|
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 |
$70.23
|
| 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 |
$66.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.64
|
| Rate for Payer: Meridian Medicaid |
$70.23
|
| 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 |
$66.88
|
| 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 |
$66.88
|
| 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
|
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 |
$121.98
|
| 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 |
$116.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.16
|
| Rate for Payer: Meridian Medicaid |
$121.98
|
| 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 |
$116.16
|
| 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 |
$116.16
|
| Rate for Payer: VA VA |
$49.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.04
|
|
|
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 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 |
$121.98
|
| 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 |
$116.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.16
|
| Rate for Payer: Meridian Medicaid |
$121.98
|
| 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 |
$116.16
|
| 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 |
$116.16
|
| 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 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 |
$97.86 |
| 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 |
$97.86
|
| 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 |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| 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 |
$93.19
|
| 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 |
$93.19
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
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 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 |
$302.95 |
| 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 |
$302.95
|
| 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 |
$288.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: Meridian Medicaid |
$302.95
|
| 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 |
$288.51
|
| 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 |
$288.51
|
| 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 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 |
$18.59
|
| 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 |
$17.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: Meridian Medicaid |
$18.59
|
| 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 |
$17.71
|
| 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 |
$17.71
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC PSYCH/NEUROPSYCH TEST SINGLE AUTOMATED
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 96146
|
| Hospital Charge Code |
91800013
|
|
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 PSYCHOLOGICAL TEST EVAL PHYS/QHP 1ST HOUR
|
Facility
|
IP
|
$714.00
|
|
|
Service Code
|
CPT 96130
|
| Hospital Charge Code |
91800450
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$464.10 |
| Max. Negotiated Rate |
$642.60 |
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: BCBS Trust/PPO |
$582.84
|
| Rate for Payer: BCN Commercial |
$551.78
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$606.90
|
| Rate for Payer: Nomi Health Commercial |
$585.48
|
| Rate for Payer: PHP Commercial |
$606.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO |
$621.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$478.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$628.32
|
| Rate for Payer: UHC Core |
$596.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.50
|
|
|
HC PSYCHOLOGICAL TEST EVAL PHYS/QHP 1ST HOUR
|
Facility
|
OP
|
$714.00
|
|
|
Service Code
|
CPT 96130
|
| Hospital Charge Code |
91800450
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$169.57 |
| Max. Negotiated Rate |
$642.60 |
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: Aetna Medicare |
$185.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$223.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$223.12
|
| Rate for Payer: BCBS Complete |
$236.41
|
| Rate for Payer: BCBS MAPPO |
$178.50
|
| Rate for Payer: BCBS Trust/PPO |
$586.98
|
| Rate for Payer: BCN Commercial |
$555.13
|
| Rate for Payer: BCN Medicare Advantage |
$178.50
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.50
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.50
|
| Rate for Payer: Mclaren Medicaid |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.43
|
| Rate for Payer: Meridian Medicaid |
$236.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$205.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$606.90
|
| Rate for Payer: Nomi Health Commercial |
$585.48
|
| Rate for Payer: PACE Senior Care Partners |
$169.57
|
| Rate for Payer: PACE SWMI |
$178.50
|
| Rate for Payer: PHP Commercial |
$606.90
|
| Rate for Payer: PHP Medicare Advantage |
$178.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO |
$621.18
|
| Rate for Payer: Priority Health Medicare |
$180.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$478.38
|
| Rate for Payer: Railroad Medicare Medicare |
$178.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$628.32
|
| Rate for Payer: UHC Core |
$596.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$178.50
|
| Rate for Payer: UHC Exchange |
$178.50
|
| Rate for Payer: UHC Medicare Advantage |
$178.50
|
| Rate for Payer: UHCCP Medicaid |
$225.14
|
| Rate for Payer: VA VA |
$178.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.50
|
|
|
HC PSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HOUR
|
Facility
|
OP
|
$542.64
|
|
|
Service Code
|
CPT 96131
|
| Hospital Charge Code |
91800449
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$128.88 |
| Max. Negotiated Rate |
$488.38 |
| Rate for Payer: Aetna Commercial |
$461.24
|
| Rate for Payer: Aetna Medicare |
$141.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$169.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$169.57
|
| Rate for Payer: BCBS Complete |
$217.06
|
| Rate for Payer: BCBS MAPPO |
$135.66
|
| Rate for Payer: BCBS Trust/PPO |
$446.10
|
| Rate for Payer: BCN Commercial |
$421.90
|
| Rate for Payer: BCN Medicare Advantage |
$135.66
|
| Rate for Payer: Cash Price |
$434.11
|
| Rate for Payer: Cofinity Commercial |
$466.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.66
|
| Rate for Payer: Healthscope Commercial |
$488.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.24
|
| Rate for Payer: Nomi Health Commercial |
$444.96
|
| Rate for Payer: PACE Senior Care Partners |
$128.88
|
| Rate for Payer: PACE SWMI |
$135.66
|
| Rate for Payer: PHP Commercial |
$461.24
|
| Rate for Payer: PHP Medicare Advantage |
$135.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.72
|
| Rate for Payer: Priority Health HMO/PPO |
$472.10
|
| Rate for Payer: Priority Health Medicare |
$137.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$363.57
|
| Rate for Payer: Railroad Medicare Medicare |
$135.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$477.52
|
| Rate for Payer: UHC Core |
$453.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$135.66
|
| Rate for Payer: UHC Exchange |
$135.66
|
| Rate for Payer: UHC Medicare Advantage |
$135.66
|
| Rate for Payer: VA VA |
$135.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.98
|
|
|
HC PSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HOUR
|
Facility
|
IP
|
$542.64
|
|
|
Service Code
|
CPT 96131
|
| Hospital Charge Code |
91800449
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$352.72 |
| Max. Negotiated Rate |
$488.38 |
| Rate for Payer: Aetna Commercial |
$461.24
|
| Rate for Payer: BCBS Trust/PPO |
$442.96
|
| Rate for Payer: BCN Commercial |
$419.35
|
| Rate for Payer: Cash Price |
$434.11
|
| Rate for Payer: Cofinity Commercial |
$466.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.11
|
| Rate for Payer: Healthscope Commercial |
$488.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.24
|
| Rate for Payer: Nomi Health Commercial |
$444.96
|
| Rate for Payer: PHP Commercial |
$461.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.72
|
| Rate for Payer: Priority Health HMO/PPO |
$472.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$363.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$477.52
|
| Rate for Payer: UHC Core |
$453.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.98
|
|
|
HC PSYCHOTHERAPY 30 MIN W/PATIENT
|
Facility
|
OP
|
$86.96
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
91400001
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$20.65 |
| Max. Negotiated Rate |
$121.98 |
| Rate for Payer: Aetna Commercial |
$73.92
|
| Rate for Payer: Aetna Medicare |
$22.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.18
|
| Rate for Payer: BCBS Complete |
$121.98
|
| Rate for Payer: BCBS MAPPO |
$21.74
|
| Rate for Payer: BCBS Trust/PPO |
$71.49
|
| Rate for Payer: BCN Commercial |
$67.61
|
| Rate for Payer: BCN Medicare Advantage |
$21.74
|
| Rate for Payer: Cash Price |
$69.57
|
| Rate for Payer: Cash Price |
$69.57
|
| Rate for Payer: Cofinity Commercial |
$74.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.74
|
| Rate for Payer: Healthscope Commercial |
$78.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.22
|
| Rate for Payer: Mclaren Medicaid |
$116.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.83
|
| Rate for Payer: Meridian Medicaid |
$121.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.92
|
| Rate for Payer: Nomi Health Commercial |
$71.31
|
| Rate for Payer: PACE Senior Care Partners |
$20.65
|
| Rate for Payer: PACE SWMI |
$21.74
|
| Rate for Payer: PHP Commercial |
$73.92
|
| Rate for Payer: PHP Medicare Advantage |
$21.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.52
|
| Rate for Payer: Priority Health HMO/PPO |
$75.66
|
| Rate for Payer: Priority Health Medicare |
$21.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.26
|
| Rate for Payer: Railroad Medicare Medicare |
$21.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.52
|
| Rate for Payer: UHC Core |
$72.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.74
|
| Rate for Payer: UHC Exchange |
$21.74
|
| Rate for Payer: UHC Medicare Advantage |
$21.74
|
| Rate for Payer: UHCCP Medicaid |
$116.16
|
| Rate for Payer: VA VA |
$21.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.22
|
|
|
HC PSYCHOTHERAPY 30 MIN W/PATIENT
|
Facility
|
IP
|
$86.96
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
91400001
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$56.52 |
| Max. Negotiated Rate |
$78.26 |
| Rate for Payer: Aetna Commercial |
$73.92
|
| Rate for Payer: BCBS Trust/PPO |
$70.99
|
| Rate for Payer: BCN Commercial |
$67.20
|
| Rate for Payer: Cash Price |
$69.57
|
| Rate for Payer: Cofinity Commercial |
$74.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.57
|
| Rate for Payer: Healthscope Commercial |
$78.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.92
|
| Rate for Payer: Nomi Health Commercial |
$71.31
|
| Rate for Payer: PHP Commercial |
$73.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.52
|
| Rate for Payer: Priority Health HMO/PPO |
$75.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.52
|
| Rate for Payer: UHC Core |
$72.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.22
|
|
|
HC PSYCHOTHERAPY 45 MIN W/PATIENT
|
Facility
|
IP
|
$156.11
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
91400002
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$101.47 |
| Max. Negotiated Rate |
$140.50 |
| Rate for Payer: Aetna Commercial |
$132.69
|
| Rate for Payer: BCBS Trust/PPO |
$127.43
|
| Rate for Payer: BCN Commercial |
$120.64
|
| Rate for Payer: Cash Price |
$124.89
|
| Rate for Payer: Cofinity Commercial |
$134.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.89
|
| Rate for Payer: Healthscope Commercial |
$140.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.69
|
| Rate for Payer: Nomi Health Commercial |
$128.01
|
| Rate for Payer: PHP Commercial |
$132.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.47
|
| Rate for Payer: Priority Health HMO/PPO |
$135.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.38
|
| Rate for Payer: UHC Core |
$130.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.08
|
|
|
HC PSYCHOTHERAPY 45 MIN W/PATIENT
|
Facility
|
OP
|
$156.11
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
91400002
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$37.08 |
| Max. Negotiated Rate |
$140.50 |
| Rate for Payer: Aetna Commercial |
$132.69
|
| Rate for Payer: Aetna Medicare |
$40.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.78
|
| Rate for Payer: BCBS Complete |
$121.98
|
| Rate for Payer: BCBS MAPPO |
$39.03
|
| Rate for Payer: BCBS Trust/PPO |
$128.34
|
| Rate for Payer: BCN Commercial |
$121.38
|
| Rate for Payer: BCN Medicare Advantage |
$39.03
|
| Rate for Payer: Cash Price |
$124.89
|
| Rate for Payer: Cash Price |
$124.89
|
| Rate for Payer: Cofinity Commercial |
$134.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.03
|
| Rate for Payer: Healthscope Commercial |
$140.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.08
|
| Rate for Payer: Mclaren Medicaid |
$116.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.98
|
| Rate for Payer: Meridian Medicaid |
$121.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.69
|
| Rate for Payer: Nomi Health Commercial |
$128.01
|
| Rate for Payer: PACE Senior Care Partners |
$37.08
|
| Rate for Payer: PACE SWMI |
$39.03
|
| Rate for Payer: PHP Commercial |
$132.69
|
| Rate for Payer: PHP Medicare Advantage |
$39.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.47
|
| Rate for Payer: Priority Health HMO/PPO |
$135.82
|
| Rate for Payer: Priority Health Medicare |
$39.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.59
|
| Rate for Payer: Railroad Medicare Medicare |
$39.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.38
|
| Rate for Payer: UHC Core |
$130.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.03
|
| Rate for Payer: UHC Exchange |
$39.03
|
| Rate for Payer: UHC Medicare Advantage |
$39.03
|
| Rate for Payer: UHCCP Medicaid |
$116.16
|
| Rate for Payer: VA VA |
$39.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.08
|
|
