|
HC PSG W CPAP PEDS 5 AND UNDER
|
Facility
|
IP
|
$5,865.71
|
|
|
Service Code
|
CPT 95783
|
| Hospital Charge Code |
92000018
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$2,580.91 |
| Max. Negotiated Rate |
$5,279.14 |
| Rate for Payer: Aetna American Axle |
$3,812.71
|
| Rate for Payer: Aetna Commercial |
$4,985.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,812.71
|
| Rate for Payer: Cash Price |
$4,692.57
|
| Rate for Payer: Cofinity Commercial |
$4,106.00
|
| Rate for Payer: Cofinity Commercial |
$5,044.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,692.57
|
| Rate for Payer: Healthscope Commercial |
$5,279.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,106.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,399.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,985.85
|
| Rate for Payer: PHP Commercial |
$4,985.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,106.00
|
| Rate for Payer: Priority Health SBD |
$3,695.40
|
| Rate for Payer: UMR Bronson Commercial |
$2,580.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,399.28
|
|
|
HC PSORALEN
|
Facility
|
OP
|
$2,114.62
|
|
|
Service Code
|
HCPCS P9073
|
| Hospital Charge Code |
39000085
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$281.32 |
| Max. Negotiated Rate |
$1,903.16 |
| Rate for Payer: Aetna American Axle |
$1,374.50
|
| Rate for Payer: Aetna Commercial |
$1,797.43
|
| Rate for Payer: Aetna Medicare |
$534.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,374.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$642.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$642.88
|
| Rate for Payer: BCBS Complete |
$295.41
|
| Rate for Payer: BCBS MAPPO |
$514.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,832.89
|
| Rate for Payer: BCN Medicare Advantage |
$514.30
|
| Rate for Payer: Cash Price |
$1,691.70
|
| Rate for Payer: Cash Price |
$1,691.70
|
| Rate for Payer: Cash Price |
$1,691.70
|
| Rate for Payer: Cofinity Commercial |
$1,818.57
|
| Rate for Payer: Cofinity Commercial |
$1,480.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,691.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$514.30
|
| Rate for Payer: Healthscope Commercial |
$1,903.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,480.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,585.96
|
| Rate for Payer: Mclaren Medicaid |
$281.32
|
| Rate for Payer: Mclaren Medicare |
$514.30
|
| Rate for Payer: Meridian Medicaid |
$295.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$540.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$591.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,797.43
|
| Rate for Payer: PACE Medicare |
$488.58
|
| Rate for Payer: PACE SWMI |
$514.30
|
| Rate for Payer: PHP Commercial |
$1,797.43
|
| Rate for Payer: PHP Medicare Advantage |
$514.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,480.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,619.05
|
| Rate for Payer: Priority Health Medicare |
$514.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,295.24
|
| Rate for Payer: Priority Health SBD |
$1,332.21
|
| Rate for Payer: Railroad Medicare Medicare |
$514.30
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$514.30
|
| Rate for Payer: UHC Medicare Advantage |
$529.73
|
| Rate for Payer: UMR Bronson Commercial |
$782.41
|
| Rate for Payer: VA VA |
$514.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,585.96
|
|
|
HC PSORALEN
|
Facility
|
IP
|
$2,114.62
|
|
|
Service Code
|
HCPCS P9073
|
| Hospital Charge Code |
39000085
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$930.43 |
| Max. Negotiated Rate |
$1,903.16 |
| Rate for Payer: Aetna American Axle |
$1,374.50
|
| Rate for Payer: Aetna Commercial |
$1,797.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,374.50
|
| Rate for Payer: Cash Price |
$1,691.70
|
| Rate for Payer: Cofinity Commercial |
$1,818.57
|
| Rate for Payer: Cofinity Commercial |
$1,480.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,691.70
|
| Rate for Payer: Healthscope Commercial |
$1,903.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,480.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,585.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,797.43
|
| Rate for Payer: PHP Commercial |
$1,797.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,480.23
|
| Rate for Payer: Priority Health SBD |
$1,332.21
|
| Rate for Payer: UMR Bronson Commercial |
$930.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,585.96
|
|
|
HC PSORALEN TREATED WASHED PLATELETS
|
Facility
|
OP
|
$2,194.62
|
|
|
Service Code
|
HCPCS P9073
|
| Hospital Charge Code |
39000086
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$281.32 |
| Max. Negotiated Rate |
$1,975.16 |
| Rate for Payer: Aetna American Axle |
$1,426.50
|
| Rate for Payer: Aetna Commercial |
$1,865.43
|
| Rate for Payer: Aetna Medicare |
$534.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,426.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$642.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$642.88
|
| Rate for Payer: BCBS Complete |
$295.41
|
| Rate for Payer: BCBS MAPPO |
$514.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,832.89
|
| Rate for Payer: BCN Medicare Advantage |
$514.30
|
| Rate for Payer: Cash Price |
$1,755.70
|
| Rate for Payer: Cash Price |
$1,755.70
|
| Rate for Payer: Cash Price |
$1,755.70
|
| Rate for Payer: Cofinity Commercial |
$1,887.37
|
| Rate for Payer: Cofinity Commercial |
$1,536.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,755.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$514.30
|
| Rate for Payer: Healthscope Commercial |
$1,975.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,536.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,645.96
|
| Rate for Payer: Mclaren Medicaid |
$281.32
|
| Rate for Payer: Mclaren Medicare |
$514.30
|
| Rate for Payer: Meridian Medicaid |
$295.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$540.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$591.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,865.43
|
| Rate for Payer: PACE Medicare |
$488.58
|
| Rate for Payer: PACE SWMI |
$514.30
|
| Rate for Payer: PHP Commercial |
$1,865.43
|
| Rate for Payer: PHP Medicare Advantage |
$514.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,536.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,619.05
|
| Rate for Payer: Priority Health Medicare |
$514.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,295.24
|
| Rate for Payer: Priority Health SBD |
$1,382.61
|
| Rate for Payer: Railroad Medicare Medicare |
$514.30
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$514.30
|
| Rate for Payer: UHC Medicare Advantage |
$529.73
|
| Rate for Payer: UMR Bronson Commercial |
$812.01
|
| Rate for Payer: VA VA |
$514.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,645.96
|
|
|
HC PSORALEN TREATED WASHED PLATELETS
|
Facility
|
IP
|
$2,194.62
|
|
|
Service Code
|
HCPCS P9073
|
| Hospital Charge Code |
39000086
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$965.63 |
| Max. Negotiated Rate |
$1,975.16 |
| Rate for Payer: Aetna American Axle |
$1,426.50
|
| Rate for Payer: Aetna Commercial |
$1,865.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,426.50
|
| Rate for Payer: Cash Price |
$1,755.70
|
| Rate for Payer: Cofinity Commercial |
$1,887.37
|
| Rate for Payer: Cofinity Commercial |
$1,536.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,755.70
|
| Rate for Payer: Healthscope Commercial |
$1,975.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,536.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,645.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,865.43
|
| Rate for Payer: PHP Commercial |
$1,865.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,536.23
|
| Rate for Payer: Priority Health SBD |
$1,382.61
|
| Rate for Payer: UMR Bronson Commercial |
$965.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,645.96
|
|
|
HC PSYCH COLLAB CARE MGMT EA ADD 30 MIN
|
Facility
|
OP
|
$87.72
|
|
|
Service Code
|
CPT 99494
|
| Hospital Charge Code |
51000094
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$32.46 |
| Max. Negotiated Rate |
$145.96 |
| Rate for Payer: Aetna American Axle |
$57.02
|
| Rate for Payer: Aetna Commercial |
$74.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.02
|
| Rate for Payer: BCBS Complete |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$145.96
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cofinity Commercial |
$75.44
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Healthscope Commercial |
$78.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.56
|
| Rate for Payer: PHP Commercial |
$74.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.40
|
| Rate for Payer: Priority Health SBD |
$55.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.94
|
| Rate for Payer: UHC Exchange |
$39.95
|
| Rate for Payer: UMR Bronson Commercial |
$32.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.79
|
|
|
HC PSYCH COLLAB CARE MGMT EA ADD 30 MIN
|
Facility
|
IP
|
$87.72
|
|
|
Service Code
|
CPT 99494
|
| Hospital Charge Code |
51000094
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$38.60 |
| Max. Negotiated Rate |
$78.95 |
| Rate for Payer: Aetna American Axle |
$57.02
|
| Rate for Payer: Aetna Commercial |
$74.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.02
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Cofinity Commercial |
$75.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Healthscope Commercial |
$78.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.56
|
| Rate for Payer: PHP Commercial |
$74.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.40
|
| Rate for Payer: Priority Health SBD |
$55.26
|
| Rate for Payer: UMR Bronson Commercial |
$38.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.79
|
|
|
HC PSYCH COLLAB CARE MGMT INIT 70 MIN
|
Facility
|
OP
|
$93.84
|
|
|
Service Code
|
CPT 99492
|
| Hospital Charge Code |
51000092
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$396.56 |
| Rate for Payer: Aetna American Axle |
$61.00
|
| Rate for Payer: Aetna Commercial |
$79.76
|
| Rate for Payer: Aetna Medicare |
$82.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$99.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$99.04
|
| Rate for Payer: BCBS Complete |
$45.51
|
| Rate for Payer: BCBS MAPPO |
$79.23
|
| Rate for Payer: BCBS Trust/PPO |
$396.56
|
| Rate for Payer: BCN Medicare Advantage |
$79.23
|
| Rate for Payer: Cash Price |
$75.07
|
| Rate for Payer: Cash Price |
$75.07
|
| Rate for Payer: Cofinity Commercial |
$80.70
|
| Rate for Payer: Cofinity Commercial |
$65.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.23
|
| Rate for Payer: Healthscope Commercial |
$84.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.38
|
| Rate for Payer: Mclaren Medicaid |
$43.34
|
| Rate for Payer: Mclaren Medicare |
$79.23
|
| Rate for Payer: Meridian Medicaid |
$45.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$83.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$79.76
|
| Rate for Payer: PACE Medicare |
$75.27
|
| Rate for Payer: PACE SWMI |
$79.23
|
| Rate for Payer: PHP Commercial |
$79.76
|
| Rate for Payer: PHP Medicare Advantage |
$79.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.42
|
| Rate for Payer: Priority Health Medicare |
$79.23
|
| Rate for Payer: Priority Health Narrow Network |
$199.54
|
| Rate for Payer: Priority Health SBD |
$59.12
|
| Rate for Payer: Railroad Medicare Medicare |
$79.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.23
|
| Rate for Payer: UHC Exchange |
$91.36
|
| Rate for Payer: UHC Medicare Advantage |
$81.61
|
| Rate for Payer: UMR Bronson Commercial |
$34.72
|
| Rate for Payer: VA VA |
$79.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.38
|
|
|
HC PSYCH COLLAB CARE MGMT INIT 70 MIN
|
Facility
|
IP
|
$93.84
|
|
|
Service Code
|
CPT 99492
|
| Hospital Charge Code |
51000092
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$41.29 |
| Max. Negotiated Rate |
$84.46 |
| Rate for Payer: Aetna American Axle |
$61.00
|
| Rate for Payer: Aetna Commercial |
$79.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.00
|
| Rate for Payer: Cash Price |
$75.07
|
| Rate for Payer: Cofinity Commercial |
$65.69
|
| Rate for Payer: Cofinity Commercial |
$80.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.07
|
| Rate for Payer: Healthscope Commercial |
$84.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$79.76
|
| Rate for Payer: PHP Commercial |
$79.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.69
|
| Rate for Payer: Priority Health SBD |
$59.12
|
| Rate for Payer: UMR Bronson Commercial |
$41.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.38
|
|
|
HC PSYCH COLLAB CARE MGMT SUBSEQ 60 MIN
|
Facility
|
IP
|
$103.22
|
|
|
Service Code
|
CPT 99493
|
| Hospital Charge Code |
51000093
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$45.42 |
| Max. Negotiated Rate |
$92.90 |
| Rate for Payer: Aetna American Axle |
$67.09
|
| Rate for Payer: Aetna Commercial |
$87.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.09
|
| Rate for Payer: Cash Price |
$82.58
|
| Rate for Payer: Cofinity Commercial |
$72.25
|
| Rate for Payer: Cofinity Commercial |
$88.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.58
|
| Rate for Payer: Healthscope Commercial |
$92.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.74
|
| Rate for Payer: PHP Commercial |
$87.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.25
|
| Rate for Payer: Priority Health SBD |
$65.03
|
| Rate for Payer: UMR Bronson Commercial |
$45.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.42
|
|
|
HC PSYCH COLLAB CARE MGMT SUBSEQ 60 MIN
|
Facility
|
OP
|
$103.22
|
|
|
Service Code
|
CPT 99493
|
| Hospital Charge Code |
51000093
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$38.19 |
| Max. Negotiated Rate |
$446.15 |
| Rate for Payer: Aetna American Axle |
$67.09
|
| Rate for Payer: Aetna Commercial |
$87.74
|
| Rate for Payer: Aetna Medicare |
$147.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$177.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$177.15
|
| Rate for Payer: BCBS Complete |
$81.40
|
| Rate for Payer: BCBS MAPPO |
$141.72
|
| Rate for Payer: BCBS Trust/PPO |
$288.94
|
| Rate for Payer: BCN Medicare Advantage |
$141.72
|
| Rate for Payer: Cash Price |
$82.58
|
| Rate for Payer: Cash Price |
$82.58
|
| Rate for Payer: Cofinity Commercial |
$72.25
|
| Rate for Payer: Cofinity Commercial |
$88.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.72
|
| Rate for Payer: Healthscope Commercial |
$92.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.42
|
| Rate for Payer: Mclaren Medicaid |
$77.52
|
| Rate for Payer: Mclaren Medicare |
$141.72
|
| Rate for Payer: Meridian Medicaid |
$81.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$148.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$162.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.74
|
| Rate for Payer: PACE Medicare |
$134.63
|
| Rate for Payer: PACE SWMI |
$141.72
|
| Rate for Payer: PHP Commercial |
$87.74
|
| Rate for Payer: PHP Medicare Advantage |
$141.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$446.15
|
| Rate for Payer: Priority Health Medicare |
$141.72
|
| Rate for Payer: Priority Health Narrow Network |
$356.92
|
| Rate for Payer: Priority Health SBD |
$65.03
|
| Rate for Payer: Railroad Medicare Medicare |
$141.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.72
|
| Rate for Payer: UHC Exchange |
$99.87
|
| Rate for Payer: UHC Medicare Advantage |
$145.97
|
| Rate for Payer: UMR Bronson Commercial |
$38.19
|
| Rate for Payer: VA VA |
$141.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.42
|
|
|
HC PSYCH DIAGNOSTIC EVAL W/MED SVCS
|
Facility
|
OP
|
$194.82
|
|
|
Service Code
|
CPT 90792
|
| Hospital Charge Code |
91400008
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$72.08 |
| Max. Negotiated Rate |
$446.15 |
| Rate for Payer: Aetna American Axle |
$126.63
|
| Rate for Payer: Aetna Commercial |
$165.60
|
| Rate for Payer: Aetna Medicare |
$147.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$177.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$177.15
|
| Rate for Payer: BCBS Complete |
$81.40
|
| Rate for Payer: BCBS MAPPO |
$141.72
|
| Rate for Payer: BCN Medicare Advantage |
$141.72
|
| Rate for Payer: Cash Price |
$155.86
|
| Rate for Payer: Cash Price |
$155.86
|
| Rate for Payer: Cofinity Commercial |
$167.55
|
| Rate for Payer: Cofinity Commercial |
$136.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.72
|
| Rate for Payer: Healthscope Commercial |
$175.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.12
|
| Rate for Payer: Mclaren Medicaid |
$77.52
|
| Rate for Payer: Mclaren Medicare |
$141.72
|
| Rate for Payer: Meridian Medicaid |
$81.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$148.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$162.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.60
|
| Rate for Payer: PACE Medicare |
$134.63
|
| Rate for Payer: PACE SWMI |
$141.72
|
| Rate for Payer: PHP Commercial |
$165.60
|
| Rate for Payer: PHP Medicare Advantage |
$141.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$446.15
|
| Rate for Payer: Priority Health Medicare |
$141.72
|
| Rate for Payer: Priority Health Narrow Network |
$356.92
|
| Rate for Payer: Priority Health SBD |
$122.74
|
| Rate for Payer: Railroad Medicare Medicare |
$141.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.72
|
| Rate for Payer: UHC Exchange |
$166.34
|
| Rate for Payer: UHC Medicare Advantage |
$145.97
|
| Rate for Payer: UMR Bronson Commercial |
$72.08
|
| Rate for Payer: VA VA |
$141.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.12
|
|
|
HC PSYCH DIAGNOSTIC EVAL W/MED SVCS
|
Facility
|
IP
|
$194.82
|
|
|
Service Code
|
CPT 90792
|
| Hospital Charge Code |
91400008
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$85.72 |
| Max. Negotiated Rate |
$175.34 |
| Rate for Payer: Aetna American Axle |
$126.63
|
| Rate for Payer: Aetna Commercial |
$165.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.63
|
| Rate for Payer: Cash Price |
$155.86
|
| Rate for Payer: Cofinity Commercial |
$136.37
|
| Rate for Payer: Cofinity Commercial |
$167.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.86
|
| Rate for Payer: Healthscope Commercial |
$175.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.60
|
| Rate for Payer: PHP Commercial |
$165.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.37
|
| Rate for Payer: Priority Health SBD |
$122.74
|
| Rate for Payer: UMR Bronson Commercial |
$85.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.12
|
|
|
HC PSYCHIATRIC DIAG EVAL
|
Facility
|
IP
|
$194.82
|
|
|
Service Code
|
CPT 90791
|
| Hospital Charge Code |
91400004
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$85.72 |
| Max. Negotiated Rate |
$175.34 |
| Rate for Payer: Aetna American Axle |
$126.63
|
| Rate for Payer: Aetna Commercial |
$165.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.63
|
| Rate for Payer: Cash Price |
$155.86
|
| Rate for Payer: Cofinity Commercial |
$136.37
|
| Rate for Payer: Cofinity Commercial |
$167.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.86
|
| Rate for Payer: Healthscope Commercial |
$175.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.60
|
| Rate for Payer: PHP Commercial |
$165.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.37
|
| Rate for Payer: Priority Health SBD |
$122.74
|
| Rate for Payer: UMR Bronson Commercial |
$85.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.12
|
|
|
HC PSYCHIATRIC DIAG EVAL
|
Facility
|
OP
|
$194.82
|
|
|
Service Code
|
CPT 90791
|
| Hospital Charge Code |
91400004
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$72.08 |
| Max. Negotiated Rate |
$446.15 |
| Rate for Payer: Aetna American Axle |
$126.63
|
| Rate for Payer: Aetna Commercial |
$165.60
|
| Rate for Payer: Aetna Medicare |
$147.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$177.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$177.15
|
| Rate for Payer: BCBS Complete |
$81.40
|
| Rate for Payer: BCBS MAPPO |
$141.72
|
| Rate for Payer: BCN Medicare Advantage |
$141.72
|
| Rate for Payer: Cash Price |
$155.86
|
| Rate for Payer: Cash Price |
$155.86
|
| Rate for Payer: Cofinity Commercial |
$167.55
|
| Rate for Payer: Cofinity Commercial |
$136.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.72
|
| Rate for Payer: Healthscope Commercial |
$175.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.12
|
| Rate for Payer: Mclaren Medicaid |
$77.52
|
| Rate for Payer: Mclaren Medicare |
$141.72
|
| Rate for Payer: Meridian Medicaid |
$81.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$148.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$162.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.60
|
| Rate for Payer: PACE Medicare |
$134.63
|
| Rate for Payer: PACE SWMI |
$141.72
|
| Rate for Payer: PHP Commercial |
$165.60
|
| Rate for Payer: PHP Medicare Advantage |
$141.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$446.15
|
| Rate for Payer: Priority Health Medicare |
$141.72
|
| Rate for Payer: Priority Health Narrow Network |
$356.92
|
| Rate for Payer: Priority Health SBD |
$122.74
|
| Rate for Payer: Railroad Medicare Medicare |
$141.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.72
|
| Rate for Payer: UHC Exchange |
$145.06
|
| Rate for Payer: UHC Medicare Advantage |
$145.97
|
| Rate for Payer: UMR Bronson Commercial |
$72.08
|
| Rate for Payer: VA VA |
$141.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.12
|
|
|
HC PSYCH/NEUROPSYCH TEST BY PHYS 30 MIN
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 96136
|
| Hospital Charge Code |
91800009
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$9.44 |
| Max. Negotiated Rate |
$491.00 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$285.94
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.85
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$22.59
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$9.44
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC PSYCH/NEUROPSYCH TEST BY PHYS 30 MIN
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 96136
|
| Hospital Charge Code |
91800009
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$11.22 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: UMR Bronson Commercial |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH 30 MIN
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 96138
|
| Hospital Charge Code |
91800011
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$9.44 |
| Max. Negotiated Rate |
$1,114.93 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$368.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$442.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$442.70
|
| Rate for Payer: BCBS Complete |
$203.43
|
| Rate for Payer: BCBS MAPPO |
$354.16
|
| Rate for Payer: BCN Medicare Advantage |
$354.16
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.16
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$193.73
|
| Rate for Payer: Mclaren Medicare |
$354.16
|
| Rate for Payer: Meridian Medicaid |
$203.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$371.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Medicare |
$336.45
|
| Rate for Payer: PACE SWMI |
$354.16
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$354.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,114.93
|
| Rate for Payer: Priority Health Medicare |
$354.16
|
| Rate for Payer: Priority Health Narrow Network |
$891.94
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: Railroad Medicare Medicare |
$354.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.10
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.16
|
| Rate for Payer: UHC Exchange |
$33.73
|
| Rate for Payer: UHC Medicare Advantage |
$364.78
|
| Rate for Payer: UMR Bronson Commercial |
$9.44
|
| Rate for Payer: VA VA |
$354.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH 30 MIN
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 96138
|
| Hospital Charge Code |
91800011
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$11.22 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: UMR Bronson Commercial |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH EA ADDL 30 MIN
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT 96139
|
| Hospital Charge Code |
91800012
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna American Axle |
$9.94
|
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.94
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: UMR Bronson Commercial |
$6.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH EA ADDL 30 MIN
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT 96139
|
| Hospital Charge Code |
91800012
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$491.00 |
| Rate for Payer: Aetna American Axle |
$9.94
|
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.94
|
| Rate for Payer: BCBS Complete |
$6.12
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.18
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Exchange |
$34.71
|
| Rate for Payer: UMR Bronson Commercial |
$5.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC PSYCH/NEUROPSYCH TEST PHYS EA ADDL 30 MIN
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT 96137
|
| Hospital Charge Code |
91800010
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna American Axle |
$9.94
|
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.94
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: UMR Bronson Commercial |
$6.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC PSYCH/NEUROPSYCH TEST PHYS EA ADDL 30 MIN
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT 96137
|
| Hospital Charge Code |
91800010
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$491.00 |
| Rate for Payer: Aetna American Axle |
$9.94
|
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.94
|
| Rate for Payer: BCBS Complete |
$6.12
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.08
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Exchange |
$17.35
|
| Rate for Payer: UMR Bronson Commercial |
$5.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC PSYCH/NEUROPSYCH TEST SINGLE AUTOMATED
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 96146
|
| Hospital Charge Code |
91800013
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$491.00 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$27.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.09
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$26.47
|
| Rate for Payer: BCN Medicare Advantage |
$26.47
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.47
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$14.48
|
| Rate for Payer: Mclaren Medicare |
$26.47
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Medicare |
$25.15
|
| Rate for Payer: PACE SWMI |
$26.47
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$26.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.33
|
| Rate for Payer: Priority Health Medicare |
$26.47
|
| Rate for Payer: Priority Health Narrow Network |
$66.66
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: Railroad Medicare Medicare |
$26.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.52
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.47
|
| Rate for Payer: UHC Exchange |
$2.29
|
| Rate for Payer: UHC Medicare Advantage |
$27.26
|
| Rate for Payer: UMR Bronson Commercial |
$9.44
|
| Rate for Payer: VA VA |
$26.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC PSYCH/NEUROPSYCH TEST SINGLE AUTOMATED
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 96146
|
| Hospital Charge Code |
91800013
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$11.22 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: UMR Bronson Commercial |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
