|
HALOPERIDOL 2 MG TABLET
|
Facility
|
OP
|
$266.40
|
|
|
Service Code
|
NDC 51079073520
|
| Hospital Charge Code |
3581
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$104.70 |
| Max. Negotiated Rate |
$239.76 |
| Rate for Payer: Aetna Commercial |
$226.44
|
| Rate for Payer: Aetna Medicare |
$133.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.16
|
| Rate for Payer: BCBS Complete |
$106.56
|
| Rate for Payer: Cash Price |
$213.12
|
| Rate for Payer: Cofinity Advantage |
$186.48
|
| Rate for Payer: Cofinity Commercial |
$229.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.12
|
| Rate for Payer: Healthscope Commercial |
$239.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$213.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.80
|
| Rate for Payer: PHP Commercial |
$226.44
|
| Rate for Payer: Priority Health SBD |
$167.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.16
|
| Rate for Payer: UHC Core |
$138.79
|
| Rate for Payer: UHC Exchange |
$104.70
|
|
|
HALOPERIDOL 2 MG TABLET
|
Facility
|
IP
|
$266.40
|
|
|
Service Code
|
NDC 51079073520
|
| Hospital Charge Code |
3581
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$167.83 |
| Max. Negotiated Rate |
$239.76 |
| Rate for Payer: Aetna Commercial |
$226.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.16
|
| Rate for Payer: Cash Price |
$213.12
|
| Rate for Payer: Cofinity Advantage |
$186.48
|
| Rate for Payer: Cofinity Commercial |
$229.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.12
|
| Rate for Payer: Healthscope Commercial |
$239.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.80
|
| Rate for Payer: PHP Commercial |
$226.44
|
| Rate for Payer: Priority Health SBD |
$167.83
|
|
|
HALOPERIDOL 2 MG TABLET
|
Facility
|
IP
|
$446.50
|
|
|
Service Code
|
NDC 00378021401
|
| Hospital Charge Code |
3581
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$281.30 |
| Max. Negotiated Rate |
$401.85 |
| Rate for Payer: Aetna Commercial |
$379.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.23
|
| Rate for Payer: Cash Price |
$357.20
|
| Rate for Payer: Cofinity Advantage |
$312.55
|
| Rate for Payer: Cofinity Commercial |
$383.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.20
|
| Rate for Payer: Healthscope Commercial |
$401.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.88
|
| Rate for Payer: PHP Commercial |
$379.52
|
| Rate for Payer: Priority Health SBD |
$281.30
|
|
|
HALOPERIDOL 2 MG TABLET
|
Facility
|
OP
|
$446.50
|
|
|
Service Code
|
NDC 00378021401
|
| Hospital Charge Code |
3581
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$175.47 |
| Max. Negotiated Rate |
$401.85 |
| Rate for Payer: Aetna Commercial |
$379.52
|
| Rate for Payer: Aetna Medicare |
$223.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.23
|
| Rate for Payer: BCBS Complete |
$178.60
|
| Rate for Payer: Cash Price |
$357.20
|
| Rate for Payer: Cofinity Advantage |
$312.55
|
| Rate for Payer: Cofinity Commercial |
$383.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.20
|
| Rate for Payer: Healthscope Commercial |
$401.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$357.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.88
|
| Rate for Payer: PHP Commercial |
$379.52
|
| Rate for Payer: Priority Health SBD |
$281.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.23
|
| Rate for Payer: UHC Core |
$232.63
|
| Rate for Payer: UHC Exchange |
$175.47
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
OP
|
$2.71
|
|
|
Service Code
|
NDC 51079073601
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$2.44 |
| Rate for Payer: Aetna Commercial |
$2.30
|
| Rate for Payer: Aetna Medicare |
$1.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.76
|
| Rate for Payer: BCBS Complete |
$1.08
|
| Rate for Payer: Cash Price |
$2.17
|
| Rate for Payer: Cofinity Advantage |
$1.90
|
| Rate for Payer: Cofinity Commercial |
$2.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$2.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.03
|
| Rate for Payer: PHP Commercial |
$2.30
|
| Rate for Payer: Priority Health SBD |
$1.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.76
|
| Rate for Payer: UHC Core |
$1.41
|
| Rate for Payer: UHC Exchange |
$1.07
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
IP
|
$2.71
|
|
|
Service Code
|
NDC 51079073601
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.71 |
| Max. Negotiated Rate |
$2.44 |
| Rate for Payer: Aetna Commercial |
$2.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.76
|
| Rate for Payer: Cash Price |
$2.17
|
| Rate for Payer: Cofinity Advantage |
$1.90
|
| Rate for Payer: Cofinity Commercial |
$2.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$2.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.03
|
| Rate for Payer: PHP Commercial |
$2.30
|
| Rate for Payer: Priority Health SBD |
$1.71
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
OP
|
$270.72
|
|
|
Service Code
|
NDC 51079073620
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$106.39 |
| Max. Negotiated Rate |
$243.65 |
| Rate for Payer: Aetna Commercial |
$230.11
|
| Rate for Payer: Aetna Medicare |
$135.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.97
|
| Rate for Payer: BCBS Complete |
$108.29
|
| Rate for Payer: Cash Price |
$216.58
|
| Rate for Payer: Cofinity Advantage |
$189.50
|
| Rate for Payer: Cofinity Commercial |
$232.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.58
|
| Rate for Payer: Healthscope Commercial |
$243.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$216.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$203.04
|
| Rate for Payer: PHP Commercial |
$230.11
|
| Rate for Payer: Priority Health SBD |
$170.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.97
|
| Rate for Payer: UHC Core |
$141.05
|
| Rate for Payer: UHC Exchange |
$106.39
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
IP
|
$270.72
|
|
|
Service Code
|
NDC 51079073620
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$170.55 |
| Max. Negotiated Rate |
$243.65 |
| Rate for Payer: Aetna Commercial |
$230.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.97
|
| Rate for Payer: Cash Price |
$216.58
|
| Rate for Payer: Cofinity Advantage |
$189.50
|
| Rate for Payer: Cofinity Commercial |
$232.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.58
|
| Rate for Payer: Healthscope Commercial |
$243.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$203.04
|
| Rate for Payer: PHP Commercial |
$230.11
|
| Rate for Payer: Priority Health SBD |
$170.55
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
IP
|
$375.36
|
|
|
Service Code
|
NDC 00904678261
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$236.48 |
| Max. Negotiated Rate |
$337.82 |
| Rate for Payer: Aetna Commercial |
$319.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.98
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Advantage |
$262.75
|
| Rate for Payer: Cofinity Commercial |
$322.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Healthscope Commercial |
$337.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.52
|
| Rate for Payer: PHP Commercial |
$319.06
|
| Rate for Payer: Priority Health SBD |
$236.48
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
IP
|
$337.92
|
|
|
Service Code
|
NDC 00832154001
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$212.89 |
| Max. Negotiated Rate |
$304.13 |
| Rate for Payer: Aetna Commercial |
$287.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.65
|
| Rate for Payer: Cash Price |
$270.34
|
| Rate for Payer: Cofinity Advantage |
$236.54
|
| Rate for Payer: Cofinity Commercial |
$290.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.34
|
| Rate for Payer: Healthscope Commercial |
$304.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.44
|
| Rate for Payer: PHP Commercial |
$287.23
|
| Rate for Payer: Priority Health SBD |
$212.89
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
OP
|
$289.05
|
|
|
Service Code
|
NDC 68382007901
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$113.60 |
| Max. Negotiated Rate |
$260.14 |
| Rate for Payer: Aetna Commercial |
$245.69
|
| Rate for Payer: Aetna Medicare |
$144.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.88
|
| Rate for Payer: BCBS Complete |
$115.62
|
| Rate for Payer: Cash Price |
$231.24
|
| Rate for Payer: Cofinity Advantage |
$202.34
|
| Rate for Payer: Cofinity Commercial |
$248.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.24
|
| Rate for Payer: Healthscope Commercial |
$260.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.79
|
| Rate for Payer: PHP Commercial |
$245.69
|
| Rate for Payer: Priority Health SBD |
$182.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.88
|
| Rate for Payer: UHC Core |
$150.60
|
| Rate for Payer: UHC Exchange |
$113.60
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
OP
|
$375.36
|
|
|
Service Code
|
NDC 00904678261
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$147.52 |
| Max. Negotiated Rate |
$337.82 |
| Rate for Payer: Aetna Commercial |
$319.06
|
| Rate for Payer: Aetna Medicare |
$187.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.98
|
| Rate for Payer: BCBS Complete |
$150.14
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Advantage |
$262.75
|
| Rate for Payer: Cofinity Commercial |
$322.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Healthscope Commercial |
$337.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$300.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.52
|
| Rate for Payer: PHP Commercial |
$319.06
|
| Rate for Payer: Priority Health SBD |
$236.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.98
|
| Rate for Payer: UHC Core |
$195.56
|
| Rate for Payer: UHC Exchange |
$147.52
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
IP
|
$289.05
|
|
|
Service Code
|
NDC 68382007901
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$182.10 |
| Max. Negotiated Rate |
$260.14 |
| Rate for Payer: Aetna Commercial |
$245.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.88
|
| Rate for Payer: Cash Price |
$231.24
|
| Rate for Payer: Cofinity Advantage |
$202.34
|
| Rate for Payer: Cofinity Commercial |
$248.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.24
|
| Rate for Payer: Healthscope Commercial |
$260.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.79
|
| Rate for Payer: PHP Commercial |
$245.69
|
| Rate for Payer: Priority Health SBD |
$182.10
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
OP
|
$337.92
|
|
|
Service Code
|
NDC 00832154001
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$132.80 |
| Max. Negotiated Rate |
$304.13 |
| Rate for Payer: Aetna Commercial |
$287.23
|
| Rate for Payer: Aetna Medicare |
$168.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.65
|
| Rate for Payer: BCBS Complete |
$135.17
|
| Rate for Payer: Cash Price |
$270.34
|
| Rate for Payer: Cofinity Advantage |
$236.54
|
| Rate for Payer: Cofinity Commercial |
$290.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.34
|
| Rate for Payer: Healthscope Commercial |
$304.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.44
|
| Rate for Payer: PHP Commercial |
$287.23
|
| Rate for Payer: Priority Health SBD |
$212.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.65
|
| Rate for Payer: UHC Core |
$176.06
|
| Rate for Payer: UHC Exchange |
$132.80
|
|
|
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE
|
Facility
|
IP
|
$249.66
|
|
|
Service Code
|
NDC 54838050140
|
| Hospital Charge Code |
3585
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$157.29 |
| Max. Negotiated Rate |
$224.69 |
| Rate for Payer: Aetna Commercial |
$212.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.28
|
| Rate for Payer: Cash Price |
$199.73
|
| Rate for Payer: Cofinity Advantage |
$174.76
|
| Rate for Payer: Cofinity Commercial |
$214.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.73
|
| Rate for Payer: Healthscope Commercial |
$224.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.25
|
| Rate for Payer: PHP Commercial |
$212.21
|
| Rate for Payer: Priority Health SBD |
$157.29
|
|
|
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE
|
Facility
|
OP
|
$249.66
|
|
|
Service Code
|
NDC 54838050140
|
| Hospital Charge Code |
3585
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$98.12 |
| Max. Negotiated Rate |
$224.69 |
| Rate for Payer: Aetna Commercial |
$212.21
|
| Rate for Payer: Aetna Medicare |
$124.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.28
|
| Rate for Payer: BCBS Complete |
$99.86
|
| Rate for Payer: Cash Price |
$199.73
|
| Rate for Payer: Cofinity Advantage |
$174.76
|
| Rate for Payer: Cofinity Commercial |
$214.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.73
|
| Rate for Payer: Healthscope Commercial |
$224.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.25
|
| Rate for Payer: PHP Commercial |
$212.21
|
| Rate for Payer: Priority Health SBD |
$157.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.28
|
| Rate for Payer: UHC Core |
$130.07
|
| Rate for Payer: UHC Exchange |
$98.12
|
|
|
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE
|
Facility
|
OP
|
$243.96
|
|
|
Service Code
|
NDC 00121058104
|
| Hospital Charge Code |
3585
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$95.88 |
| Max. Negotiated Rate |
$219.56 |
| Rate for Payer: Aetna Commercial |
$207.37
|
| Rate for Payer: Aetna Medicare |
$121.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.57
|
| Rate for Payer: BCBS Complete |
$97.58
|
| Rate for Payer: Cash Price |
$195.17
|
| Rate for Payer: Cofinity Advantage |
$170.77
|
| Rate for Payer: Cofinity Commercial |
$209.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.17
|
| Rate for Payer: Healthscope Commercial |
$219.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.97
|
| Rate for Payer: PHP Commercial |
$207.37
|
| Rate for Payer: Priority Health SBD |
$153.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.57
|
| Rate for Payer: UHC Core |
$127.10
|
| Rate for Payer: UHC Exchange |
$95.88
|
|
|
HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE
|
Facility
|
IP
|
$243.96
|
|
|
Service Code
|
NDC 00121058104
|
| Hospital Charge Code |
3585
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$153.69 |
| Max. Negotiated Rate |
$219.56 |
| Rate for Payer: Aetna Commercial |
$207.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.57
|
| Rate for Payer: Cash Price |
$195.17
|
| Rate for Payer: Cofinity Advantage |
$170.77
|
| Rate for Payer: Cofinity Commercial |
$209.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.17
|
| Rate for Payer: Healthscope Commercial |
$219.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.97
|
| Rate for Payer: PHP Commercial |
$207.37
|
| Rate for Payer: Priority Health SBD |
$153.69
|
|
|
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$12.88
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
3584
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.11 |
| Max. Negotiated Rate |
$11.59 |
| Rate for Payer: Aetna Commercial |
$10.95
|
| Rate for Payer: Aetna Commercial |
$8.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.84
|
| Rate for Payer: Cash Price |
$8.42
|
| Rate for Payer: Cash Price |
$10.30
|
| Rate for Payer: Cofinity Advantage |
$9.02
|
| Rate for Payer: Cofinity Advantage |
$7.37
|
| Rate for Payer: Cofinity Commercial |
$9.06
|
| Rate for Payer: Cofinity Commercial |
$11.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.42
|
| Rate for Payer: Healthscope Commercial |
$11.59
|
| Rate for Payer: Healthscope Commercial |
$9.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.66
|
| Rate for Payer: PHP Commercial |
$8.95
|
| Rate for Payer: PHP Commercial |
$10.95
|
| Rate for Payer: Priority Health SBD |
$8.11
|
| Rate for Payer: Priority Health SBD |
$6.63
|
|
|
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$12.88
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
3584
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$11.59 |
| Rate for Payer: Aetna Commercial |
$10.95
|
| Rate for Payer: Aetna Commercial |
$8.95
|
| Rate for Payer: Aetna Medicare |
$5.26
|
| Rate for Payer: Aetna Medicare |
$6.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.84
|
| Rate for Payer: BCBS Complete |
$4.21
|
| Rate for Payer: BCBS Complete |
$5.15
|
| Rate for Payer: BCBS Trust/PPO |
$1.82
|
| Rate for Payer: BCBS Trust/PPO |
$1.82
|
| Rate for Payer: BCN Commercial |
$1.82
|
| Rate for Payer: BCN Commercial |
$1.82
|
| Rate for Payer: Cash Price |
$10.30
|
| Rate for Payer: Cash Price |
$8.42
|
| Rate for Payer: Cash Price |
$10.30
|
| Rate for Payer: Cash Price |
$8.42
|
| Rate for Payer: Cofinity Advantage |
$9.02
|
| Rate for Payer: Cofinity Advantage |
$7.37
|
| Rate for Payer: Cofinity Commercial |
$11.08
|
| Rate for Payer: Cofinity Commercial |
$9.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.30
|
| Rate for Payer: Healthscope Commercial |
$9.48
|
| Rate for Payer: Healthscope Commercial |
$11.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.90
|
| Rate for Payer: PHP Commercial |
$10.95
|
| Rate for Payer: PHP Commercial |
$8.95
|
| Rate for Payer: Priority Health SBD |
$8.11
|
| Rate for Payer: Priority Health SBD |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.20
|
| Rate for Payer: UHC Core |
$1.20
|
| Rate for Payer: UHC Core |
$1.20
|
| Rate for Payer: UHC Exchange |
$1.20
|
| Rate for Payer: UHC Exchange |
$1.20
|
|
|
HAND AND WRIST PROCEDURES
|
Facility
|
IP
|
$16,880.25
|
|
|
Service Code
|
APR-DRG 3164
|
| Min. Negotiated Rate |
$16,076.42 |
| Max. Negotiated Rate |
$16,880.25 |
| Rate for Payer: BCBS Complete |
$16,880.25
|
| Rate for Payer: Mclaren Medicaid |
$16,076.42
|
| Rate for Payer: Meridian Medicaid |
$16,880.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,076.42
|
| Rate for Payer: UHC Medicaid |
$16,076.42
|
| Rate for Payer: UHCCP Medicaid |
$16,076.42
|
|
|
HAND AND WRIST PROCEDURES
|
Facility
|
IP
|
$7,691.39
|
|
|
Service Code
|
APR-DRG 3162
|
| Min. Negotiated Rate |
$7,325.14 |
| Max. Negotiated Rate |
$7,691.39 |
| Rate for Payer: BCBS Complete |
$7,691.39
|
| Rate for Payer: Mclaren Medicaid |
$7,325.14
|
| Rate for Payer: Meridian Medicaid |
$7,691.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,325.14
|
| Rate for Payer: UHC Medicaid |
$7,325.14
|
| Rate for Payer: UHCCP Medicaid |
$7,325.14
|
|
|
HAND AND WRIST PROCEDURES
|
Facility
|
IP
|
$11,914.32
|
|
|
Service Code
|
APR-DRG 3163
|
| Min. Negotiated Rate |
$11,346.97 |
| Max. Negotiated Rate |
$11,914.32 |
| Rate for Payer: BCBS Complete |
$11,914.32
|
| Rate for Payer: Mclaren Medicaid |
$11,346.97
|
| Rate for Payer: Meridian Medicaid |
$11,914.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,346.97
|
| Rate for Payer: UHC Medicaid |
$11,346.97
|
| Rate for Payer: UHCCP Medicaid |
$11,346.97
|
|
|
HAND AND WRIST PROCEDURES
|
Facility
|
IP
|
$7,013.75
|
|
|
Service Code
|
APR-DRG 3161
|
| Min. Negotiated Rate |
$6,679.76 |
| Max. Negotiated Rate |
$7,013.75 |
| Rate for Payer: BCBS Complete |
$7,013.75
|
| Rate for Payer: Mclaren Medicaid |
$6,679.76
|
| Rate for Payer: Meridian Medicaid |
$7,013.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,679.76
|
| Rate for Payer: UHC Medicaid |
$6,679.76
|
| Rate for Payer: UHCCP Medicaid |
$6,679.76
|
|
|
HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$25,661.09
|
|
|
Service Code
|
MSDRG 513
|
| Min. Negotiated Rate |
$12,108.28 |
| Max. Negotiated Rate |
$25,661.09 |
| Rate for Payer: Aetna Medicare |
$13,255.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,931.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,931.95
|
| Rate for Payer: BCBS MAPPO |
$12,745.56
|
| Rate for Payer: BCBS Trust/PPO |
$24,473.06
|
| Rate for Payer: BCN Commercial |
$24,473.06
|
| Rate for Payer: BCN Medicare Advantage |
$12,745.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,745.56
|
| Rate for Payer: Mclaren Medicare |
$12,745.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,382.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,657.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,020.12
|
| Rate for Payer: Nomi Health Commercial |
$20,308.47
|
| Rate for Payer: PACE Medicare |
$12,108.28
|
| Rate for Payer: PACE SWMI |
$12,745.56
|
| Rate for Payer: PHP Medicare Advantage |
$12,745.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,381.09
|
| Rate for Payer: Priority Health Medicare |
$12,745.56
|
| Rate for Payer: Priority Health Tiered Network |
$20,304.86
|
| Rate for Payer: Railroad Medicare Medicare |
$12,745.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,661.09
|
| Rate for Payer: UHC Core |
$21,468.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,745.56
|
| Rate for Payer: UHC Exchange |
$17,532.98
|
| Rate for Payer: VA VA |
$12,745.56
|
|
