|
HC PSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HOUR
|
Facility
|
IP
|
$553.49
|
|
|
Service Code
|
CPT 96131
|
| Hospital Charge Code |
91800449
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$243.54 |
| Max. Negotiated Rate |
$498.14 |
| Rate for Payer: Aetna American Axle |
$359.77
|
| Rate for Payer: Aetna Commercial |
$470.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.77
|
| Rate for Payer: Cash Price |
$442.79
|
| Rate for Payer: Cofinity Advantage |
$387.44
|
| Rate for Payer: Cofinity Commercial |
$476.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.79
|
| Rate for Payer: Healthscope Commercial |
$498.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$387.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$415.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$470.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.12
|
| Rate for Payer: PHP Commercial |
$470.47
|
| Rate for Payer: Priority Health SBD |
$348.70
|
| Rate for Payer: UMR Bronson Commercial |
$243.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$415.12
|
|
|
HC PSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HOUR
|
Facility
|
OP
|
$553.49
|
|
|
Service Code
|
CPT 96131
|
| Hospital Charge Code |
91800449
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$204.79 |
| Max. Negotiated Rate |
$498.14 |
| Rate for Payer: Aetna American Axle |
$359.77
|
| Rate for Payer: Aetna Commercial |
$470.47
|
| Rate for Payer: Aetna Medicare |
$276.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.77
|
| Rate for Payer: BCBS Complete |
$221.40
|
| Rate for Payer: Cash Price |
$442.79
|
| Rate for Payer: Cofinity Advantage |
$387.44
|
| Rate for Payer: Cofinity Commercial |
$476.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.79
|
| Rate for Payer: Healthscope Commercial |
$498.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$387.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$415.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$442.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$470.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.12
|
| Rate for Payer: PHP Commercial |
$470.47
|
| Rate for Payer: Priority Health SBD |
$348.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.77
|
| Rate for Payer: UHC Core |
$288.37
|
| Rate for Payer: UHC Exchange |
$217.52
|
| Rate for Payer: UMR Bronson Commercial |
$204.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$415.12
|
|
|
HC PSYCHOTHERAPY 30 MIN W/PATIENT
|
Facility
|
OP
|
$88.70
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
91400001
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$32.82 |
| Max. Negotiated Rate |
$571.94 |
| Rate for Payer: Aetna American Axle |
$57.66
|
| Rate for Payer: Aetna Commercial |
$75.39
|
| Rate for Payer: Aetna Medicare |
$183.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.66
|
| 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 |
$70.96
|
| Rate for Payer: Cash Price |
$70.96
|
| Rate for Payer: Cofinity Advantage |
$62.09
|
| Rate for Payer: Cofinity Commercial |
$76.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.86
|
| Rate for Payer: Healthscope Commercial |
$79.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.53
|
| 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 |
$75.39
|
| Rate for Payer: Nomi Health Commercial |
$530.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.53
|
| Rate for Payer: PACE Medicare |
$168.02
|
| Rate for Payer: PACE SWMI |
$176.86
|
| Rate for Payer: PHP Commercial |
$75.39
|
| 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 |
$55.88
|
| 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 |
$32.82
|
| Rate for Payer: VA VA |
$176.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.53
|
|
|
HC PSYCHOTHERAPY 30 MIN W/PATIENT
|
Facility
|
IP
|
$88.70
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
91400001
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$39.03 |
| Max. Negotiated Rate |
$79.83 |
| Rate for Payer: Aetna American Axle |
$57.66
|
| Rate for Payer: Aetna Commercial |
$75.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.66
|
| Rate for Payer: Cash Price |
$70.96
|
| Rate for Payer: Cofinity Advantage |
$62.09
|
| Rate for Payer: Cofinity Commercial |
$76.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.96
|
| Rate for Payer: Healthscope Commercial |
$79.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.53
|
| Rate for Payer: PHP Commercial |
$75.39
|
| Rate for Payer: Priority Health SBD |
$55.88
|
| Rate for Payer: UMR Bronson Commercial |
$39.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.53
|
|
|
HC PSYCHOTHERAPY 45 MIN W/PATIENT
|
Facility
|
OP
|
$159.23
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
91400002
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$58.92 |
| Max. Negotiated Rate |
$571.94 |
| Rate for Payer: Aetna American Axle |
$103.50
|
| Rate for Payer: Aetna Commercial |
$135.35
|
| Rate for Payer: Aetna Medicare |
$183.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.50
|
| 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 |
$127.38
|
| Rate for Payer: Cash Price |
$127.38
|
| Rate for Payer: Cofinity Advantage |
$111.46
|
| Rate for Payer: Cofinity Commercial |
$136.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.86
|
| Rate for Payer: Healthscope Commercial |
$143.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$111.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.42
|
| 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 |
$135.35
|
| Rate for Payer: Nomi Health Commercial |
$530.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.42
|
| Rate for Payer: PACE Medicare |
$168.02
|
| Rate for Payer: PACE SWMI |
$176.86
|
| Rate for Payer: PHP Commercial |
$135.35
|
| 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 |
$100.31
|
| 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 |
$58.92
|
| Rate for Payer: VA VA |
$176.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.42
|
|
|
HC PSYCHOTHERAPY 45 MIN W/PATIENT
|
Facility
|
IP
|
$159.23
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
91400002
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$70.06 |
| Max. Negotiated Rate |
$143.31 |
| Rate for Payer: Aetna American Axle |
$103.50
|
| Rate for Payer: Aetna Commercial |
$135.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.50
|
| Rate for Payer: Cash Price |
$127.38
|
| Rate for Payer: Cofinity Advantage |
$111.46
|
| Rate for Payer: Cofinity Commercial |
$136.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.38
|
| Rate for Payer: Healthscope Commercial |
$143.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$111.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.42
|
| Rate for Payer: PHP Commercial |
$135.35
|
| Rate for Payer: Priority Health SBD |
$100.31
|
| Rate for Payer: UMR Bronson Commercial |
$70.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.42
|
|
|
HC PSYCHOTHERAPY 60 MIN W PT
|
Facility
|
OP
|
$133.71
|
|
|
Service Code
|
CPT 90837
|
| Hospital Charge Code |
91400005
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$49.47 |
| Max. Negotiated Rate |
$571.94 |
| Rate for Payer: Aetna American Axle |
$86.91
|
| Rate for Payer: Aetna Commercial |
$113.65
|
| Rate for Payer: Aetna Medicare |
$183.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.91
|
| 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 |
$106.97
|
| Rate for Payer: Cash Price |
$106.97
|
| Rate for Payer: Cofinity Advantage |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$114.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.86
|
| Rate for Payer: Healthscope Commercial |
$120.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.28
|
| 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 |
$113.65
|
| Rate for Payer: Nomi Health Commercial |
$530.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.28
|
| Rate for Payer: PACE Medicare |
$168.02
|
| Rate for Payer: PACE SWMI |
$176.86
|
| Rate for Payer: PHP Commercial |
$113.65
|
| 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 |
$84.24
|
| 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 |
$49.47
|
| Rate for Payer: VA VA |
$176.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.28
|
|
|
HC PSYCHOTHERAPY 60 MIN W PT
|
Facility
|
IP
|
$133.71
|
|
|
Service Code
|
CPT 90837
|
| Hospital Charge Code |
91400005
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$58.83 |
| Max. Negotiated Rate |
$120.34 |
| Rate for Payer: Aetna American Axle |
$86.91
|
| Rate for Payer: Aetna Commercial |
$113.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.91
|
| Rate for Payer: Cash Price |
$106.97
|
| Rate for Payer: Cofinity Advantage |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$114.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.97
|
| Rate for Payer: Healthscope Commercial |
$120.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.28
|
| Rate for Payer: PHP Commercial |
$113.65
|
| Rate for Payer: Priority Health SBD |
$84.24
|
| Rate for Payer: UMR Bronson Commercial |
$58.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.28
|
|
|
HC PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 90785
|
| Hospital Charge Code |
91400012
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$11.11 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna American Axle |
$30.43
|
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$23.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: BCBS Complete |
$18.73
|
| Rate for Payer: BCBS Trust/PPO |
$11.11
|
| Rate for Payer: BCN Commercial |
$11.11
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Advantage |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: UMR Bronson Commercial |
$17.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 90785
|
| Hospital Charge Code |
91400012
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna American Axle |
$30.43
|
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Advantage |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: UMR Bronson Commercial |
$20.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC PSYCHOTHERAPY FOR CRISIS EA ADDL 15 MIN
|
Facility
|
OP
|
$120.69
|
|
|
Service Code
|
CPT 90840
|
| Hospital Charge Code |
91400014
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$44.66 |
| Max. Negotiated Rate |
$108.62 |
| Rate for Payer: Aetna American Axle |
$78.45
|
| Rate for Payer: Aetna Commercial |
$102.59
|
| Rate for Payer: Aetna Medicare |
$60.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.45
|
| Rate for Payer: BCBS Complete |
$48.28
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cofinity Advantage |
$84.48
|
| Rate for Payer: Cofinity Commercial |
$103.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.55
|
| Rate for Payer: Healthscope Commercial |
$108.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.52
|
| Rate for Payer: PHP Commercial |
$102.59
|
| Rate for Payer: Priority Health SBD |
$76.03
|
| Rate for Payer: UMR Bronson Commercial |
$44.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.52
|
|
|
HC PSYCHOTHERAPY FOR CRISIS EA ADDL 15 MIN
|
Facility
|
IP
|
$120.69
|
|
|
Service Code
|
CPT 90840
|
| Hospital Charge Code |
91400014
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$53.10 |
| Max. Negotiated Rate |
$108.62 |
| Rate for Payer: Aetna American Axle |
$78.45
|
| Rate for Payer: Aetna Commercial |
$102.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.45
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cofinity Advantage |
$84.48
|
| Rate for Payer: Cofinity Commercial |
$103.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.55
|
| Rate for Payer: Healthscope Commercial |
$108.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.52
|
| Rate for Payer: PHP Commercial |
$102.59
|
| Rate for Payer: Priority Health SBD |
$76.03
|
| Rate for Payer: UMR Bronson Commercial |
$53.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.52
|
|
|
HC PSYCHOTHERAPY FOR CRISIS FIRST 60 MIN
|
Facility
|
IP
|
$234.09
|
|
|
Service Code
|
CPT 90839
|
| Hospital Charge Code |
91400003
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$103.00 |
| Max. Negotiated Rate |
$210.68 |
| Rate for Payer: Aetna American Axle |
$152.16
|
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.16
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Advantage |
$163.86
|
| Rate for Payer: Cofinity Commercial |
$201.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Healthscope Commercial |
$210.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$163.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$175.57
|
| Rate for Payer: PHP Commercial |
$198.98
|
| Rate for Payer: Priority Health SBD |
$147.48
|
| Rate for Payer: UMR Bronson Commercial |
$103.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.57
|
|
|
HC PSYCHOTHERAPY FOR CRISIS FIRST 60 MIN
|
Facility
|
OP
|
$234.09
|
|
|
Service Code
|
CPT 90839
|
| Hospital Charge Code |
91400003
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$86.61 |
| Max. Negotiated Rate |
$571.94 |
| Rate for Payer: Aetna American Axle |
$152.16
|
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: Aetna Medicare |
$183.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.16
|
| 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 |
$187.27
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Advantage |
$163.86
|
| Rate for Payer: Cofinity Commercial |
$201.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.86
|
| Rate for Payer: Healthscope Commercial |
$210.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$163.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.57
|
| 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 |
$198.98
|
| Rate for Payer: Nomi Health Commercial |
$530.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$175.57
|
| Rate for Payer: PACE Medicare |
$168.02
|
| Rate for Payer: PACE SWMI |
$176.86
|
| Rate for Payer: PHP Commercial |
$198.98
|
| 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 |
$147.48
|
| 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 |
$86.61
|
| Rate for Payer: VA VA |
$176.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.57
|
|
|
HC PTCA ADD/BRANCH
|
Facility
|
IP
|
$7,436.42
|
|
|
Service Code
|
CPT 92921
|
| Hospital Charge Code |
48100099
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,272.02 |
| Max. Negotiated Rate |
$6,692.78 |
| Rate for Payer: Aetna American Axle |
$4,833.67
|
| Rate for Payer: Aetna Commercial |
$6,320.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,833.67
|
| Rate for Payer: Cash Price |
$5,949.14
|
| Rate for Payer: Cofinity Advantage |
$5,205.49
|
| Rate for Payer: Cofinity Commercial |
$6,395.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,949.14
|
| Rate for Payer: Healthscope Commercial |
$6,692.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,205.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,577.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,320.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,577.31
|
| Rate for Payer: PHP Commercial |
$6,320.96
|
| Rate for Payer: Priority Health SBD |
$4,684.94
|
| Rate for Payer: UMR Bronson Commercial |
$3,272.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,577.31
|
|
|
HC PTCA ADD/BRANCH
|
Facility
|
OP
|
$7,436.42
|
|
|
Service Code
|
CPT 92921
|
| Hospital Charge Code |
48100099
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$575.81 |
| Max. Negotiated Rate |
$6,692.78 |
| Rate for Payer: Aetna American Axle |
$4,833.67
|
| Rate for Payer: Aetna Commercial |
$6,320.96
|
| Rate for Payer: Aetna Medicare |
$3,718.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,833.67
|
| Rate for Payer: BCBS Complete |
$2,974.57
|
| Rate for Payer: BCBS Trust/PPO |
$575.81
|
| Rate for Payer: BCN Commercial |
$575.81
|
| Rate for Payer: Cash Price |
$5,949.14
|
| Rate for Payer: Cash Price |
$5,949.14
|
| Rate for Payer: Cash Price |
$5,949.14
|
| Rate for Payer: Cofinity Advantage |
$5,205.49
|
| Rate for Payer: Cofinity Commercial |
$6,395.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,949.14
|
| Rate for Payer: Healthscope Commercial |
$6,692.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,205.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,577.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,949.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,320.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,577.31
|
| Rate for Payer: PHP Commercial |
$6,320.96
|
| Rate for Payer: Priority Health SBD |
$4,684.94
|
| Rate for Payer: UMR Bronson Commercial |
$2,751.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,577.31
|
|
|
HC PTCA VESSEL/BRANCH
|
Facility
|
OP
|
$11,423.75
|
|
|
Service Code
|
CPT 92920
|
| Hospital Charge Code |
48100098
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,965.99 |
| Max. Negotiated Rate |
$18,339.80 |
| Rate for Payer: Aetna American Axle |
$7,425.44
|
| Rate for Payer: Aetna Commercial |
$9,710.19
|
| Rate for Payer: Aetna Medicare |
$5,897.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,425.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,088.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,088.88
|
| Rate for Payer: BCBS Complete |
$3,114.57
|
| Rate for Payer: BCBS MAPPO |
$5,671.10
|
| Rate for Payer: BCBS Trust/PPO |
$6,096.33
|
| Rate for Payer: BCN Commercial |
$6,096.33
|
| Rate for Payer: BCN Medicare Advantage |
$5,671.10
|
| Rate for Payer: Cash Price |
$9,139.00
|
| Rate for Payer: Cash Price |
$9,139.00
|
| Rate for Payer: Cash Price |
$9,139.00
|
| Rate for Payer: Cofinity Advantage |
$7,996.62
|
| Rate for Payer: Cofinity Commercial |
$9,824.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,139.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,671.10
|
| Rate for Payer: Healthscope Commercial |
$10,281.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,996.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,567.81
|
| Rate for Payer: Mclaren Medicaid |
$5,671.10
|
| Rate for Payer: Mclaren Medicare |
$5,671.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,954.65
|
| Rate for Payer: Meridian Medicaid |
$5,954.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,521.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,238.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,710.19
|
| Rate for Payer: Nomi Health Commercial |
$17,013.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,567.81
|
| Rate for Payer: PACE Medicare |
$5,387.55
|
| Rate for Payer: PACE SWMI |
$5,671.10
|
| Rate for Payer: PHP Commercial |
$9,710.19
|
| Rate for Payer: PHP Medicare Advantage |
$5,671.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,965.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18,339.80
|
| Rate for Payer: Priority Health Medicare |
$5,671.10
|
| Rate for Payer: Priority Health SBD |
$7,196.96
|
| Rate for Payer: Priority Health Tiered Network |
$14,671.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5,671.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,671.10
|
| Rate for Payer: UHC Medicaid |
$2,965.99
|
| Rate for Payer: UHCCP Medicaid |
$2,965.99
|
| Rate for Payer: UMR Bronson Commercial |
$4,226.79
|
| Rate for Payer: VA VA |
$5,671.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,567.81
|
|
|
HC PTCA VESSEL/BRANCH
|
Facility
|
IP
|
$11,423.75
|
|
|
Service Code
|
CPT 92920
|
| Hospital Charge Code |
48100098
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,026.45 |
| Max. Negotiated Rate |
$10,281.38 |
| Rate for Payer: Aetna American Axle |
$7,425.44
|
| Rate for Payer: Aetna Commercial |
$9,710.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,425.44
|
| Rate for Payer: Cash Price |
$9,139.00
|
| Rate for Payer: Cofinity Advantage |
$7,996.62
|
| Rate for Payer: Cofinity Commercial |
$9,824.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,139.00
|
| Rate for Payer: Healthscope Commercial |
$10,281.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,996.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,567.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,710.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,567.81
|
| Rate for Payer: PHP Commercial |
$9,710.19
|
| Rate for Payer: Priority Health SBD |
$7,196.96
|
| Rate for Payer: UMR Bronson Commercial |
$5,026.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,567.81
|
|
|
HC PTCRAWDES ADD.BRANCH
|
Facility
|
IP
|
$19,483.94
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
48100080
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,572.93 |
| Max. Negotiated Rate |
$17,535.55 |
| Rate for Payer: Aetna American Axle |
$12,664.56
|
| Rate for Payer: Aetna Commercial |
$16,561.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,664.56
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Advantage |
$13,638.76
|
| Rate for Payer: Cofinity Commercial |
$16,756.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Healthscope Commercial |
$17,535.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,638.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,612.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: PHP Commercial |
$16,561.35
|
| Rate for Payer: Priority Health SBD |
$12,274.88
|
| Rate for Payer: UMR Bronson Commercial |
$8,572.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,612.95
|
|
|
HC PTCRAWDES ADD.BRANCH
|
Facility
|
OP
|
$19,483.94
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
48100080
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$17,535.55 |
| Rate for Payer: Aetna American Axle |
$12,664.56
|
| Rate for Payer: Aetna Commercial |
$16,561.35
|
| Rate for Payer: Aetna Medicare |
$9,741.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,664.56
|
| Rate for Payer: BCBS Complete |
$7,793.58
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Advantage |
$13,638.76
|
| Rate for Payer: Cofinity Commercial |
$16,756.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Healthscope Commercial |
$17,535.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,638.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,612.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,587.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: PHP Commercial |
$16,561.35
|
| Rate for Payer: Priority Health SBD |
$12,274.88
|
| Rate for Payer: UMR Bronson Commercial |
$7,209.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,612.95
|
|
|
HC PTCRAWDES VES/BRANCH
|
Facility
|
IP
|
$29,741.77
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
48100079
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,086.38 |
| Max. Negotiated Rate |
$26,767.59 |
| Rate for Payer: Aetna American Axle |
$19,332.15
|
| Rate for Payer: Aetna Commercial |
$25,280.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,332.15
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cofinity Advantage |
$20,819.24
|
| Rate for Payer: Cofinity Commercial |
$25,577.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,793.42
|
| Rate for Payer: Healthscope Commercial |
$26,767.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,819.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,306.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,280.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,306.33
|
| Rate for Payer: PHP Commercial |
$25,280.50
|
| Rate for Payer: Priority Health SBD |
$18,737.32
|
| Rate for Payer: UMR Bronson Commercial |
$13,086.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,306.33
|
|
|
HC PTCRAWDES VES/BRANCH
|
Facility
|
OP
|
$29,741.77
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
48100079
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,552.97 |
| Max. Negotiated Rate |
$59,069.70 |
| Rate for Payer: Aetna American Axle |
$19,332.15
|
| Rate for Payer: Aetna Commercial |
$25,280.50
|
| Rate for Payer: Aetna Medicare |
$18,996.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,332.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCBS Trust/PPO |
$16,679.35
|
| Rate for Payer: BCN Commercial |
$16,679.35
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cofinity Advantage |
$20,819.24
|
| Rate for Payer: Cofinity Commercial |
$25,577.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,793.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$26,767.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,819.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,306.33
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$19,179.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,280.50
|
| Rate for Payer: Nomi Health Commercial |
$54,797.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,306.33
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$25,280.50
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59,069.70
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health SBD |
$18,737.32
|
| Rate for Payer: Priority Health Tiered Network |
$47,255.76
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: UMR Bronson Commercial |
$11,004.45
|
| Rate for Payer: VA VA |
$18,265.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,306.33
|
|
|
HC PTCRAWPTCA ADD.BRANCH
|
Facility
|
OP
|
$12,179.11
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
48100097
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$359.51 |
| Max. Negotiated Rate |
$10,961.20 |
| Rate for Payer: Aetna American Axle |
$7,916.42
|
| Rate for Payer: Aetna Commercial |
$10,352.24
|
| Rate for Payer: Aetna Medicare |
$6,089.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,916.42
|
| Rate for Payer: BCBS Complete |
$4,871.64
|
| Rate for Payer: BCBS Trust/PPO |
$359.51
|
| Rate for Payer: BCN Commercial |
$359.51
|
| Rate for Payer: Cash Price |
$9,743.29
|
| Rate for Payer: Cash Price |
$9,743.29
|
| Rate for Payer: Cash Price |
$9,743.29
|
| Rate for Payer: Cofinity Advantage |
$8,525.38
|
| Rate for Payer: Cofinity Commercial |
$10,474.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,743.29
|
| Rate for Payer: Healthscope Commercial |
$10,961.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,525.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,134.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,743.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,352.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,134.33
|
| Rate for Payer: PHP Commercial |
$10,352.24
|
| Rate for Payer: Priority Health SBD |
$7,672.84
|
| Rate for Payer: UMR Bronson Commercial |
$4,506.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,134.33
|
|
|
HC PTCRAWPTCA ADD.BRANCH
|
Facility
|
IP
|
$12,179.11
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
48100097
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,358.81 |
| Max. Negotiated Rate |
$10,961.20 |
| Rate for Payer: Aetna American Axle |
$7,916.42
|
| Rate for Payer: Aetna Commercial |
$10,352.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,916.42
|
| Rate for Payer: Cash Price |
$9,743.29
|
| Rate for Payer: Cofinity Advantage |
$8,525.38
|
| Rate for Payer: Cofinity Commercial |
$10,474.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,743.29
|
| Rate for Payer: Healthscope Commercial |
$10,961.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,525.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,134.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,352.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,134.33
|
| Rate for Payer: PHP Commercial |
$10,352.24
|
| Rate for Payer: Priority Health SBD |
$7,672.84
|
| Rate for Payer: UMR Bronson Commercial |
$5,358.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,134.33
|
|
|
HC PTCRAWSTENT ADD.BRANCH
|
Facility
|
OP
|
$19,483.94
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
48100078
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$376.45 |
| Max. Negotiated Rate |
$17,535.55 |
| Rate for Payer: Aetna American Axle |
$12,664.56
|
| Rate for Payer: Aetna Commercial |
$16,561.35
|
| Rate for Payer: Aetna Medicare |
$9,741.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,664.56
|
| Rate for Payer: BCBS Complete |
$7,793.58
|
| Rate for Payer: BCBS Trust/PPO |
$376.45
|
| Rate for Payer: BCN Commercial |
$376.45
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Advantage |
$13,638.76
|
| Rate for Payer: Cofinity Commercial |
$16,756.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Healthscope Commercial |
$17,535.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,638.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,612.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,587.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: PHP Commercial |
$16,561.35
|
| Rate for Payer: Priority Health SBD |
$12,274.88
|
| Rate for Payer: UMR Bronson Commercial |
$7,209.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,612.95
|
|
