|
FRAXEL PARTIAL TREATMENT - BILATERAL EYES
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 00157
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$122.40 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
|
|
FRAXEL PARTIAL TREATMENT - PERI-ORAL
|
Professional
|
Both
|
$510.00
|
|
|
Service Code
|
HCPCS 00156
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$204.00 |
| Max. Negotiated Rate |
$331.50 |
| Rate for Payer: Aetna Medicare |
$255.00
|
| Rate for Payer: BCBS Complete |
$204.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.50
|
|
|
FRAXEL PARTIAL TREATMENT - UPPER LIP
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 00158
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Medicare |
$127.50
|
| Rate for Payer: BCBS Complete |
$102.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
|
|
FRAXEL RESTORE
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 00168
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Medicare |
$127.50
|
| Rate for Payer: BCBS Complete |
$102.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
|
|
FRAXEL SMALL SCAR
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 00159
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$51.20 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
|
|
FRAXEL STRETCH MARKS - ENTIRE ABDOMEN
|
Professional
|
Both
|
$816.00
|
|
|
Service Code
|
HCPCS 00165
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$326.40 |
| Max. Negotiated Rate |
$530.40 |
| Rate for Payer: Aetna Medicare |
$408.00
|
| Rate for Payer: BCBS Complete |
$326.40
|
| Rate for Payer: Cash Price |
$652.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.40
|
|
|
FRAXEL STRETCH MARKS - PERI-UMBILICAL
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 00164
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$244.80 |
| Max. Negotiated Rate |
$397.80 |
| Rate for Payer: Aetna Medicare |
$306.00
|
| Rate for Payer: BCBS Complete |
$244.80
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
|
|
FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS, AND/OR FEET; 20 SQ CM OR LESS
|
Facility
|
OP
|
$1,360.67
|
|
|
Service Code
|
CPT 15240
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,295.79 |
| Max. Negotiated Rate |
$1,360.67 |
| Rate for Payer: BCBS Complete |
$1,360.67
|
| Rate for Payer: Mclaren Medicaid |
$1,295.79
|
| Rate for Payer: Meridian Medicaid |
$1,360.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,295.79
|
| Rate for Payer: UHCCP Medicaid |
$1,295.79
|
|
|
FUROSEMIDE 10 MG/ML INJECTION (CODE)
|
Facility
|
OP
|
$13.11
|
|
|
Service Code
|
HCPCS J1940
|
| Hospital Charge Code |
163713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.11 |
| Max. Negotiated Rate |
$11.80 |
| Rate for Payer: Aetna Commercial |
$11.14
|
| Rate for Payer: Aetna Commercial |
$6.76
|
| Rate for Payer: Aetna Commercial |
$21.65
|
| Rate for Payer: Aetna Commercial |
$10.37
|
| Rate for Payer: Aetna Commercial |
$9.26
|
| Rate for Payer: Aetna Commercial |
$18.96
|
| Rate for Payer: Aetna Medicare |
$6.62
|
| Rate for Payer: Aetna Medicare |
$3.41
|
| Rate for Payer: Aetna Medicare |
$3.17
|
| Rate for Payer: Aetna Medicare |
$2.83
|
| Rate for Payer: Aetna Medicare |
$5.80
|
| Rate for Payer: Aetna Medicare |
$2.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.41
|
| Rate for Payer: BCBS Complete |
$5.24
|
| Rate for Payer: BCBS Complete |
$10.19
|
| Rate for Payer: BCBS Complete |
$4.88
|
| Rate for Payer: BCBS Complete |
$4.36
|
| Rate for Payer: BCBS Complete |
$8.92
|
| Rate for Payer: BCBS Complete |
$3.18
|
| Rate for Payer: BCBS MAPPO |
$5.58
|
| Rate for Payer: BCBS MAPPO |
$2.72
|
| Rate for Payer: BCBS MAPPO |
$3.05
|
| Rate for Payer: BCBS MAPPO |
$1.99
|
| Rate for Payer: BCBS MAPPO |
$6.37
|
| Rate for Payer: BCBS MAPPO |
$3.28
|
| Rate for Payer: BCBS Trust/PPO |
$18.34
|
| Rate for Payer: BCBS Trust/PPO |
$10.03
|
| Rate for Payer: BCBS Trust/PPO |
$8.96
|
| Rate for Payer: BCBS Trust/PPO |
$20.94
|
| Rate for Payer: BCBS Trust/PPO |
$6.54
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$17.35
|
| Rate for Payer: BCN Commercial |
$9.49
|
| Rate for Payer: BCN Commercial |
$8.47
|
| Rate for Payer: BCN Commercial |
$6.18
|
| Rate for Payer: BCN Commercial |
$19.80
|
| Rate for Payer: BCN Commercial |
$10.19
|
| Rate for Payer: BCN Medicare Advantage |
$3.28
|
| Rate for Payer: BCN Medicare Advantage |
$5.58
|
| Rate for Payer: BCN Medicare Advantage |
$3.05
|
| Rate for Payer: BCN Medicare Advantage |
$2.72
|
| Rate for Payer: BCN Medicare Advantage |
$1.99
|
| Rate for Payer: BCN Medicare Advantage |
$6.37
|
| Rate for Payer: Cash Price |
$20.38
|
| Rate for Payer: Cash Price |
$6.36
|
| Rate for Payer: Cash Price |
$17.85
|
| Rate for Payer: Cash Price |
$8.72
|
| Rate for Payer: Cash Price |
$9.76
|
| Rate for Payer: Cash Price |
$10.49
|
| Rate for Payer: Cofinity Commercial |
$6.84
|
| Rate for Payer: Cofinity Commercial |
$11.27
|
| Rate for Payer: Cofinity Commercial |
$10.49
|
| Rate for Payer: Cofinity Commercial |
$9.37
|
| Rate for Payer: Cofinity Commercial |
$21.90
|
| Rate for Payer: Cofinity Commercial |
$19.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.37
|
| Rate for Payer: Healthscope Commercial |
$9.81
|
| Rate for Payer: Healthscope Commercial |
$10.98
|
| Rate for Payer: Healthscope Commercial |
$11.80
|
| Rate for Payer: Healthscope Commercial |
$20.08
|
| Rate for Payer: Healthscope Commercial |
$22.92
|
| Rate for Payer: Healthscope Commercial |
$7.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.18
|
| 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 |
$3.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.96
|
| Rate for Payer: Nomi Health Commercial |
$8.94
|
| Rate for Payer: Nomi Health Commercial |
$20.89
|
| Rate for Payer: Nomi Health Commercial |
$10.00
|
| Rate for Payer: Nomi Health Commercial |
$10.75
|
| Rate for Payer: Nomi Health Commercial |
$6.52
|
| Rate for Payer: Nomi Health Commercial |
$18.29
|
| Rate for Payer: PACE Senior Care Partners |
$1.89
|
| Rate for Payer: PACE Senior Care Partners |
$5.30
|
| Rate for Payer: PACE Senior Care Partners |
$2.90
|
| Rate for Payer: PACE Senior Care Partners |
$2.59
|
| Rate for Payer: PACE Senior Care Partners |
$3.11
|
| Rate for Payer: PACE Senior Care Partners |
$6.05
|
| Rate for Payer: PACE SWMI |
$5.58
|
| Rate for Payer: PACE SWMI |
$3.28
|
| Rate for Payer: PACE SWMI |
$1.99
|
| Rate for Payer: PACE SWMI |
$3.05
|
| Rate for Payer: PACE SWMI |
$6.37
|
| Rate for Payer: PACE SWMI |
$2.72
|
| Rate for Payer: PHP Commercial |
$6.76
|
| Rate for Payer: PHP Commercial |
$11.14
|
| Rate for Payer: PHP Commercial |
$21.65
|
| Rate for Payer: PHP Commercial |
$9.26
|
| Rate for Payer: PHP Commercial |
$10.37
|
| Rate for Payer: PHP Commercial |
$18.96
|
| Rate for Payer: PHP Medicare Advantage |
$2.72
|
| Rate for Payer: PHP Medicare Advantage |
$5.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.37
|
| Rate for Payer: PHP Medicare Advantage |
$1.99
|
| Rate for Payer: PHP Medicare Advantage |
$3.28
|
| Rate for Payer: PHP Medicare Advantage |
$3.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.17
|
| Rate for Payer: Priority Health HMO/PPO |
$11.41
|
| Rate for Payer: Priority Health HMO/PPO |
$10.61
|
| Rate for Payer: Priority Health HMO/PPO |
$6.92
|
| Rate for Payer: Priority Health HMO/PPO |
$19.41
|
| Rate for Payer: Priority Health HMO/PPO |
$9.48
|
| Rate for Payer: Priority Health HMO/PPO |
$22.16
|
| Rate for Payer: Priority Health Medicare |
$2.01
|
| Rate for Payer: Priority Health Medicare |
$6.43
|
| Rate for Payer: Priority Health Medicare |
$2.75
|
| Rate for Payer: Priority Health Medicare |
$3.08
|
| Rate for Payer: Priority Health Medicare |
$3.31
|
| Rate for Payer: Priority Health Medicare |
$5.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.17
|
| Rate for Payer: Railroad Medicare Medicare |
$6.37
|
| Rate for Payer: Railroad Medicare Medicare |
$3.28
|
| Rate for Payer: Railroad Medicare Medicare |
$1.99
|
| Rate for Payer: Railroad Medicare Medicare |
$5.58
|
| Rate for Payer: Railroad Medicare Medicare |
$3.05
|
| Rate for Payer: Railroad Medicare Medicare |
$2.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.74
|
| Rate for Payer: UHC Core |
$21.27
|
| Rate for Payer: UHC Core |
$18.63
|
| Rate for Payer: UHC Core |
$10.19
|
| Rate for Payer: UHC Core |
$9.10
|
| Rate for Payer: UHC Core |
$10.95
|
| Rate for Payer: UHC Core |
$6.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.72
|
| Rate for Payer: UHC Exchange |
$6.37
|
| Rate for Payer: UHC Exchange |
$3.05
|
| Rate for Payer: UHC Exchange |
$3.28
|
| Rate for Payer: UHC Exchange |
$2.72
|
| Rate for Payer: UHC Exchange |
$1.99
|
| Rate for Payer: UHC Exchange |
$5.58
|
| Rate for Payer: UHC Medicare Advantage |
$3.28
|
| Rate for Payer: UHC Medicare Advantage |
$1.99
|
| Rate for Payer: UHC Medicare Advantage |
$3.05
|
| Rate for Payer: UHC Medicare Advantage |
$6.37
|
| Rate for Payer: UHC Medicare Advantage |
$2.72
|
| Rate for Payer: UHC Medicare Advantage |
$5.58
|
| Rate for Payer: VA VA |
$5.58
|
| Rate for Payer: VA VA |
$2.72
|
| Rate for Payer: VA VA |
$3.28
|
| Rate for Payer: VA VA |
$3.05
|
| Rate for Payer: VA VA |
$1.99
|
| Rate for Payer: VA VA |
$6.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.10
|
|
|
FUROSEMIDE 10 MG/ML INJECTION (CODE)
|
Facility
|
IP
|
$7.95
|
|
|
Service Code
|
HCPCS J1940
|
| Hospital Charge Code |
163713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$7.16 |
| Rate for Payer: Aetna Commercial |
$6.76
|
| Rate for Payer: Aetna Commercial |
$9.26
|
| Rate for Payer: Aetna Commercial |
$11.14
|
| Rate for Payer: Aetna Commercial |
$10.37
|
| Rate for Payer: Aetna Commercial |
$18.96
|
| Rate for Payer: Aetna Commercial |
$21.65
|
| Rate for Payer: BCBS Trust/PPO |
$6.49
|
| Rate for Payer: BCBS Trust/PPO |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCBS Trust/PPO |
$9.96
|
| Rate for Payer: BCBS Trust/PPO |
$8.90
|
| Rate for Payer: BCBS Trust/PPO |
$10.70
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Commercial |
$17.24
|
| Rate for Payer: BCN Commercial |
$8.42
|
| Rate for Payer: BCN Commercial |
$10.13
|
| Rate for Payer: BCN Commercial |
$6.14
|
| Rate for Payer: BCN Commercial |
$9.43
|
| Rate for Payer: Cash Price |
$6.36
|
| Rate for Payer: Cash Price |
$9.76
|
| Rate for Payer: Cash Price |
$10.49
|
| Rate for Payer: Cash Price |
$17.85
|
| Rate for Payer: Cash Price |
$8.72
|
| Rate for Payer: Cash Price |
$20.38
|
| Rate for Payer: Cofinity Commercial |
$21.90
|
| Rate for Payer: Cofinity Commercial |
$10.49
|
| Rate for Payer: Cofinity Commercial |
$11.27
|
| Rate for Payer: Cofinity Commercial |
$19.19
|
| Rate for Payer: Cofinity Commercial |
$9.37
|
| Rate for Payer: Cofinity Commercial |
$6.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.36
|
| Rate for Payer: Healthscope Commercial |
$9.81
|
| Rate for Payer: Healthscope Commercial |
$10.98
|
| Rate for Payer: Healthscope Commercial |
$22.92
|
| Rate for Payer: Healthscope Commercial |
$7.16
|
| Rate for Payer: Healthscope Commercial |
$20.08
|
| Rate for Payer: Healthscope Commercial |
$11.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.14
|
| Rate for Payer: Nomi Health Commercial |
$20.89
|
| Rate for Payer: Nomi Health Commercial |
$8.94
|
| Rate for Payer: Nomi Health Commercial |
$10.00
|
| Rate for Payer: Nomi Health Commercial |
$18.29
|
| Rate for Payer: Nomi Health Commercial |
$10.75
|
| Rate for Payer: Nomi Health Commercial |
$6.52
|
| Rate for Payer: PHP Commercial |
$21.65
|
| Rate for Payer: PHP Commercial |
$6.76
|
| Rate for Payer: PHP Commercial |
$10.37
|
| Rate for Payer: PHP Commercial |
$9.26
|
| Rate for Payer: PHP Commercial |
$11.14
|
| Rate for Payer: PHP Commercial |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.52
|
| Rate for Payer: Priority Health HMO/PPO |
$9.48
|
| Rate for Payer: Priority Health HMO/PPO |
$10.61
|
| Rate for Payer: Priority Health HMO/PPO |
$19.41
|
| Rate for Payer: Priority Health HMO/PPO |
$22.16
|
| Rate for Payer: Priority Health HMO/PPO |
$11.41
|
| Rate for Payer: Priority Health HMO/PPO |
$6.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.00
|
| Rate for Payer: UHC Core |
$6.64
|
| Rate for Payer: UHC Core |
$10.19
|
| Rate for Payer: UHC Core |
$10.95
|
| Rate for Payer: UHC Core |
$21.27
|
| Rate for Payer: UHC Core |
$18.63
|
| Rate for Payer: UHC Core |
$9.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.18
|
|
|
FUROSEMIDE 10 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$8.15
|
|
|
Service Code
|
HCPCS J1940
|
| Hospital Charge Code |
3291
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$7.34 |
| Rate for Payer: Aetna Commercial |
$6.93
|
| Rate for Payer: Aetna Commercial |
$12.88
|
| Rate for Payer: Aetna Commercial |
$18.96
|
| Rate for Payer: Aetna Commercial |
$21.65
|
| Rate for Payer: Aetna Commercial |
$12.62
|
| Rate for Payer: Aetna Commercial |
$11.69
|
| Rate for Payer: Aetna Commercial |
$10.37
|
| Rate for Payer: Aetna Commercial |
$13.86
|
| Rate for Payer: Aetna Commercial |
$9.26
|
| Rate for Payer: Aetna Commercial |
$6.76
|
| Rate for Payer: Aetna Commercial |
$23.96
|
| Rate for Payer: Aetna Commercial |
$8.73
|
| Rate for Payer: Aetna Commercial |
$9.64
|
| Rate for Payer: Aetna Commercial |
$11.14
|
| Rate for Payer: BCBS Trust/PPO |
$8.38
|
| Rate for Payer: BCBS Trust/PPO |
$6.49
|
| Rate for Payer: BCBS Trust/PPO |
$13.31
|
| Rate for Payer: BCBS Trust/PPO |
$23.01
|
| Rate for Payer: BCBS Trust/PPO |
$9.26
|
| Rate for Payer: BCBS Trust/PPO |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$11.22
|
| Rate for Payer: BCBS Trust/PPO |
$12.37
|
| Rate for Payer: BCBS Trust/PPO |
$10.70
|
| Rate for Payer: BCBS Trust/PPO |
$9.96
|
| Rate for Payer: BCBS Trust/PPO |
$12.12
|
| Rate for Payer: BCBS Trust/PPO |
$6.65
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCBS Trust/PPO |
$8.90
|
| Rate for Payer: BCN Commercial |
$9.43
|
| Rate for Payer: BCN Commercial |
$10.63
|
| Rate for Payer: BCN Commercial |
$21.79
|
| Rate for Payer: BCN Commercial |
$8.76
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Commercial |
$6.14
|
| Rate for Payer: BCN Commercial |
$12.60
|
| Rate for Payer: BCN Commercial |
$7.94
|
| Rate for Payer: BCN Commercial |
$11.48
|
| Rate for Payer: BCN Commercial |
$17.24
|
| Rate for Payer: BCN Commercial |
$8.42
|
| Rate for Payer: BCN Commercial |
$10.13
|
| Rate for Payer: BCN Commercial |
$11.71
|
| Rate for Payer: BCN Commercial |
$6.30
|
| Rate for Payer: Cash Price |
$6.52
|
| Rate for Payer: Cash Price |
$10.49
|
| Rate for Payer: Cash Price |
$13.04
|
| Rate for Payer: Cash Price |
$8.72
|
| Rate for Payer: Cash Price |
$9.07
|
| Rate for Payer: Cash Price |
$9.76
|
| Rate for Payer: Cash Price |
$8.22
|
| Rate for Payer: Cash Price |
$11.88
|
| Rate for Payer: Cash Price |
$12.12
|
| Rate for Payer: Cash Price |
$6.36
|
| Rate for Payer: Cash Price |
$11.00
|
| Rate for Payer: Cash Price |
$22.55
|
| Rate for Payer: Cash Price |
$20.38
|
| Rate for Payer: Cash Price |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$13.03
|
| Rate for Payer: Cofinity Commercial |
$6.84
|
| Rate for Payer: Cofinity Commercial |
$11.82
|
| Rate for Payer: Cofinity Commercial |
$7.01
|
| Rate for Payer: Cofinity Commercial |
$12.77
|
| Rate for Payer: Cofinity Commercial |
$9.37
|
| Rate for Payer: Cofinity Commercial |
$19.19
|
| Rate for Payer: Cofinity Commercial |
$11.27
|
| Rate for Payer: Cofinity Commercial |
$9.75
|
| Rate for Payer: Cofinity Commercial |
$10.49
|
| Rate for Payer: Cofinity Commercial |
$8.83
|
| Rate for Payer: Cofinity Commercial |
$14.02
|
| Rate for Payer: Cofinity Commercial |
$24.24
|
| Rate for Payer: Cofinity Commercial |
$21.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.00
|
| Rate for Payer: Healthscope Commercial |
$11.80
|
| Rate for Payer: Healthscope Commercial |
$14.67
|
| Rate for Payer: Healthscope Commercial |
$20.08
|
| Rate for Payer: Healthscope Commercial |
$22.92
|
| Rate for Payer: Healthscope Commercial |
$25.37
|
| Rate for Payer: Healthscope Commercial |
$7.16
|
| Rate for Payer: Healthscope Commercial |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$12.38
|
| Rate for Payer: Healthscope Commercial |
$7.34
|
| Rate for Payer: Healthscope Commercial |
$9.24
|
| Rate for Payer: Healthscope Commercial |
$10.21
|
| Rate for Payer: Healthscope Commercial |
$9.81
|
| Rate for Payer: Healthscope Commercial |
$13.64
|
| Rate for Payer: Healthscope Commercial |
$10.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.65
|
| Rate for Payer: Nomi Health Commercial |
$18.29
|
| Rate for Payer: Nomi Health Commercial |
$20.89
|
| Rate for Payer: Nomi Health Commercial |
$12.42
|
| Rate for Payer: Nomi Health Commercial |
$13.37
|
| Rate for Payer: Nomi Health Commercial |
$6.68
|
| Rate for Payer: Nomi Health Commercial |
$10.00
|
| Rate for Payer: Nomi Health Commercial |
$6.52
|
| Rate for Payer: Nomi Health Commercial |
$10.75
|
| Rate for Payer: Nomi Health Commercial |
$12.18
|
| Rate for Payer: Nomi Health Commercial |
$11.28
|
| Rate for Payer: Nomi Health Commercial |
$9.30
|
| Rate for Payer: Nomi Health Commercial |
$23.12
|
| Rate for Payer: Nomi Health Commercial |
$8.42
|
| Rate for Payer: Nomi Health Commercial |
$8.94
|
| Rate for Payer: PHP Commercial |
$12.62
|
| Rate for Payer: PHP Commercial |
$11.69
|
| Rate for Payer: PHP Commercial |
$6.93
|
| Rate for Payer: PHP Commercial |
$12.88
|
| Rate for Payer: PHP Commercial |
$11.14
|
| Rate for Payer: PHP Commercial |
$13.86
|
| Rate for Payer: PHP Commercial |
$18.96
|
| Rate for Payer: PHP Commercial |
$21.65
|
| Rate for Payer: PHP Commercial |
$23.96
|
| Rate for Payer: PHP Commercial |
$10.37
|
| Rate for Payer: PHP Commercial |
$9.64
|
| Rate for Payer: PHP Commercial |
$8.73
|
| Rate for Payer: PHP Commercial |
$9.26
|
| Rate for Payer: PHP Commercial |
$6.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.94
|
| Rate for Payer: Priority Health HMO/PPO |
$8.93
|
| Rate for Payer: Priority Health HMO/PPO |
$13.18
|
| Rate for Payer: Priority Health HMO/PPO |
$6.92
|
| Rate for Payer: Priority Health HMO/PPO |
$19.41
|
| Rate for Payer: Priority Health HMO/PPO |
$11.41
|
| Rate for Payer: Priority Health HMO/PPO |
$22.16
|
| Rate for Payer: Priority Health HMO/PPO |
$7.09
|
| Rate for Payer: Priority Health HMO/PPO |
$9.48
|
| Rate for Payer: Priority Health HMO/PPO |
$10.61
|
| Rate for Payer: Priority Health HMO/PPO |
$9.87
|
| Rate for Payer: Priority Health HMO/PPO |
$14.18
|
| Rate for Payer: Priority Health HMO/PPO |
$24.53
|
| Rate for Payer: Priority Health HMO/PPO |
$11.96
|
| Rate for Payer: Priority Health HMO/PPO |
$12.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.81
|
| Rate for Payer: UHC Core |
$10.19
|
| Rate for Payer: UHC Core |
$8.58
|
| Rate for Payer: UHC Core |
$9.47
|
| Rate for Payer: UHC Core |
$18.63
|
| Rate for Payer: UHC Core |
$9.10
|
| Rate for Payer: UHC Core |
$11.48
|
| Rate for Payer: UHC Core |
$21.27
|
| Rate for Payer: UHC Core |
$12.65
|
| Rate for Payer: UHC Core |
$23.54
|
| Rate for Payer: UHC Core |
$6.81
|
| Rate for Payer: UHC Core |
$6.64
|
| Rate for Payer: UHC Core |
$10.95
|
| Rate for Payer: UHC Core |
$12.40
|
| Rate for Payer: UHC Core |
$13.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.50
|
|
|
FUROSEMIDE 10 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$10.90
|
|
|
Service Code
|
HCPCS J1940
|
| Hospital Charge Code |
3291
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$9.81 |
| Rate for Payer: Aetna Commercial |
$9.26
|
| Rate for Payer: Aetna Commercial |
$12.88
|
| Rate for Payer: Aetna Commercial |
$11.69
|
| Rate for Payer: Aetna Commercial |
$18.96
|
| Rate for Payer: Aetna Commercial |
$9.64
|
| Rate for Payer: Aetna Commercial |
$6.76
|
| Rate for Payer: Aetna Commercial |
$12.62
|
| Rate for Payer: Aetna Commercial |
$10.37
|
| Rate for Payer: Aetna Commercial |
$11.14
|
| Rate for Payer: Aetna Commercial |
$23.96
|
| Rate for Payer: Aetna Commercial |
$6.93
|
| Rate for Payer: Aetna Commercial |
$21.65
|
| Rate for Payer: Aetna Commercial |
$8.73
|
| Rate for Payer: Aetna Commercial |
$13.86
|
| Rate for Payer: Aetna Medicare |
$4.24
|
| Rate for Payer: Aetna Medicare |
$2.12
|
| Rate for Payer: Aetna Medicare |
$5.80
|
| Rate for Payer: Aetna Medicare |
$2.83
|
| Rate for Payer: Aetna Medicare |
$3.58
|
| Rate for Payer: Aetna Medicare |
$3.41
|
| Rate for Payer: Aetna Medicare |
$3.17
|
| Rate for Payer: Aetna Medicare |
$2.95
|
| Rate for Payer: Aetna Medicare |
$3.86
|
| Rate for Payer: Aetna Medicare |
$7.33
|
| Rate for Payer: Aetna Medicare |
$6.62
|
| Rate for Payer: Aetna Medicare |
$2.07
|
| Rate for Payer: Aetna Medicare |
$3.94
|
| Rate for Payer: Aetna Medicare |
$2.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.81
|
| Rate for Payer: BCBS Complete |
$6.06
|
| Rate for Payer: BCBS Complete |
$10.19
|
| Rate for Payer: BCBS Complete |
$4.36
|
| Rate for Payer: BCBS Complete |
$3.26
|
| Rate for Payer: BCBS Complete |
$5.24
|
| Rate for Payer: BCBS Complete |
$6.52
|
| Rate for Payer: BCBS Complete |
$5.50
|
| Rate for Payer: BCBS Complete |
$4.88
|
| Rate for Payer: BCBS Complete |
$4.11
|
| Rate for Payer: BCBS Complete |
$3.18
|
| Rate for Payer: BCBS Complete |
$11.28
|
| Rate for Payer: BCBS Complete |
$4.54
|
| Rate for Payer: BCBS Complete |
$8.92
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS MAPPO |
$7.05
|
| Rate for Payer: BCBS MAPPO |
$2.04
|
| Rate for Payer: BCBS MAPPO |
$4.08
|
| Rate for Payer: BCBS MAPPO |
$5.58
|
| Rate for Payer: BCBS MAPPO |
$2.84
|
| Rate for Payer: BCBS MAPPO |
$3.44
|
| Rate for Payer: BCBS MAPPO |
$3.79
|
| Rate for Payer: BCBS MAPPO |
$6.37
|
| Rate for Payer: BCBS MAPPO |
$3.71
|
| Rate for Payer: BCBS MAPPO |
$3.28
|
| Rate for Payer: BCBS MAPPO |
$1.99
|
| Rate for Payer: BCBS MAPPO |
$3.05
|
| Rate for Payer: BCBS MAPPO |
$2.72
|
| Rate for Payer: BCBS MAPPO |
$2.57
|
| Rate for Payer: BCBS Trust/PPO |
$20.94
|
| Rate for Payer: BCBS Trust/PPO |
$18.34
|
| Rate for Payer: BCBS Trust/PPO |
$8.96
|
| Rate for Payer: BCBS Trust/PPO |
$8.44
|
| Rate for Payer: BCBS Trust/PPO |
$12.45
|
| Rate for Payer: BCBS Trust/PPO |
$12.21
|
| Rate for Payer: BCBS Trust/PPO |
$6.70
|
| Rate for Payer: BCBS Trust/PPO |
$6.54
|
| Rate for Payer: BCBS Trust/PPO |
$9.32
|
| Rate for Payer: BCBS Trust/PPO |
$13.40
|
| Rate for Payer: BCBS Trust/PPO |
$23.17
|
| Rate for Payer: BCBS Trust/PPO |
$10.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.30
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$21.92
|
| Rate for Payer: BCN Commercial |
$12.67
|
| Rate for Payer: BCN Commercial |
$8.82
|
| Rate for Payer: BCN Commercial |
$6.18
|
| Rate for Payer: BCN Commercial |
$9.49
|
| Rate for Payer: BCN Commercial |
$10.69
|
| Rate for Payer: BCN Commercial |
$11.78
|
| Rate for Payer: BCN Commercial |
$6.34
|
| Rate for Payer: BCN Commercial |
$11.55
|
| Rate for Payer: BCN Commercial |
$19.80
|
| Rate for Payer: BCN Commercial |
$7.98
|
| Rate for Payer: BCN Commercial |
$8.47
|
| Rate for Payer: BCN Commercial |
$17.35
|
| Rate for Payer: BCN Commercial |
$10.19
|
| Rate for Payer: BCN Medicare Advantage |
$3.28
|
| Rate for Payer: BCN Medicare Advantage |
$3.71
|
| Rate for Payer: BCN Medicare Advantage |
$3.05
|
| Rate for Payer: BCN Medicare Advantage |
$3.79
|
| Rate for Payer: BCN Medicare Advantage |
$6.37
|
| Rate for Payer: BCN Medicare Advantage |
$3.44
|
| Rate for Payer: BCN Medicare Advantage |
$2.72
|
| Rate for Payer: BCN Medicare Advantage |
$5.58
|
| Rate for Payer: BCN Medicare Advantage |
$2.84
|
| Rate for Payer: BCN Medicare Advantage |
$7.05
|
| Rate for Payer: BCN Medicare Advantage |
$2.57
|
| Rate for Payer: BCN Medicare Advantage |
$2.04
|
| Rate for Payer: BCN Medicare Advantage |
$1.99
|
| Rate for Payer: BCN Medicare Advantage |
$4.08
|
| Rate for Payer: Cash Price |
$17.85
|
| Rate for Payer: Cash Price |
$9.76
|
| Rate for Payer: Cash Price |
$6.36
|
| Rate for Payer: Cash Price |
$6.52
|
| Rate for Payer: Cash Price |
$11.88
|
| Rate for Payer: Cash Price |
$20.38
|
| Rate for Payer: Cash Price |
$10.49
|
| Rate for Payer: Cash Price |
$12.12
|
| Rate for Payer: Cash Price |
$8.22
|
| Rate for Payer: Cash Price |
$8.72
|
| Rate for Payer: Cash Price |
$11.00
|
| Rate for Payer: Cash Price |
$13.04
|
| Rate for Payer: Cash Price |
$9.07
|
| Rate for Payer: Cash Price |
$22.55
|
| Rate for Payer: Cofinity Commercial |
$6.84
|
| Rate for Payer: Cofinity Commercial |
$19.19
|
| Rate for Payer: Cofinity Commercial |
$11.82
|
| Rate for Payer: Cofinity Commercial |
$14.02
|
| Rate for Payer: Cofinity Commercial |
$24.24
|
| Rate for Payer: Cofinity Commercial |
$7.01
|
| Rate for Payer: Cofinity Commercial |
$21.90
|
| Rate for Payer: Cofinity Commercial |
$11.27
|
| Rate for Payer: Cofinity Commercial |
$13.03
|
| Rate for Payer: Cofinity Commercial |
$9.75
|
| Rate for Payer: Cofinity Commercial |
$12.77
|
| Rate for Payer: Cofinity Commercial |
$9.37
|
| Rate for Payer: Cofinity Commercial |
$8.83
|
| Rate for Payer: Cofinity Commercial |
$10.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.99
|
| Rate for Payer: Healthscope Commercial |
$10.98
|
| Rate for Payer: Healthscope Commercial |
$14.67
|
| Rate for Payer: Healthscope Commercial |
$20.08
|
| Rate for Payer: Healthscope Commercial |
$9.24
|
| Rate for Payer: Healthscope Commercial |
$7.16
|
| Rate for Payer: Healthscope Commercial |
$10.21
|
| Rate for Payer: Healthscope Commercial |
$25.37
|
| Rate for Payer: Healthscope Commercial |
$22.92
|
| Rate for Payer: Healthscope Commercial |
$7.34
|
| Rate for Payer: Healthscope Commercial |
$13.64
|
| Rate for Payer: Healthscope Commercial |
$9.81
|
| Rate for Payer: Healthscope Commercial |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$11.80
|
| Rate for Payer: Healthscope Commercial |
$12.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.44
|
| 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 |
$2.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.93
|
| Rate for Payer: Nomi Health Commercial |
$11.28
|
| Rate for Payer: Nomi Health Commercial |
$12.18
|
| Rate for Payer: Nomi Health Commercial |
$18.29
|
| Rate for Payer: Nomi Health Commercial |
$6.68
|
| Rate for Payer: Nomi Health Commercial |
$20.89
|
| Rate for Payer: Nomi Health Commercial |
$10.00
|
| Rate for Payer: Nomi Health Commercial |
$13.37
|
| Rate for Payer: Nomi Health Commercial |
$10.75
|
| Rate for Payer: Nomi Health Commercial |
$6.52
|
| Rate for Payer: Nomi Health Commercial |
$9.30
|
| Rate for Payer: Nomi Health Commercial |
$8.42
|
| Rate for Payer: Nomi Health Commercial |
$12.42
|
| Rate for Payer: Nomi Health Commercial |
$23.12
|
| Rate for Payer: Nomi Health Commercial |
$8.94
|
| Rate for Payer: PACE Senior Care Partners |
$2.69
|
| Rate for Payer: PACE Senior Care Partners |
$3.27
|
| Rate for Payer: PACE Senior Care Partners |
$1.94
|
| Rate for Payer: PACE Senior Care Partners |
$3.53
|
| Rate for Payer: PACE Senior Care Partners |
$1.89
|
| Rate for Payer: PACE Senior Care Partners |
$3.60
|
| Rate for Payer: PACE Senior Care Partners |
$6.05
|
| Rate for Payer: PACE Senior Care Partners |
$2.90
|
| Rate for Payer: PACE Senior Care Partners |
$5.30
|
| Rate for Payer: PACE Senior Care Partners |
$3.11
|
| Rate for Payer: PACE Senior Care Partners |
$6.70
|
| Rate for Payer: PACE Senior Care Partners |
$2.44
|
| Rate for Payer: PACE Senior Care Partners |
$2.59
|
| Rate for Payer: PACE Senior Care Partners |
$3.87
|
| Rate for Payer: PACE SWMI |
$3.71
|
| Rate for Payer: PACE SWMI |
$2.57
|
| Rate for Payer: PACE SWMI |
$2.72
|
| Rate for Payer: PACE SWMI |
$7.05
|
| Rate for Payer: PACE SWMI |
$2.84
|
| Rate for Payer: PACE SWMI |
$2.04
|
| Rate for Payer: PACE SWMI |
$4.08
|
| Rate for Payer: PACE SWMI |
$3.44
|
| Rate for Payer: PACE SWMI |
$3.05
|
| Rate for Payer: PACE SWMI |
$5.58
|
| Rate for Payer: PACE SWMI |
$3.79
|
| Rate for Payer: PACE SWMI |
$6.37
|
| Rate for Payer: PACE SWMI |
$1.99
|
| Rate for Payer: PACE SWMI |
$3.28
|
| Rate for Payer: PHP Commercial |
$11.14
|
| Rate for Payer: PHP Commercial |
$12.88
|
| Rate for Payer: PHP Commercial |
$6.93
|
| Rate for Payer: PHP Commercial |
$11.69
|
| Rate for Payer: PHP Commercial |
$13.86
|
| Rate for Payer: PHP Commercial |
$9.26
|
| Rate for Payer: PHP Commercial |
$8.73
|
| Rate for Payer: PHP Commercial |
$23.96
|
| Rate for Payer: PHP Commercial |
$18.96
|
| Rate for Payer: PHP Commercial |
$12.62
|
| Rate for Payer: PHP Commercial |
$10.37
|
| Rate for Payer: PHP Commercial |
$21.65
|
| Rate for Payer: PHP Commercial |
$6.76
|
| Rate for Payer: PHP Commercial |
$9.64
|
| Rate for Payer: PHP Medicare Advantage |
$2.04
|
| Rate for Payer: PHP Medicare Advantage |
$1.99
|
| Rate for Payer: PHP Medicare Advantage |
$3.71
|
| Rate for Payer: PHP Medicare Advantage |
$3.79
|
| Rate for Payer: PHP Medicare Advantage |
$4.08
|
| Rate for Payer: PHP Medicare Advantage |
$5.58
|
| Rate for Payer: PHP Medicare Advantage |
$3.28
|
| Rate for Payer: PHP Medicare Advantage |
$2.84
|
| Rate for Payer: PHP Medicare Advantage |
$6.37
|
| Rate for Payer: PHP Medicare Advantage |
$7.05
|
| Rate for Payer: PHP Medicare Advantage |
$2.72
|
| Rate for Payer: PHP Medicare Advantage |
$3.05
|
| Rate for Payer: PHP Medicare Advantage |
$2.57
|
| Rate for Payer: PHP Medicare Advantage |
$3.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.08
|
| Rate for Payer: Priority Health HMO/PPO |
$13.18
|
| Rate for Payer: Priority Health HMO/PPO |
$12.92
|
| Rate for Payer: Priority Health HMO/PPO |
$7.09
|
| Rate for Payer: Priority Health HMO/PPO |
$11.41
|
| Rate for Payer: Priority Health HMO/PPO |
$19.41
|
| Rate for Payer: Priority Health HMO/PPO |
$8.93
|
| Rate for Payer: Priority Health HMO/PPO |
$9.48
|
| Rate for Payer: Priority Health HMO/PPO |
$10.61
|
| Rate for Payer: Priority Health HMO/PPO |
$24.53
|
| Rate for Payer: Priority Health HMO/PPO |
$22.16
|
| Rate for Payer: Priority Health HMO/PPO |
$6.92
|
| Rate for Payer: Priority Health HMO/PPO |
$9.87
|
| Rate for Payer: Priority Health HMO/PPO |
$11.96
|
| Rate for Payer: Priority Health HMO/PPO |
$14.18
|
| Rate for Payer: Priority Health Medicare |
$2.86
|
| Rate for Payer: Priority Health Medicare |
$5.63
|
| Rate for Payer: Priority Health Medicare |
$2.01
|
| Rate for Payer: Priority Health Medicare |
$3.08
|
| Rate for Payer: Priority Health Medicare |
$3.83
|
| Rate for Payer: Priority Health Medicare |
$3.31
|
| Rate for Payer: Priority Health Medicare |
$2.75
|
| Rate for Payer: Priority Health Medicare |
$4.12
|
| Rate for Payer: Priority Health Medicare |
$2.06
|
| Rate for Payer: Priority Health Medicare |
$7.12
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Medicare |
$6.43
|
| Rate for Payer: Priority Health Medicare |
$2.59
|
| Rate for Payer: Priority Health Medicare |
$3.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.06
|
| Rate for Payer: Railroad Medicare Medicare |
$2.57
|
| Rate for Payer: Railroad Medicare Medicare |
$1.99
|
| Rate for Payer: Railroad Medicare Medicare |
$3.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3.44
|
| Rate for Payer: Railroad Medicare Medicare |
$2.04
|
| Rate for Payer: Railroad Medicare Medicare |
$3.79
|
| Rate for Payer: Railroad Medicare Medicare |
$7.05
|
| Rate for Payer: Railroad Medicare Medicare |
$6.37
|
| Rate for Payer: Railroad Medicare Medicare |
$4.08
|
| Rate for Payer: Railroad Medicare Medicare |
$3.28
|
| Rate for Payer: Railroad Medicare Medicare |
$3.71
|
| Rate for Payer: Railroad Medicare Medicare |
$2.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.98
|
| Rate for Payer: UHC Core |
$12.40
|
| Rate for Payer: UHC Core |
$6.81
|
| Rate for Payer: UHC Core |
$12.65
|
| Rate for Payer: UHC Core |
$11.48
|
| Rate for Payer: UHC Core |
$13.61
|
| Rate for Payer: UHC Core |
$10.95
|
| Rate for Payer: UHC Core |
$18.63
|
| Rate for Payer: UHC Core |
$10.19
|
| Rate for Payer: UHC Core |
$21.27
|
| Rate for Payer: UHC Core |
$9.47
|
| Rate for Payer: UHC Core |
$23.54
|
| Rate for Payer: UHC Core |
$8.58
|
| Rate for Payer: UHC Core |
$9.10
|
| Rate for Payer: UHC Core |
$6.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.05
|
| Rate for Payer: UHC Exchange |
$2.84
|
| Rate for Payer: UHC Exchange |
$2.72
|
| Rate for Payer: UHC Exchange |
$2.57
|
| Rate for Payer: UHC Exchange |
$3.71
|
| Rate for Payer: UHC Exchange |
$7.05
|
| Rate for Payer: UHC Exchange |
$6.37
|
| Rate for Payer: UHC Exchange |
$3.05
|
| Rate for Payer: UHC Exchange |
$1.99
|
| Rate for Payer: UHC Exchange |
$5.58
|
| Rate for Payer: UHC Exchange |
$2.04
|
| Rate for Payer: UHC Exchange |
$3.28
|
| Rate for Payer: UHC Exchange |
$4.08
|
| Rate for Payer: UHC Exchange |
$3.44
|
| Rate for Payer: UHC Exchange |
$3.79
|
| Rate for Payer: UHC Medicare Advantage |
$1.99
|
| Rate for Payer: UHC Medicare Advantage |
$3.79
|
| Rate for Payer: UHC Medicare Advantage |
$3.71
|
| Rate for Payer: UHC Medicare Advantage |
$3.28
|
| Rate for Payer: UHC Medicare Advantage |
$6.37
|
| Rate for Payer: UHC Medicare Advantage |
$7.05
|
| Rate for Payer: UHC Medicare Advantage |
$4.08
|
| Rate for Payer: UHC Medicare Advantage |
$2.04
|
| Rate for Payer: UHC Medicare Advantage |
$3.05
|
| Rate for Payer: UHC Medicare Advantage |
$3.44
|
| Rate for Payer: UHC Medicare Advantage |
$2.84
|
| Rate for Payer: UHC Medicare Advantage |
$5.58
|
| Rate for Payer: UHC Medicare Advantage |
$2.72
|
| Rate for Payer: UHC Medicare Advantage |
$2.57
|
| Rate for Payer: VA VA |
$6.37
|
| Rate for Payer: VA VA |
$1.99
|
| Rate for Payer: VA VA |
$3.05
|
| Rate for Payer: VA VA |
$5.58
|
| Rate for Payer: VA VA |
$3.71
|
| Rate for Payer: VA VA |
$2.57
|
| Rate for Payer: VA VA |
$3.28
|
| Rate for Payer: VA VA |
$4.08
|
| Rate for Payer: VA VA |
$2.72
|
| Rate for Payer: VA VA |
$7.05
|
| Rate for Payer: VA VA |
$3.44
|
| Rate for Payer: VA VA |
$2.84
|
| Rate for Payer: VA VA |
$3.79
|
| Rate for Payer: VA VA |
$2.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.15
|
|
|
FUROSEMIDE 10 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$2.21
|
|
|
Service Code
|
NDC 09900000335
|
| Hospital Charge Code |
3292
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.44 |
| Max. Negotiated Rate |
$1.99 |
| Rate for Payer: Aetna Commercial |
$1.88
|
| Rate for Payer: BCBS Trust/PPO |
$1.80
|
| Rate for Payer: BCN Commercial |
$1.71
|
| Rate for Payer: Cash Price |
$1.77
|
| Rate for Payer: Cofinity Commercial |
$1.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.77
|
| Rate for Payer: Healthscope Commercial |
$1.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.88
|
| Rate for Payer: Nomi Health Commercial |
$1.81
|
| Rate for Payer: PHP Commercial |
$1.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.44
|
| Rate for Payer: Priority Health HMO/PPO |
$1.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.94
|
| Rate for Payer: UHC Core |
$1.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.66
|
|
|
FUROSEMIDE 10 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$2.21
|
|
|
Service Code
|
NDC 09900000335
|
| Hospital Charge Code |
3292
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$1.99 |
| Rate for Payer: Aetna Commercial |
$1.88
|
| Rate for Payer: Aetna Medicare |
$0.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.69
|
| Rate for Payer: BCBS Complete |
$0.88
|
| Rate for Payer: BCBS MAPPO |
$0.55
|
| Rate for Payer: BCBS Trust/PPO |
$1.82
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Medicare Advantage |
$0.55
|
| Rate for Payer: Cash Price |
$1.77
|
| Rate for Payer: Cofinity Commercial |
$1.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.55
|
| Rate for Payer: Healthscope Commercial |
$1.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.88
|
| Rate for Payer: Nomi Health Commercial |
$1.81
|
| Rate for Payer: PACE Senior Care Partners |
$0.52
|
| Rate for Payer: PACE SWMI |
$0.55
|
| Rate for Payer: PHP Commercial |
$1.88
|
| Rate for Payer: PHP Medicare Advantage |
$0.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.44
|
| Rate for Payer: Priority Health HMO/PPO |
$1.92
|
| Rate for Payer: Priority Health Medicare |
$0.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.48
|
| Rate for Payer: Railroad Medicare Medicare |
$0.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.94
|
| Rate for Payer: UHC Core |
$1.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.55
|
| Rate for Payer: UHC Exchange |
$0.55
|
| Rate for Payer: UHC Medicare Advantage |
$0.55
|
| Rate for Payer: VA VA |
$0.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.66
|
|
|
FUROSEMIDE 10 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$126.90
|
|
|
Service Code
|
NDC 00054329446
|
| Hospital Charge Code |
3292
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.48 |
| Max. Negotiated Rate |
$114.21 |
| Rate for Payer: Aetna Commercial |
$107.86
|
| Rate for Payer: BCBS Trust/PPO |
$103.59
|
| Rate for Payer: BCN Commercial |
$98.07
|
| Rate for Payer: Cash Price |
$101.52
|
| Rate for Payer: Cofinity Commercial |
$109.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.52
|
| Rate for Payer: Healthscope Commercial |
$114.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.86
|
| Rate for Payer: Nomi Health Commercial |
$104.06
|
| Rate for Payer: PHP Commercial |
$107.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.48
|
| Rate for Payer: Priority Health HMO/PPO |
$110.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.67
|
| Rate for Payer: UHC Core |
$105.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.18
|
|
|
FUROSEMIDE 10 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$126.90
|
|
|
Service Code
|
NDC 00054329446
|
| Hospital Charge Code |
3292
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$30.14 |
| Max. Negotiated Rate |
$114.21 |
| Rate for Payer: Aetna Commercial |
$107.86
|
| Rate for Payer: Aetna Medicare |
$32.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.66
|
| Rate for Payer: BCBS Complete |
$50.76
|
| Rate for Payer: BCBS MAPPO |
$31.72
|
| Rate for Payer: BCBS Trust/PPO |
$104.32
|
| Rate for Payer: BCN Commercial |
$98.66
|
| Rate for Payer: BCN Medicare Advantage |
$31.72
|
| Rate for Payer: Cash Price |
$101.52
|
| Rate for Payer: Cofinity Commercial |
$109.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.72
|
| Rate for Payer: Healthscope Commercial |
$114.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.86
|
| Rate for Payer: Nomi Health Commercial |
$104.06
|
| Rate for Payer: PACE Senior Care Partners |
$30.14
|
| Rate for Payer: PACE SWMI |
$31.72
|
| Rate for Payer: PHP Commercial |
$107.86
|
| Rate for Payer: PHP Medicare Advantage |
$31.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.48
|
| Rate for Payer: Priority Health HMO/PPO |
$110.40
|
| Rate for Payer: Priority Health Medicare |
$32.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.02
|
| Rate for Payer: Railroad Medicare Medicare |
$31.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.67
|
| Rate for Payer: UHC Core |
$105.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.72
|
| Rate for Payer: UHC Exchange |
$31.72
|
| Rate for Payer: UHC Medicare Advantage |
$31.72
|
| Rate for Payer: VA VA |
$31.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.18
|
|
|
FUROSEMIDE 20 MG TABLET
|
Facility
|
OP
|
$368.95
|
|
|
Service Code
|
NDC 00054829725
|
| Hospital Charge Code |
3294
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$87.63 |
| Max. Negotiated Rate |
$332.06 |
| Rate for Payer: Aetna Commercial |
$313.61
|
| Rate for Payer: Aetna Medicare |
$95.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.30
|
| Rate for Payer: BCBS Complete |
$147.58
|
| Rate for Payer: BCBS MAPPO |
$92.24
|
| Rate for Payer: BCBS Trust/PPO |
$303.31
|
| Rate for Payer: BCN Commercial |
$286.86
|
| Rate for Payer: BCN Medicare Advantage |
$92.24
|
| Rate for Payer: Cash Price |
$295.16
|
| Rate for Payer: Cofinity Commercial |
$317.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.24
|
| Rate for Payer: Healthscope Commercial |
$332.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.61
|
| Rate for Payer: Nomi Health Commercial |
$302.54
|
| Rate for Payer: PACE Senior Care Partners |
$87.63
|
| Rate for Payer: PACE SWMI |
$92.24
|
| Rate for Payer: PHP Commercial |
$313.61
|
| Rate for Payer: PHP Medicare Advantage |
$92.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.82
|
| Rate for Payer: Priority Health HMO/PPO |
$320.99
|
| Rate for Payer: Priority Health Medicare |
$93.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$247.20
|
| Rate for Payer: Railroad Medicare Medicare |
$92.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.68
|
| Rate for Payer: UHC Core |
$308.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.24
|
| Rate for Payer: UHC Exchange |
$92.24
|
| Rate for Payer: UHC Medicare Advantage |
$92.24
|
| Rate for Payer: VA VA |
$92.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.71
|
|
|
FUROSEMIDE 20 MG TABLET
|
Facility
|
OP
|
$1.37
|
|
|
Service Code
|
NDC 51079007201
|
| Hospital Charge Code |
3294
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$1.23 |
| Rate for Payer: Aetna Commercial |
$1.16
|
| Rate for Payer: Aetna Medicare |
$0.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.43
|
| Rate for Payer: BCBS Complete |
$0.55
|
| Rate for Payer: BCBS MAPPO |
$0.34
|
| Rate for Payer: BCBS Trust/PPO |
$1.13
|
| Rate for Payer: BCN Commercial |
$1.07
|
| Rate for Payer: BCN Medicare Advantage |
$0.34
|
| Rate for Payer: Cash Price |
$1.10
|
| Rate for Payer: Cofinity Commercial |
$1.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.34
|
| Rate for Payer: Healthscope Commercial |
$1.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.16
|
| Rate for Payer: Nomi Health Commercial |
$1.12
|
| Rate for Payer: PACE Senior Care Partners |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.34
|
| Rate for Payer: PHP Commercial |
$1.16
|
| Rate for Payer: PHP Medicare Advantage |
$0.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.89
|
| Rate for Payer: Priority Health HMO/PPO |
$1.19
|
| Rate for Payer: Priority Health Medicare |
$0.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.92
|
| Rate for Payer: Railroad Medicare Medicare |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.21
|
| Rate for Payer: UHC Core |
$1.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.34
|
| Rate for Payer: UHC Exchange |
$0.34
|
| Rate for Payer: UHC Medicare Advantage |
$0.34
|
| Rate for Payer: VA VA |
$0.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.03
|
|
|
FUROSEMIDE 20 MG TABLET
|
Facility
|
IP
|
$129.25
|
|
|
Service Code
|
NDC 00904717761
|
| Hospital Charge Code |
3294
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$84.01 |
| Max. Negotiated Rate |
$116.32 |
| Rate for Payer: Aetna Commercial |
$109.86
|
| Rate for Payer: BCBS Trust/PPO |
$105.51
|
| Rate for Payer: BCN Commercial |
$99.88
|
| Rate for Payer: Cash Price |
$103.40
|
| Rate for Payer: Cofinity Commercial |
$111.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.40
|
| Rate for Payer: Healthscope Commercial |
$116.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.86
|
| Rate for Payer: Nomi Health Commercial |
$105.98
|
| Rate for Payer: PHP Commercial |
$109.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.01
|
| Rate for Payer: Priority Health HMO/PPO |
$112.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.74
|
| Rate for Payer: UHC Core |
$107.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.94
|
|
|
FUROSEMIDE 20 MG TABLET
|
Facility
|
OP
|
$129.25
|
|
|
Service Code
|
NDC 00904717761
|
| Hospital Charge Code |
3294
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$30.70 |
| Max. Negotiated Rate |
$116.32 |
| Rate for Payer: Aetna Commercial |
$109.86
|
| Rate for Payer: Aetna Medicare |
$33.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.39
|
| Rate for Payer: BCBS Complete |
$51.70
|
| Rate for Payer: BCBS MAPPO |
$32.31
|
| Rate for Payer: BCBS Trust/PPO |
$106.26
|
| Rate for Payer: BCN Commercial |
$100.49
|
| Rate for Payer: BCN Medicare Advantage |
$32.31
|
| Rate for Payer: Cash Price |
$103.40
|
| Rate for Payer: Cofinity Commercial |
$111.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.31
|
| Rate for Payer: Healthscope Commercial |
$116.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.86
|
| Rate for Payer: Nomi Health Commercial |
$105.98
|
| Rate for Payer: PACE Senior Care Partners |
$30.70
|
| Rate for Payer: PACE SWMI |
$32.31
|
| Rate for Payer: PHP Commercial |
$109.86
|
| Rate for Payer: PHP Medicare Advantage |
$32.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.01
|
| Rate for Payer: Priority Health HMO/PPO |
$112.45
|
| Rate for Payer: Priority Health Medicare |
$32.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.60
|
| Rate for Payer: Railroad Medicare Medicare |
$32.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.74
|
| Rate for Payer: UHC Core |
$107.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.31
|
| Rate for Payer: UHC Exchange |
$32.31
|
| Rate for Payer: UHC Medicare Advantage |
$32.31
|
| Rate for Payer: VA VA |
$32.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.94
|
|
|
FUROSEMIDE 20 MG TABLET
|
Facility
|
IP
|
$1.37
|
|
|
Service Code
|
NDC 51079007201
|
| Hospital Charge Code |
3294
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.89 |
| Max. Negotiated Rate |
$1.23 |
| Rate for Payer: Aetna Commercial |
$1.16
|
| Rate for Payer: BCBS Trust/PPO |
$1.12
|
| Rate for Payer: BCN Commercial |
$1.06
|
| Rate for Payer: Cash Price |
$1.10
|
| Rate for Payer: Cofinity Commercial |
$1.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.10
|
| Rate for Payer: Healthscope Commercial |
$1.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.16
|
| Rate for Payer: Nomi Health Commercial |
$1.12
|
| Rate for Payer: PHP Commercial |
$1.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.89
|
| Rate for Payer: Priority Health HMO/PPO |
$1.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.21
|
| Rate for Payer: UHC Core |
$1.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.03
|
|
|
FUROSEMIDE 20 MG TABLET
|
Facility
|
IP
|
$368.95
|
|
|
Service Code
|
NDC 00054829725
|
| Hospital Charge Code |
3294
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$239.82 |
| Max. Negotiated Rate |
$332.06 |
| Rate for Payer: Aetna Commercial |
$313.61
|
| Rate for Payer: BCBS Trust/PPO |
$301.17
|
| Rate for Payer: BCN Commercial |
$285.12
|
| Rate for Payer: Cash Price |
$295.16
|
| Rate for Payer: Cofinity Commercial |
$317.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$295.16
|
| Rate for Payer: Healthscope Commercial |
$332.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.61
|
| Rate for Payer: Nomi Health Commercial |
$302.54
|
| Rate for Payer: PHP Commercial |
$313.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.82
|
| Rate for Payer: Priority Health HMO/PPO |
$320.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$247.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.68
|
| Rate for Payer: UHC Core |
$308.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.71
|
|
|
FUROSEMIDE 40 MG TABLET
|
Facility
|
IP
|
$413.60
|
|
|
Service Code
|
NDC 00054829925
|
| Hospital Charge Code |
3295
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$268.84 |
| Max. Negotiated Rate |
$372.24 |
| Rate for Payer: Aetna Commercial |
$351.56
|
| Rate for Payer: BCBS Trust/PPO |
$337.62
|
| Rate for Payer: BCN Commercial |
$319.63
|
| Rate for Payer: Cash Price |
$330.88
|
| Rate for Payer: Cofinity Commercial |
$355.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.88
|
| Rate for Payer: Healthscope Commercial |
$372.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.56
|
| Rate for Payer: Nomi Health Commercial |
$339.15
|
| Rate for Payer: PHP Commercial |
$351.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.84
|
| Rate for Payer: Priority Health HMO/PPO |
$359.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.97
|
| Rate for Payer: UHC Core |
$345.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.20
|
|
|
FUROSEMIDE 40 MG TABLET
|
Facility
|
OP
|
$413.60
|
|
|
Service Code
|
NDC 00054829925
|
| Hospital Charge Code |
3295
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$98.23 |
| Max. Negotiated Rate |
$372.24 |
| Rate for Payer: Aetna Commercial |
$351.56
|
| Rate for Payer: Aetna Medicare |
$107.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.25
|
| Rate for Payer: BCBS Complete |
$165.44
|
| Rate for Payer: BCBS MAPPO |
$103.40
|
| Rate for Payer: BCBS Trust/PPO |
$340.02
|
| Rate for Payer: BCN Commercial |
$321.57
|
| Rate for Payer: BCN Medicare Advantage |
$103.40
|
| Rate for Payer: Cash Price |
$330.88
|
| Rate for Payer: Cofinity Commercial |
$355.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.40
|
| Rate for Payer: Healthscope Commercial |
$372.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.56
|
| Rate for Payer: Nomi Health Commercial |
$339.15
|
| Rate for Payer: PACE Senior Care Partners |
$98.23
|
| Rate for Payer: PACE SWMI |
$103.40
|
| Rate for Payer: PHP Commercial |
$351.56
|
| Rate for Payer: PHP Medicare Advantage |
$103.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.84
|
| Rate for Payer: Priority Health HMO/PPO |
$359.83
|
| Rate for Payer: Priority Health Medicare |
$104.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.11
|
| Rate for Payer: Railroad Medicare Medicare |
$103.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.97
|
| Rate for Payer: UHC Core |
$345.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.40
|
| Rate for Payer: UHC Exchange |
$103.40
|
| Rate for Payer: UHC Medicare Advantage |
$103.40
|
| Rate for Payer: VA VA |
$103.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.20
|
|
|
FUROSEMIDE 40 MG TABLET
|
Facility
|
OP
|
$1.49
|
|
|
Service Code
|
NDC 51079007301
|
| Hospital Charge Code |
3295
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$1.34 |
| Rate for Payer: Aetna Commercial |
$1.27
|
| Rate for Payer: Aetna Medicare |
$0.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.47
|
| Rate for Payer: BCBS Complete |
$0.60
|
| Rate for Payer: BCBS MAPPO |
$0.37
|
| Rate for Payer: BCBS Trust/PPO |
$1.22
|
| Rate for Payer: BCN Commercial |
$1.16
|
| Rate for Payer: BCN Medicare Advantage |
$0.37
|
| Rate for Payer: Cash Price |
$1.19
|
| Rate for Payer: Cofinity Commercial |
$1.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.37
|
| Rate for Payer: Healthscope Commercial |
$1.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.27
|
| Rate for Payer: Nomi Health Commercial |
$1.22
|
| Rate for Payer: PACE Senior Care Partners |
$0.35
|
| Rate for Payer: PACE SWMI |
$0.37
|
| Rate for Payer: PHP Commercial |
$1.27
|
| Rate for Payer: PHP Medicare Advantage |
$0.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.97
|
| Rate for Payer: Priority Health HMO/PPO |
$1.30
|
| Rate for Payer: Priority Health Medicare |
$0.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.00
|
| Rate for Payer: Railroad Medicare Medicare |
$0.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.31
|
| Rate for Payer: UHC Core |
$1.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.37
|
| Rate for Payer: UHC Exchange |
$0.37
|
| Rate for Payer: UHC Medicare Advantage |
$0.37
|
| Rate for Payer: VA VA |
$0.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.12
|
|
