|
HC OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Facility
|
OP
|
$8,531.28
|
|
|
Service Code
|
CPT 28113
|
| Hospital Charge Code |
76100367
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,504.06 |
| Max. Negotiated Rate |
$7,678.15 |
| Rate for Payer: Aetna Commercial |
$7,251.59
|
| Rate for Payer: Aetna Medicare |
$2,218.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,666.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,666.03
|
| Rate for Payer: BCBS Complete |
$1,579.14
|
| Rate for Payer: BCBS MAPPO |
$2,132.82
|
| Rate for Payer: BCBS Trust/PPO |
$7,013.57
|
| Rate for Payer: BCN Commercial |
$7,013.57
|
| Rate for Payer: BCN Medicare Advantage |
$2,132.82
|
| Rate for Payer: Cash Price |
$6,825.02
|
| Rate for Payer: Cofinity Commercial |
$7,336.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,825.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,132.82
|
| Rate for Payer: Healthscope Commercial |
$7,678.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,398.46
|
| Rate for Payer: Mclaren Medicaid |
$1,504.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,239.46
|
| Rate for Payer: Meridian Medicaid |
$1,579.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,452.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,346.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,251.59
|
| Rate for Payer: Nomi Health Commercial |
$6,995.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,398.46
|
| Rate for Payer: PACE Senior Care Partners |
$2,026.18
|
| Rate for Payer: PACE SWMI |
$2,132.82
|
| Rate for Payer: PHP Commercial |
$7,251.59
|
| Rate for Payer: PHP Medicare Advantage |
$2,132.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,504.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,422.21
|
| Rate for Payer: Priority Health Medicare |
$2,154.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,937.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,132.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,507.53
|
| Rate for Payer: UHC Core |
$7,123.62
|
| Rate for Payer: UHC Exchange |
$2,132.82
|
| Rate for Payer: UHC Medicaid |
$1,504.06
|
| Rate for Payer: UHC Medicare Advantage |
$2,132.82
|
| Rate for Payer: UHCCP Medicaid |
$1,504.06
|
| Rate for Payer: VA VA |
$2,132.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,398.46
|
|
|
HC OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Facility
|
IP
|
$8,531.28
|
|
|
Service Code
|
CPT 28113
|
| Hospital Charge Code |
76100367
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,937.77 |
| Max. Negotiated Rate |
$7,678.15 |
| Rate for Payer: Aetna Commercial |
$7,251.59
|
| Rate for Payer: BCBS Trust/PPO |
$7,045.98
|
| Rate for Payer: BCN Commercial |
$7,045.98
|
| Rate for Payer: Cash Price |
$6,825.02
|
| Rate for Payer: Cofinity Commercial |
$7,336.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,825.02
|
| Rate for Payer: Healthscope Commercial |
$7,678.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,398.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,251.59
|
| Rate for Payer: Nomi Health Commercial |
$6,995.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,398.46
|
| Rate for Payer: PHP Commercial |
$7,251.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,422.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,937.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,507.53
|
| Rate for Payer: UHC Core |
$7,123.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,398.46
|
|
|
HC OSTEOCALCIN
|
Facility
|
OP
|
$105.06
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.52 |
| Max. Negotiated Rate |
$94.55 |
| Rate for Payer: UHC Medicaid |
$18.52
|
| Rate for Payer: UHC Medicare Advantage |
$26.27
|
| Rate for Payer: UHCCP Medicaid |
$18.52
|
| Rate for Payer: VA VA |
$26.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.80
|
| Rate for Payer: Aetna Commercial |
$89.30
|
| Rate for Payer: Aetna Medicare |
$27.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.83
|
| Rate for Payer: BCBS Complete |
$19.45
|
| Rate for Payer: BCBS MAPPO |
$26.27
|
| Rate for Payer: BCBS Trust/PPO |
$86.37
|
| Rate for Payer: BCN Commercial |
$86.37
|
| Rate for Payer: BCN Medicare Advantage |
$26.27
|
| Rate for Payer: Cash Price |
$84.05
|
| Rate for Payer: Cofinity Commercial |
$90.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.27
|
| Rate for Payer: Healthscope Commercial |
$94.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.80
|
| Rate for Payer: Mclaren Medicaid |
$18.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.58
|
| Rate for Payer: Meridian Medicaid |
$19.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.30
|
| Rate for Payer: Nomi Health Commercial |
$86.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.80
|
| Rate for Payer: PACE Senior Care Partners |
$24.95
|
| Rate for Payer: PACE SWMI |
$26.27
|
| Rate for Payer: PHP Commercial |
$89.30
|
| Rate for Payer: PHP Medicare Advantage |
$26.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$91.40
|
| Rate for Payer: Priority Health Medicare |
$26.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.12
|
| Rate for Payer: Railroad Medicare Medicare |
$26.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.45
|
| Rate for Payer: UHC Core |
$87.73
|
| Rate for Payer: UHC Exchange |
$26.27
|
|
|
HC OSTEOCALCIN
|
Facility
|
IP
|
$105.06
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$73.12 |
| Max. Negotiated Rate |
$94.55 |
| Rate for Payer: Aetna Commercial |
$89.30
|
| Rate for Payer: BCBS Trust/PPO |
$86.77
|
| Rate for Payer: BCN Commercial |
$86.77
|
| Rate for Payer: Cash Price |
$84.05
|
| Rate for Payer: Cofinity Commercial |
$90.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.05
|
| Rate for Payer: Healthscope Commercial |
$94.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.30
|
| Rate for Payer: Nomi Health Commercial |
$86.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.80
|
| Rate for Payer: PHP Commercial |
$89.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$91.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.45
|
| Rate for Payer: UHC Core |
$87.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.80
|
|
|
HC OSTEOPATHIC MANIPULATION 1-2 BODY REGIONS
|
Facility
|
OP
|
$37.82
|
|
|
Service Code
|
CPT 98925
|
| Hospital Charge Code |
53000001
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$6.67 |
| Max. Negotiated Rate |
$34.04 |
| Rate for Payer: Aetna Commercial |
$32.15
|
| Rate for Payer: Aetna Medicare |
$9.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.82
|
| Rate for Payer: BCBS Complete |
$7.00
|
| Rate for Payer: BCBS MAPPO |
$9.46
|
| Rate for Payer: BCBS Trust/PPO |
$31.09
|
| Rate for Payer: BCN Commercial |
$31.09
|
| Rate for Payer: BCN Medicare Advantage |
$9.46
|
| Rate for Payer: Cash Price |
$30.26
|
| Rate for Payer: Cofinity Commercial |
$32.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.46
|
| Rate for Payer: Healthscope Commercial |
$34.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.36
|
| Rate for Payer: Mclaren Medicaid |
$6.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.93
|
| Rate for Payer: Meridian Medicaid |
$7.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.15
|
| Rate for Payer: Nomi Health Commercial |
$31.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.36
|
| Rate for Payer: PACE Senior Care Partners |
$8.98
|
| Rate for Payer: PACE SWMI |
$9.46
|
| Rate for Payer: PHP Commercial |
$32.15
|
| Rate for Payer: PHP Medicare Advantage |
$9.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32.90
|
| Rate for Payer: Priority Health Medicare |
$9.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.32
|
| Rate for Payer: Railroad Medicare Medicare |
$9.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.28
|
| Rate for Payer: UHC Core |
$31.58
|
| Rate for Payer: UHC Exchange |
$9.46
|
| Rate for Payer: UHC Medicaid |
$6.67
|
| Rate for Payer: UHC Medicare Advantage |
$9.46
|
| Rate for Payer: UHCCP Medicaid |
$6.67
|
| Rate for Payer: VA VA |
$9.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.36
|
|
|
HC OSTEOPATHIC MANIPULATION 1-2 BODY REGIONS
|
Facility
|
IP
|
$37.82
|
|
|
Service Code
|
CPT 98925
|
| Hospital Charge Code |
53000001
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$26.32 |
| Max. Negotiated Rate |
$34.04 |
| Rate for Payer: Aetna Commercial |
$32.15
|
| Rate for Payer: BCBS Trust/PPO |
$31.24
|
| Rate for Payer: BCN Commercial |
$31.24
|
| Rate for Payer: Cash Price |
$30.26
|
| Rate for Payer: Cofinity Commercial |
$32.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.26
|
| Rate for Payer: Healthscope Commercial |
$34.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.15
|
| Rate for Payer: Nomi Health Commercial |
$31.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.36
|
| Rate for Payer: PHP Commercial |
$32.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.28
|
| Rate for Payer: UHC Core |
$31.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.36
|
|
|
HC OSTEOPATHIC MANIPULATION 3-4 BODY REGIONS
|
Facility
|
OP
|
$32.15
|
|
|
Service Code
|
CPT 98926
|
| Hospital Charge Code |
53000002
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$5.67 |
| Max. Negotiated Rate |
$28.93 |
| Rate for Payer: Aetna Commercial |
$27.33
|
| Rate for Payer: Aetna Medicare |
$8.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.05
|
| Rate for Payer: BCBS Complete |
$5.95
|
| Rate for Payer: BCBS MAPPO |
$8.04
|
| Rate for Payer: BCBS Trust/PPO |
$26.43
|
| Rate for Payer: BCN Commercial |
$26.43
|
| Rate for Payer: BCN Medicare Advantage |
$8.04
|
| Rate for Payer: Cash Price |
$25.72
|
| Rate for Payer: Cofinity Commercial |
$27.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.04
|
| Rate for Payer: Healthscope Commercial |
$28.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.11
|
| Rate for Payer: Mclaren Medicaid |
$5.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.44
|
| Rate for Payer: Meridian Medicaid |
$5.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.33
|
| Rate for Payer: Nomi Health Commercial |
$26.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.11
|
| Rate for Payer: PACE Senior Care Partners |
$7.64
|
| Rate for Payer: PACE SWMI |
$8.04
|
| Rate for Payer: PHP Commercial |
$27.33
|
| Rate for Payer: PHP Medicare Advantage |
$8.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.97
|
| Rate for Payer: Priority Health Medicare |
$8.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.38
|
| Rate for Payer: Railroad Medicare Medicare |
$8.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.29
|
| Rate for Payer: UHC Core |
$26.85
|
| Rate for Payer: UHC Exchange |
$8.04
|
| Rate for Payer: UHC Medicaid |
$5.67
|
| Rate for Payer: UHC Medicare Advantage |
$8.04
|
| Rate for Payer: UHCCP Medicaid |
$5.67
|
| Rate for Payer: VA VA |
$8.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.11
|
|
|
HC OSTEOPATHIC MANIPULATION 3-4 BODY REGIONS
|
Facility
|
IP
|
$32.15
|
|
|
Service Code
|
CPT 98926
|
| Hospital Charge Code |
53000002
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$22.38 |
| Max. Negotiated Rate |
$28.93 |
| Rate for Payer: Aetna Commercial |
$27.33
|
| Rate for Payer: BCBS Trust/PPO |
$26.55
|
| Rate for Payer: BCN Commercial |
$26.55
|
| Rate for Payer: Cash Price |
$25.72
|
| Rate for Payer: Cofinity Commercial |
$27.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.72
|
| Rate for Payer: Healthscope Commercial |
$28.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.33
|
| Rate for Payer: Nomi Health Commercial |
$26.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.11
|
| Rate for Payer: PHP Commercial |
$27.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.29
|
| Rate for Payer: UHC Core |
$26.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.11
|
|
|
HC OSTEOPATHIC MANIPULATION 5-6 BODY REGIONS
|
Facility
|
OP
|
$60.61
|
|
|
Service Code
|
CPT 98927
|
| Hospital Charge Code |
53000003
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$10.69 |
| Max. Negotiated Rate |
$54.55 |
| Rate for Payer: Aetna Commercial |
$51.52
|
| Rate for Payer: Aetna Medicare |
$15.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.94
|
| Rate for Payer: BCBS Complete |
$11.22
|
| Rate for Payer: BCBS MAPPO |
$15.15
|
| Rate for Payer: BCBS Trust/PPO |
$49.83
|
| Rate for Payer: BCN Commercial |
$49.83
|
| Rate for Payer: BCN Medicare Advantage |
$15.15
|
| Rate for Payer: Cash Price |
$48.49
|
| Rate for Payer: Cofinity Commercial |
$52.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.15
|
| Rate for Payer: Healthscope Commercial |
$54.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.46
|
| Rate for Payer: Mclaren Medicaid |
$10.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.91
|
| Rate for Payer: Meridian Medicaid |
$11.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.52
|
| Rate for Payer: Nomi Health Commercial |
$49.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.46
|
| Rate for Payer: PACE Senior Care Partners |
$14.39
|
| Rate for Payer: PACE SWMI |
$15.15
|
| Rate for Payer: PHP Commercial |
$51.52
|
| Rate for Payer: PHP Medicare Advantage |
$15.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.73
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.18
|
| Rate for Payer: Railroad Medicare Medicare |
$15.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.34
|
| Rate for Payer: UHC Core |
$50.61
|
| Rate for Payer: UHC Exchange |
$15.15
|
| Rate for Payer: UHC Medicaid |
$10.69
|
| Rate for Payer: UHC Medicare Advantage |
$15.15
|
| Rate for Payer: UHCCP Medicaid |
$10.69
|
| Rate for Payer: VA VA |
$15.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.46
|
|
|
HC OSTEOPATHIC MANIPULATION 5-6 BODY REGIONS
|
Facility
|
IP
|
$60.61
|
|
|
Service Code
|
CPT 98927
|
| Hospital Charge Code |
53000003
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$42.18 |
| Max. Negotiated Rate |
$54.55 |
| Rate for Payer: Aetna Commercial |
$51.52
|
| Rate for Payer: BCBS Trust/PPO |
$50.06
|
| Rate for Payer: BCN Commercial |
$50.06
|
| Rate for Payer: Cash Price |
$48.49
|
| Rate for Payer: Cofinity Commercial |
$52.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.49
|
| Rate for Payer: Healthscope Commercial |
$54.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.52
|
| Rate for Payer: Nomi Health Commercial |
$49.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.46
|
| Rate for Payer: PHP Commercial |
$51.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.34
|
| Rate for Payer: UHC Core |
$50.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.46
|
|
|
HC OSTEOPATHIC MANIPULATION 7-8 BODY REGIONS
|
Facility
|
OP
|
$72.88
|
|
|
Service Code
|
CPT 98928
|
| Hospital Charge Code |
53000004
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$12.85 |
| Max. Negotiated Rate |
$65.59 |
| Rate for Payer: Aetna Commercial |
$61.95
|
| Rate for Payer: Aetna Medicare |
$18.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.77
|
| Rate for Payer: BCBS Complete |
$13.49
|
| Rate for Payer: BCBS MAPPO |
$18.22
|
| Rate for Payer: BCBS Trust/PPO |
$59.91
|
| Rate for Payer: BCN Commercial |
$59.91
|
| Rate for Payer: BCN Medicare Advantage |
$18.22
|
| Rate for Payer: Cash Price |
$58.30
|
| Rate for Payer: Cofinity Commercial |
$62.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.22
|
| Rate for Payer: Healthscope Commercial |
$65.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.66
|
| Rate for Payer: Mclaren Medicaid |
$12.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.13
|
| Rate for Payer: Meridian Medicaid |
$13.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.95
|
| Rate for Payer: Nomi Health Commercial |
$59.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.66
|
| Rate for Payer: PACE Senior Care Partners |
$17.31
|
| Rate for Payer: PACE SWMI |
$18.22
|
| Rate for Payer: PHP Commercial |
$61.95
|
| Rate for Payer: PHP Medicare Advantage |
$18.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.41
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.72
|
| Rate for Payer: Railroad Medicare Medicare |
$18.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.13
|
| Rate for Payer: UHC Core |
$60.85
|
| Rate for Payer: UHC Exchange |
$18.22
|
| Rate for Payer: UHC Medicaid |
$12.85
|
| Rate for Payer: UHC Medicare Advantage |
$18.22
|
| Rate for Payer: UHCCP Medicaid |
$12.85
|
| Rate for Payer: VA VA |
$18.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.66
|
|
|
HC OSTEOPATHIC MANIPULATION 7-8 BODY REGIONS
|
Facility
|
IP
|
$72.88
|
|
|
Service Code
|
CPT 98928
|
| Hospital Charge Code |
53000004
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$65.59 |
| Rate for Payer: Aetna Commercial |
$61.95
|
| Rate for Payer: BCBS Trust/PPO |
$60.19
|
| Rate for Payer: BCN Commercial |
$60.19
|
| Rate for Payer: Cash Price |
$58.30
|
| Rate for Payer: Cofinity Commercial |
$62.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.30
|
| Rate for Payer: Healthscope Commercial |
$65.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.95
|
| Rate for Payer: Nomi Health Commercial |
$59.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.66
|
| Rate for Payer: PHP Commercial |
$61.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.13
|
| Rate for Payer: UHC Core |
$60.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.66
|
|
|
HC OSTEOPATHIC MANIPULATION 9-10 BODY REGIONS
|
Facility
|
OP
|
$66.92
|
|
|
Service Code
|
CPT 98929
|
| Hospital Charge Code |
53000005
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$11.80 |
| Max. Negotiated Rate |
$60.23 |
| Rate for Payer: Aetna Commercial |
$56.88
|
| Rate for Payer: Aetna Medicare |
$17.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.91
|
| Rate for Payer: BCBS Complete |
$12.39
|
| Rate for Payer: BCBS MAPPO |
$16.73
|
| Rate for Payer: BCBS Trust/PPO |
$55.01
|
| Rate for Payer: BCN Commercial |
$55.01
|
| Rate for Payer: BCN Medicare Advantage |
$16.73
|
| Rate for Payer: Cash Price |
$53.54
|
| Rate for Payer: Cofinity Commercial |
$57.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.73
|
| Rate for Payer: Healthscope Commercial |
$60.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.19
|
| Rate for Payer: Mclaren Medicaid |
$11.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.57
|
| Rate for Payer: Meridian Medicaid |
$12.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.88
|
| Rate for Payer: Nomi Health Commercial |
$54.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.19
|
| Rate for Payer: PACE Senior Care Partners |
$15.89
|
| Rate for Payer: PACE SWMI |
$16.73
|
| Rate for Payer: PHP Commercial |
$56.88
|
| Rate for Payer: PHP Medicare Advantage |
$16.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.22
|
| Rate for Payer: Priority Health Medicare |
$16.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.58
|
| Rate for Payer: Railroad Medicare Medicare |
$16.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.89
|
| Rate for Payer: UHC Core |
$55.88
|
| Rate for Payer: UHC Exchange |
$16.73
|
| Rate for Payer: UHC Medicaid |
$11.80
|
| Rate for Payer: UHC Medicare Advantage |
$16.73
|
| Rate for Payer: UHCCP Medicaid |
$11.80
|
| Rate for Payer: VA VA |
$16.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.19
|
|
|
HC OSTEOPATHIC MANIPULATION 9-10 BODY REGIONS
|
Facility
|
IP
|
$66.92
|
|
|
Service Code
|
CPT 98929
|
| Hospital Charge Code |
53000005
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$46.58 |
| Max. Negotiated Rate |
$60.23 |
| Rate for Payer: Aetna Commercial |
$56.88
|
| Rate for Payer: BCBS Trust/PPO |
$55.27
|
| Rate for Payer: BCN Commercial |
$55.27
|
| Rate for Payer: Cash Price |
$53.54
|
| Rate for Payer: Cofinity Commercial |
$57.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.54
|
| Rate for Payer: Healthscope Commercial |
$60.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.88
|
| Rate for Payer: Nomi Health Commercial |
$54.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.19
|
| Rate for Payer: PHP Commercial |
$56.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.89
|
| Rate for Payer: UHC Core |
$55.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.19
|
|
|
HC OSTIAL PRO SYSTEM
|
Facility
|
OP
|
$2,028.41
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$357.61 |
| Max. Negotiated Rate |
$1,825.57 |
| Rate for Payer: Aetna Commercial |
$1,724.15
|
| Rate for Payer: Aetna Medicare |
$527.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$633.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$633.88
|
| Rate for Payer: BCBS Complete |
$375.46
|
| Rate for Payer: BCBS MAPPO |
$507.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,667.56
|
| Rate for Payer: BCN Commercial |
$1,667.56
|
| Rate for Payer: BCN Medicare Advantage |
$507.10
|
| Rate for Payer: Cash Price |
$1,622.73
|
| Rate for Payer: Cofinity Commercial |
$1,744.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,622.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$507.10
|
| Rate for Payer: Healthscope Commercial |
$1,825.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,521.31
|
| Rate for Payer: Mclaren Medicaid |
$357.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$532.46
|
| Rate for Payer: Meridian Medicaid |
$375.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$583.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$557.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,724.15
|
| Rate for Payer: Nomi Health Commercial |
$1,663.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,521.31
|
| Rate for Payer: PACE Senior Care Partners |
$481.75
|
| Rate for Payer: PACE SWMI |
$507.10
|
| Rate for Payer: PHP Commercial |
$1,724.15
|
| Rate for Payer: PHP Medicare Advantage |
$507.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,764.72
|
| Rate for Payer: Priority Health Medicare |
$512.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,411.77
|
| Rate for Payer: Railroad Medicare Medicare |
$507.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,785.00
|
| Rate for Payer: UHC Core |
$1,693.72
|
| Rate for Payer: UHC Exchange |
$507.10
|
| Rate for Payer: UHC Medicaid |
$357.61
|
| Rate for Payer: UHC Medicare Advantage |
$507.10
|
| Rate for Payer: UHCCP Medicaid |
$357.61
|
| Rate for Payer: VA VA |
$507.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,521.31
|
|
|
HC OSTIAL PRO SYSTEM
|
Facility
|
IP
|
$2,028.41
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,411.77 |
| Max. Negotiated Rate |
$1,825.57 |
| Rate for Payer: Aetna Commercial |
$1,724.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,675.26
|
| Rate for Payer: BCN Commercial |
$1,675.26
|
| Rate for Payer: Cash Price |
$1,622.73
|
| Rate for Payer: Cofinity Commercial |
$1,744.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,622.73
|
| Rate for Payer: Healthscope Commercial |
$1,825.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,521.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,724.15
|
| Rate for Payer: Nomi Health Commercial |
$1,663.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,521.31
|
| Rate for Payer: PHP Commercial |
$1,724.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,764.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,411.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,785.00
|
| Rate for Payer: UHC Core |
$1,693.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,521.31
|
|
|
HC OSTO-ZYME
|
Facility
|
IP
|
$43.96
|
|
| Hospital Charge Code |
27000129
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$39.56 |
| Rate for Payer: Aetna Commercial |
$37.37
|
| Rate for Payer: BCBS Trust/PPO |
$36.31
|
| Rate for Payer: BCN Commercial |
$36.31
|
| Rate for Payer: Cash Price |
$35.17
|
| Rate for Payer: Cofinity Commercial |
$37.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.17
|
| Rate for Payer: Healthscope Commercial |
$39.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.37
|
| Rate for Payer: Nomi Health Commercial |
$36.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.97
|
| Rate for Payer: PHP Commercial |
$37.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.68
|
| Rate for Payer: UHC Core |
$36.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.97
|
|
|
HC OSTO-ZYME
|
Facility
|
OP
|
$43.96
|
|
| Hospital Charge Code |
27000129
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.75 |
| Max. Negotiated Rate |
$39.56 |
| Rate for Payer: Aetna Commercial |
$37.37
|
| Rate for Payer: Aetna Medicare |
$11.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.74
|
| Rate for Payer: BCBS Complete |
$8.14
|
| Rate for Payer: BCBS MAPPO |
$10.99
|
| Rate for Payer: BCBS Trust/PPO |
$36.14
|
| Rate for Payer: BCN Commercial |
$36.14
|
| Rate for Payer: BCN Medicare Advantage |
$10.99
|
| Rate for Payer: Cash Price |
$35.17
|
| Rate for Payer: Cofinity Commercial |
$37.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.99
|
| Rate for Payer: Healthscope Commercial |
$39.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.97
|
| Rate for Payer: Mclaren Medicaid |
$7.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.54
|
| Rate for Payer: Meridian Medicaid |
$8.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.37
|
| Rate for Payer: Nomi Health Commercial |
$36.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.97
|
| Rate for Payer: PACE Senior Care Partners |
$10.44
|
| Rate for Payer: PACE SWMI |
$10.99
|
| Rate for Payer: PHP Commercial |
$37.37
|
| Rate for Payer: PHP Medicare Advantage |
$10.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.25
|
| Rate for Payer: Priority Health Medicare |
$11.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.60
|
| Rate for Payer: Railroad Medicare Medicare |
$10.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.68
|
| Rate for Payer: UHC Core |
$36.71
|
| Rate for Payer: UHC Exchange |
$10.99
|
| Rate for Payer: UHC Medicaid |
$7.75
|
| Rate for Payer: UHC Medicare Advantage |
$10.99
|
| Rate for Payer: UHCCP Medicaid |
$7.75
|
| Rate for Payer: VA VA |
$10.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.97
|
|
|
HC OSU OBSERVATION PER HOUR
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200009
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna Medicare |
$41.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.00
|
| Rate for Payer: BCBS Complete |
$29.62
|
| Rate for Payer: BCBS MAPPO |
$40.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.54
|
| Rate for Payer: BCN Commercial |
$131.54
|
| Rate for Payer: BCN Medicare Advantage |
$40.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Mclaren Medicaid |
$28.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.00
|
| Rate for Payer: Meridian Medicaid |
$29.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PACE Senior Care Partners |
$38.00
|
| Rate for Payer: PACE SWMI |
$40.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: PHP Medicare Advantage |
$40.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Medicare |
$40.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: Railroad Medicare Medicare |
$40.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: UHC Exchange |
$40.00
|
| Rate for Payer: UHC Medicaid |
$28.21
|
| Rate for Payer: UHC Medicare Advantage |
$40.00
|
| Rate for Payer: UHCCP Medicaid |
$850.00
|
| Rate for Payer: VA VA |
$40.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC OSU OBSERVATION PER HOUR
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200009
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$111.36 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: BCBS Trust/PPO |
$132.14
|
| Rate for Payer: BCN Commercial |
$132.14
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC OT EVAL HIGH COMPLEXITY
|
Facility
|
OP
|
$284.84
|
|
|
Service Code
|
CPT 97167
|
| Hospital Charge Code |
43400009
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$50.22 |
| Max. Negotiated Rate |
$256.36 |
| Rate for Payer: Aetna Commercial |
$242.11
|
| Rate for Payer: Aetna Medicare |
$74.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.01
|
| Rate for Payer: BCBS Complete |
$52.72
|
| Rate for Payer: BCBS MAPPO |
$71.21
|
| Rate for Payer: BCBS Trust/PPO |
$234.17
|
| Rate for Payer: BCN Commercial |
$234.17
|
| Rate for Payer: BCN Medicare Advantage |
$71.21
|
| Rate for Payer: Cash Price |
$227.87
|
| Rate for Payer: Cofinity Commercial |
$244.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.21
|
| Rate for Payer: Healthscope Commercial |
$256.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.63
|
| Rate for Payer: Mclaren Medicaid |
$50.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.77
|
| Rate for Payer: Meridian Medicaid |
$52.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.11
|
| Rate for Payer: Nomi Health Commercial |
$233.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.63
|
| Rate for Payer: PACE Senior Care Partners |
$67.65
|
| Rate for Payer: PACE SWMI |
$71.21
|
| Rate for Payer: PHP Commercial |
$242.11
|
| Rate for Payer: PHP Medicare Advantage |
$71.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$247.81
|
| Rate for Payer: Priority Health Medicare |
$71.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.25
|
| Rate for Payer: Railroad Medicare Medicare |
$71.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.66
|
| Rate for Payer: UHC Core |
$237.84
|
| Rate for Payer: UHC Exchange |
$71.21
|
| Rate for Payer: UHC Medicaid |
$50.22
|
| Rate for Payer: UHC Medicare Advantage |
$71.21
|
| Rate for Payer: UHCCP Medicaid |
$50.22
|
| Rate for Payer: VA VA |
$71.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.63
|
|
|
HC OT EVAL HIGH COMPLEXITY
|
Facility
|
IP
|
$284.84
|
|
|
Service Code
|
CPT 97167
|
| Hospital Charge Code |
43400009
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$198.25 |
| Max. Negotiated Rate |
$256.36 |
| Rate for Payer: Aetna Commercial |
$242.11
|
| Rate for Payer: BCBS Trust/PPO |
$235.25
|
| Rate for Payer: BCN Commercial |
$235.25
|
| Rate for Payer: Cash Price |
$227.87
|
| Rate for Payer: Cofinity Commercial |
$244.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.87
|
| Rate for Payer: Healthscope Commercial |
$256.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.11
|
| Rate for Payer: Nomi Health Commercial |
$233.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.63
|
| Rate for Payer: PHP Commercial |
$242.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$247.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.66
|
| Rate for Payer: UHC Core |
$237.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.63
|
|
|
HC OT EVAL LOW COMPLEXITY
|
Facility
|
IP
|
$233.04
|
|
|
Service Code
|
CPT 97165
|
| Hospital Charge Code |
43400007
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$162.20 |
| Max. Negotiated Rate |
$209.74 |
| Rate for Payer: Aetna Commercial |
$198.08
|
| Rate for Payer: BCBS Trust/PPO |
$192.47
|
| Rate for Payer: BCN Commercial |
$192.47
|
| Rate for Payer: Cash Price |
$186.43
|
| Rate for Payer: Cofinity Commercial |
$200.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.43
|
| Rate for Payer: Healthscope Commercial |
$209.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.08
|
| Rate for Payer: Nomi Health Commercial |
$191.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.78
|
| Rate for Payer: PHP Commercial |
$198.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$202.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.08
|
| Rate for Payer: UHC Core |
$194.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.78
|
|
|
HC OT EVAL LOW COMPLEXITY
|
Facility
|
OP
|
$233.04
|
|
|
Service Code
|
CPT 97165
|
| Hospital Charge Code |
43400007
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$41.08 |
| Max. Negotiated Rate |
$209.74 |
| Rate for Payer: Aetna Commercial |
$198.08
|
| Rate for Payer: Aetna Medicare |
$60.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.83
|
| Rate for Payer: BCBS Complete |
$43.14
|
| Rate for Payer: BCBS MAPPO |
$58.26
|
| Rate for Payer: BCBS Trust/PPO |
$191.58
|
| Rate for Payer: BCN Commercial |
$191.58
|
| Rate for Payer: BCN Medicare Advantage |
$58.26
|
| Rate for Payer: Cash Price |
$186.43
|
| Rate for Payer: Cofinity Commercial |
$200.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.26
|
| Rate for Payer: Healthscope Commercial |
$209.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.78
|
| Rate for Payer: Mclaren Medicaid |
$41.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.17
|
| Rate for Payer: Meridian Medicaid |
$43.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.08
|
| Rate for Payer: Nomi Health Commercial |
$191.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.78
|
| Rate for Payer: PACE Senior Care Partners |
$55.35
|
| Rate for Payer: PACE SWMI |
$58.26
|
| Rate for Payer: PHP Commercial |
$198.08
|
| Rate for Payer: PHP Medicare Advantage |
$58.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$202.74
|
| Rate for Payer: Priority Health Medicare |
$58.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.20
|
| Rate for Payer: Railroad Medicare Medicare |
$58.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.08
|
| Rate for Payer: UHC Core |
$194.59
|
| Rate for Payer: UHC Exchange |
$58.26
|
| Rate for Payer: UHC Medicaid |
$41.08
|
| Rate for Payer: UHC Medicare Advantage |
$58.26
|
| Rate for Payer: UHCCP Medicaid |
$41.08
|
| Rate for Payer: VA VA |
$58.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.78
|
|
|
HC OT EVAL MODERATE COMPLEXITY
|
Facility
|
OP
|
$258.94
|
|
|
Service Code
|
CPT 97166
|
| Hospital Charge Code |
43400008
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$45.65 |
| Max. Negotiated Rate |
$233.05 |
| Rate for Payer: Aetna Commercial |
$220.10
|
| Rate for Payer: Aetna Medicare |
$67.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.92
|
| Rate for Payer: BCBS Complete |
$47.93
|
| Rate for Payer: BCBS MAPPO |
$64.73
|
| Rate for Payer: BCBS Trust/PPO |
$212.87
|
| Rate for Payer: BCN Commercial |
$212.87
|
| Rate for Payer: BCN Medicare Advantage |
$64.73
|
| Rate for Payer: Cash Price |
$207.15
|
| Rate for Payer: Cofinity Commercial |
$222.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.73
|
| Rate for Payer: Healthscope Commercial |
$233.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.21
|
| Rate for Payer: Mclaren Medicaid |
$45.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.97
|
| Rate for Payer: Meridian Medicaid |
$47.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.10
|
| Rate for Payer: Nomi Health Commercial |
$212.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.21
|
| Rate for Payer: PACE Senior Care Partners |
$61.50
|
| Rate for Payer: PACE SWMI |
$64.73
|
| Rate for Payer: PHP Commercial |
$220.10
|
| Rate for Payer: PHP Medicare Advantage |
$64.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$225.28
|
| Rate for Payer: Priority Health Medicare |
$65.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$180.22
|
| Rate for Payer: Railroad Medicare Medicare |
$64.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.87
|
| Rate for Payer: UHC Core |
$216.21
|
| Rate for Payer: UHC Exchange |
$64.73
|
| Rate for Payer: UHC Medicaid |
$45.65
|
| Rate for Payer: UHC Medicare Advantage |
$64.73
|
| Rate for Payer: UHCCP Medicaid |
$45.65
|
| Rate for Payer: VA VA |
$64.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.21
|
|
