|
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET
|
Facility
|
OP
|
$6,646.02
|
|
|
Service Code
|
NDC 61958070101
|
| Hospital Charge Code |
39255
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,578.43 |
| Max. Negotiated Rate |
$5,981.42 |
| Rate for Payer: Aetna Commercial |
$5,649.12
|
| Rate for Payer: Aetna Medicare |
$1,727.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,076.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,076.88
|
| Rate for Payer: BCBS Complete |
$2,658.41
|
| Rate for Payer: BCBS MAPPO |
$1,661.50
|
| Rate for Payer: BCBS Trust/PPO |
$5,463.69
|
| Rate for Payer: BCN Commercial |
$5,167.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,661.50
|
| Rate for Payer: Cash Price |
$5,316.82
|
| Rate for Payer: Cofinity Commercial |
$5,715.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,316.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,661.50
|
| Rate for Payer: Healthscope Commercial |
$5,981.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,984.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,744.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,910.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,649.12
|
| Rate for Payer: Nomi Health Commercial |
$5,449.74
|
| Rate for Payer: PACE Senior Care Partners |
$1,578.43
|
| Rate for Payer: PACE SWMI |
$1,661.50
|
| Rate for Payer: PHP Commercial |
$5,649.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,661.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,319.91
|
| Rate for Payer: Priority Health HMO/PPO |
$5,782.04
|
| Rate for Payer: Priority Health Medicare |
$1,678.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,452.83
|
| Rate for Payer: Railroad Medicare Medicare |
$1,661.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,848.50
|
| Rate for Payer: UHC Core |
$5,549.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,661.50
|
| Rate for Payer: UHC Exchange |
$1,661.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,661.50
|
| Rate for Payer: VA VA |
$1,661.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,984.52
|
|
|
EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET
|
Facility
|
IP
|
$6,646.02
|
|
|
Service Code
|
NDC 61958070101
|
| Hospital Charge Code |
39255
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4,319.91 |
| Max. Negotiated Rate |
$5,981.42 |
| Rate for Payer: Aetna Commercial |
$5,649.12
|
| Rate for Payer: BCBS Trust/PPO |
$5,425.15
|
| Rate for Payer: BCN Commercial |
$5,136.04
|
| Rate for Payer: Cash Price |
$5,316.82
|
| Rate for Payer: Cofinity Commercial |
$5,715.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,316.82
|
| Rate for Payer: Healthscope Commercial |
$5,981.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,984.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,649.12
|
| Rate for Payer: Nomi Health Commercial |
$5,449.74
|
| Rate for Payer: PHP Commercial |
$5,649.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,319.91
|
| Rate for Payer: Priority Health HMO/PPO |
$5,782.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,452.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,848.50
|
| Rate for Payer: UHC Core |
$5,549.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,984.52
|
|
|
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$29.42
|
|
|
Service Code
|
NDC 43598007811
|
| Hospital Charge Code |
9929
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.99 |
| Max. Negotiated Rate |
$26.48 |
| Rate for Payer: Aetna Commercial |
$25.01
|
| Rate for Payer: Aetna Medicare |
$7.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.19
|
| Rate for Payer: BCBS Complete |
$11.77
|
| Rate for Payer: BCBS MAPPO |
$7.36
|
| Rate for Payer: BCBS Trust/PPO |
$24.19
|
| Rate for Payer: BCN Commercial |
$22.87
|
| Rate for Payer: BCN Medicare Advantage |
$7.36
|
| Rate for Payer: Cash Price |
$23.54
|
| Rate for Payer: Cofinity Commercial |
$25.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.36
|
| Rate for Payer: Healthscope Commercial |
$26.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.01
|
| Rate for Payer: Nomi Health Commercial |
$24.12
|
| Rate for Payer: PACE Senior Care Partners |
$6.99
|
| Rate for Payer: PACE SWMI |
$7.36
|
| Rate for Payer: PHP Commercial |
$25.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.12
|
| Rate for Payer: Priority Health HMO/PPO |
$25.60
|
| Rate for Payer: Priority Health Medicare |
$7.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.71
|
| Rate for Payer: Railroad Medicare Medicare |
$7.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.89
|
| Rate for Payer: UHC Core |
$24.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.36
|
| Rate for Payer: UHC Exchange |
$7.36
|
| Rate for Payer: UHC Medicare Advantage |
$7.36
|
| Rate for Payer: VA VA |
$7.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.06
|
|
|
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.38
|
|
|
Service Code
|
NDC 00143978710
|
| Hospital Charge Code |
9929
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$17.44 |
| Rate for Payer: Aetna Commercial |
$16.47
|
| Rate for Payer: Aetna Medicare |
$5.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.06
|
| Rate for Payer: BCBS Complete |
$7.75
|
| Rate for Payer: BCBS MAPPO |
$4.84
|
| Rate for Payer: BCBS Trust/PPO |
$15.93
|
| Rate for Payer: BCN Commercial |
$15.07
|
| Rate for Payer: BCN Medicare Advantage |
$4.84
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cofinity Commercial |
$16.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.84
|
| Rate for Payer: Healthscope Commercial |
$17.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.47
|
| Rate for Payer: Nomi Health Commercial |
$15.89
|
| Rate for Payer: PACE Senior Care Partners |
$4.60
|
| Rate for Payer: PACE SWMI |
$4.84
|
| Rate for Payer: PHP Commercial |
$16.47
|
| Rate for Payer: PHP Medicare Advantage |
$4.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.60
|
| Rate for Payer: Priority Health HMO/PPO |
$16.86
|
| Rate for Payer: Priority Health Medicare |
$4.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.98
|
| Rate for Payer: Railroad Medicare Medicare |
$4.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.05
|
| Rate for Payer: UHC Core |
$16.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.84
|
| Rate for Payer: UHC Exchange |
$4.84
|
| Rate for Payer: UHC Medicare Advantage |
$4.84
|
| Rate for Payer: VA VA |
$4.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.54
|
|
|
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$29.42
|
|
|
Service Code
|
NDC 43598007811
|
| Hospital Charge Code |
9929
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$19.12 |
| Max. Negotiated Rate |
$26.48 |
| Rate for Payer: Aetna Commercial |
$25.01
|
| Rate for Payer: BCBS Trust/PPO |
$24.02
|
| Rate for Payer: BCN Commercial |
$22.74
|
| Rate for Payer: Cash Price |
$23.54
|
| Rate for Payer: Cofinity Commercial |
$25.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.54
|
| Rate for Payer: Healthscope Commercial |
$26.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.01
|
| Rate for Payer: Nomi Health Commercial |
$24.12
|
| Rate for Payer: PHP Commercial |
$25.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.12
|
| Rate for Payer: Priority Health HMO/PPO |
$25.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.89
|
| Rate for Payer: UHC Core |
$24.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.06
|
|
|
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.38
|
|
|
Service Code
|
NDC 00143978710
|
| Hospital Charge Code |
9929
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$17.44 |
| Rate for Payer: Aetna Commercial |
$16.47
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$14.98
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cofinity Commercial |
$16.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$17.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.47
|
| Rate for Payer: Nomi Health Commercial |
$15.89
|
| Rate for Payer: PHP Commercial |
$16.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.60
|
| Rate for Payer: Priority Health HMO/PPO |
$16.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.05
|
| Rate for Payer: UHC Core |
$16.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.54
|
|
|
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$29.42
|
|
|
Service Code
|
NDC 43598007858
|
| Hospital Charge Code |
9929
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.99 |
| Max. Negotiated Rate |
$26.48 |
| Rate for Payer: Aetna Commercial |
$25.01
|
| Rate for Payer: Aetna Medicare |
$7.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.19
|
| Rate for Payer: BCBS Complete |
$11.77
|
| Rate for Payer: BCBS MAPPO |
$7.36
|
| Rate for Payer: BCBS Trust/PPO |
$24.19
|
| Rate for Payer: BCN Commercial |
$22.87
|
| Rate for Payer: BCN Medicare Advantage |
$7.36
|
| Rate for Payer: Cash Price |
$23.54
|
| Rate for Payer: Cofinity Commercial |
$25.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.36
|
| Rate for Payer: Healthscope Commercial |
$26.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.01
|
| Rate for Payer: Nomi Health Commercial |
$24.12
|
| Rate for Payer: PACE Senior Care Partners |
$6.99
|
| Rate for Payer: PACE SWMI |
$7.36
|
| Rate for Payer: PHP Commercial |
$25.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.12
|
| Rate for Payer: Priority Health HMO/PPO |
$25.60
|
| Rate for Payer: Priority Health Medicare |
$7.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.71
|
| Rate for Payer: Railroad Medicare Medicare |
$7.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.89
|
| Rate for Payer: UHC Core |
$24.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.36
|
| Rate for Payer: UHC Exchange |
$7.36
|
| Rate for Payer: UHC Medicare Advantage |
$7.36
|
| Rate for Payer: VA VA |
$7.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.06
|
|
|
ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$29.42
|
|
|
Service Code
|
NDC 43598007858
|
| Hospital Charge Code |
9929
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$19.12 |
| Max. Negotiated Rate |
$26.48 |
| Rate for Payer: Aetna Commercial |
$25.01
|
| Rate for Payer: BCBS Trust/PPO |
$24.02
|
| Rate for Payer: BCN Commercial |
$22.74
|
| Rate for Payer: Cash Price |
$23.54
|
| Rate for Payer: Cofinity Commercial |
$25.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.54
|
| Rate for Payer: Healthscope Commercial |
$26.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.01
|
| Rate for Payer: Nomi Health Commercial |
$24.12
|
| Rate for Payer: PHP Commercial |
$25.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.12
|
| Rate for Payer: Priority Health HMO/PPO |
$25.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.89
|
| Rate for Payer: UHC Core |
$24.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.06
|
|
|
ENDOCERVICAL CURETTAGE (NOT DONE AS PART OF A DILATION AND CURETTAGE)
|
Facility
|
OP
|
$647.70
|
|
|
Service Code
|
CPT 57505
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$145.60 |
| Max. Negotiated Rate |
$647.70 |
| Rate for Payer: BCBS Complete |
$647.70
|
| Rate for Payer: BCCCP Commercial |
$145.60
|
| Rate for Payer: Mclaren Medicaid |
$616.81
|
| Rate for Payer: Meridian Medicaid |
$647.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$616.81
|
| Rate for Payer: UHCCP Medicaid |
$616.81
|
|
|
ENDOMETRIAL ABLATION, THERMAL, WITHOUT HYSTEROSCOPIC GUIDANCE
|
Facility
|
OP
|
$3,671.97
|
|
|
Service Code
|
CPT 58353
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,496.88 |
| Max. Negotiated Rate |
$3,671.97 |
| Rate for Payer: BCBS Complete |
$3,671.97
|
| Rate for Payer: Mclaren Medicaid |
$3,496.88
|
| Rate for Payer: Meridian Medicaid |
$3,671.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,496.88
|
| Rate for Payer: UHCCP Medicaid |
$3,496.88
|
|
|
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$107.76
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105903
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$25.59 |
| Max. Negotiated Rate |
$96.98 |
| Rate for Payer: Aetna Commercial |
$91.60
|
| Rate for Payer: Aetna Commercial |
$52.77
|
| Rate for Payer: Aetna Commercial |
$32.59
|
| Rate for Payer: Aetna Commercial |
$25.87
|
| Rate for Payer: Aetna Medicare |
$7.91
|
| Rate for Payer: Aetna Medicare |
$28.02
|
| Rate for Payer: Aetna Medicare |
$9.97
|
| Rate for Payer: Aetna Medicare |
$16.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.68
|
| Rate for Payer: BCBS Complete |
$43.10
|
| Rate for Payer: BCBS Complete |
$12.17
|
| Rate for Payer: BCBS Complete |
$24.83
|
| Rate for Payer: BCBS Complete |
$15.34
|
| Rate for Payer: BCBS MAPPO |
$26.94
|
| Rate for Payer: BCBS MAPPO |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$15.52
|
| Rate for Payer: BCBS MAPPO |
$9.58
|
| Rate for Payer: BCBS Trust/PPO |
$88.59
|
| Rate for Payer: BCBS Trust/PPO |
$51.04
|
| Rate for Payer: BCBS Trust/PPO |
$25.02
|
| Rate for Payer: BCBS Trust/PPO |
$31.52
|
| Rate for Payer: BCN Commercial |
$83.78
|
| Rate for Payer: BCN Commercial |
$29.81
|
| Rate for Payer: BCN Commercial |
$23.66
|
| Rate for Payer: BCN Commercial |
$48.27
|
| Rate for Payer: BCN Medicare Advantage |
$7.61
|
| Rate for Payer: BCN Medicare Advantage |
$15.52
|
| Rate for Payer: BCN Medicare Advantage |
$26.94
|
| Rate for Payer: BCN Medicare Advantage |
$9.58
|
| Rate for Payer: Cash Price |
$86.21
|
| Rate for Payer: Cash Price |
$49.66
|
| Rate for Payer: Cash Price |
$30.67
|
| Rate for Payer: Cash Price |
$24.34
|
| Rate for Payer: Cofinity Commercial |
$53.39
|
| Rate for Payer: Cofinity Commercial |
$26.17
|
| Rate for Payer: Cofinity Commercial |
$92.67
|
| Rate for Payer: Cofinity Commercial |
$32.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.58
|
| Rate for Payer: Healthscope Commercial |
$96.98
|
| Rate for Payer: Healthscope Commercial |
$55.87
|
| Rate for Payer: Healthscope Commercial |
$34.51
|
| Rate for Payer: Healthscope Commercial |
$27.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.59
|
| Rate for Payer: Nomi Health Commercial |
$31.44
|
| Rate for Payer: Nomi Health Commercial |
$50.91
|
| Rate for Payer: Nomi Health Commercial |
$88.36
|
| Rate for Payer: Nomi Health Commercial |
$24.95
|
| Rate for Payer: PACE Senior Care Partners |
$25.59
|
| Rate for Payer: PACE Senior Care Partners |
$9.11
|
| Rate for Payer: PACE Senior Care Partners |
$14.74
|
| Rate for Payer: PACE Senior Care Partners |
$7.23
|
| Rate for Payer: PACE SWMI |
$7.61
|
| Rate for Payer: PACE SWMI |
$26.94
|
| Rate for Payer: PACE SWMI |
$9.58
|
| Rate for Payer: PACE SWMI |
$15.52
|
| Rate for Payer: PHP Commercial |
$32.59
|
| Rate for Payer: PHP Commercial |
$52.77
|
| Rate for Payer: PHP Commercial |
$25.87
|
| Rate for Payer: PHP Commercial |
$91.60
|
| Rate for Payer: PHP Medicare Advantage |
$7.61
|
| Rate for Payer: PHP Medicare Advantage |
$26.94
|
| Rate for Payer: PHP Medicare Advantage |
$15.52
|
| Rate for Payer: PHP Medicare Advantage |
$9.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.04
|
| Rate for Payer: Priority Health HMO/PPO |
$26.47
|
| Rate for Payer: Priority Health HMO/PPO |
$54.01
|
| Rate for Payer: Priority Health HMO/PPO |
$33.36
|
| Rate for Payer: Priority Health HMO/PPO |
$93.75
|
| Rate for Payer: Priority Health Medicare |
$9.68
|
| Rate for Payer: Priority Health Medicare |
$27.21
|
| Rate for Payer: Priority Health Medicare |
$7.68
|
| Rate for Payer: Priority Health Medicare |
$15.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.20
|
| Rate for Payer: Railroad Medicare Medicare |
$7.61
|
| Rate for Payer: Railroad Medicare Medicare |
$9.58
|
| Rate for Payer: Railroad Medicare Medicare |
$26.94
|
| Rate for Payer: Railroad Medicare Medicare |
$15.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.78
|
| Rate for Payer: UHC Core |
$89.98
|
| Rate for Payer: UHC Core |
$51.84
|
| Rate for Payer: UHC Core |
$25.41
|
| Rate for Payer: UHC Core |
$32.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.61
|
| Rate for Payer: UHC Exchange |
$15.52
|
| Rate for Payer: UHC Exchange |
$7.61
|
| Rate for Payer: UHC Exchange |
$26.94
|
| Rate for Payer: UHC Exchange |
$9.58
|
| Rate for Payer: UHC Medicare Advantage |
$15.52
|
| Rate for Payer: UHC Medicare Advantage |
$26.94
|
| Rate for Payer: UHC Medicare Advantage |
$9.58
|
| Rate for Payer: UHC Medicare Advantage |
$7.61
|
| Rate for Payer: VA VA |
$7.61
|
| Rate for Payer: VA VA |
$15.52
|
| Rate for Payer: VA VA |
$9.58
|
| Rate for Payer: VA VA |
$26.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.76
|
|
|
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$38.34
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105903
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.92 |
| Max. Negotiated Rate |
$34.51 |
| Rate for Payer: Aetna Commercial |
$32.59
|
| Rate for Payer: Aetna Commercial |
$25.87
|
| Rate for Payer: Aetna Commercial |
$91.60
|
| Rate for Payer: Aetna Commercial |
$52.77
|
| Rate for Payer: BCBS Trust/PPO |
$31.30
|
| Rate for Payer: BCBS Trust/PPO |
$50.68
|
| Rate for Payer: BCBS Trust/PPO |
$24.84
|
| Rate for Payer: BCBS Trust/PPO |
$87.96
|
| Rate for Payer: BCN Commercial |
$29.63
|
| Rate for Payer: BCN Commercial |
$83.28
|
| Rate for Payer: BCN Commercial |
$47.98
|
| Rate for Payer: BCN Commercial |
$23.52
|
| Rate for Payer: Cash Price |
$24.34
|
| Rate for Payer: Cash Price |
$30.67
|
| Rate for Payer: Cash Price |
$49.66
|
| Rate for Payer: Cash Price |
$86.21
|
| Rate for Payer: Cofinity Commercial |
$92.67
|
| Rate for Payer: Cofinity Commercial |
$53.39
|
| Rate for Payer: Cofinity Commercial |
$32.97
|
| Rate for Payer: Cofinity Commercial |
$26.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.66
|
| Rate for Payer: Healthscope Commercial |
$55.87
|
| Rate for Payer: Healthscope Commercial |
$27.39
|
| Rate for Payer: Healthscope Commercial |
$34.51
|
| Rate for Payer: Healthscope Commercial |
$96.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.77
|
| Rate for Payer: Nomi Health Commercial |
$88.36
|
| Rate for Payer: Nomi Health Commercial |
$24.95
|
| Rate for Payer: Nomi Health Commercial |
$50.91
|
| Rate for Payer: Nomi Health Commercial |
$31.44
|
| Rate for Payer: PHP Commercial |
$25.87
|
| Rate for Payer: PHP Commercial |
$91.60
|
| Rate for Payer: PHP Commercial |
$32.59
|
| Rate for Payer: PHP Commercial |
$52.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.92
|
| Rate for Payer: Priority Health HMO/PPO |
$33.36
|
| Rate for Payer: Priority Health HMO/PPO |
$54.01
|
| Rate for Payer: Priority Health HMO/PPO |
$93.75
|
| Rate for Payer: Priority Health HMO/PPO |
$26.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.74
|
| Rate for Payer: UHC Core |
$32.01
|
| Rate for Payer: UHC Core |
$51.84
|
| Rate for Payer: UHC Core |
$25.41
|
| Rate for Payer: UHC Core |
$89.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.76
|
|
|
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$74.50
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105904
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$67.05 |
| Rate for Payer: Aetna Commercial |
$63.32
|
| Rate for Payer: Aetna Commercial |
$30.00
|
| Rate for Payer: Aetna Commercial |
$31.77
|
| Rate for Payer: Aetna Commercial |
$38.77
|
| Rate for Payer: Aetna Commercial |
$90.19
|
| Rate for Payer: BCBS Trust/PPO |
$37.23
|
| Rate for Payer: BCBS Trust/PPO |
$60.81
|
| Rate for Payer: BCBS Trust/PPO |
$30.51
|
| Rate for Payer: BCBS Trust/PPO |
$28.81
|
| Rate for Payer: BCBS Trust/PPO |
$86.62
|
| Rate for Payer: BCN Commercial |
$35.25
|
| Rate for Payer: BCN Commercial |
$28.89
|
| Rate for Payer: BCN Commercial |
$82.00
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: BCN Commercial |
$57.57
|
| Rate for Payer: Cash Price |
$84.89
|
| Rate for Payer: Cash Price |
$59.60
|
| Rate for Payer: Cash Price |
$29.90
|
| Rate for Payer: Cash Price |
$28.23
|
| Rate for Payer: Cash Price |
$36.49
|
| Rate for Payer: Cofinity Commercial |
$64.07
|
| Rate for Payer: Cofinity Commercial |
$91.25
|
| Rate for Payer: Cofinity Commercial |
$39.22
|
| Rate for Payer: Cofinity Commercial |
$32.15
|
| Rate for Payer: Cofinity Commercial |
$30.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.60
|
| Rate for Payer: Healthscope Commercial |
$31.76
|
| Rate for Payer: Healthscope Commercial |
$33.64
|
| Rate for Payer: Healthscope Commercial |
$95.50
|
| Rate for Payer: Healthscope Commercial |
$41.05
|
| Rate for Payer: Healthscope Commercial |
$67.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.77
|
| Rate for Payer: Nomi Health Commercial |
$87.01
|
| Rate for Payer: Nomi Health Commercial |
$28.94
|
| Rate for Payer: Nomi Health Commercial |
$30.65
|
| Rate for Payer: Nomi Health Commercial |
$37.40
|
| Rate for Payer: Nomi Health Commercial |
$61.09
|
| Rate for Payer: PHP Commercial |
$31.77
|
| Rate for Payer: PHP Commercial |
$30.00
|
| Rate for Payer: PHP Commercial |
$90.19
|
| Rate for Payer: PHP Commercial |
$38.77
|
| Rate for Payer: PHP Commercial |
$63.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.97
|
| Rate for Payer: Priority Health HMO/PPO |
$92.32
|
| Rate for Payer: Priority Health HMO/PPO |
$64.82
|
| Rate for Payer: Priority Health HMO/PPO |
$32.52
|
| Rate for Payer: Priority Health HMO/PPO |
$39.68
|
| Rate for Payer: Priority Health HMO/PPO |
$30.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.14
|
| Rate for Payer: UHC Core |
$88.60
|
| Rate for Payer: UHC Core |
$29.47
|
| Rate for Payer: UHC Core |
$38.08
|
| Rate for Payer: UHC Core |
$62.21
|
| Rate for Payer: UHC Core |
$31.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.21
|
|
|
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$35.29
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105904
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.38 |
| Max. Negotiated Rate |
$31.76 |
| Rate for Payer: Aetna Commercial |
$30.00
|
| Rate for Payer: Aetna Commercial |
$31.77
|
| Rate for Payer: Aetna Commercial |
$38.77
|
| Rate for Payer: Aetna Commercial |
$90.19
|
| Rate for Payer: Aetna Commercial |
$63.32
|
| Rate for Payer: Aetna Medicare |
$9.72
|
| Rate for Payer: Aetna Medicare |
$27.59
|
| Rate for Payer: Aetna Medicare |
$9.18
|
| Rate for Payer: Aetna Medicare |
$11.86
|
| Rate for Payer: Aetna Medicare |
$19.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.25
|
| Rate for Payer: BCBS Complete |
$18.24
|
| Rate for Payer: BCBS Complete |
$42.44
|
| Rate for Payer: BCBS Complete |
$14.12
|
| Rate for Payer: BCBS Complete |
$14.95
|
| Rate for Payer: BCBS Complete |
$29.80
|
| Rate for Payer: BCBS MAPPO |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$26.53
|
| Rate for Payer: BCBS MAPPO |
$8.82
|
| Rate for Payer: BCBS MAPPO |
$11.40
|
| Rate for Payer: BCBS MAPPO |
$18.62
|
| Rate for Payer: BCBS Trust/PPO |
$87.23
|
| Rate for Payer: BCBS Trust/PPO |
$29.01
|
| Rate for Payer: BCBS Trust/PPO |
$30.73
|
| Rate for Payer: BCBS Trust/PPO |
$61.25
|
| Rate for Payer: BCBS Trust/PPO |
$37.50
|
| Rate for Payer: BCN Commercial |
$57.92
|
| Rate for Payer: BCN Commercial |
$82.50
|
| Rate for Payer: BCN Commercial |
$27.44
|
| Rate for Payer: BCN Commercial |
$29.06
|
| Rate for Payer: BCN Commercial |
$35.46
|
| Rate for Payer: BCN Medicare Advantage |
$18.62
|
| Rate for Payer: BCN Medicare Advantage |
$11.40
|
| Rate for Payer: BCN Medicare Advantage |
$26.53
|
| Rate for Payer: BCN Medicare Advantage |
$8.82
|
| Rate for Payer: BCN Medicare Advantage |
$9.34
|
| Rate for Payer: Cash Price |
$84.89
|
| Rate for Payer: Cash Price |
$36.49
|
| Rate for Payer: Cash Price |
$59.60
|
| Rate for Payer: Cash Price |
$29.90
|
| Rate for Payer: Cash Price |
$28.23
|
| Rate for Payer: Cofinity Commercial |
$64.07
|
| Rate for Payer: Cofinity Commercial |
$91.25
|
| Rate for Payer: Cofinity Commercial |
$30.35
|
| Rate for Payer: Cofinity Commercial |
$39.22
|
| Rate for Payer: Cofinity Commercial |
$32.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.34
|
| Rate for Payer: Healthscope Commercial |
$31.76
|
| Rate for Payer: Healthscope Commercial |
$95.50
|
| Rate for Payer: Healthscope Commercial |
$41.05
|
| Rate for Payer: Healthscope Commercial |
$33.64
|
| Rate for Payer: Healthscope Commercial |
$67.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.32
|
| Rate for Payer: Nomi Health Commercial |
$28.94
|
| Rate for Payer: Nomi Health Commercial |
$37.40
|
| Rate for Payer: Nomi Health Commercial |
$30.65
|
| Rate for Payer: Nomi Health Commercial |
$61.09
|
| Rate for Payer: Nomi Health Commercial |
$87.01
|
| Rate for Payer: PACE Senior Care Partners |
$25.20
|
| Rate for Payer: PACE Senior Care Partners |
$10.83
|
| Rate for Payer: PACE Senior Care Partners |
$8.38
|
| Rate for Payer: PACE Senior Care Partners |
$8.88
|
| Rate for Payer: PACE Senior Care Partners |
$17.69
|
| Rate for Payer: PACE SWMI |
$26.53
|
| Rate for Payer: PACE SWMI |
$11.40
|
| Rate for Payer: PACE SWMI |
$9.34
|
| Rate for Payer: PACE SWMI |
$8.82
|
| Rate for Payer: PACE SWMI |
$18.62
|
| Rate for Payer: PHP Commercial |
$63.32
|
| Rate for Payer: PHP Commercial |
$31.77
|
| Rate for Payer: PHP Commercial |
$38.77
|
| Rate for Payer: PHP Commercial |
$30.00
|
| Rate for Payer: PHP Commercial |
$90.19
|
| Rate for Payer: PHP Medicare Advantage |
$9.34
|
| Rate for Payer: PHP Medicare Advantage |
$11.40
|
| Rate for Payer: PHP Medicare Advantage |
$18.62
|
| Rate for Payer: PHP Medicare Advantage |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$8.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.97
|
| Rate for Payer: Priority Health HMO/PPO |
$92.32
|
| Rate for Payer: Priority Health HMO/PPO |
$32.52
|
| Rate for Payer: Priority Health HMO/PPO |
$64.82
|
| Rate for Payer: Priority Health HMO/PPO |
$39.68
|
| Rate for Payer: Priority Health HMO/PPO |
$30.70
|
| Rate for Payer: Priority Health Medicare |
$18.81
|
| Rate for Payer: Priority Health Medicare |
$9.44
|
| Rate for Payer: Priority Health Medicare |
$8.91
|
| Rate for Payer: Priority Health Medicare |
$11.52
|
| Rate for Payer: Priority Health Medicare |
$26.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.92
|
| Rate for Payer: Railroad Medicare Medicare |
$11.40
|
| Rate for Payer: Railroad Medicare Medicare |
$9.34
|
| Rate for Payer: Railroad Medicare Medicare |
$26.53
|
| Rate for Payer: Railroad Medicare Medicare |
$8.82
|
| Rate for Payer: Railroad Medicare Medicare |
$18.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.89
|
| Rate for Payer: UHC Core |
$29.47
|
| Rate for Payer: UHC Core |
$62.21
|
| Rate for Payer: UHC Core |
$31.21
|
| Rate for Payer: UHC Core |
$38.08
|
| Rate for Payer: UHC Core |
$88.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.34
|
| Rate for Payer: UHC Exchange |
$9.34
|
| Rate for Payer: UHC Exchange |
$18.62
|
| Rate for Payer: UHC Exchange |
$26.53
|
| Rate for Payer: UHC Exchange |
$11.40
|
| Rate for Payer: UHC Exchange |
$8.82
|
| Rate for Payer: UHC Medicare Advantage |
$8.82
|
| Rate for Payer: UHC Medicare Advantage |
$18.62
|
| Rate for Payer: UHC Medicare Advantage |
$9.34
|
| Rate for Payer: UHC Medicare Advantage |
$26.53
|
| Rate for Payer: UHC Medicare Advantage |
$11.40
|
| Rate for Payer: VA VA |
$26.53
|
| Rate for Payer: VA VA |
$11.40
|
| Rate for Payer: VA VA |
$8.82
|
| Rate for Payer: VA VA |
$18.62
|
| Rate for Payer: VA VA |
$9.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.04
|
|
|
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$48.67
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
31921
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$31.64 |
| Max. Negotiated Rate |
$43.80 |
| Rate for Payer: Aetna Commercial |
$41.37
|
| Rate for Payer: Aetna Commercial |
$48.54
|
| Rate for Payer: Aetna Commercial |
$79.15
|
| Rate for Payer: BCBS Trust/PPO |
$46.61
|
| Rate for Payer: BCBS Trust/PPO |
$39.73
|
| Rate for Payer: BCBS Trust/PPO |
$76.01
|
| Rate for Payer: BCN Commercial |
$44.13
|
| Rate for Payer: BCN Commercial |
$37.61
|
| Rate for Payer: BCN Commercial |
$71.96
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cash Price |
$74.50
|
| Rate for Payer: Cash Price |
$45.68
|
| Rate for Payer: Cofinity Commercial |
$80.08
|
| Rate for Payer: Cofinity Commercial |
$49.11
|
| Rate for Payer: Cofinity Commercial |
$41.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.50
|
| Rate for Payer: Healthscope Commercial |
$51.39
|
| Rate for Payer: Healthscope Commercial |
$43.80
|
| Rate for Payer: Healthscope Commercial |
$83.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.15
|
| Rate for Payer: Nomi Health Commercial |
$39.91
|
| Rate for Payer: Nomi Health Commercial |
$46.82
|
| Rate for Payer: Nomi Health Commercial |
$76.36
|
| Rate for Payer: PHP Commercial |
$48.54
|
| Rate for Payer: PHP Commercial |
$41.37
|
| Rate for Payer: PHP Commercial |
$79.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.12
|
| Rate for Payer: Priority Health HMO/PPO |
$81.01
|
| Rate for Payer: Priority Health HMO/PPO |
$49.68
|
| Rate for Payer: Priority Health HMO/PPO |
$42.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.83
|
| Rate for Payer: UHC Core |
$40.64
|
| Rate for Payer: UHC Core |
$77.76
|
| Rate for Payer: UHC Core |
$47.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.82
|
|
|
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$48.67
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
31921
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.56 |
| Max. Negotiated Rate |
$43.80 |
| Rate for Payer: Aetna Commercial |
$41.37
|
| Rate for Payer: Aetna Commercial |
$79.15
|
| Rate for Payer: Aetna Commercial |
$48.54
|
| Rate for Payer: Aetna Medicare |
$24.21
|
| Rate for Payer: Aetna Medicare |
$12.65
|
| Rate for Payer: Aetna Medicare |
$14.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.10
|
| Rate for Payer: BCBS Complete |
$22.84
|
| Rate for Payer: BCBS Complete |
$19.47
|
| Rate for Payer: BCBS Complete |
$37.25
|
| Rate for Payer: BCBS MAPPO |
$23.28
|
| Rate for Payer: BCBS MAPPO |
$12.17
|
| Rate for Payer: BCBS MAPPO |
$14.28
|
| Rate for Payer: BCBS Trust/PPO |
$46.94
|
| Rate for Payer: BCBS Trust/PPO |
$40.01
|
| Rate for Payer: BCBS Trust/PPO |
$76.55
|
| Rate for Payer: BCN Commercial |
$44.40
|
| Rate for Payer: BCN Commercial |
$72.40
|
| Rate for Payer: BCN Commercial |
$37.84
|
| Rate for Payer: BCN Medicare Advantage |
$12.17
|
| Rate for Payer: BCN Medicare Advantage |
$14.28
|
| Rate for Payer: BCN Medicare Advantage |
$23.28
|
| Rate for Payer: Cash Price |
$45.68
|
| Rate for Payer: Cash Price |
$74.50
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cofinity Commercial |
$80.08
|
| Rate for Payer: Cofinity Commercial |
$41.86
|
| Rate for Payer: Cofinity Commercial |
$49.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.17
|
| Rate for Payer: Healthscope Commercial |
$51.39
|
| Rate for Payer: Healthscope Commercial |
$43.80
|
| Rate for Payer: Healthscope Commercial |
$83.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.37
|
| Rate for Payer: Nomi Health Commercial |
$76.36
|
| Rate for Payer: Nomi Health Commercial |
$39.91
|
| Rate for Payer: Nomi Health Commercial |
$46.82
|
| Rate for Payer: PACE Senior Care Partners |
$22.12
|
| Rate for Payer: PACE Senior Care Partners |
$11.56
|
| Rate for Payer: PACE Senior Care Partners |
$13.56
|
| Rate for Payer: PACE SWMI |
$14.28
|
| Rate for Payer: PACE SWMI |
$12.17
|
| Rate for Payer: PACE SWMI |
$23.28
|
| Rate for Payer: PHP Commercial |
$79.15
|
| Rate for Payer: PHP Commercial |
$48.54
|
| Rate for Payer: PHP Commercial |
$41.37
|
| Rate for Payer: PHP Medicare Advantage |
$14.28
|
| Rate for Payer: PHP Medicare Advantage |
$23.28
|
| Rate for Payer: PHP Medicare Advantage |
$12.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.12
|
| Rate for Payer: Priority Health HMO/PPO |
$81.01
|
| Rate for Payer: Priority Health HMO/PPO |
$42.34
|
| Rate for Payer: Priority Health HMO/PPO |
$49.68
|
| Rate for Payer: Priority Health Medicare |
$12.29
|
| Rate for Payer: Priority Health Medicare |
$23.51
|
| Rate for Payer: Priority Health Medicare |
$14.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.61
|
| Rate for Payer: Railroad Medicare Medicare |
$14.28
|
| Rate for Payer: Railroad Medicare Medicare |
$23.28
|
| Rate for Payer: Railroad Medicare Medicare |
$12.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.83
|
| Rate for Payer: UHC Core |
$77.76
|
| Rate for Payer: UHC Core |
$47.68
|
| Rate for Payer: UHC Core |
$40.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.28
|
| Rate for Payer: UHC Exchange |
$14.28
|
| Rate for Payer: UHC Exchange |
$12.17
|
| Rate for Payer: UHC Exchange |
$23.28
|
| Rate for Payer: UHC Medicare Advantage |
$12.17
|
| Rate for Payer: UHC Medicare Advantage |
$14.28
|
| Rate for Payer: UHC Medicare Advantage |
$23.28
|
| Rate for Payer: VA VA |
$14.28
|
| Rate for Payer: VA VA |
$23.28
|
| Rate for Payer: VA VA |
$12.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.82
|
|
|
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$32.29
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105899
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.99 |
| Max. Negotiated Rate |
$29.06 |
| Rate for Payer: Aetna Commercial |
$27.45
|
| Rate for Payer: Aetna Commercial |
$14.34
|
| Rate for Payer: Aetna Commercial |
$15.66
|
| Rate for Payer: Aetna Commercial |
$22.57
|
| Rate for Payer: Aetna Commercial |
$15.82
|
| Rate for Payer: Aetna Commercial |
$12.61
|
| Rate for Payer: Aetna Commercial |
$23.61
|
| Rate for Payer: BCBS Trust/PPO |
$26.36
|
| Rate for Payer: BCBS Trust/PPO |
$13.77
|
| Rate for Payer: BCBS Trust/PPO |
$22.68
|
| Rate for Payer: BCBS Trust/PPO |
$12.11
|
| Rate for Payer: BCBS Trust/PPO |
$21.67
|
| Rate for Payer: BCBS Trust/PPO |
$15.04
|
| Rate for Payer: BCBS Trust/PPO |
$15.19
|
| Rate for Payer: BCN Commercial |
$14.23
|
| Rate for Payer: BCN Commercial |
$21.47
|
| Rate for Payer: BCN Commercial |
$24.95
|
| Rate for Payer: BCN Commercial |
$20.52
|
| Rate for Payer: BCN Commercial |
$13.04
|
| Rate for Payer: BCN Commercial |
$14.38
|
| Rate for Payer: BCN Commercial |
$11.47
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cash Price |
$11.87
|
| Rate for Payer: Cash Price |
$21.24
|
| Rate for Payer: Cash Price |
$25.83
|
| Rate for Payer: Cash Price |
$22.22
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$14.89
|
| Rate for Payer: Cofinity Commercial |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$12.76
|
| Rate for Payer: Cofinity Commercial |
$22.83
|
| Rate for Payer: Cofinity Commercial |
$15.84
|
| Rate for Payer: Cofinity Commercial |
$14.51
|
| Rate for Payer: Cofinity Commercial |
$27.77
|
| Rate for Payer: Cofinity Commercial |
$23.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.83
|
| Rate for Payer: Healthscope Commercial |
$15.18
|
| Rate for Payer: Healthscope Commercial |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$25.00
|
| Rate for Payer: Healthscope Commercial |
$23.90
|
| Rate for Payer: Healthscope Commercial |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$29.06
|
| Rate for Payer: Healthscope Commercial |
$16.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.66
|
| Rate for Payer: Nomi Health Commercial |
$15.26
|
| Rate for Payer: Nomi Health Commercial |
$12.17
|
| Rate for Payer: Nomi Health Commercial |
$26.48
|
| Rate for Payer: Nomi Health Commercial |
$22.78
|
| Rate for Payer: Nomi Health Commercial |
$21.77
|
| Rate for Payer: Nomi Health Commercial |
$15.10
|
| Rate for Payer: Nomi Health Commercial |
$13.83
|
| Rate for Payer: PHP Commercial |
$12.61
|
| Rate for Payer: PHP Commercial |
$15.82
|
| Rate for Payer: PHP Commercial |
$22.57
|
| Rate for Payer: PHP Commercial |
$23.61
|
| Rate for Payer: PHP Commercial |
$27.45
|
| Rate for Payer: PHP Commercial |
$14.34
|
| Rate for Payer: PHP Commercial |
$15.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.10
|
| Rate for Payer: Priority Health HMO/PPO |
$14.68
|
| Rate for Payer: Priority Health HMO/PPO |
$23.10
|
| Rate for Payer: Priority Health HMO/PPO |
$28.09
|
| Rate for Payer: Priority Health HMO/PPO |
$16.03
|
| Rate for Payer: Priority Health HMO/PPO |
$16.19
|
| Rate for Payer: Priority Health HMO/PPO |
$12.91
|
| Rate for Payer: Priority Health HMO/PPO |
$24.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.21
|
| Rate for Payer: UHC Core |
$12.39
|
| Rate for Payer: UHC Core |
$23.20
|
| Rate for Payer: UHC Core |
$14.09
|
| Rate for Payer: UHC Core |
$15.38
|
| Rate for Payer: UHC Core |
$22.17
|
| Rate for Payer: UHC Core |
$26.96
|
| Rate for Payer: UHC Core |
$15.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.84
|
|
|
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$26.55
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105899
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.31 |
| Max. Negotiated Rate |
$23.90 |
| Rate for Payer: Aetna Commercial |
$22.57
|
| Rate for Payer: Aetna Commercial |
$27.45
|
| Rate for Payer: Aetna Commercial |
$14.34
|
| Rate for Payer: Aetna Commercial |
$23.61
|
| Rate for Payer: Aetna Commercial |
$15.66
|
| Rate for Payer: Aetna Commercial |
$12.61
|
| Rate for Payer: Aetna Commercial |
$15.82
|
| Rate for Payer: Aetna Medicare |
$4.39
|
| Rate for Payer: Aetna Medicare |
$3.86
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Aetna Medicare |
$8.40
|
| Rate for Payer: Aetna Medicare |
$4.84
|
| Rate for Payer: Aetna Medicare |
$7.22
|
| Rate for Payer: Aetna Medicare |
$4.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.30
|
| Rate for Payer: BCBS Complete |
$11.11
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS Complete |
$6.75
|
| Rate for Payer: BCBS Complete |
$7.44
|
| Rate for Payer: BCBS Complete |
$10.62
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS Complete |
$12.92
|
| Rate for Payer: BCBS MAPPO |
$6.64
|
| Rate for Payer: BCBS MAPPO |
$8.07
|
| Rate for Payer: BCBS MAPPO |
$6.94
|
| Rate for Payer: BCBS MAPPO |
$4.65
|
| Rate for Payer: BCBS MAPPO |
$4.22
|
| Rate for Payer: BCBS MAPPO |
$3.71
|
| Rate for Payer: BCBS MAPPO |
$4.60
|
| Rate for Payer: BCBS Trust/PPO |
$12.20
|
| Rate for Payer: BCBS Trust/PPO |
$13.87
|
| Rate for Payer: BCBS Trust/PPO |
$26.55
|
| Rate for Payer: BCBS Trust/PPO |
$22.84
|
| Rate for Payer: BCBS Trust/PPO |
$15.14
|
| Rate for Payer: BCBS Trust/PPO |
$21.83
|
| Rate for Payer: BCBS Trust/PPO |
$15.30
|
| Rate for Payer: BCN Commercial |
$14.47
|
| Rate for Payer: BCN Commercial |
$11.54
|
| Rate for Payer: BCN Commercial |
$14.32
|
| Rate for Payer: BCN Commercial |
$13.12
|
| Rate for Payer: BCN Commercial |
$21.60
|
| Rate for Payer: BCN Commercial |
$20.64
|
| Rate for Payer: BCN Commercial |
$25.11
|
| Rate for Payer: BCN Medicare Advantage |
$8.07
|
| Rate for Payer: BCN Medicare Advantage |
$6.64
|
| Rate for Payer: BCN Medicare Advantage |
$6.94
|
| Rate for Payer: BCN Medicare Advantage |
$4.60
|
| Rate for Payer: BCN Medicare Advantage |
$3.71
|
| Rate for Payer: BCN Medicare Advantage |
$4.22
|
| Rate for Payer: BCN Medicare Advantage |
$4.65
|
| Rate for Payer: Cash Price |
$11.87
|
| Rate for Payer: Cash Price |
$25.83
|
| Rate for Payer: Cash Price |
$21.24
|
| Rate for Payer: Cash Price |
$14.89
|
| Rate for Payer: Cash Price |
$22.22
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cofinity Commercial |
$15.84
|
| Rate for Payer: Cofinity Commercial |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$27.77
|
| Rate for Payer: Cofinity Commercial |
$12.76
|
| Rate for Payer: Cofinity Commercial |
$14.51
|
| Rate for Payer: Cofinity Commercial |
$22.83
|
| Rate for Payer: Cofinity Commercial |
$23.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.65
|
| Rate for Payer: Healthscope Commercial |
$16.75
|
| Rate for Payer: Healthscope Commercial |
$23.90
|
| Rate for Payer: Healthscope Commercial |
$25.00
|
| Rate for Payer: Healthscope Commercial |
$15.18
|
| Rate for Payer: Healthscope Commercial |
$29.06
|
| Rate for Payer: Healthscope Commercial |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$16.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.34
|
| Rate for Payer: Nomi Health Commercial |
$22.78
|
| Rate for Payer: Nomi Health Commercial |
$12.17
|
| Rate for Payer: Nomi Health Commercial |
$13.83
|
| Rate for Payer: Nomi Health Commercial |
$26.48
|
| Rate for Payer: Nomi Health Commercial |
$15.26
|
| Rate for Payer: Nomi Health Commercial |
$15.10
|
| Rate for Payer: Nomi Health Commercial |
$21.77
|
| Rate for Payer: PACE Senior Care Partners |
$6.31
|
| Rate for Payer: PACE Senior Care Partners |
$7.67
|
| Rate for Payer: PACE Senior Care Partners |
$4.42
|
| Rate for Payer: PACE Senior Care Partners |
$4.01
|
| Rate for Payer: PACE Senior Care Partners |
$3.52
|
| Rate for Payer: PACE Senior Care Partners |
$4.37
|
| Rate for Payer: PACE Senior Care Partners |
$6.60
|
| Rate for Payer: PACE SWMI |
$6.94
|
| Rate for Payer: PACE SWMI |
$4.60
|
| Rate for Payer: PACE SWMI |
$6.64
|
| Rate for Payer: PACE SWMI |
$3.71
|
| Rate for Payer: PACE SWMI |
$4.65
|
| Rate for Payer: PACE SWMI |
$4.22
|
| Rate for Payer: PACE SWMI |
$8.07
|
| Rate for Payer: PHP Commercial |
$22.57
|
| Rate for Payer: PHP Commercial |
$15.66
|
| Rate for Payer: PHP Commercial |
$23.61
|
| Rate for Payer: PHP Commercial |
$27.45
|
| Rate for Payer: PHP Commercial |
$12.61
|
| Rate for Payer: PHP Commercial |
$14.34
|
| Rate for Payer: PHP Commercial |
$15.82
|
| Rate for Payer: PHP Medicare Advantage |
$3.71
|
| Rate for Payer: PHP Medicare Advantage |
$4.65
|
| Rate for Payer: PHP Medicare Advantage |
$4.60
|
| Rate for Payer: PHP Medicare Advantage |
$6.64
|
| Rate for Payer: PHP Medicare Advantage |
$6.94
|
| Rate for Payer: PHP Medicare Advantage |
$4.22
|
| Rate for Payer: PHP Medicare Advantage |
$8.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.65
|
| Rate for Payer: Priority Health HMO/PPO |
$14.68
|
| Rate for Payer: Priority Health HMO/PPO |
$16.19
|
| Rate for Payer: Priority Health HMO/PPO |
$23.10
|
| Rate for Payer: Priority Health HMO/PPO |
$24.17
|
| Rate for Payer: Priority Health HMO/PPO |
$16.03
|
| Rate for Payer: Priority Health HMO/PPO |
$28.09
|
| Rate for Payer: Priority Health HMO/PPO |
$12.91
|
| Rate for Payer: Priority Health Medicare |
$4.26
|
| Rate for Payer: Priority Health Medicare |
$4.70
|
| Rate for Payer: Priority Health Medicare |
$4.65
|
| Rate for Payer: Priority Health Medicare |
$3.75
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Medicare |
$7.01
|
| Rate for Payer: Priority Health Medicare |
$8.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.47
|
| Rate for Payer: Railroad Medicare Medicare |
$8.07
|
| Rate for Payer: Railroad Medicare Medicare |
$3.71
|
| Rate for Payer: Railroad Medicare Medicare |
$6.94
|
| Rate for Payer: Railroad Medicare Medicare |
$4.65
|
| Rate for Payer: Railroad Medicare Medicare |
$4.60
|
| Rate for Payer: Railroad Medicare Medicare |
$4.22
|
| Rate for Payer: Railroad Medicare Medicare |
$6.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.06
|
| Rate for Payer: UHC Core |
$14.09
|
| Rate for Payer: UHC Core |
$23.20
|
| Rate for Payer: UHC Core |
$12.39
|
| Rate for Payer: UHC Core |
$15.54
|
| Rate for Payer: UHC Core |
$15.38
|
| Rate for Payer: UHC Core |
$22.17
|
| Rate for Payer: UHC Core |
$26.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.07
|
| Rate for Payer: UHC Exchange |
$4.65
|
| Rate for Payer: UHC Exchange |
$6.94
|
| Rate for Payer: UHC Exchange |
$8.07
|
| Rate for Payer: UHC Exchange |
$4.22
|
| Rate for Payer: UHC Exchange |
$4.60
|
| Rate for Payer: UHC Exchange |
$3.71
|
| Rate for Payer: UHC Exchange |
$6.64
|
| Rate for Payer: UHC Medicare Advantage |
$8.07
|
| Rate for Payer: UHC Medicare Advantage |
$3.71
|
| Rate for Payer: UHC Medicare Advantage |
$4.60
|
| Rate for Payer: UHC Medicare Advantage |
$4.65
|
| Rate for Payer: UHC Medicare Advantage |
$6.64
|
| Rate for Payer: UHC Medicare Advantage |
$6.94
|
| Rate for Payer: UHC Medicare Advantage |
$4.22
|
| Rate for Payer: VA VA |
$4.60
|
| Rate for Payer: VA VA |
$4.65
|
| Rate for Payer: VA VA |
$4.22
|
| Rate for Payer: VA VA |
$8.07
|
| Rate for Payer: VA VA |
$3.71
|
| Rate for Payer: VA VA |
$6.64
|
| Rate for Payer: VA VA |
$6.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.91
|
|
|
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$16.87
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105900
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.01 |
| Max. Negotiated Rate |
$15.18 |
| Rate for Payer: Aetna Commercial |
$14.34
|
| Rate for Payer: Aetna Commercial |
$15.04
|
| Rate for Payer: Aetna Commercial |
$16.68
|
| Rate for Payer: Aetna Commercial |
$21.07
|
| Rate for Payer: Aetna Commercial |
$21.14
|
| Rate for Payer: Aetna Commercial |
$21.56
|
| Rate for Payer: Aetna Commercial |
$30.04
|
| Rate for Payer: Aetna Commercial |
$36.60
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Aetna Medicare |
$11.20
|
| Rate for Payer: Aetna Medicare |
$9.19
|
| Rate for Payer: Aetna Medicare |
$5.10
|
| Rate for Payer: Aetna Medicare |
$6.45
|
| Rate for Payer: Aetna Medicare |
$4.39
|
| Rate for Payer: Aetna Medicare |
$4.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.13
|
| Rate for Payer: BCBS Complete |
$9.95
|
| Rate for Payer: BCBS Complete |
$7.08
|
| Rate for Payer: BCBS Complete |
$7.85
|
| Rate for Payer: BCBS Complete |
$9.92
|
| Rate for Payer: BCBS Complete |
$6.75
|
| Rate for Payer: BCBS Complete |
$10.15
|
| Rate for Payer: BCBS Complete |
$14.14
|
| Rate for Payer: BCBS Complete |
$17.22
|
| Rate for Payer: BCBS MAPPO |
$4.42
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS MAPPO |
$6.34
|
| Rate for Payer: BCBS MAPPO |
$4.90
|
| Rate for Payer: BCBS MAPPO |
$8.84
|
| Rate for Payer: BCBS MAPPO |
$6.20
|
| Rate for Payer: BCBS MAPPO |
$4.22
|
| Rate for Payer: BCBS MAPPO |
$10.76
|
| Rate for Payer: BCBS Trust/PPO |
$16.13
|
| Rate for Payer: BCBS Trust/PPO |
$20.38
|
| Rate for Payer: BCBS Trust/PPO |
$35.40
|
| Rate for Payer: BCBS Trust/PPO |
$20.86
|
| Rate for Payer: BCBS Trust/PPO |
$20.45
|
| Rate for Payer: BCBS Trust/PPO |
$13.87
|
| Rate for Payer: BCBS Trust/PPO |
$14.55
|
| Rate for Payer: BCBS Trust/PPO |
$29.05
|
| Rate for Payer: BCN Commercial |
$33.48
|
| Rate for Payer: BCN Commercial |
$19.27
|
| Rate for Payer: BCN Commercial |
$13.76
|
| Rate for Payer: BCN Commercial |
$19.73
|
| Rate for Payer: BCN Commercial |
$19.34
|
| Rate for Payer: BCN Commercial |
$27.48
|
| Rate for Payer: BCN Commercial |
$13.12
|
| Rate for Payer: BCN Commercial |
$15.25
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: BCN Medicare Advantage |
$8.84
|
| Rate for Payer: BCN Medicare Advantage |
$4.90
|
| Rate for Payer: BCN Medicare Advantage |
$4.22
|
| Rate for Payer: BCN Medicare Advantage |
$10.76
|
| Rate for Payer: BCN Medicare Advantage |
$6.34
|
| Rate for Payer: BCN Medicare Advantage |
$6.20
|
| Rate for Payer: BCN Medicare Advantage |
$4.42
|
| Rate for Payer: Cash Price |
$20.30
|
| Rate for Payer: Cash Price |
$14.16
|
| Rate for Payer: Cash Price |
$19.90
|
| Rate for Payer: Cash Price |
$28.27
|
| Rate for Payer: Cash Price |
$15.70
|
| Rate for Payer: Cash Price |
$19.83
|
| Rate for Payer: Cash Price |
$34.45
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cofinity Commercial |
$15.22
|
| Rate for Payer: Cofinity Commercial |
$21.82
|
| Rate for Payer: Cofinity Commercial |
$21.39
|
| Rate for Payer: Cofinity Commercial |
$37.03
|
| Rate for Payer: Cofinity Commercial |
$16.87
|
| Rate for Payer: Cofinity Commercial |
$30.39
|
| Rate for Payer: Cofinity Commercial |
$14.51
|
| Rate for Payer: Cofinity Commercial |
$21.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.76
|
| Rate for Payer: Healthscope Commercial |
$17.66
|
| Rate for Payer: Healthscope Commercial |
$31.81
|
| Rate for Payer: Healthscope Commercial |
$15.18
|
| Rate for Payer: Healthscope Commercial |
$22.38
|
| Rate for Payer: Healthscope Commercial |
$38.75
|
| Rate for Payer: Healthscope Commercial |
$22.31
|
| Rate for Payer: Healthscope Commercial |
$15.93
|
| Rate for Payer: Healthscope Commercial |
$22.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.34
|
| Rate for Payer: Nomi Health Commercial |
$14.51
|
| Rate for Payer: Nomi Health Commercial |
$20.80
|
| Rate for Payer: Nomi Health Commercial |
$20.33
|
| Rate for Payer: Nomi Health Commercial |
$16.09
|
| Rate for Payer: Nomi Health Commercial |
$28.98
|
| Rate for Payer: Nomi Health Commercial |
$35.31
|
| Rate for Payer: Nomi Health Commercial |
$13.83
|
| Rate for Payer: Nomi Health Commercial |
$20.39
|
| Rate for Payer: PACE Senior Care Partners |
$10.23
|
| Rate for Payer: PACE Senior Care Partners |
$4.01
|
| Rate for Payer: PACE Senior Care Partners |
$5.89
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE Senior Care Partners |
$8.39
|
| Rate for Payer: PACE Senior Care Partners |
$4.66
|
| Rate for Payer: PACE Senior Care Partners |
$4.20
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PACE SWMI |
$4.22
|
| Rate for Payer: PACE SWMI |
$4.90
|
| Rate for Payer: PACE SWMI |
$6.20
|
| Rate for Payer: PACE SWMI |
$4.42
|
| Rate for Payer: PACE SWMI |
$6.34
|
| Rate for Payer: PACE SWMI |
$8.84
|
| Rate for Payer: PACE SWMI |
$10.76
|
| Rate for Payer: PHP Commercial |
$16.68
|
| Rate for Payer: PHP Commercial |
$36.60
|
| Rate for Payer: PHP Commercial |
$14.34
|
| Rate for Payer: PHP Commercial |
$21.14
|
| Rate for Payer: PHP Commercial |
$21.07
|
| Rate for Payer: PHP Commercial |
$30.04
|
| Rate for Payer: PHP Commercial |
$21.56
|
| Rate for Payer: PHP Commercial |
$15.04
|
| Rate for Payer: PHP Medicare Advantage |
$8.84
|
| Rate for Payer: PHP Medicare Advantage |
$6.20
|
| Rate for Payer: PHP Medicare Advantage |
$4.42
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: PHP Medicare Advantage |
$4.90
|
| Rate for Payer: PHP Medicare Advantage |
$10.76
|
| Rate for Payer: PHP Medicare Advantage |
$6.34
|
| Rate for Payer: PHP Medicare Advantage |
$4.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.99
|
| Rate for Payer: Priority Health HMO/PPO |
$37.46
|
| Rate for Payer: Priority Health HMO/PPO |
$21.64
|
| Rate for Payer: Priority Health HMO/PPO |
$21.57
|
| Rate for Payer: Priority Health HMO/PPO |
$22.07
|
| Rate for Payer: Priority Health HMO/PPO |
$14.68
|
| Rate for Payer: Priority Health HMO/PPO |
$15.40
|
| Rate for Payer: Priority Health HMO/PPO |
$30.75
|
| Rate for Payer: Priority Health HMO/PPO |
$17.07
|
| Rate for Payer: Priority Health Medicare |
$10.87
|
| Rate for Payer: Priority Health Medicare |
$6.28
|
| Rate for Payer: Priority Health Medicare |
$6.26
|
| Rate for Payer: Priority Health Medicare |
$4.47
|
| Rate for Payer: Priority Health Medicare |
$4.26
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Medicare |
$8.92
|
| Rate for Payer: Priority Health Medicare |
$4.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.68
|
| Rate for Payer: Railroad Medicare Medicare |
$4.90
|
| Rate for Payer: Railroad Medicare Medicare |
$6.34
|
| Rate for Payer: Railroad Medicare Medicare |
$4.42
|
| Rate for Payer: Railroad Medicare Medicare |
$4.22
|
| Rate for Payer: Railroad Medicare Medicare |
$8.84
|
| Rate for Payer: Railroad Medicare Medicare |
$10.76
|
| Rate for Payer: Railroad Medicare Medicare |
$6.20
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.89
|
| Rate for Payer: UHC Core |
$20.77
|
| Rate for Payer: UHC Core |
$14.78
|
| Rate for Payer: UHC Core |
$21.18
|
| Rate for Payer: UHC Core |
$14.09
|
| Rate for Payer: UHC Core |
$16.38
|
| Rate for Payer: UHC Core |
$20.70
|
| Rate for Payer: UHC Core |
$35.96
|
| Rate for Payer: UHC Core |
$29.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Exchange |
$6.34
|
| Rate for Payer: UHC Exchange |
$4.90
|
| Rate for Payer: UHC Exchange |
$8.84
|
| Rate for Payer: UHC Exchange |
$4.42
|
| Rate for Payer: UHC Exchange |
$4.22
|
| Rate for Payer: UHC Exchange |
$6.22
|
| Rate for Payer: UHC Exchange |
$6.20
|
| Rate for Payer: UHC Exchange |
$10.76
|
| Rate for Payer: UHC Medicare Advantage |
$4.42
|
| Rate for Payer: UHC Medicare Advantage |
$6.34
|
| Rate for Payer: UHC Medicare Advantage |
$8.84
|
| Rate for Payer: UHC Medicare Advantage |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.20
|
| Rate for Payer: UHC Medicare Advantage |
$4.90
|
| Rate for Payer: UHC Medicare Advantage |
$10.76
|
| Rate for Payer: UHC Medicare Advantage |
$4.22
|
| Rate for Payer: VA VA |
$8.84
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: VA VA |
$4.42
|
| Rate for Payer: VA VA |
$6.20
|
| Rate for Payer: VA VA |
$4.22
|
| Rate for Payer: VA VA |
$10.76
|
| Rate for Payer: VA VA |
$6.34
|
| Rate for Payer: VA VA |
$4.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.65
|
|
|
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$25.37
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105900
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.49 |
| Max. Negotiated Rate |
$22.83 |
| Rate for Payer: Aetna Commercial |
$21.56
|
| Rate for Payer: Aetna Commercial |
$21.14
|
| Rate for Payer: Aetna Commercial |
$16.68
|
| Rate for Payer: Aetna Commercial |
$14.34
|
| Rate for Payer: Aetna Commercial |
$15.04
|
| Rate for Payer: Aetna Commercial |
$21.07
|
| Rate for Payer: Aetna Commercial |
$36.60
|
| Rate for Payer: Aetna Commercial |
$30.04
|
| Rate for Payer: BCBS Trust/PPO |
$28.85
|
| Rate for Payer: BCBS Trust/PPO |
$20.30
|
| Rate for Payer: BCBS Trust/PPO |
$20.71
|
| Rate for Payer: BCBS Trust/PPO |
$13.77
|
| Rate for Payer: BCBS Trust/PPO |
$35.15
|
| Rate for Payer: BCBS Trust/PPO |
$14.45
|
| Rate for Payer: BCBS Trust/PPO |
$20.24
|
| Rate for Payer: BCBS Trust/PPO |
$16.02
|
| Rate for Payer: BCN Commercial |
$15.16
|
| Rate for Payer: BCN Commercial |
$13.04
|
| Rate for Payer: BCN Commercial |
$19.16
|
| Rate for Payer: BCN Commercial |
$13.68
|
| Rate for Payer: BCN Commercial |
$19.61
|
| Rate for Payer: BCN Commercial |
$33.28
|
| Rate for Payer: BCN Commercial |
$19.22
|
| Rate for Payer: BCN Commercial |
$27.31
|
| Rate for Payer: Cash Price |
$28.27
|
| Rate for Payer: Cash Price |
$15.70
|
| Rate for Payer: Cash Price |
$19.90
|
| Rate for Payer: Cash Price |
$14.16
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$19.83
|
| Rate for Payer: Cash Price |
$34.45
|
| Rate for Payer: Cash Price |
$20.30
|
| Rate for Payer: Cofinity Commercial |
$21.32
|
| Rate for Payer: Cofinity Commercial |
$14.51
|
| Rate for Payer: Cofinity Commercial |
$16.87
|
| Rate for Payer: Cofinity Commercial |
$15.22
|
| Rate for Payer: Cofinity Commercial |
$21.39
|
| Rate for Payer: Cofinity Commercial |
$21.82
|
| Rate for Payer: Cofinity Commercial |
$30.39
|
| Rate for Payer: Cofinity Commercial |
$37.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.16
|
| Rate for Payer: Healthscope Commercial |
$15.18
|
| Rate for Payer: Healthscope Commercial |
$38.75
|
| Rate for Payer: Healthscope Commercial |
$31.81
|
| Rate for Payer: Healthscope Commercial |
$22.31
|
| Rate for Payer: Healthscope Commercial |
$15.93
|
| Rate for Payer: Healthscope Commercial |
$17.66
|
| Rate for Payer: Healthscope Commercial |
$22.83
|
| Rate for Payer: Healthscope Commercial |
$22.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.04
|
| Rate for Payer: Nomi Health Commercial |
$28.98
|
| Rate for Payer: Nomi Health Commercial |
$20.39
|
| Rate for Payer: Nomi Health Commercial |
$20.80
|
| Rate for Payer: Nomi Health Commercial |
$35.31
|
| Rate for Payer: Nomi Health Commercial |
$13.83
|
| Rate for Payer: Nomi Health Commercial |
$14.51
|
| Rate for Payer: Nomi Health Commercial |
$20.33
|
| Rate for Payer: Nomi Health Commercial |
$16.09
|
| Rate for Payer: PHP Commercial |
$36.60
|
| Rate for Payer: PHP Commercial |
$14.34
|
| Rate for Payer: PHP Commercial |
$16.68
|
| Rate for Payer: PHP Commercial |
$21.07
|
| Rate for Payer: PHP Commercial |
$30.04
|
| Rate for Payer: PHP Commercial |
$15.04
|
| Rate for Payer: PHP Commercial |
$21.14
|
| Rate for Payer: PHP Commercial |
$21.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.99
|
| Rate for Payer: Priority Health HMO/PPO |
$21.64
|
| Rate for Payer: Priority Health HMO/PPO |
$22.07
|
| Rate for Payer: Priority Health HMO/PPO |
$15.40
|
| Rate for Payer: Priority Health HMO/PPO |
$14.68
|
| Rate for Payer: Priority Health HMO/PPO |
$21.57
|
| Rate for Payer: Priority Health HMO/PPO |
$30.75
|
| Rate for Payer: Priority Health HMO/PPO |
$17.07
|
| Rate for Payer: Priority Health HMO/PPO |
$37.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.58
|
| Rate for Payer: UHC Core |
$20.70
|
| Rate for Payer: UHC Core |
$14.09
|
| Rate for Payer: UHC Core |
$21.18
|
| Rate for Payer: UHC Core |
$14.78
|
| Rate for Payer: UHC Core |
$20.77
|
| Rate for Payer: UHC Core |
$35.96
|
| Rate for Payer: UHC Core |
$29.51
|
| Rate for Payer: UHC Core |
$16.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.65
|
|
|
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$18.75
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105901
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.19 |
| Max. Negotiated Rate |
$16.88 |
| Rate for Payer: Aetna Commercial |
$15.94
|
| Rate for Payer: Aetna Commercial |
$18.50
|
| Rate for Payer: Aetna Commercial |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$17.77
|
| Rate for Payer: BCBS Trust/PPO |
$15.31
|
| Rate for Payer: BCBS Trust/PPO |
$22.03
|
| Rate for Payer: BCN Commercial |
$16.82
|
| Rate for Payer: BCN Commercial |
$14.49
|
| Rate for Payer: BCN Commercial |
$20.86
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cash Price |
$21.59
|
| Rate for Payer: Cash Price |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$23.21
|
| Rate for Payer: Cofinity Commercial |
$18.72
|
| Rate for Payer: Cofinity Commercial |
$16.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.59
|
| Rate for Payer: Healthscope Commercial |
$19.59
|
| Rate for Payer: Healthscope Commercial |
$16.88
|
| Rate for Payer: Healthscope Commercial |
$24.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.94
|
| Rate for Payer: Nomi Health Commercial |
$15.38
|
| Rate for Payer: Nomi Health Commercial |
$17.85
|
| Rate for Payer: Nomi Health Commercial |
$22.13
|
| Rate for Payer: PHP Commercial |
$18.50
|
| Rate for Payer: PHP Commercial |
$15.94
|
| Rate for Payer: PHP Commercial |
$22.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.15
|
| Rate for Payer: Priority Health HMO/PPO |
$23.48
|
| Rate for Payer: Priority Health HMO/PPO |
$18.94
|
| Rate for Payer: Priority Health HMO/PPO |
$16.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.50
|
| Rate for Payer: UHC Core |
$15.66
|
| Rate for Payer: UHC Core |
$22.54
|
| Rate for Payer: UHC Core |
$18.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.33
|
|
|
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$18.75
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105901
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.45 |
| Max. Negotiated Rate |
$16.88 |
| Rate for Payer: Aetna Commercial |
$15.94
|
| Rate for Payer: Aetna Commercial |
$22.94
|
| Rate for Payer: Aetna Commercial |
$18.50
|
| Rate for Payer: Aetna Medicare |
$7.02
|
| Rate for Payer: Aetna Medicare |
$4.88
|
| Rate for Payer: Aetna Medicare |
$5.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.43
|
| Rate for Payer: BCBS Complete |
$8.71
|
| Rate for Payer: BCBS Complete |
$7.50
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS MAPPO |
$6.75
|
| Rate for Payer: BCBS MAPPO |
$4.69
|
| Rate for Payer: BCBS MAPPO |
$5.44
|
| Rate for Payer: BCBS Trust/PPO |
$17.90
|
| Rate for Payer: BCBS Trust/PPO |
$15.41
|
| Rate for Payer: BCBS Trust/PPO |
$22.19
|
| Rate for Payer: BCN Commercial |
$16.93
|
| Rate for Payer: BCN Commercial |
$20.98
|
| Rate for Payer: BCN Commercial |
$14.58
|
| Rate for Payer: BCN Medicare Advantage |
$4.69
|
| Rate for Payer: BCN Medicare Advantage |
$5.44
|
| Rate for Payer: BCN Medicare Advantage |
$6.75
|
| Rate for Payer: Cash Price |
$17.42
|
| Rate for Payer: Cash Price |
$21.59
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cofinity Commercial |
$23.21
|
| Rate for Payer: Cofinity Commercial |
$16.12
|
| Rate for Payer: Cofinity Commercial |
$18.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.69
|
| Rate for Payer: Healthscope Commercial |
$19.59
|
| Rate for Payer: Healthscope Commercial |
$16.88
|
| Rate for Payer: Healthscope Commercial |
$24.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.94
|
| Rate for Payer: Nomi Health Commercial |
$22.13
|
| Rate for Payer: Nomi Health Commercial |
$15.38
|
| Rate for Payer: Nomi Health Commercial |
$17.85
|
| Rate for Payer: PACE Senior Care Partners |
$6.41
|
| Rate for Payer: PACE Senior Care Partners |
$4.45
|
| Rate for Payer: PACE Senior Care Partners |
$5.17
|
| Rate for Payer: PACE SWMI |
$5.44
|
| Rate for Payer: PACE SWMI |
$4.69
|
| Rate for Payer: PACE SWMI |
$6.75
|
| Rate for Payer: PHP Commercial |
$22.94
|
| Rate for Payer: PHP Commercial |
$18.50
|
| Rate for Payer: PHP Commercial |
$15.94
|
| Rate for Payer: PHP Medicare Advantage |
$5.44
|
| Rate for Payer: PHP Medicare Advantage |
$6.75
|
| Rate for Payer: PHP Medicare Advantage |
$4.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.15
|
| Rate for Payer: Priority Health HMO/PPO |
$23.48
|
| Rate for Payer: Priority Health HMO/PPO |
$16.31
|
| Rate for Payer: Priority Health HMO/PPO |
$18.94
|
| Rate for Payer: Priority Health Medicare |
$4.73
|
| Rate for Payer: Priority Health Medicare |
$6.81
|
| Rate for Payer: Priority Health Medicare |
$5.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.56
|
| Rate for Payer: Railroad Medicare Medicare |
$5.44
|
| Rate for Payer: Railroad Medicare Medicare |
$6.75
|
| Rate for Payer: Railroad Medicare Medicare |
$4.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.50
|
| Rate for Payer: UHC Core |
$22.54
|
| Rate for Payer: UHC Core |
$18.18
|
| Rate for Payer: UHC Core |
$15.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.44
|
| Rate for Payer: UHC Exchange |
$5.44
|
| Rate for Payer: UHC Exchange |
$4.69
|
| Rate for Payer: UHC Exchange |
$6.75
|
| Rate for Payer: UHC Medicare Advantage |
$4.69
|
| Rate for Payer: UHC Medicare Advantage |
$5.44
|
| Rate for Payer: UHC Medicare Advantage |
$6.75
|
| Rate for Payer: VA VA |
$5.44
|
| Rate for Payer: VA VA |
$6.75
|
| Rate for Payer: VA VA |
$4.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.33
|
|
|
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$22.31
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105902
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$20.08 |
| Rate for Payer: Aetna Commercial |
$18.96
|
| Rate for Payer: Aetna Commercial |
$73.28
|
| Rate for Payer: Aetna Commercial |
$42.22
|
| Rate for Payer: Aetna Medicare |
$22.41
|
| Rate for Payer: Aetna Medicare |
$5.80
|
| Rate for Payer: Aetna Medicare |
$12.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.94
|
| Rate for Payer: BCBS Complete |
$19.87
|
| Rate for Payer: BCBS Complete |
$8.92
|
| Rate for Payer: BCBS Complete |
$34.48
|
| Rate for Payer: BCBS MAPPO |
$21.55
|
| Rate for Payer: BCBS MAPPO |
$5.58
|
| Rate for Payer: BCBS MAPPO |
$12.42
|
| Rate for Payer: BCBS Trust/PPO |
$40.83
|
| Rate for Payer: BCBS Trust/PPO |
$18.34
|
| Rate for Payer: BCBS Trust/PPO |
$70.87
|
| Rate for Payer: BCN Commercial |
$38.62
|
| Rate for Payer: BCN Commercial |
$67.03
|
| Rate for Payer: BCN Commercial |
$17.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.58
|
| Rate for Payer: BCN Medicare Advantage |
$12.42
|
| Rate for Payer: BCN Medicare Advantage |
$21.55
|
| Rate for Payer: Cash Price |
$39.74
|
| Rate for Payer: Cash Price |
$68.97
|
| Rate for Payer: Cash Price |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$19.19
|
| Rate for Payer: Cofinity Commercial |
$42.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.58
|
| Rate for Payer: Healthscope Commercial |
$44.70
|
| Rate for Payer: Healthscope Commercial |
$20.08
|
| Rate for Payer: Healthscope Commercial |
$77.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.96
|
| Rate for Payer: Nomi Health Commercial |
$70.69
|
| Rate for Payer: Nomi Health Commercial |
$18.29
|
| Rate for Payer: Nomi Health Commercial |
$40.73
|
| Rate for Payer: PACE Senior Care Partners |
$20.47
|
| Rate for Payer: PACE Senior Care Partners |
$5.30
|
| Rate for Payer: PACE Senior Care Partners |
$11.80
|
| Rate for Payer: PACE SWMI |
$12.42
|
| Rate for Payer: PACE SWMI |
$5.58
|
| Rate for Payer: PACE SWMI |
$21.55
|
| Rate for Payer: PHP Commercial |
$73.28
|
| Rate for Payer: PHP Commercial |
$42.22
|
| Rate for Payer: PHP Commercial |
$18.96
|
| Rate for Payer: PHP Medicare Advantage |
$12.42
|
| Rate for Payer: PHP Medicare Advantage |
$21.55
|
| Rate for Payer: PHP Medicare Advantage |
$5.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.29
|
| Rate for Payer: Priority Health HMO/PPO |
$75.00
|
| Rate for Payer: Priority Health HMO/PPO |
$19.41
|
| Rate for Payer: Priority Health HMO/PPO |
$43.21
|
| Rate for Payer: Priority Health Medicare |
$5.63
|
| Rate for Payer: Priority Health Medicare |
$21.77
|
| Rate for Payer: Priority Health Medicare |
$12.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.95
|
| Rate for Payer: Railroad Medicare Medicare |
$12.42
|
| Rate for Payer: Railroad Medicare Medicare |
$21.55
|
| Rate for Payer: Railroad Medicare Medicare |
$5.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.63
|
| Rate for Payer: UHC Core |
$71.99
|
| Rate for Payer: UHC Core |
$41.47
|
| Rate for Payer: UHC Core |
$18.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.42
|
| Rate for Payer: UHC Exchange |
$12.42
|
| Rate for Payer: UHC Exchange |
$5.58
|
| Rate for Payer: UHC Exchange |
$21.55
|
| Rate for Payer: UHC Medicare Advantage |
$5.58
|
| Rate for Payer: UHC Medicare Advantage |
$12.42
|
| Rate for Payer: UHC Medicare Advantage |
$21.55
|
| Rate for Payer: VA VA |
$12.42
|
| Rate for Payer: VA VA |
$21.55
|
| Rate for Payer: VA VA |
$5.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.25
|
|
|
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$22.31
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105902
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.50 |
| Max. Negotiated Rate |
$20.08 |
| Rate for Payer: Aetna Commercial |
$18.96
|
| Rate for Payer: Aetna Commercial |
$42.22
|
| Rate for Payer: Aetna Commercial |
$73.28
|
| Rate for Payer: BCBS Trust/PPO |
$40.55
|
| Rate for Payer: BCBS Trust/PPO |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$70.37
|
| Rate for Payer: BCN Commercial |
$38.38
|
| Rate for Payer: BCN Commercial |
$17.24
|
| Rate for Payer: BCN Commercial |
$66.62
|
| Rate for Payer: Cash Price |
$17.85
|
| Rate for Payer: Cash Price |
$68.97
|
| Rate for Payer: Cash Price |
$39.74
|
| Rate for Payer: Cofinity Commercial |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$42.72
|
| Rate for Payer: Cofinity Commercial |
$19.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.97
|
| Rate for Payer: Healthscope Commercial |
$44.70
|
| Rate for Payer: Healthscope Commercial |
$20.08
|
| Rate for Payer: Healthscope Commercial |
$77.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.28
|
| Rate for Payer: Nomi Health Commercial |
$18.29
|
| Rate for Payer: Nomi Health Commercial |
$40.73
|
| Rate for Payer: Nomi Health Commercial |
$70.69
|
| Rate for Payer: PHP Commercial |
$42.22
|
| Rate for Payer: PHP Commercial |
$18.96
|
| Rate for Payer: PHP Commercial |
$73.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.29
|
| Rate for Payer: Priority Health HMO/PPO |
$75.00
|
| Rate for Payer: Priority Health HMO/PPO |
$43.21
|
| Rate for Payer: Priority Health HMO/PPO |
$19.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.63
|
| Rate for Payer: UHC Core |
$18.63
|
| Rate for Payer: UHC Core |
$71.99
|
| Rate for Payer: UHC Core |
$41.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.25
|
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
OP
|
$252.96
|
|
|
Service Code
|
NDC 65862065401
|
| Hospital Charge Code |
26547
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$60.08 |
| Max. Negotiated Rate |
$227.66 |
| Rate for Payer: Aetna Commercial |
$215.02
|
| Rate for Payer: Aetna Medicare |
$65.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.05
|
| Rate for Payer: BCBS Complete |
$101.18
|
| Rate for Payer: BCBS MAPPO |
$63.24
|
| Rate for Payer: BCBS Trust/PPO |
$207.96
|
| Rate for Payer: BCN Commercial |
$196.68
|
| Rate for Payer: BCN Medicare Advantage |
$63.24
|
| Rate for Payer: Cash Price |
$202.37
|
| Rate for Payer: Cofinity Commercial |
$217.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.24
|
| Rate for Payer: Healthscope Commercial |
$227.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.02
|
| Rate for Payer: Nomi Health Commercial |
$207.43
|
| Rate for Payer: PACE Senior Care Partners |
$60.08
|
| Rate for Payer: PACE SWMI |
$63.24
|
| Rate for Payer: PHP Commercial |
$215.02
|
| Rate for Payer: PHP Medicare Advantage |
$63.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.42
|
| Rate for Payer: Priority Health HMO/PPO |
$220.08
|
| Rate for Payer: Priority Health Medicare |
$63.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.48
|
| Rate for Payer: Railroad Medicare Medicare |
$63.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.60
|
| Rate for Payer: UHC Core |
$211.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.24
|
| Rate for Payer: UHC Exchange |
$63.24
|
| Rate for Payer: UHC Medicare Advantage |
$63.24
|
| Rate for Payer: VA VA |
$63.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.72
|
|
