|
HC PSYCH/NEUROPSYCH TEST SINGLE AUTOMATED
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 96146
|
| Hospital Charge Code |
91800013
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$15.07 |
| Max. Negotiated Rate |
$44.67 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: Aetna Medicare |
$28.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: ASR ASR |
$25.73
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$21.87
|
| Rate for Payer: BCN Commercial |
$21.87
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$24.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$25.73
|
| Rate for Payer: Healthscope Whirlpool |
$26.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$28.82
|
| Rate for Payer: Mclaren Commercial |
$23.88
|
| Rate for Payer: Mclaren Medicaid |
$28.82
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$15.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$31.70
|
| Rate for Payer: PHP Medicaid |
$15.45
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$21.67
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health Narrow Network |
$17.34
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$44.67
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP DNSP |
$28.82
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: VA VA |
$28.82
|
|
|
HC PSYCHOLOGICAL TEST EVAL PHYS/QHP 1ST HOUR
|
Facility
|
IP
|
$728.28
|
|
|
Service Code
|
CPT 96130
|
| Hospital Charge Code |
91800450
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$546.21 |
| Max. Negotiated Rate |
$728.28 |
| Rate for Payer: Aetna Commercial |
$655.45
|
| Rate for Payer: ASR ASR |
$706.43
|
| Rate for Payer: BCBS Trust/PPO |
$598.06
|
| Rate for Payer: BCN Commercial |
$598.06
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cofinity Commercial |
$684.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.62
|
| Rate for Payer: Healthscope Commercial |
$706.43
|
| Rate for Payer: Healthscope Whirlpool |
$728.28
|
| Rate for Payer: Mclaren Commercial |
$655.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.04
|
| Rate for Payer: Nomi Health Commercial |
$597.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$640.89
|
|
|
HC PSYCHOLOGICAL TEST EVAL PHYS/QHP 1ST HOUR
|
Facility
|
OP
|
$728.28
|
|
|
Service Code
|
CPT 96130
|
| Hospital Charge Code |
91800450
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$728.28 |
| Rate for Payer: Aetna Commercial |
$655.45
|
| Rate for Payer: Aetna Medicare |
$215.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: ASR ASR |
$706.43
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$600.47
|
| Rate for Payer: BCN Commercial |
$600.47
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cofinity Commercial |
$684.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$706.43
|
| Rate for Payer: Healthscope Whirlpool |
$728.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$215.15
|
| Rate for Payer: Mclaren Commercial |
$655.45
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$118.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.04
|
| Rate for Payer: Nomi Health Commercial |
$597.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.21
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$236.66
|
| Rate for Payer: PHP Medicaid |
$115.32
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$171.60
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health Narrow Network |
$137.28
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$640.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$333.48
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP DNSP |
$215.15
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
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 |
$553.49 |
| Rate for Payer: Aetna Commercial |
$498.14
|
| Rate for Payer: Aetna Medicare |
$204.79
|
| Rate for Payer: ASR ASR |
$536.89
|
| Rate for Payer: BCBS Complete |
$221.40
|
| Rate for Payer: BCBS Trust/PPO |
$456.35
|
| Rate for Payer: BCN Commercial |
$456.35
|
| Rate for Payer: Cash Price |
$442.79
|
| Rate for Payer: Cofinity Commercial |
$520.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.79
|
| Rate for Payer: Healthscope Commercial |
$536.89
|
| Rate for Payer: Healthscope Whirlpool |
$553.49
|
| Rate for Payer: Mclaren Commercial |
$498.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$442.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$470.47
|
| Rate for Payer: Nomi Health Commercial |
$453.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$484.97
|
| Rate for Payer: Priority Health Narrow Network |
$388.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$487.07
|
|
|
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 |
$415.12 |
| Max. Negotiated Rate |
$553.49 |
| Rate for Payer: Aetna Commercial |
$498.14
|
| Rate for Payer: ASR ASR |
$536.89
|
| Rate for Payer: BCBS Trust/PPO |
$454.53
|
| Rate for Payer: BCN Commercial |
$454.53
|
| Rate for Payer: Cash Price |
$442.79
|
| Rate for Payer: Cofinity Commercial |
$520.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.79
|
| Rate for Payer: Healthscope Commercial |
$536.89
|
| Rate for Payer: Healthscope Whirlpool |
$553.49
|
| Rate for Payer: Mclaren Commercial |
$498.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$470.47
|
| Rate for Payer: Nomi Health Commercial |
$453.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$487.07
|
|
|
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 |
$66.53 |
| Max. Negotiated Rate |
$221.07 |
| Rate for Payer: Aetna Commercial |
$79.83
|
| Rate for Payer: Aetna Medicare |
$176.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.07
|
| Rate for Payer: ASR ASR |
$86.04
|
| Rate for Payer: BCBS Complete |
$97.13
|
| Rate for Payer: BCBS MAPPO |
$176.86
|
| Rate for Payer: BCBS Trust/PPO |
$73.13
|
| Rate for Payer: BCN Commercial |
$73.13
|
| 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 Commercial |
$83.38
|
| 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 |
$86.04
|
| Rate for Payer: Healthscope Whirlpool |
$88.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$176.86
|
| Rate for Payer: Mclaren Commercial |
$79.83
|
| 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 |
$97.13
|
| 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 |
$72.73
|
| 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 |
$194.55
|
| Rate for Payer: PHP Medicaid |
$94.80
|
| 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/Tiered Network |
$104.59
|
| Rate for Payer: Priority Health Medicare |
$176.86
|
| Rate for Payer: Priority Health Narrow Network |
$83.67
|
| Rate for Payer: Railroad Medicare Medicare |
$176.86
|
| Rate for Payer: UHC Medicaid |
$92.50
|
| Rate for Payer: UHCCP DNSP |
$176.86
|
| Rate for Payer: UHCCP Medicaid |
$92.50
|
| Rate for Payer: VA VA |
$176.86
|
|
|
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 |
$66.53 |
| Max. Negotiated Rate |
$88.70 |
| Rate for Payer: Aetna Commercial |
$79.83
|
| Rate for Payer: ASR ASR |
$86.04
|
| Rate for Payer: BCBS Trust/PPO |
$72.84
|
| Rate for Payer: BCN Commercial |
$72.84
|
| Rate for Payer: Cash Price |
$70.96
|
| Rate for Payer: Cofinity Commercial |
$83.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.96
|
| Rate for Payer: Healthscope Commercial |
$86.04
|
| Rate for Payer: Healthscope Whirlpool |
$88.70
|
| Rate for Payer: Mclaren Commercial |
$79.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.39
|
| Rate for Payer: Nomi Health Commercial |
$72.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$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 |
$92.50 |
| Max. Negotiated Rate |
$221.07 |
| Rate for Payer: Aetna Commercial |
$143.31
|
| Rate for Payer: Aetna Medicare |
$176.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.07
|
| Rate for Payer: ASR ASR |
$154.45
|
| Rate for Payer: BCBS Complete |
$97.13
|
| Rate for Payer: BCBS MAPPO |
$176.86
|
| Rate for Payer: BCBS Trust/PPO |
$131.29
|
| Rate for Payer: BCN Commercial |
$131.29
|
| 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 Commercial |
$149.68
|
| 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 |
$154.45
|
| Rate for Payer: Healthscope Whirlpool |
$159.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$176.86
|
| Rate for Payer: Mclaren Commercial |
$143.31
|
| 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 |
$97.13
|
| 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 |
$130.57
|
| 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 |
$194.55
|
| Rate for Payer: PHP Medicaid |
$94.80
|
| 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/Tiered Network |
$139.05
|
| Rate for Payer: Priority Health Medicare |
$176.86
|
| Rate for Payer: Priority Health Narrow Network |
$111.24
|
| Rate for Payer: Railroad Medicare Medicare |
$176.86
|
| Rate for Payer: UHC Medicaid |
$92.50
|
| Rate for Payer: UHCCP DNSP |
$176.86
|
| Rate for Payer: UHCCP Medicaid |
$92.50
|
| Rate for Payer: VA VA |
$176.86
|
|
|
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 |
$119.42 |
| Max. Negotiated Rate |
$159.23 |
| Rate for Payer: Aetna Commercial |
$143.31
|
| Rate for Payer: ASR ASR |
$154.45
|
| Rate for Payer: BCBS Trust/PPO |
$130.76
|
| Rate for Payer: BCN Commercial |
$130.76
|
| Rate for Payer: Cash Price |
$127.38
|
| Rate for Payer: Cofinity Commercial |
$149.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.38
|
| Rate for Payer: Healthscope Commercial |
$154.45
|
| Rate for Payer: Healthscope Whirlpool |
$159.23
|
| Rate for Payer: Mclaren Commercial |
$143.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.35
|
| Rate for Payer: Nomi Health Commercial |
$130.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.42
|
|
|
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 |
$100.28 |
| Max. Negotiated Rate |
$133.71 |
| Rate for Payer: Aetna Commercial |
$120.34
|
| Rate for Payer: ASR ASR |
$129.70
|
| Rate for Payer: BCBS Trust/PPO |
$109.80
|
| Rate for Payer: BCN Commercial |
$109.80
|
| Rate for Payer: Cash Price |
$106.97
|
| Rate for Payer: Cofinity Commercial |
$125.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.97
|
| Rate for Payer: Healthscope Commercial |
$129.70
|
| Rate for Payer: Healthscope Whirlpool |
$133.71
|
| Rate for Payer: Mclaren Commercial |
$120.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.65
|
| Rate for Payer: Nomi Health Commercial |
$109.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.28
|
|
|
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 |
$92.50 |
| Max. Negotiated Rate |
$221.07 |
| Rate for Payer: Aetna Commercial |
$120.34
|
| Rate for Payer: Aetna Medicare |
$176.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.07
|
| Rate for Payer: ASR ASR |
$129.70
|
| Rate for Payer: BCBS Complete |
$97.13
|
| Rate for Payer: BCBS MAPPO |
$176.86
|
| Rate for Payer: BCBS Trust/PPO |
$110.24
|
| Rate for Payer: BCN Commercial |
$110.24
|
| 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 Commercial |
$125.69
|
| 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 |
$129.70
|
| Rate for Payer: Healthscope Whirlpool |
$133.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$176.86
|
| Rate for Payer: Mclaren Commercial |
$120.34
|
| 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 |
$97.13
|
| 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 |
$109.64
|
| 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 |
$194.55
|
| Rate for Payer: PHP Medicaid |
$94.80
|
| 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/Tiered Network |
$139.05
|
| Rate for Payer: Priority Health Medicare |
$176.86
|
| Rate for Payer: Priority Health Narrow Network |
$111.24
|
| Rate for Payer: Railroad Medicare Medicare |
$176.86
|
| Rate for Payer: UHC Medicaid |
$92.50
|
| Rate for Payer: UHCCP DNSP |
$176.86
|
| Rate for Payer: UHCCP Medicaid |
$92.50
|
| Rate for Payer: VA VA |
$176.86
|
|
|
HC PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 90785
|
| Hospital Charge Code |
91400012
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$35.12 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: BCBS Trust/PPO |
$38.45
|
| Rate for Payer: BCN Commercial |
$38.45
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$45.42
|
| Rate for Payer: Healthscope Whirlpool |
$46.82
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
|
|
HC PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 90785
|
| Hospital Charge Code |
91400012
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: Aetna Medicare |
$17.32
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: BCBS Complete |
$18.73
|
| Rate for Payer: BCBS Trust/PPO |
$38.60
|
| Rate for Payer: BCN Commercial |
$38.60
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$45.42
|
| Rate for Payer: Healthscope Whirlpool |
$46.82
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
|
|
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 |
$0.01 |
| Max. Negotiated Rate |
$120.69 |
| Rate for Payer: Aetna Commercial |
$108.62
|
| Rate for Payer: Aetna Medicare |
$44.66
|
| Rate for Payer: ASR ASR |
$117.07
|
| Rate for Payer: BCBS Complete |
$48.28
|
| Rate for Payer: BCBS Trust/PPO |
$99.51
|
| Rate for Payer: BCN Commercial |
$99.51
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cofinity Commercial |
$113.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.55
|
| Rate for Payer: Healthscope Commercial |
$117.07
|
| Rate for Payer: Healthscope Whirlpool |
$120.69
|
| Rate for Payer: Mclaren Commercial |
$108.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.59
|
| Rate for Payer: Nomi Health Commercial |
$98.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
|
|
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 |
$90.52 |
| Max. Negotiated Rate |
$120.69 |
| Rate for Payer: Aetna Commercial |
$108.62
|
| Rate for Payer: ASR ASR |
$117.07
|
| Rate for Payer: BCBS Trust/PPO |
$99.11
|
| Rate for Payer: BCN Commercial |
$99.11
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cofinity Commercial |
$113.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.55
|
| Rate for Payer: Healthscope Commercial |
$117.07
|
| Rate for Payer: Healthscope Whirlpool |
$120.69
|
| Rate for Payer: Mclaren Commercial |
$108.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.59
|
| Rate for Payer: Nomi Health Commercial |
$98.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.52
|
|
|
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 |
$92.50 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$210.68
|
| Rate for Payer: Aetna Medicare |
$176.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.07
|
| Rate for Payer: ASR ASR |
$227.07
|
| Rate for Payer: BCBS Complete |
$97.13
|
| Rate for Payer: BCBS MAPPO |
$176.86
|
| Rate for Payer: BCBS Trust/PPO |
$193.01
|
| Rate for Payer: BCN Commercial |
$193.01
|
| 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 Commercial |
$220.04
|
| 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 |
$227.07
|
| Rate for Payer: Healthscope Whirlpool |
$234.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$176.86
|
| Rate for Payer: Mclaren Commercial |
$210.68
|
| 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 |
$97.13
|
| 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 |
$191.95
|
| 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 |
$194.55
|
| Rate for Payer: PHP Medicaid |
$94.80
|
| 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/Tiered Network |
$139.05
|
| Rate for Payer: Priority Health Medicare |
$176.86
|
| Rate for Payer: Priority Health Narrow Network |
$111.24
|
| Rate for Payer: Railroad Medicare Medicare |
$176.86
|
| Rate for Payer: UHC Medicaid |
$92.50
|
| Rate for Payer: UHCCP DNSP |
$176.86
|
| Rate for Payer: UHCCP Medicaid |
$92.50
|
| Rate for Payer: VA VA |
$176.86
|
|
|
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 |
$175.57 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$210.68
|
| Rate for Payer: ASR ASR |
$227.07
|
| Rate for Payer: BCBS Trust/PPO |
$192.23
|
| Rate for Payer: BCN Commercial |
$192.23
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$220.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Healthscope Commercial |
$227.07
|
| Rate for Payer: Healthscope Whirlpool |
$234.09
|
| Rate for Payer: Mclaren Commercial |
$210.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Nomi Health Commercial |
$191.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$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 |
$5,577.31 |
| Max. Negotiated Rate |
$7,436.42 |
| Rate for Payer: Aetna Commercial |
$6,692.78
|
| Rate for Payer: ASR ASR |
$7,213.33
|
| Rate for Payer: BCBS Trust/PPO |
$6,106.79
|
| Rate for Payer: BCN Commercial |
$6,106.79
|
| Rate for Payer: Cash Price |
$5,949.14
|
| Rate for Payer: Cofinity Commercial |
$6,990.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,949.14
|
| Rate for Payer: Healthscope Commercial |
$7,213.33
|
| Rate for Payer: Healthscope Whirlpool |
$7,436.42
|
| Rate for Payer: Mclaren Commercial |
$6,692.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,320.96
|
| Rate for Payer: Nomi Health Commercial |
$6,097.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,577.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,544.05
|
|
|
HC PTCA ADD/BRANCH
|
Facility
|
OP
|
$7,436.42
|
|
|
Service Code
|
CPT 92921
|
| Hospital Charge Code |
48100099
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,751.48 |
| Max. Negotiated Rate |
$7,436.42 |
| Rate for Payer: Aetna Commercial |
$6,692.78
|
| Rate for Payer: Aetna Medicare |
$2,751.48
|
| Rate for Payer: ASR ASR |
$7,213.33
|
| Rate for Payer: BCBS Complete |
$2,974.57
|
| Rate for Payer: BCBS Trust/PPO |
$6,131.33
|
| Rate for Payer: BCN Commercial |
$6,131.33
|
| Rate for Payer: Cash Price |
$5,949.14
|
| Rate for Payer: Cofinity Commercial |
$6,990.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,949.14
|
| Rate for Payer: Healthscope Commercial |
$7,213.33
|
| Rate for Payer: Healthscope Whirlpool |
$7,436.42
|
| Rate for Payer: Mclaren Commercial |
$6,692.78
|
| 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: Nomi Health Commercial |
$6,097.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,577.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,515.79
|
| Rate for Payer: Priority Health Narrow Network |
$5,212.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,544.05
|
|
|
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 |
$11,423.75 |
| Rate for Payer: Aetna Commercial |
$10,281.38
|
| Rate for Payer: Aetna Medicare |
$5,671.10
|
| 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: ASR ASR |
$11,081.04
|
| Rate for Payer: BCBS Complete |
$3,114.57
|
| Rate for Payer: BCBS MAPPO |
$5,671.10
|
| Rate for Payer: BCBS Trust/PPO |
$9,418.88
|
| Rate for Payer: BCN Commercial |
$9,418.88
|
| 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: Cofinity Commercial |
$10,738.33
|
| 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 |
$11,081.04
|
| Rate for Payer: Healthscope Whirlpool |
$11,423.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,671.10
|
| Rate for Payer: Mclaren Commercial |
$10,281.38
|
| 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 |
$3,114.57
|
| 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 |
$9,367.48
|
| 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 |
$6,238.21
|
| Rate for Payer: PHP Medicaid |
$3,039.71
|
| 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/Tiered Network |
$5,078.10
|
| Rate for Payer: Priority Health Medicare |
$5,671.10
|
| Rate for Payer: Priority Health Narrow Network |
$4,062.48
|
| Rate for Payer: Railroad Medicare Medicare |
$5,671.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,052.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,671.10
|
| Rate for Payer: UHC Exchange |
$8,790.20
|
| Rate for Payer: UHC Medicaid |
$2,965.99
|
| Rate for Payer: UHCCP DNSP |
$5,671.10
|
| Rate for Payer: UHCCP Medicaid |
$2,965.99
|
| Rate for Payer: VA VA |
$5,671.10
|
|
|
HC PTCA VESSEL/BRANCH
|
Facility
|
IP
|
$11,423.75
|
|
|
Service Code
|
CPT 92920
|
| Hospital Charge Code |
48100098
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,567.81 |
| Max. Negotiated Rate |
$11,423.75 |
| Rate for Payer: Aetna Commercial |
$10,281.38
|
| Rate for Payer: ASR ASR |
$11,081.04
|
| Rate for Payer: BCBS Trust/PPO |
$9,381.18
|
| Rate for Payer: BCN Commercial |
$9,381.18
|
| Rate for Payer: Cash Price |
$9,139.00
|
| Rate for Payer: Cofinity Commercial |
$10,738.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,139.00
|
| Rate for Payer: Healthscope Commercial |
$11,081.04
|
| Rate for Payer: Healthscope Whirlpool |
$11,423.75
|
| Rate for Payer: Mclaren Commercial |
$10,281.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,710.19
|
| Rate for Payer: Nomi Health Commercial |
$9,367.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,567.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,052.90
|
|
|
HC PTCRAWDES ADD.BRANCH
|
Facility
|
IP
|
$19,483.94
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
48100080
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$14,612.95 |
| Max. Negotiated Rate |
$19,483.94 |
| Rate for Payer: Aetna Commercial |
$17,535.55
|
| Rate for Payer: ASR ASR |
$18,899.42
|
| Rate for Payer: BCBS Trust/PPO |
$16,000.21
|
| Rate for Payer: BCN Commercial |
$16,000.21
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Commercial |
$18,314.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Healthscope Commercial |
$18,899.42
|
| Rate for Payer: Healthscope Whirlpool |
$19,483.94
|
| Rate for Payer: Mclaren Commercial |
$17,535.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Nomi Health Commercial |
$15,976.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,145.87
|
|
|
HC PTCRAWDES ADD.BRANCH
|
Facility
|
OP
|
$19,483.94
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
48100080
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,209.06 |
| Max. Negotiated Rate |
$19,483.94 |
| Rate for Payer: Aetna Commercial |
$17,535.55
|
| Rate for Payer: Aetna Medicare |
$7,209.06
|
| Rate for Payer: ASR ASR |
$18,899.42
|
| Rate for Payer: BCBS Complete |
$7,793.58
|
| Rate for Payer: BCBS Trust/PPO |
$16,064.51
|
| Rate for Payer: BCN Commercial |
$16,064.51
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Commercial |
$18,314.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Healthscope Commercial |
$18,899.42
|
| Rate for Payer: Healthscope Whirlpool |
$19,483.94
|
| Rate for Payer: Mclaren Commercial |
$17,535.55
|
| 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: Nomi Health Commercial |
$15,976.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9,799.08
|
| Rate for Payer: Priority Health Narrow Network |
$7,839.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,145.87
|
|
|
HC PTCRAWDES VES/BRANCH
|
Facility
|
OP
|
$29,741.77
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
48100079
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,839.27 |
| Max. Negotiated Rate |
$29,741.77 |
| Rate for Payer: Aetna Commercial |
$26,767.59
|
| Rate for Payer: Aetna Medicare |
$18,265.72
|
| 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: ASR ASR |
$28,849.52
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCBS Trust/PPO |
$24,522.09
|
| Rate for Payer: BCN Commercial |
$24,522.09
|
| 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: Cofinity Commercial |
$27,957.26
|
| 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 |
$28,849.52
|
| Rate for Payer: Healthscope Whirlpool |
$29,741.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,265.72
|
| Rate for Payer: Mclaren Commercial |
$26,767.59
|
| 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 |
$10,031.53
|
| 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 |
$24,388.25
|
| 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 |
$20,092.29
|
| Rate for Payer: PHP Medicaid |
$9,790.43
|
| 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/Tiered Network |
$9,799.08
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health Narrow Network |
$7,839.27
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,172.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Exchange |
$28,311.87
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP DNSP |
$18,265.72
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: VA VA |
$18,265.72
|
|
|
HC PTCRAWDES VES/BRANCH
|
Facility
|
IP
|
$29,741.77
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
48100079
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,306.33 |
| Max. Negotiated Rate |
$29,741.77 |
| Rate for Payer: Aetna Commercial |
$26,767.59
|
| Rate for Payer: ASR ASR |
$28,849.52
|
| Rate for Payer: BCBS Trust/PPO |
$24,423.94
|
| Rate for Payer: BCN Commercial |
$24,423.94
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cofinity Commercial |
$27,957.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,793.42
|
| Rate for Payer: Healthscope Commercial |
$28,849.52
|
| Rate for Payer: Healthscope Whirlpool |
$29,741.77
|
| Rate for Payer: Mclaren Commercial |
$26,767.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,280.50
|
| Rate for Payer: Nomi Health Commercial |
$24,388.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,306.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,172.76
|
|
