|
GYNECOLOGIC PROCEDURES FOR MALIGNANCY
|
Facility
|
IP
|
$24,311.16
|
|
|
Service Code
|
APR-DRG 5114
|
| Min. Negotiated Rate |
$23,153.49 |
| Max. Negotiated Rate |
$24,311.16 |
| Rate for Payer: BCBS Complete |
$24,311.16
|
| Rate for Payer: Mclaren Medicaid |
$23,153.49
|
| Rate for Payer: Meridian Medicaid |
$24,311.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$23,153.49
|
| Rate for Payer: UHC Medicaid |
$23,153.49
|
| Rate for Payer: UHCCP Medicaid |
$23,153.49
|
|
|
GYNECOLOGIC PROCEDURES FOR MALIGNANCY
|
Facility
|
IP
|
$9,623.92
|
|
|
Service Code
|
APR-DRG 5112
|
| Min. Negotiated Rate |
$9,165.64 |
| Max. Negotiated Rate |
$9,623.92 |
| Rate for Payer: BCBS Complete |
$9,623.92
|
| Rate for Payer: Mclaren Medicaid |
$9,165.64
|
| Rate for Payer: Meridian Medicaid |
$9,623.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,165.64
|
| Rate for Payer: UHC Medicaid |
$9,165.64
|
| Rate for Payer: UHCCP Medicaid |
$9,165.64
|
|
|
GYNECOLOGIC PROCEDURES FOR MALIGNANCY
|
Facility
|
IP
|
$13,797.52
|
|
|
Service Code
|
APR-DRG 5113
|
| Min. Negotiated Rate |
$13,140.49 |
| Max. Negotiated Rate |
$13,797.52 |
| Rate for Payer: BCBS Complete |
$13,797.52
|
| Rate for Payer: Mclaren Medicaid |
$13,140.49
|
| Rate for Payer: Meridian Medicaid |
$13,797.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,140.49
|
| Rate for Payer: UHC Medicaid |
$13,140.49
|
| Rate for Payer: UHCCP Medicaid |
$13,140.49
|
|
|
GYNECOLOGIC PROCEDURES WITHOUT MALIGNANCY
|
Facility
|
IP
|
$27,145.44
|
|
|
Service Code
|
APR-DRG 5134
|
| Min. Negotiated Rate |
$25,852.80 |
| Max. Negotiated Rate |
$27,145.44 |
| Rate for Payer: BCBS Complete |
$27,145.44
|
| Rate for Payer: Mclaren Medicaid |
$25,852.80
|
| Rate for Payer: Meridian Medicaid |
$27,145.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$25,852.80
|
| Rate for Payer: UHC Medicaid |
$25,852.80
|
| Rate for Payer: UHCCP Medicaid |
$25,852.80
|
|
|
GYNECOLOGIC PROCEDURES WITHOUT MALIGNANCY
|
Facility
|
IP
|
$6,904.81
|
|
|
Service Code
|
APR-DRG 5131
|
| Min. Negotiated Rate |
$6,576.00 |
| Max. Negotiated Rate |
$6,904.81 |
| Rate for Payer: BCBS Complete |
$6,904.81
|
| Rate for Payer: Mclaren Medicaid |
$6,576.00
|
| Rate for Payer: Meridian Medicaid |
$6,904.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,576.00
|
| Rate for Payer: UHC Medicaid |
$6,576.00
|
| Rate for Payer: UHCCP Medicaid |
$6,576.00
|
|
|
GYNECOLOGIC PROCEDURES WITHOUT MALIGNANCY
|
Facility
|
IP
|
$8,953.48
|
|
|
Service Code
|
APR-DRG 5132
|
| Min. Negotiated Rate |
$8,527.12 |
| Max. Negotiated Rate |
$8,953.48 |
| Rate for Payer: BCBS Complete |
$8,953.48
|
| Rate for Payer: Mclaren Medicaid |
$8,527.12
|
| Rate for Payer: Meridian Medicaid |
$8,953.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,527.12
|
| Rate for Payer: UHC Medicaid |
$8,527.12
|
| Rate for Payer: UHCCP Medicaid |
$8,527.12
|
|
|
GYNECOLOGIC PROCEDURES WITHOUT MALIGNANCY
|
Facility
|
IP
|
$13,614.00
|
|
|
Service Code
|
APR-DRG 5133
|
| Min. Negotiated Rate |
$12,965.71 |
| Max. Negotiated Rate |
$13,614.00 |
| Rate for Payer: BCBS Complete |
$13,614.00
|
| Rate for Payer: Mclaren Medicaid |
$12,965.71
|
| Rate for Payer: Meridian Medicaid |
$13,614.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,965.71
|
| Rate for Payer: UHC Medicaid |
$12,965.71
|
| Rate for Payer: UHCCP Medicaid |
$12,965.71
|
|
|
HAIR REMOVAL
|
Professional
|
Both
|
$84.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Medicare |
$42.00
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
|
|
HALOPERIDOL 1 MG TABLET
|
Facility
|
IP
|
$290.70
|
|
|
Service Code
|
NDC 00904739061
|
| Hospital Charge Code |
3579
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$202.33 |
| Max. Negotiated Rate |
$261.63 |
| Rate for Payer: Aetna Commercial |
$247.09
|
| Rate for Payer: BCBS Trust/PPO |
$240.09
|
| Rate for Payer: BCN Commercial |
$240.09
|
| Rate for Payer: Cash Price |
$232.56
|
| Rate for Payer: Cofinity Commercial |
$250.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.56
|
| Rate for Payer: Healthscope Commercial |
$261.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.09
|
| Rate for Payer: Nomi Health Commercial |
$238.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.03
|
| Rate for Payer: PHP Commercial |
$247.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$252.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$202.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.82
|
| Rate for Payer: UHC Core |
$242.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.03
|
|
|
HALOPERIDOL 1 MG TABLET
|
Facility
|
IP
|
$4.12
|
|
|
Service Code
|
NDC 51079073401
|
| Hospital Charge Code |
3579
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.87 |
| Max. Negotiated Rate |
$3.71 |
| Rate for Payer: Aetna Commercial |
$3.50
|
| Rate for Payer: BCBS Trust/PPO |
$3.40
|
| Rate for Payer: BCN Commercial |
$3.40
|
| Rate for Payer: Cash Price |
$3.30
|
| Rate for Payer: Cofinity Commercial |
$3.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.30
|
| Rate for Payer: Healthscope Commercial |
$3.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.50
|
| Rate for Payer: Nomi Health Commercial |
$3.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.09
|
| Rate for Payer: PHP Commercial |
$3.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.63
|
| Rate for Payer: UHC Core |
$3.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.09
|
|
|
HALOPERIDOL 1 MG TABLET
|
Facility
|
OP
|
$411.35
|
|
|
Service Code
|
NDC 51079073420
|
| Hospital Charge Code |
3579
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$72.52 |
| Max. Negotiated Rate |
$370.21 |
| Rate for Payer: Aetna Commercial |
$349.65
|
| Rate for Payer: Aetna Medicare |
$106.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$128.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$128.55
|
| Rate for Payer: BCBS Complete |
$76.14
|
| Rate for Payer: BCBS MAPPO |
$102.84
|
| Rate for Payer: BCBS Trust/PPO |
$338.17
|
| Rate for Payer: BCN Commercial |
$338.17
|
| Rate for Payer: BCN Medicare Advantage |
$102.84
|
| Rate for Payer: Cash Price |
$329.08
|
| Rate for Payer: Cofinity Commercial |
$353.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.84
|
| Rate for Payer: Healthscope Commercial |
$370.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$308.51
|
| Rate for Payer: Mclaren Medicaid |
$72.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.98
|
| Rate for Payer: Meridian Medicaid |
$76.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$113.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.65
|
| Rate for Payer: Nomi Health Commercial |
$337.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$308.51
|
| Rate for Payer: PACE Senior Care Partners |
$97.70
|
| Rate for Payer: PACE SWMI |
$102.84
|
| Rate for Payer: PHP Commercial |
$349.65
|
| Rate for Payer: PHP Medicare Advantage |
$102.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$357.87
|
| Rate for Payer: Priority Health Medicare |
$103.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$286.30
|
| Rate for Payer: Railroad Medicare Medicare |
$102.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$361.99
|
| Rate for Payer: UHC Core |
$343.48
|
| Rate for Payer: UHC Exchange |
$102.84
|
| Rate for Payer: UHC Medicaid |
$72.52
|
| Rate for Payer: UHC Medicare Advantage |
$102.84
|
| Rate for Payer: UHCCP Medicaid |
$72.52
|
| Rate for Payer: VA VA |
$102.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$308.51
|
|
|
HALOPERIDOL 1 MG TABLET
|
Facility
|
IP
|
$411.35
|
|
|
Service Code
|
NDC 51079073420
|
| Hospital Charge Code |
3579
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$286.30 |
| Max. Negotiated Rate |
$370.21 |
| Rate for Payer: Aetna Commercial |
$349.65
|
| Rate for Payer: BCBS Trust/PPO |
$339.73
|
| Rate for Payer: BCN Commercial |
$339.73
|
| Rate for Payer: Cash Price |
$329.08
|
| Rate for Payer: Cofinity Commercial |
$353.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.08
|
| Rate for Payer: Healthscope Commercial |
$370.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$308.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.65
|
| Rate for Payer: Nomi Health Commercial |
$337.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$308.51
|
| Rate for Payer: PHP Commercial |
$349.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$357.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$286.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$361.99
|
| Rate for Payer: UHC Core |
$343.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$308.51
|
|
|
HALOPERIDOL 1 MG TABLET
|
Facility
|
OP
|
$4.12
|
|
|
Service Code
|
NDC 51079073401
|
| Hospital Charge Code |
3579
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.73 |
| Max. Negotiated Rate |
$3.71 |
| Rate for Payer: Aetna Commercial |
$3.50
|
| Rate for Payer: Aetna Medicare |
$1.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.29
|
| Rate for Payer: BCBS Complete |
$0.76
|
| Rate for Payer: BCBS MAPPO |
$1.03
|
| Rate for Payer: BCBS Trust/PPO |
$3.39
|
| Rate for Payer: BCN Commercial |
$3.39
|
| Rate for Payer: BCN Medicare Advantage |
$1.03
|
| Rate for Payer: Cash Price |
$3.30
|
| Rate for Payer: Cofinity Commercial |
$3.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.03
|
| Rate for Payer: Healthscope Commercial |
$3.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.09
|
| Rate for Payer: Mclaren Medicaid |
$0.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.08
|
| Rate for Payer: Meridian Medicaid |
$0.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.50
|
| Rate for Payer: Nomi Health Commercial |
$3.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.09
|
| Rate for Payer: PACE Senior Care Partners |
$0.98
|
| Rate for Payer: PACE SWMI |
$1.03
|
| Rate for Payer: PHP Commercial |
$3.50
|
| Rate for Payer: PHP Medicare Advantage |
$1.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.58
|
| Rate for Payer: Priority Health Medicare |
$1.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.63
|
| Rate for Payer: UHC Core |
$3.44
|
| Rate for Payer: UHC Exchange |
$1.03
|
| Rate for Payer: UHC Medicaid |
$0.73
|
| Rate for Payer: UHC Medicare Advantage |
$1.03
|
| Rate for Payer: UHCCP Medicaid |
$0.73
|
| Rate for Payer: VA VA |
$1.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.09
|
|
|
HALOPERIDOL 1 MG TABLET
|
Facility
|
OP
|
$290.70
|
|
|
Service Code
|
NDC 00904739061
|
| Hospital Charge Code |
3579
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$51.25 |
| Max. Negotiated Rate |
$261.63 |
| Rate for Payer: Aetna Commercial |
$247.09
|
| Rate for Payer: Aetna Medicare |
$75.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$90.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$90.84
|
| Rate for Payer: BCBS Complete |
$53.81
|
| Rate for Payer: BCBS MAPPO |
$72.67
|
| Rate for Payer: BCBS Trust/PPO |
$238.98
|
| Rate for Payer: BCN Commercial |
$238.98
|
| Rate for Payer: BCN Medicare Advantage |
$72.67
|
| Rate for Payer: Cash Price |
$232.56
|
| Rate for Payer: Cofinity Commercial |
$250.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.67
|
| Rate for Payer: Healthscope Commercial |
$261.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.03
|
| Rate for Payer: Mclaren Medicaid |
$51.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.31
|
| Rate for Payer: Meridian Medicaid |
$53.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$79.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.09
|
| Rate for Payer: Nomi Health Commercial |
$238.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.03
|
| Rate for Payer: PACE Senior Care Partners |
$69.04
|
| Rate for Payer: PACE SWMI |
$72.67
|
| Rate for Payer: PHP Commercial |
$247.09
|
| Rate for Payer: PHP Medicare Advantage |
$72.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$252.91
|
| Rate for Payer: Priority Health Medicare |
$73.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$202.33
|
| Rate for Payer: Railroad Medicare Medicare |
$72.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.82
|
| Rate for Payer: UHC Core |
$242.73
|
| Rate for Payer: UHC Exchange |
$72.67
|
| Rate for Payer: UHC Medicaid |
$51.25
|
| Rate for Payer: UHC Medicare Advantage |
$72.67
|
| Rate for Payer: UHCCP Medicaid |
$51.25
|
| Rate for Payer: VA VA |
$72.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.03
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
IP
|
$375.36
|
|
|
Service Code
|
NDC 00904678261
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$261.25 |
| Max. Negotiated Rate |
$337.82 |
| Rate for Payer: Aetna Commercial |
$319.06
|
| Rate for Payer: BCBS Trust/PPO |
$310.01
|
| Rate for Payer: BCN Commercial |
$310.01
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Commercial |
$322.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Healthscope Commercial |
$337.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.06
|
| Rate for Payer: Nomi Health Commercial |
$307.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.52
|
| Rate for Payer: PHP Commercial |
$319.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$326.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.32
|
| Rate for Payer: UHC Core |
$313.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.52
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
IP
|
$289.05
|
|
|
Service Code
|
NDC 68382007901
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$201.18 |
| Max. Negotiated Rate |
$260.14 |
| Rate for Payer: Aetna Commercial |
$245.69
|
| Rate for Payer: BCBS Trust/PPO |
$238.73
|
| Rate for Payer: BCN Commercial |
$238.73
|
| Rate for Payer: Cash Price |
$231.24
|
| Rate for Payer: Cofinity Commercial |
$248.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.24
|
| Rate for Payer: Healthscope Commercial |
$260.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$216.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.69
|
| Rate for Payer: Nomi Health Commercial |
$237.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.79
|
| Rate for Payer: PHP Commercial |
$245.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$251.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.36
|
| Rate for Payer: UHC Core |
$241.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$216.79
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
OP
|
$375.36
|
|
|
Service Code
|
NDC 00904678261
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$66.18 |
| Max. Negotiated Rate |
$337.82 |
| Rate for Payer: Aetna Commercial |
$319.06
|
| Rate for Payer: Aetna Medicare |
$97.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$117.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$117.30
|
| Rate for Payer: BCBS Complete |
$69.48
|
| Rate for Payer: BCBS MAPPO |
$93.84
|
| Rate for Payer: BCBS Trust/PPO |
$308.58
|
| Rate for Payer: BCN Commercial |
$308.58
|
| Rate for Payer: BCN Medicare Advantage |
$93.84
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Commercial |
$322.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$337.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.52
|
| Rate for Payer: Mclaren Medicaid |
$66.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.53
|
| Rate for Payer: Meridian Medicaid |
$69.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.06
|
| Rate for Payer: Nomi Health Commercial |
$307.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.52
|
| Rate for Payer: PACE Senior Care Partners |
$89.15
|
| Rate for Payer: PACE SWMI |
$93.84
|
| Rate for Payer: PHP Commercial |
$319.06
|
| Rate for Payer: PHP Medicare Advantage |
$93.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$326.56
|
| Rate for Payer: Priority Health Medicare |
$94.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.25
|
| Rate for Payer: Railroad Medicare Medicare |
$93.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.32
|
| Rate for Payer: UHC Core |
$313.43
|
| Rate for Payer: UHC Exchange |
$93.84
|
| Rate for Payer: UHC Medicaid |
$66.18
|
| Rate for Payer: UHC Medicare Advantage |
$93.84
|
| Rate for Payer: UHCCP Medicaid |
$66.18
|
| Rate for Payer: VA VA |
$93.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.52
|
|
|
HALOPERIDOL 5 MG TABLET
|
Facility
|
OP
|
$289.05
|
|
|
Service Code
|
NDC 68382007901
|
| Hospital Charge Code |
3583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$50.96 |
| Max. Negotiated Rate |
$260.14 |
| Rate for Payer: Aetna Commercial |
$245.69
|
| Rate for Payer: Aetna Medicare |
$75.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$90.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$90.33
|
| Rate for Payer: BCBS Complete |
$53.50
|
| Rate for Payer: BCBS MAPPO |
$72.26
|
| Rate for Payer: BCBS Trust/PPO |
$237.63
|
| Rate for Payer: BCN Commercial |
$237.63
|
| Rate for Payer: BCN Medicare Advantage |
$72.26
|
| Rate for Payer: Cash Price |
$231.24
|
| Rate for Payer: Cofinity Commercial |
$248.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.26
|
| Rate for Payer: Healthscope Commercial |
$260.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$216.79
|
| Rate for Payer: Mclaren Medicaid |
$50.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.88
|
| Rate for Payer: Meridian Medicaid |
$53.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$79.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.69
|
| Rate for Payer: Nomi Health Commercial |
$237.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.79
|
| Rate for Payer: PACE Senior Care Partners |
$68.65
|
| Rate for Payer: PACE SWMI |
$72.26
|
| Rate for Payer: PHP Commercial |
$245.69
|
| Rate for Payer: PHP Medicare Advantage |
$72.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$251.47
|
| Rate for Payer: Priority Health Medicare |
$72.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.18
|
| Rate for Payer: Railroad Medicare Medicare |
$72.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.36
|
| Rate for Payer: UHC Core |
$241.36
|
| Rate for Payer: UHC Exchange |
$72.26
|
| Rate for Payer: UHC Medicaid |
$50.96
|
| Rate for Payer: UHC Medicare Advantage |
$72.26
|
| Rate for Payer: UHCCP Medicaid |
$50.96
|
| Rate for Payer: VA VA |
$72.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$216.79
|
|
|
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION
|
Facility
|
IP
|
$204.63
|
|
|
Service Code
|
HCPCS J1631
|
| Hospital Charge Code |
10162
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$142.42 |
| Max. Negotiated Rate |
$184.17 |
| Rate for Payer: Aetna Commercial |
$173.94
|
| Rate for Payer: Aetna Commercial |
$466.73
|
| Rate for Payer: BCBS Trust/PPO |
$169.00
|
| Rate for Payer: BCBS Trust/PPO |
$453.49
|
| Rate for Payer: BCN Commercial |
$169.00
|
| Rate for Payer: BCN Commercial |
$453.49
|
| Rate for Payer: Cash Price |
$163.70
|
| Rate for Payer: Cash Price |
$439.27
|
| Rate for Payer: Cofinity Commercial |
$472.22
|
| Rate for Payer: Cofinity Commercial |
$175.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$439.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.70
|
| Rate for Payer: Healthscope Commercial |
$184.17
|
| Rate for Payer: Healthscope Commercial |
$494.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$411.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$466.73
|
| Rate for Payer: Nomi Health Commercial |
$167.80
|
| Rate for Payer: Nomi Health Commercial |
$450.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$411.82
|
| Rate for Payer: PHP Commercial |
$466.73
|
| Rate for Payer: PHP Commercial |
$173.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$477.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$178.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$382.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$483.20
|
| Rate for Payer: UHC Core |
$170.87
|
| Rate for Payer: UHC Core |
$458.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$411.82
|
|
|
HALOPERIDOL DECANOATE 100 MG/ML INTRAMUSCULAR SOLUTION
|
Facility
|
OP
|
$204.63
|
|
|
Service Code
|
HCPCS J1631
|
| Hospital Charge Code |
10162
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$36.08 |
| Max. Negotiated Rate |
$184.17 |
| Rate for Payer: Aetna Commercial |
$173.94
|
| Rate for Payer: Aetna Commercial |
$466.73
|
| Rate for Payer: Aetna Medicare |
$142.76
|
| Rate for Payer: Aetna Medicare |
$53.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$171.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$171.59
|
| Rate for Payer: BCBS Complete |
$37.88
|
| Rate for Payer: BCBS Complete |
$101.64
|
| Rate for Payer: BCBS MAPPO |
$51.16
|
| Rate for Payer: BCBS MAPPO |
$137.27
|
| Rate for Payer: BCBS Trust/PPO |
$168.23
|
| Rate for Payer: BCBS Trust/PPO |
$451.41
|
| Rate for Payer: BCN Commercial |
$451.41
|
| Rate for Payer: BCN Commercial |
$168.23
|
| Rate for Payer: BCN Medicare Advantage |
$137.27
|
| Rate for Payer: BCN Medicare Advantage |
$51.16
|
| Rate for Payer: Cash Price |
$163.70
|
| Rate for Payer: Cash Price |
$439.27
|
| Rate for Payer: Cofinity Commercial |
$175.98
|
| Rate for Payer: Cofinity Commercial |
$472.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$439.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.16
|
| Rate for Payer: Healthscope Commercial |
$184.17
|
| Rate for Payer: Healthscope Commercial |
$494.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$411.82
|
| Rate for Payer: Mclaren Medicaid |
$96.80
|
| Rate for Payer: Mclaren Medicaid |
$36.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.72
|
| Rate for Payer: Meridian Medicaid |
$37.88
|
| Rate for Payer: Meridian Medicaid |
$101.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$157.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$151.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$466.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.94
|
| Rate for Payer: Nomi Health Commercial |
$450.25
|
| Rate for Payer: Nomi Health Commercial |
$167.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$411.82
|
| Rate for Payer: PACE Senior Care Partners |
$130.41
|
| Rate for Payer: PACE Senior Care Partners |
$48.60
|
| Rate for Payer: PACE SWMI |
$137.27
|
| Rate for Payer: PACE SWMI |
$51.16
|
| Rate for Payer: PHP Commercial |
$173.94
|
| Rate for Payer: PHP Commercial |
$466.73
|
| Rate for Payer: PHP Medicare Advantage |
$51.16
|
| Rate for Payer: PHP Medicare Advantage |
$137.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$477.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$178.03
|
| Rate for Payer: Priority Health Medicare |
$138.65
|
| Rate for Payer: Priority Health Medicare |
$51.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$382.17
|
| Rate for Payer: Railroad Medicare Medicare |
$51.16
|
| Rate for Payer: Railroad Medicare Medicare |
$137.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$483.20
|
| Rate for Payer: UHC Core |
$458.49
|
| Rate for Payer: UHC Core |
$170.87
|
| Rate for Payer: UHC Exchange |
$137.27
|
| Rate for Payer: UHC Exchange |
$51.16
|
| Rate for Payer: UHC Medicaid |
$96.80
|
| Rate for Payer: UHC Medicaid |
$36.08
|
| Rate for Payer: UHC Medicare Advantage |
$51.16
|
| Rate for Payer: UHC Medicare Advantage |
$137.27
|
| Rate for Payer: UHCCP Medicaid |
$36.08
|
| Rate for Payer: UHCCP Medicaid |
$96.80
|
| Rate for Payer: VA VA |
$51.16
|
| Rate for Payer: VA VA |
$137.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$411.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.47
|
|
|
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION
|
Facility
|
IP
|
$107.15
|
|
|
Service Code
|
HCPCS J1631
|
| Hospital Charge Code |
10163
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$74.58 |
| Max. Negotiated Rate |
$96.44 |
| Rate for Payer: Aetna Commercial |
$91.08
|
| Rate for Payer: BCBS Trust/PPO |
$88.50
|
| Rate for Payer: BCN Commercial |
$88.50
|
| Rate for Payer: Cash Price |
$85.72
|
| Rate for Payer: Cofinity Commercial |
$92.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.72
|
| Rate for Payer: Healthscope Commercial |
$96.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.08
|
| Rate for Payer: Nomi Health Commercial |
$87.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.36
|
| Rate for Payer: PHP Commercial |
$91.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.29
|
| Rate for Payer: UHC Core |
$89.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.36
|
|
|
HALOPERIDOL DECANOATE 50 MG/ML INTRAMUSCULAR SOLUTION
|
Facility
|
OP
|
$107.15
|
|
|
Service Code
|
HCPCS J1631
|
| Hospital Charge Code |
10163
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.89 |
| Max. Negotiated Rate |
$96.44 |
| Rate for Payer: Aetna Commercial |
$91.08
|
| Rate for Payer: Aetna Medicare |
$27.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.48
|
| Rate for Payer: BCBS Complete |
$19.83
|
| Rate for Payer: BCBS MAPPO |
$26.79
|
| Rate for Payer: BCBS Trust/PPO |
$88.09
|
| Rate for Payer: BCN Commercial |
$88.09
|
| Rate for Payer: BCN Medicare Advantage |
$26.79
|
| Rate for Payer: Cash Price |
$85.72
|
| Rate for Payer: Cofinity Commercial |
$92.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.79
|
| Rate for Payer: Healthscope Commercial |
$96.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.36
|
| Rate for Payer: Mclaren Medicaid |
$18.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.13
|
| Rate for Payer: Meridian Medicaid |
$19.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.08
|
| Rate for Payer: Nomi Health Commercial |
$87.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.36
|
| Rate for Payer: PACE Senior Care Partners |
$25.45
|
| Rate for Payer: PACE SWMI |
$26.79
|
| Rate for Payer: PHP Commercial |
$91.08
|
| Rate for Payer: PHP Medicare Advantage |
$26.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.22
|
| Rate for Payer: Priority Health Medicare |
$27.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.58
|
| Rate for Payer: Railroad Medicare Medicare |
$26.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.29
|
| Rate for Payer: UHC Core |
$89.47
|
| Rate for Payer: UHC Exchange |
$26.79
|
| Rate for Payer: UHC Medicaid |
$18.89
|
| Rate for Payer: UHC Medicare Advantage |
$26.79
|
| Rate for Payer: UHCCP Medicaid |
$18.89
|
| Rate for Payer: VA VA |
$26.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.36
|
|
|
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$10.53
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
3584
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.86 |
| Max. Negotiated Rate |
$9.48 |
| Rate for Payer: Aetna Commercial |
$8.95
|
| Rate for Payer: Aetna Commercial |
$20.48
|
| Rate for Payer: Aetna Commercial |
$10.95
|
| Rate for Payer: Aetna Medicare |
$6.26
|
| Rate for Payer: Aetna Medicare |
$2.74
|
| Rate for Payer: Aetna Medicare |
$3.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.53
|
| Rate for Payer: BCBS Complete |
$2.38
|
| Rate for Payer: BCBS Complete |
$1.95
|
| Rate for Payer: BCBS Complete |
$4.46
|
| Rate for Payer: BCBS MAPPO |
$6.02
|
| Rate for Payer: BCBS MAPPO |
$2.63
|
| Rate for Payer: BCBS MAPPO |
$3.22
|
| Rate for Payer: BCBS Trust/PPO |
$8.66
|
| Rate for Payer: BCBS Trust/PPO |
$10.59
|
| Rate for Payer: BCBS Trust/PPO |
$19.80
|
| Rate for Payer: BCN Commercial |
$10.59
|
| Rate for Payer: BCN Commercial |
$19.80
|
| Rate for Payer: BCN Commercial |
$8.66
|
| Rate for Payer: BCN Medicare Advantage |
$6.02
|
| Rate for Payer: BCN Medicare Advantage |
$3.22
|
| Rate for Payer: BCN Medicare Advantage |
$2.63
|
| Rate for Payer: Cash Price |
$19.27
|
| Rate for Payer: Cash Price |
$10.30
|
| Rate for Payer: Cash Price |
$8.42
|
| Rate for Payer: Cofinity Commercial |
$9.06
|
| Rate for Payer: Cofinity Commercial |
$11.08
|
| Rate for Payer: Cofinity Commercial |
$20.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.63
|
| Rate for Payer: Healthscope Commercial |
$11.59
|
| Rate for Payer: Healthscope Commercial |
$9.48
|
| Rate for Payer: Healthscope Commercial |
$21.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.66
|
| Rate for Payer: Mclaren Medicaid |
$1.86
|
| Rate for Payer: Mclaren Medicaid |
$4.25
|
| Rate for Payer: Mclaren Medicaid |
$2.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.32
|
| Rate for Payer: Meridian Medicaid |
$4.46
|
| Rate for Payer: Meridian Medicaid |
$1.95
|
| Rate for Payer: Meridian Medicaid |
$2.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.95
|
| Rate for Payer: Nomi Health Commercial |
$19.75
|
| Rate for Payer: Nomi Health Commercial |
$10.56
|
| Rate for Payer: Nomi Health Commercial |
$8.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.90
|
| Rate for Payer: PACE Senior Care Partners |
$3.06
|
| Rate for Payer: PACE Senior Care Partners |
$2.50
|
| Rate for Payer: PACE Senior Care Partners |
$5.72
|
| Rate for Payer: PACE SWMI |
$6.02
|
| Rate for Payer: PACE SWMI |
$3.22
|
| Rate for Payer: PACE SWMI |
$2.63
|
| Rate for Payer: PHP Commercial |
$8.95
|
| Rate for Payer: PHP Commercial |
$20.48
|
| Rate for Payer: PHP Commercial |
$10.95
|
| Rate for Payer: PHP Medicare Advantage |
$3.22
|
| Rate for Payer: PHP Medicare Advantage |
$2.63
|
| Rate for Payer: PHP Medicare Advantage |
$6.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.96
|
| Rate for Payer: Priority Health Medicare |
$6.08
|
| Rate for Payer: Priority Health Medicare |
$3.25
|
| Rate for Payer: Priority Health Medicare |
$2.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.33
|
| Rate for Payer: Railroad Medicare Medicare |
$3.22
|
| Rate for Payer: Railroad Medicare Medicare |
$6.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.27
|
| Rate for Payer: UHC Core |
$8.79
|
| Rate for Payer: UHC Core |
$20.12
|
| Rate for Payer: UHC Core |
$10.75
|
| Rate for Payer: UHC Exchange |
$6.02
|
| Rate for Payer: UHC Exchange |
$3.22
|
| Rate for Payer: UHC Exchange |
$2.63
|
| Rate for Payer: UHC Medicaid |
$1.86
|
| Rate for Payer: UHC Medicaid |
$4.25
|
| Rate for Payer: UHC Medicaid |
$2.27
|
| Rate for Payer: UHC Medicare Advantage |
$3.22
|
| Rate for Payer: UHC Medicare Advantage |
$2.63
|
| Rate for Payer: UHC Medicare Advantage |
$6.02
|
| Rate for Payer: UHCCP Medicaid |
$2.27
|
| Rate for Payer: UHCCP Medicaid |
$1.86
|
| Rate for Payer: UHCCP Medicaid |
$4.25
|
| Rate for Payer: VA VA |
$2.63
|
| Rate for Payer: VA VA |
$6.02
|
| Rate for Payer: VA VA |
$3.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.07
|
|
|
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$10.53
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
3584
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$9.48 |
| Rate for Payer: Aetna Commercial |
$8.95
|
| Rate for Payer: Aetna Commercial |
$10.95
|
| Rate for Payer: Aetna Commercial |
$20.48
|
| Rate for Payer: BCBS Trust/PPO |
$10.64
|
| Rate for Payer: BCBS Trust/PPO |
$8.70
|
| Rate for Payer: BCBS Trust/PPO |
$19.90
|
| Rate for Payer: BCN Commercial |
$10.64
|
| Rate for Payer: BCN Commercial |
$8.70
|
| Rate for Payer: BCN Commercial |
$19.90
|
| Rate for Payer: Cash Price |
$8.42
|
| Rate for Payer: Cash Price |
$19.27
|
| Rate for Payer: Cash Price |
$10.30
|
| Rate for Payer: Cofinity Commercial |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$11.08
|
| Rate for Payer: Cofinity Commercial |
$9.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.27
|
| Rate for Payer: Healthscope Commercial |
$11.59
|
| Rate for Payer: Healthscope Commercial |
$9.48
|
| Rate for Payer: Healthscope Commercial |
$21.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.48
|
| Rate for Payer: Nomi Health Commercial |
$8.63
|
| Rate for Payer: Nomi Health Commercial |
$10.56
|
| Rate for Payer: Nomi Health Commercial |
$19.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.07
|
| Rate for Payer: PHP Commercial |
$8.95
|
| Rate for Payer: PHP Commercial |
$20.48
|
| Rate for Payer: PHP Commercial |
$10.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.27
|
| Rate for Payer: UHC Core |
$8.79
|
| Rate for Payer: UHC Core |
$20.12
|
| Rate for Payer: UHC Core |
$10.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.66
|
|
|
HAND AND WRIST PROCEDURES
|
Facility
|
IP
|
$15,482.83
|
|
|
Service Code
|
APR-DRG 3164
|
| Min. Negotiated Rate |
$14,745.56 |
| Max. Negotiated Rate |
$15,482.83 |
| Rate for Payer: BCBS Complete |
$15,482.83
|
| Rate for Payer: Mclaren Medicaid |
$14,745.56
|
| Rate for Payer: Meridian Medicaid |
$15,482.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,745.56
|
| Rate for Payer: UHC Medicaid |
$14,745.56
|
| Rate for Payer: UHCCP Medicaid |
$14,745.56
|
|
