|
HC PSG W CPAP PEDS 5 AND UNDER
|
Facility
|
IP
|
$5,983.02
|
|
|
Service Code
|
CPT 95783
|
| Hospital Charge Code |
92000018
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$3,888.96 |
| Max. Negotiated Rate |
$5,384.72 |
| Rate for Payer: Aetna Commercial |
$5,085.57
|
| Rate for Payer: BCBS Trust/PPO |
$4,883.94
|
| Rate for Payer: BCN Commercial |
$4,623.68
|
| Rate for Payer: Cash Price |
$4,786.42
|
| Rate for Payer: Cofinity Commercial |
$5,145.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,786.42
|
| Rate for Payer: Healthscope Commercial |
$5,384.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,487.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,085.57
|
| Rate for Payer: Nomi Health Commercial |
$4,906.08
|
| Rate for Payer: PHP Commercial |
$5,085.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,888.96
|
| Rate for Payer: Priority Health HMO/PPO |
$5,205.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,008.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,265.06
|
| Rate for Payer: UHC Core |
$4,995.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,487.26
|
|
|
HC PSG W CPAP PEDS 5 AND UNDER
|
Facility
|
OP
|
$5,983.02
|
|
|
Service Code
|
CPT 95783
|
| Hospital Charge Code |
92000018
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$720.70 |
| Max. Negotiated Rate |
$5,384.72 |
| Rate for Payer: Aetna Commercial |
$5,085.57
|
| Rate for Payer: Aetna Medicare |
$1,555.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,869.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,869.69
|
| Rate for Payer: BCBS Complete |
$756.79
|
| Rate for Payer: BCBS MAPPO |
$1,495.76
|
| Rate for Payer: BCBS Trust/PPO |
$4,918.64
|
| Rate for Payer: BCN Commercial |
$4,651.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,495.76
|
| Rate for Payer: Cash Price |
$4,786.42
|
| Rate for Payer: Cash Price |
$4,786.42
|
| Rate for Payer: Cofinity Commercial |
$5,145.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,786.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,495.76
|
| Rate for Payer: Healthscope Commercial |
$5,384.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,487.26
|
| Rate for Payer: Mclaren Medicaid |
$720.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,570.54
|
| Rate for Payer: Meridian Medicaid |
$756.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,720.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,085.57
|
| Rate for Payer: Nomi Health Commercial |
$4,906.08
|
| Rate for Payer: PACE Senior Care Partners |
$1,420.97
|
| Rate for Payer: PACE SWMI |
$1,495.76
|
| Rate for Payer: PHP Commercial |
$5,085.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,495.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$720.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,888.96
|
| Rate for Payer: Priority Health HMO/PPO |
$5,205.23
|
| Rate for Payer: Priority Health Medicare |
$1,510.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,008.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,495.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,265.06
|
| Rate for Payer: UHC Core |
$4,995.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,495.76
|
| Rate for Payer: UHC Exchange |
$1,495.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,495.76
|
| Rate for Payer: UHCCP Medicaid |
$720.70
|
| Rate for Payer: VA VA |
$1,495.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,487.26
|
|
|
HC PSORALEN
|
Facility
|
OP
|
$2,156.91
|
|
|
Service Code
|
HCPCS P9073
|
| Hospital Charge Code |
39000085
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$416.02 |
| Max. Negotiated Rate |
$1,941.22 |
| Rate for Payer: Aetna Commercial |
$1,833.37
|
| Rate for Payer: Aetna Medicare |
$560.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$674.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$674.03
|
| Rate for Payer: BCBS Complete |
$436.85
|
| Rate for Payer: BCBS MAPPO |
$539.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,773.20
|
| Rate for Payer: BCN Commercial |
$1,677.00
|
| Rate for Payer: BCN Medicare Advantage |
$539.23
|
| Rate for Payer: Cash Price |
$1,725.53
|
| Rate for Payer: Cash Price |
$1,725.53
|
| Rate for Payer: Cofinity Commercial |
$1,854.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,725.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$539.23
|
| Rate for Payer: Healthscope Commercial |
$1,941.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,617.68
|
| Rate for Payer: Mclaren Medicaid |
$416.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$566.19
|
| Rate for Payer: Meridian Medicaid |
$436.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$620.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,833.37
|
| Rate for Payer: Nomi Health Commercial |
$1,768.67
|
| Rate for Payer: PACE Senior Care Partners |
$512.27
|
| Rate for Payer: PACE SWMI |
$539.23
|
| Rate for Payer: PHP Commercial |
$1,833.37
|
| Rate for Payer: PHP Medicare Advantage |
$539.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,401.99
|
| Rate for Payer: Priority Health HMO/PPO |
$1,876.51
|
| Rate for Payer: Priority Health Medicare |
$544.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,445.13
|
| Rate for Payer: Railroad Medicare Medicare |
$539.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,898.08
|
| Rate for Payer: UHC Core |
$1,801.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$539.23
|
| Rate for Payer: UHC Exchange |
$539.23
|
| Rate for Payer: UHC Medicare Advantage |
$539.23
|
| Rate for Payer: UHCCP Medicaid |
$416.02
|
| Rate for Payer: VA VA |
$539.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,617.68
|
|
|
HC PSORALEN
|
Facility
|
IP
|
$2,156.91
|
|
|
Service Code
|
HCPCS P9073
|
| Hospital Charge Code |
39000085
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,401.99 |
| Max. Negotiated Rate |
$1,941.22 |
| Rate for Payer: Aetna Commercial |
$1,833.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,760.69
|
| Rate for Payer: BCN Commercial |
$1,666.86
|
| Rate for Payer: Cash Price |
$1,725.53
|
| Rate for Payer: Cofinity Commercial |
$1,854.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,725.53
|
| Rate for Payer: Healthscope Commercial |
$1,941.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,617.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,833.37
|
| Rate for Payer: Nomi Health Commercial |
$1,768.67
|
| Rate for Payer: PHP Commercial |
$1,833.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,401.99
|
| Rate for Payer: Priority Health HMO/PPO |
$1,876.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,445.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,898.08
|
| Rate for Payer: UHC Core |
$1,801.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,617.68
|
|
|
HC PSORALEN TREATED WASHED PLATELETS
|
Facility
|
IP
|
$2,238.51
|
|
|
Service Code
|
HCPCS P9073
|
| Hospital Charge Code |
39000086
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,455.03 |
| Max. Negotiated Rate |
$2,014.66 |
| Rate for Payer: Aetna Commercial |
$1,902.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,827.30
|
| Rate for Payer: BCN Commercial |
$1,729.92
|
| Rate for Payer: Cash Price |
$1,790.81
|
| Rate for Payer: Cofinity Commercial |
$1,925.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,790.81
|
| Rate for Payer: Healthscope Commercial |
$2,014.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,678.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,902.73
|
| Rate for Payer: Nomi Health Commercial |
$1,835.58
|
| Rate for Payer: PHP Commercial |
$1,902.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,455.03
|
| Rate for Payer: Priority Health HMO/PPO |
$1,947.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,499.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,969.89
|
| Rate for Payer: UHC Core |
$1,869.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,678.88
|
|
|
HC PSORALEN TREATED WASHED PLATELETS
|
Facility
|
OP
|
$2,238.51
|
|
|
Service Code
|
HCPCS P9073
|
| Hospital Charge Code |
39000086
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$416.02 |
| Max. Negotiated Rate |
$2,014.66 |
| Rate for Payer: Aetna Commercial |
$1,902.73
|
| Rate for Payer: Aetna Medicare |
$582.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$699.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$699.53
|
| Rate for Payer: BCBS Complete |
$436.85
|
| Rate for Payer: BCBS MAPPO |
$559.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,840.28
|
| Rate for Payer: BCN Commercial |
$1,740.44
|
| Rate for Payer: BCN Medicare Advantage |
$559.63
|
| Rate for Payer: Cash Price |
$1,790.81
|
| Rate for Payer: Cash Price |
$1,790.81
|
| Rate for Payer: Cofinity Commercial |
$1,925.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,790.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$559.63
|
| Rate for Payer: Healthscope Commercial |
$2,014.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,678.88
|
| Rate for Payer: Mclaren Medicaid |
$416.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$587.61
|
| Rate for Payer: Meridian Medicaid |
$436.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$643.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,902.73
|
| Rate for Payer: Nomi Health Commercial |
$1,835.58
|
| Rate for Payer: PACE Senior Care Partners |
$531.65
|
| Rate for Payer: PACE SWMI |
$559.63
|
| Rate for Payer: PHP Commercial |
$1,902.73
|
| Rate for Payer: PHP Medicare Advantage |
$559.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,455.03
|
| Rate for Payer: Priority Health HMO/PPO |
$1,947.50
|
| Rate for Payer: Priority Health Medicare |
$565.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,499.80
|
| Rate for Payer: Railroad Medicare Medicare |
$559.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,969.89
|
| Rate for Payer: UHC Core |
$1,869.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$559.63
|
| Rate for Payer: UHC Exchange |
$559.63
|
| Rate for Payer: UHC Medicare Advantage |
$559.63
|
| Rate for Payer: UHCCP Medicaid |
$416.02
|
| Rate for Payer: VA VA |
$559.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,678.88
|
|
|
HC PSYCH COLLAB CARE MGMT EA ADD 30 MIN
|
Facility
|
IP
|
$89.47
|
|
|
Service Code
|
CPT 99494
|
| Hospital Charge Code |
51000094
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$58.16 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: BCBS Trust/PPO |
$73.03
|
| Rate for Payer: BCN Commercial |
$69.14
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Nomi Health Commercial |
$73.37
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.16
|
| Rate for Payer: Priority Health HMO/PPO |
$77.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.73
|
| Rate for Payer: UHC Core |
$74.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.10
|
|
|
HC PSYCH COLLAB CARE MGMT EA ADD 30 MIN
|
Facility
|
OP
|
$89.47
|
|
|
Service Code
|
CPT 99494
|
| Hospital Charge Code |
51000094
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.25 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: Aetna Medicare |
$23.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.96
|
| Rate for Payer: BCBS Complete |
$35.79
|
| Rate for Payer: BCBS MAPPO |
$22.37
|
| Rate for Payer: BCBS Trust/PPO |
$73.55
|
| Rate for Payer: BCN Commercial |
$69.56
|
| Rate for Payer: BCN Medicare Advantage |
$22.37
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.37
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Nomi Health Commercial |
$73.37
|
| Rate for Payer: PACE Senior Care Partners |
$21.25
|
| Rate for Payer: PACE SWMI |
$22.37
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: PHP Medicare Advantage |
$22.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.16
|
| Rate for Payer: Priority Health HMO/PPO |
$77.84
|
| Rate for Payer: Priority Health Medicare |
$22.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.94
|
| Rate for Payer: Railroad Medicare Medicare |
$22.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.73
|
| Rate for Payer: UHC Core |
$74.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.37
|
| Rate for Payer: UHC Exchange |
$22.37
|
| Rate for Payer: UHC Medicare Advantage |
$22.37
|
| Rate for Payer: VA VA |
$22.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.10
|
|
|
HC PSYCH COLLAB CARE MGMT INIT 70 MIN
|
Facility
|
OP
|
$95.72
|
|
|
Service Code
|
CPT 99492
|
| Hospital Charge Code |
51000092
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$22.73 |
| Max. Negotiated Rate |
$86.15 |
| Rate for Payer: Aetna Commercial |
$81.36
|
| Rate for Payer: Aetna Medicare |
$24.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.91
|
| Rate for Payer: BCBS Complete |
$68.81
|
| Rate for Payer: BCBS MAPPO |
$23.93
|
| Rate for Payer: BCBS Trust/PPO |
$78.69
|
| Rate for Payer: BCN Commercial |
$74.42
|
| Rate for Payer: BCN Medicare Advantage |
$23.93
|
| Rate for Payer: Cash Price |
$76.58
|
| Rate for Payer: Cash Price |
$76.58
|
| Rate for Payer: Cofinity Commercial |
$82.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.93
|
| Rate for Payer: Healthscope Commercial |
$86.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.79
|
| Rate for Payer: Mclaren Medicaid |
$65.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.13
|
| Rate for Payer: Meridian Medicaid |
$68.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.36
|
| Rate for Payer: Nomi Health Commercial |
$78.49
|
| Rate for Payer: PACE Senior Care Partners |
$22.73
|
| Rate for Payer: PACE SWMI |
$23.93
|
| Rate for Payer: PHP Commercial |
$81.36
|
| Rate for Payer: PHP Medicare Advantage |
$23.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.22
|
| Rate for Payer: Priority Health HMO/PPO |
$83.28
|
| Rate for Payer: Priority Health Medicare |
$24.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.13
|
| Rate for Payer: Railroad Medicare Medicare |
$23.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.23
|
| Rate for Payer: UHC Core |
$79.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.93
|
| Rate for Payer: UHC Exchange |
$23.93
|
| Rate for Payer: UHC Medicare Advantage |
$23.93
|
| Rate for Payer: UHCCP Medicaid |
$65.53
|
| Rate for Payer: VA VA |
$23.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.79
|
|
|
HC PSYCH COLLAB CARE MGMT INIT 70 MIN
|
Facility
|
IP
|
$95.72
|
|
|
Service Code
|
CPT 99492
|
| Hospital Charge Code |
51000092
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$62.22 |
| Max. Negotiated Rate |
$86.15 |
| Rate for Payer: Aetna Commercial |
$81.36
|
| Rate for Payer: BCBS Trust/PPO |
$78.14
|
| Rate for Payer: BCN Commercial |
$73.97
|
| Rate for Payer: Cash Price |
$76.58
|
| Rate for Payer: Cofinity Commercial |
$82.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.58
|
| Rate for Payer: Healthscope Commercial |
$86.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.36
|
| Rate for Payer: Nomi Health Commercial |
$78.49
|
| Rate for Payer: PHP Commercial |
$81.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.22
|
| Rate for Payer: Priority Health HMO/PPO |
$83.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.23
|
| Rate for Payer: UHC Core |
$79.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.79
|
|
|
HC PSYCH COLLAB CARE MGMT SUBSEQ 60 MIN
|
Facility
|
OP
|
$105.28
|
|
|
Service Code
|
CPT 99493
|
| Hospital Charge Code |
51000093
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$94.75 |
| Rate for Payer: Aetna Commercial |
$89.49
|
| Rate for Payer: Aetna Medicare |
$27.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.90
|
| Rate for Payer: BCBS Complete |
$68.81
|
| Rate for Payer: BCBS MAPPO |
$26.32
|
| Rate for Payer: BCBS Trust/PPO |
$86.55
|
| Rate for Payer: BCN Commercial |
$81.86
|
| Rate for Payer: BCN Medicare Advantage |
$26.32
|
| Rate for Payer: Cash Price |
$84.22
|
| Rate for Payer: Cash Price |
$84.22
|
| Rate for Payer: Cofinity Commercial |
$90.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.32
|
| Rate for Payer: Healthscope Commercial |
$94.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.96
|
| Rate for Payer: Mclaren Medicaid |
$65.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.64
|
| Rate for Payer: Meridian Medicaid |
$68.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.49
|
| Rate for Payer: Nomi Health Commercial |
$86.33
|
| Rate for Payer: PACE Senior Care Partners |
$25.00
|
| Rate for Payer: PACE SWMI |
$26.32
|
| Rate for Payer: PHP Commercial |
$89.49
|
| Rate for Payer: PHP Medicare Advantage |
$26.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.43
|
| Rate for Payer: Priority Health HMO/PPO |
$91.59
|
| Rate for Payer: Priority Health Medicare |
$26.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.54
|
| Rate for Payer: Railroad Medicare Medicare |
$26.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.65
|
| Rate for Payer: UHC Core |
$87.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.32
|
| Rate for Payer: UHC Exchange |
$26.32
|
| Rate for Payer: UHC Medicare Advantage |
$26.32
|
| Rate for Payer: UHCCP Medicaid |
$65.53
|
| Rate for Payer: VA VA |
$26.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.96
|
|
|
HC PSYCH COLLAB CARE MGMT SUBSEQ 60 MIN
|
Facility
|
IP
|
$105.28
|
|
|
Service Code
|
CPT 99493
|
| Hospital Charge Code |
51000093
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$68.43 |
| Max. Negotiated Rate |
$94.75 |
| Rate for Payer: Aetna Commercial |
$89.49
|
| Rate for Payer: BCBS Trust/PPO |
$85.94
|
| Rate for Payer: BCN Commercial |
$81.36
|
| Rate for Payer: Cash Price |
$84.22
|
| Rate for Payer: Cofinity Commercial |
$90.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.22
|
| Rate for Payer: Healthscope Commercial |
$94.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.49
|
| Rate for Payer: Nomi Health Commercial |
$86.33
|
| Rate for Payer: PHP Commercial |
$89.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.43
|
| Rate for Payer: Priority Health HMO/PPO |
$91.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.65
|
| Rate for Payer: UHC Core |
$87.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.96
|
|
|
HC PSYCH DIAGNOSTIC EVAL W/MED SVCS
|
Facility
|
IP
|
$198.72
|
|
|
Service Code
|
CPT 90792
|
| Hospital Charge Code |
91400008
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$129.17 |
| Max. Negotiated Rate |
$178.85 |
| Rate for Payer: Aetna Commercial |
$168.91
|
| Rate for Payer: BCBS Trust/PPO |
$162.22
|
| Rate for Payer: BCN Commercial |
$153.57
|
| Rate for Payer: Cash Price |
$158.98
|
| Rate for Payer: Cofinity Commercial |
$170.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.98
|
| Rate for Payer: Healthscope Commercial |
$178.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.91
|
| Rate for Payer: Nomi Health Commercial |
$162.95
|
| Rate for Payer: PHP Commercial |
$168.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.17
|
| Rate for Payer: Priority Health HMO/PPO |
$172.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.87
|
| Rate for Payer: UHC Core |
$165.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.04
|
|
|
HC PSYCH DIAGNOSTIC EVAL W/MED SVCS
|
Facility
|
OP
|
$198.72
|
|
|
Service Code
|
CPT 90792
|
| Hospital Charge Code |
91400008
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$47.20 |
| Max. Negotiated Rate |
$178.85 |
| Rate for Payer: Aetna Commercial |
$168.91
|
| Rate for Payer: Aetna Medicare |
$51.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.10
|
| Rate for Payer: BCBS Complete |
$119.51
|
| Rate for Payer: BCBS MAPPO |
$49.68
|
| Rate for Payer: BCBS Trust/PPO |
$163.37
|
| Rate for Payer: BCN Commercial |
$154.50
|
| Rate for Payer: BCN Medicare Advantage |
$49.68
|
| Rate for Payer: Cash Price |
$158.98
|
| Rate for Payer: Cash Price |
$158.98
|
| Rate for Payer: Cofinity Commercial |
$170.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.68
|
| Rate for Payer: Healthscope Commercial |
$178.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.04
|
| Rate for Payer: Mclaren Medicaid |
$113.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.16
|
| Rate for Payer: Meridian Medicaid |
$119.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.91
|
| Rate for Payer: Nomi Health Commercial |
$162.95
|
| Rate for Payer: PACE Senior Care Partners |
$47.20
|
| Rate for Payer: PACE SWMI |
$49.68
|
| Rate for Payer: PHP Commercial |
$168.91
|
| Rate for Payer: PHP Medicare Advantage |
$49.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.17
|
| Rate for Payer: Priority Health HMO/PPO |
$172.89
|
| Rate for Payer: Priority Health Medicare |
$50.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.14
|
| Rate for Payer: Railroad Medicare Medicare |
$49.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.87
|
| Rate for Payer: UHC Core |
$165.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.68
|
| Rate for Payer: UHC Exchange |
$49.68
|
| Rate for Payer: UHC Medicare Advantage |
$49.68
|
| Rate for Payer: UHCCP Medicaid |
$113.81
|
| Rate for Payer: VA VA |
$49.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.04
|
|
|
HC PSYCHIATRIC DIAG EVAL
|
Facility
|
IP
|
$198.72
|
|
|
Service Code
|
CPT 90791
|
| Hospital Charge Code |
91400004
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$129.17 |
| Max. Negotiated Rate |
$178.85 |
| Rate for Payer: Aetna Commercial |
$168.91
|
| Rate for Payer: BCBS Trust/PPO |
$162.22
|
| Rate for Payer: BCN Commercial |
$153.57
|
| Rate for Payer: Cash Price |
$158.98
|
| Rate for Payer: Cofinity Commercial |
$170.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.98
|
| Rate for Payer: Healthscope Commercial |
$178.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.91
|
| Rate for Payer: Nomi Health Commercial |
$162.95
|
| Rate for Payer: PHP Commercial |
$168.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.17
|
| Rate for Payer: Priority Health HMO/PPO |
$172.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.87
|
| Rate for Payer: UHC Core |
$165.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.04
|
|
|
HC PSYCHIATRIC DIAG EVAL
|
Facility
|
OP
|
$198.72
|
|
|
Service Code
|
CPT 90791
|
| Hospital Charge Code |
91400004
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$47.20 |
| Max. Negotiated Rate |
$178.85 |
| Rate for Payer: Aetna Commercial |
$168.91
|
| Rate for Payer: Aetna Medicare |
$51.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.10
|
| Rate for Payer: BCBS Complete |
$119.51
|
| Rate for Payer: BCBS MAPPO |
$49.68
|
| Rate for Payer: BCBS Trust/PPO |
$163.37
|
| Rate for Payer: BCN Commercial |
$154.50
|
| Rate for Payer: BCN Medicare Advantage |
$49.68
|
| Rate for Payer: Cash Price |
$158.98
|
| Rate for Payer: Cash Price |
$158.98
|
| Rate for Payer: Cofinity Commercial |
$170.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.68
|
| Rate for Payer: Healthscope Commercial |
$178.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.04
|
| Rate for Payer: Mclaren Medicaid |
$113.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.16
|
| Rate for Payer: Meridian Medicaid |
$119.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.91
|
| Rate for Payer: Nomi Health Commercial |
$162.95
|
| Rate for Payer: PACE Senior Care Partners |
$47.20
|
| Rate for Payer: PACE SWMI |
$49.68
|
| Rate for Payer: PHP Commercial |
$168.91
|
| Rate for Payer: PHP Medicare Advantage |
$49.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.17
|
| Rate for Payer: Priority Health HMO/PPO |
$172.89
|
| Rate for Payer: Priority Health Medicare |
$50.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.14
|
| Rate for Payer: Railroad Medicare Medicare |
$49.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.87
|
| Rate for Payer: UHC Core |
$165.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.68
|
| Rate for Payer: UHC Exchange |
$49.68
|
| Rate for Payer: UHC Medicare Advantage |
$49.68
|
| Rate for Payer: UHCCP Medicaid |
$113.81
|
| Rate for Payer: VA VA |
$49.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.04
|
|
|
HC PSYCH/NEUROPSYCH TEST BY PHYS 30 MIN
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 96136
|
| Hospital Charge Code |
91800009
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: BCBS Trust/PPO |
$21.23
|
| Rate for Payer: BCN Commercial |
$20.10
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC PSYCH/NEUROPSYCH TEST BY PHYS 30 MIN
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 96136
|
| Hospital Charge Code |
91800009
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$95.88 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.13
|
| Rate for Payer: BCBS Complete |
$95.88
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$21.38
|
| Rate for Payer: BCN Commercial |
$20.22
|
| Rate for Payer: BCN Medicare Advantage |
$6.50
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$91.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: Meridian Medicaid |
$95.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Senior Care Partners |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.50
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Medicare |
$6.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: Railroad Medicare Medicare |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.50
|
| Rate for Payer: UHC Exchange |
$6.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.50
|
| Rate for Payer: UHCCP Medicaid |
$91.31
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH 30 MIN
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 96138
|
| Hospital Charge Code |
91800011
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: BCBS Trust/PPO |
$21.23
|
| Rate for Payer: BCN Commercial |
$20.10
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH 30 MIN
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 96138
|
| Hospital Charge Code |
91800011
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$296.82 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.13
|
| Rate for Payer: BCBS Complete |
$296.82
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$21.38
|
| Rate for Payer: BCN Commercial |
$20.22
|
| Rate for Payer: BCN Medicare Advantage |
$6.50
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$282.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: Meridian Medicaid |
$296.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Senior Care Partners |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.50
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Medicare |
$6.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: Railroad Medicare Medicare |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.50
|
| Rate for Payer: UHC Exchange |
$6.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.50
|
| Rate for Payer: UHCCP Medicaid |
$282.67
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH EA ADDL 30 MIN
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 96139
|
| Hospital Charge Code |
91800012
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$3.71 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna Medicare |
$4.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.88
|
| Rate for Payer: BCBS Complete |
$6.24
|
| Rate for Payer: BCBS MAPPO |
$3.90
|
| Rate for Payer: BCBS Trust/PPO |
$12.83
|
| Rate for Payer: BCN Commercial |
$12.14
|
| Rate for Payer: BCN Medicare Advantage |
$3.90
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.90
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PACE Senior Care Partners |
$3.71
|
| Rate for Payer: PACE SWMI |
$3.90
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: PHP Medicare Advantage |
$3.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO |
$13.58
|
| Rate for Payer: Priority Health Medicare |
$3.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.74
|
| Rate for Payer: UHC Core |
$13.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.90
|
| Rate for Payer: UHC Exchange |
$3.90
|
| Rate for Payer: UHC Medicare Advantage |
$3.90
|
| Rate for Payer: VA VA |
$3.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH EA ADDL 30 MIN
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 96139
|
| Hospital Charge Code |
91800012
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$12.74
|
| Rate for Payer: BCN Commercial |
$12.06
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO |
$13.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.74
|
| Rate for Payer: UHC Core |
$13.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC PSYCH/NEUROPSYCH TEST PHYS EA ADDL 30 MIN
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 96137
|
| Hospital Charge Code |
91800010
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$12.74
|
| Rate for Payer: BCN Commercial |
$12.06
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO |
$13.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.74
|
| Rate for Payer: UHC Core |
$13.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC PSYCH/NEUROPSYCH TEST PHYS EA ADDL 30 MIN
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 96137
|
| Hospital Charge Code |
91800010
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$3.71 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna Medicare |
$4.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.88
|
| Rate for Payer: BCBS Complete |
$6.24
|
| Rate for Payer: BCBS MAPPO |
$3.90
|
| Rate for Payer: BCBS Trust/PPO |
$12.83
|
| Rate for Payer: BCN Commercial |
$12.14
|
| Rate for Payer: BCN Medicare Advantage |
$3.90
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.90
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PACE Senior Care Partners |
$3.71
|
| Rate for Payer: PACE SWMI |
$3.90
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: PHP Medicare Advantage |
$3.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO |
$13.58
|
| Rate for Payer: Priority Health Medicare |
$3.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.74
|
| Rate for Payer: UHC Core |
$13.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.90
|
| Rate for Payer: UHC Exchange |
$3.90
|
| Rate for Payer: UHC Medicare Advantage |
$3.90
|
| Rate for Payer: VA VA |
$3.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC PSYCH/NEUROPSYCH TEST SINGLE AUTOMATED
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 96146
|
| Hospital Charge Code |
91800013
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.13
|
| Rate for Payer: BCBS Complete |
$18.21
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$21.38
|
| Rate for Payer: BCN Commercial |
$20.22
|
| Rate for Payer: BCN Medicare Advantage |
$6.50
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$17.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: Meridian Medicaid |
$18.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Senior Care Partners |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.50
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Medicare |
$6.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: Railroad Medicare Medicare |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.50
|
| Rate for Payer: UHC Exchange |
$6.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.50
|
| Rate for Payer: UHCCP Medicaid |
$17.34
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
