |
$1,057.47
|
| Rate for Payer: Cash Price |
$1,057.47
|
| Rate for Payer: Cofinity Commercial |
$1,136.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,057.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.46
|
| Rate for Payer: Healthscope Commercial |
$1,189.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$991.38
|
| Rate for Payer: Mclaren Medicaid |
$411.09
|
| Rate for Payer: Meridian Medicaid |
$431.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$346.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$380.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,123.56
|
| Rate for Payer: PACE Senior Care Partners |
$313.94
|
| Rate for Payer: PACE SWMI |
$330.46
|
| Rate for Payer: PHP Commercial |
$1,123.56
|
| Rate for Payer: PHP Medicare Advantage |
$330.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.00
|
| Rate for Payer: Priority Health Medicare |
$330.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$806.19
|
| Rate for Payer: Railroad Medicare Medicare |
$330.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,163.22
|
| Rate for Payer: UHC Core |
$1,103.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$330.46
|
| Rate for Payer: UHC Medicare Advantage |
$340.37
|
| Rate for Payer: VA VA |
$330.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$991.38
|
|
|
HC OSMOLALITY SERUM
|
Facility
|
IP
|
$53.86
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
30100378
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.85 |
| Max. Negotiated Rate |
$48.47 |
| Rate for Payer: Aetna Commercial |
$45.78
|
| Rate for Payer: BCBS Trust/PPO |
$41.62
|
| Rate for Payer: BCN Commercial |
$41.62
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$46.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.09
|
| Rate for Payer: Healthscope Commercial |
$48.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.78
|
| Rate for Payer: PHP Commercial |
$45.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.40
|
| Rate for Payer: UHC Core |
$44.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.40
|
|
|
HC OSMOLALITY SERUM
|
Facility
|
OP
|
$53.86
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
30100378
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.88 |
| Max. Negotiated Rate |
$48.47 |
| Rate for Payer: Aetna Commercial |
$45.78
|
| Rate for Payer: Aetna Medicare |
$14.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.83
|
| Rate for Payer: BCBS Complete |
$5.12
|
| Rate for Payer: BCBS MAPPO |
$13.46
|
| Rate for Payer: BCBS Trust/PPO |
$41.88
|
| Rate for Payer: BCN Commercial |
$41.88
|
| Rate for Payer: BCN Medicare Advantage |
$13.46
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$46.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.46
|
| Rate for Payer: Healthscope Commercial |
$48.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.40
|
| Rate for Payer: Mclaren Medicaid |
$4.88
|
| Rate for Payer: Meridian Medicaid |
$5.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.78
|
| Rate for Payer: PACE Senior Care Partners |
$12.79
|
| Rate for Payer: PACE SWMI |
$13.46
|
| Rate for Payer: PHP Commercial |
$45.78
|
| Rate for Payer: PHP Medicare Advantage |
$13.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.86
|
| Rate for Payer: Priority Health Medicare |
$13.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.40
|
| Rate for Payer: UHC Core |
$44.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.46
|
| Rate for Payer: UHC Medicare Advantage |
$13.87
|
| Rate for Payer: VA VA |
$13.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.40
|
|
|
HC OSMOLALITY URINE
|
Facility
|
IP
|
$52.80
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
30100379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$47.52 |
| Rate for Payer: Aetna Commercial |
$44.88
|
| Rate for Payer: BCBS Trust/PPO |
$40.80
|
| Rate for Payer: BCN Commercial |
$40.80
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cofinity Commercial |
$45.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.24
|
| Rate for Payer: Healthscope Commercial |
$47.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.88
|
| Rate for Payer: PHP Commercial |
$44.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.46
|
| Rate for Payer: UHC Core |
$44.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.60
|
|
|
HC OSMOLALITY URINE
|
Facility
|
OP
|
$52.80
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
30100379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.03 |
| Max. Negotiated Rate |
$47.52 |
| Rate for Payer: Aetna Commercial |
$44.88
|
| Rate for Payer: Aetna Medicare |
$13.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.50
|
| Rate for Payer: BCBS Complete |
$5.28
|
| Rate for Payer: BCBS MAPPO |
$13.20
|
| Rate for Payer: BCBS Trust/PPO |
$41.05
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: BCN Medicare Advantage |
$13.20
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cofinity Commercial |
$45.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.20
|
| Rate for Payer: Healthscope Commercial |
$47.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.60
|
| Rate for Payer: Mclaren Medicaid |
$5.03
|
| Rate for Payer: Meridian Medicaid |
$5.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.88
|
| Rate for Payer: PACE Senior Care Partners |
$12.54
|
| Rate for Payer: PACE SWMI |
$13.20
|
| Rate for Payer: PHP Commercial |
$44.88
|
| Rate for Payer: PHP Medicare Advantage |
$13.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.94
|
| Rate for Payer: Priority Health Medicare |
$13.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.20
|
| Rate for Payer: Railroad Medicare Medicare |
$13.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.46
|
| Rate for Payer: UHC Core |
$44.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.20
|
| Rate for Payer: UHC Medicare Advantage |
$13.60
|
| Rate for Payer: VA VA |
$13.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.60
|
|
|
HC OSMOTIC FRAGILITY RBC
|
Facility
|
IP
|
$128.84
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
30500052
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$78.58 |
| Max. Negotiated Rate |
$115.96 |
| Rate for Payer: Aetna Commercial |
$109.51
|
| Rate for Payer: BCBS Trust/PPO |
$99.57
|
| Rate for Payer: BCN Commercial |
$99.57
|
| Rate for Payer: Cash Price |
$103.07
|
| Rate for Payer: Cofinity Commercial |
$110.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.07
|
| Rate for Payer: Healthscope Commercial |
$115.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.51
|
| Rate for Payer: PHP Commercial |
$109.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.38
|
| Rate for Payer: UHC Core |
$107.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.63
|
|
|
HC OSMOTIC FRAGILITY RBC
|
Facility
|
OP
|
$128.84
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
30500052
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$115.96 |
| Rate for Payer: Aetna Commercial |
$109.51
|
| Rate for Payer: Aetna Medicare |
$33.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.26
|
| Rate for Payer: BCBS Complete |
$10.35
|
| Rate for Payer: BCBS MAPPO |
$32.21
|
| Rate for Payer: BCBS Trust/PPO |
$100.17
|
| Rate for Payer: BCN Commercial |
$100.17
|
| Rate for Payer: BCN Medicare Advantage |
$32.21
|
| Rate for Payer: Cash Price |
$103.07
|
| Rate for Payer: Cash Price |
$103.07
|
| Rate for Payer: Cofinity Commercial |
$110.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.21
|
| Rate for Payer: Healthscope Commercial |
$115.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.63
|
| Rate for Payer: Mclaren Medicaid |
$9.86
|
| Rate for Payer: Meridian Medicaid |
$10.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.51
|
| Rate for Payer: PACE Senior Care Partners |
$30.60
|
| Rate for Payer: PACE SWMI |
$32.21
|
| Rate for Payer: PHP Commercial |
$109.51
|
| Rate for Payer: PHP Medicare Advantage |
$32.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.09
|
| Rate for Payer: Priority Health Medicare |
$32.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.58
|
| Rate for Payer: Railroad Medicare Medicare |
$32.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.38
|
| Rate for Payer: UHC Core |
$107.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.21
|
| Rate for Payer: UHC Medicare Advantage |
$33.18
|
| Rate for Payer: VA VA |
$32.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.63
|
|
|
HC OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Facility
|
IP
|
$8,200.00
|
|
|
Service Code
|
CPT 28111
|
| Hospital Charge Code |
76100365
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,001.18 |
| Max. Negotiated Rate |
$7,380.00 |
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,336.96
|
| Rate for Payer: BCN Commercial |
$6,336.96
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$7,052.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,560.00
|
| Rate for Payer: Healthscope Commercial |
$7,380.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,150.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PHP Commercial |
$6,970.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,134.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,001.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,216.00
|
| Rate for Payer: UHC Core |
$6,847.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,150.00
|
|
|
HC OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Facility
|
OP
|
$8,200.00
|
|
|
Service Code
|
CPT 28111
|
| Hospital Charge Code |
76100365
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,947.50 |
| Max. Negotiated Rate |
$7,380.00 |
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: Aetna Medicare |
$2,132.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,562.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,562.50
|
| Rate for Payer: BCBS Complete |
$2,229.50
|
| Rate for Payer: BCBS MAPPO |
$2,050.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,375.50
|
| Rate for Payer: BCN Commercial |
$6,375.50
|
| Rate for Payer: BCN Medicare Advantage |
$2,050.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$7,052.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,560.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,050.00
|
| Rate for Payer: Healthscope Commercial |
$7,380.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,150.00
|
| Rate for Payer: Mclaren Medicaid |
$2,123.34
|
| Rate for Payer: Meridian Medicaid |
$2,229.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,152.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,357.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,947.50
|
| Rate for Payer: PACE SWMI |
$2,050.00
|
| Rate for Payer: PHP Commercial |
$6,970.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,050.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,123.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,134.00
|
| Rate for Payer: Priority Health Medicare |
$2,050.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,001.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,050.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,216.00
|
| Rate for Payer: UHC Core |
$6,847.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,050.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,111.50
|
| Rate for Payer: VA VA |
$2,050.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,150.00
|
|
|
HC OSTECTOMY COMPLETE 2,3 OR 4TH METATARSAL HEAD
|
Facility
|
OP
|
$8,200.00
|
|
|
Service Code
|
CPT 28112
|
| Hospital Charge Code |
76100366
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,947.50 |
| Max. Negotiated Rate |
$7,380.00 |
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: Aetna Medicare |
$2,132.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,562.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,562.50
|
| Rate for Payer: BCBS Complete |
$2,229.50
|
| Rate for Payer: BCBS MAPPO |
$2,050.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,375.50
|
| Rate for Payer: BCN Commercial |
$6,375.50
|
| Rate for Payer: BCN Medicare Advantage |
$2,050.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$7,052.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,560.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,050.00
|
| Rate for Payer: Healthscope Commercial |
$7,380.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,150.00
|
| Rate for Payer: Mclaren Medicaid |
$2,123.34
|
| Rate for Payer: Meridian Medicaid |
$2,229.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,152.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,357.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,947.50
|
| Rate for Payer: PACE SWMI |
$2,050.00
|
| Rate for Payer: PHP Commercial |
$6,970.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,050.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,123.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,134.00
|
| Rate for Payer: Priority Health Medicare |
$2,050.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,001.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,050.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,216.00
|
| Rate for Payer: UHC Core |
$6,847.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,050.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,111.50
|
| Rate for Payer: VA VA |
$2,050.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,150.00
|
|
|
HC OSTECTOMY COMPLETE 2,3 OR 4TH METATARSAL HEAD
|
Facility
|
IP
|
$8,200.00
|
|
|
Service Code
|
CPT 28112
|
| Hospital Charge Code |
76100366
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,001.18 |
| Max. Negotiated Rate |
$7,380.00 |
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,336.96
|
| Rate for Payer: BCN Commercial |
$6,336.96
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$7,052.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,560.00
|
| Rate for Payer: Healthscope Commercial |
$7,380.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,150.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PHP Commercial |
$6,970.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,134.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,001.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,216.00
|
| Rate for Payer: UHC Core |
$6,847.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,150.00
|
|
|
HC OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Facility
|
IP
|
$8,200.00
|
|
|
Service Code
|
CPT 28113
|
| Hospital Charge Code |
76100367
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,001.18 |
| Max. Negotiated Rate |
$7,380.00 |
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,336.96
|
| Rate for Payer: BCN Commercial |
$6,336.96
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$7,052.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,560.00
|
| Rate for Payer: Healthscope Commercial |
$7,380.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,150.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PHP Commercial |
$6,970.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,134.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,001.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,216.00
|
| Rate for Payer: UHC Core |
$6,847.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,150.00
|
|
|
HC OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Facility
|
OP
|
$8,200.00
|
|
|
Service Code
|
CPT 28113
|
| Hospital Charge Code |
76100367
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,947.50 |
| Max. Negotiated Rate |
$7,380.00 |
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: Aetna Medicare |
$2,132.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,562.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,562.50
|
| Rate for Payer: BCBS Complete |
$2,229.50
|
| Rate for Payer: BCBS MAPPO |
$2,050.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,375.50
|
| Rate for Payer: BCN Commercial |
$6,375.50
|
| Rate for Payer: BCN Medicare Advantage |
$2,050.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$7,052.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,560.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,050.00
|
| Rate for Payer: Healthscope Commercial |
$7,380.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,150.00
|
| Rate for Payer: Mclaren Medicaid |
$2,123.34
|
| Rate for Payer: Meridian Medicaid |
$2,229.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,152.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,357.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,947.50
|
| Rate for Payer: PACE SWMI |
$2,050.00
|
| Rate for Payer: PHP Commercial |
$6,970.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,050.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,123.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,134.00
|
| Rate for Payer: Priority Health Medicare |
$2,050.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,001.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,050.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,216.00
|
| Rate for Payer: UHC Core |
$6,847.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,050.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,111.50
|
| Rate for Payer: VA VA |
$2,050.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,150.00
|
|
|
HC OSTEOCALCIN
|
Facility
|
IP
|
$100.98
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$61.59 |
| Max. Negotiated Rate |
$90.88 |
| Rate for Payer: Aetna Commercial |
$85.83
|
| Rate for Payer: BCBS Trust/PPO |
$78.04
|
| Rate for Payer: BCN Commercial |
$78.04
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cofinity Commercial |
$86.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.78
|
| Rate for Payer: Healthscope Commercial |
$90.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.83
|
| Rate for Payer: PHP Commercial |
$85.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.86
|
| Rate for Payer: UHC Core |
$84.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.74
|
|
|
HC OSTEOCALCIN
|
Facility
|
OP
|
$100.98
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.03 |
| Max. Negotiated Rate |
$90.88 |
| Rate for Payer: Aetna Commercial |
$85.83
|
| Rate for Payer: Aetna Medicare |
$26.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.56
|
| Rate for Payer: BCBS Complete |
$23.13
|
| Rate for Payer: BCBS MAPPO |
$25.24
|
| Rate for Payer: BCBS Trust/PPO |
$78.51
|
| Rate for Payer: BCN Commercial |
$78.51
|
| Rate for Payer: BCN Medicare Advantage |
$25.24
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cofinity Commercial |
$86.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.24
|
| Rate for Payer: Healthscope Commercial |
$90.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.74
|
| Rate for Payer: Mclaren Medicaid |
$22.03
|
| Rate for Payer: Meridian Medicaid |
$23.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.83
|
| Rate for Payer: PACE Senior Care Partners |
$23.98
|
| Rate for Payer: PACE SWMI |
$25.24
|
| Rate for Payer: PHP Commercial |
$85.83
|
| Rate for Payer: PHP Medicare Advantage |
$25.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.85
|
| Rate for Payer: Priority Health Medicare |
$25.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.59
|
| Rate for Payer: Railroad Medicare Medicare |
$25.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.86
|
| Rate for Payer: UHC Core |
$84.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.24
|
| Rate for Payer: UHC Medicare Advantage |
$26.00
|
| Rate for Payer: VA VA |
$25.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.74
|
|
|
HC OSTEOPATHIC MANIPULATION 1-2 BODY REGIONS
|
Facility
|
IP
|
$30.90
|
|
|
Service Code
|
CPT 98925
|
| Hospital Charge Code |
53000001
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$18.85 |
| Max. Negotiated Rate |
$27.81 |
| Rate for Payer: Aetna Commercial |
$26.26
|
| Rate for Payer: BCBS Trust/PPO |
$23.88
|
| Rate for Payer: BCN Commercial |
$23.88
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cofinity Commercial |
$26.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.72
|
| Rate for Payer: Healthscope Commercial |
$27.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.26
|
| Rate for Payer: PHP Commercial |
$26.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.19
|
| Rate for Payer: UHC Core |
$25.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.18
|
|
|
HC OSTEOPATHIC MANIPULATION 1-2 BODY REGIONS
|
Facility
|
OP
|
$30.90
|
|
|
Service Code
|
CPT 98925
|
| Hospital Charge Code |
53000001
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$7.34 |
| Max. Negotiated Rate |
$27.81 |
| Rate for Payer: Aetna Commercial |
$26.26
|
| Rate for Payer: Aetna Medicare |
$8.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.66
|
| Rate for Payer: BCBS Complete |
$17.87
|
| Rate for Payer: BCBS MAPPO |
$7.72
|
| Rate for Payer: BCBS Trust/PPO |
$24.02
|
| Rate for Payer: BCN Commercial |
$24.02
|
| Rate for Payer: BCN Medicare Advantage |
$7.72
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cofinity Commercial |
$26.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.72
|
| Rate for Payer: Healthscope Commercial |
$27.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.18
|
| Rate for Payer: Mclaren Medicaid |
$17.02
|
| Rate for Payer: Meridian Medicaid |
$17.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.26
|
| Rate for Payer: PACE Senior Care Partners |
$7.34
|
| Rate for Payer: PACE SWMI |
$7.72
|
| Rate for Payer: PHP Commercial |
$26.26
|
| Rate for Payer: PHP Medicare Advantage |
$7.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.88
|
| Rate for Payer: Priority Health Medicare |
$7.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.85
|
| Rate for Payer: Railroad Medicare Medicare |
$7.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.19
|
| Rate for Payer: UHC Core |
$25.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.72
|
| Rate for Payer: UHC Medicare Advantage |
$7.96
|
| Rate for Payer: VA VA |
$7.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.18
|
|
|
HC OSTEOPATHIC MANIPULATION 3-4 BODY REGIONS
|
Facility
|
OP
|
$30.90
|
|
|
Service Code
|
CPT 98926
|
| Hospital Charge Code |
53000002
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$7.34 |
| Max. Negotiated Rate |
$27.81 |
| Rate for Payer: Aetna Commercial |
$26.26
|
| Rate for Payer: Aetna Medicare |
$8.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.66
|
| Rate for Payer: BCBS Complete |
$17.87
|
| Rate for Payer: BCBS MAPPO |
$7.72
|
| Rate for Payer: BCBS Trust/PPO |
$24.02
|
| Rate for Payer: BCN Commercial |
$24.02
|
| Rate for Payer: BCN Medicare Advantage |
$7.72
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cofinity Commercial |
$26.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.72
|
| Rate for Payer: Healthscope Commercial |
$27.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.18
|
| Rate for Payer: Mclaren Medicaid |
$17.02
|
| Rate for Payer: Meridian Medicaid |
$17.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.26
|
| Rate for Payer: PACE Senior Care Partners |
$7.34
|
| Rate for Payer: PACE SWMI |
$7.72
|
| Rate for Payer: PHP Commercial |
$26.26
|
| Rate for Payer: PHP Medicare Advantage |
$7.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.88
|
| Rate for Payer: Priority Health Medicare |
$7.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.85
|
| Rate for Payer: Railroad Medicare Medicare |
$7.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.19
|
| Rate for Payer: UHC Core |
$25.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.72
|
| Rate for Payer: UHC Medicare Advantage |
$7.96
|
| Rate for Payer: VA VA |
$7.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.18
|
|
|
HC OSTEOPATHIC MANIPULATION 3-4 BODY REGIONS
|
Facility
|
IP
|
$30.90
|
|
|
Service Code
|
CPT 98926
|
| Hospital Charge Code |
53000002
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$18.85 |
| Max. Negotiated Rate |
$27.81 |
| Rate for Payer: Aetna Commercial |
$26.26
|
| Rate for Payer: BCBS Trust/PPO |
$23.88
|
| Rate for Payer: BCN Commercial |
$23.88
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cofinity Commercial |
$26.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.72
|
| Rate for Payer: Healthscope Commercial |
$27.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.26
|
| Rate for Payer: PHP Commercial |
$26.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.19
|
| Rate for Payer: UHC Core |
$25.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.18
|
|
