|
FUROSEMIDE 20 MG TABLET
|
Facility
|
IP
|
$368.95
|
|
|
Service Code
|
NDC 00054829725
|
| Hospital Charge Code |
3294
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$256.79 |
| Max. Negotiated Rate |
$332.06 |
| Rate for Payer: Aetna Commercial |
$313.61
|
| Rate for Payer: BCBS Trust/PPO |
$304.72
|
| Rate for Payer: BCN Commercial |
$304.72
|
| Rate for Payer: Cash Price |
$295.16
|
| Rate for Payer: Cofinity Commercial |
$317.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.16
|
| Rate for Payer: Healthscope Commercial |
$332.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.61
|
| Rate for Payer: Nomi Health Commercial |
$302.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.71
|
| Rate for Payer: PHP Commercial |
$313.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$320.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.68
|
| Rate for Payer: UHC Core |
$308.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.71
|
|
|
FUROSEMIDE 20 MG TABLET
|
Facility
|
IP
|
$138.65
|
|
|
Service Code
|
NDC 00904717761
|
| Hospital Charge Code |
3294
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$96.50 |
| Max. Negotiated Rate |
$124.78 |
| Rate for Payer: Aetna Commercial |
$117.85
|
| Rate for Payer: BCBS Trust/PPO |
$114.51
|
| Rate for Payer: BCN Commercial |
$114.51
|
| Rate for Payer: Cash Price |
$110.92
|
| Rate for Payer: Cofinity Commercial |
$119.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.92
|
| Rate for Payer: Healthscope Commercial |
$124.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.85
|
| Rate for Payer: Nomi Health Commercial |
$113.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.99
|
| Rate for Payer: PHP Commercial |
$117.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$120.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.01
|
| Rate for Payer: UHC Core |
$115.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.99
|
|
|
FUROSEMIDE 20 MG TABLET
|
Facility
|
OP
|
$1.37
|
|
|
Service Code
|
NDC 51079007201
|
| Hospital Charge Code |
3294
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$1.23 |
| Rate for Payer: Aetna Commercial |
$1.16
|
| Rate for Payer: Aetna Medicare |
$0.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.43
|
| Rate for Payer: BCBS Complete |
$0.25
|
| Rate for Payer: BCBS MAPPO |
$0.34
|
| Rate for Payer: BCBS Trust/PPO |
$1.13
|
| Rate for Payer: BCN Commercial |
$1.13
|
| Rate for Payer: BCN Medicare Advantage |
$0.34
|
| Rate for Payer: Cash Price |
$1.10
|
| Rate for Payer: Cofinity Commercial |
$1.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.34
|
| Rate for Payer: Healthscope Commercial |
$1.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.03
|
| Rate for Payer: Mclaren Medicaid |
$0.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.36
|
| Rate for Payer: Meridian Medicaid |
$0.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.16
|
| Rate for Payer: Nomi Health Commercial |
$1.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.03
|
| Rate for Payer: PACE Senior Care Partners |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.34
|
| Rate for Payer: PHP Commercial |
$1.16
|
| Rate for Payer: PHP Medicare Advantage |
$0.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.19
|
| Rate for Payer: Priority Health Medicare |
$0.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.95
|
| Rate for Payer: Railroad Medicare Medicare |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.21
|
| Rate for Payer: UHC Core |
$1.14
|
| Rate for Payer: UHC Exchange |
$0.34
|
| Rate for Payer: UHC Medicaid |
$0.24
|
| Rate for Payer: UHC Medicare Advantage |
$0.34
|
| Rate for Payer: UHCCP Medicaid |
$0.24
|
| Rate for Payer: VA VA |
$0.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.03
|
|
|
FUROSEMIDE 20 MG TABLET
|
Facility
|
OP
|
$368.95
|
|
|
Service Code
|
NDC 00054829725
|
| Hospital Charge Code |
3294
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$65.05 |
| Max. Negotiated Rate |
$332.06 |
| Rate for Payer: Aetna Commercial |
$313.61
|
| Rate for Payer: Aetna Medicare |
$95.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.30
|
| Rate for Payer: BCBS Complete |
$68.29
|
| Rate for Payer: BCBS MAPPO |
$92.24
|
| Rate for Payer: BCBS Trust/PPO |
$303.31
|
| Rate for Payer: BCN Commercial |
$303.31
|
| Rate for Payer: BCN Medicare Advantage |
$92.24
|
| Rate for Payer: Cash Price |
$295.16
|
| Rate for Payer: Cofinity Commercial |
$317.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.24
|
| Rate for Payer: Healthscope Commercial |
$332.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.71
|
| Rate for Payer: Mclaren Medicaid |
$65.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.85
|
| Rate for Payer: Meridian Medicaid |
$68.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$101.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.61
|
| Rate for Payer: Nomi Health Commercial |
$302.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.71
|
| Rate for Payer: PACE Senior Care Partners |
$87.63
|
| Rate for Payer: PACE SWMI |
$92.24
|
| Rate for Payer: PHP Commercial |
$313.61
|
| Rate for Payer: PHP Medicare Advantage |
$92.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$320.99
|
| Rate for Payer: Priority Health Medicare |
$93.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.79
|
| Rate for Payer: Railroad Medicare Medicare |
$92.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.68
|
| Rate for Payer: UHC Core |
$308.07
|
| Rate for Payer: UHC Exchange |
$92.24
|
| Rate for Payer: UHC Medicaid |
$65.05
|
| Rate for Payer: UHC Medicare Advantage |
$92.24
|
| Rate for Payer: UHCCP Medicaid |
$65.05
|
| Rate for Payer: VA VA |
$92.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.71
|
|
|
FUROSEMIDE 20 MG TABLET
|
Facility
|
IP
|
$1.37
|
|
|
Service Code
|
NDC 51079007201
|
| Hospital Charge Code |
3294
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.95 |
| Max. Negotiated Rate |
$1.23 |
| Rate for Payer: Aetna Commercial |
$1.16
|
| Rate for Payer: BCBS Trust/PPO |
$1.13
|
| Rate for Payer: BCN Commercial |
$1.13
|
| Rate for Payer: Cash Price |
$1.10
|
| Rate for Payer: Cofinity Commercial |
$1.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.10
|
| Rate for Payer: Healthscope Commercial |
$1.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.16
|
| Rate for Payer: Nomi Health Commercial |
$1.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.03
|
| Rate for Payer: PHP Commercial |
$1.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.21
|
| Rate for Payer: UHC Core |
$1.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.03
|
|
|
FUROSEMIDE 20 MG TABLET
|
Facility
|
OP
|
$138.65
|
|
|
Service Code
|
NDC 00904717761
|
| Hospital Charge Code |
3294
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$24.44 |
| Max. Negotiated Rate |
$124.78 |
| Rate for Payer: Aetna Commercial |
$117.85
|
| Rate for Payer: Aetna Medicare |
$36.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.33
|
| Rate for Payer: BCBS Complete |
$25.66
|
| Rate for Payer: BCBS MAPPO |
$34.66
|
| Rate for Payer: BCBS Trust/PPO |
$113.98
|
| Rate for Payer: BCN Commercial |
$113.98
|
| Rate for Payer: BCN Medicare Advantage |
$34.66
|
| Rate for Payer: Cash Price |
$110.92
|
| Rate for Payer: Cofinity Commercial |
$119.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.66
|
| Rate for Payer: Healthscope Commercial |
$124.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.99
|
| Rate for Payer: Mclaren Medicaid |
$24.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.40
|
| Rate for Payer: Meridian Medicaid |
$25.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.85
|
| Rate for Payer: Nomi Health Commercial |
$113.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.99
|
| Rate for Payer: PACE Senior Care Partners |
$32.93
|
| Rate for Payer: PACE SWMI |
$34.66
|
| Rate for Payer: PHP Commercial |
$117.85
|
| Rate for Payer: PHP Medicare Advantage |
$34.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$120.63
|
| Rate for Payer: Priority Health Medicare |
$35.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.50
|
| Rate for Payer: Railroad Medicare Medicare |
$34.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.01
|
| Rate for Payer: UHC Core |
$115.77
|
| Rate for Payer: UHC Exchange |
$34.66
|
| Rate for Payer: UHC Medicaid |
$24.44
|
| Rate for Payer: UHC Medicare Advantage |
$34.66
|
| Rate for Payer: UHCCP Medicaid |
$24.44
|
| Rate for Payer: VA VA |
$34.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.99
|
|
|
FUROSEMIDE 40 MG TABLET
|
Facility
|
IP
|
$1.49
|
|
|
Service Code
|
NDC 51079007301
|
| Hospital Charge Code |
3295
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.04 |
| Max. Negotiated Rate |
$1.34 |
| Rate for Payer: Aetna Commercial |
$1.27
|
| Rate for Payer: BCBS Trust/PPO |
$1.23
|
| Rate for Payer: BCN Commercial |
$1.23
|
| Rate for Payer: Cash Price |
$1.19
|
| Rate for Payer: Cofinity Commercial |
$1.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.19
|
| Rate for Payer: Healthscope Commercial |
$1.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.27
|
| Rate for Payer: Nomi Health Commercial |
$1.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.12
|
| Rate for Payer: PHP Commercial |
$1.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.31
|
| Rate for Payer: UHC Core |
$1.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.12
|
|
|
FUROSEMIDE 40 MG TABLET
|
Facility
|
OP
|
$1.49
|
|
|
Service Code
|
NDC 51079007301
|
| Hospital Charge Code |
3295
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.26 |
| Max. Negotiated Rate |
$1.34 |
| Rate for Payer: Aetna Commercial |
$1.27
|
| Rate for Payer: Aetna Medicare |
$0.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.47
|
| Rate for Payer: BCBS Complete |
$0.28
|
| Rate for Payer: BCBS MAPPO |
$0.37
|
| Rate for Payer: BCBS Trust/PPO |
$1.22
|
| Rate for Payer: BCN Commercial |
$1.22
|
| Rate for Payer: BCN Medicare Advantage |
$0.37
|
| Rate for Payer: Cash Price |
$1.19
|
| Rate for Payer: Cofinity Commercial |
$1.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.37
|
| Rate for Payer: Healthscope Commercial |
$1.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.12
|
| Rate for Payer: Mclaren Medicaid |
$0.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.39
|
| Rate for Payer: Meridian Medicaid |
$0.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.27
|
| Rate for Payer: Nomi Health Commercial |
$1.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.12
|
| Rate for Payer: PACE Senior Care Partners |
$0.35
|
| Rate for Payer: PACE SWMI |
$0.37
|
| Rate for Payer: PHP Commercial |
$1.27
|
| Rate for Payer: PHP Medicare Advantage |
$0.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.30
|
| Rate for Payer: Priority Health Medicare |
$0.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.04
|
| Rate for Payer: Railroad Medicare Medicare |
$0.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.31
|
| Rate for Payer: UHC Core |
$1.24
|
| Rate for Payer: UHC Exchange |
$0.37
|
| Rate for Payer: UHC Medicaid |
$0.26
|
| Rate for Payer: UHC Medicare Advantage |
$0.37
|
| Rate for Payer: UHCCP Medicaid |
$0.26
|
| Rate for Payer: VA VA |
$0.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.12
|
|
|
FUROSEMIDE 40 MG TABLET
|
Facility
|
IP
|
$413.60
|
|
|
Service Code
|
NDC 00054829925
|
| Hospital Charge Code |
3295
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$287.87 |
| Max. Negotiated Rate |
$372.24 |
| Rate for Payer: Aetna Commercial |
$351.56
|
| Rate for Payer: BCBS Trust/PPO |
$341.59
|
| Rate for Payer: BCN Commercial |
$341.59
|
| Rate for Payer: Cash Price |
$330.88
|
| Rate for Payer: Cofinity Commercial |
$355.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.88
|
| Rate for Payer: Healthscope Commercial |
$372.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.56
|
| Rate for Payer: Nomi Health Commercial |
$339.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.20
|
| Rate for Payer: PHP Commercial |
$351.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$359.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$287.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.97
|
| Rate for Payer: UHC Core |
$345.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.20
|
|
|
FUROSEMIDE 40 MG TABLET
|
Facility
|
IP
|
$199.75
|
|
|
Service Code
|
NDC 00904717861
|
| Hospital Charge Code |
3295
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$139.03 |
| Max. Negotiated Rate |
$179.78 |
| Rate for Payer: Aetna Commercial |
$169.79
|
| Rate for Payer: BCBS Trust/PPO |
$164.97
|
| Rate for Payer: BCN Commercial |
$164.97
|
| Rate for Payer: Cash Price |
$159.80
|
| Rate for Payer: Cofinity Commercial |
$171.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.80
|
| Rate for Payer: Healthscope Commercial |
$179.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.79
|
| Rate for Payer: Nomi Health Commercial |
$163.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.81
|
| Rate for Payer: PHP Commercial |
$169.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$173.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.78
|
| Rate for Payer: UHC Core |
$166.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.81
|
|
|
FUROSEMIDE 40 MG TABLET
|
Facility
|
OP
|
$413.60
|
|
|
Service Code
|
NDC 00054829925
|
| Hospital Charge Code |
3295
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$72.92 |
| Max. Negotiated Rate |
$372.24 |
| Rate for Payer: Aetna Commercial |
$351.56
|
| Rate for Payer: Aetna Medicare |
$107.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.25
|
| Rate for Payer: BCBS Complete |
$76.56
|
| Rate for Payer: BCBS MAPPO |
$103.40
|
| Rate for Payer: BCBS Trust/PPO |
$340.02
|
| Rate for Payer: BCN Commercial |
$340.02
|
| Rate for Payer: BCN Medicare Advantage |
$103.40
|
| Rate for Payer: Cash Price |
$330.88
|
| Rate for Payer: Cofinity Commercial |
$355.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.40
|
| Rate for Payer: Healthscope Commercial |
$372.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.20
|
| Rate for Payer: Mclaren Medicaid |
$72.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.57
|
| Rate for Payer: Meridian Medicaid |
$76.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$113.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.56
|
| Rate for Payer: Nomi Health Commercial |
$339.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.20
|
| Rate for Payer: PACE Senior Care Partners |
$98.23
|
| Rate for Payer: PACE SWMI |
$103.40
|
| Rate for Payer: PHP Commercial |
$351.56
|
| Rate for Payer: PHP Medicare Advantage |
$103.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$359.83
|
| Rate for Payer: Priority Health Medicare |
$104.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$287.87
|
| Rate for Payer: Railroad Medicare Medicare |
$103.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.97
|
| Rate for Payer: UHC Core |
$345.36
|
| Rate for Payer: UHC Exchange |
$103.40
|
| Rate for Payer: UHC Medicaid |
$72.92
|
| Rate for Payer: UHC Medicare Advantage |
$103.40
|
| Rate for Payer: UHCCP Medicaid |
$72.92
|
| Rate for Payer: VA VA |
$103.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.20
|
|
|
FUROSEMIDE 40 MG TABLET
|
Facility
|
OP
|
$199.75
|
|
|
Service Code
|
NDC 00904717861
|
| Hospital Charge Code |
3295
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$35.22 |
| Max. Negotiated Rate |
$179.78 |
| Rate for Payer: Aetna Commercial |
$169.79
|
| Rate for Payer: Aetna Medicare |
$51.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.42
|
| Rate for Payer: BCBS Complete |
$36.97
|
| Rate for Payer: BCBS MAPPO |
$49.94
|
| Rate for Payer: BCBS Trust/PPO |
$164.21
|
| Rate for Payer: BCN Commercial |
$164.21
|
| Rate for Payer: BCN Medicare Advantage |
$49.94
|
| Rate for Payer: Cash Price |
$159.80
|
| Rate for Payer: Cofinity Commercial |
$171.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$179.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.81
|
| Rate for Payer: Mclaren Medicaid |
$35.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.43
|
| Rate for Payer: Meridian Medicaid |
$36.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.79
|
| Rate for Payer: Nomi Health Commercial |
$163.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.81
|
| Rate for Payer: PACE Senior Care Partners |
$47.44
|
| Rate for Payer: PACE SWMI |
$49.94
|
| Rate for Payer: PHP Commercial |
$169.79
|
| Rate for Payer: PHP Medicare Advantage |
$49.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$173.78
|
| Rate for Payer: Priority Health Medicare |
$50.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.03
|
| Rate for Payer: Railroad Medicare Medicare |
$49.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.78
|
| Rate for Payer: UHC Core |
$166.79
|
| Rate for Payer: UHC Exchange |
$49.94
|
| Rate for Payer: UHC Medicaid |
$35.22
|
| Rate for Payer: UHC Medicare Advantage |
$49.94
|
| Rate for Payer: UHCCP Medicaid |
$35.22
|
| Rate for Payer: VA VA |
$49.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.81
|
|
|
G1001 CDSM - EVICORE
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G1001
|
| Hospital Charge Code |
99000393
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
G1001 CDSM - EVICORE
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G1001
|
| Hospital Charge Code |
99000393
|
|
Hospital Revenue Code
|
990
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.00
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: BCBS MAPPO |
$0.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.00
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Mclaren Medicaid |
$0.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.00
|
| Rate for Payer: Meridian Medicaid |
$0.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PACE Senior Care Partners |
$0.00
|
| Rate for Payer: PACE SWMI |
$0.00
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$0.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$0.00
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.00
|
| Rate for Payer: UHC Medicaid |
$0.00
|
| Rate for Payer: UHC Medicare Advantage |
$0.00
|
| Rate for Payer: UHCCP Medicaid |
$0.00
|
| Rate for Payer: VA VA |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
G1002 CDSM - MEDCURRENT
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G1002
|
| Hospital Charge Code |
99000394
|
|
Hospital Revenue Code
|
990
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.00
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: BCBS MAPPO |
$0.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.00
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Mclaren Medicaid |
$0.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.00
|
| Rate for Payer: Meridian Medicaid |
$0.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PACE Senior Care Partners |
$0.00
|
| Rate for Payer: PACE SWMI |
$0.00
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$0.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$0.00
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.00
|
| Rate for Payer: UHC Medicaid |
$0.00
|
| Rate for Payer: UHC Medicare Advantage |
$0.00
|
| Rate for Payer: UHCCP Medicaid |
$0.00
|
| Rate for Payer: VA VA |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
G1002 CDSM - MEDCURRENT
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G1002
|
| Hospital Charge Code |
99000394
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
G1003 CDSM - MEDICALIS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G1003
|
| Hospital Charge Code |
99000395
|
|
Hospital Revenue Code
|
990
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.00
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: BCBS MAPPO |
$0.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.00
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Mclaren Medicaid |
$0.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.00
|
| Rate for Payer: Meridian Medicaid |
$0.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PACE Senior Care Partners |
$0.00
|
| Rate for Payer: PACE SWMI |
$0.00
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$0.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$0.00
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.00
|
| Rate for Payer: UHC Medicaid |
$0.00
|
| Rate for Payer: UHC Medicare Advantage |
$0.00
|
| Rate for Payer: UHCCP Medicaid |
$0.00
|
| Rate for Payer: VA VA |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
G1003 CDSM - MEDICALIS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G1003
|
| Hospital Charge Code |
99000395
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
G1004 CDSM - NATIONAL DECISION SUPPORT COMPANY
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G1004
|
| Hospital Charge Code |
99000396
|
|
Hospital Revenue Code
|
990
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.00
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: BCBS MAPPO |
$0.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.00
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Mclaren Medicaid |
$0.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.00
|
| Rate for Payer: Meridian Medicaid |
$0.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PACE Senior Care Partners |
$0.00
|
| Rate for Payer: PACE SWMI |
$0.00
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$0.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$0.00
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.00
|
| Rate for Payer: UHC Medicaid |
$0.00
|
| Rate for Payer: UHC Medicare Advantage |
$0.00
|
| Rate for Payer: UHCCP Medicaid |
$0.00
|
| Rate for Payer: VA VA |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
G1004 CDSM - NATIONAL DECISION SUPPORT COMPANY
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G1004
|
| Hospital Charge Code |
99000396
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
G1007 CDSM - AIM SPECIALITY HEALTH
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G1007
|
| Hospital Charge Code |
99000399
|
|
Hospital Revenue Code
|
990
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.00
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: BCBS MAPPO |
$0.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.00
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Mclaren Medicaid |
$0.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.00
|
| Rate for Payer: Meridian Medicaid |
$0.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PACE Senior Care Partners |
$0.00
|
| Rate for Payer: PACE SWMI |
$0.00
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$0.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$0.00
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.00
|
| Rate for Payer: UHC Medicaid |
$0.00
|
| Rate for Payer: UHC Medicare Advantage |
$0.00
|
| Rate for Payer: UHCCP Medicaid |
$0.00
|
| Rate for Payer: VA VA |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
G1007 CDSM - AIM SPECIALITY HEALTH
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G1007
|
| Hospital Charge Code |
99000399
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
G1008 CDSM - CRANBERRY PEAK
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G1008
|
| Hospital Charge Code |
99000400
|
|
Hospital Revenue Code
|
990
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.00
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: BCBS MAPPO |
$0.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.00
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Mclaren Medicaid |
$0.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.00
|
| Rate for Payer: Meridian Medicaid |
$0.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PACE Senior Care Partners |
$0.00
|
| Rate for Payer: PACE SWMI |
$0.00
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$0.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$0.00
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.00
|
| Rate for Payer: UHC Medicaid |
$0.00
|
| Rate for Payer: UHC Medicare Advantage |
$0.00
|
| Rate for Payer: UHCCP Medicaid |
$0.00
|
| Rate for Payer: VA VA |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
G1008 CDSM - CRANBERRY PEAK
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G1008
|
| Hospital Charge Code |
99000400
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
G1010 CDSM - STANSON
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G1010
|
| Hospital Charge Code |
99000402
|
|
Hospital Revenue Code
|
990
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.00
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: BCBS MAPPO |
$0.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.00
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Mclaren Medicaid |
$0.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.00
|
| Rate for Payer: Meridian Medicaid |
$0.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PACE Senior Care Partners |
$0.00
|
| Rate for Payer: PACE SWMI |
$0.00
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$0.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$0.00
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.00
|
| Rate for Payer: UHC Medicaid |
$0.00
|
| Rate for Payer: UHC Medicare Advantage |
$0.00
|
| Rate for Payer: UHCCP Medicaid |
$0.00
|
| Rate for Payer: VA VA |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
