|
HC PSYCH COLLAB CARE MGMT SUBSEQ 60 MIN
|
Facility
|
OP
|
$126.34
|
|
|
Service Code
|
CPT 99493
|
| Hospital Charge Code |
51000093
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$22.27 |
| Max. Negotiated Rate |
$113.71 |
| Rate for Payer: Aetna Commercial |
$107.39
|
| Rate for Payer: Aetna Medicare |
$32.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.48
|
| Rate for Payer: BCBS Complete |
$23.39
|
| Rate for Payer: BCBS MAPPO |
$31.59
|
| Rate for Payer: BCBS Trust/PPO |
$103.86
|
| Rate for Payer: BCN Commercial |
$103.86
|
| Rate for Payer: BCN Medicare Advantage |
$31.59
|
| Rate for Payer: Cash Price |
$101.07
|
| Rate for Payer: Cofinity Commercial |
$108.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.59
|
| Rate for Payer: Healthscope Commercial |
$113.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.75
|
| Rate for Payer: Mclaren Medicaid |
$22.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.16
|
| Rate for Payer: Meridian Medicaid |
$23.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.39
|
| Rate for Payer: Nomi Health Commercial |
$103.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.75
|
| Rate for Payer: PACE Senior Care Partners |
$30.01
|
| Rate for Payer: PACE SWMI |
$31.59
|
| Rate for Payer: PHP Commercial |
$107.39
|
| Rate for Payer: PHP Medicare Advantage |
$31.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$109.92
|
| Rate for Payer: Priority Health Medicare |
$31.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.93
|
| Rate for Payer: Railroad Medicare Medicare |
$31.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.18
|
| Rate for Payer: UHC Core |
$105.49
|
| Rate for Payer: UHC Exchange |
$31.59
|
| Rate for Payer: UHC Medicaid |
$22.27
|
| Rate for Payer: UHC Medicare Advantage |
$31.59
|
| Rate for Payer: UHCCP Medicaid |
$22.27
|
| Rate for Payer: VA VA |
$31.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.75
|
|
|
HC PSYCH COLLAB CARE MGMT SUBSEQ 60 MIN
|
Facility
|
IP
|
$126.34
|
|
|
Service Code
|
CPT 99493
|
| Hospital Charge Code |
51000093
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$87.93 |
| Max. Negotiated Rate |
$113.71 |
| Rate for Payer: Aetna Commercial |
$107.39
|
| Rate for Payer: BCBS Trust/PPO |
$104.34
|
| Rate for Payer: BCN Commercial |
$104.34
|
| Rate for Payer: Cash Price |
$101.07
|
| Rate for Payer: Cofinity Commercial |
$108.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.07
|
| Rate for Payer: Healthscope Commercial |
$113.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.39
|
| Rate for Payer: Nomi Health Commercial |
$103.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.75
|
| Rate for Payer: PHP Commercial |
$107.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$109.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.18
|
| Rate for Payer: UHC Core |
$105.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.75
|
|
|
HC PSYCH DIAGNOSTIC EVAL W/MED SVCS
|
Facility
|
IP
|
$202.69
|
|
|
Service Code
|
CPT 90792
|
| Hospital Charge Code |
91400008
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$141.07 |
| Max. Negotiated Rate |
$182.42 |
| Rate for Payer: Aetna Commercial |
$172.29
|
| Rate for Payer: BCBS Trust/PPO |
$167.40
|
| Rate for Payer: BCN Commercial |
$167.40
|
| Rate for Payer: Cash Price |
$162.15
|
| Rate for Payer: Cofinity Commercial |
$174.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.15
|
| Rate for Payer: Healthscope Commercial |
$182.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.29
|
| Rate for Payer: Nomi Health Commercial |
$166.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.02
|
| Rate for Payer: PHP Commercial |
$172.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$176.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.07
|
| Rate for Payer: UHC Core |
$169.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.02
|
|
|
HC PSYCH DIAGNOSTIC EVAL W/MED SVCS
|
Facility
|
OP
|
$202.69
|
|
|
Service Code
|
CPT 90792
|
| Hospital Charge Code |
91400008
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$35.73 |
| Max. Negotiated Rate |
$182.42 |
| Rate for Payer: Aetna Commercial |
$172.29
|
| Rate for Payer: Aetna Medicare |
$52.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.34
|
| Rate for Payer: BCBS Complete |
$37.52
|
| Rate for Payer: BCBS MAPPO |
$50.67
|
| Rate for Payer: BCBS Trust/PPO |
$166.63
|
| Rate for Payer: BCN Commercial |
$166.63
|
| Rate for Payer: BCN Medicare Advantage |
$50.67
|
| Rate for Payer: Cash Price |
$162.15
|
| Rate for Payer: Cofinity Commercial |
$174.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.67
|
| Rate for Payer: Healthscope Commercial |
$182.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.02
|
| Rate for Payer: Mclaren Medicaid |
$35.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.21
|
| Rate for Payer: Meridian Medicaid |
$37.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.29
|
| Rate for Payer: Nomi Health Commercial |
$166.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.02
|
| Rate for Payer: PACE Senior Care Partners |
$48.14
|
| Rate for Payer: PACE SWMI |
$50.67
|
| Rate for Payer: PHP Commercial |
$172.29
|
| Rate for Payer: PHP Medicare Advantage |
$50.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$176.34
|
| Rate for Payer: Priority Health Medicare |
$51.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.07
|
| Rate for Payer: Railroad Medicare Medicare |
$50.67
|
| Rate for Payer: UHC Core |
$169.25
|
| Rate for Payer: UHC Exchange |
$50.67
|
| Rate for Payer: UHC Medicaid |
$35.73
|
| Rate for Payer: UHC Medicare Advantage |
$50.67
|
| Rate for Payer: UHCCP Medicaid |
$35.73
|
| Rate for Payer: VA VA |
$50.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.02
|
|
|
HC PSYCHIATRIC DIAG EVAL
|
Facility
|
OP
|
$202.69
|
|
|
Service Code
|
CPT 90791
|
| Hospital Charge Code |
91400004
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$35.73 |
| Max. Negotiated Rate |
$182.42 |
| Rate for Payer: Aetna Commercial |
$172.29
|
| Rate for Payer: Aetna Medicare |
$52.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.34
|
| Rate for Payer: BCBS Complete |
$37.52
|
| Rate for Payer: BCBS MAPPO |
$50.67
|
| Rate for Payer: BCBS Trust/PPO |
$166.63
|
| Rate for Payer: BCN Commercial |
$166.63
|
| Rate for Payer: BCN Medicare Advantage |
$50.67
|
| Rate for Payer: Cash Price |
$162.15
|
| Rate for Payer: Cofinity Commercial |
$174.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.67
|
| Rate for Payer: Healthscope Commercial |
$182.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.02
|
| Rate for Payer: Mclaren Medicaid |
$35.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.21
|
| Rate for Payer: Meridian Medicaid |
$37.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.29
|
| Rate for Payer: Nomi Health Commercial |
$166.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.02
|
| Rate for Payer: PACE Senior Care Partners |
$48.14
|
| Rate for Payer: PACE SWMI |
$50.67
|
| Rate for Payer: PHP Commercial |
$172.29
|
| Rate for Payer: PHP Medicare Advantage |
$50.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$176.34
|
| Rate for Payer: Priority Health Medicare |
$51.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.07
|
| Rate for Payer: Railroad Medicare Medicare |
$50.67
|
| Rate for Payer: UHC Core |
$169.25
|
| Rate for Payer: UHC Exchange |
$50.67
|
| Rate for Payer: UHC Medicaid |
$35.73
|
| Rate for Payer: UHC Medicare Advantage |
$50.67
|
| Rate for Payer: UHCCP Medicaid |
$35.73
|
| Rate for Payer: VA VA |
$50.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.02
|
|
|
HC PSYCHIATRIC DIAG EVAL
|
Facility
|
IP
|
$202.69
|
|
|
Service Code
|
CPT 90791
|
| Hospital Charge Code |
91400004
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$141.07 |
| Max. Negotiated Rate |
$182.42 |
| Rate for Payer: Aetna Commercial |
$172.29
|
| Rate for Payer: BCBS Trust/PPO |
$167.40
|
| Rate for Payer: BCN Commercial |
$167.40
|
| Rate for Payer: Cash Price |
$162.15
|
| Rate for Payer: Cofinity Commercial |
$174.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.15
|
| Rate for Payer: Healthscope Commercial |
$182.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.29
|
| Rate for Payer: Nomi Health Commercial |
$166.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.02
|
| Rate for Payer: PHP Commercial |
$172.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$176.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.07
|
| Rate for Payer: UHC Core |
$169.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.02
|
|
|
HC PSYCH/NEUROPSYCH TEST BY PHYS 30 MIN
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 96136
|
| Hospital Charge Code |
91800009
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC PSYCH/NEUROPSYCH TEST BY PHYS 30 MIN
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 96136
|
| Hospital Charge Code |
91800009
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH 30 MIN
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 96138
|
| Hospital Charge Code |
91800011
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH 30 MIN
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 96138
|
| Hospital Charge Code |
91800011
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH EA ADDL 30 MIN
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
CPT 96139
|
| Hospital Charge Code |
91800012
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$2.81 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$4.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.97
|
| Rate for Payer: BCBS Complete |
$2.95
|
| Rate for Payer: BCBS MAPPO |
$3.98
|
| Rate for Payer: BCBS Trust/PPO |
$13.09
|
| Rate for Payer: BCN Commercial |
$13.09
|
| Rate for Payer: BCN Medicare Advantage |
$3.98
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.98
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Mclaren Medicaid |
$2.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.18
|
| Rate for Payer: Meridian Medicaid |
$2.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PACE Senior Care Partners |
$3.78
|
| Rate for Payer: PACE SWMI |
$3.98
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: PHP Medicare Advantage |
$3.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.85
|
| Rate for Payer: Priority Health Medicare |
$4.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.08
|
| Rate for Payer: Railroad Medicare Medicare |
$3.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.01
|
| Rate for Payer: UHC Core |
$13.29
|
| Rate for Payer: UHC Exchange |
$3.98
|
| Rate for Payer: UHC Medicaid |
$2.81
|
| Rate for Payer: UHC Medicare Advantage |
$3.98
|
| Rate for Payer: UHCCP Medicaid |
$2.81
|
| Rate for Payer: VA VA |
$3.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH EA ADDL 30 MIN
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
CPT 96139
|
| Hospital Charge Code |
91800012
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: BCBS Trust/PPO |
$13.15
|
| Rate for Payer: BCN Commercial |
$13.15
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.01
|
| Rate for Payer: UHC Core |
$13.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC PSYCH/NEUROPSYCH TEST PHYS EA ADDL 30 MIN
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
CPT 96137
|
| Hospital Charge Code |
91800010
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: BCBS Trust/PPO |
$13.15
|
| Rate for Payer: BCN Commercial |
$13.15
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.01
|
| Rate for Payer: UHC Core |
$13.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC PSYCH/NEUROPSYCH TEST PHYS EA ADDL 30 MIN
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
CPT 96137
|
| Hospital Charge Code |
91800010
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$2.81 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$4.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.97
|
| Rate for Payer: BCBS Complete |
$2.95
|
| Rate for Payer: BCBS MAPPO |
$3.98
|
| Rate for Payer: BCBS Trust/PPO |
$13.09
|
| Rate for Payer: BCN Commercial |
$13.09
|
| Rate for Payer: BCN Medicare Advantage |
$3.98
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.98
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Mclaren Medicaid |
$2.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.18
|
| Rate for Payer: Meridian Medicaid |
$2.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PACE Senior Care Partners |
$3.78
|
| Rate for Payer: PACE SWMI |
$3.98
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: PHP Medicare Advantage |
$3.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.85
|
| Rate for Payer: Priority Health Medicare |
$4.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.08
|
| Rate for Payer: Railroad Medicare Medicare |
$3.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.01
|
| Rate for Payer: UHC Core |
$13.29
|
| Rate for Payer: UHC Exchange |
$3.98
|
| Rate for Payer: UHC Medicaid |
$2.81
|
| Rate for Payer: UHC Medicare Advantage |
$3.98
|
| Rate for Payer: UHCCP Medicaid |
$2.81
|
| Rate for Payer: VA VA |
$3.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC PSYCH/NEUROPSYCH TEST SINGLE AUTOMATED
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 96146
|
| Hospital Charge Code |
91800013
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC PSYCH/NEUROPSYCH TEST SINGLE AUTOMATED
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 96146
|
| Hospital Charge Code |
91800013
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC PSYCHOLOGICAL TEST EVAL PHYS/QHP 1ST HOUR
|
Facility
|
IP
|
$728.28
|
|
|
Service Code
|
CPT 96130
|
| Hospital Charge Code |
91800450
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$506.88 |
| Max. Negotiated Rate |
$655.45 |
| Rate for Payer: Aetna Commercial |
$619.04
|
| Rate for Payer: BCBS Trust/PPO |
$601.49
|
| Rate for Payer: BCN Commercial |
$601.49
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cofinity Commercial |
$626.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.62
|
| Rate for Payer: Healthscope Commercial |
$655.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.04
|
| Rate for Payer: Nomi Health Commercial |
$597.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.21
|
| Rate for Payer: PHP Commercial |
$619.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$633.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$506.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$640.89
|
| Rate for Payer: UHC Core |
$608.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.21
|
|
|
HC PSYCHOLOGICAL TEST EVAL PHYS/QHP 1ST HOUR
|
Facility
|
OP
|
$728.28
|
|
|
Service Code
|
CPT 96130
|
| Hospital Charge Code |
91800450
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$128.40 |
| Max. Negotiated Rate |
$655.45 |
| Rate for Payer: Aetna Commercial |
$619.04
|
| Rate for Payer: Aetna Medicare |
$189.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$227.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$227.59
|
| Rate for Payer: BCBS Complete |
$134.80
|
| Rate for Payer: BCBS MAPPO |
$182.07
|
| Rate for Payer: BCBS Trust/PPO |
$598.72
|
| Rate for Payer: BCN Commercial |
$598.72
|
| Rate for Payer: BCN Medicare Advantage |
$182.07
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cofinity Commercial |
$626.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.07
|
| Rate for Payer: Healthscope Commercial |
$655.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.21
|
| Rate for Payer: Mclaren Medicaid |
$128.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.17
|
| Rate for Payer: Meridian Medicaid |
$134.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$209.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$200.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.04
|
| Rate for Payer: Nomi Health Commercial |
$597.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.21
|
| Rate for Payer: PACE Senior Care Partners |
$172.97
|
| Rate for Payer: PACE SWMI |
$182.07
|
| Rate for Payer: PHP Commercial |
$619.04
|
| Rate for Payer: PHP Medicare Advantage |
$182.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$633.60
|
| Rate for Payer: Priority Health Medicare |
$183.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$506.88
|
| Rate for Payer: Railroad Medicare Medicare |
$182.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$640.89
|
| Rate for Payer: UHC Core |
$608.11
|
| Rate for Payer: UHC Exchange |
$182.07
|
| Rate for Payer: UHC Medicaid |
$128.40
|
| Rate for Payer: UHC Medicare Advantage |
$182.07
|
| Rate for Payer: UHCCP Medicaid |
$128.40
|
| Rate for Payer: VA VA |
$182.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.21
|
|
|
HC PSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HOUR
|
Facility
|
IP
|
$553.49
|
|
|
Service Code
|
CPT 96131
|
| Hospital Charge Code |
91800449
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$385.23 |
| Max. Negotiated Rate |
$498.14 |
| Rate for Payer: Aetna Commercial |
$470.47
|
| Rate for Payer: BCBS Trust/PPO |
$457.13
|
| Rate for Payer: BCN Commercial |
$457.13
|
| Rate for Payer: Cash Price |
$442.79
|
| Rate for Payer: Cofinity Commercial |
$476.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.79
|
| Rate for Payer: Healthscope Commercial |
$498.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$415.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$470.47
|
| Rate for Payer: Nomi Health Commercial |
$453.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.12
|
| Rate for Payer: PHP Commercial |
$470.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$481.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$385.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$487.07
|
| Rate for Payer: UHC Core |
$462.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$415.12
|
|
|
HC PSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HOUR
|
Facility
|
OP
|
$553.49
|
|
|
Service Code
|
CPT 96131
|
| Hospital Charge Code |
91800449
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$97.58 |
| Max. Negotiated Rate |
$498.14 |
| Rate for Payer: Aetna Commercial |
$470.47
|
| Rate for Payer: Aetna Medicare |
$143.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.97
|
| Rate for Payer: BCBS Complete |
$102.45
|
| Rate for Payer: BCBS MAPPO |
$138.37
|
| Rate for Payer: BCBS Trust/PPO |
$455.02
|
| Rate for Payer: BCN Commercial |
$455.02
|
| Rate for Payer: BCN Medicare Advantage |
$138.37
|
| Rate for Payer: Cash Price |
$442.79
|
| Rate for Payer: Cofinity Commercial |
$476.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.37
|
| Rate for Payer: Healthscope Commercial |
$498.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$415.12
|
| Rate for Payer: Mclaren Medicaid |
$97.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.29
|
| Rate for Payer: Meridian Medicaid |
$102.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$152.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$470.47
|
| Rate for Payer: Nomi Health Commercial |
$453.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.12
|
| Rate for Payer: PACE Senior Care Partners |
$131.45
|
| Rate for Payer: PACE SWMI |
$138.37
|
| Rate for Payer: PHP Commercial |
$470.47
|
| Rate for Payer: PHP Medicare Advantage |
$138.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$481.54
|
| Rate for Payer: Priority Health Medicare |
$139.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$385.23
|
| Rate for Payer: Railroad Medicare Medicare |
$138.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$487.07
|
| Rate for Payer: UHC Core |
$462.16
|
| Rate for Payer: UHC Exchange |
$138.37
|
| Rate for Payer: UHC Medicaid |
$97.58
|
| Rate for Payer: UHC Medicare Advantage |
$138.37
|
| Rate for Payer: UHCCP Medicaid |
$97.58
|
| Rate for Payer: VA VA |
$138.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$415.12
|
|
|
HC PSYCHOTHERAPY 30 MIN W/PATIENT
|
Facility
|
IP
|
$88.70
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
91400001
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$61.74 |
| Max. Negotiated Rate |
$79.83 |
| Rate for Payer: Aetna Commercial |
$75.39
|
| Rate for Payer: BCBS Trust/PPO |
$73.26
|
| Rate for Payer: BCN Commercial |
$73.26
|
| Rate for Payer: Cash Price |
$70.96
|
| Rate for Payer: Cofinity Commercial |
$76.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.96
|
| Rate for Payer: Healthscope Commercial |
$79.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.39
|
| Rate for Payer: Nomi Health Commercial |
$72.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.53
|
| Rate for Payer: PHP Commercial |
$75.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.74
|
| Rate for Payer: UHC Core |
$74.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.53
|
|
|
HC PSYCHOTHERAPY 30 MIN W/PATIENT
|
Facility
|
OP
|
$88.70
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
91400001
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$15.64 |
| Max. Negotiated Rate |
$79.83 |
| Rate for Payer: Aetna Commercial |
$75.39
|
| Rate for Payer: Aetna Medicare |
$23.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.72
|
| Rate for Payer: BCBS Complete |
$16.42
|
| Rate for Payer: BCBS MAPPO |
$22.18
|
| Rate for Payer: BCBS Trust/PPO |
$72.92
|
| Rate for Payer: BCN Commercial |
$72.92
|
| Rate for Payer: BCN Medicare Advantage |
$22.18
|
| Rate for Payer: Cash Price |
$70.96
|
| Rate for Payer: Cofinity Commercial |
$76.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.18
|
| Rate for Payer: Healthscope Commercial |
$79.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.53
|
| Rate for Payer: Mclaren Medicaid |
$15.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.28
|
| Rate for Payer: Meridian Medicaid |
$16.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.39
|
| Rate for Payer: Nomi Health Commercial |
$72.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.53
|
| Rate for Payer: PACE Senior Care Partners |
$21.07
|
| Rate for Payer: PACE SWMI |
$22.18
|
| Rate for Payer: PHP Commercial |
$75.39
|
| Rate for Payer: PHP Medicare Advantage |
$22.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.17
|
| Rate for Payer: Priority Health Medicare |
$22.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.74
|
| Rate for Payer: Railroad Medicare Medicare |
$22.18
|
| Rate for Payer: UHC Core |
$74.06
|
| Rate for Payer: UHC Exchange |
$22.18
|
| Rate for Payer: UHC Medicaid |
$15.64
|
| Rate for Payer: UHC Medicare Advantage |
$22.18
|
| Rate for Payer: UHCCP Medicaid |
$15.64
|
| Rate for Payer: VA VA |
$22.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.53
|
|
|
HC PSYCHOTHERAPY 45 MIN W/PATIENT
|
Facility
|
IP
|
$159.23
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
91400002
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$110.82 |
| Max. Negotiated Rate |
$143.31 |
| Rate for Payer: Aetna Commercial |
$135.35
|
| Rate for Payer: BCBS Trust/PPO |
$131.51
|
| Rate for Payer: BCN Commercial |
$131.51
|
| Rate for Payer: Cash Price |
$127.38
|
| Rate for Payer: Cofinity Commercial |
$136.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.38
|
| Rate for Payer: Healthscope Commercial |
$143.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.35
|
| Rate for Payer: Nomi Health Commercial |
$130.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.42
|
| Rate for Payer: PHP Commercial |
$135.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$138.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.82
|
| Rate for Payer: UHC Core |
$132.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.42
|
|
|
HC PSYCHOTHERAPY 45 MIN W/PATIENT
|
Facility
|
OP
|
$159.23
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
91400002
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$28.07 |
| Max. Negotiated Rate |
$143.31 |
| Rate for Payer: Aetna Commercial |
$135.35
|
| Rate for Payer: Aetna Medicare |
$41.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.76
|
| Rate for Payer: BCBS Complete |
$29.47
|
| Rate for Payer: BCBS MAPPO |
$39.81
|
| Rate for Payer: BCBS Trust/PPO |
$130.90
|
| Rate for Payer: BCN Commercial |
$130.90
|
| Rate for Payer: BCN Medicare Advantage |
$39.81
|
| Rate for Payer: Cash Price |
$127.38
|
| Rate for Payer: Cofinity Commercial |
$136.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.81
|
| Rate for Payer: Healthscope Commercial |
$143.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.42
|
| Rate for Payer: Mclaren Medicaid |
$28.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.80
|
| Rate for Payer: Meridian Medicaid |
$29.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.35
|
| Rate for Payer: Nomi Health Commercial |
$130.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.42
|
| Rate for Payer: PACE Senior Care Partners |
$37.82
|
| Rate for Payer: PACE SWMI |
$39.81
|
| Rate for Payer: PHP Commercial |
$135.35
|
| Rate for Payer: PHP Medicare Advantage |
$39.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$138.53
|
| Rate for Payer: Priority Health Medicare |
$40.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.82
|
| Rate for Payer: Railroad Medicare Medicare |
$39.81
|
| Rate for Payer: UHC Core |
$132.96
|
| Rate for Payer: UHC Exchange |
$39.81
|
| Rate for Payer: UHC Medicaid |
$28.07
|
| Rate for Payer: UHC Medicare Advantage |
$39.81
|
| Rate for Payer: UHCCP Medicaid |
$28.07
|
| Rate for Payer: VA VA |
$39.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.42
|
|
|
HC PSYCHOTHERAPY 60 MIN W PT
|
Facility
|
OP
|
$133.71
|
|
|
Service Code
|
CPT 90837
|
| Hospital Charge Code |
91400005
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$23.57 |
| Max. Negotiated Rate |
$120.34 |
| Rate for Payer: Aetna Commercial |
$113.65
|
| Rate for Payer: Aetna Medicare |
$34.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.78
|
| Rate for Payer: BCBS Complete |
$24.75
|
| Rate for Payer: BCBS MAPPO |
$33.43
|
| Rate for Payer: BCBS Trust/PPO |
$109.92
|
| Rate for Payer: BCN Commercial |
$109.92
|
| Rate for Payer: BCN Medicare Advantage |
$33.43
|
| Rate for Payer: Cash Price |
$106.97
|
| Rate for Payer: Cofinity Commercial |
$114.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.43
|
| Rate for Payer: Healthscope Commercial |
$120.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.28
|
| Rate for Payer: Mclaren Medicaid |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.10
|
| Rate for Payer: Meridian Medicaid |
$24.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.65
|
| Rate for Payer: Nomi Health Commercial |
$109.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.28
|
| Rate for Payer: PACE Senior Care Partners |
$31.76
|
| Rate for Payer: PACE SWMI |
$33.43
|
| Rate for Payer: PHP Commercial |
$113.65
|
| Rate for Payer: PHP Medicare Advantage |
$33.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.33
|
| Rate for Payer: Priority Health Medicare |
$33.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.06
|
| Rate for Payer: Railroad Medicare Medicare |
$33.43
|
| Rate for Payer: UHC Core |
$111.65
|
| Rate for Payer: UHC Exchange |
$33.43
|
| Rate for Payer: UHC Medicaid |
$23.57
|
| Rate for Payer: UHC Medicare Advantage |
$33.43
|
| Rate for Payer: UHCCP Medicaid |
$23.57
|
| Rate for Payer: VA VA |
$33.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.28
|
|
