|
ANASTROZOLE 1 MG TABLET
|
Facility
|
OP
|
$3.96
|
|
|
Service Code
|
NDC 60687011211
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.70 |
| Max. Negotiated Rate |
$3.56 |
| Rate for Payer: Aetna Commercial |
$3.37
|
| Rate for Payer: Aetna Medicare |
$1.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.24
|
| Rate for Payer: BCBS Complete |
$0.73
|
| Rate for Payer: BCBS MAPPO |
$0.99
|
| Rate for Payer: BCBS Trust/PPO |
$3.26
|
| Rate for Payer: BCN Commercial |
$3.26
|
| Rate for Payer: BCN Medicare Advantage |
$0.99
|
| Rate for Payer: Cash Price |
$3.17
|
| Rate for Payer: Cofinity Commercial |
$3.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.99
|
| Rate for Payer: Healthscope Commercial |
$3.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.97
|
| Rate for Payer: Mclaren Medicaid |
$0.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.04
|
| Rate for Payer: Meridian Medicaid |
$0.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.37
|
| Rate for Payer: Nomi Health Commercial |
$3.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.97
|
| Rate for Payer: PACE Senior Care Partners |
$0.94
|
| Rate for Payer: PACE SWMI |
$0.99
|
| Rate for Payer: PHP Commercial |
$3.37
|
| Rate for Payer: PHP Medicare Advantage |
$0.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.45
|
| Rate for Payer: Priority Health Medicare |
$1.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.76
|
| Rate for Payer: Railroad Medicare Medicare |
$0.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.48
|
| Rate for Payer: UHC Core |
$3.31
|
| Rate for Payer: UHC Exchange |
$0.99
|
| Rate for Payer: UHC Medicaid |
$0.70
|
| Rate for Payer: UHC Medicare Advantage |
$0.99
|
| Rate for Payer: UHCCP Medicaid |
$0.70
|
| Rate for Payer: VA VA |
$0.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.97
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
IP
|
$118.66
|
|
|
Service Code
|
NDC 60687011221
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.59 |
| Max. Negotiated Rate |
$106.79 |
| Rate for Payer: Aetna Commercial |
$100.86
|
| Rate for Payer: BCBS Trust/PPO |
$98.00
|
| Rate for Payer: BCN Commercial |
$98.00
|
| Rate for Payer: Cash Price |
$94.93
|
| Rate for Payer: Cofinity Commercial |
$102.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.93
|
| Rate for Payer: Healthscope Commercial |
$106.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.86
|
| Rate for Payer: Nomi Health Commercial |
$97.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.00
|
| Rate for Payer: PHP Commercial |
$100.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$103.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.42
|
| Rate for Payer: UHC Core |
$99.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.00
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
OP
|
$118.66
|
|
|
Service Code
|
NDC 60687011221
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.92 |
| Max. Negotiated Rate |
$106.79 |
| Rate for Payer: Aetna Commercial |
$100.86
|
| Rate for Payer: Aetna Medicare |
$30.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.08
|
| Rate for Payer: BCBS Complete |
$21.96
|
| Rate for Payer: BCBS MAPPO |
$29.66
|
| Rate for Payer: BCBS Trust/PPO |
$97.55
|
| Rate for Payer: BCN Commercial |
$97.55
|
| Rate for Payer: BCN Medicare Advantage |
$29.66
|
| Rate for Payer: Cash Price |
$94.93
|
| Rate for Payer: Cofinity Commercial |
$102.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.66
|
| Rate for Payer: Healthscope Commercial |
$106.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.00
|
| Rate for Payer: Mclaren Medicaid |
$20.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.15
|
| Rate for Payer: Meridian Medicaid |
$21.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.86
|
| Rate for Payer: Nomi Health Commercial |
$97.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.00
|
| Rate for Payer: PACE Senior Care Partners |
$28.18
|
| Rate for Payer: PACE SWMI |
$29.66
|
| Rate for Payer: PHP Commercial |
$100.86
|
| Rate for Payer: PHP Medicare Advantage |
$29.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$103.23
|
| Rate for Payer: Priority Health Medicare |
$29.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.59
|
| Rate for Payer: Railroad Medicare Medicare |
$29.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.42
|
| Rate for Payer: UHC Core |
$99.08
|
| Rate for Payer: UHC Exchange |
$29.66
|
| Rate for Payer: UHC Medicaid |
$20.92
|
| Rate for Payer: UHC Medicare Advantage |
$29.66
|
| Rate for Payer: UHCCP Medicaid |
$20.92
|
| Rate for Payer: VA VA |
$29.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.00
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
OP
|
$40.89
|
|
|
Service Code
|
NDC 16729003510
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.21 |
| Max. Negotiated Rate |
$36.80 |
| Rate for Payer: Aetna Commercial |
$34.76
|
| Rate for Payer: Aetna Medicare |
$10.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.78
|
| Rate for Payer: BCBS Complete |
$7.57
|
| Rate for Payer: BCBS MAPPO |
$10.22
|
| Rate for Payer: BCBS Trust/PPO |
$33.62
|
| Rate for Payer: BCN Commercial |
$33.62
|
| Rate for Payer: BCN Medicare Advantage |
$10.22
|
| Rate for Payer: Cash Price |
$32.71
|
| Rate for Payer: Cofinity Commercial |
$35.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.22
|
| Rate for Payer: Healthscope Commercial |
$36.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.67
|
| Rate for Payer: Mclaren Medicaid |
$7.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.73
|
| Rate for Payer: Meridian Medicaid |
$7.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.76
|
| Rate for Payer: Nomi Health Commercial |
$33.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.67
|
| Rate for Payer: PACE Senior Care Partners |
$9.71
|
| Rate for Payer: PACE SWMI |
$10.22
|
| Rate for Payer: PHP Commercial |
$34.76
|
| Rate for Payer: PHP Medicare Advantage |
$10.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.57
|
| Rate for Payer: Priority Health Medicare |
$10.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.46
|
| Rate for Payer: Railroad Medicare Medicare |
$10.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.98
|
| Rate for Payer: UHC Core |
$34.14
|
| Rate for Payer: UHC Exchange |
$10.22
|
| Rate for Payer: UHC Medicaid |
$7.21
|
| Rate for Payer: UHC Medicare Advantage |
$10.22
|
| Rate for Payer: UHCCP Medicaid |
$7.21
|
| Rate for Payer: VA VA |
$10.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.67
|
|
|
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS
|
Facility
|
IP
|
$3,223.40
|
|
|
Service Code
|
APR-DRG 1982
|
| Min. Negotiated Rate |
$3,069.90 |
| Max. Negotiated Rate |
$3,223.40 |
| Rate for Payer: BCBS Complete |
$3,223.40
|
| Rate for Payer: Mclaren Medicaid |
$3,069.90
|
| Rate for Payer: Meridian Medicaid |
$3,223.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,069.90
|
| Rate for Payer: UHC Medicaid |
$3,069.90
|
| Rate for Payer: UHCCP Medicaid |
$3,069.90
|
|
|
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS
|
Facility
|
IP
|
$8,929.29
|
|
|
Service Code
|
APR-DRG 1984
|
| Min. Negotiated Rate |
$8,504.08 |
| Max. Negotiated Rate |
$8,929.29 |
| Rate for Payer: BCBS Complete |
$8,929.29
|
| Rate for Payer: Mclaren Medicaid |
$8,504.08
|
| Rate for Payer: Meridian Medicaid |
$8,929.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,504.08
|
| Rate for Payer: UHC Medicaid |
$8,504.08
|
| Rate for Payer: UHCCP Medicaid |
$8,504.08
|
|
|
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS
|
Facility
|
IP
|
$2,731.74
|
|
|
Service Code
|
APR-DRG 1981
|
| Min. Negotiated Rate |
$2,601.66 |
| Max. Negotiated Rate |
$2,731.74 |
| Rate for Payer: BCBS Complete |
$2,731.74
|
| Rate for Payer: Mclaren Medicaid |
$2,601.66
|
| Rate for Payer: Meridian Medicaid |
$2,731.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,601.66
|
| Rate for Payer: UHC Medicaid |
$2,601.66
|
| Rate for Payer: UHCCP Medicaid |
$2,601.66
|
|
|
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS
|
Facility
|
IP
|
$4,265.09
|
|
|
Service Code
|
APR-DRG 1983
|
| Min. Negotiated Rate |
$4,061.99 |
| Max. Negotiated Rate |
$4,265.09 |
| Rate for Payer: BCBS Complete |
$4,265.09
|
| Rate for Payer: Mclaren Medicaid |
$4,061.99
|
| Rate for Payer: Meridian Medicaid |
$4,265.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,061.99
|
| Rate for Payer: UHC Medicaid |
$4,061.99
|
| Rate for Payer: UHCCP Medicaid |
$4,061.99
|
|
|
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$140.31
|
|
|
Service Code
|
HCPCS J0348
|
| Hospital Charge Code |
88093
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.74 |
| Max. Negotiated Rate |
$126.28 |
| Rate for Payer: Aetna Commercial |
$119.26
|
| Rate for Payer: Aetna Medicare |
$36.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.85
|
| Rate for Payer: BCBS Complete |
$25.97
|
| Rate for Payer: BCBS MAPPO |
$35.08
|
| Rate for Payer: BCBS Trust/PPO |
$115.35
|
| Rate for Payer: BCN Commercial |
$115.35
|
| Rate for Payer: BCN Medicare Advantage |
$35.08
|
| Rate for Payer: Cash Price |
$112.25
|
| Rate for Payer: Cofinity Commercial |
$120.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.08
|
| Rate for Payer: Healthscope Commercial |
$126.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.23
|
| Rate for Payer: Mclaren Medicaid |
$24.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.83
|
| Rate for Payer: Meridian Medicaid |
$25.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.26
|
| Rate for Payer: Nomi Health Commercial |
$115.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.23
|
| Rate for Payer: PACE Senior Care Partners |
$33.32
|
| Rate for Payer: PACE SWMI |
$35.08
|
| Rate for Payer: PHP Commercial |
$119.26
|
| Rate for Payer: PHP Medicare Advantage |
$35.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$122.07
|
| Rate for Payer: Priority Health Medicare |
$35.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.66
|
| Rate for Payer: Railroad Medicare Medicare |
$35.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.47
|
| Rate for Payer: UHC Core |
$117.16
|
| Rate for Payer: UHC Exchange |
$35.08
|
| Rate for Payer: UHC Medicaid |
$24.74
|
| Rate for Payer: UHC Medicare Advantage |
$35.08
|
| Rate for Payer: UHCCP Medicaid |
$24.74
|
| Rate for Payer: VA VA |
$35.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.23
|
|
|
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$140.31
|
|
|
Service Code
|
HCPCS J0348
|
| Hospital Charge Code |
88093
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$97.66 |
| Max. Negotiated Rate |
$126.28 |
| Rate for Payer: Aetna Commercial |
$119.26
|
| Rate for Payer: BCBS Trust/PPO |
$115.88
|
| Rate for Payer: BCN Commercial |
$115.88
|
| Rate for Payer: Cash Price |
$112.25
|
| Rate for Payer: Cofinity Commercial |
$120.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.25
|
| Rate for Payer: Healthscope Commercial |
$126.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.26
|
| Rate for Payer: Nomi Health Commercial |
$115.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.23
|
| Rate for Payer: PHP Commercial |
$119.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$122.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.47
|
| Rate for Payer: UHC Core |
$117.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.23
|
|
|
ANOXIC AND OTHER SEVERE BRAIN DAMAGE
|
Facility
|
IP
|
$6,446.80
|
|
|
Service Code
|
APR-DRG 0592
|
| Min. Negotiated Rate |
$6,139.81 |
| Max. Negotiated Rate |
$6,446.80 |
| Rate for Payer: BCBS Complete |
$6,446.80
|
| Rate for Payer: Mclaren Medicaid |
$6,139.81
|
| Rate for Payer: Meridian Medicaid |
$6,446.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,139.81
|
| Rate for Payer: UHC Medicaid |
$6,139.81
|
| Rate for Payer: UHCCP Medicaid |
$6,139.81
|
|
|
ANOXIC AND OTHER SEVERE BRAIN DAMAGE
|
Facility
|
IP
|
$4,026.88
|
|
|
Service Code
|
APR-DRG 0591
|
| Min. Negotiated Rate |
$3,835.13 |
| Max. Negotiated Rate |
$4,026.88 |
| Rate for Payer: BCBS Complete |
$4,026.88
|
| Rate for Payer: Mclaren Medicaid |
$3,835.13
|
| Rate for Payer: Meridian Medicaid |
$4,026.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,835.13
|
| Rate for Payer: UHC Medicaid |
$3,835.13
|
| Rate for Payer: UHCCP Medicaid |
$3,835.13
|
|
|
ANOXIC AND OTHER SEVERE BRAIN DAMAGE
|
Facility
|
IP
|
$8,336.67
|
|
|
Service Code
|
APR-DRG 0593
|
| Min. Negotiated Rate |
$7,939.68 |
| Max. Negotiated Rate |
$8,336.67 |
| Rate for Payer: BCBS Complete |
$8,336.67
|
| Rate for Payer: Mclaren Medicaid |
$7,939.68
|
| Rate for Payer: Meridian Medicaid |
$8,336.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,939.68
|
| Rate for Payer: UHC Medicaid |
$7,939.68
|
| Rate for Payer: UHCCP Medicaid |
$7,939.68
|
|
|
ANOXIC AND OTHER SEVERE BRAIN DAMAGE
|
Facility
|
IP
|
$13,767.54
|
|
|
Service Code
|
APR-DRG 0594
|
| Min. Negotiated Rate |
$13,111.95 |
| Max. Negotiated Rate |
$13,767.54 |
| Rate for Payer: BCBS Complete |
$13,767.54
|
| Rate for Payer: Mclaren Medicaid |
$13,111.95
|
| Rate for Payer: Meridian Medicaid |
$13,767.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,111.95
|
| Rate for Payer: UHC Medicaid |
$13,111.95
|
| Rate for Payer: UHCCP Medicaid |
$13,111.95
|
|
|
ANTEPARTUM WITH O.R. PROCEDURE
|
Facility
|
IP
|
$2,644.98
|
|
|
Service Code
|
APR-DRG 5471
|
| Min. Negotiated Rate |
$2,519.02 |
| Max. Negotiated Rate |
$2,644.98 |
| Rate for Payer: BCBS Complete |
$2,644.98
|
| Rate for Payer: Mclaren Medicaid |
$2,519.02
|
| Rate for Payer: Meridian Medicaid |
$2,644.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,519.02
|
| Rate for Payer: UHC Medicaid |
$2,519.02
|
| Rate for Payer: UHCCP Medicaid |
$2,519.02
|
|
|
ANTEPARTUM WITH O.R. PROCEDURE
|
Facility
|
IP
|
$5,012.31
|
|
|
Service Code
|
APR-DRG 5472
|
| Min. Negotiated Rate |
$4,773.63 |
| Max. Negotiated Rate |
$5,012.31 |
| Rate for Payer: BCBS Complete |
$5,012.31
|
| Rate for Payer: Mclaren Medicaid |
$4,773.63
|
| Rate for Payer: Meridian Medicaid |
$5,012.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,773.63
|
| Rate for Payer: UHC Medicaid |
$4,773.63
|
| Rate for Payer: UHCCP Medicaid |
$4,773.63
|
|
|
ANTEPARTUM WITH O.R. PROCEDURE
|
Facility
|
IP
|
$14,486.37
|
|
|
Service Code
|
APR-DRG 5474
|
| Min. Negotiated Rate |
$13,796.54 |
| Max. Negotiated Rate |
$14,486.37 |
| Rate for Payer: BCBS Complete |
$14,486.37
|
| Rate for Payer: Mclaren Medicaid |
$13,796.54
|
| Rate for Payer: Meridian Medicaid |
$14,486.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,796.54
|
| Rate for Payer: UHC Medicaid |
$13,796.54
|
| Rate for Payer: UHCCP Medicaid |
$13,796.54
|
|
|
ANTEPARTUM WITH O.R. PROCEDURE
|
Facility
|
IP
|
$7,592.60
|
|
|
Service Code
|
APR-DRG 5473
|
| Min. Negotiated Rate |
$7,231.05 |
| Max. Negotiated Rate |
$7,592.60 |
| Rate for Payer: BCBS Complete |
$7,592.60
|
| Rate for Payer: Mclaren Medicaid |
$7,231.05
|
| Rate for Payer: Meridian Medicaid |
$7,592.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,231.05
|
| Rate for Payer: UHC Medicaid |
$7,231.05
|
| Rate for Payer: UHCCP Medicaid |
$7,231.05
|
|
|
ANTEPARTUM WITHOUT O.R. PROCEDURE
|
Facility
|
IP
|
$2,655.49
|
|
|
Service Code
|
APR-DRG 5662
|
| Min. Negotiated Rate |
$2,529.04 |
| Max. Negotiated Rate |
$2,655.49 |
| Rate for Payer: BCBS Complete |
$2,655.49
|
| Rate for Payer: Mclaren Medicaid |
$2,529.04
|
| Rate for Payer: Meridian Medicaid |
$2,655.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,529.04
|
| Rate for Payer: UHC Medicaid |
$2,529.04
|
| Rate for Payer: UHCCP Medicaid |
$2,529.04
|
|
|
ANTEPARTUM WITHOUT O.R. PROCEDURE
|
Facility
|
IP
|
$1,849.91
|
|
|
Service Code
|
APR-DRG 5661
|
| Min. Negotiated Rate |
$1,761.81 |
| Max. Negotiated Rate |
$1,849.91 |
| Rate for Payer: BCBS Complete |
$1,849.91
|
| Rate for Payer: Mclaren Medicaid |
$1,761.81
|
| Rate for Payer: Meridian Medicaid |
$1,849.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,761.81
|
| Rate for Payer: UHC Medicaid |
$1,761.81
|
| Rate for Payer: UHCCP Medicaid |
$1,761.81
|
|
|
ANTEPARTUM WITHOUT O.R. PROCEDURE
|
Facility
|
IP
|
$4,665.25
|
|
|
Service Code
|
APR-DRG 5663
|
| Min. Negotiated Rate |
$4,443.10 |
| Max. Negotiated Rate |
$4,665.25 |
| Rate for Payer: BCBS Complete |
$4,665.25
|
| Rate for Payer: Mclaren Medicaid |
$4,443.10
|
| Rate for Payer: Meridian Medicaid |
$4,665.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,443.10
|
| Rate for Payer: UHC Medicaid |
$4,443.10
|
| Rate for Payer: UHCCP Medicaid |
$4,443.10
|
|
|
ANTEPARTUM WITHOUT O.R. PROCEDURE
|
Facility
|
IP
|
$8,927.19
|
|
|
Service Code
|
APR-DRG 5664
|
| Min. Negotiated Rate |
$8,502.08 |
| Max. Negotiated Rate |
$8,927.19 |
| Rate for Payer: BCBS Complete |
$8,927.19
|
| Rate for Payer: Mclaren Medicaid |
$8,502.08
|
| Rate for Payer: Meridian Medicaid |
$8,927.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,502.08
|
| Rate for Payer: UHC Medicaid |
$8,502.08
|
| Rate for Payer: UHCCP Medicaid |
$8,502.08
|
|
|
ANTIHEMOPHILIC FACTOR-VWF 1,200 UNIT INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$2.72
|
|
|
Service Code
|
HCPCS J7187
|
| Hospital Charge Code |
70405
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$2.45 |
| Rate for Payer: Aetna Commercial |
$2.31
|
| Rate for Payer: Aetna Medicare |
$0.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.85
|
| Rate for Payer: BCBS Complete |
$0.50
|
| Rate for Payer: BCBS MAPPO |
$0.68
|
| Rate for Payer: BCBS Trust/PPO |
$2.24
|
| Rate for Payer: BCN Commercial |
$2.24
|
| Rate for Payer: BCN Medicare Advantage |
$0.68
|
| Rate for Payer: Cash Price |
$2.18
|
| Rate for Payer: Cofinity Commercial |
$2.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.68
|
| Rate for Payer: Healthscope Commercial |
$2.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.04
|
| Rate for Payer: Mclaren Medicaid |
$0.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.71
|
| Rate for Payer: Meridian Medicaid |
$0.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.31
|
| Rate for Payer: Nomi Health Commercial |
$2.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.04
|
| Rate for Payer: PACE Senior Care Partners |
$0.65
|
| Rate for Payer: PACE SWMI |
$0.68
|
| Rate for Payer: PHP Commercial |
$2.31
|
| Rate for Payer: PHP Medicare Advantage |
$0.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.37
|
| Rate for Payer: Priority Health Medicare |
$0.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.89
|
| Rate for Payer: Railroad Medicare Medicare |
$0.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.39
|
| Rate for Payer: UHC Core |
$2.27
|
| Rate for Payer: UHC Exchange |
$0.68
|
| Rate for Payer: UHC Medicaid |
$0.48
|
| Rate for Payer: UHC Medicare Advantage |
$0.68
|
| Rate for Payer: UHCCP Medicaid |
$0.48
|
| Rate for Payer: VA VA |
$0.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.04
|
|
|
ANTIHEMOPHILIC FACTOR-VWF 1,200 UNIT INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$2.72
|
|
|
Service Code
|
HCPCS J7187
|
| Hospital Charge Code |
70405
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.89 |
| Max. Negotiated Rate |
$2.45 |
| Rate for Payer: Aetna Commercial |
$2.31
|
| Rate for Payer: BCBS Trust/PPO |
$2.25
|
| Rate for Payer: BCN Commercial |
$2.25
|
| Rate for Payer: Cash Price |
$2.18
|
| Rate for Payer: Cofinity Commercial |
$2.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.18
|
| Rate for Payer: Healthscope Commercial |
$2.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.31
|
| Rate for Payer: Nomi Health Commercial |
$2.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.04
|
| Rate for Payer: PHP Commercial |
$2.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.39
|
| Rate for Payer: UHC Core |
$2.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.04
|
|
|
ANTIHEMOPHILIC FACTOR-VWF 2,400 UNIT INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$2.72
|
|
|
Service Code
|
HCPCS J7187
|
| Hospital Charge Code |
70406
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.89 |
| Max. Negotiated Rate |
$2.45 |
| Rate for Payer: Aetna Commercial |
$2.31
|
| Rate for Payer: BCBS Trust/PPO |
$2.25
|
| Rate for Payer: BCN Commercial |
$2.25
|
| Rate for Payer: Cash Price |
$2.18
|
| Rate for Payer: Cofinity Commercial |
$2.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.18
|
| Rate for Payer: Healthscope Commercial |
$2.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.31
|
| Rate for Payer: Nomi Health Commercial |
$2.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.04
|
| Rate for Payer: PHP Commercial |
$2.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.39
|
| Rate for Payer: UHC Core |
$2.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.04
|
|
