|
HC PSORALEN
|
Facility
|
OP
|
$2,200.05
|
|
|
Service Code
|
HCPCS P9073
|
| Hospital Charge Code |
39000085
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$309.83 |
| Max. Negotiated Rate |
$1,980.05 |
| Rate for Payer: Aetna American Axle |
$1,430.03
|
| Rate for Payer: Aetna Commercial |
$1,870.04
|
| Rate for Payer: Aetna Medicare |
$616.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,430.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$740.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$740.51
|
| Rate for Payer: BCBS Complete |
$325.35
|
| Rate for Payer: BCBS MAPPO |
$592.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,553.53
|
| Rate for Payer: BCN Commercial |
$1,553.53
|
| Rate for Payer: BCN Medicare Advantage |
$592.41
|
| Rate for Payer: Cash Price |
$1,760.04
|
| Rate for Payer: Cash Price |
$1,760.04
|
| Rate for Payer: Cofinity Advantage |
$1,540.04
|
| Rate for Payer: Cofinity Commercial |
$1,892.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,760.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$592.41
|
| Rate for Payer: Healthscope Commercial |
$1,980.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,540.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,650.04
|
| Rate for Payer: Mclaren Medicaid |
$592.41
|
| Rate for Payer: Mclaren Medicare |
$592.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$622.03
|
| Rate for Payer: Meridian Medicaid |
$622.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$681.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$651.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,870.04
|
| Rate for Payer: Nomi Health Commercial |
$1,777.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,650.04
|
| Rate for Payer: PACE Medicare |
$562.79
|
| Rate for Payer: PACE SWMI |
$592.41
|
| Rate for Payer: PHP Commercial |
$1,870.04
|
| Rate for Payer: PHP Medicare Advantage |
$592.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,915.80
|
| Rate for Payer: Priority Health Medicare |
$592.41
|
| Rate for Payer: Priority Health SBD |
$1,386.03
|
| Rate for Payer: Priority Health Tiered Network |
$1,532.64
|
| Rate for Payer: Railroad Medicare Medicare |
$592.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,430.03
|
| Rate for Payer: UHC Core |
$1,146.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$592.41
|
| Rate for Payer: UHC Exchange |
$864.62
|
| Rate for Payer: UHC Medicaid |
$309.83
|
| Rate for Payer: UHCCP Medicaid |
$309.83
|
| Rate for Payer: UMR Bronson Commercial |
$814.02
|
| Rate for Payer: VA VA |
$592.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,650.04
|
|
|
HC PSORALEN TREATED WASHED PLATELETS
|
Facility
|
OP
|
$2,283.28
|
|
|
Service Code
|
HCPCS P9073
|
| Hospital Charge Code |
39000086
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$309.83 |
| Max. Negotiated Rate |
$2,054.95 |
| Rate for Payer: Aetna American Axle |
$1,484.13
|
| Rate for Payer: Aetna Commercial |
$1,940.79
|
| Rate for Payer: Aetna Medicare |
$616.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,484.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$740.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$740.51
|
| Rate for Payer: BCBS Complete |
$325.35
|
| Rate for Payer: BCBS MAPPO |
$592.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,553.53
|
| Rate for Payer: BCN Commercial |
$1,553.53
|
| Rate for Payer: BCN Medicare Advantage |
$592.41
|
| Rate for Payer: Cash Price |
$1,826.62
|
| Rate for Payer: Cash Price |
$1,826.62
|
| Rate for Payer: Cofinity Advantage |
$1,598.30
|
| Rate for Payer: Cofinity Commercial |
$1,963.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,826.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$592.41
|
| Rate for Payer: Healthscope Commercial |
$2,054.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,598.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,712.46
|
| Rate for Payer: Mclaren Medicaid |
$592.41
|
| Rate for Payer: Mclaren Medicare |
$592.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$622.03
|
| Rate for Payer: Meridian Medicaid |
$622.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$681.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$651.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,940.79
|
| Rate for Payer: Nomi Health Commercial |
$1,777.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,712.46
|
| Rate for Payer: PACE Medicare |
$562.79
|
| Rate for Payer: PACE SWMI |
$592.41
|
| Rate for Payer: PHP Commercial |
$1,940.79
|
| Rate for Payer: PHP Medicare Advantage |
$592.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,915.80
|
| Rate for Payer: Priority Health Medicare |
$592.41
|
| Rate for Payer: Priority Health SBD |
$1,438.47
|
| Rate for Payer: Priority Health Tiered Network |
$1,532.64
|
| Rate for Payer: Railroad Medicare Medicare |
$592.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,484.13
|
| Rate for Payer: UHC Core |
$1,189.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$592.41
|
| Rate for Payer: UHC Exchange |
$897.33
|
| Rate for Payer: UHC Medicaid |
$309.83
|
| Rate for Payer: UHCCP Medicaid |
$309.83
|
| Rate for Payer: UMR Bronson Commercial |
$844.81
|
| Rate for Payer: VA VA |
$592.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,712.46
|
|
|
HC PSORALEN TREATED WASHED PLATELETS
|
Facility
|
IP
|
$2,283.28
|
|
|
Service Code
|
HCPCS P9073
|
| Hospital Charge Code |
39000086
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,004.64 |
| Max. Negotiated Rate |
$2,054.95 |
| Rate for Payer: Aetna American Axle |
$1,484.13
|
| Rate for Payer: Aetna Commercial |
$1,940.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,484.13
|
| Rate for Payer: Cash Price |
$1,826.62
|
| Rate for Payer: Cofinity Advantage |
$1,598.30
|
| Rate for Payer: Cofinity Commercial |
$1,963.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,826.62
|
| Rate for Payer: Healthscope Commercial |
$2,054.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,598.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,712.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,940.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,712.46
|
| Rate for Payer: PHP Commercial |
$1,940.79
|
| Rate for Payer: Priority Health SBD |
$1,438.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,004.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,712.46
|
|
|
HC PSYCH COLLAB CARE MGMT EA ADD 30 MIN
|
Facility
|
OP
|
$91.26
|
|
|
Service Code
|
CPT 99494
|
| Hospital Charge Code |
51000094
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$33.77 |
| Max. Negotiated Rate |
$121.74 |
| Rate for Payer: Aetna American Axle |
$59.32
|
| Rate for Payer: Aetna Commercial |
$77.57
|
| Rate for Payer: Aetna Medicare |
$45.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.32
|
| Rate for Payer: BCBS Complete |
$36.50
|
| Rate for Payer: BCBS Trust/PPO |
$121.74
|
| Rate for Payer: BCN Commercial |
$121.74
|
| Rate for Payer: Cash Price |
$73.01
|
| Rate for Payer: Cash Price |
$73.01
|
| Rate for Payer: Cofinity Advantage |
$63.88
|
| Rate for Payer: Cofinity Commercial |
$78.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.01
|
| Rate for Payer: Healthscope Commercial |
$82.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.44
|
| Rate for Payer: PHP Commercial |
$77.57
|
| Rate for Payer: Priority Health SBD |
$57.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.32
|
| Rate for Payer: UHC Core |
$47.55
|
| Rate for Payer: UHC Exchange |
$35.87
|
| Rate for Payer: UMR Bronson Commercial |
$33.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.44
|
|
|
HC PSYCH COLLAB CARE MGMT EA ADD 30 MIN
|
Facility
|
IP
|
$91.26
|
|
|
Service Code
|
CPT 99494
|
| Hospital Charge Code |
51000094
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$40.15 |
| Max. Negotiated Rate |
$82.13 |
| Rate for Payer: Aetna American Axle |
$59.32
|
| Rate for Payer: Aetna Commercial |
$77.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.32
|
| Rate for Payer: Cash Price |
$73.01
|
| Rate for Payer: Cofinity Advantage |
$63.88
|
| Rate for Payer: Cofinity Commercial |
$78.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.01
|
| Rate for Payer: Healthscope Commercial |
$82.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.44
|
| Rate for Payer: PHP Commercial |
$77.57
|
| Rate for Payer: Priority Health SBD |
$57.49
|
| Rate for Payer: UMR Bronson Commercial |
$40.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.44
|
|
|
HC PSYCH COLLAB CARE MGMT INIT 70 MIN
|
Facility
|
OP
|
$97.63
|
|
|
Service Code
|
CPT 99492
|
| Hospital Charge Code |
51000092
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$36.12 |
| Max. Negotiated Rate |
$330.74 |
| Rate for Payer: Aetna American Axle |
$63.46
|
| Rate for Payer: Aetna Commercial |
$82.99
|
| Rate for Payer: Aetna Medicare |
$105.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.53
|
| Rate for Payer: BCBS Complete |
$55.59
|
| Rate for Payer: BCBS MAPPO |
$101.22
|
| Rate for Payer: BCBS Trust/PPO |
$330.74
|
| Rate for Payer: BCN Commercial |
$330.74
|
| Rate for Payer: BCN Medicare Advantage |
$101.22
|
| Rate for Payer: Cash Price |
$78.10
|
| Rate for Payer: Cash Price |
$78.10
|
| Rate for Payer: Cofinity Advantage |
$68.34
|
| Rate for Payer: Cofinity Commercial |
$83.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.22
|
| Rate for Payer: Healthscope Commercial |
$87.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.22
|
| Rate for Payer: Mclaren Medicaid |
$101.22
|
| Rate for Payer: Mclaren Medicare |
$101.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.28
|
| Rate for Payer: Meridian Medicaid |
$106.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.99
|
| Rate for Payer: Nomi Health Commercial |
$303.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.22
|
| Rate for Payer: PACE Medicare |
$96.16
|
| Rate for Payer: PACE SWMI |
$101.22
|
| Rate for Payer: PHP Commercial |
$82.99
|
| Rate for Payer: PHP Medicare Advantage |
$101.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$327.36
|
| Rate for Payer: Priority Health Medicare |
$101.22
|
| Rate for Payer: Priority Health SBD |
$61.51
|
| Rate for Payer: Priority Health Tiered Network |
$261.89
|
| Rate for Payer: Railroad Medicare Medicare |
$101.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.46
|
| Rate for Payer: UHC Core |
$50.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.22
|
| Rate for Payer: UHC Exchange |
$38.37
|
| Rate for Payer: UHC Medicaid |
$52.94
|
| Rate for Payer: UHCCP Medicaid |
$52.94
|
| Rate for Payer: UMR Bronson Commercial |
$36.12
|
| Rate for Payer: VA VA |
$101.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.22
|
|
|
HC PSYCH COLLAB CARE MGMT INIT 70 MIN
|
Facility
|
IP
|
$97.63
|
|
|
Service Code
|
CPT 99492
|
| Hospital Charge Code |
51000092
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.96 |
| Max. Negotiated Rate |
$87.87 |
| Rate for Payer: Aetna American Axle |
$63.46
|
| Rate for Payer: Aetna Commercial |
$82.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.46
|
| Rate for Payer: Cash Price |
$78.10
|
| Rate for Payer: Cofinity Advantage |
$68.34
|
| Rate for Payer: Cofinity Commercial |
$83.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.10
|
| Rate for Payer: Healthscope Commercial |
$87.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.22
|
| Rate for Payer: PHP Commercial |
$82.99
|
| Rate for Payer: Priority Health SBD |
$61.51
|
| Rate for Payer: UMR Bronson Commercial |
$42.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.22
|
|
|
HC PSYCH COLLAB CARE MGMT SUBSEQ 60 MIN
|
Facility
|
IP
|
$126.34
|
|
|
Service Code
|
CPT 99493
|
| Hospital Charge Code |
51000093
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$113.71 |
| Rate for Payer: Aetna American Axle |
$82.12
|
| Rate for Payer: Aetna Commercial |
$107.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.12
|
| Rate for Payer: Cash Price |
$101.07
|
| Rate for Payer: Cofinity Advantage |
$88.44
|
| Rate for Payer: Cofinity Commercial |
$108.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.07
|
| Rate for Payer: Healthscope Commercial |
$113.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.75
|
| Rate for Payer: PHP Commercial |
$107.39
|
| Rate for Payer: Priority Health SBD |
$79.59
|
| Rate for Payer: UMR Bronson Commercial |
$55.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.75
|
|
|
HC PSYCH COLLAB CARE MGMT SUBSEQ 60 MIN
|
Facility
|
OP
|
$126.34
|
|
|
Service Code
|
CPT 99493
|
| Hospital Charge Code |
51000093
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$46.75 |
| Max. Negotiated Rate |
$327.36 |
| Rate for Payer: Aetna American Axle |
$82.12
|
| Rate for Payer: Aetna Commercial |
$107.39
|
| Rate for Payer: Aetna Medicare |
$105.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.53
|
| Rate for Payer: BCBS Complete |
$55.59
|
| Rate for Payer: BCBS MAPPO |
$101.22
|
| Rate for Payer: BCBS Trust/PPO |
$240.99
|
| Rate for Payer: BCN Commercial |
$240.99
|
| Rate for Payer: BCN Medicare Advantage |
$101.22
|
| Rate for Payer: Cash Price |
$101.07
|
| Rate for Payer: Cash Price |
$101.07
|
| Rate for Payer: Cofinity Advantage |
$88.44
|
| Rate for Payer: Cofinity Commercial |
$108.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.22
|
| Rate for Payer: Healthscope Commercial |
$113.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.75
|
| Rate for Payer: Mclaren Medicaid |
$101.22
|
| Rate for Payer: Mclaren Medicare |
$101.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.28
|
| Rate for Payer: Meridian Medicaid |
$106.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.39
|
| Rate for Payer: Nomi Health Commercial |
$303.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.75
|
| Rate for Payer: PACE Medicare |
$96.16
|
| Rate for Payer: PACE SWMI |
$101.22
|
| Rate for Payer: PHP Commercial |
$107.39
|
| Rate for Payer: PHP Medicare Advantage |
$101.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$327.36
|
| Rate for Payer: Priority Health Medicare |
$101.22
|
| Rate for Payer: Priority Health SBD |
$79.59
|
| Rate for Payer: Priority Health Tiered Network |
$261.89
|
| Rate for Payer: Railroad Medicare Medicare |
$101.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.12
|
| Rate for Payer: UHC Core |
$65.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.22
|
| Rate for Payer: UHC Exchange |
$49.65
|
| Rate for Payer: UHC Medicaid |
$52.94
|
| Rate for Payer: UHCCP Medicaid |
$52.94
|
| Rate for Payer: UMR Bronson Commercial |
$46.75
|
| Rate for Payer: VA VA |
$101.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.75
|
|
|
HC PSYCH DIAGNOSTIC EVAL W/MED SVCS
|
Facility
|
IP
|
$202.69
|
|
|
Service Code
|
CPT 90792
|
| Hospital Charge Code |
91400008
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$89.18 |
| Max. Negotiated Rate |
$182.42 |
| Rate for Payer: Aetna American Axle |
$131.75
|
| Rate for Payer: Aetna Commercial |
$172.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.75
|
| Rate for Payer: Cash Price |
$162.15
|
| Rate for Payer: Cofinity Advantage |
$141.88
|
| Rate for Payer: Cofinity Commercial |
$174.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.15
|
| Rate for Payer: Healthscope Commercial |
$182.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$141.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.02
|
| Rate for Payer: PHP Commercial |
$172.29
|
| Rate for Payer: Priority Health SBD |
$127.69
|
| Rate for Payer: UMR Bronson Commercial |
$89.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.02
|
|
|
HC PSYCH DIAGNOSTIC EVAL W/MED SVCS
|
Facility
|
OP
|
$202.69
|
|
|
Service Code
|
CPT 90792
|
| Hospital Charge Code |
91400008
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$571.94 |
| Rate for Payer: Aetna American Axle |
$131.75
|
| Rate for Payer: Aetna Commercial |
$172.29
|
| Rate for Payer: Aetna Medicare |
$183.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.07
|
| Rate for Payer: BCBS Complete |
$97.13
|
| Rate for Payer: BCBS MAPPO |
$176.86
|
| Rate for Payer: BCN Medicare Advantage |
$176.86
|
| Rate for Payer: Cash Price |
$162.15
|
| Rate for Payer: Cash Price |
$162.15
|
| Rate for Payer: Cofinity Advantage |
$141.88
|
| Rate for Payer: Cofinity Commercial |
$174.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.86
|
| Rate for Payer: Healthscope Commercial |
$182.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$141.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.02
|
| Rate for Payer: Mclaren Medicaid |
$176.86
|
| Rate for Payer: Mclaren Medicare |
$176.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.70
|
| Rate for Payer: Meridian Medicaid |
$185.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.29
|
| Rate for Payer: Nomi Health Commercial |
$530.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.02
|
| Rate for Payer: PACE Medicare |
$168.02
|
| Rate for Payer: PACE SWMI |
$176.86
|
| Rate for Payer: PHP Commercial |
$172.29
|
| Rate for Payer: PHP Medicare Advantage |
$176.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$571.94
|
| Rate for Payer: Priority Health Medicare |
$176.86
|
| Rate for Payer: Priority Health SBD |
$127.69
|
| Rate for Payer: Priority Health Tiered Network |
$457.55
|
| Rate for Payer: Railroad Medicare Medicare |
$176.86
|
| Rate for Payer: UHC Medicaid |
$92.50
|
| Rate for Payer: UHCCP Medicaid |
$92.50
|
| Rate for Payer: UMR Bronson Commercial |
$75.00
|
| Rate for Payer: VA VA |
$176.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.02
|
|
|
HC PSYCHIATRIC DIAG EVAL
|
Facility
|
IP
|
$202.69
|
|
|
Service Code
|
CPT 90791
|
| Hospital Charge Code |
91400004
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$89.18 |
| Max. Negotiated Rate |
$182.42 |
| Rate for Payer: Aetna American Axle |
$131.75
|
| Rate for Payer: Aetna Commercial |
$172.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.75
|
| Rate for Payer: Cash Price |
$162.15
|
| Rate for Payer: Cofinity Advantage |
$141.88
|
| Rate for Payer: Cofinity Commercial |
$174.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.15
|
| Rate for Payer: Healthscope Commercial |
$182.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$141.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.02
|
| Rate for Payer: PHP Commercial |
$172.29
|
| Rate for Payer: Priority Health SBD |
$127.69
|
| Rate for Payer: UMR Bronson Commercial |
$89.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.02
|
|
|
HC PSYCHIATRIC DIAG EVAL
|
Facility
|
OP
|
$202.69
|
|
|
Service Code
|
CPT 90791
|
| Hospital Charge Code |
91400004
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$571.94 |
| Rate for Payer: Aetna American Axle |
$131.75
|
| Rate for Payer: Aetna Commercial |
$172.29
|
| Rate for Payer: Aetna Medicare |
$183.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.07
|
| Rate for Payer: BCBS Complete |
$97.13
|
| Rate for Payer: BCBS MAPPO |
$176.86
|
| Rate for Payer: BCN Medicare Advantage |
$176.86
|
| Rate for Payer: Cash Price |
$162.15
|
| Rate for Payer: Cash Price |
$162.15
|
| Rate for Payer: Cofinity Advantage |
$141.88
|
| Rate for Payer: Cofinity Commercial |
$174.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.86
|
| Rate for Payer: Healthscope Commercial |
$182.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$141.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.02
|
| Rate for Payer: Mclaren Medicaid |
$176.86
|
| Rate for Payer: Mclaren Medicare |
$176.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.70
|
| Rate for Payer: Meridian Medicaid |
$185.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.29
|
| Rate for Payer: Nomi Health Commercial |
$530.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.02
|
| Rate for Payer: PACE Medicare |
$168.02
|
| Rate for Payer: PACE SWMI |
$176.86
|
| Rate for Payer: PHP Commercial |
$172.29
|
| Rate for Payer: PHP Medicare Advantage |
$176.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$571.94
|
| Rate for Payer: Priority Health Medicare |
$176.86
|
| Rate for Payer: Priority Health SBD |
$127.69
|
| Rate for Payer: Priority Health Tiered Network |
$457.55
|
| Rate for Payer: Railroad Medicare Medicare |
$176.86
|
| Rate for Payer: UHC Medicaid |
$92.50
|
| Rate for Payer: UHCCP Medicaid |
$92.50
|
| Rate for Payer: UMR Bronson Commercial |
$75.00
|
| Rate for Payer: VA VA |
$176.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.02
|
|
|
HC PSYCH/NEUROPSYCH TEST BY PHYS 30 MIN
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 96136
|
| Hospital Charge Code |
91800009
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$9.82 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.24
|
| Rate for Payer: UHC Core |
$13.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$10.43
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC PSYCH/NEUROPSYCH TEST BY PHYS 30 MIN
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 96136
|
| Hospital Charge Code |
91800009
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH 30 MIN
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 96138
|
| Hospital Charge Code |
91800011
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH 30 MIN
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 96138
|
| Hospital Charge Code |
91800011
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$9.82 |
| Max. Negotiated Rate |
$1,439.47 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$462.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$556.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$556.40
|
| Rate for Payer: BCBS Complete |
$244.46
|
| Rate for Payer: BCBS MAPPO |
$445.12
|
| Rate for Payer: BCN Medicare Advantage |
$445.12
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.12
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$445.12
|
| Rate for Payer: Mclaren Medicare |
$445.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.38
|
| Rate for Payer: Meridian Medicaid |
$467.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$511.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$489.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$1,335.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$422.86
|
| Rate for Payer: PACE SWMI |
$445.12
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$445.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,439.47
|
| Rate for Payer: Priority Health Medicare |
$445.12
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: Priority Health Tiered Network |
$1,151.58
|
| Rate for Payer: Railroad Medicare Medicare |
$445.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.24
|
| Rate for Payer: UHC Core |
$13.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.12
|
| Rate for Payer: UHC Exchange |
$10.43
|
| Rate for Payer: UHC Medicaid |
$232.80
|
| Rate for Payer: UHCCP Medicaid |
$232.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: VA VA |
$445.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH EA ADDL 30 MIN
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
CPT 96139
|
| Hospital Charge Code |
91800012
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna American Axle |
$10.35
|
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: UMR Bronson Commercial |
$7.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH EA ADDL 30 MIN
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
CPT 96139
|
| Hospital Charge Code |
91800012
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna American Axle |
$10.35
|
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: BCBS Complete |
$6.37
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.35
|
| Rate for Payer: UHC Core |
$8.29
|
| Rate for Payer: UHC Exchange |
$6.26
|
| Rate for Payer: UMR Bronson Commercial |
$5.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC PSYCH/NEUROPSYCH TEST PHYS EA ADDL 30 MIN
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
CPT 96137
|
| Hospital Charge Code |
91800010
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna American Axle |
$10.35
|
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: BCBS Complete |
$6.37
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.35
|
| Rate for Payer: UHC Core |
$8.29
|
| Rate for Payer: UHC Exchange |
$6.26
|
| Rate for Payer: UMR Bronson Commercial |
$5.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC PSYCH/NEUROPSYCH TEST PHYS EA ADDL 30 MIN
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
CPT 96137
|
| Hospital Charge Code |
91800010
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna American Axle |
$10.35
|
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: UMR Bronson Commercial |
$7.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC PSYCH/NEUROPSYCH TEST SINGLE AUTOMATED
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 96146
|
| Hospital Charge Code |
91800013
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$9.82 |
| Max. Negotiated Rate |
$93.19 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$29.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$28.82
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$30.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$86.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$93.19
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: Priority Health Tiered Network |
$74.55
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.24
|
| Rate for Payer: UHC Core |
$13.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$10.43
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: VA VA |
$28.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC PSYCH/NEUROPSYCH TEST SINGLE AUTOMATED
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 96146
|
| Hospital Charge Code |
91800013
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC PSYCHOLOGICAL TEST EVAL PHYS/QHP 1ST HOUR
|
Facility
|
IP
|
$728.28
|
|
|
Service Code
|
CPT 96130
|
| Hospital Charge Code |
91800450
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$320.44 |
| Max. Negotiated Rate |
$655.45 |
| Rate for Payer: Aetna American Axle |
$473.38
|
| Rate for Payer: Aetna Commercial |
$619.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.38
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cofinity Advantage |
$509.80
|
| Rate for Payer: Cofinity Commercial |
$626.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.62
|
| Rate for Payer: Healthscope Commercial |
$655.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$509.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.21
|
| Rate for Payer: PHP Commercial |
$619.04
|
| Rate for Payer: Priority Health SBD |
$458.82
|
| Rate for Payer: UMR Bronson Commercial |
$320.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.21
|
|
|
HC PSYCHOLOGICAL TEST EVAL PHYS/QHP 1ST HOUR
|
Facility
|
OP
|
$728.28
|
|
|
Service Code
|
CPT 96130
|
| Hospital Charge Code |
91800450
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$695.77 |
| Rate for Payer: Aetna American Axle |
$473.38
|
| Rate for Payer: Aetna Commercial |
$619.04
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cofinity Advantage |
$509.80
|
| Rate for Payer: Cofinity Commercial |
$626.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$655.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$509.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.21
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.04
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.21
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$619.04
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$458.82
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.38
|
| Rate for Payer: UHC Core |
$379.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$286.21
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: UMR Bronson Commercial |
$269.46
|
| Rate for Payer: VA VA |
$215.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.21
|
|
