|
DARBEPOETIN ALFA 40 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE
|
Facility
|
IP
|
$964.99
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
76965
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$607.94 |
| Max. Negotiated Rate |
$868.49 |
| Rate for Payer: Aetna Commercial |
$820.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$627.24
|
| Rate for Payer: Cash Price |
$771.99
|
| Rate for Payer: Cofinity Advantage |
$675.49
|
| Rate for Payer: Cofinity Commercial |
$829.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.99
|
| Rate for Payer: Healthscope Commercial |
$868.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$820.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$723.74
|
| Rate for Payer: PHP Commercial |
$820.24
|
| Rate for Payer: Priority Health SBD |
$607.94
|
|
|
DARBEPOETIN ALFA 40 MCG/ML IN POLYSORBATE INJECTION
|
Facility
|
OP
|
$964.99
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
76963
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.61 |
| Max. Negotiated Rate |
$868.49 |
| Rate for Payer: Aetna Commercial |
$820.24
|
| Rate for Payer: Aetna Medicare |
$3.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$627.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.84
|
| Rate for Payer: BCBS Complete |
$1.69
|
| Rate for Payer: BCBS MAPPO |
$3.07
|
| Rate for Payer: BCBS Trust/PPO |
$7.44
|
| Rate for Payer: BCN Commercial |
$7.44
|
| Rate for Payer: BCN Medicare Advantage |
$3.07
|
| Rate for Payer: Cash Price |
$771.99
|
| Rate for Payer: Cash Price |
$771.99
|
| Rate for Payer: Cofinity Advantage |
$675.49
|
| Rate for Payer: Cofinity Commercial |
$829.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.07
|
| Rate for Payer: Healthscope Commercial |
$868.49
|
| Rate for Payer: Mclaren Medicaid |
$1.61
|
| Rate for Payer: Mclaren Medicare |
$3.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.22
|
| Rate for Payer: Meridian Medicaid |
$3.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$820.24
|
| Rate for Payer: Nomi Health Commercial |
$9.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$723.74
|
| Rate for Payer: PACE Medicare |
$2.92
|
| Rate for Payer: PACE SWMI |
$3.07
|
| Rate for Payer: PHP Commercial |
$820.24
|
| Rate for Payer: PHP Medicare Advantage |
$3.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.23
|
| Rate for Payer: Priority Health Medicare |
$3.07
|
| Rate for Payer: Priority Health SBD |
$607.94
|
| Rate for Payer: Priority Health Tiered Network |
$7.38
|
| Rate for Payer: Railroad Medicare Medicare |
$3.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.98
|
| Rate for Payer: UHC Core |
$4.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.07
|
| Rate for Payer: UHC Exchange |
$4.98
|
| Rate for Payer: UHC Medicaid |
$1.61
|
| Rate for Payer: UHCCP Medicaid |
$1.61
|
| Rate for Payer: VA VA |
$3.07
|
|
|
DARBEPOETIN ALFA 500 MCG/ML IN POLYSORBATE INJECTION SYRINGE
|
Facility
|
OP
|
$9,800.65
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
76334
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.61 |
| Max. Negotiated Rate |
$8,820.58 |
| Rate for Payer: Aetna Commercial |
$8,330.55
|
| Rate for Payer: Aetna Medicare |
$3.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,370.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.84
|
| Rate for Payer: BCBS Complete |
$1.69
|
| Rate for Payer: BCBS MAPPO |
$3.07
|
| Rate for Payer: BCBS Trust/PPO |
$7.44
|
| Rate for Payer: BCN Commercial |
$7.44
|
| Rate for Payer: BCN Medicare Advantage |
$3.07
|
| Rate for Payer: Cash Price |
$7,840.52
|
| Rate for Payer: Cash Price |
$7,840.52
|
| Rate for Payer: Cofinity Advantage |
$6,860.45
|
| Rate for Payer: Cofinity Commercial |
$8,428.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,840.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.07
|
| Rate for Payer: Healthscope Commercial |
$8,820.58
|
| Rate for Payer: Mclaren Medicaid |
$1.61
|
| Rate for Payer: Mclaren Medicare |
$3.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.22
|
| Rate for Payer: Meridian Medicaid |
$3.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,330.55
|
| Rate for Payer: Nomi Health Commercial |
$9.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,350.49
|
| Rate for Payer: PACE Medicare |
$2.92
|
| Rate for Payer: PACE SWMI |
$3.07
|
| Rate for Payer: PHP Commercial |
$8,330.55
|
| Rate for Payer: PHP Medicare Advantage |
$3.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.23
|
| Rate for Payer: Priority Health Medicare |
$3.07
|
| Rate for Payer: Priority Health SBD |
$6,174.41
|
| Rate for Payer: Priority Health Tiered Network |
$7.38
|
| Rate for Payer: Railroad Medicare Medicare |
$3.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.98
|
| Rate for Payer: UHC Core |
$4.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.07
|
| Rate for Payer: UHC Exchange |
$4.98
|
| Rate for Payer: UHC Medicaid |
$1.61
|
| Rate for Payer: UHCCP Medicaid |
$1.61
|
| Rate for Payer: VA VA |
$3.07
|
|
|
DARBEPOETIN ALFA 500 MCG/ML IN POLYSORBATE INJECTION SYRINGE
|
Facility
|
IP
|
$9,800.65
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
76334
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6,174.41 |
| Max. Negotiated Rate |
$8,820.58 |
| Rate for Payer: Aetna Commercial |
$8,330.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,370.42
|
| Rate for Payer: Cash Price |
$7,840.52
|
| Rate for Payer: Cofinity Advantage |
$6,860.45
|
| Rate for Payer: Cofinity Commercial |
$8,428.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,840.52
|
| Rate for Payer: Healthscope Commercial |
$8,820.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,330.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,350.49
|
| Rate for Payer: PHP Commercial |
$8,330.55
|
| Rate for Payer: Priority Health SBD |
$6,174.41
|
|
|
DARBEPOETIN ALFA 60 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE
|
Facility
|
IP
|
$1,447.49
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
76966
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$911.92 |
| Max. Negotiated Rate |
$1,302.74 |
| Rate for Payer: Aetna Commercial |
$1,230.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$940.87
|
| Rate for Payer: Cash Price |
$1,157.99
|
| Rate for Payer: Cofinity Advantage |
$1,013.24
|
| Rate for Payer: Cofinity Commercial |
$1,244.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,157.99
|
| Rate for Payer: Healthscope Commercial |
$1,302.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,230.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,085.62
|
| Rate for Payer: PHP Commercial |
$1,230.37
|
| Rate for Payer: Priority Health SBD |
$911.92
|
|
|
DARBEPOETIN ALFA 60 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE
|
Facility
|
OP
|
$1,447.49
|
|
|
Service Code
|
HCPCS J0881
|
| Hospital Charge Code |
76966
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.61 |
| Max. Negotiated Rate |
$1,302.74 |
| Rate for Payer: Aetna Commercial |
$1,230.37
|
| Rate for Payer: Aetna Medicare |
$3.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$940.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.84
|
| Rate for Payer: BCBS Complete |
$1.69
|
| Rate for Payer: BCBS MAPPO |
$3.07
|
| Rate for Payer: BCBS Trust/PPO |
$7.44
|
| Rate for Payer: BCN Commercial |
$7.44
|
| Rate for Payer: BCN Medicare Advantage |
$3.07
|
| Rate for Payer: Cash Price |
$1,157.99
|
| Rate for Payer: Cash Price |
$1,157.99
|
| Rate for Payer: Cofinity Advantage |
$1,013.24
|
| Rate for Payer: Cofinity Commercial |
$1,244.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,157.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.07
|
| Rate for Payer: Healthscope Commercial |
$1,302.74
|
| Rate for Payer: Mclaren Medicaid |
$1.61
|
| Rate for Payer: Mclaren Medicare |
$3.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.22
|
| Rate for Payer: Meridian Medicaid |
$3.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,230.37
|
| Rate for Payer: Nomi Health Commercial |
$9.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,085.62
|
| Rate for Payer: PACE Medicare |
$2.92
|
| Rate for Payer: PACE SWMI |
$3.07
|
| Rate for Payer: PHP Commercial |
$1,230.37
|
| Rate for Payer: PHP Medicare Advantage |
$3.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.23
|
| Rate for Payer: Priority Health Medicare |
$3.07
|
| Rate for Payer: Priority Health SBD |
$911.92
|
| Rate for Payer: Priority Health Tiered Network |
$7.38
|
| Rate for Payer: Railroad Medicare Medicare |
$3.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.98
|
| Rate for Payer: UHC Core |
$4.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.07
|
| Rate for Payer: UHC Exchange |
$4.98
|
| Rate for Payer: UHC Medicaid |
$1.61
|
| Rate for Payer: UHCCP Medicaid |
$1.61
|
| Rate for Payer: VA VA |
$3.07
|
|
|
DARUNAVIR 800 MG-COBICISTAT 150 MG TABLET
|
Facility
|
IP
|
$8,898.65
|
|
|
Service Code
|
NDC 59676057530
|
| Hospital Charge Code |
173955
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5,606.15 |
| Max. Negotiated Rate |
$8,008.78 |
| Rate for Payer: Aetna Commercial |
$7,563.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,784.12
|
| Rate for Payer: Cash Price |
$7,118.92
|
| Rate for Payer: Cofinity Advantage |
$6,229.06
|
| Rate for Payer: Cofinity Commercial |
$7,652.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,118.92
|
| Rate for Payer: Healthscope Commercial |
$8,008.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,563.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,673.99
|
| Rate for Payer: PHP Commercial |
$7,563.85
|
| Rate for Payer: Priority Health SBD |
$5,606.15
|
|
|
DARUNAVIR 800 MG-COBICISTAT 150 MG TABLET
|
Facility
|
OP
|
$8,898.65
|
|
|
Service Code
|
NDC 59676057530
|
| Hospital Charge Code |
173955
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3,497.17 |
| Max. Negotiated Rate |
$8,008.78 |
| Rate for Payer: Aetna Commercial |
$7,563.85
|
| Rate for Payer: Aetna Medicare |
$4,449.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,784.12
|
| Rate for Payer: BCBS Complete |
$3,559.46
|
| Rate for Payer: Cash Price |
$7,118.92
|
| Rate for Payer: Cofinity Advantage |
$6,229.06
|
| Rate for Payer: Cofinity Commercial |
$7,652.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,118.92
|
| Rate for Payer: Healthscope Commercial |
$8,008.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,118.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,563.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,673.99
|
| Rate for Payer: PHP Commercial |
$7,563.85
|
| Rate for Payer: Priority Health SBD |
$5,606.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,784.12
|
| Rate for Payer: UHC Core |
$4,636.20
|
| Rate for Payer: UHC Exchange |
$3,497.17
|
|
|
DARUNAVIR 800 MG TABLET
|
Facility
|
OP
|
$34.05
|
|
|
Service Code
|
NDC 60687081911
|
| Hospital Charge Code |
163784
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.38 |
| Max. Negotiated Rate |
$30.64 |
| Rate for Payer: Aetna Commercial |
$28.94
|
| Rate for Payer: Aetna Medicare |
$17.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.13
|
| Rate for Payer: BCBS Complete |
$13.62
|
| Rate for Payer: Cash Price |
$27.24
|
| Rate for Payer: Cofinity Advantage |
$23.84
|
| Rate for Payer: Cofinity Commercial |
$29.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.24
|
| Rate for Payer: Healthscope Commercial |
$30.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.54
|
| Rate for Payer: PHP Commercial |
$28.94
|
| Rate for Payer: Priority Health SBD |
$21.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.13
|
| Rate for Payer: UHC Core |
$17.74
|
| Rate for Payer: UHC Exchange |
$13.38
|
|
|
DARUNAVIR 800 MG TABLET
|
Facility
|
IP
|
$1,021.43
|
|
|
Service Code
|
NDC 60687081921
|
| Hospital Charge Code |
163784
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$643.50 |
| Max. Negotiated Rate |
$919.29 |
| Rate for Payer: Aetna Commercial |
$868.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.93
|
| Rate for Payer: Cash Price |
$817.14
|
| Rate for Payer: Cofinity Advantage |
$715.00
|
| Rate for Payer: Cofinity Commercial |
$878.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.14
|
| Rate for Payer: Healthscope Commercial |
$919.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$766.07
|
| Rate for Payer: PHP Commercial |
$868.22
|
| Rate for Payer: Priority Health SBD |
$643.50
|
|
|
DARUNAVIR 800 MG TABLET
|
Facility
|
OP
|
$1,021.43
|
|
|
Service Code
|
NDC 60687081921
|
| Hospital Charge Code |
163784
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$401.42 |
| Max. Negotiated Rate |
$919.29 |
| Rate for Payer: Aetna Commercial |
$868.22
|
| Rate for Payer: Aetna Medicare |
$510.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.93
|
| Rate for Payer: BCBS Complete |
$408.57
|
| Rate for Payer: Cash Price |
$817.14
|
| Rate for Payer: Cofinity Advantage |
$715.00
|
| Rate for Payer: Cofinity Commercial |
$878.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.14
|
| Rate for Payer: Healthscope Commercial |
$919.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$817.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$766.07
|
| Rate for Payer: PHP Commercial |
$868.22
|
| Rate for Payer: Priority Health SBD |
$643.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.93
|
| Rate for Payer: UHC Core |
$532.17
|
| Rate for Payer: UHC Exchange |
$401.42
|
|
|
DARUNAVIR 800 MG TABLET
|
Facility
|
IP
|
$34.05
|
|
|
Service Code
|
NDC 60687081911
|
| Hospital Charge Code |
163784
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$21.45 |
| Max. Negotiated Rate |
$30.64 |
| Rate for Payer: Aetna Commercial |
$28.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.13
|
| Rate for Payer: Cash Price |
$27.24
|
| Rate for Payer: Cofinity Advantage |
$23.84
|
| Rate for Payer: Cofinity Commercial |
$29.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.24
|
| Rate for Payer: Healthscope Commercial |
$30.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.54
|
| Rate for Payer: PHP Commercial |
$28.94
|
| Rate for Payer: Priority Health SBD |
$21.45
|
|
|
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$1,153.96
|
|
|
Service Code
|
HCPCS J9150
|
| Hospital Charge Code |
22661
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$726.99 |
| Max. Negotiated Rate |
$1,038.56 |
| Rate for Payer: Aetna Commercial |
$980.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$750.07
|
| Rate for Payer: Cash Price |
$923.17
|
| Rate for Payer: Cofinity Advantage |
$807.77
|
| Rate for Payer: Cofinity Commercial |
$992.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$923.17
|
| Rate for Payer: Healthscope Commercial |
$1,038.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$980.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$865.47
|
| Rate for Payer: PHP Commercial |
$980.87
|
| Rate for Payer: Priority Health SBD |
$726.99
|
|
|
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$1,153.96
|
|
|
Service Code
|
HCPCS J9150
|
| Hospital Charge Code |
22661
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$66.04 |
| Max. Negotiated Rate |
$1,038.56 |
| Rate for Payer: Aetna Commercial |
$980.87
|
| Rate for Payer: Aetna Medicare |
$576.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$750.07
|
| Rate for Payer: BCBS Complete |
$461.58
|
| Rate for Payer: BCBS Trust/PPO |
$66.04
|
| Rate for Payer: BCN Commercial |
$66.04
|
| Rate for Payer: Cash Price |
$923.17
|
| Rate for Payer: Cash Price |
$923.17
|
| Rate for Payer: Cofinity Advantage |
$807.77
|
| Rate for Payer: Cofinity Commercial |
$992.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$923.17
|
| Rate for Payer: Healthscope Commercial |
$1,038.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$923.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$980.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$865.47
|
| Rate for Payer: PHP Commercial |
$980.87
|
| Rate for Payer: Priority Health SBD |
$726.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$750.07
|
| Rate for Payer: UHC Core |
$601.21
|
| Rate for Payer: UHC Exchange |
$453.51
|
|
|
D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC
|
Facility
|
IP
|
$33,400.33
|
|
|
Service Code
|
MSDRG 744
|
| Min. Negotiated Rate |
$15,594.16 |
| Max. Negotiated Rate |
$33,400.33 |
| Rate for Payer: Aetna Medicare |
$17,071.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,518.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,518.64
|
| Rate for Payer: BCBS MAPPO |
$16,414.91
|
| Rate for Payer: BCBS Trust/PPO |
$30,144.82
|
| Rate for Payer: BCN Commercial |
$30,144.82
|
| Rate for Payer: BCN Medicare Advantage |
$16,414.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,414.91
|
| Rate for Payer: Mclaren Medicare |
$16,414.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,235.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,877.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$18,056.40
|
| Rate for Payer: Nomi Health Commercial |
$26,433.39
|
| Rate for Payer: PACE Medicare |
$15,594.16
|
| Rate for Payer: PACE SWMI |
$16,414.91
|
| Rate for Payer: PHP Medicare Advantage |
$16,414.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$33,035.88
|
| Rate for Payer: Priority Health Medicare |
$16,414.91
|
| Rate for Payer: Priority Health Tiered Network |
$26,428.70
|
| Rate for Payer: Railroad Medicare Medicare |
$16,414.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33,400.33
|
| Rate for Payer: UHC Core |
$27,943.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16,414.91
|
| Rate for Payer: UHC Exchange |
$22,820.83
|
| Rate for Payer: VA VA |
$16,414.91
|
|
|
D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC
|
Facility
|
IP
|
$24,058.74
|
|
|
Service Code
|
MSDRG 745
|
| Min. Negotiated Rate |
$8,901.36 |
| Max. Negotiated Rate |
$24,058.74 |
| Rate for Payer: Aetna Medicare |
$9,744.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,712.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,712.31
|
| Rate for Payer: BCBS MAPPO |
$9,369.85
|
| Rate for Payer: BCBS Trust/PPO |
$24,058.74
|
| Rate for Payer: BCN Commercial |
$24,058.74
|
| Rate for Payer: BCN Medicare Advantage |
$9,369.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,369.85
|
| Rate for Payer: Mclaren Medicare |
$9,369.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,838.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,775.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$10,306.83
|
| Rate for Payer: Nomi Health Commercial |
$14,673.75
|
| Rate for Payer: PACE Medicare |
$8,901.36
|
| Rate for Payer: PACE SWMI |
$9,369.85
|
| Rate for Payer: PHP Medicare Advantage |
$9,369.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18,338.93
|
| Rate for Payer: Priority Health Medicare |
$9,369.85
|
| Rate for Payer: Priority Health Tiered Network |
$14,671.15
|
| Rate for Payer: Railroad Medicare Medicare |
$9,369.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,541.25
|
| Rate for Payer: UHC Core |
$15,512.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9,369.85
|
| Rate for Payer: UHC Exchange |
$12,668.34
|
| Rate for Payer: VA VA |
$9,369.85
|
|
|
DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASCIA, IF PERFORMED); FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$5,321.93
|
|
|
Service Code
|
CPT 11044
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,065.14
|
| Rate for Payer: BCN Commercial |
$1,065.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
DEBRIDEMENT (EG, HIGH PRESSURE WATERJET WITH/WITHOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT WITH SCISSORS, SCALPEL AND FORCEPS), OPEN WOUND, (EG, FIBRIN, DEVITALIZED EPIDERMIS AND/OR DERMIS, EXUDATE, DEBRIS, BIOFILM), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, USE OF A WHIRLPOOL, WHEN PERFORMED AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION, TOTAL WOUND(S) SURFACE AREA; FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$646.50
|
|
|
Service Code
|
CPT 97597
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$121.98
|
| Rate for Payer: BCN Commercial |
$121.98
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Mclaren Medicaid |
$104.55
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
DEBRIDEMENT, MASTOIDECTOMY CAVITY, SIMPLE (EG, ROUTINE CLEANING)
|
Facility
|
OP
|
$646.50
|
|
|
Service Code
|
CPT 69220
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$77.68 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$77.68
|
| Rate for Payer: BCN Commercial |
$77.68
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Mclaren Medicaid |
$104.55
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
|
DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$194.12
|
|
|
Service Code
|
CPT 11046
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$194.12 |
| Max. Negotiated Rate |
$194.12 |
| Rate for Payer: BCBS Trust/PPO |
$194.12
|
| Rate for Payer: BCN Commercial |
$194.12
|
|
|
DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$2,381.49
|
|
|
Service Code
|
CPT 11043
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$385.14 |
| Max. Negotiated Rate |
$2,381.49 |
| Rate for Payer: Aetna Medicare |
$765.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$920.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$920.51
|
| Rate for Payer: BCBS Complete |
$404.44
|
| Rate for Payer: BCBS MAPPO |
$736.41
|
| Rate for Payer: BCBS Trust/PPO |
$551.04
|
| Rate for Payer: BCN Commercial |
$551.04
|
| Rate for Payer: BCN Medicare Advantage |
$736.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.41
|
| Rate for Payer: Mclaren Medicaid |
$385.14
|
| Rate for Payer: Mclaren Medicare |
$736.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.23
|
| Rate for Payer: Meridian Medicaid |
$773.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$846.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$810.05
|
| Rate for Payer: Nomi Health Commercial |
$2,209.23
|
| Rate for Payer: PACE Medicare |
$699.59
|
| Rate for Payer: PACE SWMI |
$736.41
|
| Rate for Payer: PHP Medicare Advantage |
$736.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,381.49
|
| Rate for Payer: Priority Health Medicare |
$736.41
|
| Rate for Payer: Priority Health Tiered Network |
$1,905.19
|
| Rate for Payer: Railroad Medicare Medicare |
$736.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$736.41
|
| Rate for Payer: UHC Medicaid |
$385.14
|
| Rate for Payer: UHCCP Medicaid |
$385.14
|
| Rate for Payer: VA VA |
$736.41
|
|
|
DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$107.75
|
|
|
Service Code
|
CPT 11045
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$107.75 |
| Max. Negotiated Rate |
$107.75 |
| Rate for Payer: BCBS Trust/PPO |
$107.75
|
| Rate for Payer: BCN Commercial |
$107.75
|
|
|
DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$1,309.90
|
|
|
Service Code
|
CPT 11042
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$236.23
|
| Rate for Payer: BCN Commercial |
$236.23
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Mclaren Medicaid |
$211.84
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
DECITABINE 50 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$317.55
|
|
|
Service Code
|
HCPCS J0894
|
| Hospital Charge Code |
76364
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$200.06 |
| Max. Negotiated Rate |
$285.80 |
| Rate for Payer: Aetna Commercial |
$269.92
|
| Rate for Payer: Aetna Commercial |
$844.83
|
| Rate for Payer: Aetna Commercial |
$471.12
|
| Rate for Payer: Aetna Commercial |
$392.33
|
| Rate for Payer: Aetna Commercial |
$316.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.41
|
| Rate for Payer: Cash Price |
$795.14
|
| Rate for Payer: Cash Price |
$443.41
|
| Rate for Payer: Cash Price |
$254.04
|
| Rate for Payer: Cash Price |
$297.42
|
| Rate for Payer: Cash Price |
$369.25
|
| Rate for Payer: Cofinity Advantage |
$387.98
|
| Rate for Payer: Cofinity Advantage |
$222.28
|
| Rate for Payer: Cofinity Advantage |
$323.09
|
| Rate for Payer: Cofinity Advantage |
$695.74
|
| Rate for Payer: Cofinity Advantage |
$260.24
|
| Rate for Payer: Cofinity Commercial |
$319.72
|
| Rate for Payer: Cofinity Commercial |
$854.77
|
| Rate for Payer: Cofinity Commercial |
$396.94
|
| Rate for Payer: Cofinity Commercial |
$273.09
|
| Rate for Payer: Cofinity Commercial |
$476.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.14
|
| Rate for Payer: Healthscope Commercial |
$498.83
|
| Rate for Payer: Healthscope Commercial |
$334.59
|
| Rate for Payer: Healthscope Commercial |
$415.40
|
| Rate for Payer: Healthscope Commercial |
$285.80
|
| Rate for Payer: Healthscope Commercial |
$894.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$844.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$471.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$238.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$278.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$745.44
|
| Rate for Payer: PHP Commercial |
$471.12
|
| Rate for Payer: PHP Commercial |
$269.92
|
| Rate for Payer: PHP Commercial |
$392.33
|
| Rate for Payer: PHP Commercial |
$316.00
|
| Rate for Payer: PHP Commercial |
$844.83
|
| Rate for Payer: Priority Health SBD |
$626.17
|
| Rate for Payer: Priority Health SBD |
$290.78
|
| Rate for Payer: Priority Health SBD |
$200.06
|
| Rate for Payer: Priority Health SBD |
$234.22
|
| Rate for Payer: Priority Health SBD |
$349.18
|
|
|
DECITABINE 50 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$993.92
|
|
|
Service Code
|
HCPCS J0894
|
| Hospital Charge Code |
76364
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$894.53 |
| Rate for Payer: Aetna Commercial |
$844.83
|
| Rate for Payer: Aetna Commercial |
$392.33
|
| Rate for Payer: Aetna Commercial |
$316.00
|
| Rate for Payer: Aetna Commercial |
$471.12
|
| Rate for Payer: Aetna Commercial |
$269.92
|
| Rate for Payer: Aetna Medicare |
$158.78
|
| Rate for Payer: Aetna Medicare |
$185.88
|
| Rate for Payer: Aetna Medicare |
$230.78
|
| Rate for Payer: Aetna Medicare |
$496.96
|
| Rate for Payer: Aetna Medicare |
$277.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.41
|
| Rate for Payer: BCBS Complete |
$397.57
|
| Rate for Payer: BCBS Complete |
$148.71
|
| Rate for Payer: BCBS Complete |
$184.62
|
| Rate for Payer: BCBS Complete |
$127.02
|
| Rate for Payer: BCBS Complete |
$221.70
|
| Rate for Payer: BCBS Trust/PPO |
$1.63
|
| Rate for Payer: BCBS Trust/PPO |
$1.63
|
| Rate for Payer: BCBS Trust/PPO |
$1.63
|
| Rate for Payer: BCBS Trust/PPO |
$1.63
|
| Rate for Payer: BCBS Trust/PPO |
$1.63
|
| Rate for Payer: BCN Commercial |
$1.63
|
| Rate for Payer: BCN Commercial |
$1.63
|
| Rate for Payer: BCN Commercial |
$1.63
|
| Rate for Payer: BCN Commercial |
$1.63
|
| Rate for Payer: BCN Commercial |
$1.63
|
| Rate for Payer: Cash Price |
$443.41
|
| Rate for Payer: Cash Price |
$297.42
|
| Rate for Payer: Cash Price |
$254.04
|
| Rate for Payer: Cash Price |
$254.04
|
| Rate for Payer: Cash Price |
$369.25
|
| Rate for Payer: Cash Price |
$297.42
|
| Rate for Payer: Cash Price |
$369.25
|
| Rate for Payer: Cash Price |
$443.41
|
| Rate for Payer: Cash Price |
$795.14
|
| Rate for Payer: Cash Price |
$795.14
|
| Rate for Payer: Cofinity Advantage |
$695.74
|
| Rate for Payer: Cofinity Advantage |
$387.98
|
| Rate for Payer: Cofinity Advantage |
$260.24
|
| Rate for Payer: Cofinity Advantage |
$222.28
|
| Rate for Payer: Cofinity Advantage |
$323.09
|
| Rate for Payer: Cofinity Commercial |
$396.94
|
| Rate for Payer: Cofinity Commercial |
$319.72
|
| Rate for Payer: Cofinity Commercial |
$476.66
|
| Rate for Payer: Cofinity Commercial |
$854.77
|
| Rate for Payer: Cofinity Commercial |
$273.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.42
|
| Rate for Payer: Healthscope Commercial |
$334.59
|
| Rate for Payer: Healthscope Commercial |
$894.53
|
| Rate for Payer: Healthscope Commercial |
$498.83
|
| Rate for Payer: Healthscope Commercial |
$415.40
|
| Rate for Payer: Healthscope Commercial |
$285.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$443.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$369.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$795.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$844.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$471.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$745.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$278.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$238.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.69
|
| Rate for Payer: PHP Commercial |
$392.33
|
| Rate for Payer: PHP Commercial |
$316.00
|
| Rate for Payer: PHP Commercial |
$269.92
|
| Rate for Payer: PHP Commercial |
$844.83
|
| Rate for Payer: PHP Commercial |
$471.12
|
| Rate for Payer: Priority Health SBD |
$290.78
|
| Rate for Payer: Priority Health SBD |
$349.18
|
| Rate for Payer: Priority Health SBD |
$626.17
|
| Rate for Payer: Priority Health SBD |
$234.22
|
| Rate for Payer: Priority Health SBD |
$200.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
|
