|
HC OSMOTIC FRAGILITY RBC
|
Facility
|
OP
|
$128.84
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
30500052
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.31 |
| Max. Negotiated Rate |
$115.96 |
| Rate for Payer: Aetna American Axle |
$83.75
|
| Rate for Payer: Aetna Commercial |
$109.51
|
| Rate for Payer: Aetna Medicare |
$13.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.70
|
| Rate for Payer: BCBS Complete |
$7.67
|
| Rate for Payer: BCBS MAPPO |
$13.36
|
| Rate for Payer: BCBS Trust/PPO |
$12.01
|
| Rate for Payer: BCN Medicare Advantage |
$13.36
|
| Rate for Payer: Cash Price |
$103.07
|
| Rate for Payer: Cash Price |
$103.07
|
| Rate for Payer: Cofinity Commercial |
$110.80
|
| Rate for Payer: Cofinity Commercial |
$90.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$115.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.63
|
| Rate for Payer: Mclaren Medicaid |
$7.31
|
| Rate for Payer: Mclaren Medicare |
$13.36
|
| Rate for Payer: Meridian Medicaid |
$7.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.51
|
| Rate for Payer: PACE Medicare |
$12.69
|
| Rate for Payer: PACE SWMI |
$13.36
|
| Rate for Payer: PHP Commercial |
$109.51
|
| Rate for Payer: PHP Medicare Advantage |
$13.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.99
|
| Rate for Payer: Priority Health Medicare |
$13.36
|
| Rate for Payer: Priority Health Narrow Network |
$9.59
|
| Rate for Payer: Priority Health SBD |
$81.17
|
| Rate for Payer: Railroad Medicare Medicare |
$13.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.03
|
| Rate for Payer: UHC Core |
$22.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.36
|
| Rate for Payer: UHC Exchange |
$13.36
|
| Rate for Payer: UHC Medicare Advantage |
$13.76
|
| Rate for Payer: UMR Bronson Commercial |
$47.67
|
| Rate for Payer: VA VA |
$13.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.63
|
|
|
HC OSMOTIC FRAGILITY RBC
|
Facility
|
IP
|
$128.84
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
30500052
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$56.69 |
| Max. Negotiated Rate |
$115.96 |
| Rate for Payer: Aetna American Axle |
$83.75
|
| Rate for Payer: Aetna Commercial |
$109.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.75
|
| Rate for Payer: Cash Price |
$103.07
|
| Rate for Payer: Cofinity Commercial |
$110.80
|
| Rate for Payer: Cofinity Commercial |
$90.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.07
|
| Rate for Payer: Healthscope Commercial |
$115.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.19
|
| 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 SBD |
$81.17
|
| Rate for Payer: UMR Bronson Commercial |
$56.69
|
| 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 |
$3,608.00 |
| Max. Negotiated Rate |
$7,380.00 |
| Rate for Payer: Aetna American Axle |
$5,330.00
|
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,330.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$5,740.00
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$5,740.00
|
| 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 SBD |
$5,166.00
|
| Rate for Payer: UMR Bronson Commercial |
$3,608.00
|
| 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 |
$315.65 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$5,330.00
|
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,330.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,810.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| 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: Cofinity Commercial |
$5,740.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,560.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$7,380.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,740.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,150.00
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$6,970.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,057.42
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$7,245.94
|
| Rate for Payer: Priority Health SBD |
$5,166.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$347.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$315.65
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$3,034.00
|
| Rate for Payer: VA VA |
$2,877.15
|
| 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 |
$3,608.00 |
| Max. Negotiated Rate |
$7,380.00 |
| Rate for Payer: Aetna American Axle |
$5,330.00
|
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,330.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$5,740.00
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$5,740.00
|
| 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 SBD |
$5,166.00
|
| Rate for Payer: UMR Bronson Commercial |
$3,608.00
|
| 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 |
$310.74 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$5,330.00
|
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,330.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,810.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$5,740.00
|
| 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 |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$7,380.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,740.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,150.00
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$6,970.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,057.42
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$7,245.94
|
| Rate for Payer: Priority Health SBD |
$5,166.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$310.74
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$3,034.00
|
| Rate for Payer: VA VA |
$2,877.15
|
| 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 |
$423.38 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$5,330.00
|
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,330.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,810.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$5,740.00
|
| 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 |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$7,380.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,740.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,150.00
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$6,970.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,057.42
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$7,245.94
|
| Rate for Payer: Priority Health SBD |
$5,166.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$465.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$423.38
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$3,034.00
|
| Rate for Payer: VA VA |
$2,877.15
|
| 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 |
$3,608.00 |
| Max. Negotiated Rate |
$7,380.00 |
| Rate for Payer: Aetna American Axle |
$5,330.00
|
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,330.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$5,740.00
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$5,740.00
|
| 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 SBD |
$5,166.00
|
| Rate for Payer: UMR Bronson Commercial |
$3,608.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,150.00
|
|
|
HC OSTEOCALCIN
|
Facility
|
OP
|
$100.98
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.33 |
| Max. Negotiated Rate |
$90.88 |
| Rate for Payer: Aetna American Axle |
$65.64
|
| Rate for Payer: Aetna Commercial |
$85.83
|
| Rate for Payer: Aetna Medicare |
$31.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.31
|
| Rate for Payer: BCBS Complete |
$17.15
|
| Rate for Payer: BCBS MAPPO |
$29.85
|
| Rate for Payer: BCBS Trust/PPO |
$26.85
|
| Rate for Payer: BCN Medicare Advantage |
$29.85
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cofinity Commercial |
$86.84
|
| Rate for Payer: Cofinity Commercial |
$70.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.85
|
| Rate for Payer: Healthscope Commercial |
$90.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.74
|
| Rate for Payer: Mclaren Medicaid |
$16.33
|
| Rate for Payer: Mclaren Medicare |
$29.85
|
| Rate for Payer: Meridian Medicaid |
$17.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.83
|
| Rate for Payer: PACE Medicare |
$28.36
|
| Rate for Payer: PACE SWMI |
$29.85
|
| Rate for Payer: PHP Commercial |
$85.83
|
| Rate for Payer: PHP Medicare Advantage |
$29.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.94
|
| Rate for Payer: Priority Health Medicare |
$29.85
|
| Rate for Payer: Priority Health Narrow Network |
$32.75
|
| Rate for Payer: Priority Health SBD |
$63.62
|
| Rate for Payer: Railroad Medicare Medicare |
$29.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.82
|
| Rate for Payer: UHC Core |
$49.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.85
|
| Rate for Payer: UHC Exchange |
$29.85
|
| Rate for Payer: UHC Medicare Advantage |
$30.75
|
| Rate for Payer: UMR Bronson Commercial |
$37.36
|
| Rate for Payer: VA VA |
$29.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.74
|
|
|
HC OSTEOCALCIN
|
Facility
|
IP
|
$100.98
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.43 |
| Max. Negotiated Rate |
$90.88 |
| Rate for Payer: Aetna American Axle |
$65.64
|
| Rate for Payer: Aetna Commercial |
$85.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.64
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cofinity Commercial |
$70.69
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$70.69
|
| 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 SBD |
$63.62
|
| Rate for Payer: UMR Bronson Commercial |
$44.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.74
|
|
|
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 |
$11.43 |
| Max. Negotiated Rate |
$72.60 |
| Rate for Payer: Aetna American Axle |
$20.08
|
| Rate for Payer: Aetna Commercial |
$26.26
|
| Rate for Payer: Aetna Medicare |
$23.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.82
|
| Rate for Payer: BCBS Complete |
$13.25
|
| Rate for Payer: BCBS MAPPO |
$23.06
|
| Rate for Payer: BCBS Trust/PPO |
$48.11
|
| Rate for Payer: BCN Medicare Advantage |
$23.06
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cofinity Commercial |
$21.63
|
| 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 |
$23.06
|
| Rate for Payer: Healthscope Commercial |
$27.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.18
|
| Rate for Payer: Mclaren Medicaid |
$12.61
|
| Rate for Payer: Mclaren Medicare |
$23.06
|
| Rate for Payer: Meridian Medicaid |
$13.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.26
|
| Rate for Payer: PACE Medicare |
$21.91
|
| Rate for Payer: PACE SWMI |
$23.06
|
| Rate for Payer: PHP Commercial |
$26.26
|
| Rate for Payer: PHP Medicare Advantage |
$23.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.60
|
| Rate for Payer: Priority Health Medicare |
$23.06
|
| Rate for Payer: Priority Health Narrow Network |
$58.08
|
| Rate for Payer: Priority Health SBD |
$19.47
|
| Rate for Payer: Railroad Medicare Medicare |
$23.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.06
|
| Rate for Payer: UHC Exchange |
$22.27
|
| Rate for Payer: UHC Medicare Advantage |
$23.75
|
| Rate for Payer: UMR Bronson Commercial |
$11.43
|
| Rate for Payer: VA VA |
$23.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.18
|
|
|
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 |
$13.60 |
| Max. Negotiated Rate |
$27.81 |
| Rate for Payer: Aetna American Axle |
$20.08
|
| Rate for Payer: Aetna Commercial |
$26.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.08
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cofinity Commercial |
$21.63
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$21.63
|
| 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 SBD |
$19.47
|
| Rate for Payer: UMR Bronson Commercial |
$13.60
|
| 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 |
$11.43 |
| Max. Negotiated Rate |
$72.60 |
| Rate for Payer: Aetna American Axle |
$20.08
|
| Rate for Payer: Aetna Commercial |
$26.26
|
| Rate for Payer: Aetna Medicare |
$23.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.82
|
| Rate for Payer: BCBS Complete |
$13.25
|
| Rate for Payer: BCBS MAPPO |
$23.06
|
| Rate for Payer: BCBS Trust/PPO |
$64.89
|
| Rate for Payer: BCN Medicare Advantage |
$23.06
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cofinity Commercial |
$26.57
|
| Rate for Payer: Cofinity Commercial |
$21.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.06
|
| Rate for Payer: Healthscope Commercial |
$27.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.18
|
| Rate for Payer: Mclaren Medicaid |
$12.61
|
| Rate for Payer: Mclaren Medicare |
$23.06
|
| Rate for Payer: Meridian Medicaid |
$13.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.26
|
| Rate for Payer: PACE Medicare |
$21.91
|
| Rate for Payer: PACE SWMI |
$23.06
|
| Rate for Payer: PHP Commercial |
$26.26
|
| Rate for Payer: PHP Medicare Advantage |
$23.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.60
|
| Rate for Payer: Priority Health Medicare |
$23.06
|
| Rate for Payer: Priority Health Narrow Network |
$58.08
|
| Rate for Payer: Priority Health SBD |
$19.47
|
| Rate for Payer: Railroad Medicare Medicare |
$23.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.06
|
| Rate for Payer: UHC Exchange |
$33.73
|
| Rate for Payer: UHC Medicare Advantage |
$23.75
|
| Rate for Payer: UMR Bronson Commercial |
$11.43
|
| Rate for Payer: VA VA |
$23.06
|
| 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 |
$13.60 |
| Max. Negotiated Rate |
$27.81 |
| Rate for Payer: Aetna American Axle |
$20.08
|
| Rate for Payer: Aetna Commercial |
$26.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.08
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cofinity Commercial |
$21.63
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$21.63
|
| 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 SBD |
$19.47
|
| Rate for Payer: UMR Bronson Commercial |
$13.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.18
|
|
|
HC OSTEOPATHIC MANIPULATION 5-6 BODY REGIONS
|
Facility
|
IP
|
$58.25
|
|
|
Service Code
|
CPT 98927
|
| Hospital Charge Code |
53000003
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$25.63 |
| Max. Negotiated Rate |
$52.42 |
| Rate for Payer: Aetna American Axle |
$37.86
|
| Rate for Payer: Aetna Commercial |
$49.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.86
|
| Rate for Payer: Cash Price |
$46.60
|
| Rate for Payer: Cofinity Commercial |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$50.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.60
|
| Rate for Payer: Healthscope Commercial |
$52.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.51
|
| Rate for Payer: PHP Commercial |
$49.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.78
|
| Rate for Payer: Priority Health SBD |
$36.70
|
| Rate for Payer: UMR Bronson Commercial |
$25.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.69
|
|
|
HC OSTEOPATHIC MANIPULATION 5-6 BODY REGIONS
|
Facility
|
OP
|
$58.25
|
|
|
Service Code
|
CPT 98927
|
| Hospital Charge Code |
53000003
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$12.61 |
| Max. Negotiated Rate |
$80.53 |
| Rate for Payer: Aetna American Axle |
$37.86
|
| Rate for Payer: Aetna Commercial |
$49.51
|
| Rate for Payer: Aetna Medicare |
$23.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.82
|
| Rate for Payer: BCBS Complete |
$13.25
|
| Rate for Payer: BCBS MAPPO |
$23.06
|
| Rate for Payer: BCBS Trust/PPO |
$80.53
|
| Rate for Payer: BCN Medicare Advantage |
$23.06
|
| Rate for Payer: Cash Price |
$46.60
|
| Rate for Payer: Cash Price |
$46.60
|
| Rate for Payer: Cofinity Commercial |
$50.10
|
| Rate for Payer: Cofinity Commercial |
$40.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.06
|
| Rate for Payer: Healthscope Commercial |
$52.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.69
|
| Rate for Payer: Mclaren Medicaid |
$12.61
|
| Rate for Payer: Mclaren Medicare |
$23.06
|
| Rate for Payer: Meridian Medicaid |
$13.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.51
|
| Rate for Payer: PACE Medicare |
$21.91
|
| Rate for Payer: PACE SWMI |
$23.06
|
| Rate for Payer: PHP Commercial |
$49.51
|
| Rate for Payer: PHP Medicare Advantage |
$23.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.60
|
| Rate for Payer: Priority Health Medicare |
$23.06
|
| Rate for Payer: Priority Health Narrow Network |
$58.08
|
| Rate for Payer: Priority Health SBD |
$36.70
|
| Rate for Payer: Railroad Medicare Medicare |
$23.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.06
|
| Rate for Payer: UHC Exchange |
$44.86
|
| Rate for Payer: UHC Medicare Advantage |
$23.75
|
| Rate for Payer: UMR Bronson Commercial |
$21.55
|
| Rate for Payer: VA VA |
$23.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.69
|
|
|
HC OSTEOPATHIC MANIPULATION 7-8 BODY REGIONS
|
Facility
|
OP
|
$59.54
|
|
|
Service Code
|
CPT 98928
|
| Hospital Charge Code |
53000004
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$12.61 |
| Max. Negotiated Rate |
$93.98 |
| Rate for Payer: Aetna American Axle |
$38.70
|
| Rate for Payer: Aetna Commercial |
$50.61
|
| Rate for Payer: Aetna Medicare |
$23.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.82
|
| Rate for Payer: BCBS Complete |
$13.25
|
| Rate for Payer: BCBS MAPPO |
$23.06
|
| Rate for Payer: BCBS Trust/PPO |
$93.98
|
| Rate for Payer: BCN Medicare Advantage |
$23.06
|
| Rate for Payer: Cash Price |
$47.63
|
| Rate for Payer: Cash Price |
$47.63
|
| Rate for Payer: Cofinity Commercial |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$41.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.06
|
| Rate for Payer: Healthscope Commercial |
$53.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.66
|
| Rate for Payer: Mclaren Medicaid |
$12.61
|
| Rate for Payer: Mclaren Medicare |
$23.06
|
| Rate for Payer: Meridian Medicaid |
$13.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.61
|
| Rate for Payer: PACE Medicare |
$21.91
|
| Rate for Payer: PACE SWMI |
$23.06
|
| Rate for Payer: PHP Commercial |
$50.61
|
| Rate for Payer: PHP Medicare Advantage |
$23.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.60
|
| Rate for Payer: Priority Health Medicare |
$23.06
|
| Rate for Payer: Priority Health Narrow Network |
$58.08
|
| Rate for Payer: Priority Health SBD |
$37.51
|
| Rate for Payer: Railroad Medicare Medicare |
$23.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.06
|
| Rate for Payer: UHC Exchange |
$56.65
|
| Rate for Payer: UHC Medicare Advantage |
$23.75
|
| Rate for Payer: UMR Bronson Commercial |
$22.03
|
| Rate for Payer: VA VA |
$23.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.66
|
|
|
HC OSTEOPATHIC MANIPULATION 7-8 BODY REGIONS
|
Facility
|
IP
|
$59.54
|
|
|
Service Code
|
CPT 98928
|
| Hospital Charge Code |
53000004
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$53.59 |
| Rate for Payer: Aetna American Axle |
$38.70
|
| Rate for Payer: Aetna Commercial |
$50.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.70
|
| Rate for Payer: Cash Price |
$47.63
|
| Rate for Payer: Cofinity Commercial |
$41.68
|
| Rate for Payer: Cofinity Commercial |
$51.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.63
|
| Rate for Payer: Healthscope Commercial |
$53.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.61
|
| Rate for Payer: PHP Commercial |
$50.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.68
|
| Rate for Payer: Priority Health SBD |
$37.51
|
| Rate for Payer: UMR Bronson Commercial |
$26.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.66
|
|
|
HC OSTEOPATHIC MANIPULATION 9-10 BODY REGIONS
|
Facility
|
IP
|
$64.32
|
|
|
Service Code
|
CPT 98929
|
| Hospital Charge Code |
53000005
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$28.30 |
| Max. Negotiated Rate |
$57.89 |
| Rate for Payer: Aetna American Axle |
$41.81
|
| Rate for Payer: Aetna Commercial |
$54.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.81
|
| Rate for Payer: Cash Price |
$51.46
|
| Rate for Payer: Cofinity Commercial |
$45.02
|
| Rate for Payer: Cofinity Commercial |
$55.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.46
|
| Rate for Payer: Healthscope Commercial |
$57.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.67
|
| Rate for Payer: PHP Commercial |
$54.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.02
|
| Rate for Payer: Priority Health SBD |
$40.52
|
| Rate for Payer: UMR Bronson Commercial |
$28.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.24
|
|
|
HC OSTEOPATHIC MANIPULATION 9-10 BODY REGIONS
|
Facility
|
OP
|
$64.32
|
|
|
Service Code
|
CPT 98929
|
| Hospital Charge Code |
53000005
|
|
Hospital Revenue Code
|
530
|
| Min. Negotiated Rate |
$12.61 |
| Max. Negotiated Rate |
$106.28 |
| Rate for Payer: Aetna American Axle |
$41.81
|
| Rate for Payer: Aetna Commercial |
$54.67
|
| Rate for Payer: Aetna Medicare |
$23.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.82
|
| Rate for Payer: BCBS Complete |
$13.25
|
| Rate for Payer: BCBS MAPPO |
$23.06
|
| Rate for Payer: BCBS Trust/PPO |
$106.28
|
| Rate for Payer: BCN Medicare Advantage |
$23.06
|
| Rate for Payer: Cash Price |
$51.46
|
| Rate for Payer: Cash Price |
$51.46
|
| Rate for Payer: Cofinity Commercial |
$45.02
|
| Rate for Payer: Cofinity Commercial |
$55.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.06
|
| Rate for Payer: Healthscope Commercial |
$57.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.24
|
| Rate for Payer: Mclaren Medicaid |
$12.61
|
| Rate for Payer: Mclaren Medicare |
$23.06
|
| Rate for Payer: Meridian Medicaid |
$13.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.67
|
| Rate for Payer: PACE Medicare |
$21.91
|
| Rate for Payer: PACE SWMI |
$23.06
|
| Rate for Payer: PHP Commercial |
$54.67
|
| Rate for Payer: PHP Medicare Advantage |
$23.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.60
|
| Rate for Payer: Priority Health Medicare |
$23.06
|
| Rate for Payer: Priority Health Narrow Network |
$58.08
|
| Rate for Payer: Priority Health SBD |
$40.52
|
| Rate for Payer: Railroad Medicare Medicare |
$23.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.06
|
| Rate for Payer: UHC Exchange |
$67.78
|
| Rate for Payer: UHC Medicare Advantage |
$23.75
|
| Rate for Payer: UMR Bronson Commercial |
$23.80
|
| Rate for Payer: VA VA |
$23.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.24
|
|
|
HC OSTIAL PRO SYSTEM
|
Facility
|
OP
|
$1,949.65
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$721.37 |
| Max. Negotiated Rate |
$1,754.68 |
| Rate for Payer: Aetna American Axle |
$1,267.27
|
| Rate for Payer: Aetna Commercial |
$1,657.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,267.27
|
| Rate for Payer: BCBS Complete |
$779.86
|
| Rate for Payer: Cash Price |
$1,559.72
|
| Rate for Payer: Cofinity Commercial |
$1,364.76
|
| Rate for Payer: Cofinity Commercial |
$1,676.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,559.72
|
| Rate for Payer: Healthscope Commercial |
$1,754.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,364.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,462.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,657.20
|
| Rate for Payer: PHP Commercial |
$1,657.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,364.76
|
| Rate for Payer: Priority Health SBD |
$1,228.28
|
| Rate for Payer: UMR Bronson Commercial |
$721.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,462.24
|
|
|
HC OSTIAL PRO SYSTEM
|
Facility
|
IP
|
$1,949.65
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$857.85 |
| Max. Negotiated Rate |
$1,754.68 |
| Rate for Payer: Aetna American Axle |
$1,267.27
|
| Rate for Payer: Aetna Commercial |
$1,657.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,267.27
|
| Rate for Payer: Cash Price |
$1,559.72
|
| Rate for Payer: Cofinity Commercial |
$1,364.76
|
| Rate for Payer: Cofinity Commercial |
$1,676.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,559.72
|
| Rate for Payer: Healthscope Commercial |
$1,754.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,364.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,462.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,657.20
|
| Rate for Payer: PHP Commercial |
$1,657.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,364.76
|
| Rate for Payer: Priority Health SBD |
$1,228.28
|
| Rate for Payer: UMR Bronson Commercial |
$857.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,462.24
|
|
|
HC OSTO-ZYME
|
Facility
|
OP
|
$42.25
|
|
| Hospital Charge Code |
27000129
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.63 |
| Max. Negotiated Rate |
$38.02 |
| Rate for Payer: Aetna American Axle |
$27.46
|
| Rate for Payer: Aetna Commercial |
$35.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.46
|
| Rate for Payer: BCBS Complete |
$16.90
|
| Rate for Payer: Cash Price |
$33.80
|
| Rate for Payer: Cofinity Commercial |
$29.58
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.80
|
| Rate for Payer: Healthscope Commercial |
$38.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.91
|
| Rate for Payer: PHP Commercial |
$35.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.58
|
| Rate for Payer: Priority Health SBD |
$26.62
|
| Rate for Payer: UMR Bronson Commercial |
$15.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.69
|
|
|
HC OSTO-ZYME
|
Facility
|
IP
|
$42.25
|
|
| Hospital Charge Code |
27000129
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.59 |
| Max. Negotiated Rate |
$38.02 |
| Rate for Payer: Aetna American Axle |
$27.46
|
| Rate for Payer: Aetna Commercial |
$35.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.46
|
| Rate for Payer: Cash Price |
$33.80
|
| Rate for Payer: Cofinity Commercial |
$29.58
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.80
|
| Rate for Payer: Healthscope Commercial |
$38.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.91
|
| Rate for Payer: PHP Commercial |
$35.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.58
|
| Rate for Payer: Priority Health SBD |
$26.62
|
| Rate for Payer: UMR Bronson Commercial |
$18.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.69
|
|
|
HC OSU OBSERVATION PER HOUR
|
Facility
|
IP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200009
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$59.11 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna American Axle |
$87.31
|
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.31
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Cofinity Commercial |
$94.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health SBD |
$84.63
|
| Rate for Payer: UMR Bronson Commercial |
$59.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
