|
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
|
|
|
HC PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 90785
|
| Hospital Charge Code |
91400012
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$12.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.63
|
| Rate for Payer: BCBS Complete |
$8.67
|
| Rate for Payer: BCBS MAPPO |
$11.71
|
| Rate for Payer: BCBS Trust/PPO |
$38.49
|
| Rate for Payer: BCN Commercial |
$38.49
|
| Rate for Payer: BCN Medicare Advantage |
$11.71
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.71
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$8.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.29
|
| Rate for Payer: Meridian Medicaid |
$8.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PACE Senior Care Partners |
$11.12
|
| Rate for Payer: PACE SWMI |
$11.71
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$11.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.59
|
| Rate for Payer: Railroad Medicare Medicare |
$11.71
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: UHC Exchange |
$11.71
|
| Rate for Payer: UHC Medicaid |
$8.25
|
| Rate for Payer: UHC Medicare Advantage |
$11.71
|
| Rate for Payer: UHCCP Medicaid |
$8.25
|
| Rate for Payer: VA VA |
$11.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 90785
|
| Hospital Charge Code |
91400012
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$32.59 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: BCBS Trust/PPO |
$38.67
|
| Rate for Payer: BCN Commercial |
$38.67
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.59
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC PSYCHOTHERAPY FOR CRISIS EA ADDL 15 MIN
|
Facility
|
IP
|
$120.69
|
|
|
Service Code
|
CPT 90840
|
| Hospital Charge Code |
91400014
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$108.62 |
| Rate for Payer: Aetna Commercial |
$102.59
|
| Rate for Payer: BCBS Trust/PPO |
$99.68
|
| Rate for Payer: BCN Commercial |
$99.68
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cofinity Commercial |
$103.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.55
|
| Rate for Payer: Healthscope Commercial |
$108.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.59
|
| Rate for Payer: Nomi Health Commercial |
$98.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.52
|
| Rate for Payer: PHP Commercial |
$102.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$105.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.00
|
| Rate for Payer: UHC Core |
$100.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.52
|
|
|
HC PSYCHOTHERAPY FOR CRISIS EA ADDL 15 MIN
|
Facility
|
OP
|
$120.69
|
|
|
Service Code
|
CPT 90840
|
| Hospital Charge Code |
91400014
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$21.28 |
| Max. Negotiated Rate |
$108.62 |
| Rate for Payer: Aetna Commercial |
$102.59
|
| Rate for Payer: Aetna Medicare |
$31.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.72
|
| Rate for Payer: BCBS Complete |
$22.34
|
| Rate for Payer: BCBS MAPPO |
$30.17
|
| Rate for Payer: BCBS Trust/PPO |
$99.22
|
| Rate for Payer: BCN Commercial |
$99.22
|
| Rate for Payer: BCN Medicare Advantage |
$30.17
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cofinity Commercial |
$103.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.17
|
| Rate for Payer: Healthscope Commercial |
$108.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.52
|
| Rate for Payer: Mclaren Medicaid |
$21.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.68
|
| Rate for Payer: Meridian Medicaid |
$22.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.59
|
| Rate for Payer: Nomi Health Commercial |
$98.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.52
|
| Rate for Payer: PACE Senior Care Partners |
$28.66
|
| Rate for Payer: PACE SWMI |
$30.17
|
| Rate for Payer: PHP Commercial |
$102.59
|
| Rate for Payer: PHP Medicare Advantage |
$30.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$105.00
|
| Rate for Payer: Priority Health Medicare |
$30.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.00
|
| Rate for Payer: Railroad Medicare Medicare |
$30.17
|
| Rate for Payer: UHC Core |
$100.78
|
| Rate for Payer: UHC Exchange |
$30.17
|
| Rate for Payer: UHC Medicaid |
$21.28
|
| Rate for Payer: UHC Medicare Advantage |
$30.17
|
| Rate for Payer: UHCCP Medicaid |
$21.28
|
| Rate for Payer: VA VA |
$30.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.52
|
|
|
HC PSYCHOTHERAPY FOR CRISIS FIRST 60 MIN
|
Facility
|
OP
|
$234.09
|
|
|
Service Code
|
CPT 90839
|
| Hospital Charge Code |
91400003
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$41.27 |
| Max. Negotiated Rate |
$210.68 |
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: Aetna Medicare |
$60.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.15
|
| Rate for Payer: BCBS Complete |
$43.33
|
| Rate for Payer: BCBS MAPPO |
$58.52
|
| Rate for Payer: BCBS Trust/PPO |
$192.45
|
| Rate for Payer: BCN Commercial |
$192.45
|
| Rate for Payer: BCN Medicare Advantage |
$58.52
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$201.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.52
|
| Rate for Payer: Healthscope Commercial |
$210.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.57
|
| Rate for Payer: Mclaren Medicaid |
$41.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.45
|
| Rate for Payer: Meridian Medicaid |
$43.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Nomi Health Commercial |
$191.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$175.57
|
| Rate for Payer: PACE Senior Care Partners |
$55.60
|
| Rate for Payer: PACE SWMI |
$58.52
|
| Rate for Payer: PHP Commercial |
$198.98
|
| Rate for Payer: PHP Medicare Advantage |
$58.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$203.66
|
| Rate for Payer: Priority Health Medicare |
$59.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.93
|
| Rate for Payer: Railroad Medicare Medicare |
$58.52
|
| Rate for Payer: UHC Core |
$195.47
|
| Rate for Payer: UHC Exchange |
$58.52
|
| Rate for Payer: UHC Medicaid |
$41.27
|
| Rate for Payer: UHC Medicare Advantage |
$58.52
|
| Rate for Payer: UHCCP Medicaid |
$41.27
|
| Rate for Payer: VA VA |
$58.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.57
|
|
|
HC PSYCHOTHERAPY FOR CRISIS FIRST 60 MIN
|
Facility
|
IP
|
$234.09
|
|
|
Service Code
|
CPT 90839
|
| Hospital Charge Code |
91400003
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$162.93 |
| Max. Negotiated Rate |
$210.68 |
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: BCBS Trust/PPO |
$193.33
|
| Rate for Payer: BCN Commercial |
$193.33
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$201.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Healthscope Commercial |
$210.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Nomi Health Commercial |
$191.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$175.57
|
| Rate for Payer: PHP Commercial |
$198.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$203.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.93
|
| Rate for Payer: UHC Core |
$195.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.57
|
|
|
HC PTCA ADD/BRANCH
|
Facility
|
IP
|
$7,436.42
|
|
|
Service Code
|
CPT 92921
|
| Hospital Charge Code |
48100099
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,175.75 |
| Max. Negotiated Rate |
$6,692.78 |
| Rate for Payer: Aetna Commercial |
$6,320.96
|
| Rate for Payer: BCBS Trust/PPO |
$6,141.74
|
| Rate for Payer: BCN Commercial |
$6,141.74
|
| Rate for Payer: Cash Price |
$5,949.14
|
| Rate for Payer: Cofinity Commercial |
$6,395.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,949.14
|
| Rate for Payer: Healthscope Commercial |
$6,692.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,577.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,320.96
|
| Rate for Payer: Nomi Health Commercial |
$6,097.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,577.31
|
| Rate for Payer: PHP Commercial |
$6,320.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,469.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,175.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,544.05
|
| Rate for Payer: UHC Core |
$6,209.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,577.31
|
|
|
HC PTCA ADD/BRANCH
|
Facility
|
OP
|
$7,436.42
|
|
|
Service Code
|
CPT 92921
|
| Hospital Charge Code |
48100099
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,311.04 |
| Max. Negotiated Rate |
$6,692.78 |
| Rate for Payer: Aetna Commercial |
$6,320.96
|
| Rate for Payer: Aetna Medicare |
$1,933.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,323.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,323.88
|
| Rate for Payer: BCBS Complete |
$1,376.48
|
| Rate for Payer: BCBS MAPPO |
$1,859.11
|
| Rate for Payer: BCBS Trust/PPO |
$6,113.48
|
| Rate for Payer: BCN Commercial |
$6,113.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,859.11
|
| Rate for Payer: Cash Price |
$5,949.14
|
| Rate for Payer: Cofinity Commercial |
$6,395.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,949.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,859.11
|
| Rate for Payer: Healthscope Commercial |
$6,692.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,577.31
|
| Rate for Payer: Mclaren Medicaid |
$1,311.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,952.06
|
| Rate for Payer: Meridian Medicaid |
$1,376.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,137.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,045.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,320.96
|
| Rate for Payer: Nomi Health Commercial |
$6,097.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,577.31
|
| Rate for Payer: PACE Senior Care Partners |
$1,766.15
|
| Rate for Payer: PACE SWMI |
$1,859.11
|
| Rate for Payer: PHP Commercial |
$6,320.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,859.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,311.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,469.69
|
| Rate for Payer: Priority Health Medicare |
$1,877.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,175.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,859.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,544.05
|
| Rate for Payer: UHC Core |
$6,209.41
|
| Rate for Payer: UHC Exchange |
$1,859.11
|
| Rate for Payer: UHC Medicaid |
$1,311.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,859.11
|
| Rate for Payer: UHCCP Medicaid |
$1,311.04
|
| Rate for Payer: VA VA |
$1,859.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,577.31
|
|
|
HC PTCA VESSEL/BRANCH
|
Facility
|
OP
|
$11,423.75
|
|
|
Service Code
|
CPT 92920
|
| Hospital Charge Code |
48100098
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,014.01 |
| Max. Negotiated Rate |
$10,281.38 |
| Rate for Payer: Aetna Commercial |
$9,710.19
|
| Rate for Payer: Aetna Medicare |
$2,970.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,569.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,569.92
|
| Rate for Payer: BCBS Complete |
$2,114.54
|
| Rate for Payer: BCBS MAPPO |
$2,855.94
|
| Rate for Payer: BCBS Trust/PPO |
$9,391.46
|
| Rate for Payer: BCN Commercial |
$9,391.46
|
| Rate for Payer: BCN Medicare Advantage |
$2,855.94
|
| Rate for Payer: Cash Price |
$9,139.00
|
| Rate for Payer: Cofinity Commercial |
$9,824.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,139.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,855.94
|
| Rate for Payer: Healthscope Commercial |
$10,281.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,567.81
|
| Rate for Payer: Mclaren Medicaid |
$2,014.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,998.73
|
| Rate for Payer: Meridian Medicaid |
$2,114.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,284.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,141.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,710.19
|
| Rate for Payer: Nomi Health Commercial |
$9,367.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,567.81
|
| Rate for Payer: PACE Senior Care Partners |
$2,713.14
|
| Rate for Payer: PACE SWMI |
$2,855.94
|
| Rate for Payer: PHP Commercial |
$9,710.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,855.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,014.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,938.66
|
| Rate for Payer: Priority Health Medicare |
$2,884.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,950.93
|
| Rate for Payer: Railroad Medicare Medicare |
$2,855.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,052.90
|
| Rate for Payer: UHC Core |
$9,538.83
|
| Rate for Payer: UHC Exchange |
$2,855.94
|
| Rate for Payer: UHC Medicaid |
$2,014.01
|
| Rate for Payer: UHC Medicare Advantage |
$2,855.94
|
| Rate for Payer: UHCCP Medicaid |
$2,014.01
|
| Rate for Payer: VA VA |
$2,855.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,567.81
|
|
|
HC PTCA VESSEL/BRANCH
|
Facility
|
IP
|
$11,423.75
|
|
|
Service Code
|
CPT 92920
|
| Hospital Charge Code |
48100098
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,950.93 |
| Max. Negotiated Rate |
$10,281.38 |
| Rate for Payer: Aetna Commercial |
$9,710.19
|
| Rate for Payer: BCBS Trust/PPO |
$9,434.88
|
| Rate for Payer: BCN Commercial |
$9,434.88
|
| Rate for Payer: Cash Price |
$9,139.00
|
| Rate for Payer: Cofinity Commercial |
$9,824.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,139.00
|
| Rate for Payer: Healthscope Commercial |
$10,281.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,567.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,710.19
|
| Rate for Payer: Nomi Health Commercial |
$9,367.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,567.81
|
| Rate for Payer: PHP Commercial |
$9,710.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,938.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,950.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,052.90
|
| Rate for Payer: UHC Core |
$9,538.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,567.81
|
|
|
HC PTCRAWDES ADD.BRANCH
|
Facility
|
OP
|
$19,483.94
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
48100080
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,435.02 |
| Max. Negotiated Rate |
$17,535.55 |
| Rate for Payer: Aetna Commercial |
$16,561.35
|
| Rate for Payer: Aetna Medicare |
$5,065.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,088.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,088.73
|
| Rate for Payer: BCBS Complete |
$3,606.48
|
| Rate for Payer: BCBS MAPPO |
$4,870.98
|
| Rate for Payer: BCBS Trust/PPO |
$16,017.75
|
| Rate for Payer: BCN Commercial |
$16,017.75
|
| Rate for Payer: BCN Medicare Advantage |
$4,870.98
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Commercial |
$16,756.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,870.98
|
| Rate for Payer: Healthscope Commercial |
$17,535.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,612.95
|
| Rate for Payer: Mclaren Medicaid |
$3,435.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,114.53
|
| Rate for Payer: Meridian Medicaid |
$3,606.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,601.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,358.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Nomi Health Commercial |
$15,976.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: PACE Senior Care Partners |
$4,627.44
|
| Rate for Payer: PACE SWMI |
$4,870.98
|
| Rate for Payer: PHP Commercial |
$16,561.35
|
| Rate for Payer: PHP Medicare Advantage |
$4,870.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,435.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16,951.03
|
| Rate for Payer: Priority Health Medicare |
$4,919.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,560.82
|
| Rate for Payer: Railroad Medicare Medicare |
$4,870.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,145.87
|
| Rate for Payer: UHC Core |
$16,269.09
|
| Rate for Payer: UHC Exchange |
$4,870.98
|
| Rate for Payer: UHC Medicaid |
$3,435.02
|
| Rate for Payer: UHC Medicare Advantage |
$4,870.98
|
| Rate for Payer: UHCCP Medicaid |
$3,435.02
|
| Rate for Payer: VA VA |
$4,870.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,612.95
|
|
|
HC PTCRAWDES ADD.BRANCH
|
Facility
|
IP
|
$19,483.94
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
48100080
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,560.82 |
| Max. Negotiated Rate |
$17,535.55 |
| Rate for Payer: Aetna Commercial |
$16,561.35
|
| Rate for Payer: BCBS Trust/PPO |
$16,091.79
|
| Rate for Payer: BCN Commercial |
$16,091.79
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Commercial |
$16,756.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Healthscope Commercial |
$17,535.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,612.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Nomi Health Commercial |
$15,976.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: PHP Commercial |
$16,561.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16,951.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,560.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,145.87
|
| Rate for Payer: UHC Core |
$16,269.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,612.95
|
|
|
HC PTCRAWDES VES/BRANCH
|
Facility
|
IP
|
$29,741.77
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
48100079
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$20,700.27 |
| Max. Negotiated Rate |
$26,767.59 |
| Rate for Payer: Aetna Commercial |
$25,280.50
|
| Rate for Payer: BCBS Trust/PPO |
$24,563.73
|
| Rate for Payer: BCN Commercial |
$24,563.73
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cofinity Commercial |
$25,577.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,793.42
|
| Rate for Payer: Healthscope Commercial |
$26,767.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,306.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,280.50
|
| Rate for Payer: Nomi Health Commercial |
$24,388.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,306.33
|
| Rate for Payer: PHP Commercial |
$25,280.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25,875.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20,700.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,172.76
|
| Rate for Payer: UHC Core |
$24,834.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,306.33
|
|
|
HC PTCRAWDES VES/BRANCH
|
Facility
|
OP
|
$29,741.77
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
48100079
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,243.47 |
| Max. Negotiated Rate |
$26,767.59 |
| Rate for Payer: Aetna Commercial |
$25,280.50
|
| Rate for Payer: Aetna Medicare |
$7,732.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,294.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,294.30
|
| Rate for Payer: BCBS Complete |
$5,505.20
|
| Rate for Payer: BCBS MAPPO |
$7,435.44
|
| Rate for Payer: BCBS Trust/PPO |
$24,450.71
|
| Rate for Payer: BCN Commercial |
$24,450.71
|
| Rate for Payer: BCN Medicare Advantage |
$7,435.44
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cofinity Commercial |
$25,577.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,793.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,435.44
|
| Rate for Payer: Healthscope Commercial |
$26,767.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,306.33
|
| Rate for Payer: Mclaren Medicaid |
$5,243.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,807.21
|
| Rate for Payer: Meridian Medicaid |
$5,505.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,550.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,178.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,280.50
|
| Rate for Payer: Nomi Health Commercial |
$24,388.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,306.33
|
| Rate for Payer: PACE Senior Care Partners |
$7,063.67
|
| Rate for Payer: PACE SWMI |
$7,435.44
|
| Rate for Payer: PHP Commercial |
$25,280.50
|
| Rate for Payer: PHP Medicare Advantage |
$7,435.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,243.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25,875.34
|
| Rate for Payer: Priority Health Medicare |
$7,509.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20,700.27
|
| Rate for Payer: Railroad Medicare Medicare |
$7,435.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,172.76
|
| Rate for Payer: UHC Core |
$24,834.38
|
| Rate for Payer: UHC Exchange |
$7,435.44
|
| Rate for Payer: UHC Medicaid |
$5,243.47
|
| Rate for Payer: UHC Medicare Advantage |
$7,435.44
|
| Rate for Payer: UHCCP Medicaid |
$5,243.47
|
| Rate for Payer: VA VA |
$7,435.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,306.33
|
|
|
HC PTCRAWPTCA ADD.BRANCH
|
Facility
|
IP
|
$12,179.11
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
48100097
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,476.66 |
| Max. Negotiated Rate |
$10,961.20 |
| Rate for Payer: Aetna Commercial |
$10,352.24
|
| Rate for Payer: BCBS Trust/PPO |
$10,058.73
|
| Rate for Payer: BCN Commercial |
$10,058.73
|
| Rate for Payer: Cash Price |
$9,743.29
|
| Rate for Payer: Cofinity Commercial |
$10,474.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,743.29
|
| Rate for Payer: Healthscope Commercial |
$10,961.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,134.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,352.24
|
| Rate for Payer: Nomi Health Commercial |
$9,986.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,134.33
|
| Rate for Payer: PHP Commercial |
$10,352.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,595.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,476.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,717.62
|
| Rate for Payer: UHC Core |
$10,169.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,134.33
|
|
|
HC PTCRAWPTCA ADD.BRANCH
|
Facility
|
OP
|
$12,179.11
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
48100097
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,147.18 |
| Max. Negotiated Rate |
$10,961.20 |
| Rate for Payer: Aetna Commercial |
$10,352.24
|
| Rate for Payer: Aetna Medicare |
$3,166.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,805.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,805.97
|
| Rate for Payer: BCBS Complete |
$2,254.35
|
| Rate for Payer: BCBS MAPPO |
$3,044.78
|
| Rate for Payer: BCBS Trust/PPO |
$10,012.45
|
| Rate for Payer: BCN Commercial |
$10,012.45
|
| Rate for Payer: BCN Medicare Advantage |
$3,044.78
|
| Rate for Payer: Cash Price |
$9,743.29
|
| Rate for Payer: Cofinity Commercial |
$10,474.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,743.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,044.78
|
| Rate for Payer: Healthscope Commercial |
$10,961.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,134.33
|
| Rate for Payer: Mclaren Medicaid |
$2,147.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,197.02
|
| Rate for Payer: Meridian Medicaid |
$2,254.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,501.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,349.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,352.24
|
| Rate for Payer: Nomi Health Commercial |
$9,986.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,134.33
|
| Rate for Payer: PACE Senior Care Partners |
$2,892.54
|
| Rate for Payer: PACE SWMI |
$3,044.78
|
| Rate for Payer: PHP Commercial |
$10,352.24
|
| Rate for Payer: PHP Medicare Advantage |
$3,044.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,147.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,595.83
|
| Rate for Payer: Priority Health Medicare |
$3,075.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,476.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,044.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,717.62
|
| Rate for Payer: UHC Core |
$10,169.56
|
| Rate for Payer: UHC Exchange |
$3,044.78
|
| Rate for Payer: UHC Medicaid |
$2,147.18
|
| Rate for Payer: UHC Medicare Advantage |
$3,044.78
|
| Rate for Payer: UHCCP Medicaid |
$2,147.18
|
| Rate for Payer: VA VA |
$3,044.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,134.33
|
|
|
HC PTCRAWSTENT ADD.BRANCH
|
Facility
|
IP
|
$19,483.94
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
48100078
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,560.82 |
| Max. Negotiated Rate |
$17,535.55 |
| Rate for Payer: Aetna Commercial |
$16,561.35
|
| Rate for Payer: BCBS Trust/PPO |
$16,091.79
|
| Rate for Payer: BCN Commercial |
$16,091.79
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Commercial |
$16,756.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Healthscope Commercial |
$17,535.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,612.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Nomi Health Commercial |
$15,976.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: PHP Commercial |
$16,561.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16,951.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,560.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,145.87
|
| Rate for Payer: UHC Core |
$16,269.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,612.95
|
|
|
HC PTCRAWSTENT ADD.BRANCH
|
Facility
|
OP
|
$19,483.94
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
48100078
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,435.02 |
| Max. Negotiated Rate |
$17,535.55 |
| Rate for Payer: Aetna Commercial |
$16,561.35
|
| Rate for Payer: Aetna Medicare |
$5,065.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,088.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,088.73
|
| Rate for Payer: BCBS Complete |
$3,606.48
|
| Rate for Payer: BCBS MAPPO |
$4,870.98
|
| Rate for Payer: BCBS Trust/PPO |
$16,017.75
|
| Rate for Payer: BCN Commercial |
$16,017.75
|
| Rate for Payer: BCN Medicare Advantage |
$4,870.98
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Commercial |
$16,756.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,870.98
|
| Rate for Payer: Healthscope Commercial |
$17,535.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,612.95
|
| Rate for Payer: Mclaren Medicaid |
$3,435.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,114.53
|
| Rate for Payer: Meridian Medicaid |
$3,606.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,601.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,358.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Nomi Health Commercial |
$15,976.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: PACE Senior Care Partners |
$4,627.44
|
| Rate for Payer: PACE SWMI |
$4,870.98
|
| Rate for Payer: PHP Commercial |
$16,561.35
|
| Rate for Payer: PHP Medicare Advantage |
$4,870.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,435.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16,951.03
|
| Rate for Payer: Priority Health Medicare |
$4,919.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,560.82
|
| Rate for Payer: Railroad Medicare Medicare |
$4,870.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,145.87
|
| Rate for Payer: UHC Core |
$16,269.09
|
| Rate for Payer: UHC Exchange |
$4,870.98
|
| Rate for Payer: UHC Medicaid |
$3,435.02
|
| Rate for Payer: UHC Medicare Advantage |
$4,870.98
|
| Rate for Payer: UHCCP Medicaid |
$3,435.02
|
| Rate for Payer: VA VA |
$4,870.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,612.95
|
|
|
HC PTCRAWSTENT VES/BRANCH
|
Facility
|
IP
|
$29,741.77
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
48100077
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$20,700.27 |
| Max. Negotiated Rate |
$26,767.59 |
| Rate for Payer: Aetna Commercial |
$25,280.50
|
| Rate for Payer: BCBS Trust/PPO |
$24,563.73
|
| Rate for Payer: BCN Commercial |
$24,563.73
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cofinity Commercial |
$25,577.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,793.42
|
| Rate for Payer: Healthscope Commercial |
$26,767.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,306.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,280.50
|
| Rate for Payer: Nomi Health Commercial |
$24,388.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,306.33
|
| Rate for Payer: PHP Commercial |
$25,280.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25,875.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20,700.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,172.76
|
| Rate for Payer: UHC Core |
$24,834.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,306.33
|
|
|
HC PTCRAWSTENT VES/BRANCH
|
Facility
|
OP
|
$29,741.77
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
48100077
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,243.47 |
| Max. Negotiated Rate |
$26,767.59 |
| Rate for Payer: Aetna Commercial |
$25,280.50
|
| Rate for Payer: Aetna Medicare |
$7,732.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,294.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,294.30
|
| Rate for Payer: BCBS Complete |
$5,505.20
|
| Rate for Payer: BCBS MAPPO |
$7,435.44
|
| Rate for Payer: BCBS Trust/PPO |
$24,450.71
|
| Rate for Payer: BCN Commercial |
$24,450.71
|
| Rate for Payer: BCN Medicare Advantage |
$7,435.44
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cofinity Commercial |
$25,577.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,793.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,435.44
|
| Rate for Payer: Healthscope Commercial |
$26,767.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,306.33
|
| Rate for Payer: Mclaren Medicaid |
$5,243.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,807.21
|
| Rate for Payer: Meridian Medicaid |
$5,505.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,550.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,178.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,280.50
|
| Rate for Payer: Nomi Health Commercial |
$24,388.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,306.33
|
| Rate for Payer: PACE Senior Care Partners |
$7,063.67
|
| Rate for Payer: PACE SWMI |
$7,435.44
|
| Rate for Payer: PHP Commercial |
$25,280.50
|
| Rate for Payer: PHP Medicare Advantage |
$7,435.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,243.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25,875.34
|
| Rate for Payer: Priority Health Medicare |
$7,509.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20,700.27
|
| Rate for Payer: Railroad Medicare Medicare |
$7,435.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,172.76
|
| Rate for Payer: UHC Core |
$24,834.38
|
| Rate for Payer: UHC Exchange |
$7,435.44
|
| Rate for Payer: UHC Medicaid |
$5,243.47
|
| Rate for Payer: UHC Medicare Advantage |
$7,435.44
|
| Rate for Payer: UHCCP Medicaid |
$5,243.47
|
| Rate for Payer: VA VA |
$7,435.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,306.33
|
|
|
HC PT EVAL HIGH COMPLEXITY
|
Facility
|
OP
|
$321.01
|
|
|
Service Code
|
CPT 97163
|
| Hospital Charge Code |
42400008
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$56.59 |
| Max. Negotiated Rate |
$288.91 |
| Rate for Payer: Aetna Commercial |
$272.86
|
| Rate for Payer: Aetna Medicare |
$83.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.32
|
| Rate for Payer: BCBS Complete |
$59.42
|
| Rate for Payer: BCBS MAPPO |
$80.25
|
| Rate for Payer: BCBS Trust/PPO |
$263.90
|
| Rate for Payer: BCN Commercial |
$263.90
|
| Rate for Payer: BCN Medicare Advantage |
$80.25
|
| Rate for Payer: Cash Price |
$256.81
|
| Rate for Payer: Cofinity Commercial |
$276.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.25
|
| Rate for Payer: Healthscope Commercial |
$288.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.76
|
| Rate for Payer: Mclaren Medicaid |
$56.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.27
|
| Rate for Payer: Meridian Medicaid |
$59.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.86
|
| Rate for Payer: Nomi Health Commercial |
$263.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.76
|
| Rate for Payer: PACE Senior Care Partners |
$76.24
|
| Rate for Payer: PACE SWMI |
$80.25
|
| Rate for Payer: PHP Commercial |
$272.86
|
| Rate for Payer: PHP Medicare Advantage |
$80.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$279.28
|
| Rate for Payer: Priority Health Medicare |
$81.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$223.42
|
| Rate for Payer: Railroad Medicare Medicare |
$80.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.49
|
| Rate for Payer: UHC Core |
$268.04
|
| Rate for Payer: UHC Exchange |
$80.25
|
| Rate for Payer: UHC Medicaid |
$56.59
|
| Rate for Payer: UHC Medicare Advantage |
$80.25
|
| Rate for Payer: UHCCP Medicaid |
$56.59
|
| Rate for Payer: VA VA |
$80.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.76
|
|
|
HC PT EVAL HIGH COMPLEXITY
|
Facility
|
IP
|
$321.01
|
|
|
Service Code
|
CPT 97163
|
| Hospital Charge Code |
42400008
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$223.42 |
| Max. Negotiated Rate |
$288.91 |
| Rate for Payer: Aetna Commercial |
$272.86
|
| Rate for Payer: BCBS Trust/PPO |
$265.12
|
| Rate for Payer: BCN Commercial |
$265.12
|
| Rate for Payer: Cash Price |
$256.81
|
| Rate for Payer: Cofinity Commercial |
$276.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.81
|
| Rate for Payer: Healthscope Commercial |
$288.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.86
|
| Rate for Payer: Nomi Health Commercial |
$263.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.76
|
| Rate for Payer: PHP Commercial |
$272.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$279.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$223.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.49
|
| Rate for Payer: UHC Core |
$268.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.76
|
|
|
HC PT EVAL LOW COMPLEXITY
|
Facility
|
OP
|
$262.65
|
|
|
Service Code
|
CPT 97161
|
| Hospital Charge Code |
42400006
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$46.31 |
| Max. Negotiated Rate |
$236.38 |
| Rate for Payer: Aetna Commercial |
$223.25
|
| Rate for Payer: Aetna Medicare |
$68.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.08
|
| Rate for Payer: BCBS Complete |
$48.62
|
| Rate for Payer: BCBS MAPPO |
$65.66
|
| Rate for Payer: BCBS Trust/PPO |
$215.92
|
| Rate for Payer: BCN Commercial |
$215.92
|
| Rate for Payer: BCN Medicare Advantage |
$65.66
|
| Rate for Payer: Cash Price |
$210.12
|
| Rate for Payer: Cofinity Commercial |
$225.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.66
|
| Rate for Payer: Healthscope Commercial |
$236.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.99
|
| Rate for Payer: Mclaren Medicaid |
$46.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.95
|
| Rate for Payer: Meridian Medicaid |
$48.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.25
|
| Rate for Payer: Nomi Health Commercial |
$215.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.99
|
| Rate for Payer: PACE Senior Care Partners |
$62.38
|
| Rate for Payer: PACE SWMI |
$65.66
|
| Rate for Payer: PHP Commercial |
$223.25
|
| Rate for Payer: PHP Medicare Advantage |
$65.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.51
|
| Rate for Payer: Priority Health Medicare |
$66.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.80
|
| Rate for Payer: Railroad Medicare Medicare |
$65.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.13
|
| Rate for Payer: UHC Core |
$219.31
|
| Rate for Payer: UHC Exchange |
$65.66
|
| Rate for Payer: UHC Medicaid |
$46.31
|
| Rate for Payer: UHC Medicare Advantage |
$65.66
|
| Rate for Payer: UHCCP Medicaid |
$46.31
|
| Rate for Payer: VA VA |
$65.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.99
|
|
|
HC PT EVAL LOW COMPLEXITY
|
Facility
|
IP
|
$262.65
|
|
|
Service Code
|
CPT 97161
|
| Hospital Charge Code |
42400006
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$182.80 |
| Max. Negotiated Rate |
$236.38 |
| Rate for Payer: Aetna Commercial |
$223.25
|
| Rate for Payer: BCBS Trust/PPO |
$216.92
|
| Rate for Payer: BCN Commercial |
$216.92
|
| Rate for Payer: Cash Price |
$210.12
|
| Rate for Payer: Cofinity Commercial |
$225.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.12
|
| Rate for Payer: Healthscope Commercial |
$236.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.25
|
| Rate for Payer: Nomi Health Commercial |
$215.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.99
|
| Rate for Payer: PHP Commercial |
$223.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.13
|
| Rate for Payer: UHC Core |
$219.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.99
|
|
