|
DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE
|
Facility
|
IP
|
$117.03
|
|
|
Service Code
|
NDC 68084074332
|
| Hospital Charge Code |
9900
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$76.07 |
| Max. Negotiated Rate |
$105.33 |
| Rate for Payer: Aetna Commercial |
$99.48
|
| Rate for Payer: BCBS Trust/PPO |
$95.53
|
| Rate for Payer: BCN Commercial |
$90.44
|
| Rate for Payer: Cash Price |
$93.62
|
| Rate for Payer: Cofinity Commercial |
$100.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.62
|
| Rate for Payer: Healthscope Commercial |
$105.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.48
|
| Rate for Payer: Nomi Health Commercial |
$95.96
|
| Rate for Payer: PHP Commercial |
$99.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.07
|
| Rate for Payer: Priority Health HMO/PPO |
$101.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.99
|
| Rate for Payer: UHC Core |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.77
|
|
|
DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE
|
Facility
|
IP
|
$5.86
|
|
|
Service Code
|
NDC 68084074333
|
| Hospital Charge Code |
9900
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$5.27 |
| Rate for Payer: Aetna Commercial |
$4.98
|
| Rate for Payer: BCBS Trust/PPO |
$4.78
|
| Rate for Payer: BCN Commercial |
$4.53
|
| Rate for Payer: Cash Price |
$4.69
|
| Rate for Payer: Cofinity Commercial |
$5.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.69
|
| Rate for Payer: Healthscope Commercial |
$5.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.98
|
| Rate for Payer: Nomi Health Commercial |
$4.81
|
| Rate for Payer: PHP Commercial |
$4.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.81
|
| Rate for Payer: Priority Health HMO/PPO |
$5.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.16
|
| Rate for Payer: UHC Core |
$4.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.39
|
|
|
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$136.80
|
|
|
Service Code
|
NDC 68180065701
|
| Hospital Charge Code |
9902
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$32.49 |
| Max. Negotiated Rate |
$123.12 |
| Rate for Payer: Aetna Commercial |
$116.28
|
| Rate for Payer: Aetna Medicare |
$35.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.75
|
| Rate for Payer: BCBS Complete |
$54.72
|
| Rate for Payer: BCBS MAPPO |
$34.20
|
| Rate for Payer: BCBS Trust/PPO |
$112.46
|
| Rate for Payer: BCN Commercial |
$106.36
|
| Rate for Payer: BCN Medicare Advantage |
$34.20
|
| Rate for Payer: Cash Price |
$109.44
|
| Rate for Payer: Cofinity Commercial |
$117.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.20
|
| Rate for Payer: Healthscope Commercial |
$123.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.28
|
| Rate for Payer: Nomi Health Commercial |
$112.18
|
| Rate for Payer: PACE Senior Care Partners |
$32.49
|
| Rate for Payer: PACE SWMI |
$34.20
|
| Rate for Payer: PHP Commercial |
$116.28
|
| Rate for Payer: PHP Medicare Advantage |
$34.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.92
|
| Rate for Payer: Priority Health HMO/PPO |
$119.02
|
| Rate for Payer: Priority Health Medicare |
$34.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.66
|
| Rate for Payer: Railroad Medicare Medicare |
$34.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.38
|
| Rate for Payer: UHC Core |
$114.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.20
|
| Rate for Payer: UHC Exchange |
$34.20
|
| Rate for Payer: UHC Medicare Advantage |
$34.20
|
| Rate for Payer: VA VA |
$34.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.60
|
|
|
DOXYCYCLINE MONOHYDRATE 25 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$136.80
|
|
|
Service Code
|
NDC 68180065701
|
| Hospital Charge Code |
9902
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$88.92 |
| Max. Negotiated Rate |
$123.12 |
| Rate for Payer: Aetna Commercial |
$116.28
|
| Rate for Payer: BCBS Trust/PPO |
$111.67
|
| Rate for Payer: BCN Commercial |
$105.72
|
| Rate for Payer: Cash Price |
$109.44
|
| Rate for Payer: Cofinity Commercial |
$117.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.44
|
| Rate for Payer: Healthscope Commercial |
$123.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.28
|
| Rate for Payer: Nomi Health Commercial |
$112.18
|
| Rate for Payer: PHP Commercial |
$116.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.92
|
| Rate for Payer: Priority Health HMO/PPO |
$119.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.38
|
| Rate for Payer: UHC Core |
$114.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.60
|
|
|
DRONABINOL 2.5 MG CAPSULE
|
Facility
|
OP
|
$658.56
|
|
|
Service Code
|
NDC 67877075360
|
| Hospital Charge Code |
9904
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$156.41 |
| Max. Negotiated Rate |
$592.70 |
| Rate for Payer: Aetna Commercial |
$559.78
|
| Rate for Payer: Aetna Medicare |
$171.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$205.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$205.80
|
| Rate for Payer: BCBS Complete |
$263.42
|
| Rate for Payer: BCBS MAPPO |
$164.64
|
| Rate for Payer: BCBS Trust/PPO |
$541.40
|
| Rate for Payer: BCN Commercial |
$512.03
|
| Rate for Payer: BCN Medicare Advantage |
$164.64
|
| Rate for Payer: Cash Price |
$526.85
|
| Rate for Payer: Cofinity Commercial |
$566.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.64
|
| Rate for Payer: Healthscope Commercial |
$592.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$493.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$189.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$559.78
|
| Rate for Payer: Nomi Health Commercial |
$540.02
|
| Rate for Payer: PACE Senior Care Partners |
$156.41
|
| Rate for Payer: PACE SWMI |
$164.64
|
| Rate for Payer: PHP Commercial |
$559.78
|
| Rate for Payer: PHP Medicare Advantage |
$164.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.06
|
| Rate for Payer: Priority Health HMO/PPO |
$572.95
|
| Rate for Payer: Priority Health Medicare |
$166.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$441.24
|
| Rate for Payer: Railroad Medicare Medicare |
$164.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$579.53
|
| Rate for Payer: UHC Core |
$549.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.64
|
| Rate for Payer: UHC Exchange |
$164.64
|
| Rate for Payer: UHC Medicare Advantage |
$164.64
|
| Rate for Payer: VA VA |
$164.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$493.92
|
|
|
DRONABINOL 2.5 MG CAPSULE
|
Facility
|
IP
|
$658.56
|
|
|
Service Code
|
NDC 67877075360
|
| Hospital Charge Code |
9904
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$428.06 |
| Max. Negotiated Rate |
$592.70 |
| Rate for Payer: Aetna Commercial |
$559.78
|
| Rate for Payer: BCBS Trust/PPO |
$537.58
|
| Rate for Payer: BCN Commercial |
$508.94
|
| Rate for Payer: Cash Price |
$526.85
|
| Rate for Payer: Cofinity Commercial |
$566.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.85
|
| Rate for Payer: Healthscope Commercial |
$592.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$493.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$559.78
|
| Rate for Payer: Nomi Health Commercial |
$540.02
|
| Rate for Payer: PHP Commercial |
$559.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.06
|
| Rate for Payer: Priority Health HMO/PPO |
$572.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$441.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$579.53
|
| Rate for Payer: UHC Core |
$549.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$493.92
|
|
|
DROPERIDOL 2.5 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$54.51
|
|
|
Service Code
|
HCPCS J1790
|
| Hospital Charge Code |
2654
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$35.43 |
| Max. Negotiated Rate |
$49.06 |
| Rate for Payer: Aetna Commercial |
$46.33
|
| Rate for Payer: BCBS Trust/PPO |
$44.50
|
| Rate for Payer: BCN Commercial |
$42.13
|
| Rate for Payer: Cash Price |
$43.61
|
| Rate for Payer: Cofinity Commercial |
$46.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.61
|
| Rate for Payer: Healthscope Commercial |
$49.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.33
|
| Rate for Payer: Nomi Health Commercial |
$44.70
|
| Rate for Payer: PHP Commercial |
$46.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.43
|
| Rate for Payer: Priority Health HMO/PPO |
$47.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.97
|
| Rate for Payer: UHC Core |
$45.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.88
|
|
|
DROPERIDOL 2.5 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$54.51
|
|
|
Service Code
|
HCPCS J1790
|
| Hospital Charge Code |
2654
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$49.06 |
| Rate for Payer: Aetna Commercial |
$46.33
|
| Rate for Payer: Aetna Medicare |
$14.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.03
|
| Rate for Payer: BCBS Complete |
$21.80
|
| Rate for Payer: BCBS MAPPO |
$13.63
|
| Rate for Payer: BCBS Trust/PPO |
$44.81
|
| Rate for Payer: BCN Commercial |
$42.38
|
| Rate for Payer: BCN Medicare Advantage |
$13.63
|
| Rate for Payer: Cash Price |
$43.61
|
| Rate for Payer: Cofinity Commercial |
$46.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.63
|
| Rate for Payer: Healthscope Commercial |
$49.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.33
|
| Rate for Payer: Nomi Health Commercial |
$44.70
|
| Rate for Payer: PACE Senior Care Partners |
$12.95
|
| Rate for Payer: PACE SWMI |
$13.63
|
| Rate for Payer: PHP Commercial |
$46.33
|
| Rate for Payer: PHP Medicare Advantage |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.43
|
| Rate for Payer: Priority Health HMO/PPO |
$47.42
|
| Rate for Payer: Priority Health Medicare |
$13.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.52
|
| Rate for Payer: Railroad Medicare Medicare |
$13.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.97
|
| Rate for Payer: UHC Core |
$45.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.63
|
| Rate for Payer: UHC Exchange |
$13.63
|
| Rate for Payer: UHC Medicare Advantage |
$13.63
|
| Rate for Payer: VA VA |
$13.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.88
|
|
|
DRUG TEST PRESUMPTIVE READ BY INSTR ASSISTED DIRECT OPTICAL OBS
|
Professional
|
Both
|
$16.00
|
|
|
Service Code
|
HCPCS G0478
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$10.40 |
| Rate for Payer: Aetna Medicare |
$8.00
|
| Rate for Payer: BCBS Complete |
$6.40
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.40
|
|
|
DRUG TEST PRESUMPTIVE USING IMMUNOASSAY
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS G0479
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$53.30 |
| Rate for Payer: Aetna Medicare |
$41.00
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
|
|
DRUG TEST(S), PRESUMPTIVE READ BY DIRECT OPTICAL OBSERVATION
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS G0477
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Aetna Medicare |
$6.00
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.80
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE
|
Facility
|
OP
|
$115.35
|
|
|
Service Code
|
NDC 00904704304
|
| Hospital Charge Code |
39275
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$27.40 |
| Max. Negotiated Rate |
$103.81 |
| Rate for Payer: Aetna Commercial |
$98.05
|
| Rate for Payer: Aetna Medicare |
$29.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.05
|
| Rate for Payer: BCBS Complete |
$46.14
|
| Rate for Payer: BCBS MAPPO |
$28.84
|
| Rate for Payer: BCBS Trust/PPO |
$94.83
|
| Rate for Payer: BCN Commercial |
$89.68
|
| Rate for Payer: BCN Medicare Advantage |
$28.84
|
| Rate for Payer: Cash Price |
$92.28
|
| Rate for Payer: Cofinity Commercial |
$99.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.84
|
| Rate for Payer: Healthscope Commercial |
$103.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.05
|
| Rate for Payer: Nomi Health Commercial |
$94.59
|
| Rate for Payer: PACE Senior Care Partners |
$27.40
|
| Rate for Payer: PACE SWMI |
$28.84
|
| Rate for Payer: PHP Commercial |
$98.05
|
| Rate for Payer: PHP Medicare Advantage |
$28.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.98
|
| Rate for Payer: Priority Health HMO/PPO |
$100.35
|
| Rate for Payer: Priority Health Medicare |
$29.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.28
|
| Rate for Payer: Railroad Medicare Medicare |
$28.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.51
|
| Rate for Payer: UHC Core |
$96.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.84
|
| Rate for Payer: UHC Exchange |
$28.84
|
| Rate for Payer: UHC Medicare Advantage |
$28.84
|
| Rate for Payer: VA VA |
$28.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.51
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE
|
Facility
|
IP
|
$500.64
|
|
|
Service Code
|
NDC 00904704361
|
| Hospital Charge Code |
39275
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$325.42 |
| Max. Negotiated Rate |
$450.58 |
| Rate for Payer: Aetna Commercial |
$425.54
|
| Rate for Payer: BCBS Trust/PPO |
$408.67
|
| Rate for Payer: BCN Commercial |
$386.89
|
| Rate for Payer: Cash Price |
$400.51
|
| Rate for Payer: Cofinity Commercial |
$430.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.51
|
| Rate for Payer: Healthscope Commercial |
$450.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.54
|
| Rate for Payer: Nomi Health Commercial |
$410.52
|
| Rate for Payer: PHP Commercial |
$425.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.42
|
| Rate for Payer: Priority Health HMO/PPO |
$435.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.56
|
| Rate for Payer: UHC Core |
$418.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.48
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE
|
Facility
|
IP
|
$115.35
|
|
|
Service Code
|
NDC 00904704304
|
| Hospital Charge Code |
39275
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$74.98 |
| Max. Negotiated Rate |
$103.81 |
| Rate for Payer: Aetna Commercial |
$98.05
|
| Rate for Payer: BCBS Trust/PPO |
$94.16
|
| Rate for Payer: BCN Commercial |
$89.14
|
| Rate for Payer: Cash Price |
$92.28
|
| Rate for Payer: Cofinity Commercial |
$99.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.28
|
| Rate for Payer: Healthscope Commercial |
$103.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.05
|
| Rate for Payer: Nomi Health Commercial |
$94.59
|
| Rate for Payer: PHP Commercial |
$98.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.98
|
| Rate for Payer: Priority Health HMO/PPO |
$100.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.51
|
| Rate for Payer: UHC Core |
$96.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.51
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE
|
Facility
|
OP
|
$1,721.84
|
|
|
Service Code
|
NDC 00002323560
|
| Hospital Charge Code |
39275
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$408.94 |
| Max. Negotiated Rate |
$1,549.66 |
| Rate for Payer: Aetna Commercial |
$1,463.56
|
| Rate for Payer: Aetna Medicare |
$447.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$538.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$538.08
|
| Rate for Payer: BCBS Complete |
$688.74
|
| Rate for Payer: BCBS MAPPO |
$430.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,415.52
|
| Rate for Payer: BCN Commercial |
$1,338.73
|
| Rate for Payer: BCN Medicare Advantage |
$430.46
|
| Rate for Payer: Cash Price |
$1,377.47
|
| Rate for Payer: Cofinity Commercial |
$1,480.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,377.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$430.46
|
| Rate for Payer: Healthscope Commercial |
$1,549.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,291.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$451.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$495.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,463.56
|
| Rate for Payer: Nomi Health Commercial |
$1,411.91
|
| Rate for Payer: PACE Senior Care Partners |
$408.94
|
| Rate for Payer: PACE SWMI |
$430.46
|
| Rate for Payer: PHP Commercial |
$1,463.56
|
| Rate for Payer: PHP Medicare Advantage |
$430.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,119.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,498.00
|
| Rate for Payer: Priority Health Medicare |
$434.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,153.63
|
| Rate for Payer: Railroad Medicare Medicare |
$430.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,515.22
|
| Rate for Payer: UHC Core |
$1,437.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$430.46
|
| Rate for Payer: UHC Exchange |
$430.46
|
| Rate for Payer: UHC Medicare Advantage |
$430.46
|
| Rate for Payer: VA VA |
$430.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,291.38
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE
|
Facility
|
IP
|
$236.60
|
|
|
Service Code
|
NDC 68084067521
|
| Hospital Charge Code |
39275
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$153.79 |
| Max. Negotiated Rate |
$212.94 |
| Rate for Payer: Aetna Commercial |
$201.11
|
| Rate for Payer: BCBS Trust/PPO |
$193.14
|
| Rate for Payer: BCN Commercial |
$182.84
|
| Rate for Payer: Cash Price |
$189.28
|
| Rate for Payer: Cofinity Commercial |
$203.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.28
|
| Rate for Payer: Healthscope Commercial |
$212.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.11
|
| Rate for Payer: Nomi Health Commercial |
$194.01
|
| Rate for Payer: PHP Commercial |
$201.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.79
|
| Rate for Payer: Priority Health HMO/PPO |
$205.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.21
|
| Rate for Payer: UHC Core |
$197.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.45
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE
|
Facility
|
OP
|
$127.01
|
|
|
Service Code
|
NDC 60687072321
|
| Hospital Charge Code |
39275
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$30.16 |
| Max. Negotiated Rate |
$114.31 |
| Rate for Payer: Aetna Commercial |
$107.96
|
| Rate for Payer: Aetna Medicare |
$33.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.69
|
| Rate for Payer: BCBS Complete |
$50.80
|
| Rate for Payer: BCBS MAPPO |
$31.75
|
| Rate for Payer: BCBS Trust/PPO |
$104.41
|
| Rate for Payer: BCN Commercial |
$98.75
|
| Rate for Payer: BCN Medicare Advantage |
$31.75
|
| Rate for Payer: Cash Price |
$101.61
|
| Rate for Payer: Cofinity Commercial |
$109.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.75
|
| Rate for Payer: Healthscope Commercial |
$114.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.96
|
| Rate for Payer: Nomi Health Commercial |
$104.15
|
| Rate for Payer: PACE Senior Care Partners |
$30.16
|
| Rate for Payer: PACE SWMI |
$31.75
|
| Rate for Payer: PHP Commercial |
$107.96
|
| Rate for Payer: PHP Medicare Advantage |
$31.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.56
|
| Rate for Payer: Priority Health HMO/PPO |
$110.50
|
| Rate for Payer: Priority Health Medicare |
$32.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.10
|
| Rate for Payer: Railroad Medicare Medicare |
$31.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.77
|
| Rate for Payer: UHC Core |
$106.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.75
|
| Rate for Payer: UHC Exchange |
$31.75
|
| Rate for Payer: UHC Medicare Advantage |
$31.75
|
| Rate for Payer: VA VA |
$31.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.26
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE
|
Facility
|
OP
|
$236.60
|
|
|
Service Code
|
NDC 68084067521
|
| Hospital Charge Code |
39275
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$56.19 |
| Max. Negotiated Rate |
$212.94 |
| Rate for Payer: Aetna Commercial |
$201.11
|
| Rate for Payer: Aetna Medicare |
$61.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.94
|
| Rate for Payer: BCBS Complete |
$94.64
|
| Rate for Payer: BCBS MAPPO |
$59.15
|
| Rate for Payer: BCBS Trust/PPO |
$194.51
|
| Rate for Payer: BCN Commercial |
$183.96
|
| Rate for Payer: BCN Medicare Advantage |
$59.15
|
| Rate for Payer: Cash Price |
$189.28
|
| Rate for Payer: Cofinity Commercial |
$203.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.15
|
| Rate for Payer: Healthscope Commercial |
$212.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.11
|
| Rate for Payer: Nomi Health Commercial |
$194.01
|
| Rate for Payer: PACE Senior Care Partners |
$56.19
|
| Rate for Payer: PACE SWMI |
$59.15
|
| Rate for Payer: PHP Commercial |
$201.11
|
| Rate for Payer: PHP Medicare Advantage |
$59.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.79
|
| Rate for Payer: Priority Health HMO/PPO |
$205.84
|
| Rate for Payer: Priority Health Medicare |
$59.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.52
|
| Rate for Payer: Railroad Medicare Medicare |
$59.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.21
|
| Rate for Payer: UHC Core |
$197.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.15
|
| Rate for Payer: UHC Exchange |
$59.15
|
| Rate for Payer: UHC Medicare Advantage |
$59.15
|
| Rate for Payer: VA VA |
$59.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.45
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE
|
Facility
|
IP
|
$127.01
|
|
|
Service Code
|
NDC 60687072321
|
| Hospital Charge Code |
39275
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.56 |
| Max. Negotiated Rate |
$114.31 |
| Rate for Payer: Aetna Commercial |
$107.96
|
| Rate for Payer: BCBS Trust/PPO |
$103.68
|
| Rate for Payer: BCN Commercial |
$98.15
|
| Rate for Payer: Cash Price |
$101.61
|
| Rate for Payer: Cofinity Commercial |
$109.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.61
|
| Rate for Payer: Healthscope Commercial |
$114.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.96
|
| Rate for Payer: Nomi Health Commercial |
$104.15
|
| Rate for Payer: PHP Commercial |
$107.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.56
|
| Rate for Payer: Priority Health HMO/PPO |
$110.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.77
|
| Rate for Payer: UHC Core |
$106.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.26
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE
|
Facility
|
OP
|
$4.24
|
|
|
Service Code
|
NDC 60687072311
|
| Hospital Charge Code |
39275
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.01 |
| Max. Negotiated Rate |
$3.82 |
| Rate for Payer: Aetna Commercial |
$3.60
|
| Rate for Payer: Aetna Medicare |
$1.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.32
|
| Rate for Payer: BCBS Complete |
$1.70
|
| Rate for Payer: BCBS MAPPO |
$1.06
|
| Rate for Payer: BCBS Trust/PPO |
$3.49
|
| Rate for Payer: BCN Commercial |
$3.30
|
| Rate for Payer: BCN Medicare Advantage |
$1.06
|
| Rate for Payer: Cash Price |
$3.39
|
| Rate for Payer: Cofinity Commercial |
$3.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.06
|
| Rate for Payer: Healthscope Commercial |
$3.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.60
|
| Rate for Payer: Nomi Health Commercial |
$3.48
|
| Rate for Payer: PACE Senior Care Partners |
$1.01
|
| Rate for Payer: PACE SWMI |
$1.06
|
| Rate for Payer: PHP Commercial |
$3.60
|
| Rate for Payer: PHP Medicare Advantage |
$1.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.76
|
| Rate for Payer: Priority Health HMO/PPO |
$3.69
|
| Rate for Payer: Priority Health Medicare |
$1.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.73
|
| Rate for Payer: UHC Core |
$3.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.06
|
| Rate for Payer: UHC Exchange |
$1.06
|
| Rate for Payer: UHC Medicare Advantage |
$1.06
|
| Rate for Payer: VA VA |
$1.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.18
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE
|
Facility
|
IP
|
$7.89
|
|
|
Service Code
|
NDC 68084067511
|
| Hospital Charge Code |
39275
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$7.10 |
| Rate for Payer: Aetna Commercial |
$6.71
|
| Rate for Payer: BCBS Trust/PPO |
$6.44
|
| Rate for Payer: BCN Commercial |
$6.10
|
| Rate for Payer: Cash Price |
$6.31
|
| Rate for Payer: Cofinity Commercial |
$6.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.31
|
| Rate for Payer: Healthscope Commercial |
$7.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.71
|
| Rate for Payer: Nomi Health Commercial |
$6.47
|
| Rate for Payer: PHP Commercial |
$6.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.13
|
| Rate for Payer: Priority Health HMO/PPO |
$6.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.94
|
| Rate for Payer: UHC Core |
$6.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.92
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE
|
Facility
|
OP
|
$500.64
|
|
|
Service Code
|
NDC 00904704361
|
| Hospital Charge Code |
39275
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$118.90 |
| Max. Negotiated Rate |
$450.58 |
| Rate for Payer: Aetna Commercial |
$425.54
|
| Rate for Payer: Aetna Medicare |
$130.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.45
|
| Rate for Payer: BCBS Complete |
$200.26
|
| Rate for Payer: BCBS MAPPO |
$125.16
|
| Rate for Payer: BCBS Trust/PPO |
$411.58
|
| Rate for Payer: BCN Commercial |
$389.25
|
| Rate for Payer: BCN Medicare Advantage |
$125.16
|
| Rate for Payer: Cash Price |
$400.51
|
| Rate for Payer: Cofinity Commercial |
$430.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.16
|
| Rate for Payer: Healthscope Commercial |
$450.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.54
|
| Rate for Payer: Nomi Health Commercial |
$410.52
|
| Rate for Payer: PACE Senior Care Partners |
$118.90
|
| Rate for Payer: PACE SWMI |
$125.16
|
| Rate for Payer: PHP Commercial |
$425.54
|
| Rate for Payer: PHP Medicare Advantage |
$125.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.42
|
| Rate for Payer: Priority Health HMO/PPO |
$435.56
|
| Rate for Payer: Priority Health Medicare |
$126.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.43
|
| Rate for Payer: Railroad Medicare Medicare |
$125.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.56
|
| Rate for Payer: UHC Core |
$418.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.16
|
| Rate for Payer: UHC Exchange |
$125.16
|
| Rate for Payer: UHC Medicare Advantage |
$125.16
|
| Rate for Payer: VA VA |
$125.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.48
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE
|
Facility
|
IP
|
$1,721.84
|
|
|
Service Code
|
NDC 00002323560
|
| Hospital Charge Code |
39275
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,119.20 |
| Max. Negotiated Rate |
$1,549.66 |
| Rate for Payer: Aetna Commercial |
$1,463.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,405.54
|
| Rate for Payer: BCN Commercial |
$1,330.64
|
| Rate for Payer: Cash Price |
$1,377.47
|
| Rate for Payer: Cofinity Commercial |
$1,480.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,377.47
|
| Rate for Payer: Healthscope Commercial |
$1,549.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,291.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,463.56
|
| Rate for Payer: Nomi Health Commercial |
$1,411.91
|
| Rate for Payer: PHP Commercial |
$1,463.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,119.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,498.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,153.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,515.22
|
| Rate for Payer: UHC Core |
$1,437.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,291.38
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE
|
Facility
|
OP
|
$7.89
|
|
|
Service Code
|
NDC 68084067511
|
| Hospital Charge Code |
39275
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$7.10 |
| Rate for Payer: Aetna Commercial |
$6.71
|
| Rate for Payer: Aetna Medicare |
$2.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.47
|
| Rate for Payer: BCBS Complete |
$3.16
|
| Rate for Payer: BCBS MAPPO |
$1.97
|
| Rate for Payer: BCBS Trust/PPO |
$6.49
|
| Rate for Payer: BCN Commercial |
$6.13
|
| Rate for Payer: BCN Medicare Advantage |
$1.97
|
| Rate for Payer: Cash Price |
$6.31
|
| Rate for Payer: Cofinity Commercial |
$6.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.97
|
| Rate for Payer: Healthscope Commercial |
$7.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.71
|
| Rate for Payer: Nomi Health Commercial |
$6.47
|
| Rate for Payer: PACE Senior Care Partners |
$1.87
|
| Rate for Payer: PACE SWMI |
$1.97
|
| Rate for Payer: PHP Commercial |
$6.71
|
| Rate for Payer: PHP Medicare Advantage |
$1.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.13
|
| Rate for Payer: Priority Health HMO/PPO |
$6.86
|
| Rate for Payer: Priority Health Medicare |
$1.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.94
|
| Rate for Payer: UHC Core |
$6.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.97
|
| Rate for Payer: UHC Exchange |
$1.97
|
| Rate for Payer: UHC Medicare Advantage |
$1.97
|
| Rate for Payer: VA VA |
$1.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.92
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE
|
Facility
|
IP
|
$4.24
|
|
|
Service Code
|
NDC 60687072311
|
| Hospital Charge Code |
39275
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.76 |
| Max. Negotiated Rate |
$3.82 |
| Rate for Payer: Aetna Commercial |
$3.60
|
| Rate for Payer: BCBS Trust/PPO |
$3.46
|
| Rate for Payer: BCN Commercial |
$3.28
|
| Rate for Payer: Cash Price |
$3.39
|
| Rate for Payer: Cofinity Commercial |
$3.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.39
|
| Rate for Payer: Healthscope Commercial |
$3.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.60
|
| Rate for Payer: Nomi Health Commercial |
$3.48
|
| Rate for Payer: PHP Commercial |
$3.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.76
|
| Rate for Payer: Priority Health HMO/PPO |
$3.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.73
|
| Rate for Payer: UHC Core |
$3.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.18
|
|
