|
HC PSG W CPAP PEDS 5 AND UNDER
|
Facility
|
OP
|
$5,983.02
|
|
|
Service Code
|
CPT 95783
|
| Hospital Charge Code |
92000018
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$534.30 |
| Max. Negotiated Rate |
$5,384.72 |
| Rate for Payer: Aetna American Axle |
$3,888.96
|
| Rate for Payer: Aetna Commercial |
$5,085.57
|
| Rate for Payer: Aetna Medicare |
$1,036.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,888.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,246.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,246.02
|
| Rate for Payer: BCBS Complete |
$561.01
|
| Rate for Payer: BCBS MAPPO |
$996.82
|
| Rate for Payer: BCBS Trust/PPO |
$3,832.36
|
| Rate for Payer: BCN Commercial |
$3,832.36
|
| Rate for Payer: BCN Medicare Advantage |
$996.82
|
| Rate for Payer: Cash Price |
$4,786.42
|
| Rate for Payer: Cash Price |
$4,786.42
|
| Rate for Payer: Cash Price |
$4,786.42
|
| Rate for Payer: Cofinity Commercial |
$4,188.11
|
| Rate for Payer: Cofinity Commercial |
$5,145.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,188.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,786.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$996.82
|
| Rate for Payer: Healthscope Commercial |
$5,384.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,188.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,487.26
|
| Rate for Payer: Mclaren Medicaid |
$534.30
|
| Rate for Payer: Mclaren Medicare |
$996.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,046.66
|
| Rate for Payer: Meridian Medicaid |
$561.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,146.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,085.57
|
| Rate for Payer: Nomi Health Commercial |
$2,990.46
|
| Rate for Payer: PACE Medicare |
$946.98
|
| Rate for Payer: PACE SWMI |
$996.82
|
| Rate for Payer: PHP Commercial |
$5,085.57
|
| Rate for Payer: PHP Medicare Advantage |
$996.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,888.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,132.99
|
| Rate for Payer: Priority Health Medicare |
$996.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,506.39
|
| Rate for Payer: Priority Health SBD |
$3,769.30
|
| Rate for Payer: Railroad Medicare Medicare |
$996.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.78
|
| Rate for Payer: UHC Core |
$4,571.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$996.82
|
| Rate for Payer: UHC Exchange |
$940.71
|
| Rate for Payer: UHC Medicare Advantage |
$996.82
|
| Rate for Payer: UHCCP Medicaid |
$534.30
|
| Rate for Payer: UMR Bronson Commercial |
$2,213.72
|
| Rate for Payer: VA VA |
$996.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,487.26
|
|
|
HC PSG W CPAP PEDS 5 AND UNDER
|
Facility
|
IP
|
$5,983.02
|
|
|
Service Code
|
CPT 95783
|
| Hospital Charge Code |
92000018
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$2,632.53 |
| Max. Negotiated Rate |
$5,384.72 |
| Rate for Payer: Aetna American Axle |
$3,888.96
|
| Rate for Payer: Aetna Commercial |
$5,085.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,888.96
|
| Rate for Payer: Cash Price |
$4,786.42
|
| Rate for Payer: Cofinity Commercial |
$4,188.11
|
| Rate for Payer: Cofinity Commercial |
$5,145.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,188.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,786.42
|
| Rate for Payer: Healthscope Commercial |
$5,384.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,188.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,487.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,085.57
|
| Rate for Payer: PHP Commercial |
$5,085.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,888.96
|
| Rate for Payer: Priority Health SBD |
$3,769.30
|
| Rate for Payer: UMR Bronson Commercial |
$2,632.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,487.26
|
|
|
HC PSORALEN
|
Facility
|
OP
|
$2,156.91
|
|
|
Service Code
|
HCPCS P9073
|
| Hospital Charge Code |
39000085
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$308.42 |
| Max. Negotiated Rate |
$1,941.22 |
| Rate for Payer: Aetna American Axle |
$1,401.99
|
| Rate for Payer: Aetna Commercial |
$1,833.37
|
| Rate for Payer: Aetna Medicare |
$598.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,401.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$719.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$719.26
|
| Rate for Payer: BCBS Complete |
$323.84
|
| Rate for Payer: BCBS MAPPO |
$575.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,458.91
|
| Rate for Payer: BCN Commercial |
$1,458.91
|
| Rate for Payer: BCN Medicare Advantage |
$575.41
|
| Rate for Payer: Cash Price |
$1,725.53
|
| Rate for Payer: Cash Price |
$1,725.53
|
| Rate for Payer: Cash Price |
$1,725.53
|
| Rate for Payer: Cofinity Commercial |
$1,509.84
|
| Rate for Payer: Cofinity Commercial |
$1,854.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,509.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,725.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$575.41
|
| Rate for Payer: Healthscope Commercial |
$1,941.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,509.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,617.68
|
| Rate for Payer: Mclaren Medicaid |
$308.42
|
| Rate for Payer: Mclaren Medicare |
$575.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$604.18
|
| Rate for Payer: Meridian Medicaid |
$323.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$661.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,833.37
|
| Rate for Payer: Nomi Health Commercial |
$1,726.23
|
| Rate for Payer: PACE Medicare |
$546.64
|
| Rate for Payer: PACE SWMI |
$575.41
|
| Rate for Payer: PHP Commercial |
$1,833.37
|
| Rate for Payer: PHP Medicare Advantage |
$575.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,401.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,808.48
|
| Rate for Payer: Priority Health Medicare |
$575.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,446.78
|
| Rate for Payer: Priority Health SBD |
$1,358.85
|
| Rate for Payer: Railroad Medicare Medicare |
$575.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,619.72
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$575.41
|
| Rate for Payer: UHC Exchange |
$1,099.67
|
| Rate for Payer: UHC Medicare Advantage |
$575.41
|
| Rate for Payer: UHCCP Medicaid |
$308.42
|
| Rate for Payer: UMR Bronson Commercial |
$798.06
|
| Rate for Payer: VA VA |
$575.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,617.68
|
|
|
HC PSORALEN
|
Facility
|
IP
|
$2,156.91
|
|
|
Service Code
|
HCPCS P9073
|
| Hospital Charge Code |
39000085
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$949.04 |
| Max. Negotiated Rate |
$1,941.22 |
| Rate for Payer: Aetna American Axle |
$1,401.99
|
| Rate for Payer: Aetna Commercial |
$1,833.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,401.99
|
| Rate for Payer: Cash Price |
$1,725.53
|
| Rate for Payer: Cofinity Commercial |
$1,509.84
|
| Rate for Payer: Cofinity Commercial |
$1,854.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,509.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,725.53
|
| Rate for Payer: Healthscope Commercial |
$1,941.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,509.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,617.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,833.37
|
| Rate for Payer: PHP Commercial |
$1,833.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,401.99
|
| Rate for Payer: Priority Health SBD |
$1,358.85
|
| Rate for Payer: UMR Bronson Commercial |
$949.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,617.68
|
|
|
HC PSORALEN TREATED WASHED PLATELETS
|
Facility
|
OP
|
$2,238.51
|
|
|
Service Code
|
HCPCS P9073
|
| Hospital Charge Code |
39000086
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$308.42 |
| Max. Negotiated Rate |
$2,014.66 |
| Rate for Payer: Aetna American Axle |
$1,455.03
|
| Rate for Payer: Aetna Commercial |
$1,902.73
|
| Rate for Payer: Aetna Medicare |
$598.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,455.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$719.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$719.26
|
| Rate for Payer: BCBS Complete |
$323.84
|
| Rate for Payer: BCBS MAPPO |
$575.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,458.91
|
| Rate for Payer: BCN Commercial |
$1,458.91
|
| Rate for Payer: BCN Medicare Advantage |
$575.41
|
| Rate for Payer: Cash Price |
$1,790.81
|
| Rate for Payer: Cash Price |
$1,790.81
|
| Rate for Payer: Cash Price |
$1,790.81
|
| Rate for Payer: Cofinity Commercial |
$1,566.96
|
| Rate for Payer: Cofinity Commercial |
$1,925.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,566.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,790.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$575.41
|
| Rate for Payer: Healthscope Commercial |
$2,014.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,566.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,678.88
|
| Rate for Payer: Mclaren Medicaid |
$308.42
|
| Rate for Payer: Mclaren Medicare |
$575.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$604.18
|
| Rate for Payer: Meridian Medicaid |
$323.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$661.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,902.73
|
| Rate for Payer: Nomi Health Commercial |
$1,726.23
|
| Rate for Payer: PACE Medicare |
$546.64
|
| Rate for Payer: PACE SWMI |
$575.41
|
| Rate for Payer: PHP Commercial |
$1,902.73
|
| Rate for Payer: PHP Medicare Advantage |
$575.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,455.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,808.48
|
| Rate for Payer: Priority Health Medicare |
$575.41
|
| Rate for Payer: Priority Health Narrow Network |
$1,446.78
|
| Rate for Payer: Priority Health SBD |
$1,410.26
|
| Rate for Payer: Railroad Medicare Medicare |
$575.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,619.72
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$575.41
|
| Rate for Payer: UHC Exchange |
$1,099.67
|
| Rate for Payer: UHC Medicare Advantage |
$575.41
|
| Rate for Payer: UHCCP Medicaid |
$308.42
|
| Rate for Payer: UMR Bronson Commercial |
$828.25
|
| Rate for Payer: VA VA |
$575.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,678.88
|
|
|
HC PSORALEN TREATED WASHED PLATELETS
|
Facility
|
IP
|
$2,238.51
|
|
|
Service Code
|
HCPCS P9073
|
| Hospital Charge Code |
39000086
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$984.94 |
| Max. Negotiated Rate |
$2,014.66 |
| Rate for Payer: Aetna American Axle |
$1,455.03
|
| Rate for Payer: Aetna Commercial |
$1,902.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,455.03
|
| Rate for Payer: Cash Price |
$1,790.81
|
| Rate for Payer: Cofinity Commercial |
$1,566.96
|
| Rate for Payer: Cofinity Commercial |
$1,925.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,566.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,790.81
|
| Rate for Payer: Healthscope Commercial |
$2,014.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,566.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,678.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,902.73
|
| Rate for Payer: PHP Commercial |
$1,902.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,455.03
|
| Rate for Payer: Priority Health SBD |
$1,410.26
|
| Rate for Payer: UMR Bronson Commercial |
$984.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,678.88
|
|
|
HC PSYCH COLLAB CARE MGMT EA ADD 30 MIN
|
Facility
|
OP
|
$89.47
|
|
|
Service Code
|
CPT 99494
|
| Hospital Charge Code |
51000094
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$33.10 |
| Max. Negotiated Rate |
$121.79 |
| Rate for Payer: Aetna American Axle |
$58.16
|
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: Aetna Medicare |
$44.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.16
|
| Rate for Payer: BCBS Complete |
$35.79
|
| Rate for Payer: BCBS Trust/PPO |
$121.79
|
| Rate for Payer: BCN Commercial |
$121.79
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.16
|
| Rate for Payer: Priority Health SBD |
$56.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.13
|
| Rate for Payer: UHC Exchange |
$39.21
|
| Rate for Payer: UMR Bronson Commercial |
$33.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.10
|
|
|
HC PSYCH COLLAB CARE MGMT EA ADD 30 MIN
|
Facility
|
IP
|
$89.47
|
|
|
Service Code
|
CPT 99494
|
| Hospital Charge Code |
51000094
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$39.37 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna American Axle |
$58.16
|
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.16
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.16
|
| Rate for Payer: Priority Health SBD |
$56.37
|
| Rate for Payer: UMR Bronson Commercial |
$39.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.10
|
|
|
HC PSYCH COLLAB CARE MGMT INIT 70 MIN
|
Facility
|
OP
|
$95.72
|
|
|
Service Code
|
CPT 99492
|
| Hospital Charge Code |
51000092
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$35.42 |
| Max. Negotiated Rate |
$330.88 |
| Rate for Payer: Aetna American Axle |
$62.22
|
| Rate for Payer: Aetna Commercial |
$81.36
|
| Rate for Payer: Aetna Medicare |
$94.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.29
|
| Rate for Payer: BCBS Complete |
$51.01
|
| Rate for Payer: BCBS MAPPO |
$90.63
|
| Rate for Payer: BCBS Trust/PPO |
$330.88
|
| Rate for Payer: BCN Commercial |
$330.88
|
| Rate for Payer: BCN Medicare Advantage |
$90.63
|
| Rate for Payer: Cash Price |
$76.58
|
| Rate for Payer: Cash Price |
$76.58
|
| Rate for Payer: Cofinity Commercial |
$82.32
|
| Rate for Payer: Cofinity Commercial |
$67.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.63
|
| Rate for Payer: Healthscope Commercial |
$86.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.79
|
| Rate for Payer: Mclaren Medicaid |
$48.58
|
| Rate for Payer: Mclaren Medicare |
$90.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.16
|
| Rate for Payer: Meridian Medicaid |
$51.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.36
|
| Rate for Payer: Nomi Health Commercial |
$271.89
|
| Rate for Payer: PACE Medicare |
$86.10
|
| Rate for Payer: PACE SWMI |
$90.63
|
| Rate for Payer: PHP Commercial |
$81.36
|
| Rate for Payer: PHP Medicare Advantage |
$90.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$284.86
|
| Rate for Payer: Priority Health Medicare |
$90.63
|
| Rate for Payer: Priority Health Narrow Network |
$227.89
|
| Rate for Payer: Priority Health SBD |
$60.30
|
| Rate for Payer: Railroad Medicare Medicare |
$90.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.63
|
| Rate for Payer: UHC Exchange |
$89.73
|
| Rate for Payer: UHC Medicare Advantage |
$90.63
|
| Rate for Payer: UHCCP Medicaid |
$48.58
|
| Rate for Payer: UMR Bronson Commercial |
$35.42
|
| Rate for Payer: VA VA |
$90.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.79
|
|
|
HC PSYCH COLLAB CARE MGMT INIT 70 MIN
|
Facility
|
IP
|
$95.72
|
|
|
Service Code
|
CPT 99492
|
| Hospital Charge Code |
51000092
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.12 |
| Max. Negotiated Rate |
$86.15 |
| Rate for Payer: Aetna American Axle |
$62.22
|
| Rate for Payer: Aetna Commercial |
$81.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.22
|
| Rate for Payer: Cash Price |
$76.58
|
| Rate for Payer: Cofinity Commercial |
$67.00
|
| Rate for Payer: Cofinity Commercial |
$82.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.58
|
| Rate for Payer: Healthscope Commercial |
$86.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.36
|
| Rate for Payer: PHP Commercial |
$81.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.22
|
| Rate for Payer: Priority Health SBD |
$60.30
|
| Rate for Payer: UMR Bronson Commercial |
$42.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.79
|
|
|
HC PSYCH COLLAB CARE MGMT SUBSEQ 60 MIN
|
Facility
|
OP
|
$105.28
|
|
|
Service Code
|
CPT 99493
|
| Hospital Charge Code |
51000093
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$38.95 |
| Max. Negotiated Rate |
$284.86 |
| Rate for Payer: Aetna American Axle |
$68.43
|
| Rate for Payer: Aetna Commercial |
$89.49
|
| Rate for Payer: Aetna Medicare |
$94.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.29
|
| Rate for Payer: BCBS Complete |
$51.01
|
| Rate for Payer: BCBS MAPPO |
$90.63
|
| Rate for Payer: BCBS Trust/PPO |
$241.09
|
| Rate for Payer: BCN Commercial |
$241.09
|
| Rate for Payer: BCN Medicare Advantage |
$90.63
|
| Rate for Payer: Cash Price |
$84.22
|
| Rate for Payer: Cash Price |
$84.22
|
| Rate for Payer: Cofinity Commercial |
$90.54
|
| Rate for Payer: Cofinity Commercial |
$73.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$73.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.63
|
| Rate for Payer: Healthscope Commercial |
$94.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.96
|
| Rate for Payer: Mclaren Medicaid |
$48.58
|
| Rate for Payer: Mclaren Medicare |
$90.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.16
|
| Rate for Payer: Meridian Medicaid |
$51.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.49
|
| Rate for Payer: Nomi Health Commercial |
$271.89
|
| Rate for Payer: PACE Medicare |
$86.10
|
| Rate for Payer: PACE SWMI |
$90.63
|
| Rate for Payer: PHP Commercial |
$89.49
|
| Rate for Payer: PHP Medicare Advantage |
$90.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$284.86
|
| Rate for Payer: Priority Health Medicare |
$90.63
|
| Rate for Payer: Priority Health Narrow Network |
$227.89
|
| Rate for Payer: Priority Health SBD |
$66.33
|
| Rate for Payer: Railroad Medicare Medicare |
$90.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.63
|
| Rate for Payer: UHC Exchange |
$98.16
|
| Rate for Payer: UHC Medicare Advantage |
$90.63
|
| Rate for Payer: UHCCP Medicaid |
$48.58
|
| Rate for Payer: UMR Bronson Commercial |
$38.95
|
| Rate for Payer: VA VA |
$90.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.96
|
|
|
HC PSYCH COLLAB CARE MGMT SUBSEQ 60 MIN
|
Facility
|
IP
|
$105.28
|
|
|
Service Code
|
CPT 99493
|
| Hospital Charge Code |
51000093
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$46.32 |
| Max. Negotiated Rate |
$94.75 |
| Rate for Payer: Aetna American Axle |
$68.43
|
| Rate for Payer: Aetna Commercial |
$89.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.43
|
| Rate for Payer: Cash Price |
$84.22
|
| Rate for Payer: Cofinity Commercial |
$73.70
|
| Rate for Payer: Cofinity Commercial |
$90.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$73.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.22
|
| Rate for Payer: Healthscope Commercial |
$94.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.49
|
| Rate for Payer: PHP Commercial |
$89.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.43
|
| Rate for Payer: Priority Health SBD |
$66.33
|
| Rate for Payer: UMR Bronson Commercial |
$46.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.96
|
|
|
HC PSYCH DIAGNOSTIC EVAL W/MED SVCS
|
Facility
|
IP
|
$198.72
|
|
|
Service Code
|
CPT 90792
|
| Hospital Charge Code |
91400008
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$87.44 |
| Max. Negotiated Rate |
$178.85 |
| Rate for Payer: Aetna American Axle |
$129.17
|
| Rate for Payer: Aetna Commercial |
$168.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.17
|
| Rate for Payer: Cash Price |
$158.98
|
| Rate for Payer: Cofinity Commercial |
$139.10
|
| Rate for Payer: Cofinity Commercial |
$170.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$139.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.98
|
| Rate for Payer: Healthscope Commercial |
$178.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.91
|
| Rate for Payer: PHP Commercial |
$168.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.17
|
| Rate for Payer: Priority Health SBD |
$125.19
|
| Rate for Payer: UMR Bronson Commercial |
$87.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.04
|
|
|
HC PSYCH DIAGNOSTIC EVAL W/MED SVCS
|
Facility
|
OP
|
$198.72
|
|
|
Service Code
|
CPT 90792
|
| Hospital Charge Code |
91400008
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$73.53 |
| Max. Negotiated Rate |
$494.78 |
| Rate for Payer: Aetna American Axle |
$129.17
|
| Rate for Payer: Aetna Commercial |
$168.91
|
| Rate for Payer: Aetna Medicare |
$163.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$196.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$196.78
|
| Rate for Payer: BCBS Complete |
$88.60
|
| Rate for Payer: BCBS MAPPO |
$157.42
|
| Rate for Payer: BCN Medicare Advantage |
$157.42
|
| Rate for Payer: Cash Price |
$158.98
|
| Rate for Payer: Cash Price |
$158.98
|
| Rate for Payer: Cofinity Commercial |
$170.90
|
| Rate for Payer: Cofinity Commercial |
$139.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$139.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.42
|
| Rate for Payer: Healthscope Commercial |
$178.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.04
|
| Rate for Payer: Mclaren Medicaid |
$84.38
|
| Rate for Payer: Mclaren Medicare |
$157.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.29
|
| Rate for Payer: Meridian Medicaid |
$88.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$181.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.91
|
| Rate for Payer: Nomi Health Commercial |
$472.26
|
| Rate for Payer: PACE Medicare |
$149.55
|
| Rate for Payer: PACE SWMI |
$157.42
|
| Rate for Payer: PHP Commercial |
$168.91
|
| Rate for Payer: PHP Medicare Advantage |
$157.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$494.78
|
| Rate for Payer: Priority Health Medicare |
$157.42
|
| Rate for Payer: Priority Health Narrow Network |
$395.82
|
| Rate for Payer: Priority Health SBD |
$125.19
|
| Rate for Payer: Railroad Medicare Medicare |
$157.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.42
|
| Rate for Payer: UHC Exchange |
$165.12
|
| Rate for Payer: UHC Medicare Advantage |
$157.42
|
| Rate for Payer: UHCCP Medicaid |
$84.38
|
| Rate for Payer: UMR Bronson Commercial |
$73.53
|
| Rate for Payer: VA VA |
$157.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.04
|
|
|
HC PSYCHIATRIC DIAG EVAL
|
Facility
|
OP
|
$198.72
|
|
|
Service Code
|
CPT 90791
|
| Hospital Charge Code |
91400004
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$73.53 |
| Max. Negotiated Rate |
$494.78 |
| Rate for Payer: Aetna American Axle |
$129.17
|
| Rate for Payer: Aetna Commercial |
$168.91
|
| Rate for Payer: Aetna Medicare |
$163.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$196.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$196.78
|
| Rate for Payer: BCBS Complete |
$88.60
|
| Rate for Payer: BCBS MAPPO |
$157.42
|
| Rate for Payer: BCN Medicare Advantage |
$157.42
|
| Rate for Payer: Cash Price |
$158.98
|
| Rate for Payer: Cash Price |
$158.98
|
| Rate for Payer: Cofinity Commercial |
$170.90
|
| Rate for Payer: Cofinity Commercial |
$139.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$139.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.42
|
| Rate for Payer: Healthscope Commercial |
$178.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.04
|
| Rate for Payer: Mclaren Medicaid |
$84.38
|
| Rate for Payer: Mclaren Medicare |
$157.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.29
|
| Rate for Payer: Meridian Medicaid |
$88.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$181.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.91
|
| Rate for Payer: Nomi Health Commercial |
$472.26
|
| Rate for Payer: PACE Medicare |
$149.55
|
| Rate for Payer: PACE SWMI |
$157.42
|
| Rate for Payer: PHP Commercial |
$168.91
|
| Rate for Payer: PHP Medicare Advantage |
$157.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$494.78
|
| Rate for Payer: Priority Health Medicare |
$157.42
|
| Rate for Payer: Priority Health Narrow Network |
$395.82
|
| Rate for Payer: Priority Health SBD |
$125.19
|
| Rate for Payer: Railroad Medicare Medicare |
$157.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.42
|
| Rate for Payer: UHC Exchange |
$144.20
|
| Rate for Payer: UHC Medicare Advantage |
$157.42
|
| Rate for Payer: UHCCP Medicaid |
$84.38
|
| Rate for Payer: UMR Bronson Commercial |
$73.53
|
| Rate for Payer: VA VA |
$157.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.04
|
|
|
HC PSYCHIATRIC DIAG EVAL
|
Facility
|
IP
|
$198.72
|
|
|
Service Code
|
CPT 90791
|
| Hospital Charge Code |
91400004
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$87.44 |
| Max. Negotiated Rate |
$178.85 |
| Rate for Payer: Aetna American Axle |
$129.17
|
| Rate for Payer: Aetna Commercial |
$168.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.17
|
| Rate for Payer: Cash Price |
$158.98
|
| Rate for Payer: Cofinity Commercial |
$139.10
|
| Rate for Payer: Cofinity Commercial |
$170.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$139.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.98
|
| Rate for Payer: Healthscope Commercial |
$178.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.91
|
| Rate for Payer: PHP Commercial |
$168.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.17
|
| Rate for Payer: Priority Health SBD |
$125.19
|
| Rate for Payer: UMR Bronson Commercial |
$87.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.04
|
|
|
HC PSYCH/NEUROPSYCH TEST BY PHYS 30 MIN
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 96136
|
| Hospital Charge Code |
91800009
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: UMR Bronson Commercial |
$11.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC PSYCH/NEUROPSYCH TEST BY PHYS 30 MIN
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 96136
|
| Hospital Charge Code |
91800009
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$491.00 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$378.87
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.95
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$317.56
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.60
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$22.36
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: UMR Bronson Commercial |
$9.62
|
| Rate for Payer: VA VA |
$126.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH 30 MIN
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 96138
|
| Hospital Charge Code |
91800011
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: UMR Bronson Commercial |
$11.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH 30 MIN
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 96138
|
| Hospital Charge Code |
91800011
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$1,228.82 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$406.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$488.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$488.71
|
| Rate for Payer: BCBS Complete |
$220.04
|
| Rate for Payer: BCBS MAPPO |
$390.97
|
| Rate for Payer: BCN Medicare Advantage |
$390.97
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.97
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$209.56
|
| Rate for Payer: Mclaren Medicare |
$390.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$410.52
|
| Rate for Payer: Meridian Medicaid |
$220.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$449.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$1,172.91
|
| Rate for Payer: PACE Medicare |
$371.42
|
| Rate for Payer: PACE SWMI |
$390.97
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$390.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,228.82
|
| Rate for Payer: Priority Health Medicare |
$390.97
|
| Rate for Payer: Priority Health Narrow Network |
$983.06
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$390.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.89
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.97
|
| Rate for Payer: UHC Exchange |
$30.81
|
| Rate for Payer: UHC Medicare Advantage |
$390.97
|
| Rate for Payer: UHCCP Medicaid |
$209.56
|
| Rate for Payer: UMR Bronson Commercial |
$9.62
|
| Rate for Payer: VA VA |
$390.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH EA ADDL 30 MIN
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 96139
|
| Hospital Charge Code |
91800012
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$5.78 |
| Max. Negotiated Rate |
$491.00 |
| Rate for Payer: Aetna American Axle |
$10.15
|
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna Medicare |
$7.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: BCBS Complete |
$6.24
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.88
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Exchange |
$31.71
|
| Rate for Payer: UMR Bronson Commercial |
$5.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC PSYCH/NEUROPSYCH TEST BY TECH EA ADDL 30 MIN
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 96139
|
| Hospital Charge Code |
91800012
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$6.87 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna American Axle |
$10.15
|
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: UMR Bronson Commercial |
$6.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC PSYCH/NEUROPSYCH TEST PHYS EA ADDL 30 MIN
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 96137
|
| Hospital Charge Code |
91800010
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$5.78 |
| Max. Negotiated Rate |
$491.00 |
| Rate for Payer: Aetna American Axle |
$10.15
|
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna Medicare |
$7.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: BCBS Complete |
$6.24
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.96
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Exchange |
$17.24
|
| Rate for Payer: UMR Bronson Commercial |
$5.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC PSYCH/NEUROPSYCH TEST PHYS EA ADDL 30 MIN
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 96137
|
| Hospital Charge Code |
91800010
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$6.87 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna American Axle |
$10.15
|
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: UMR Bronson Commercial |
$6.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC PSYCH/NEUROPSYCH TEST SINGLE AUTOMATED
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 96146
|
| Hospital Charge Code |
91800013
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: UMR Bronson Commercial |
$11.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
