|
HC PSYCH/NEUROPSYCH TEST SINGLE AUTOMATED
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 96146
|
| Hospital Charge Code |
91800013
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$2.17 |
| 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 |
$24.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.99
|
| Rate for Payer: BCBS Complete |
$13.50
|
| Rate for Payer: BCBS MAPPO |
$23.99
|
| Rate for Payer: BCN Medicare Advantage |
$23.99
|
| 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 |
$23.99
|
| 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 |
$12.86
|
| Rate for Payer: Mclaren Medicare |
$23.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.19
|
| Rate for Payer: Meridian Medicaid |
$13.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$71.97
|
| Rate for Payer: PACE Medicare |
$22.79
|
| Rate for Payer: PACE SWMI |
$23.99
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$23.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.43
|
| Rate for Payer: Priority Health Medicare |
$23.99
|
| Rate for Payer: Priority Health Narrow Network |
$60.34
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$23.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.39
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.99
|
| Rate for Payer: UHC Exchange |
$2.17
|
| Rate for Payer: UHC Medicare Advantage |
$23.99
|
| Rate for Payer: UHCCP Medicaid |
$12.86
|
| Rate for Payer: UMR Bronson Commercial |
$9.62
|
| Rate for Payer: VA VA |
$23.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC PSYCHOLOGICAL TEST EVAL PHYS/QHP 1ST HOUR
|
Facility
|
OP
|
$714.00
|
|
|
Service Code
|
CPT 96130
|
| Hospital Charge Code |
91800450
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$105.44 |
| Max. Negotiated Rate |
$958.92 |
| Rate for Payer: Aetna American Axle |
$464.10
|
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: Aetna Medicare |
$317.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$499.80
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$499.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$499.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.50
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$606.90
|
| Rate for Payer: Nomi Health Commercial |
$915.30
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$606.90
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$958.92
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$767.14
|
| Rate for Payer: Priority Health SBD |
$449.82
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.98
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$105.44
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: UMR Bronson Commercial |
$264.18
|
| Rate for Payer: VA VA |
$305.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.50
|
|
|
HC PSYCHOLOGICAL TEST EVAL PHYS/QHP 1ST HOUR
|
Facility
|
IP
|
$714.00
|
|
|
Service Code
|
CPT 96130
|
| Hospital Charge Code |
91800450
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$314.16 |
| Max. Negotiated Rate |
$642.60 |
| Rate for Payer: Aetna American Axle |
$464.10
|
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.10
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$499.80
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$499.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$499.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$606.90
|
| Rate for Payer: PHP Commercial |
$606.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health SBD |
$449.82
|
| Rate for Payer: UMR Bronson Commercial |
$314.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.50
|
|
|
HC PSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HOUR
|
Facility
|
IP
|
$542.64
|
|
|
Service Code
|
CPT 96131
|
| Hospital Charge Code |
91800449
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$238.76 |
| Max. Negotiated Rate |
$488.38 |
| Rate for Payer: Aetna American Axle |
$352.72
|
| Rate for Payer: Aetna Commercial |
$461.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.72
|
| Rate for Payer: Cash Price |
$434.11
|
| Rate for Payer: Cofinity Commercial |
$379.85
|
| Rate for Payer: Cofinity Commercial |
$466.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$379.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.11
|
| Rate for Payer: Healthscope Commercial |
$488.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$379.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.24
|
| Rate for Payer: PHP Commercial |
$461.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.72
|
| Rate for Payer: Priority Health SBD |
$341.86
|
| Rate for Payer: UMR Bronson Commercial |
$238.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.98
|
|
|
HC PSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HOUR
|
Facility
|
OP
|
$542.64
|
|
|
Service Code
|
CPT 96131
|
| Hospital Charge Code |
91800449
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$73.26 |
| Max. Negotiated Rate |
$491.00 |
| Rate for Payer: Aetna American Axle |
$352.72
|
| Rate for Payer: Aetna Commercial |
$461.24
|
| Rate for Payer: Aetna Medicare |
$271.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.72
|
| Rate for Payer: BCBS Complete |
$217.06
|
| Rate for Payer: Cash Price |
$434.11
|
| Rate for Payer: Cash Price |
$434.11
|
| Rate for Payer: Cash Price |
$434.11
|
| Rate for Payer: Cofinity Commercial |
$466.67
|
| Rate for Payer: Cofinity Commercial |
$379.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$379.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.11
|
| Rate for Payer: Healthscope Commercial |
$488.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$379.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.24
|
| Rate for Payer: PHP Commercial |
$461.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.72
|
| Rate for Payer: Priority Health SBD |
$341.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.59
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Exchange |
$73.26
|
| Rate for Payer: UMR Bronson Commercial |
$200.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.98
|
|
|
HC PSYCHOTHERAPY 30 MIN W/PATIENT
|
Facility
|
IP
|
$86.96
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
91400001
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$38.26 |
| Max. Negotiated Rate |
$78.26 |
| Rate for Payer: Aetna American Axle |
$56.52
|
| Rate for Payer: Aetna Commercial |
$73.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.52
|
| Rate for Payer: Cash Price |
$69.57
|
| Rate for Payer: Cofinity Commercial |
$60.87
|
| Rate for Payer: Cofinity Commercial |
$74.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.57
|
| Rate for Payer: Healthscope Commercial |
$78.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.92
|
| Rate for Payer: PHP Commercial |
$73.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.52
|
| Rate for Payer: Priority Health SBD |
$54.78
|
| Rate for Payer: UMR Bronson Commercial |
$38.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.22
|
|
|
HC PSYCHOTHERAPY 30 MIN W/PATIENT
|
Facility
|
OP
|
$86.96
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
91400001
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$32.18 |
| Max. Negotiated Rate |
$494.78 |
| Rate for Payer: Aetna American Axle |
$56.52
|
| Rate for Payer: Aetna Commercial |
$73.92
|
| Rate for Payer: Aetna Medicare |
$163.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.52
|
| 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 |
$69.57
|
| Rate for Payer: Cash Price |
$69.57
|
| Rate for Payer: Cofinity Commercial |
$74.79
|
| Rate for Payer: Cofinity Commercial |
$60.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.42
|
| Rate for Payer: Healthscope Commercial |
$78.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.22
|
| 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 |
$73.92
|
| 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 |
$73.92
|
| 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 |
$56.52
|
| 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 |
$54.78
|
| Rate for Payer: Railroad Medicare Medicare |
$157.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.42
|
| Rate for Payer: UHC Exchange |
$66.77
|
| Rate for Payer: UHC Medicare Advantage |
$157.42
|
| Rate for Payer: UHCCP Medicaid |
$84.38
|
| Rate for Payer: UMR Bronson Commercial |
$32.18
|
| Rate for Payer: VA VA |
$157.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.22
|
|
|
HC PSYCHOTHERAPY 45 MIN W/PATIENT
|
Facility
|
OP
|
$156.11
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
91400002
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$57.76 |
| Max. Negotiated Rate |
$494.78 |
| Rate for Payer: Aetna American Axle |
$101.47
|
| Rate for Payer: Aetna Commercial |
$132.69
|
| Rate for Payer: Aetna Medicare |
$163.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.47
|
| 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 |
$124.89
|
| Rate for Payer: Cash Price |
$124.89
|
| Rate for Payer: Cofinity Commercial |
$134.25
|
| Rate for Payer: Cofinity Commercial |
$109.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$109.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.42
|
| Rate for Payer: Healthscope Commercial |
$140.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.08
|
| 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 |
$132.69
|
| 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 |
$132.69
|
| 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 |
$101.47
|
| 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 |
$98.35
|
| Rate for Payer: Railroad Medicare Medicare |
$157.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.42
|
| Rate for Payer: UHC Exchange |
$88.20
|
| Rate for Payer: UHC Medicare Advantage |
$157.42
|
| Rate for Payer: UHCCP Medicaid |
$84.38
|
| Rate for Payer: UMR Bronson Commercial |
$57.76
|
| Rate for Payer: VA VA |
$157.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.08
|
|
|
HC PSYCHOTHERAPY 45 MIN W/PATIENT
|
Facility
|
IP
|
$156.11
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
91400002
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$68.69 |
| Max. Negotiated Rate |
$140.50 |
| Rate for Payer: Aetna American Axle |
$101.47
|
| Rate for Payer: Aetna Commercial |
$132.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.47
|
| Rate for Payer: Cash Price |
$124.89
|
| Rate for Payer: Cofinity Commercial |
$109.28
|
| Rate for Payer: Cofinity Commercial |
$134.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$109.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.89
|
| Rate for Payer: Healthscope Commercial |
$140.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.69
|
| Rate for Payer: PHP Commercial |
$132.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.47
|
| Rate for Payer: Priority Health SBD |
$98.35
|
| Rate for Payer: UMR Bronson Commercial |
$68.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.08
|
|
|
HC PSYCHOTHERAPY 60 MIN W PT
|
Facility
|
IP
|
$131.09
|
|
|
Service Code
|
CPT 90837
|
| Hospital Charge Code |
91400005
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$57.68 |
| Max. Negotiated Rate |
$117.98 |
| Rate for Payer: Aetna American Axle |
$85.21
|
| Rate for Payer: Aetna Commercial |
$111.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.21
|
| Rate for Payer: Cash Price |
$104.87
|
| Rate for Payer: Cofinity Commercial |
$112.74
|
| Rate for Payer: Cofinity Commercial |
$91.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.87
|
| Rate for Payer: Healthscope Commercial |
$117.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.43
|
| Rate for Payer: PHP Commercial |
$111.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.21
|
| Rate for Payer: Priority Health SBD |
$82.59
|
| Rate for Payer: UMR Bronson Commercial |
$57.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.32
|
|
|
HC PSYCHOTHERAPY 60 MIN W PT
|
Facility
|
OP
|
$131.09
|
|
|
Service Code
|
CPT 90837
|
| Hospital Charge Code |
91400005
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$48.50 |
| Max. Negotiated Rate |
$494.78 |
| Rate for Payer: Aetna American Axle |
$85.21
|
| Rate for Payer: Aetna Commercial |
$111.43
|
| Rate for Payer: Aetna Medicare |
$163.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.21
|
| 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 |
$104.87
|
| Rate for Payer: Cash Price |
$104.87
|
| Rate for Payer: Cofinity Commercial |
$91.76
|
| Rate for Payer: Cofinity Commercial |
$112.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.42
|
| Rate for Payer: Healthscope Commercial |
$117.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.32
|
| 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 |
$111.43
|
| 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 |
$111.43
|
| 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 |
$85.21
|
| 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 |
$82.59
|
| Rate for Payer: Railroad Medicare Medicare |
$157.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.42
|
| Rate for Payer: UHC Exchange |
$130.20
|
| Rate for Payer: UHC Medicare Advantage |
$157.42
|
| Rate for Payer: UHCCP Medicaid |
$84.38
|
| Rate for Payer: UMR Bronson Commercial |
$48.50
|
| Rate for Payer: VA VA |
$157.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.32
|
|
|
HC PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 90785
|
| Hospital Charge Code |
91400012
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: UMR Bronson Commercial |
$20.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 90785
|
| Hospital Charge Code |
91400012
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$11.11 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$22.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: BCBS Complete |
$18.36
|
| Rate for Payer: BCBS Trust/PPO |
$11.11
|
| Rate for Payer: BCN Commercial |
$11.11
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: UMR Bronson Commercial |
$16.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC PSYCHOTHERAPY FOR CRISIS EA ADDL 15 MIN
|
Facility
|
IP
|
$118.32
|
|
|
Service Code
|
CPT 90840
|
| Hospital Charge Code |
91400014
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$52.06 |
| Max. Negotiated Rate |
$106.49 |
| Rate for Payer: Aetna American Axle |
$76.91
|
| Rate for Payer: Aetna Commercial |
$100.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.91
|
| Rate for Payer: Cash Price |
$94.66
|
| Rate for Payer: Cofinity Commercial |
$101.76
|
| Rate for Payer: Cofinity Commercial |
$82.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.66
|
| Rate for Payer: Healthscope Commercial |
$106.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.57
|
| Rate for Payer: PHP Commercial |
$100.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.91
|
| Rate for Payer: Priority Health SBD |
$74.54
|
| Rate for Payer: UMR Bronson Commercial |
$52.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.74
|
|
|
HC PSYCHOTHERAPY FOR CRISIS EA ADDL 15 MIN
|
Facility
|
OP
|
$118.32
|
|
|
Service Code
|
CPT 90840
|
| Hospital Charge Code |
91400014
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$43.78 |
| Max. Negotiated Rate |
$106.49 |
| Rate for Payer: Aetna American Axle |
$76.91
|
| Rate for Payer: Aetna Commercial |
$100.57
|
| Rate for Payer: Aetna Medicare |
$59.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.91
|
| Rate for Payer: BCBS Complete |
$47.33
|
| Rate for Payer: Cash Price |
$94.66
|
| Rate for Payer: Cash Price |
$94.66
|
| Rate for Payer: Cofinity Commercial |
$82.82
|
| Rate for Payer: Cofinity Commercial |
$101.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.66
|
| Rate for Payer: Healthscope Commercial |
$106.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.57
|
| Rate for Payer: PHP Commercial |
$100.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.91
|
| Rate for Payer: Priority Health SBD |
$74.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.44
|
| Rate for Payer: UHC Exchange |
$63.13
|
| Rate for Payer: UMR Bronson Commercial |
$43.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.74
|
|
|
HC PSYCHOTHERAPY FOR CRISIS FIRST 60 MIN
|
Facility
|
OP
|
$229.50
|
|
|
Service Code
|
CPT 90839
|
| Hospital Charge Code |
91400003
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$84.38 |
| Max. Negotiated Rate |
$494.78 |
| Rate for Payer: Aetna American Axle |
$149.18
|
| Rate for Payer: Aetna Commercial |
$195.08
|
| Rate for Payer: Aetna Medicare |
$163.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.18
|
| 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 |
$183.60
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$197.37
|
| Rate for Payer: Cofinity Commercial |
$160.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$160.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.42
|
| Rate for Payer: Healthscope Commercial |
$206.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.12
|
| 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 |
$195.08
|
| 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 |
$195.08
|
| 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 |
$149.18
|
| 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 |
$144.58
|
| Rate for Payer: Railroad Medicare Medicare |
$157.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.42
|
| Rate for Payer: UHC Exchange |
$125.86
|
| Rate for Payer: UHC Medicare Advantage |
$157.42
|
| Rate for Payer: UHCCP Medicaid |
$84.38
|
| Rate for Payer: UMR Bronson Commercial |
$84.92
|
| Rate for Payer: VA VA |
$157.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.12
|
|
|
HC PSYCHOTHERAPY FOR CRISIS FIRST 60 MIN
|
Facility
|
IP
|
$229.50
|
|
|
Service Code
|
CPT 90839
|
| Hospital Charge Code |
91400003
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$100.98 |
| Max. Negotiated Rate |
$206.55 |
| Rate for Payer: Aetna American Axle |
$149.18
|
| Rate for Payer: Aetna Commercial |
$195.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.18
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$160.65
|
| Rate for Payer: Cofinity Commercial |
$197.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$160.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$206.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.08
|
| Rate for Payer: PHP Commercial |
$195.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.18
|
| Rate for Payer: Priority Health SBD |
$144.58
|
| Rate for Payer: UMR Bronson Commercial |
$100.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.12
|
|
|
HC PTCA ADD/BRANCH
|
Facility
|
OP
|
$7,290.61
|
|
|
Service Code
|
CPT 92921
|
| Hospital Charge Code |
48100099
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$545.89 |
| Max. Negotiated Rate |
$8,596.00 |
| Rate for Payer: Aetna American Axle |
$4,738.90
|
| Rate for Payer: Aetna Commercial |
$6,197.02
|
| Rate for Payer: Aetna Medicare |
$3,645.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,738.90
|
| Rate for Payer: BCBS Complete |
$2,916.24
|
| Rate for Payer: BCBS Trust/PPO |
$545.89
|
| Rate for Payer: BCN Commercial |
$545.89
|
| Rate for Payer: Cash Price |
$5,832.49
|
| Rate for Payer: Cash Price |
$5,832.49
|
| Rate for Payer: Cash Price |
$5,832.49
|
| Rate for Payer: Cofinity Commercial |
$6,269.92
|
| Rate for Payer: Cofinity Commercial |
$5,103.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,103.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,832.49
|
| Rate for Payer: Healthscope Commercial |
$6,561.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,103.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,467.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,197.02
|
| Rate for Payer: PHP Commercial |
$6,197.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,738.90
|
| Rate for Payer: Priority Health SBD |
$4,593.08
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,697.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,467.96
|
|
|
HC PTCA ADD/BRANCH
|
Facility
|
IP
|
$7,290.61
|
|
|
Service Code
|
CPT 92921
|
| Hospital Charge Code |
48100099
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,207.87 |
| Max. Negotiated Rate |
$6,561.55 |
| Rate for Payer: Aetna American Axle |
$4,738.90
|
| Rate for Payer: Aetna Commercial |
$6,197.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,738.90
|
| Rate for Payer: Cash Price |
$5,832.49
|
| Rate for Payer: Cofinity Commercial |
$5,103.43
|
| Rate for Payer: Cofinity Commercial |
$6,269.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,103.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,832.49
|
| Rate for Payer: Healthscope Commercial |
$6,561.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,103.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,467.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,197.02
|
| Rate for Payer: PHP Commercial |
$6,197.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,738.90
|
| Rate for Payer: Priority Health SBD |
$4,593.08
|
| Rate for Payer: UMR Bronson Commercial |
$3,207.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,467.96
|
|
|
HC PTCA VESSEL/BRANCH
|
Facility
|
IP
|
$11,199.75
|
|
|
Service Code
|
CPT 92920
|
| Hospital Charge Code |
48100098
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,927.89 |
| Max. Negotiated Rate |
$10,079.78 |
| Rate for Payer: Aetna American Axle |
$7,279.84
|
| Rate for Payer: Aetna Commercial |
$9,519.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,279.84
|
| Rate for Payer: Cash Price |
$8,959.80
|
| Rate for Payer: Cofinity Commercial |
$7,839.82
|
| Rate for Payer: Cofinity Commercial |
$9,631.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,839.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,959.80
|
| Rate for Payer: Healthscope Commercial |
$10,079.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,839.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,399.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,519.79
|
| Rate for Payer: PHP Commercial |
$9,519.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,279.84
|
| Rate for Payer: Priority Health SBD |
$7,055.84
|
| Rate for Payer: UMR Bronson Commercial |
$4,927.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,399.81
|
|
|
HC PTCA VESSEL/BRANCH
|
Facility
|
OP
|
$11,199.75
|
|
|
Service Code
|
CPT 92920
|
| Hospital Charge Code |
48100098
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$508.71 |
| Max. Negotiated Rate |
$17,557.45 |
| Rate for Payer: Aetna American Axle |
$7,279.84
|
| Rate for Payer: Aetna Commercial |
$9,519.79
|
| Rate for Payer: Aetna Medicare |
$5,809.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,279.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,982.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,982.80
|
| Rate for Payer: BCBS Complete |
$3,143.94
|
| Rate for Payer: BCBS MAPPO |
$5,586.24
|
| Rate for Payer: BCBS Trust/PPO |
$5,779.60
|
| Rate for Payer: BCN Commercial |
$5,779.60
|
| Rate for Payer: BCN Medicare Advantage |
$5,586.24
|
| Rate for Payer: Cash Price |
$8,959.80
|
| Rate for Payer: Cash Price |
$8,959.80
|
| Rate for Payer: Cash Price |
$8,959.80
|
| Rate for Payer: Cofinity Commercial |
$9,631.78
|
| Rate for Payer: Cofinity Commercial |
$7,839.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,839.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,959.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,586.24
|
| Rate for Payer: Healthscope Commercial |
$10,079.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,839.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,399.81
|
| Rate for Payer: Mclaren Medicaid |
$2,994.22
|
| Rate for Payer: Mclaren Medicare |
$5,586.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,865.55
|
| Rate for Payer: Meridian Medicaid |
$3,143.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,424.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,519.79
|
| Rate for Payer: Nomi Health Commercial |
$11,731.10
|
| Rate for Payer: PACE Medicare |
$5,306.93
|
| Rate for Payer: PACE SWMI |
$5,586.24
|
| Rate for Payer: PHP Commercial |
$9,519.79
|
| Rate for Payer: PHP Medicare Advantage |
$5,586.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,994.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,279.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,557.45
|
| Rate for Payer: Priority Health Medicare |
$5,586.24
|
| Rate for Payer: Priority Health Narrow Network |
$14,045.96
|
| Rate for Payer: Priority Health SBD |
$7,055.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5,586.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$559.58
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,586.24
|
| Rate for Payer: UHC Exchange |
$508.71
|
| Rate for Payer: UHC Medicare Advantage |
$5,586.24
|
| Rate for Payer: UHCCP Medicaid |
$2,994.22
|
| Rate for Payer: UMR Bronson Commercial |
$4,143.91
|
| Rate for Payer: VA VA |
$5,586.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,399.81
|
|
|
HC PTCRAWDES ADD.BRANCH
|
Facility
|
IP
|
$19,101.90
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
48100080
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,404.84 |
| Max. Negotiated Rate |
$17,191.71 |
| Rate for Payer: Aetna American Axle |
$12,416.24
|
| Rate for Payer: Aetna Commercial |
$16,236.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,416.24
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cofinity Commercial |
$13,371.33
|
| Rate for Payer: Cofinity Commercial |
$16,427.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$13,371.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,281.52
|
| Rate for Payer: Healthscope Commercial |
$17,191.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,371.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,326.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,236.62
|
| Rate for Payer: PHP Commercial |
$16,236.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,416.24
|
| Rate for Payer: Priority Health SBD |
$12,034.20
|
| Rate for Payer: UMR Bronson Commercial |
$8,404.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,326.42
|
|
|
HC PTCRAWDES ADD.BRANCH
|
Facility
|
OP
|
$19,101.90
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
48100080
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$17,191.71 |
| Rate for Payer: Aetna American Axle |
$12,416.24
|
| Rate for Payer: Aetna Commercial |
$16,236.62
|
| Rate for Payer: Aetna Medicare |
$9,550.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,416.24
|
| Rate for Payer: BCBS Complete |
$7,640.76
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cofinity Commercial |
$16,427.63
|
| Rate for Payer: Cofinity Commercial |
$13,371.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$13,371.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,281.52
|
| Rate for Payer: Healthscope Commercial |
$17,191.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,371.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,326.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,236.62
|
| Rate for Payer: PHP Commercial |
$16,236.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,416.24
|
| Rate for Payer: Priority Health SBD |
$12,034.20
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UMR Bronson Commercial |
$7,067.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,326.42
|
|
|
HC PTCRAWDES VES/BRANCH
|
Facility
|
OP
|
$29,158.60
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
48100079
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,430.19 |
| Max. Negotiated Rate |
$55,296.52 |
| Rate for Payer: Aetna American Axle |
$18,953.09
|
| Rate for Payer: Aetna Commercial |
$24,784.81
|
| Rate for Payer: Aetna Medicare |
$18,297.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,953.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,992.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,992.05
|
| Rate for Payer: BCBS Complete |
$9,901.70
|
| Rate for Payer: BCBS MAPPO |
$17,593.64
|
| Rate for Payer: BCBS Trust/PPO |
$15,812.76
|
| Rate for Payer: BCN Commercial |
$15,812.76
|
| Rate for Payer: BCN Medicare Advantage |
$17,593.64
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cofinity Commercial |
$25,076.40
|
| Rate for Payer: Cofinity Commercial |
$20,411.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,411.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,326.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,593.64
|
| Rate for Payer: Healthscope Commercial |
$26,242.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,411.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,868.95
|
| Rate for Payer: Mclaren Medicaid |
$9,430.19
|
| Rate for Payer: Mclaren Medicare |
$17,593.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,473.32
|
| Rate for Payer: Meridian Medicaid |
$9,901.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,232.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,784.81
|
| Rate for Payer: Nomi Health Commercial |
$36,946.64
|
| Rate for Payer: PACE Medicare |
$16,713.96
|
| Rate for Payer: PACE SWMI |
$17,593.64
|
| Rate for Payer: PHP Commercial |
$24,784.81
|
| Rate for Payer: PHP Medicare Advantage |
$17,593.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,430.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,953.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55,296.52
|
| Rate for Payer: Priority Health Medicare |
$17,593.64
|
| Rate for Payer: Priority Health Narrow Network |
$44,237.22
|
| Rate for Payer: Priority Health SBD |
$18,369.92
|
| Rate for Payer: Railroad Medicare Medicare |
$17,593.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,524.34
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,593.64
|
| Rate for Payer: UHC Exchange |
$33,623.21
|
| Rate for Payer: UHC Medicare Advantage |
$17,593.64
|
| Rate for Payer: UHCCP Medicaid |
$9,430.19
|
| Rate for Payer: UMR Bronson Commercial |
$10,788.68
|
| Rate for Payer: VA VA |
$17,593.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,868.95
|
|
|
HC PTCRAWDES VES/BRANCH
|
Facility
|
IP
|
$29,158.60
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
48100079
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,829.78 |
| Max. Negotiated Rate |
$26,242.74 |
| Rate for Payer: Aetna American Axle |
$18,953.09
|
| Rate for Payer: Aetna Commercial |
$24,784.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,953.09
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cofinity Commercial |
$20,411.02
|
| Rate for Payer: Cofinity Commercial |
$25,076.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,411.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,326.88
|
| Rate for Payer: Healthscope Commercial |
$26,242.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,411.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,868.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,784.81
|
| Rate for Payer: PHP Commercial |
$24,784.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,953.09
|
| Rate for Payer: Priority Health SBD |
$18,369.92
|
| Rate for Payer: UMR Bronson Commercial |
$12,829.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,868.95
|
|
