|
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$14.88
|
|
|
Service Code
|
HCPCS J1596
|
| Hospital Charge Code |
3497
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.37 |
| Max. Negotiated Rate |
$13.39 |
| Rate for Payer: Aetna Commercial |
$12.65
|
| Rate for Payer: Aetna Commercial |
$13.52
|
| Rate for Payer: Aetna Commercial |
$12.73
|
| Rate for Payer: Aetna Commercial |
$13.12
|
| Rate for Payer: Aetna Commercial |
$13.57
|
| Rate for Payer: Aetna Commercial |
$18.47
|
| Rate for Payer: Aetna Commercial |
$18.34
|
| Rate for Payer: Aetna Commercial |
$14.03
|
| Rate for Payer: Aetna Commercial |
$16.17
|
| Rate for Payer: Aetna Commercial |
$15.68
|
| Rate for Payer: Aetna Commercial |
$20.55
|
| Rate for Payer: Aetna Commercial |
$21.50
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Commercial |
$27.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.03
|
| Rate for Payer: Cash Price |
$11.90
|
| Rate for Payer: Cash Price |
$20.23
|
| Rate for Payer: Cash Price |
$17.26
|
| Rate for Payer: Cash Price |
$11.98
|
| Rate for Payer: Cash Price |
$19.34
|
| Rate for Payer: Cash Price |
$15.22
|
| Rate for Payer: Cash Price |
$12.34
|
| Rate for Payer: Cash Price |
$12.72
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Cash Price |
$25.54
|
| Rate for Payer: Cash Price |
$14.76
|
| Rate for Payer: Cash Price |
$12.78
|
| Rate for Payer: Cash Price |
$20.41
|
| Rate for Payer: Cash Price |
$13.21
|
| Rate for Payer: Cofinity Commercial |
$10.80
|
| Rate for Payer: Cofinity Commercial |
$13.67
|
| Rate for Payer: Cofinity Commercial |
$11.13
|
| Rate for Payer: Cofinity Commercial |
$12.80
|
| Rate for Payer: Cofinity Commercial |
$13.27
|
| Rate for Payer: Cofinity Commercial |
$10.49
|
| Rate for Payer: Cofinity Commercial |
$12.88
|
| Rate for Payer: Cofinity Commercial |
$10.42
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$13.73
|
| Rate for Payer: Cofinity Commercial |
$11.56
|
| Rate for Payer: Cofinity Commercial |
$14.20
|
| Rate for Payer: Cofinity Commercial |
$12.92
|
| Rate for Payer: Cofinity Commercial |
$15.87
|
| Rate for Payer: Cofinity Commercial |
$13.31
|
| Rate for Payer: Cofinity Commercial |
$16.36
|
| Rate for Payer: Cofinity Commercial |
$15.11
|
| Rate for Payer: Cofinity Commercial |
$18.56
|
| Rate for Payer: Cofinity Commercial |
$15.21
|
| Rate for Payer: Cofinity Commercial |
$18.69
|
| Rate for Payer: Cofinity Commercial |
$16.93
|
| Rate for Payer: Cofinity Commercial |
$20.79
|
| Rate for Payer: Cofinity Commercial |
$17.70
|
| Rate for Payer: Cofinity Commercial |
$21.75
|
| Rate for Payer: Cofinity Commercial |
$17.86
|
| Rate for Payer: Cofinity Commercial |
$21.94
|
| Rate for Payer: Cofinity Commercial |
$22.35
|
| Rate for Payer: Cofinity Commercial |
$27.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.21
|
| Rate for Payer: Healthscope Commercial |
$13.89
|
| Rate for Payer: Healthscope Commercial |
$19.56
|
| Rate for Payer: Healthscope Commercial |
$22.96
|
| Rate for Payer: Healthscope Commercial |
$13.39
|
| Rate for Payer: Healthscope Commercial |
$14.31
|
| Rate for Payer: Healthscope Commercial |
$13.48
|
| Rate for Payer: Healthscope Commercial |
$22.76
|
| Rate for Payer: Healthscope Commercial |
$28.74
|
| Rate for Payer: Healthscope Commercial |
$14.86
|
| Rate for Payer: Healthscope Commercial |
$17.12
|
| Rate for Payer: Healthscope Commercial |
$16.60
|
| Rate for Payer: Healthscope Commercial |
$21.76
|
| Rate for Payer: Healthscope Commercial |
$19.42
|
| Rate for Payer: Healthscope Commercial |
$14.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.55
|
| Rate for Payer: PHP Commercial |
$18.34
|
| Rate for Payer: PHP Commercial |
$13.12
|
| Rate for Payer: PHP Commercial |
$21.50
|
| Rate for Payer: PHP Commercial |
$20.55
|
| Rate for Payer: PHP Commercial |
$15.68
|
| Rate for Payer: PHP Commercial |
$13.57
|
| Rate for Payer: PHP Commercial |
$12.65
|
| Rate for Payer: PHP Commercial |
$16.17
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Commercial |
$13.52
|
| Rate for Payer: PHP Commercial |
$12.73
|
| Rate for Payer: PHP Commercial |
$27.14
|
| Rate for Payer: PHP Commercial |
$14.03
|
| Rate for Payer: PHP Commercial |
$18.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.38
|
| Rate for Payer: Priority Health SBD |
$15.93
|
| Rate for Payer: Priority Health SBD |
$15.23
|
| Rate for Payer: Priority Health SBD |
$10.40
|
| Rate for Payer: Priority Health SBD |
$10.06
|
| Rate for Payer: Priority Health SBD |
$9.44
|
| Rate for Payer: Priority Health SBD |
$9.37
|
| Rate for Payer: Priority Health SBD |
$10.02
|
| Rate for Payer: Priority Health SBD |
$20.12
|
| Rate for Payer: Priority Health SBD |
$13.69
|
| Rate for Payer: Priority Health SBD |
$13.60
|
| Rate for Payer: Priority Health SBD |
$11.98
|
| Rate for Payer: Priority Health SBD |
$16.07
|
| Rate for Payer: Priority Health SBD |
$11.62
|
| Rate for Payer: Priority Health SBD |
$9.72
|
|
|
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$14.88
|
|
|
Service Code
|
HCPCS J1596
|
| Hospital Charge Code |
3497
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$13.39 |
| Rate for Payer: Aetna Commercial |
$12.65
|
| Rate for Payer: Aetna Commercial |
$12.73
|
| Rate for Payer: Aetna Commercial |
$27.14
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Commercial |
$21.50
|
| Rate for Payer: Aetna Commercial |
$20.55
|
| Rate for Payer: Aetna Commercial |
$18.47
|
| Rate for Payer: Aetna Commercial |
$18.34
|
| Rate for Payer: Aetna Commercial |
$16.17
|
| Rate for Payer: Aetna Commercial |
$15.68
|
| Rate for Payer: Aetna Commercial |
$14.03
|
| Rate for Payer: Aetna Commercial |
$13.57
|
| Rate for Payer: Aetna Commercial |
$13.52
|
| Rate for Payer: Aetna Commercial |
$13.12
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS Trust/PPO |
$1.41
|
| Rate for Payer: BCBS Trust/PPO |
$1.41
|
| Rate for Payer: BCBS Trust/PPO |
$1.41
|
| Rate for Payer: BCBS Trust/PPO |
$1.41
|
| Rate for Payer: BCBS Trust/PPO |
$1.41
|
| Rate for Payer: BCBS Trust/PPO |
$1.41
|
| Rate for Payer: BCBS Trust/PPO |
$1.41
|
| Rate for Payer: BCBS Trust/PPO |
$1.41
|
| Rate for Payer: BCBS Trust/PPO |
$1.41
|
| Rate for Payer: BCBS Trust/PPO |
$1.41
|
| Rate for Payer: BCBS Trust/PPO |
$1.41
|
| Rate for Payer: BCBS Trust/PPO |
$1.41
|
| Rate for Payer: BCBS Trust/PPO |
$1.41
|
| Rate for Payer: BCBS Trust/PPO |
$1.41
|
| Rate for Payer: BCN Commercial |
$1.41
|
| Rate for Payer: BCN Commercial |
$1.41
|
| Rate for Payer: BCN Commercial |
$1.41
|
| Rate for Payer: BCN Commercial |
$1.41
|
| Rate for Payer: BCN Commercial |
$1.41
|
| Rate for Payer: BCN Commercial |
$1.41
|
| Rate for Payer: BCN Commercial |
$1.41
|
| Rate for Payer: BCN Commercial |
$1.41
|
| Rate for Payer: BCN Commercial |
$1.41
|
| Rate for Payer: BCN Commercial |
$1.41
|
| Rate for Payer: BCN Commercial |
$1.41
|
| Rate for Payer: BCN Commercial |
$1.41
|
| Rate for Payer: BCN Commercial |
$1.41
|
| Rate for Payer: BCN Commercial |
$1.41
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: Cash Price |
$20.23
|
| Rate for Payer: Cash Price |
$12.34
|
| Rate for Payer: Cash Price |
$15.22
|
| Rate for Payer: Cash Price |
$20.41
|
| Rate for Payer: Cash Price |
$20.41
|
| Rate for Payer: Cash Price |
$12.34
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Cash Price |
$11.90
|
| Rate for Payer: Cash Price |
$25.54
|
| Rate for Payer: Cash Price |
$15.22
|
| Rate for Payer: Cash Price |
$13.21
|
| Rate for Payer: Cash Price |
$12.72
|
| Rate for Payer: Cash Price |
$14.76
|
| Rate for Payer: Cash Price |
$11.98
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Cash Price |
$20.23
|
| Rate for Payer: Cash Price |
$19.34
|
| Rate for Payer: Cash Price |
$17.26
|
| Rate for Payer: Cash Price |
$14.76
|
| Rate for Payer: Cash Price |
$12.72
|
| Rate for Payer: Cash Price |
$17.26
|
| Rate for Payer: Cash Price |
$12.78
|
| Rate for Payer: Cash Price |
$19.34
|
| Rate for Payer: Cash Price |
$11.90
|
| Rate for Payer: Cash Price |
$13.21
|
| Rate for Payer: Cash Price |
$25.54
|
| Rate for Payer: Cash Price |
$12.78
|
| Rate for Payer: Cash Price |
$11.98
|
| Rate for Payer: Cofinity Commercial |
$10.49
|
| Rate for Payer: Cofinity Commercial |
$21.75
|
| Rate for Payer: Cofinity Commercial |
$20.79
|
| Rate for Payer: Cofinity Commercial |
$16.93
|
| Rate for Payer: Cofinity Commercial |
$12.80
|
| Rate for Payer: Cofinity Commercial |
$17.86
|
| Rate for Payer: Cofinity Commercial |
$13.73
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$15.11
|
| Rate for Payer: Cofinity Commercial |
$17.70
|
| Rate for Payer: Cofinity Commercial |
$12.88
|
| Rate for Payer: Cofinity Commercial |
$16.36
|
| Rate for Payer: Cofinity Commercial |
$13.67
|
| Rate for Payer: Cofinity Commercial |
$10.80
|
| Rate for Payer: Cofinity Commercial |
$11.13
|
| Rate for Payer: Cofinity Commercial |
$10.42
|
| Rate for Payer: Cofinity Commercial |
$18.56
|
| Rate for Payer: Cofinity Commercial |
$18.69
|
| Rate for Payer: Cofinity Commercial |
$13.31
|
| Rate for Payer: Cofinity Commercial |
$14.20
|
| Rate for Payer: Cofinity Commercial |
$11.56
|
| Rate for Payer: Cofinity Commercial |
$15.21
|
| Rate for Payer: Cofinity Commercial |
$27.46
|
| Rate for Payer: Cofinity Commercial |
$12.92
|
| Rate for Payer: Cofinity Commercial |
$15.87
|
| Rate for Payer: Cofinity Commercial |
$21.94
|
| Rate for Payer: Cofinity Commercial |
$22.35
|
| Rate for Payer: Cofinity Commercial |
$13.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Healthscope Commercial |
$13.89
|
| Rate for Payer: Healthscope Commercial |
$13.39
|
| Rate for Payer: Healthscope Commercial |
$19.56
|
| Rate for Payer: Healthscope Commercial |
$13.48
|
| Rate for Payer: Healthscope Commercial |
$19.42
|
| Rate for Payer: Healthscope Commercial |
$14.37
|
| Rate for Payer: Healthscope Commercial |
$21.76
|
| Rate for Payer: Healthscope Commercial |
$17.12
|
| Rate for Payer: Healthscope Commercial |
$28.74
|
| Rate for Payer: Healthscope Commercial |
$16.60
|
| Rate for Payer: Healthscope Commercial |
$14.86
|
| Rate for Payer: Healthscope Commercial |
$22.96
|
| Rate for Payer: Healthscope Commercial |
$14.31
|
| Rate for Payer: Healthscope Commercial |
$22.76
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.12
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PHP Commercial |
$18.34
|
| Rate for Payer: PHP Commercial |
$18.47
|
| Rate for Payer: PHP Commercial |
$20.55
|
| Rate for Payer: PHP Commercial |
$14.03
|
| Rate for Payer: PHP Commercial |
$13.12
|
| Rate for Payer: PHP Commercial |
$16.17
|
| Rate for Payer: PHP Commercial |
$27.14
|
| Rate for Payer: PHP Commercial |
$12.65
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Commercial |
$12.73
|
| Rate for Payer: PHP Commercial |
$13.57
|
| Rate for Payer: PHP Commercial |
$15.68
|
| Rate for Payer: PHP Commercial |
$21.50
|
| Rate for Payer: PHP Commercial |
$13.52
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health SBD |
$20.12
|
| Rate for Payer: Priority Health SBD |
$15.93
|
| Rate for Payer: Priority Health SBD |
$10.40
|
| Rate for Payer: Priority Health SBD |
$9.72
|
| Rate for Payer: Priority Health SBD |
$10.06
|
| Rate for Payer: Priority Health SBD |
$9.37
|
| Rate for Payer: Priority Health SBD |
$13.69
|
| Rate for Payer: Priority Health SBD |
$13.60
|
| Rate for Payer: Priority Health SBD |
$11.98
|
| Rate for Payer: Priority Health SBD |
$11.62
|
| Rate for Payer: Priority Health SBD |
$16.07
|
| Rate for Payer: Priority Health SBD |
$15.23
|
| Rate for Payer: Priority Health SBD |
$9.44
|
| Rate for Payer: Priority Health SBD |
$10.02
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHCCP Medicaid |
$0.33
|
| Rate for Payer: UHCCP Medicaid |
$0.33
|
| Rate for Payer: UHCCP Medicaid |
$0.33
|
| Rate for Payer: UHCCP Medicaid |
$0.33
|
| Rate for Payer: UHCCP Medicaid |
$0.33
|
| Rate for Payer: UHCCP Medicaid |
$0.33
|
| Rate for Payer: UHCCP Medicaid |
$0.33
|
| Rate for Payer: UHCCP Medicaid |
$0.33
|
| Rate for Payer: UHCCP Medicaid |
$0.33
|
| Rate for Payer: UHCCP Medicaid |
$0.33
|
| Rate for Payer: UHCCP Medicaid |
$0.33
|
| Rate for Payer: UHCCP Medicaid |
$0.33
|
| Rate for Payer: UHCCP Medicaid |
$0.33
|
| Rate for Payer: UHCCP Medicaid |
$0.33
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
|
|
GLYCOPYRROLATE 0.2 MG/ML ORAL SOLN (CUSTOM)
|
Facility
|
OP
|
$442.67
|
|
|
Service Code
|
NDC 00900000230
|
| Hospital Charge Code |
158482
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$177.07 |
| Max. Negotiated Rate |
$398.40 |
| Rate for Payer: Aetna Commercial |
$376.27
|
| Rate for Payer: Aetna Medicare |
$221.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.74
|
| Rate for Payer: BCBS Complete |
$177.07
|
| Rate for Payer: Cash Price |
$354.14
|
| Rate for Payer: Cofinity Commercial |
$309.87
|
| Rate for Payer: Cofinity Commercial |
$380.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$309.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.14
|
| Rate for Payer: Healthscope Commercial |
$398.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.27
|
| Rate for Payer: PHP Commercial |
$376.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.74
|
| Rate for Payer: Priority Health SBD |
$278.88
|
|
|
GLYCOPYRROLATE 0.2 MG/ML ORAL SOLN (CUSTOM)
|
Facility
|
IP
|
$442.67
|
|
|
Service Code
|
NDC 00900000230
|
| Hospital Charge Code |
158482
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$278.88 |
| Max. Negotiated Rate |
$398.40 |
| Rate for Payer: Aetna Commercial |
$376.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.74
|
| Rate for Payer: Cash Price |
$354.14
|
| Rate for Payer: Cofinity Commercial |
$309.87
|
| Rate for Payer: Cofinity Commercial |
$380.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$309.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.14
|
| Rate for Payer: Healthscope Commercial |
$398.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.27
|
| Rate for Payer: PHP Commercial |
$376.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.74
|
| Rate for Payer: Priority Health SBD |
$278.88
|
|
|
GLYCOPYRROLATE 1 MG TABLET
|
Facility
|
IP
|
$385.70
|
|
|
Service Code
|
NDC 69076047501
|
| Hospital Charge Code |
10130
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$242.99 |
| Max. Negotiated Rate |
$347.13 |
| Rate for Payer: Aetna Commercial |
$327.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.70
|
| Rate for Payer: Cash Price |
$308.56
|
| Rate for Payer: Cofinity Commercial |
$269.99
|
| Rate for Payer: Cofinity Commercial |
$331.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$269.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.56
|
| Rate for Payer: Healthscope Commercial |
$347.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.84
|
| Rate for Payer: PHP Commercial |
$327.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.70
|
| Rate for Payer: Priority Health SBD |
$242.99
|
|
|
GLYCOPYRROLATE 1 MG TABLET
|
Facility
|
IP
|
$380.16
|
|
|
Service Code
|
NDC 00904670961
|
| Hospital Charge Code |
10130
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$239.50 |
| Max. Negotiated Rate |
$342.14 |
| Rate for Payer: Aetna Commercial |
$323.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.10
|
| Rate for Payer: Cash Price |
$304.13
|
| Rate for Payer: Cofinity Commercial |
$266.11
|
| Rate for Payer: Cofinity Commercial |
$326.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$266.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.13
|
| Rate for Payer: Healthscope Commercial |
$342.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$323.14
|
| Rate for Payer: PHP Commercial |
$323.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.10
|
| Rate for Payer: Priority Health SBD |
$239.50
|
|
|
GLYCOPYRROLATE 1 MG TABLET
|
Facility
|
IP
|
$246.75
|
|
|
Service Code
|
NDC 23155060601
|
| Hospital Charge Code |
10130
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$155.45 |
| Max. Negotiated Rate |
$222.08 |
| Rate for Payer: Aetna Commercial |
$209.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.39
|
| Rate for Payer: Cash Price |
$197.40
|
| Rate for Payer: Cofinity Commercial |
$172.72
|
| Rate for Payer: Cofinity Commercial |
$212.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$172.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.40
|
| Rate for Payer: Healthscope Commercial |
$222.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.74
|
| Rate for Payer: PHP Commercial |
$209.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.39
|
| Rate for Payer: Priority Health SBD |
$155.45
|
|
|
GLYCOPYRROLATE 1 MG TABLET
|
Facility
|
OP
|
$246.75
|
|
|
Service Code
|
NDC 23155060601
|
| Hospital Charge Code |
10130
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$98.70 |
| Max. Negotiated Rate |
$222.08 |
| Rate for Payer: Aetna Commercial |
$209.74
|
| Rate for Payer: Aetna Medicare |
$123.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.39
|
| Rate for Payer: BCBS Complete |
$98.70
|
| Rate for Payer: Cash Price |
$197.40
|
| Rate for Payer: Cofinity Commercial |
$172.72
|
| Rate for Payer: Cofinity Commercial |
$212.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$172.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.40
|
| Rate for Payer: Healthscope Commercial |
$222.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.74
|
| Rate for Payer: PHP Commercial |
$209.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.39
|
| Rate for Payer: Priority Health SBD |
$155.45
|
|
|
GLYCOPYRROLATE 1 MG TABLET
|
Facility
|
OP
|
$385.70
|
|
|
Service Code
|
NDC 69076047501
|
| Hospital Charge Code |
10130
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$154.28 |
| Max. Negotiated Rate |
$347.13 |
| Rate for Payer: Aetna Commercial |
$327.84
|
| Rate for Payer: Aetna Medicare |
$192.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.70
|
| Rate for Payer: BCBS Complete |
$154.28
|
| Rate for Payer: Cash Price |
$308.56
|
| Rate for Payer: Cofinity Commercial |
$269.99
|
| Rate for Payer: Cofinity Commercial |
$331.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$269.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.56
|
| Rate for Payer: Healthscope Commercial |
$347.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.84
|
| Rate for Payer: PHP Commercial |
$327.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.70
|
| Rate for Payer: Priority Health SBD |
$242.99
|
|
|
GLYCOPYRROLATE 1 MG TABLET
|
Facility
|
OP
|
$380.16
|
|
|
Service Code
|
NDC 00904670961
|
| Hospital Charge Code |
10130
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$152.06 |
| Max. Negotiated Rate |
$342.14 |
| Rate for Payer: Aetna Commercial |
$323.14
|
| Rate for Payer: Aetna Medicare |
$190.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.10
|
| Rate for Payer: BCBS Complete |
$152.06
|
| Rate for Payer: Cash Price |
$304.13
|
| Rate for Payer: Cofinity Commercial |
$266.11
|
| Rate for Payer: Cofinity Commercial |
$326.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$266.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.13
|
| Rate for Payer: Healthscope Commercial |
$342.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$323.14
|
| Rate for Payer: PHP Commercial |
$323.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.10
|
| Rate for Payer: Priority Health SBD |
$239.50
|
|
|
GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$6,234.37
|
|
|
Service Code
|
HCPCS J1602
|
| Hospital Charge Code |
167346
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3,927.65 |
| Max. Negotiated Rate |
$5,610.93 |
| Rate for Payer: Aetna Commercial |
$5,299.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,052.34
|
| Rate for Payer: Cash Price |
$4,987.50
|
| Rate for Payer: Cofinity Commercial |
$4,364.06
|
| Rate for Payer: Cofinity Commercial |
$5,361.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,364.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,987.50
|
| Rate for Payer: Healthscope Commercial |
$5,610.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,299.21
|
| Rate for Payer: PHP Commercial |
$5,299.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,052.34
|
| Rate for Payer: Priority Health SBD |
$3,927.65
|
|
|
GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$6,234.37
|
|
|
Service Code
|
HCPCS J1602
|
| Hospital Charge Code |
167346
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$5,610.93 |
| Rate for Payer: Aetna Commercial |
$5,299.21
|
| Rate for Payer: Aetna Medicare |
$10.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,052.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.18
|
| Rate for Payer: BCBS Complete |
$5.93
|
| Rate for Payer: BCBS MAPPO |
$10.54
|
| Rate for Payer: BCBS Trust/PPO |
$31.33
|
| Rate for Payer: BCN Commercial |
$31.33
|
| Rate for Payer: BCN Medicare Advantage |
$10.54
|
| Rate for Payer: Cash Price |
$4,987.50
|
| Rate for Payer: Cash Price |
$4,987.50
|
| Rate for Payer: Cofinity Commercial |
$5,361.56
|
| Rate for Payer: Cofinity Commercial |
$4,364.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,364.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,987.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.54
|
| Rate for Payer: Healthscope Commercial |
$5,610.93
|
| Rate for Payer: Mclaren Medicaid |
$5.65
|
| Rate for Payer: Mclaren Medicare |
$10.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.07
|
| Rate for Payer: Meridian Medicaid |
$5.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,299.21
|
| Rate for Payer: Nomi Health Commercial |
$31.62
|
| Rate for Payer: PACE Medicare |
$10.01
|
| Rate for Payer: PACE SWMI |
$10.54
|
| Rate for Payer: PHP Commercial |
$5,299.21
|
| Rate for Payer: PHP Medicare Advantage |
$10.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,052.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.95
|
| Rate for Payer: Priority Health Medicare |
$10.54
|
| Rate for Payer: Priority Health Narrow Network |
$25.56
|
| Rate for Payer: Priority Health SBD |
$3,927.65
|
| Rate for Payer: Railroad Medicare Medicare |
$10.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.54
|
| Rate for Payer: UHC Medicare Advantage |
$10.54
|
| Rate for Payer: UHCCP Medicaid |
$5.93
|
| Rate for Payer: VA VA |
$10.54
|
|
|
GOSERELIN 3.6 MG SUBCUTANEOUS IMPLANT
|
Facility
|
IP
|
$3,364.48
|
|
|
Service Code
|
HCPCS J9202
|
| Hospital Charge Code |
10137
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,119.62 |
| Max. Negotiated Rate |
$3,028.03 |
| Rate for Payer: Aetna Commercial |
$2,859.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,186.91
|
| Rate for Payer: Cash Price |
$2,691.58
|
| Rate for Payer: Cofinity Commercial |
$2,355.14
|
| Rate for Payer: Cofinity Commercial |
$2,893.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,355.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,691.58
|
| Rate for Payer: Healthscope Commercial |
$3,028.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,859.81
|
| Rate for Payer: PHP Commercial |
$2,859.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,186.91
|
| Rate for Payer: Priority Health SBD |
$2,119.62
|
|
|
GOSERELIN 3.6 MG SUBCUTANEOUS IMPLANT
|
Facility
|
OP
|
$3,364.48
|
|
|
Service Code
|
HCPCS J9202
|
| Hospital Charge Code |
10137
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$376.84 |
| Max. Negotiated Rate |
$3,028.03 |
| Rate for Payer: Aetna Commercial |
$2,859.81
|
| Rate for Payer: Aetna Medicare |
$731.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,186.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$878.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$878.82
|
| Rate for Payer: BCBS Complete |
$395.68
|
| Rate for Payer: BCBS MAPPO |
$703.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,870.80
|
| Rate for Payer: BCN Commercial |
$1,870.80
|
| Rate for Payer: BCN Medicare Advantage |
$703.06
|
| Rate for Payer: Cash Price |
$2,691.58
|
| Rate for Payer: Cash Price |
$2,691.58
|
| Rate for Payer: Cofinity Commercial |
$2,893.45
|
| Rate for Payer: Cofinity Commercial |
$2,355.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,355.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,691.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.06
|
| Rate for Payer: Healthscope Commercial |
$3,028.03
|
| Rate for Payer: Mclaren Medicaid |
$376.84
|
| Rate for Payer: Mclaren Medicare |
$703.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.21
|
| Rate for Payer: Meridian Medicaid |
$395.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,859.81
|
| Rate for Payer: Nomi Health Commercial |
$2,109.18
|
| Rate for Payer: PACE Medicare |
$667.91
|
| Rate for Payer: PACE SWMI |
$703.06
|
| Rate for Payer: PHP Commercial |
$2,859.81
|
| Rate for Payer: PHP Medicare Advantage |
$703.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$376.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,186.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,942.00
|
| Rate for Payer: Priority Health Medicare |
$703.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,553.60
|
| Rate for Payer: Priority Health SBD |
$2,119.62
|
| Rate for Payer: Railroad Medicare Medicare |
$703.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,979.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$703.06
|
| Rate for Payer: UHC Medicare Advantage |
$703.06
|
| Rate for Payer: UHCCP Medicaid |
$395.82
|
| Rate for Payer: VA VA |
$703.06
|
|
|
GRAFIX PRIME, GRAFIXPL PRIME, STRAVIX AND STRAVIXPL, PER SQUARE CENTIMETER
|
Facility
|
OP
|
$159.83
|
|
|
Service Code
|
CPT Q4133
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$159.83 |
| Max. Negotiated Rate |
$159.83 |
| Rate for Payer: BCBS Trust/PPO |
$159.83
|
| Rate for Payer: BCN Commercial |
$159.83
|
|
|
GRAFT; EAR CARTILAGE, AUTOGENOUS, TO NOSE OR EAR (INCLUDES OBTAINING GRAFT)
|
Facility
|
OP
|
$18,216.88
|
|
|
Service Code
|
CPT 21235
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$599.74 |
| Max. Negotiated Rate |
$18,216.88 |
| Rate for Payer: Aetna Medicare |
$6,027.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,245.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,245.06
|
| Rate for Payer: BCBS Complete |
$3,262.02
|
| Rate for Payer: BCBS MAPPO |
$5,796.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,135.21
|
| Rate for Payer: BCN Commercial |
$3,135.21
|
| Rate for Payer: BCN Medicare Advantage |
$5,796.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,796.05
|
| Rate for Payer: Mclaren Medicaid |
$3,106.68
|
| Rate for Payer: Mclaren Medicare |
$5,796.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,085.85
|
| Rate for Payer: Meridian Medicaid |
$3,262.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,665.46
|
| Rate for Payer: Nomi Health Commercial |
$12,171.70
|
| Rate for Payer: PACE Medicare |
$5,506.25
|
| Rate for Payer: PACE SWMI |
$5,796.05
|
| Rate for Payer: PHP Medicare Advantage |
$5,796.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,106.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,216.88
|
| Rate for Payer: Priority Health Medicare |
$5,796.05
|
| Rate for Payer: Priority Health Narrow Network |
$14,573.50
|
| Rate for Payer: Railroad Medicare Medicare |
$5,796.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$599.74
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,796.05
|
| Rate for Payer: UHC Exchange |
$3,362.00
|
| Rate for Payer: UHC Medicare Advantage |
$5,796.05
|
| Rate for Payer: UHCCP Medicaid |
$3,263.18
|
| Rate for Payer: VA VA |
$5,796.05
|
|
|
GRAFTING OF AUTOLOGOUS SOFT TISSUE, OTHER, HARVESTED BY DIRECT EXCISION (EG, FAT, DERMIS, FASCIA)
|
Facility
|
OP
|
$11,273.70
|
|
|
Service Code
|
CPT 15769
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$508.43 |
| Max. Negotiated Rate |
$11,273.70 |
| Rate for Payer: Aetna Medicare |
$3,730.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,483.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,483.69
|
| Rate for Payer: BCBS Complete |
$2,018.74
|
| Rate for Payer: BCBS MAPPO |
$3,586.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,493.89
|
| Rate for Payer: BCN Commercial |
$1,493.89
|
| Rate for Payer: BCN Medicare Advantage |
$3,586.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,586.95
|
| Rate for Payer: Mclaren Medicaid |
$1,922.61
|
| Rate for Payer: Mclaren Medicare |
$3,586.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,766.30
|
| Rate for Payer: Meridian Medicaid |
$2,018.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,124.99
|
| Rate for Payer: Nomi Health Commercial |
$7,532.60
|
| Rate for Payer: PACE Medicare |
$3,407.60
|
| Rate for Payer: PACE SWMI |
$3,586.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,586.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,922.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,273.70
|
| Rate for Payer: Priority Health Medicare |
$3,586.95
|
| Rate for Payer: Priority Health Narrow Network |
$9,018.96
|
| Rate for Payer: Railroad Medicare Medicare |
$3,586.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$508.43
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,586.95
|
| Rate for Payer: UHC Exchange |
$5,811.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,586.95
|
| Rate for Payer: UHCCP Medicaid |
$2,019.45
|
| Rate for Payer: VA VA |
$3,586.95
|
|
|
GUAIFENESIN 100 MG/5 ML ORAL LIQUID
|
Facility
|
OP
|
$3.80
|
|
|
Service Code
|
NDC 00121174410
|
| Hospital Charge Code |
3542
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.52 |
| Max. Negotiated Rate |
$3.42 |
| Rate for Payer: Aetna Commercial |
$3.23
|
| Rate for Payer: Aetna Medicare |
$1.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.47
|
| Rate for Payer: BCBS Complete |
$1.52
|
| Rate for Payer: Cash Price |
$3.04
|
| Rate for Payer: Cofinity Commercial |
$2.66
|
| Rate for Payer: Cofinity Commercial |
$3.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.04
|
| Rate for Payer: Healthscope Commercial |
$3.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.23
|
| Rate for Payer: PHP Commercial |
$3.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.47
|
| Rate for Payer: Priority Health SBD |
$2.39
|
|
|
GUAIFENESIN 100 MG/5 ML ORAL LIQUID
|
Facility
|
OP
|
$3.14
|
|
|
Service Code
|
NDC 50383006312
|
| Hospital Charge Code |
3542
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$2.83 |
| Rate for Payer: Aetna Commercial |
$2.67
|
| Rate for Payer: Aetna Medicare |
$1.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.04
|
| Rate for Payer: BCBS Complete |
$1.26
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Cofinity Commercial |
$2.20
|
| Rate for Payer: Cofinity Commercial |
$2.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.51
|
| Rate for Payer: Healthscope Commercial |
$2.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.67
|
| Rate for Payer: PHP Commercial |
$2.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.04
|
| Rate for Payer: Priority Health SBD |
$1.98
|
|
|
GUAIFENESIN 100 MG/5 ML ORAL LIQUID
|
Facility
|
IP
|
$3.80
|
|
|
Service Code
|
NDC 00121174410
|
| Hospital Charge Code |
3542
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.39 |
| Max. Negotiated Rate |
$3.42 |
| Rate for Payer: Aetna Commercial |
$3.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.47
|
| Rate for Payer: Cash Price |
$3.04
|
| Rate for Payer: Cofinity Commercial |
$2.66
|
| Rate for Payer: Cofinity Commercial |
$3.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.04
|
| Rate for Payer: Healthscope Commercial |
$3.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.23
|
| Rate for Payer: PHP Commercial |
$3.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.47
|
| Rate for Payer: Priority Health SBD |
$2.39
|
|
|
GUAIFENESIN 100 MG/5 ML ORAL LIQUID
|
Facility
|
IP
|
$7.73
|
|
|
Service Code
|
NDC 00121148800
|
| Hospital Charge Code |
3542
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.87 |
| Max. Negotiated Rate |
$6.96 |
| Rate for Payer: Aetna Commercial |
$6.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.02
|
| Rate for Payer: Cash Price |
$6.18
|
| Rate for Payer: Cofinity Commercial |
$5.41
|
| Rate for Payer: Cofinity Commercial |
$6.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.18
|
| Rate for Payer: Healthscope Commercial |
$6.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.57
|
| Rate for Payer: PHP Commercial |
$6.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.02
|
| Rate for Payer: Priority Health SBD |
$4.87
|
|
|
GUAIFENESIN 100 MG/5 ML ORAL LIQUID
|
Facility
|
IP
|
$3.14
|
|
|
Service Code
|
NDC 50383006312
|
| Hospital Charge Code |
3542
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.98 |
| Max. Negotiated Rate |
$2.83 |
| Rate for Payer: Aetna Commercial |
$2.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.04
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Cofinity Commercial |
$2.20
|
| Rate for Payer: Cofinity Commercial |
$2.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.51
|
| Rate for Payer: Healthscope Commercial |
$2.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.67
|
| Rate for Payer: PHP Commercial |
$2.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.04
|
| Rate for Payer: Priority Health SBD |
$1.98
|
|
|
GUAIFENESIN 100 MG/5 ML ORAL LIQUID
|
Facility
|
IP
|
$7.73
|
|
|
Service Code
|
NDC 00121148810
|
| Hospital Charge Code |
3542
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.87 |
| Max. Negotiated Rate |
$6.96 |
| Rate for Payer: Aetna Commercial |
$6.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.02
|
| Rate for Payer: Cash Price |
$6.18
|
| Rate for Payer: Cofinity Commercial |
$5.41
|
| Rate for Payer: Cofinity Commercial |
$6.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.18
|
| Rate for Payer: Healthscope Commercial |
$6.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.57
|
| Rate for Payer: PHP Commercial |
$6.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.02
|
| Rate for Payer: Priority Health SBD |
$4.87
|
|
|
GUAIFENESIN 100 MG/5 ML ORAL LIQUID
|
Facility
|
OP
|
$7.73
|
|
|
Service Code
|
NDC 00121148810
|
| Hospital Charge Code |
3542
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$6.96 |
| Rate for Payer: Aetna Commercial |
$6.57
|
| Rate for Payer: Aetna Medicare |
$3.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.02
|
| Rate for Payer: BCBS Complete |
$3.09
|
| Rate for Payer: Cash Price |
$6.18
|
| Rate for Payer: Cofinity Commercial |
$5.41
|
| Rate for Payer: Cofinity Commercial |
$6.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.18
|
| Rate for Payer: Healthscope Commercial |
$6.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.57
|
| Rate for Payer: PHP Commercial |
$6.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.02
|
| Rate for Payer: Priority Health SBD |
$4.87
|
|
|
GUAIFENESIN 100 MG/5 ML ORAL LIQUID
|
Facility
|
OP
|
$7.73
|
|
|
Service Code
|
NDC 00121148800
|
| Hospital Charge Code |
3542
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$6.96 |
| Rate for Payer: Aetna Commercial |
$6.57
|
| Rate for Payer: Aetna Medicare |
$3.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.02
|
| Rate for Payer: BCBS Complete |
$3.09
|
| Rate for Payer: Cash Price |
$6.18
|
| Rate for Payer: Cofinity Commercial |
$5.41
|
| Rate for Payer: Cofinity Commercial |
$6.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.18
|
| Rate for Payer: Healthscope Commercial |
$6.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.57
|
| Rate for Payer: PHP Commercial |
$6.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.02
|
| Rate for Payer: Priority Health SBD |
$4.87
|
|
