|
FEVER AND INFLAMMATORY CONDITIONS
|
Facility
|
IP
|
$10,900.73
|
|
|
Service Code
|
APR-DRG 7224
|
| Min. Negotiated Rate |
$10,381.64 |
| Max. Negotiated Rate |
$10,900.73 |
| Rate for Payer: BCBS Complete |
$10,900.73
|
| Rate for Payer: Mclaren Medicaid |
$10,381.64
|
| Rate for Payer: Meridian Medicaid |
$10,900.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,381.64
|
| Rate for Payer: UHC Medicaid |
$10,381.64
|
| Rate for Payer: UHCCP Medicaid |
$10,381.64
|
|
|
FEVER AND INFLAMMATORY CONDITIONS
|
Facility
|
IP
|
$3,184.68
|
|
|
Service Code
|
APR-DRG 7222
|
| Min. Negotiated Rate |
$3,033.03 |
| Max. Negotiated Rate |
$3,184.68 |
| Rate for Payer: BCBS Complete |
$3,184.68
|
| Rate for Payer: Mclaren Medicaid |
$3,033.03
|
| Rate for Payer: Meridian Medicaid |
$3,184.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,033.03
|
| Rate for Payer: UHC Medicaid |
$3,033.03
|
| Rate for Payer: UHCCP Medicaid |
$3,033.03
|
|
|
FEVER AND INFLAMMATORY CONDITIONS
|
Facility
|
IP
|
$2,634.31
|
|
|
Service Code
|
APR-DRG 7221
|
| Min. Negotiated Rate |
$2,508.87 |
| Max. Negotiated Rate |
$2,634.31 |
| Rate for Payer: BCBS Complete |
$2,634.31
|
| Rate for Payer: Mclaren Medicaid |
$2,508.87
|
| Rate for Payer: Meridian Medicaid |
$2,634.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,508.87
|
| Rate for Payer: UHC Medicaid |
$2,508.87
|
| Rate for Payer: UHCCP Medicaid |
$2,508.87
|
|
|
FEVER AND INFLAMMATORY CONDITIONS
|
Facility
|
IP
|
$14,469.51
|
|
|
Service Code
|
MSDRG 864
|
| Min. Negotiated Rate |
$7,067.37 |
| Max. Negotiated Rate |
$14,469.51 |
| Rate for Payer: Aetna Medicare |
$7,736.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,299.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,299.17
|
| Rate for Payer: BCBS MAPPO |
$7,439.34
|
| Rate for Payer: BCBS Trust/PPO |
$13,775.61
|
| Rate for Payer: BCN Commercial |
$13,775.61
|
| Rate for Payer: BCN Medicare Advantage |
$7,439.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,439.34
|
| Rate for Payer: Mclaren Medicare |
$7,439.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,811.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,555.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,183.27
|
| Rate for Payer: Nomi Health Commercial |
$11,451.33
|
| Rate for Payer: PACE Medicare |
$7,067.37
|
| Rate for Payer: PACE SWMI |
$7,439.34
|
| Rate for Payer: PHP Medicare Advantage |
$7,439.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14,311.62
|
| Rate for Payer: Priority Health Medicare |
$7,439.34
|
| Rate for Payer: Priority Health Tiered Network |
$11,449.30
|
| Rate for Payer: Railroad Medicare Medicare |
$7,439.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,469.51
|
| Rate for Payer: UHC Core |
$12,105.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,439.34
|
| Rate for Payer: UHC Exchange |
$9,886.31
|
| Rate for Payer: VA VA |
$7,439.34
|
|
|
FILGRASTIM-AAFI 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$485.96
|
|
|
Service Code
|
HCPCS Q5110
|
| Hospital Charge Code |
188114
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$306.15 |
| Max. Negotiated Rate |
$437.36 |
| Rate for Payer: Aetna Commercial |
$413.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.87
|
| Rate for Payer: Cash Price |
$388.77
|
| Rate for Payer: Cofinity Advantage |
$340.17
|
| Rate for Payer: Cofinity Commercial |
$417.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.77
|
| Rate for Payer: Healthscope Commercial |
$437.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$364.47
|
| Rate for Payer: PHP Commercial |
$413.07
|
| Rate for Payer: Priority Health SBD |
$306.15
|
|
|
FILGRASTIM-AAFI 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$485.96
|
|
|
Service Code
|
HCPCS Q5110
|
| Hospital Charge Code |
188114
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$437.36 |
| Rate for Payer: Aetna Commercial |
$413.07
|
| Rate for Payer: Aetna Medicare |
$0.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.35
|
| Rate for Payer: BCBS Complete |
$0.15
|
| Rate for Payer: BCBS MAPPO |
$0.28
|
| Rate for Payer: BCBS Trust/PPO |
$0.52
|
| Rate for Payer: BCN Commercial |
$0.52
|
| Rate for Payer: BCN Medicare Advantage |
$0.28
|
| Rate for Payer: Cash Price |
$388.77
|
| Rate for Payer: Cash Price |
$388.77
|
| Rate for Payer: Cofinity Advantage |
$340.17
|
| Rate for Payer: Cofinity Commercial |
$417.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.28
|
| Rate for Payer: Healthscope Commercial |
$437.36
|
| Rate for Payer: Mclaren Medicaid |
$0.15
|
| Rate for Payer: Mclaren Medicare |
$0.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.29
|
| Rate for Payer: Meridian Medicaid |
$0.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.07
|
| Rate for Payer: Nomi Health Commercial |
$0.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$364.47
|
| Rate for Payer: PACE Medicare |
$0.27
|
| Rate for Payer: PACE SWMI |
$0.28
|
| Rate for Payer: PHP Commercial |
$413.07
|
| Rate for Payer: PHP Medicare Advantage |
$0.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Medicare |
$0.28
|
| Rate for Payer: Priority Health SBD |
$306.15
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Railroad Medicare Medicare |
$0.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.46
|
| Rate for Payer: UHC Core |
$0.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.28
|
| Rate for Payer: UHC Exchange |
$0.46
|
| Rate for Payer: UHC Medicaid |
$0.15
|
| Rate for Payer: UHCCP Medicaid |
$0.15
|
| Rate for Payer: VA VA |
$0.28
|
|
|
FILGRASTIM-AAFI 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$777.53
|
|
|
Service Code
|
HCPCS Q5110
|
| Hospital Charge Code |
188115
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$489.84 |
| Max. Negotiated Rate |
$699.78 |
| Rate for Payer: Aetna Commercial |
$660.90
|
| Rate for Payer: Aetna Commercial |
$660.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.40
|
| Rate for Payer: Cash Price |
$622.02
|
| Rate for Payer: Cash Price |
$622.03
|
| Rate for Payer: Cofinity Advantage |
$544.27
|
| Rate for Payer: Cofinity Advantage |
$544.28
|
| Rate for Payer: Cofinity Commercial |
$668.68
|
| Rate for Payer: Cofinity Commercial |
$668.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.02
|
| Rate for Payer: Healthscope Commercial |
$699.79
|
| Rate for Payer: Healthscope Commercial |
$699.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$660.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$660.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$583.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$583.15
|
| Rate for Payer: PHP Commercial |
$660.90
|
| Rate for Payer: PHP Commercial |
$660.91
|
| Rate for Payer: Priority Health SBD |
$489.84
|
| Rate for Payer: Priority Health SBD |
$489.85
|
|
|
FILGRASTIM-AAFI 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$777.53
|
|
|
Service Code
|
HCPCS Q5110
|
| Hospital Charge Code |
188115
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$699.78 |
| Rate for Payer: Aetna Commercial |
$660.90
|
| Rate for Payer: Aetna Commercial |
$660.91
|
| Rate for Payer: Aetna Medicare |
$0.29
|
| Rate for Payer: Aetna Medicare |
$0.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.35
|
| Rate for Payer: BCBS Complete |
$0.15
|
| Rate for Payer: BCBS Complete |
$0.15
|
| Rate for Payer: BCBS MAPPO |
$0.28
|
| Rate for Payer: BCBS MAPPO |
$0.28
|
| Rate for Payer: BCBS Trust/PPO |
$0.52
|
| Rate for Payer: BCBS Trust/PPO |
$0.52
|
| Rate for Payer: BCN Commercial |
$0.52
|
| Rate for Payer: BCN Commercial |
$0.52
|
| Rate for Payer: BCN Medicare Advantage |
$0.28
|
| Rate for Payer: BCN Medicare Advantage |
$0.28
|
| Rate for Payer: Cash Price |
$622.02
|
| Rate for Payer: Cash Price |
$622.03
|
| Rate for Payer: Cash Price |
$622.03
|
| Rate for Payer: Cash Price |
$622.02
|
| Rate for Payer: Cofinity Advantage |
$544.28
|
| Rate for Payer: Cofinity Advantage |
$544.27
|
| Rate for Payer: Cofinity Commercial |
$668.68
|
| Rate for Payer: Cofinity Commercial |
$668.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.28
|
| Rate for Payer: Healthscope Commercial |
$699.78
|
| Rate for Payer: Healthscope Commercial |
$699.79
|
| Rate for Payer: Mclaren Medicaid |
$0.15
|
| Rate for Payer: Mclaren Medicaid |
$0.15
|
| Rate for Payer: Mclaren Medicare |
$0.28
|
| Rate for Payer: Mclaren Medicare |
$0.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.29
|
| Rate for Payer: Meridian Medicaid |
$0.29
|
| Rate for Payer: Meridian Medicaid |
$0.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$660.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$660.91
|
| Rate for Payer: Nomi Health Commercial |
$0.84
|
| Rate for Payer: Nomi Health Commercial |
$0.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$583.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$583.15
|
| Rate for Payer: PACE Medicare |
$0.27
|
| Rate for Payer: PACE Medicare |
$0.27
|
| Rate for Payer: PACE SWMI |
$0.28
|
| Rate for Payer: PACE SWMI |
$0.28
|
| Rate for Payer: PHP Commercial |
$660.91
|
| Rate for Payer: PHP Commercial |
$660.90
|
| Rate for Payer: PHP Medicare Advantage |
$0.28
|
| Rate for Payer: PHP Medicare Advantage |
$0.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Medicare |
$0.28
|
| Rate for Payer: Priority Health Medicare |
$0.28
|
| Rate for Payer: Priority Health SBD |
$489.85
|
| Rate for Payer: Priority Health SBD |
$489.84
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Railroad Medicare Medicare |
$0.28
|
| Rate for Payer: Railroad Medicare Medicare |
$0.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.46
|
| Rate for Payer: UHC Core |
$0.46
|
| Rate for Payer: UHC Core |
$0.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.28
|
| Rate for Payer: UHC Exchange |
$0.46
|
| Rate for Payer: UHC Exchange |
$0.46
|
| Rate for Payer: UHC Medicaid |
$0.15
|
| Rate for Payer: UHC Medicaid |
$0.15
|
| Rate for Payer: UHCCP Medicaid |
$0.15
|
| Rate for Payer: UHCCP Medicaid |
$0.15
|
| Rate for Payer: VA VA |
$0.28
|
| Rate for Payer: VA VA |
$0.28
|
|
|
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE
|
Facility
|
OP
|
$493.81
|
|
|
Service Code
|
HCPCS Q5101
|
| Hospital Charge Code |
175519
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$444.43 |
| Rate for Payer: Aetna Commercial |
$419.74
|
| Rate for Payer: Aetna Commercial |
$419.75
|
| Rate for Payer: Aetna Medicare |
$0.36
|
| Rate for Payer: Aetna Medicare |
$0.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.44
|
| Rate for Payer: BCBS Complete |
$0.19
|
| Rate for Payer: BCBS Complete |
$0.19
|
| Rate for Payer: BCBS MAPPO |
$0.35
|
| Rate for Payer: BCBS MAPPO |
$0.35
|
| Rate for Payer: BCBS Trust/PPO |
$0.71
|
| Rate for Payer: BCBS Trust/PPO |
$0.71
|
| Rate for Payer: BCN Commercial |
$0.71
|
| Rate for Payer: BCN Commercial |
$0.71
|
| Rate for Payer: BCN Medicare Advantage |
$0.35
|
| Rate for Payer: BCN Medicare Advantage |
$0.35
|
| Rate for Payer: Cash Price |
$395.05
|
| Rate for Payer: Cash Price |
$395.06
|
| Rate for Payer: Cash Price |
$395.06
|
| Rate for Payer: Cash Price |
$395.05
|
| Rate for Payer: Cofinity Advantage |
$345.67
|
| Rate for Payer: Cofinity Advantage |
$345.67
|
| Rate for Payer: Cofinity Commercial |
$424.69
|
| Rate for Payer: Cofinity Commercial |
$424.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.35
|
| Rate for Payer: Healthscope Commercial |
$444.43
|
| Rate for Payer: Healthscope Commercial |
$444.44
|
| Rate for Payer: Mclaren Medicaid |
$0.18
|
| Rate for Payer: Mclaren Medicaid |
$0.18
|
| Rate for Payer: Mclaren Medicare |
$0.35
|
| Rate for Payer: Mclaren Medicare |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.37
|
| Rate for Payer: Meridian Medicaid |
$0.37
|
| Rate for Payer: Meridian Medicaid |
$0.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.75
|
| Rate for Payer: Nomi Health Commercial |
$1.05
|
| Rate for Payer: Nomi Health Commercial |
$1.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.37
|
| Rate for Payer: PACE Medicare |
$0.33
|
| Rate for Payer: PACE Medicare |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.35
|
| Rate for Payer: PACE SWMI |
$0.35
|
| Rate for Payer: PHP Commercial |
$419.75
|
| Rate for Payer: PHP Commercial |
$419.74
|
| Rate for Payer: PHP Medicare Advantage |
$0.35
|
| Rate for Payer: PHP Medicare Advantage |
$0.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1.44
|
| Rate for Payer: Priority Health Medicare |
$0.35
|
| Rate for Payer: Priority Health Medicare |
$0.35
|
| Rate for Payer: Priority Health SBD |
$311.11
|
| Rate for Payer: Priority Health SBD |
$311.10
|
| Rate for Payer: Priority Health Tiered Network |
$1.15
|
| Rate for Payer: Priority Health Tiered Network |
$1.15
|
| Rate for Payer: Railroad Medicare Medicare |
$0.35
|
| Rate for Payer: Railroad Medicare Medicare |
$0.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.35
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UHC Medicaid |
$0.18
|
| Rate for Payer: UHC Medicaid |
$0.18
|
| Rate for Payer: UHCCP Medicaid |
$0.18
|
| Rate for Payer: UHCCP Medicaid |
$0.18
|
| Rate for Payer: VA VA |
$0.35
|
| Rate for Payer: VA VA |
$0.35
|
|
|
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE
|
Facility
|
IP
|
$493.81
|
|
|
Service Code
|
HCPCS Q5101
|
| Hospital Charge Code |
175519
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$311.10 |
| Max. Negotiated Rate |
$444.43 |
| Rate for Payer: Aetna Commercial |
$419.74
|
| Rate for Payer: Aetna Commercial |
$419.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.98
|
| Rate for Payer: Cash Price |
$395.05
|
| Rate for Payer: Cash Price |
$395.06
|
| Rate for Payer: Cofinity Advantage |
$345.67
|
| Rate for Payer: Cofinity Advantage |
$345.67
|
| Rate for Payer: Cofinity Commercial |
$424.68
|
| Rate for Payer: Cofinity Commercial |
$424.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.05
|
| Rate for Payer: Healthscope Commercial |
$444.44
|
| Rate for Payer: Healthscope Commercial |
$444.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.37
|
| Rate for Payer: PHP Commercial |
$419.74
|
| Rate for Payer: PHP Commercial |
$419.75
|
| Rate for Payer: Priority Health SBD |
$311.10
|
| Rate for Payer: Priority Health SBD |
$311.11
|
|
|
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE
|
Facility
|
IP
|
$790.09
|
|
|
Service Code
|
HCPCS Q5101
|
| Hospital Charge Code |
175518
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$497.76 |
| Max. Negotiated Rate |
$711.08 |
| Rate for Payer: Aetna Commercial |
$671.58
|
| Rate for Payer: Aetna Commercial |
$671.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.57
|
| Rate for Payer: Cash Price |
$632.07
|
| Rate for Payer: Cash Price |
$632.08
|
| Rate for Payer: Cofinity Advantage |
$553.06
|
| Rate for Payer: Cofinity Advantage |
$553.07
|
| Rate for Payer: Cofinity Commercial |
$679.48
|
| Rate for Payer: Cofinity Commercial |
$679.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.07
|
| Rate for Payer: Healthscope Commercial |
$711.09
|
| Rate for Payer: Healthscope Commercial |
$711.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$592.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$592.58
|
| Rate for Payer: PHP Commercial |
$671.58
|
| Rate for Payer: PHP Commercial |
$671.59
|
| Rate for Payer: Priority Health SBD |
$497.76
|
| Rate for Payer: Priority Health SBD |
$497.76
|
|
|
FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE
|
Facility
|
OP
|
$790.09
|
|
|
Service Code
|
HCPCS Q5101
|
| Hospital Charge Code |
175518
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$711.08 |
| Rate for Payer: Aetna Commercial |
$671.58
|
| Rate for Payer: Aetna Commercial |
$671.59
|
| Rate for Payer: Aetna Medicare |
$0.36
|
| Rate for Payer: Aetna Medicare |
$0.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.44
|
| Rate for Payer: BCBS Complete |
$0.19
|
| Rate for Payer: BCBS Complete |
$0.19
|
| Rate for Payer: BCBS MAPPO |
$0.35
|
| Rate for Payer: BCBS MAPPO |
$0.35
|
| Rate for Payer: BCBS Trust/PPO |
$0.71
|
| Rate for Payer: BCBS Trust/PPO |
$0.71
|
| Rate for Payer: BCN Commercial |
$0.71
|
| Rate for Payer: BCN Commercial |
$0.71
|
| Rate for Payer: BCN Medicare Advantage |
$0.35
|
| Rate for Payer: BCN Medicare Advantage |
$0.35
|
| Rate for Payer: Cash Price |
$632.07
|
| Rate for Payer: Cash Price |
$632.08
|
| Rate for Payer: Cash Price |
$632.08
|
| Rate for Payer: Cash Price |
$632.07
|
| Rate for Payer: Cofinity Advantage |
$553.07
|
| Rate for Payer: Cofinity Advantage |
$553.06
|
| Rate for Payer: Cofinity Commercial |
$679.49
|
| Rate for Payer: Cofinity Commercial |
$679.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.35
|
| Rate for Payer: Healthscope Commercial |
$711.08
|
| Rate for Payer: Healthscope Commercial |
$711.09
|
| Rate for Payer: Mclaren Medicaid |
$0.18
|
| Rate for Payer: Mclaren Medicaid |
$0.18
|
| Rate for Payer: Mclaren Medicare |
$0.35
|
| Rate for Payer: Mclaren Medicare |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.37
|
| Rate for Payer: Meridian Medicaid |
$0.37
|
| Rate for Payer: Meridian Medicaid |
$0.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.59
|
| Rate for Payer: Nomi Health Commercial |
$1.05
|
| Rate for Payer: Nomi Health Commercial |
$1.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$592.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$592.58
|
| Rate for Payer: PACE Medicare |
$0.33
|
| Rate for Payer: PACE Medicare |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.35
|
| Rate for Payer: PACE SWMI |
$0.35
|
| Rate for Payer: PHP Commercial |
$671.59
|
| Rate for Payer: PHP Commercial |
$671.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.35
|
| Rate for Payer: PHP Medicare Advantage |
$0.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1.44
|
| Rate for Payer: Priority Health Medicare |
$0.35
|
| Rate for Payer: Priority Health Medicare |
$0.35
|
| Rate for Payer: Priority Health SBD |
$497.76
|
| Rate for Payer: Priority Health SBD |
$497.76
|
| Rate for Payer: Priority Health Tiered Network |
$1.15
|
| Rate for Payer: Priority Health Tiered Network |
$1.15
|
| Rate for Payer: Railroad Medicare Medicare |
$0.35
|
| Rate for Payer: Railroad Medicare Medicare |
$0.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Core |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.35
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UHC Medicaid |
$0.18
|
| Rate for Payer: UHC Medicaid |
$0.18
|
| Rate for Payer: UHCCP Medicaid |
$0.18
|
| Rate for Payer: UHCCP Medicaid |
$0.18
|
| Rate for Payer: VA VA |
$0.35
|
| Rate for Payer: VA VA |
$0.35
|
|
|
FINASTERIDE 5 MG TABLET
|
Facility
|
OP
|
$257.28
|
|
|
Service Code
|
NDC 00904683061
|
| Hospital Charge Code |
10037
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$101.11 |
| Max. Negotiated Rate |
$231.55 |
| Rate for Payer: Aetna Commercial |
$218.69
|
| Rate for Payer: Aetna Medicare |
$128.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.23
|
| Rate for Payer: BCBS Complete |
$102.91
|
| Rate for Payer: Cash Price |
$205.82
|
| Rate for Payer: Cofinity Advantage |
$180.10
|
| Rate for Payer: Cofinity Commercial |
$221.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.82
|
| Rate for Payer: Healthscope Commercial |
$231.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$205.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.96
|
| Rate for Payer: PHP Commercial |
$218.69
|
| Rate for Payer: Priority Health SBD |
$162.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.23
|
| Rate for Payer: UHC Core |
$134.04
|
| Rate for Payer: UHC Exchange |
$101.11
|
|
|
FINASTERIDE 5 MG TABLET
|
Facility
|
IP
|
$148.05
|
|
|
Service Code
|
NDC 16729009001
|
| Hospital Charge Code |
10037
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$93.27 |
| Max. Negotiated Rate |
$133.25 |
| Rate for Payer: Aetna Commercial |
$125.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.23
|
| Rate for Payer: Cash Price |
$118.44
|
| Rate for Payer: Cofinity Advantage |
$103.64
|
| Rate for Payer: Cofinity Commercial |
$127.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.44
|
| Rate for Payer: Healthscope Commercial |
$133.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.04
|
| Rate for Payer: PHP Commercial |
$125.84
|
| Rate for Payer: Priority Health SBD |
$93.27
|
|
|
FINASTERIDE 5 MG TABLET
|
Facility
|
OP
|
$220.88
|
|
|
Service Code
|
NDC 50268031415
|
| Hospital Charge Code |
10037
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$86.81 |
| Max. Negotiated Rate |
$198.79 |
| Rate for Payer: Aetna Commercial |
$187.75
|
| Rate for Payer: Aetna Medicare |
$110.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.57
|
| Rate for Payer: BCBS Complete |
$88.35
|
| Rate for Payer: Cash Price |
$176.70
|
| Rate for Payer: Cofinity Advantage |
$154.62
|
| Rate for Payer: Cofinity Commercial |
$189.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.70
|
| Rate for Payer: Healthscope Commercial |
$198.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.66
|
| Rate for Payer: PHP Commercial |
$187.75
|
| Rate for Payer: Priority Health SBD |
$139.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.57
|
| Rate for Payer: UHC Core |
$115.08
|
| Rate for Payer: UHC Exchange |
$86.81
|
|
|
FINASTERIDE 5 MG TABLET
|
Facility
|
OP
|
$53.58
|
|
|
Service Code
|
NDC 16729009010
|
| Hospital Charge Code |
10037
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$21.06 |
| Max. Negotiated Rate |
$48.22 |
| Rate for Payer: Aetna Commercial |
$45.54
|
| Rate for Payer: Aetna Medicare |
$26.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.83
|
| Rate for Payer: BCBS Complete |
$21.43
|
| Rate for Payer: Cash Price |
$42.86
|
| Rate for Payer: Cofinity Advantage |
$37.51
|
| Rate for Payer: Cofinity Commercial |
$46.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.86
|
| Rate for Payer: Healthscope Commercial |
$48.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.19
|
| Rate for Payer: PHP Commercial |
$45.54
|
| Rate for Payer: Priority Health SBD |
$33.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.83
|
| Rate for Payer: UHC Core |
$27.92
|
| Rate for Payer: UHC Exchange |
$21.06
|
|
|
FINASTERIDE 5 MG TABLET
|
Facility
|
IP
|
$257.28
|
|
|
Service Code
|
NDC 00904683061
|
| Hospital Charge Code |
10037
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$162.09 |
| Max. Negotiated Rate |
$231.55 |
| Rate for Payer: Aetna Commercial |
$218.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.23
|
| Rate for Payer: Cash Price |
$205.82
|
| Rate for Payer: Cofinity Advantage |
$180.10
|
| Rate for Payer: Cofinity Commercial |
$221.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.82
|
| Rate for Payer: Healthscope Commercial |
$231.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.96
|
| Rate for Payer: PHP Commercial |
$218.69
|
| Rate for Payer: Priority Health SBD |
$162.09
|
|
|
FINASTERIDE 5 MG TABLET
|
Facility
|
IP
|
$4.42
|
|
|
Service Code
|
NDC 50268031411
|
| Hospital Charge Code |
10037
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$3.98 |
| Rate for Payer: Aetna Commercial |
$3.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.87
|
| Rate for Payer: Cash Price |
$3.54
|
| Rate for Payer: Cofinity Advantage |
$3.09
|
| Rate for Payer: Cofinity Commercial |
$3.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.54
|
| Rate for Payer: Healthscope Commercial |
$3.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.31
|
| Rate for Payer: PHP Commercial |
$3.76
|
| Rate for Payer: Priority Health SBD |
$2.78
|
|
|
FINASTERIDE 5 MG TABLET
|
Facility
|
OP
|
$200.45
|
|
|
Service Code
|
NDC 00904683006
|
| Hospital Charge Code |
10037
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$78.78 |
| Max. Negotiated Rate |
$180.41 |
| Rate for Payer: Aetna Commercial |
$170.38
|
| Rate for Payer: Aetna Medicare |
$100.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.29
|
| Rate for Payer: BCBS Complete |
$80.18
|
| Rate for Payer: Cash Price |
$160.36
|
| Rate for Payer: Cofinity Advantage |
$140.31
|
| Rate for Payer: Cofinity Commercial |
$172.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.36
|
| Rate for Payer: Healthscope Commercial |
$180.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$160.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.34
|
| Rate for Payer: PHP Commercial |
$170.38
|
| Rate for Payer: Priority Health SBD |
$126.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.29
|
| Rate for Payer: UHC Core |
$104.43
|
| Rate for Payer: UHC Exchange |
$78.78
|
|
|
FINASTERIDE 5 MG TABLET
|
Facility
|
IP
|
$220.88
|
|
|
Service Code
|
NDC 50268031415
|
| Hospital Charge Code |
10037
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$139.15 |
| Max. Negotiated Rate |
$198.79 |
| Rate for Payer: Aetna Commercial |
$187.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.57
|
| Rate for Payer: Cash Price |
$176.70
|
| Rate for Payer: Cofinity Advantage |
$154.62
|
| Rate for Payer: Cofinity Commercial |
$189.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.70
|
| Rate for Payer: Healthscope Commercial |
$198.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.66
|
| Rate for Payer: PHP Commercial |
$187.75
|
| Rate for Payer: Priority Health SBD |
$139.15
|
|
|
FINASTERIDE 5 MG TABLET
|
Facility
|
OP
|
$4.42
|
|
|
Service Code
|
NDC 50268031411
|
| Hospital Charge Code |
10037
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$3.98 |
| Rate for Payer: Aetna Commercial |
$3.76
|
| Rate for Payer: Aetna Medicare |
$2.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.87
|
| Rate for Payer: BCBS Complete |
$1.77
|
| Rate for Payer: Cash Price |
$3.54
|
| Rate for Payer: Cofinity Advantage |
$3.09
|
| Rate for Payer: Cofinity Commercial |
$3.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.54
|
| Rate for Payer: Healthscope Commercial |
$3.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.31
|
| Rate for Payer: PHP Commercial |
$3.76
|
| Rate for Payer: Priority Health SBD |
$2.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.87
|
| Rate for Payer: UHC Core |
$2.30
|
| Rate for Payer: UHC Exchange |
$1.74
|
|
|
FINASTERIDE 5 MG TABLET
|
Facility
|
OP
|
$148.05
|
|
|
Service Code
|
NDC 16729009001
|
| Hospital Charge Code |
10037
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$58.18 |
| Max. Negotiated Rate |
$133.25 |
| Rate for Payer: Aetna Commercial |
$125.84
|
| Rate for Payer: Aetna Medicare |
$74.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.23
|
| Rate for Payer: BCBS Complete |
$59.22
|
| Rate for Payer: Cash Price |
$118.44
|
| Rate for Payer: Cofinity Advantage |
$103.64
|
| Rate for Payer: Cofinity Commercial |
$127.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.44
|
| Rate for Payer: Healthscope Commercial |
$133.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.04
|
| Rate for Payer: PHP Commercial |
$125.84
|
| Rate for Payer: Priority Health SBD |
$93.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.23
|
| Rate for Payer: UHC Core |
$77.13
|
| Rate for Payer: UHC Exchange |
$58.18
|
|
|
FINASTERIDE 5 MG TABLET
|
Facility
|
IP
|
$200.45
|
|
|
Service Code
|
NDC 00904683006
|
| Hospital Charge Code |
10037
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$126.28 |
| Max. Negotiated Rate |
$180.41 |
| Rate for Payer: Aetna Commercial |
$170.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.29
|
| Rate for Payer: Cash Price |
$160.36
|
| Rate for Payer: Cofinity Advantage |
$140.31
|
| Rate for Payer: Cofinity Commercial |
$172.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.36
|
| Rate for Payer: Healthscope Commercial |
$180.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.34
|
| Rate for Payer: PHP Commercial |
$170.38
|
| Rate for Payer: Priority Health SBD |
$126.28
|
|
|
FINASTERIDE 5 MG TABLET
|
Facility
|
IP
|
$53.58
|
|
|
Service Code
|
NDC 16729009010
|
| Hospital Charge Code |
10037
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$33.76 |
| Max. Negotiated Rate |
$48.22 |
| Rate for Payer: Aetna Commercial |
$45.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.83
|
| Rate for Payer: Cash Price |
$42.86
|
| Rate for Payer: Cofinity Advantage |
$37.51
|
| Rate for Payer: Cofinity Commercial |
$46.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.86
|
| Rate for Payer: Healthscope Commercial |
$48.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.19
|
| Rate for Payer: PHP Commercial |
$45.54
|
| Rate for Payer: Priority Health SBD |
$33.76
|
|
|
FISSURECTOMY, INCLUDING SPHINCTEROTOMY, WHEN PERFORMED
|
Facility
|
OP
|
$8,943.95
|
|
|
Service Code
|
CPT 46200
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,446.45 |
| Max. Negotiated Rate |
$8,943.95 |
| Rate for Payer: Aetna Medicare |
$2,876.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,804.48
|
| Rate for Payer: BCN Commercial |
$1,804.48
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Mclaren Medicaid |
$1,446.45
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$2,903.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Nomi Health Commercial |
$8,297.04
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,943.95
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health Tiered Network |
$7,155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,765.68
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
