|
ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$187.92
|
|
|
Service Code
|
HCPCS P9045
|
| Hospital Charge Code |
8982
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.76 |
| Max. Negotiated Rate |
$169.13 |
| Rate for Payer: Aetna Commercial |
$159.73
|
| Rate for Payer: Aetna Commercial |
$149.87
|
| Rate for Payer: Aetna Commercial |
$183.40
|
| Rate for Payer: Aetna Medicare |
$55.20
|
| Rate for Payer: Aetna Medicare |
$55.20
|
| Rate for Payer: Aetna Medicare |
$55.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.35
|
| Rate for Payer: BCBS Complete |
$29.15
|
| Rate for Payer: BCBS Complete |
$29.15
|
| Rate for Payer: BCBS Complete |
$29.15
|
| Rate for Payer: BCBS MAPPO |
$53.08
|
| Rate for Payer: BCBS MAPPO |
$53.08
|
| Rate for Payer: BCBS MAPPO |
$53.08
|
| Rate for Payer: BCBS Trust/PPO |
$133.17
|
| Rate for Payer: BCBS Trust/PPO |
$133.17
|
| Rate for Payer: BCBS Trust/PPO |
$133.17
|
| Rate for Payer: BCN Commercial |
$133.17
|
| Rate for Payer: BCN Commercial |
$133.17
|
| Rate for Payer: BCN Commercial |
$133.17
|
| Rate for Payer: BCN Medicare Advantage |
$53.08
|
| Rate for Payer: BCN Medicare Advantage |
$53.08
|
| Rate for Payer: BCN Medicare Advantage |
$53.08
|
| Rate for Payer: Cash Price |
$141.06
|
| Rate for Payer: Cash Price |
$141.06
|
| Rate for Payer: Cash Price |
$150.34
|
| Rate for Payer: Cash Price |
$150.34
|
| Rate for Payer: Cash Price |
$172.61
|
| Rate for Payer: Cash Price |
$172.61
|
| Rate for Payer: Cofinity Advantage |
$131.54
|
| Rate for Payer: Cofinity Advantage |
$123.42
|
| Rate for Payer: Cofinity Advantage |
$151.03
|
| Rate for Payer: Cofinity Commercial |
$151.64
|
| Rate for Payer: Cofinity Commercial |
$185.55
|
| Rate for Payer: Cofinity Commercial |
$161.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.08
|
| Rate for Payer: Healthscope Commercial |
$194.18
|
| Rate for Payer: Healthscope Commercial |
$169.13
|
| Rate for Payer: Healthscope Commercial |
$158.69
|
| Rate for Payer: Mclaren Medicaid |
$27.76
|
| Rate for Payer: Mclaren Medicaid |
$27.76
|
| Rate for Payer: Mclaren Medicaid |
$27.76
|
| Rate for Payer: Mclaren Medicare |
$53.08
|
| Rate for Payer: Mclaren Medicare |
$53.08
|
| Rate for Payer: Mclaren Medicare |
$53.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.73
|
| Rate for Payer: Meridian Medicaid |
$55.73
|
| Rate for Payer: Meridian Medicaid |
$55.73
|
| Rate for Payer: Meridian Medicaid |
$55.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.40
|
| Rate for Payer: Nomi Health Commercial |
$159.24
|
| Rate for Payer: Nomi Health Commercial |
$159.24
|
| Rate for Payer: Nomi Health Commercial |
$159.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.94
|
| Rate for Payer: PACE Medicare |
$50.43
|
| Rate for Payer: PACE Medicare |
$50.43
|
| Rate for Payer: PACE Medicare |
$50.43
|
| Rate for Payer: PACE SWMI |
$53.08
|
| Rate for Payer: PACE SWMI |
$53.08
|
| Rate for Payer: PACE SWMI |
$53.08
|
| Rate for Payer: PHP Commercial |
$149.87
|
| Rate for Payer: PHP Commercial |
$183.40
|
| Rate for Payer: PHP Commercial |
$159.73
|
| Rate for Payer: PHP Medicare Advantage |
$53.08
|
| Rate for Payer: PHP Medicare Advantage |
$53.08
|
| Rate for Payer: PHP Medicare Advantage |
$53.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$167.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$167.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$167.40
|
| Rate for Payer: Priority Health Medicare |
$53.08
|
| Rate for Payer: Priority Health Medicare |
$53.08
|
| Rate for Payer: Priority Health Medicare |
$53.08
|
| Rate for Payer: Priority Health SBD |
$111.08
|
| Rate for Payer: Priority Health SBD |
$118.39
|
| Rate for Payer: Priority Health SBD |
$135.93
|
| Rate for Payer: Priority Health Tiered Network |
$133.92
|
| Rate for Payer: Priority Health Tiered Network |
$133.92
|
| Rate for Payer: Priority Health Tiered Network |
$133.92
|
| Rate for Payer: Railroad Medicare Medicare |
$53.08
|
| Rate for Payer: Railroad Medicare Medicare |
$53.08
|
| Rate for Payer: Railroad Medicare Medicare |
$53.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.58
|
| Rate for Payer: UHC Core |
$87.58
|
| Rate for Payer: UHC Core |
$87.58
|
| Rate for Payer: UHC Core |
$87.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$53.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$53.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$53.08
|
| Rate for Payer: UHC Exchange |
$87.58
|
| Rate for Payer: UHC Exchange |
$87.58
|
| Rate for Payer: UHC Exchange |
$87.58
|
| Rate for Payer: UHC Medicaid |
$27.76
|
| Rate for Payer: UHC Medicaid |
$27.76
|
| Rate for Payer: UHC Medicaid |
$27.76
|
| Rate for Payer: UHCCP Medicaid |
$27.76
|
| Rate for Payer: UHCCP Medicaid |
$27.76
|
| Rate for Payer: UHCCP Medicaid |
$27.76
|
| Rate for Payer: VA VA |
$53.08
|
| Rate for Payer: VA VA |
$53.08
|
| Rate for Payer: VA VA |
$53.08
|
|
|
ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$187.92
|
|
|
Service Code
|
HCPCS P9047
|
| Hospital Charge Code |
8982
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$118.39 |
| Max. Negotiated Rate |
$169.13 |
| Rate for Payer: Aetna Commercial |
$159.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.15
|
| Rate for Payer: Cash Price |
$150.34
|
| Rate for Payer: Cofinity Advantage |
$131.54
|
| Rate for Payer: Cofinity Commercial |
$161.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.34
|
| Rate for Payer: Healthscope Commercial |
$169.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.94
|
| Rate for Payer: PHP Commercial |
$159.73
|
| Rate for Payer: Priority Health SBD |
$118.39
|
|
|
ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$187.92
|
|
|
Service Code
|
HCPCS P9045
|
| Hospital Charge Code |
8982
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$118.39 |
| Max. Negotiated Rate |
$169.13 |
| Rate for Payer: Aetna Commercial |
$159.73
|
| Rate for Payer: Aetna Commercial |
$149.87
|
| Rate for Payer: Aetna Commercial |
$183.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.61
|
| Rate for Payer: Cash Price |
$172.61
|
| Rate for Payer: Cash Price |
$150.34
|
| Rate for Payer: Cash Price |
$141.06
|
| Rate for Payer: Cofinity Advantage |
$131.54
|
| Rate for Payer: Cofinity Advantage |
$123.42
|
| Rate for Payer: Cofinity Advantage |
$151.03
|
| Rate for Payer: Cofinity Commercial |
$185.55
|
| Rate for Payer: Cofinity Commercial |
$151.64
|
| Rate for Payer: Cofinity Commercial |
$161.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.61
|
| Rate for Payer: Healthscope Commercial |
$158.69
|
| Rate for Payer: Healthscope Commercial |
$169.13
|
| Rate for Payer: Healthscope Commercial |
$194.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.94
|
| Rate for Payer: PHP Commercial |
$149.87
|
| Rate for Payer: PHP Commercial |
$183.40
|
| Rate for Payer: PHP Commercial |
$159.73
|
| Rate for Payer: Priority Health SBD |
$135.93
|
| Rate for Payer: Priority Health SBD |
$111.08
|
| Rate for Payer: Priority Health SBD |
$118.39
|
|
|
ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$187.92
|
|
|
Service Code
|
HCPCS P9047
|
| Hospital Charge Code |
8982
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.76 |
| Max. Negotiated Rate |
$169.13 |
| Rate for Payer: Aetna Commercial |
$159.73
|
| Rate for Payer: Aetna Medicare |
$55.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.35
|
| Rate for Payer: BCBS Complete |
$29.15
|
| Rate for Payer: BCBS MAPPO |
$53.08
|
| Rate for Payer: BCBS Trust/PPO |
$133.17
|
| Rate for Payer: BCN Commercial |
$133.17
|
| Rate for Payer: BCN Medicare Advantage |
$53.08
|
| Rate for Payer: Cash Price |
$150.34
|
| Rate for Payer: Cash Price |
$150.34
|
| Rate for Payer: Cofinity Advantage |
$131.54
|
| Rate for Payer: Cofinity Commercial |
$161.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.08
|
| Rate for Payer: Healthscope Commercial |
$169.13
|
| Rate for Payer: Mclaren Medicaid |
$27.76
|
| Rate for Payer: Mclaren Medicare |
$53.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.73
|
| Rate for Payer: Meridian Medicaid |
$55.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.73
|
| Rate for Payer: Nomi Health Commercial |
$159.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.94
|
| Rate for Payer: PACE Medicare |
$50.43
|
| Rate for Payer: PACE SWMI |
$53.08
|
| Rate for Payer: PHP Commercial |
$159.73
|
| Rate for Payer: PHP Medicare Advantage |
$53.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$167.40
|
| Rate for Payer: Priority Health Medicare |
$53.08
|
| Rate for Payer: Priority Health SBD |
$118.39
|
| Rate for Payer: Priority Health Tiered Network |
$133.92
|
| Rate for Payer: Railroad Medicare Medicare |
$53.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.58
|
| Rate for Payer: UHC Core |
$87.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$53.08
|
| Rate for Payer: UHC Exchange |
$87.58
|
| Rate for Payer: UHC Medicaid |
$27.76
|
| Rate for Payer: UHCCP Medicaid |
$27.76
|
| Rate for Payer: VA VA |
$53.08
|
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION
|
Facility
|
IP
|
$2.14
|
|
|
Service Code
|
HCPCS J7613
|
| Hospital Charge Code |
250
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$1.93 |
| Rate for Payer: Aetna Commercial |
$1.82
|
| Rate for Payer: Aetna Commercial |
$2.86
|
| Rate for Payer: Aetna Commercial |
$3.72
|
| Rate for Payer: Aetna Commercial |
$1.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.85
|
| Rate for Payer: Cash Price |
$3.50
|
| Rate for Payer: Cash Price |
$1.78
|
| Rate for Payer: Cash Price |
$2.70
|
| Rate for Payer: Cash Price |
$1.71
|
| Rate for Payer: Cofinity Advantage |
$2.36
|
| Rate for Payer: Cofinity Advantage |
$1.50
|
| Rate for Payer: Cofinity Advantage |
$1.56
|
| Rate for Payer: Cofinity Advantage |
$3.07
|
| Rate for Payer: Cofinity Commercial |
$3.77
|
| Rate for Payer: Cofinity Commercial |
$2.90
|
| Rate for Payer: Cofinity Commercial |
$1.84
|
| Rate for Payer: Cofinity Commercial |
$1.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.71
|
| Rate for Payer: Healthscope Commercial |
$1.93
|
| Rate for Payer: Healthscope Commercial |
$2.01
|
| Rate for Payer: Healthscope Commercial |
$3.03
|
| Rate for Payer: Healthscope Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.67
|
| Rate for Payer: PHP Commercial |
$1.90
|
| Rate for Payer: PHP Commercial |
$2.86
|
| Rate for Payer: PHP Commercial |
$1.82
|
| Rate for Payer: PHP Commercial |
$3.72
|
| Rate for Payer: Priority Health SBD |
$1.35
|
| Rate for Payer: Priority Health SBD |
$2.12
|
| Rate for Payer: Priority Health SBD |
$1.40
|
| Rate for Payer: Priority Health SBD |
$2.76
|
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION
|
Facility
|
OP
|
$4.38
|
|
|
Service Code
|
HCPCS J7613
|
| Hospital Charge Code |
250
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$3.94 |
| Rate for Payer: Aetna Commercial |
$3.72
|
| Rate for Payer: Aetna Commercial |
$2.86
|
| Rate for Payer: Aetna Commercial |
$1.82
|
| Rate for Payer: Aetna Commercial |
$1.90
|
| Rate for Payer: Aetna Medicare |
$1.07
|
| Rate for Payer: Aetna Medicare |
$1.11
|
| Rate for Payer: Aetna Medicare |
$2.19
|
| Rate for Payer: Aetna Medicare |
$1.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.39
|
| Rate for Payer: BCBS Complete |
$1.75
|
| Rate for Payer: BCBS Complete |
$0.89
|
| Rate for Payer: BCBS Complete |
$1.35
|
| Rate for Payer: BCBS Complete |
$0.86
|
| Rate for Payer: BCBS Trust/PPO |
$0.17
|
| Rate for Payer: BCBS Trust/PPO |
$0.17
|
| Rate for Payer: BCBS Trust/PPO |
$0.17
|
| Rate for Payer: BCBS Trust/PPO |
$0.17
|
| Rate for Payer: BCN Commercial |
$0.17
|
| Rate for Payer: BCN Commercial |
$0.17
|
| Rate for Payer: BCN Commercial |
$0.17
|
| Rate for Payer: BCN Commercial |
$0.17
|
| Rate for Payer: Cash Price |
$1.78
|
| Rate for Payer: Cash Price |
$2.70
|
| Rate for Payer: Cash Price |
$1.71
|
| Rate for Payer: Cash Price |
$2.70
|
| Rate for Payer: Cash Price |
$1.71
|
| Rate for Payer: Cash Price |
$1.78
|
| Rate for Payer: Cash Price |
$3.50
|
| Rate for Payer: Cash Price |
$3.50
|
| Rate for Payer: Cofinity Advantage |
$1.50
|
| Rate for Payer: Cofinity Advantage |
$1.56
|
| Rate for Payer: Cofinity Advantage |
$3.07
|
| Rate for Payer: Cofinity Advantage |
$2.36
|
| Rate for Payer: Cofinity Commercial |
$1.84
|
| Rate for Payer: Cofinity Commercial |
$2.90
|
| Rate for Payer: Cofinity Commercial |
$1.92
|
| Rate for Payer: Cofinity Commercial |
$3.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.70
|
| Rate for Payer: Healthscope Commercial |
$1.93
|
| Rate for Payer: Healthscope Commercial |
$3.94
|
| Rate for Payer: Healthscope Commercial |
$3.03
|
| Rate for Payer: Healthscope Commercial |
$2.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.29
|
| Rate for Payer: PHP Commercial |
$3.72
|
| Rate for Payer: PHP Commercial |
$1.82
|
| Rate for Payer: PHP Commercial |
$2.86
|
| Rate for Payer: PHP Commercial |
$1.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.07
|
| Rate for Payer: Priority Health SBD |
$2.12
|
| Rate for Payer: Priority Health SBD |
$2.76
|
| Rate for Payer: Priority Health SBD |
$1.40
|
| Rate for Payer: Priority Health SBD |
$1.35
|
| Rate for Payer: Priority Health Tiered Network |
$0.06
|
| Rate for Payer: Priority Health Tiered Network |
$0.06
|
| Rate for Payer: Priority Health Tiered Network |
$0.06
|
| Rate for Payer: Priority Health Tiered Network |
$0.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.85
|
| Rate for Payer: UHC Core |
$1.16
|
| Rate for Payer: UHC Core |
$1.11
|
| Rate for Payer: UHC Core |
$2.28
|
| Rate for Payer: UHC Core |
$1.76
|
| Rate for Payer: UHC Exchange |
$1.32
|
| Rate for Payer: UHC Exchange |
$0.88
|
| Rate for Payer: UHC Exchange |
$1.72
|
| Rate for Payer: UHC Exchange |
$0.84
|
|
|
ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION
|
Facility
|
OP
|
$3.36
|
|
|
Service Code
|
HCPCS J7611
|
| Hospital Charge Code |
115221
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$3.02 |
| Rate for Payer: Aetna Commercial |
$2.86
|
| Rate for Payer: Aetna Medicare |
$1.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.18
|
| Rate for Payer: BCBS Complete |
$1.34
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: Cash Price |
$2.69
|
| Rate for Payer: Cash Price |
$2.69
|
| Rate for Payer: Cofinity Advantage |
$2.35
|
| Rate for Payer: Cofinity Commercial |
$2.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.69
|
| Rate for Payer: Healthscope Commercial |
$3.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.52
|
| Rate for Payer: PHP Commercial |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.26
|
| Rate for Payer: Priority Health SBD |
$2.12
|
| Rate for Payer: Priority Health Tiered Network |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.18
|
| Rate for Payer: UHC Core |
$1.75
|
| Rate for Payer: UHC Exchange |
$1.32
|
|
|
ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION
|
Facility
|
IP
|
$3.36
|
|
|
Service Code
|
HCPCS J7611
|
| Hospital Charge Code |
115221
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$3.02 |
| Rate for Payer: Aetna Commercial |
$2.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.18
|
| Rate for Payer: Cash Price |
$2.69
|
| Rate for Payer: Cofinity Advantage |
$2.35
|
| Rate for Payer: Cofinity Commercial |
$2.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.69
|
| Rate for Payer: Healthscope Commercial |
$3.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.52
|
| Rate for Payer: PHP Commercial |
$2.86
|
| Rate for Payer: Priority Health SBD |
$2.12
|
|
|
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION
|
Facility
|
IP
|
$37.00
|
|
|
Service Code
|
HCPCS J7611
|
| Hospital Charge Code |
251
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$23.31 |
| Max. Negotiated Rate |
$33.30 |
| Rate for Payer: Aetna Commercial |
$31.45
|
| Rate for Payer: Aetna Commercial |
$140.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.36
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$132.14
|
| Rate for Payer: Cofinity Advantage |
$115.62
|
| Rate for Payer: Cofinity Advantage |
$25.90
|
| Rate for Payer: Cofinity Commercial |
$142.05
|
| Rate for Payer: Cofinity Commercial |
$31.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.14
|
| Rate for Payer: Healthscope Commercial |
$148.65
|
| Rate for Payer: Healthscope Commercial |
$33.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
| Rate for Payer: PHP Commercial |
$31.45
|
| Rate for Payer: PHP Commercial |
$140.39
|
| Rate for Payer: Priority Health SBD |
$104.06
|
| Rate for Payer: Priority Health SBD |
$23.31
|
|
|
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION
|
Facility
|
OP
|
$165.17
|
|
|
Service Code
|
HCPCS J7611
|
| Hospital Charge Code |
251
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$148.65 |
| Rate for Payer: Aetna Commercial |
$140.39
|
| Rate for Payer: Aetna Commercial |
$31.45
|
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: Aetna Medicare |
$82.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.05
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS Complete |
$66.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: Cash Price |
$132.14
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$132.14
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Advantage |
$115.62
|
| Rate for Payer: Cofinity Advantage |
$25.90
|
| Rate for Payer: Cofinity Commercial |
$142.05
|
| Rate for Payer: Cofinity Commercial |
$31.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.14
|
| Rate for Payer: Healthscope Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$148.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
| Rate for Payer: PHP Commercial |
$140.39
|
| Rate for Payer: PHP Commercial |
$31.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.26
|
| Rate for Payer: Priority Health SBD |
$104.06
|
| Rate for Payer: Priority Health SBD |
$23.31
|
| Rate for Payer: Priority Health Tiered Network |
$0.21
|
| Rate for Payer: Priority Health Tiered Network |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.05
|
| Rate for Payer: UHC Core |
$86.05
|
| Rate for Payer: UHC Core |
$19.28
|
| Rate for Payer: UHC Exchange |
$64.91
|
| Rate for Payer: UHC Exchange |
$14.54
|
|
|
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$49.70
|
|
|
Service Code
|
NDC 00054074287
|
| Hospital Charge Code |
17837
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$19.53 |
| Max. Negotiated Rate |
$44.73 |
| Rate for Payer: Aetna Commercial |
$42.24
|
| Rate for Payer: Aetna Medicare |
$24.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.30
|
| Rate for Payer: BCBS Complete |
$19.88
|
| Rate for Payer: Cash Price |
$39.76
|
| Rate for Payer: Cofinity Advantage |
$34.79
|
| Rate for Payer: Cofinity Commercial |
$42.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.76
|
| Rate for Payer: Healthscope Commercial |
$44.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.27
|
| Rate for Payer: PHP Commercial |
$42.24
|
| Rate for Payer: Priority Health SBD |
$31.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.30
|
| Rate for Payer: UHC Core |
$25.89
|
| Rate for Payer: UHC Exchange |
$19.53
|
|
|
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$50.40
|
|
|
Service Code
|
NDC 69097014260
|
| Hospital Charge Code |
17837
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$19.81 |
| Max. Negotiated Rate |
$45.36 |
| Rate for Payer: Aetna Commercial |
$42.84
|
| Rate for Payer: Aetna Medicare |
$25.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.76
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: Cash Price |
$40.32
|
| Rate for Payer: Cofinity Advantage |
$35.28
|
| Rate for Payer: Cofinity Commercial |
$43.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.32
|
| Rate for Payer: Healthscope Commercial |
$45.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.80
|
| Rate for Payer: PHP Commercial |
$42.84
|
| Rate for Payer: Priority Health SBD |
$31.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.76
|
| Rate for Payer: UHC Core |
$26.26
|
| Rate for Payer: UHC Exchange |
$19.81
|
|
|
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$49.70
|
|
|
Service Code
|
NDC 00054074287
|
| Hospital Charge Code |
17837
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.31 |
| Max. Negotiated Rate |
$44.73 |
| Rate for Payer: Aetna Commercial |
$42.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.30
|
| Rate for Payer: Cash Price |
$39.76
|
| Rate for Payer: Cofinity Advantage |
$34.79
|
| Rate for Payer: Cofinity Commercial |
$42.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.76
|
| Rate for Payer: Healthscope Commercial |
$44.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.27
|
| Rate for Payer: PHP Commercial |
$42.24
|
| Rate for Payer: Priority Health SBD |
$31.31
|
|
|
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$50.40
|
|
|
Service Code
|
NDC 69097014260
|
| Hospital Charge Code |
17837
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.75 |
| Max. Negotiated Rate |
$45.36 |
| Rate for Payer: Aetna Commercial |
$42.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.76
|
| Rate for Payer: Cash Price |
$40.32
|
| Rate for Payer: Cofinity Advantage |
$35.28
|
| Rate for Payer: Cofinity Commercial |
$43.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.32
|
| Rate for Payer: Healthscope Commercial |
$45.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.80
|
| Rate for Payer: PHP Commercial |
$42.84
|
| Rate for Payer: Priority Health SBD |
$31.75
|
|
|
ALCOHOL ABUSE AND DEPENDENCE
|
Facility
|
IP
|
$3,946.02
|
|
|
Service Code
|
APR-DRG 7752
|
| Min. Negotiated Rate |
$3,758.12 |
| Max. Negotiated Rate |
$3,946.02 |
| Rate for Payer: BCBS Complete |
$3,946.02
|
| Rate for Payer: Mclaren Medicaid |
$3,758.12
|
| Rate for Payer: Meridian Medicaid |
$3,946.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,758.12
|
| Rate for Payer: UHC Medicaid |
$3,758.12
|
| Rate for Payer: UHCCP Medicaid |
$3,758.12
|
|
|
ALCOHOL ABUSE AND DEPENDENCE
|
Facility
|
IP
|
$13,150.93
|
|
|
Service Code
|
APR-DRG 7754
|
| Min. Negotiated Rate |
$12,524.69 |
| Max. Negotiated Rate |
$13,150.93 |
| Rate for Payer: BCBS Complete |
$13,150.93
|
| Rate for Payer: Mclaren Medicaid |
$12,524.69
|
| Rate for Payer: Meridian Medicaid |
$13,150.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,524.69
|
| Rate for Payer: UHC Medicaid |
$12,524.69
|
| Rate for Payer: UHCCP Medicaid |
$12,524.69
|
|
|
ALCOHOL ABUSE AND DEPENDENCE
|
Facility
|
IP
|
$3,221.95
|
|
|
Service Code
|
APR-DRG 7751
|
| Min. Negotiated Rate |
$3,068.52 |
| Max. Negotiated Rate |
$3,221.95 |
| Rate for Payer: BCBS Complete |
$3,221.95
|
| Rate for Payer: Mclaren Medicaid |
$3,068.52
|
| Rate for Payer: Meridian Medicaid |
$3,221.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,068.52
|
| Rate for Payer: UHC Medicaid |
$3,068.52
|
| Rate for Payer: UHCCP Medicaid |
$3,068.52
|
|
|
ALCOHOL ABUSE AND DEPENDENCE
|
Facility
|
IP
|
$6,510.97
|
|
|
Service Code
|
APR-DRG 7753
|
| Min. Negotiated Rate |
$6,200.92 |
| Max. Negotiated Rate |
$6,510.97 |
| Rate for Payer: BCBS Complete |
$6,510.97
|
| Rate for Payer: Mclaren Medicaid |
$6,200.92
|
| Rate for Payer: Meridian Medicaid |
$6,510.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,200.92
|
| Rate for Payer: UHC Medicaid |
$6,200.92
|
| Rate for Payer: UHCCP Medicaid |
$6,200.92
|
|
|
ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA
|
Facility
|
IP
|
$10,055.47
|
|
|
Service Code
|
MSDRG 894
|
| Min. Negotiated Rate |
$1,069.00 |
| Max. Negotiated Rate |
$10,055.47 |
| Rate for Payer: Aetna Medicare |
$5,560.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,683.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,683.19
|
| Rate for Payer: BCBS MAPPO |
$5,346.55
|
| Rate for Payer: BCBS Trust/PPO |
$9,197.00
|
| Rate for Payer: BCN Commercial |
$9,197.00
|
| Rate for Payer: BCN Medicare Advantage |
$5,346.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,346.55
|
| Rate for Payer: Mclaren Medicare |
$5,346.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,613.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,148.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,881.20
|
| Rate for Payer: Nomi Health Commercial |
$1,069.00
|
| Rate for Payer: PACE Medicare |
$5,079.22
|
| Rate for Payer: PACE SWMI |
$5,346.55
|
| Rate for Payer: PHP Medicare Advantage |
$5,346.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,945.75
|
| Rate for Payer: Priority Health Medicare |
$5,346.55
|
| Rate for Payer: Priority Health Tiered Network |
$7,956.60
|
| Rate for Payer: Railroad Medicare Medicare |
$5,346.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,055.47
|
| Rate for Payer: UHC Core |
$8,412.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,346.55
|
| Rate for Payer: UHC Exchange |
$6,870.42
|
| Rate for Payer: VA VA |
$5,346.55
|
|
|
ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC
|
Facility
|
IP
|
$28,445.13
|
|
|
Service Code
|
MSDRG 896
|
| Min. Negotiated Rate |
$1,069.00 |
| Max. Negotiated Rate |
$28,445.13 |
| Rate for Payer: Aetna Medicare |
$14,628.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,581.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,581.90
|
| Rate for Payer: BCBS MAPPO |
$14,065.52
|
| Rate for Payer: BCBS Trust/PPO |
$24,119.60
|
| Rate for Payer: BCN Commercial |
$24,119.60
|
| Rate for Payer: BCN Medicare Advantage |
$14,065.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,065.52
|
| Rate for Payer: Mclaren Medicare |
$14,065.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,768.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,175.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,472.07
|
| Rate for Payer: Nomi Health Commercial |
$1,069.00
|
| Rate for Payer: PACE Medicare |
$13,362.24
|
| Rate for Payer: PACE SWMI |
$14,065.52
|
| Rate for Payer: PHP Medicare Advantage |
$14,065.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$28,134.75
|
| Rate for Payer: Priority Health Medicare |
$14,065.52
|
| Rate for Payer: Priority Health Tiered Network |
$22,507.79
|
| Rate for Payer: Railroad Medicare Medicare |
$14,065.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,445.13
|
| Rate for Payer: UHC Core |
$23,797.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14,065.52
|
| Rate for Payer: UHC Exchange |
$19,435.18
|
| Rate for Payer: VA VA |
$14,065.52
|
|
|
ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC
|
Facility
|
IP
|
$14,389.64
|
|
|
Service Code
|
MSDRG 897
|
| Min. Negotiated Rate |
$1,069.00 |
| Max. Negotiated Rate |
$14,389.64 |
| Rate for Payer: Aetna Medicare |
$7,697.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,251.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,251.86
|
| Rate for Payer: BCBS MAPPO |
$7,401.49
|
| Rate for Payer: BCBS Trust/PPO |
$11,481.62
|
| Rate for Payer: BCN Commercial |
$11,481.62
|
| Rate for Payer: BCN Medicare Advantage |
$7,401.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,401.49
|
| Rate for Payer: Mclaren Medicare |
$7,401.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,771.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,511.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,141.64
|
| Rate for Payer: Nomi Health Commercial |
$1,069.00
|
| Rate for Payer: PACE Medicare |
$7,031.42
|
| Rate for Payer: PACE SWMI |
$7,401.49
|
| Rate for Payer: PHP Medicare Advantage |
$7,401.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14,232.63
|
| Rate for Payer: Priority Health Medicare |
$7,401.49
|
| Rate for Payer: Priority Health Tiered Network |
$11,386.10
|
| Rate for Payer: Railroad Medicare Medicare |
$7,401.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,389.64
|
| Rate for Payer: UHC Core |
$12,038.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,401.49
|
| Rate for Payer: UHC Exchange |
$9,831.74
|
| Rate for Payer: VA VA |
$7,401.49
|
|
|
ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY
|
Facility
|
IP
|
$23,074.28
|
|
|
Service Code
|
MSDRG 895
|
| Min. Negotiated Rate |
$1,069.00 |
| Max. Negotiated Rate |
$23,074.28 |
| Rate for Payer: Aetna Medicare |
$11,979.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,398.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,398.85
|
| Rate for Payer: BCBS MAPPO |
$11,519.08
|
| Rate for Payer: BCBS Trust/PPO |
$21,856.05
|
| Rate for Payer: BCN Commercial |
$21,856.05
|
| Rate for Payer: BCN Medicare Advantage |
$11,519.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,519.08
|
| Rate for Payer: Mclaren Medicare |
$11,519.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,095.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,246.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,670.99
|
| Rate for Payer: Nomi Health Commercial |
$1,069.00
|
| Rate for Payer: PACE Medicare |
$10,943.13
|
| Rate for Payer: PACE SWMI |
$11,519.08
|
| Rate for Payer: PHP Medicare Advantage |
$11,519.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22,822.50
|
| Rate for Payer: Priority Health Medicare |
$11,519.08
|
| Rate for Payer: Priority Health Tiered Network |
$18,258.00
|
| Rate for Payer: Railroad Medicare Medicare |
$11,519.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,074.28
|
| Rate for Payer: UHC Core |
$19,304.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,519.08
|
| Rate for Payer: UHC Exchange |
$15,765.54
|
| Rate for Payer: VA VA |
$11,519.08
|
|
|
ALCOHOLIC LIVER DISEASE
|
Facility
|
IP
|
$6,296.55
|
|
|
Service Code
|
APR-DRG 2803
|
| Min. Negotiated Rate |
$5,996.72 |
| Max. Negotiated Rate |
$6,296.55 |
| Rate for Payer: BCBS Complete |
$6,296.55
|
| Rate for Payer: Mclaren Medicaid |
$5,996.72
|
| Rate for Payer: Meridian Medicaid |
$6,296.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,996.72
|
| Rate for Payer: UHC Medicaid |
$5,996.72
|
| Rate for Payer: UHCCP Medicaid |
$5,996.72
|
|
|
ALCOHOLIC LIVER DISEASE
|
Facility
|
IP
|
$4,554.30
|
|
|
Service Code
|
APR-DRG 2802
|
| Min. Negotiated Rate |
$4,337.42 |
| Max. Negotiated Rate |
$4,554.30 |
| Rate for Payer: BCBS Complete |
$4,554.30
|
| Rate for Payer: Mclaren Medicaid |
$4,337.42
|
| Rate for Payer: Meridian Medicaid |
$4,554.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,337.42
|
| Rate for Payer: UHC Medicaid |
$4,337.42
|
| Rate for Payer: UHCCP Medicaid |
$4,337.42
|
|
|
ALCOHOLIC LIVER DISEASE
|
Facility
|
IP
|
$14,710.88
|
|
|
Service Code
|
APR-DRG 2804
|
| Min. Negotiated Rate |
$14,010.36 |
| Max. Negotiated Rate |
$14,710.88 |
| Rate for Payer: BCBS Complete |
$14,710.88
|
| Rate for Payer: Mclaren Medicaid |
$14,010.36
|
| Rate for Payer: Meridian Medicaid |
$14,710.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,010.36
|
| Rate for Payer: UHC Medicaid |
$14,010.36
|
| Rate for Payer: UHCCP Medicaid |
$14,010.36
|
|
