|
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 |
$85.70 |
| Max. Negotiated Rate |
$122.43 |
| Rate for Payer: Aetna Commercial |
$110.19
|
| Rate for Payer: ASR ASR |
$118.76
|
| Rate for Payer: BCBS Trust/PPO |
$94.92
|
| Rate for Payer: BCN Commercial |
$94.92
|
| Rate for Payer: Cash Price |
$97.94
|
| Rate for Payer: Cofinity Commercial |
$115.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.94
|
| Rate for Payer: Healthscope Commercial |
$122.43
|
| Rate for Payer: Healthscope Whirlpool |
$118.76
|
| Rate for Payer: Mclaren Commercial |
$110.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.74
|
|
|
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 |
$48.97 |
| Max. Negotiated Rate |
$122.43 |
| Rate for Payer: Aetna Commercial |
$110.19
|
| Rate for Payer: ASR ASR |
$118.76
|
| Rate for Payer: BCBS Complete |
$48.97
|
| Rate for Payer: BCBS Trust/PPO |
$94.92
|
| Rate for Payer: BCN Commercial |
$94.92
|
| Rate for Payer: Cash Price |
$97.94
|
| Rate for Payer: Cash Price |
$97.94
|
| Rate for Payer: Cofinity Commercial |
$115.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.94
|
| Rate for Payer: Healthscope Commercial |
$122.43
|
| Rate for Payer: Healthscope Whirlpool |
$118.76
|
| Rate for Payer: Mclaren Commercial |
$110.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.06
|
| Rate for Payer: Priority Health Narrow Network |
$64.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.74
|
|
|
HC OSCILLATOR INIT DAY
|
Facility
|
IP
|
$2,363.12
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000039
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,654.18 |
| Max. Negotiated Rate |
$2,363.12 |
| Rate for Payer: Aetna Commercial |
$2,126.81
|
| Rate for Payer: ASR ASR |
$2,292.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,832.13
|
| Rate for Payer: BCN Commercial |
$1,832.13
|
| Rate for Payer: Cash Price |
$1,890.50
|
| Rate for Payer: Cofinity Commercial |
$2,221.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,890.50
|
| Rate for Payer: Healthscope Commercial |
$2,363.12
|
| Rate for Payer: Healthscope Whirlpool |
$2,292.23
|
| Rate for Payer: Mclaren Commercial |
$2,126.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,008.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,079.55
|
|
|
HC OSCILLATOR INIT DAY
|
Facility
|
OP
|
$2,363.12
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000039
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$304.70 |
| Max. Negotiated Rate |
$3,776.34 |
| Rate for Payer: Aetna Commercial |
$2,126.81
|
| Rate for Payer: Aetna Medicare |
$557.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$696.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$696.29
|
| Rate for Payer: ASR ASR |
$2,292.23
|
| Rate for Payer: BCBS Complete |
$319.96
|
| Rate for Payer: BCBS MAPPO |
$557.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,832.13
|
| Rate for Payer: BCN Commercial |
$1,832.13
|
| Rate for Payer: BCN Medicare Advantage |
$557.03
|
| Rate for Payer: Cash Price |
$1,890.50
|
| Rate for Payer: Cash Price |
$1,890.50
|
| Rate for Payer: Cofinity Commercial |
$2,221.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,890.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.03
|
| Rate for Payer: Healthscope Commercial |
$2,363.12
|
| Rate for Payer: Healthscope Whirlpool |
$2,292.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$557.03
|
| Rate for Payer: Mclaren Commercial |
$2,126.81
|
| Rate for Payer: Mclaren Medicaid |
$304.70
|
| Rate for Payer: Mclaren Medicare |
$557.03
|
| Rate for Payer: Meridian Medicaid |
$319.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$584.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$640.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,008.65
|
| Rate for Payer: PACE Medicare |
$529.18
|
| Rate for Payer: PACE SWMI |
$557.03
|
| Rate for Payer: PHP Commercial |
$612.73
|
| Rate for Payer: PHP Medicaid |
$304.70
|
| Rate for Payer: PHP Medicare Advantage |
$557.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,776.34
|
| Rate for Payer: Priority Health Medicare |
$557.03
|
| Rate for Payer: Priority Health Narrow Network |
$3,021.07
|
| Rate for Payer: Railroad Medicare Medicare |
$557.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,079.55
|
| Rate for Payer: UHC Medicare Advantage |
$573.74
|
| Rate for Payer: VA VA |
$557.03
|
|
|
HC OSCILLATOR SUB DAY
|
Facility
|
IP
|
$1,321.84
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000040
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$925.29 |
| Max. Negotiated Rate |
$1,321.84 |
| Rate for Payer: Aetna Commercial |
$1,189.66
|
| Rate for Payer: ASR ASR |
$1,282.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,024.82
|
| Rate for Payer: BCN Commercial |
$1,024.82
|
| Rate for Payer: Cash Price |
$1,057.47
|
| Rate for Payer: Cofinity Commercial |
$1,242.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,057.47
|
| Rate for Payer: Healthscope Commercial |
$1,321.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,282.18
|
| Rate for Payer: Mclaren Commercial |
$1,189.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,123.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,163.22
|
|
|
HC OSCILLATOR SUB DAY
|
Facility
|
OP
|
$1,321.84
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000040
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$304.70 |
| Max. Negotiated Rate |
$3,304.30 |
| Rate for Payer: Aetna Commercial |
$1,189.66
|
| Rate for Payer: Aetna Medicare |
$557.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$696.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$696.29
|
| Rate for Payer: ASR ASR |
$1,282.18
|
| Rate for Payer: BCBS Complete |
$319.96
|
| Rate for Payer: BCBS MAPPO |
$557.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,024.82
|
| Rate for Payer: BCN Commercial |
$1,024.82
|
| Rate for Payer: BCN Medicare Advantage |
$557.03
|
| Rate for Payer: Cash Price |
$1,057.47
|
| Rate for Payer: Cash Price |
$1,057.47
|
| Rate for Payer: Cofinity Commercial |
$1,242.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,057.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.03
|
| Rate for Payer: Healthscope Commercial |
$1,321.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,282.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$557.03
|
| Rate for Payer: Mclaren Commercial |
$1,189.66
|
| Rate for Payer: Mclaren Medicaid |
$304.70
|
| Rate for Payer: Mclaren Medicare |
$557.03
|
| Rate for Payer: Meridian Medicaid |
$319.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$584.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$640.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,123.56
|
| Rate for Payer: PACE Medicare |
$529.18
|
| Rate for Payer: PACE SWMI |
$557.03
|
| Rate for Payer: PHP Commercial |
$612.73
|
| Rate for Payer: PHP Medicaid |
$304.70
|
| Rate for Payer: PHP Medicare Advantage |
$557.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,304.30
|
| Rate for Payer: Priority Health Medicare |
$557.03
|
| Rate for Payer: Priority Health Narrow Network |
$2,643.44
|
| Rate for Payer: Railroad Medicare Medicare |
$557.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,163.22
|
| Rate for Payer: UHC Medicare Advantage |
$573.74
|
| Rate for Payer: VA VA |
$557.03
|
|
|
HC OSMOLALITY SERUM
|
Facility
|
IP
|
$53.86
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
30100378
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.70 |
| Max. Negotiated Rate |
$53.86 |
| Rate for Payer: Aetna Commercial |
$48.47
|
| Rate for Payer: ASR ASR |
$52.24
|
| Rate for Payer: BCBS Trust/PPO |
$41.76
|
| Rate for Payer: BCN Commercial |
$41.76
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$50.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.09
|
| Rate for Payer: Healthscope Commercial |
$53.86
|
| Rate for Payer: Healthscope Whirlpool |
$52.24
|
| Rate for Payer: Mclaren Commercial |
$48.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.40
|
|
|
HC OSMOLALITY SERUM
|
Facility
|
OP
|
$53.86
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
30100378
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$53.86 |
| Rate for Payer: Aetna Commercial |
$48.47
|
| Rate for Payer: Aetna Medicare |
$6.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.26
|
| Rate for Payer: ASR ASR |
$52.24
|
| Rate for Payer: BCBS Complete |
$3.80
|
| Rate for Payer: BCBS MAPPO |
$6.61
|
| Rate for Payer: BCBS Trust/PPO |
$41.76
|
| Rate for Payer: BCN Commercial |
$41.76
|
| Rate for Payer: BCN Medicare Advantage |
$6.61
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$50.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.61
|
| Rate for Payer: Healthscope Commercial |
$53.86
|
| Rate for Payer: Healthscope Whirlpool |
$52.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.61
|
| Rate for Payer: Mclaren Commercial |
$48.47
|
| Rate for Payer: Mclaren Medicaid |
$3.62
|
| Rate for Payer: Mclaren Medicare |
$6.61
|
| Rate for Payer: Meridian Medicaid |
$3.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.78
|
| Rate for Payer: PACE Medicare |
$6.28
|
| Rate for Payer: PACE SWMI |
$6.61
|
| Rate for Payer: PHP Commercial |
$7.27
|
| Rate for Payer: PHP Medicaid |
$3.62
|
| Rate for Payer: PHP Medicare Advantage |
$6.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.96
|
| Rate for Payer: Priority Health Medicare |
$6.61
|
| Rate for Payer: Priority Health Narrow Network |
$30.37
|
| Rate for Payer: Railroad Medicare Medicare |
$6.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.40
|
| Rate for Payer: UHC Medicare Advantage |
$6.81
|
| Rate for Payer: VA VA |
$6.61
|
|
|
HC OSMOLALITY URINE
|
Facility
|
OP
|
$52.80
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
30100379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.73 |
| Max. Negotiated Rate |
$52.80 |
| Rate for Payer: Aetna Commercial |
$47.52
|
| Rate for Payer: Aetna Medicare |
$6.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.52
|
| Rate for Payer: ASR ASR |
$51.22
|
| Rate for Payer: BCBS Complete |
$3.92
|
| Rate for Payer: BCBS MAPPO |
$6.82
|
| Rate for Payer: BCBS Trust/PPO |
$40.94
|
| Rate for Payer: BCN Commercial |
$40.94
|
| Rate for Payer: BCN Medicare Advantage |
$6.82
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cofinity Commercial |
$49.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.82
|
| Rate for Payer: Healthscope Commercial |
$52.80
|
| Rate for Payer: Healthscope Whirlpool |
$51.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.82
|
| Rate for Payer: Mclaren Commercial |
$47.52
|
| Rate for Payer: Mclaren Medicaid |
$3.73
|
| Rate for Payer: Mclaren Medicare |
$6.82
|
| Rate for Payer: Meridian Medicaid |
$3.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.88
|
| Rate for Payer: PACE Medicare |
$6.48
|
| Rate for Payer: PACE SWMI |
$6.82
|
| Rate for Payer: PHP Commercial |
$7.50
|
| Rate for Payer: PHP Medicaid |
$3.73
|
| Rate for Payer: PHP Medicare Advantage |
$6.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.05
|
| Rate for Payer: Priority Health Medicare |
$6.82
|
| Rate for Payer: Priority Health Narrow Network |
$32.84
|
| Rate for Payer: Railroad Medicare Medicare |
$6.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.46
|
| Rate for Payer: UHC Medicare Advantage |
$7.02
|
| Rate for Payer: VA VA |
$6.82
|
|
|
HC OSMOLALITY URINE
|
Facility
|
IP
|
$52.80
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
30100379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.96 |
| Max. Negotiated Rate |
$52.80 |
| Rate for Payer: Aetna Commercial |
$47.52
|
| Rate for Payer: ASR ASR |
$51.22
|
| Rate for Payer: BCBS Trust/PPO |
$40.94
|
| Rate for Payer: BCN Commercial |
$40.94
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cofinity Commercial |
$49.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.24
|
| Rate for Payer: Healthscope Commercial |
$52.80
|
| Rate for Payer: Healthscope Whirlpool |
$51.22
|
| Rate for Payer: Mclaren Commercial |
$47.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.46
|
|
|
HC OSMOTIC FRAGILITY RBC
|
Facility
|
IP
|
$128.84
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
30500052
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$90.19 |
| Max. Negotiated Rate |
$128.84 |
| Rate for Payer: Aetna Commercial |
$115.96
|
| Rate for Payer: ASR ASR |
$124.97
|
| Rate for Payer: BCBS Trust/PPO |
$99.89
|
| Rate for Payer: BCN Commercial |
$99.89
|
| Rate for Payer: Cash Price |
$103.07
|
| Rate for Payer: Cofinity Commercial |
$121.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.07
|
| Rate for Payer: Healthscope Commercial |
$128.84
|
| Rate for Payer: Healthscope Whirlpool |
$124.97
|
| Rate for Payer: Mclaren Commercial |
$115.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.38
|
|
|
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 |
$128.84 |
| Rate for Payer: Aetna Commercial |
$115.96
|
| Rate for Payer: Aetna Medicare |
$13.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.70
|
| Rate for Payer: ASR ASR |
$124.97
|
| Rate for Payer: BCBS Complete |
$7.67
|
| Rate for Payer: BCBS MAPPO |
$13.36
|
| Rate for Payer: BCBS Trust/PPO |
$99.89
|
| Rate for Payer: BCN Commercial |
$99.89
|
| 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 |
$121.11
|
| 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 |
$128.84
|
| Rate for Payer: Healthscope Whirlpool |
$124.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.36
|
| Rate for Payer: Mclaren Commercial |
$115.96
|
| 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 |
$14.70
|
| Rate for Payer: PHP Medicaid |
$7.31
|
| 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 |
$117.24
|
| Rate for Payer: Priority Health Medicare |
$13.36
|
| Rate for Payer: Priority Health Narrow Network |
$91.48
|
| Rate for Payer: Railroad Medicare Medicare |
$13.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.38
|
| Rate for Payer: UHC Medicare Advantage |
$13.76
|
| Rate for Payer: VA VA |
$13.36
|
|
|
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 |
$1,573.80 |
| Max. Negotiated Rate |
$8,200.00 |
| Rate for Payer: Aetna Commercial |
$7,380.00
|
| Rate for Payer: Aetna Medicare |
$2,877.15
|
| 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: ASR ASR |
$7,954.00
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$6,357.46
|
| Rate for Payer: BCN Commercial |
$6,357.46
|
| 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 |
$7,708.00
|
| 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 |
$8,200.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,954.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,877.15
|
| Rate for Payer: Mclaren Commercial |
$7,380.00
|
| 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 |
$3,164.86
|
| Rate for Payer: PHP Medicaid |
$1,573.80
|
| 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 |
$7,462.00
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$5,822.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,216.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
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 |
$5,740.00 |
| Max. Negotiated Rate |
$8,200.00 |
| Rate for Payer: Aetna Commercial |
$7,380.00
|
| Rate for Payer: ASR ASR |
$7,954.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,357.46
|
| Rate for Payer: BCN Commercial |
$6,357.46
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$7,708.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,560.00
|
| Rate for Payer: Healthscope Commercial |
$8,200.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,954.00
|
| Rate for Payer: Mclaren Commercial |
$7,380.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,216.00
|
|
|
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 |
$5,740.00 |
| Max. Negotiated Rate |
$8,200.00 |
| Rate for Payer: Aetna Commercial |
$7,380.00
|
| Rate for Payer: ASR ASR |
$7,954.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,357.46
|
| Rate for Payer: BCN Commercial |
$6,357.46
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$7,708.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,560.00
|
| Rate for Payer: Healthscope Commercial |
$8,200.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,954.00
|
| Rate for Payer: Mclaren Commercial |
$7,380.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,216.00
|
|
|
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 |
$1,573.80 |
| Max. Negotiated Rate |
$8,200.00 |
| Rate for Payer: Aetna Commercial |
$7,380.00
|
| Rate for Payer: Aetna Medicare |
$2,877.15
|
| 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: ASR ASR |
$7,954.00
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$6,357.46
|
| Rate for Payer: BCN Commercial |
$6,357.46
|
| 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 |
$7,708.00
|
| 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 |
$8,200.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,954.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,877.15
|
| Rate for Payer: Mclaren Commercial |
$7,380.00
|
| 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 |
$3,164.86
|
| Rate for Payer: PHP Medicaid |
$1,573.80
|
| 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 |
$7,462.00
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$5,822.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,216.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
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 |
$5,740.00 |
| Max. Negotiated Rate |
$8,200.00 |
| Rate for Payer: Aetna Commercial |
$7,380.00
|
| Rate for Payer: ASR ASR |
$7,954.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,357.46
|
| Rate for Payer: BCN Commercial |
$6,357.46
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$7,708.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,560.00
|
| Rate for Payer: Healthscope Commercial |
$8,200.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,954.00
|
| Rate for Payer: Mclaren Commercial |
$7,380.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,216.00
|
|
|
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 |
$1,573.80 |
| Max. Negotiated Rate |
$8,200.00 |
| Rate for Payer: Aetna Commercial |
$7,380.00
|
| Rate for Payer: Aetna Medicare |
$2,877.15
|
| 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: ASR ASR |
$7,954.00
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$6,357.46
|
| Rate for Payer: BCN Commercial |
$6,357.46
|
| 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 |
$7,708.00
|
| 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 |
$8,200.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,954.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,877.15
|
| Rate for Payer: Mclaren Commercial |
$7,380.00
|
| 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 |
$3,164.86
|
| Rate for Payer: PHP Medicaid |
$1,573.80
|
| 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 |
$7,462.00
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$5,822.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,216.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
HC OSTEOCALCIN
|
Facility
|
IP
|
$100.98
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.69 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Aetna Commercial |
$90.88
|
| Rate for Payer: ASR ASR |
$97.95
|
| Rate for Payer: BCBS Trust/PPO |
$78.29
|
| Rate for Payer: BCN Commercial |
$78.29
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cofinity Commercial |
$94.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.78
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Healthscope Whirlpool |
$97.95
|
| Rate for Payer: Mclaren Commercial |
$90.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.86
|
|
|
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 |
$100.98 |
| Rate for Payer: Aetna Commercial |
$90.88
|
| Rate for Payer: Aetna Medicare |
$29.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.31
|
| Rate for Payer: ASR ASR |
$97.95
|
| Rate for Payer: BCBS Complete |
$17.15
|
| Rate for Payer: BCBS MAPPO |
$29.85
|
| Rate for Payer: BCBS Trust/PPO |
$78.29
|
| Rate for Payer: BCN Commercial |
$78.29
|
| 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 |
$94.92
|
| 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 |
$100.98
|
| Rate for Payer: Healthscope Whirlpool |
$97.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$29.85
|
| Rate for Payer: Mclaren Commercial |
$90.88
|
| 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 |
$32.84
|
| Rate for Payer: PHP Medicaid |
$16.33
|
| 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 |
$91.89
|
| Rate for Payer: Priority Health Medicare |
$29.85
|
| Rate for Payer: Priority Health Narrow Network |
$71.70
|
| Rate for Payer: Railroad Medicare Medicare |
$29.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.86
|
| Rate for Payer: UHC Medicare Advantage |
$30.75
|
| Rate for Payer: VA VA |
$29.85
|
|
|
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 |
$21.63 |
| Max. Negotiated Rate |
$30.90 |
| Rate for Payer: Aetna Commercial |
$27.81
|
| Rate for Payer: ASR ASR |
$29.97
|
| Rate for Payer: BCBS Trust/PPO |
$23.96
|
| Rate for Payer: BCN Commercial |
$23.96
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cofinity Commercial |
$29.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.72
|
| Rate for Payer: Healthscope Commercial |
$30.90
|
| Rate for Payer: Healthscope Whirlpool |
$29.97
|
| Rate for Payer: Mclaren Commercial |
$27.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.19
|
|
|
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 |
$12.61 |
| Max. Negotiated Rate |
$30.90 |
| Rate for Payer: Aetna Commercial |
$27.81
|
| Rate for Payer: Aetna Medicare |
$23.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.82
|
| Rate for Payer: ASR ASR |
$29.97
|
| Rate for Payer: BCBS Complete |
$13.25
|
| Rate for Payer: BCBS MAPPO |
$23.06
|
| Rate for Payer: BCBS Trust/PPO |
$23.96
|
| Rate for Payer: BCN Commercial |
$23.96
|
| 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 |
$29.05
|
| 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 |
$30.90
|
| Rate for Payer: Healthscope Whirlpool |
$29.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.06
|
| Rate for Payer: Mclaren Commercial |
$27.81
|
| 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 |
$25.37
|
| Rate for Payer: PHP Medicaid |
$12.61
|
| 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 |
$21.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.12
|
| Rate for Payer: Priority Health Medicare |
$23.06
|
| Rate for Payer: Priority Health Narrow Network |
$21.94
|
| Rate for Payer: Railroad Medicare Medicare |
$23.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.19
|
| Rate for Payer: UHC Medicare Advantage |
$23.75
|
| Rate for Payer: VA VA |
$23.06
|
|
|
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 |
$12.61 |
| Max. Negotiated Rate |
$30.90 |
| Rate for Payer: Aetna Commercial |
$27.81
|
| Rate for Payer: Aetna Medicare |
$23.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.82
|
| Rate for Payer: ASR ASR |
$29.97
|
| Rate for Payer: BCBS Complete |
$13.25
|
| Rate for Payer: BCBS MAPPO |
$23.06
|
| Rate for Payer: BCBS Trust/PPO |
$23.96
|
| Rate for Payer: BCN Commercial |
$23.96
|
| 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 |
$29.05
|
| 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 |
$30.90
|
| Rate for Payer: Healthscope Whirlpool |
$29.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.06
|
| Rate for Payer: Mclaren Commercial |
$27.81
|
| 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 |
$25.37
|
| Rate for Payer: PHP Medicaid |
$12.61
|
| 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 |
$21.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.12
|
| Rate for Payer: Priority Health Medicare |
$23.06
|
| Rate for Payer: Priority Health Narrow Network |
$21.94
|
| Rate for Payer: Railroad Medicare Medicare |
$23.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.19
|
| Rate for Payer: UHC Medicare Advantage |
$23.75
|
| Rate for Payer: VA VA |
$23.06
|
|
|
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 |
$21.63 |
| Max. Negotiated Rate |
$30.90 |
| Rate for Payer: Aetna Commercial |
$27.81
|
| Rate for Payer: ASR ASR |
$29.97
|
| Rate for Payer: BCBS Trust/PPO |
$23.96
|
| Rate for Payer: BCN Commercial |
$23.96
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Cofinity Commercial |
$29.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.72
|
| Rate for Payer: Healthscope Commercial |
$30.90
|
| Rate for Payer: Healthscope Whirlpool |
$29.97
|
| Rate for Payer: Mclaren Commercial |
$27.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.19
|
|
|
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 |
$58.25 |
| Rate for Payer: Aetna Commercial |
$52.42
|
| Rate for Payer: Aetna Medicare |
$23.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.82
|
| Rate for Payer: ASR ASR |
$56.50
|
| Rate for Payer: BCBS Complete |
$13.25
|
| Rate for Payer: BCBS MAPPO |
$23.06
|
| Rate for Payer: BCBS Trust/PPO |
$45.16
|
| Rate for Payer: BCN Commercial |
$45.16
|
| 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 |
$54.76
|
| 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 |
$58.25
|
| Rate for Payer: Healthscope Whirlpool |
$56.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.06
|
| Rate for Payer: Mclaren Commercial |
$52.42
|
| 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 |
$25.37
|
| Rate for Payer: PHP Medicaid |
$12.61
|
| 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 |
$40.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.01
|
| Rate for Payer: Priority Health Medicare |
$23.06
|
| Rate for Payer: Priority Health Narrow Network |
$41.36
|
| Rate for Payer: Railroad Medicare Medicare |
$23.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$51.26
|
| Rate for Payer: UHC Medicare Advantage |
$23.75
|
| Rate for Payer: VA VA |
$23.06
|
|
