|
ACETAMINOPHEN 500 MG TABLET
|
Facility
IP
|
$144.90
|
|
|
Service Code
|
NDC 50580-457-11
|
| Hospital Charge Code |
102
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$88.37 |
| Max. Negotiated Rate |
$130.41 |
| Rate for Payer: Aetna Commercial |
$123.16
|
| Rate for Payer: BCBS Trust/PPO |
$111.98
|
| Rate for Payer: BCN Commercial |
$111.98
|
| Rate for Payer: Cash Price |
$115.92
|
| Rate for Payer: Cofinity Commercial |
$124.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$115.92
|
| Rate for Payer: Healthscope Commercial |
$130.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$123.16
|
| Rate for Payer: PHP Commercial |
$123.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.51
|
| Rate for Payer: UHC Core |
$120.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.68
|
|
|
ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION
|
Facility
IP
|
$5.06
|
|
|
Service Code
|
NDC 0121-1971-00
|
| Hospital Charge Code |
119323
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$4.55 |
| Rate for Payer: Aetna Commercial |
$4.30
|
| Rate for Payer: BCBS Trust/PPO |
$3.91
|
| Rate for Payer: BCN Commercial |
$3.91
|
| Rate for Payer: Cash Price |
$4.05
|
| Rate for Payer: Cofinity Commercial |
$4.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.05
|
| Rate for Payer: Healthscope Commercial |
$4.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.30
|
| Rate for Payer: PHP Commercial |
$4.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.45
|
| Rate for Payer: UHC Core |
$4.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.80
|
|
|
ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION
|
Facility
IP
|
$5.06
|
|
|
Service Code
|
NDC 0121-1971-21
|
| Hospital Charge Code |
119323
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$4.55 |
| Rate for Payer: Aetna Commercial |
$4.30
|
| Rate for Payer: BCBS Trust/PPO |
$3.91
|
| Rate for Payer: BCN Commercial |
$3.91
|
| Rate for Payer: Cash Price |
$4.05
|
| Rate for Payer: Cofinity Commercial |
$4.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.05
|
| Rate for Payer: Healthscope Commercial |
$4.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.30
|
| Rate for Payer: PHP Commercial |
$4.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.45
|
| Rate for Payer: UHC Core |
$4.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.80
|
|
|
ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION
|
Facility
IP
|
$5.69
|
|
|
Service Code
|
NDC 81033-002-20
|
| Hospital Charge Code |
119323
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$5.12 |
| Rate for Payer: Aetna Commercial |
$4.84
|
| Rate for Payer: BCBS Trust/PPO |
$4.40
|
| Rate for Payer: BCN Commercial |
$4.40
|
| Rate for Payer: Cash Price |
$4.55
|
| Rate for Payer: Cofinity Commercial |
$4.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.55
|
| Rate for Payer: Healthscope Commercial |
$5.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.84
|
| Rate for Payer: PHP Commercial |
$4.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.01
|
| Rate for Payer: UHC Core |
$4.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.27
|
|
|
ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION
|
Facility
IP
|
$3.36
|
|
|
Service Code
|
NDC 0904-6820-76
|
| Hospital Charge Code |
119323
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.05 |
| Max. Negotiated Rate |
$3.02 |
| Rate for Payer: Aetna Commercial |
$2.86
|
| Rate for Payer: BCBS Trust/PPO |
$2.60
|
| Rate for Payer: BCN Commercial |
$2.60
|
| Rate for Payer: Cash Price |
$2.69
|
| Rate for Payer: Cofinity Commercial |
$2.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.69
|
| Rate for Payer: Healthscope Commercial |
$3.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.86
|
| Rate for Payer: PHP Commercial |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.96
|
| Rate for Payer: UHC Core |
$2.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.52
|
|
|
ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION
|
Facility
IP
|
$5.69
|
|
|
Service Code
|
NDC 81033-002-30
|
| Hospital Charge Code |
119323
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$5.12 |
| Rate for Payer: Aetna Commercial |
$4.84
|
| Rate for Payer: BCBS Trust/PPO |
$4.40
|
| Rate for Payer: BCN Commercial |
$4.40
|
| Rate for Payer: Cash Price |
$4.55
|
| Rate for Payer: Cofinity Commercial |
$4.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.55
|
| Rate for Payer: Healthscope Commercial |
$5.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.84
|
| Rate for Payer: PHP Commercial |
$4.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.01
|
| Rate for Payer: UHC Core |
$4.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.27
|
|
|
ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY
|
Facility
IP
|
$1.82
|
|
|
Service Code
|
NDC 45802-730-00
|
| Hospital Charge Code |
105
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.11 |
| Max. Negotiated Rate |
$1.64 |
| Rate for Payer: Aetna Commercial |
$1.55
|
| Rate for Payer: BCBS Trust/PPO |
$1.41
|
| Rate for Payer: BCN Commercial |
$1.41
|
| Rate for Payer: Cash Price |
$1.46
|
| Rate for Payer: Cofinity Commercial |
$1.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.46
|
| Rate for Payer: Healthscope Commercial |
$1.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1.55
|
| Rate for Payer: PHP Commercial |
$1.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.60
|
| Rate for Payer: UHC Core |
$1.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.36
|
|
|
ACETAMINOPHEN 80 MG CHEWABLE TABLET
|
Facility
IP
|
$43.01
|
|
|
Service Code
|
NDC 0904-5791-46
|
| Hospital Charge Code |
99
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$26.23 |
| Max. Negotiated Rate |
$38.71 |
| Rate for Payer: Aetna Commercial |
$36.56
|
| Rate for Payer: BCBS Trust/PPO |
$33.24
|
| Rate for Payer: BCN Commercial |
$33.24
|
| Rate for Payer: Cash Price |
$34.41
|
| Rate for Payer: Cofinity Commercial |
$36.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.41
|
| Rate for Payer: Healthscope Commercial |
$38.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.56
|
| Rate for Payer: PHP Commercial |
$36.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.85
|
| Rate for Payer: UHC Core |
$35.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.26
|
|
|
ACETAZOLAMIDE 250 MG TABLET
|
Facility
IP
|
$810.67
|
|
|
Service Code
|
NDC 51672-4023-1
|
| Hospital Charge Code |
113
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$494.43 |
| Max. Negotiated Rate |
$729.60 |
| Rate for Payer: Aetna Commercial |
$689.07
|
| Rate for Payer: BCBS Trust/PPO |
$626.49
|
| Rate for Payer: BCN Commercial |
$626.49
|
| Rate for Payer: Cash Price |
$648.54
|
| Rate for Payer: Cofinity Commercial |
$697.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$648.54
|
| Rate for Payer: Healthscope Commercial |
$729.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$608.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$689.07
|
| Rate for Payer: PHP Commercial |
$689.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$567.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$705.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$494.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$713.39
|
| Rate for Payer: UHC Core |
$676.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$608.00
|
|
|
ACETAZOLAMIDE 250 MG TABLET
|
Facility
IP
|
$254.60
|
|
|
Service Code
|
NDC 23155-288-01
|
| Hospital Charge Code |
113
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$155.28 |
| Max. Negotiated Rate |
$229.14 |
| Rate for Payer: Aetna Commercial |
$216.41
|
| Rate for Payer: BCBS Trust/PPO |
$196.75
|
| Rate for Payer: BCN Commercial |
$196.75
|
| Rate for Payer: Cash Price |
$203.68
|
| Rate for Payer: Cofinity Commercial |
$218.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.68
|
| Rate for Payer: Healthscope Commercial |
$229.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.41
|
| Rate for Payer: PHP Commercial |
$216.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.05
|
| Rate for Payer: UHC Core |
$212.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.95
|
|
|
ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION
|
Facility
IP
|
$131.24
|
|
|
Service Code
|
HCPCS J1120
|
| Hospital Charge Code |
114
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$80.04 |
| Max. Negotiated Rate |
$118.12 |
| Rate for Payer: Aetna Commercial |
$111.55
|
| Rate for Payer: Aetna Commercial |
$140.68
|
| Rate for Payer: Aetna Commercial |
$80.91
|
| Rate for Payer: BCBS Trust/PPO |
$73.56
|
| Rate for Payer: BCBS Trust/PPO |
$127.90
|
| Rate for Payer: BCBS Trust/PPO |
$101.42
|
| Rate for Payer: BCN Commercial |
$73.56
|
| Rate for Payer: BCN Commercial |
$101.42
|
| Rate for Payer: BCN Commercial |
$127.90
|
| Rate for Payer: Cash Price |
$104.99
|
| Rate for Payer: Cash Price |
$76.15
|
| Rate for Payer: Cash Price |
$132.40
|
| Rate for Payer: Cofinity Commercial |
$142.33
|
| Rate for Payer: Cofinity Commercial |
$112.87
|
| Rate for Payer: Cofinity Commercial |
$81.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.40
|
| Rate for Payer: Healthscope Commercial |
$118.12
|
| Rate for Payer: Healthscope Commercial |
$148.95
|
| Rate for Payer: Healthscope Commercial |
$85.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$140.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$111.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.91
|
| Rate for Payer: PHP Commercial |
$80.91
|
| Rate for Payer: PHP Commercial |
$111.55
|
| Rate for Payer: PHP Commercial |
$140.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.49
|
| Rate for Payer: UHC Core |
$138.19
|
| Rate for Payer: UHC Core |
$109.59
|
| Rate for Payer: UHC Core |
$79.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.12
|
|
|
ACETIC ACID 2 % EAR SOLUTION
|
Facility
IP
|
$96.35
|
|
|
Service Code
|
NDC 60432-741-15
|
| Hospital Charge Code |
17801
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$58.76 |
| Max. Negotiated Rate |
$86.72 |
| Rate for Payer: Aetna Commercial |
$81.90
|
| Rate for Payer: BCBS Trust/PPO |
$74.46
|
| Rate for Payer: BCN Commercial |
$74.46
|
| Rate for Payer: Cash Price |
$77.08
|
| Rate for Payer: Cofinity Commercial |
$82.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.08
|
| Rate for Payer: Healthscope Commercial |
$86.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.90
|
| Rate for Payer: PHP Commercial |
$81.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.79
|
| Rate for Payer: UHC Core |
$80.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.26
|
|
|
ACETIC ACID (BULK) 3 % LIQUID
|
Facility
IP
|
$186.00
|
|
|
Service Code
|
NDC 5155200516
|
| Hospital Charge Code |
15091
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$113.44 |
| Max. Negotiated Rate |
$167.40 |
| Rate for Payer: Aetna Commercial |
$158.10
|
| Rate for Payer: BCBS Trust/PPO |
$143.74
|
| Rate for Payer: BCN Commercial |
$143.74
|
| Rate for Payer: Cash Price |
$148.80
|
| Rate for Payer: Cofinity Commercial |
$159.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.80
|
| Rate for Payer: Healthscope Commercial |
$167.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$158.10
|
| Rate for Payer: PHP Commercial |
$158.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.68
|
| Rate for Payer: UHC Core |
$155.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.50
|
|
|
ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT
|
Facility
IP
|
$270.17
|
|
|
Service Code
|
NDC 24208-539-20
|
| Hospital Charge Code |
32559
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$164.78 |
| Max. Negotiated Rate |
$243.15 |
| Rate for Payer: Aetna Commercial |
$229.64
|
| Rate for Payer: BCBS Trust/PPO |
$208.79
|
| Rate for Payer: BCN Commercial |
$208.79
|
| Rate for Payer: Cash Price |
$216.14
|
| Rate for Payer: Cofinity Commercial |
$232.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.14
|
| Rate for Payer: Healthscope Commercial |
$243.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.64
|
| Rate for Payer: PHP Commercial |
$229.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.75
|
| Rate for Payer: UHC Core |
$225.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.63
|
|
|
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION
|
Facility
IP
|
$130.43
|
|
|
Service Code
|
HCPCS J0132
|
| Hospital Charge Code |
38303
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$79.55 |
| Max. Negotiated Rate |
$117.39 |
| Rate for Payer: Aetna Commercial |
$110.87
|
| Rate for Payer: Aetna Commercial |
$146.05
|
| Rate for Payer: Aetna Commercial |
$522.70
|
| Rate for Payer: BCBS Trust/PPO |
$132.78
|
| Rate for Payer: BCBS Trust/PPO |
$100.80
|
| Rate for Payer: BCBS Trust/PPO |
$475.23
|
| Rate for Payer: BCN Commercial |
$132.78
|
| Rate for Payer: BCN Commercial |
$475.23
|
| Rate for Payer: BCN Commercial |
$100.80
|
| Rate for Payer: Cash Price |
$491.95
|
| Rate for Payer: Cash Price |
$104.34
|
| Rate for Payer: Cash Price |
$137.46
|
| Rate for Payer: Cofinity Commercial |
$147.77
|
| Rate for Payer: Cofinity Commercial |
$528.85
|
| Rate for Payer: Cofinity Commercial |
$112.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.95
|
| Rate for Payer: Healthscope Commercial |
$117.39
|
| Rate for Payer: Healthscope Commercial |
$553.45
|
| Rate for Payer: Healthscope Commercial |
$154.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$461.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$146.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$522.70
|
| Rate for Payer: PHP Commercial |
$522.70
|
| Rate for Payer: PHP Commercial |
$110.87
|
| Rate for Payer: PHP Commercial |
$146.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$535.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$375.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$541.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.78
|
| Rate for Payer: UHC Core |
$143.47
|
| Rate for Payer: UHC Core |
$108.91
|
| Rate for Payer: UHC Core |
$513.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$461.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.82
|
|
|
ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION
|
Facility
IP
|
$117.71
|
|
|
Service Code
|
HCPCS J7608
|
| Hospital Charge Code |
123
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$71.79 |
| Max. Negotiated Rate |
$105.94 |
| Rate for Payer: Aetna Commercial |
$100.05
|
| Rate for Payer: Aetna Commercial |
$50.43
|
| Rate for Payer: Aetna Commercial |
$75.10
|
| Rate for Payer: Aetna Commercial |
$86.54
|
| Rate for Payer: BCBS Trust/PPO |
$68.28
|
| Rate for Payer: BCBS Trust/PPO |
$78.68
|
| Rate for Payer: BCBS Trust/PPO |
$90.97
|
| Rate for Payer: BCBS Trust/PPO |
$45.85
|
| Rate for Payer: BCN Commercial |
$45.85
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Commercial |
$68.28
|
| Rate for Payer: BCN Commercial |
$90.97
|
| Rate for Payer: Cash Price |
$70.68
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Cash Price |
$47.46
|
| Rate for Payer: Cash Price |
$94.17
|
| Rate for Payer: Cofinity Commercial |
$51.02
|
| Rate for Payer: Cofinity Commercial |
$101.23
|
| Rate for Payer: Cofinity Commercial |
$87.56
|
| Rate for Payer: Cofinity Commercial |
$75.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.68
|
| Rate for Payer: Healthscope Commercial |
$53.40
|
| Rate for Payer: Healthscope Commercial |
$91.63
|
| Rate for Payer: Healthscope Commercial |
$105.94
|
| Rate for Payer: Healthscope Commercial |
$79.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$100.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.43
|
| Rate for Payer: PHP Commercial |
$100.05
|
| Rate for Payer: PHP Commercial |
$86.54
|
| Rate for Payer: PHP Commercial |
$50.43
|
| Rate for Payer: PHP Commercial |
$75.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$102.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.59
|
| Rate for Payer: UHC Core |
$85.01
|
| Rate for Payer: UHC Core |
$73.77
|
| Rate for Payer: UHC Core |
$49.54
|
| Rate for Payer: UHC Core |
$98.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.26
|
|
|
ACIDOPHILUS 25 MILLION CELL-PECTIN, CITRUS 100 MG TABLET
|
Facility
IP
|
$61.10
|
|
|
Service Code
|
NDC 536718001
|
| Hospital Charge Code |
134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$37.26 |
| Max. Negotiated Rate |
$54.99 |
| Rate for Payer: Aetna Commercial |
$51.94
|
| Rate for Payer: BCBS Trust/PPO |
$47.22
|
| Rate for Payer: BCN Commercial |
$47.22
|
| Rate for Payer: Cash Price |
$48.88
|
| Rate for Payer: Cofinity Commercial |
$52.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.88
|
| Rate for Payer: Healthscope Commercial |
$54.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.94
|
| Rate for Payer: PHP Commercial |
$51.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.77
|
| Rate for Payer: UHC Core |
$51.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.82
|
|
|
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION
|
Facility
IP
|
$57.96
|
|
|
Service Code
|
NDC 0574-0121-08
|
| Hospital Charge Code |
115331
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$35.35 |
| Max. Negotiated Rate |
$52.16 |
| Rate for Payer: Aetna Commercial |
$49.27
|
| Rate for Payer: BCBS Trust/PPO |
$44.79
|
| Rate for Payer: BCN Commercial |
$44.79
|
| Rate for Payer: Cash Price |
$46.37
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.37
|
| Rate for Payer: Healthscope Commercial |
$52.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: PHP Commercial |
$49.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.00
|
| Rate for Payer: UHC Core |
$48.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.47
|
|
|
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION
|
Facility
IP
|
$61.32
|
|
|
Service Code
|
NDC 0574-0521-76
|
| Hospital Charge Code |
115331
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$37.40 |
| Max. Negotiated Rate |
$55.19 |
| Rate for Payer: Aetna Commercial |
$52.12
|
| Rate for Payer: BCBS Trust/PPO |
$47.39
|
| Rate for Payer: BCN Commercial |
$47.39
|
| Rate for Payer: Cash Price |
$49.06
|
| Rate for Payer: Cofinity Commercial |
$52.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.06
|
| Rate for Payer: Healthscope Commercial |
$55.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.12
|
| Rate for Payer: PHP Commercial |
$52.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.96
|
| Rate for Payer: UHC Core |
$51.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.99
|
|
|
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSPENSION
|
Facility
IP
|
$97.44
|
|
|
Service Code
|
NDC 66689-201-08
|
| Hospital Charge Code |
115331
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$59.43 |
| Max. Negotiated Rate |
$87.70 |
| Rate for Payer: Aetna Commercial |
$82.82
|
| Rate for Payer: BCBS Trust/PPO |
$75.30
|
| Rate for Payer: BCN Commercial |
$75.30
|
| Rate for Payer: Cash Price |
$77.95
|
| Rate for Payer: Cofinity Commercial |
$83.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.95
|
| Rate for Payer: Healthscope Commercial |
$87.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.82
|
| Rate for Payer: PHP Commercial |
$82.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.75
|
| Rate for Payer: UHC Core |
$81.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.08
|
|
|
ACYCLOVIR 200 MG CAPSULE
|
Facility
IP
|
$293.75
|
|
|
Service Code
|
NDC 0904-5789-61
|
| Hospital Charge Code |
8969
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$179.16 |
| Max. Negotiated Rate |
$264.38 |
| Rate for Payer: Aetna Commercial |
$249.69
|
| Rate for Payer: BCBS Trust/PPO |
$227.01
|
| Rate for Payer: BCN Commercial |
$227.01
|
| Rate for Payer: Cash Price |
$235.00
|
| Rate for Payer: Cofinity Commercial |
$252.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.00
|
| Rate for Payer: Healthscope Commercial |
$264.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.69
|
| Rate for Payer: PHP Commercial |
$249.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.50
|
| Rate for Payer: UHC Core |
$245.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.31
|
|
|
ACYCLOVIR 200 MG CAPSULE
|
Facility
IP
|
$250.80
|
|
|
Service Code
|
NDC 68084-107-01
|
| Hospital Charge Code |
8969
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$152.96 |
| Max. Negotiated Rate |
$225.72 |
| Rate for Payer: Aetna Commercial |
$213.18
|
| Rate for Payer: BCBS Trust/PPO |
$193.82
|
| Rate for Payer: BCN Commercial |
$193.82
|
| Rate for Payer: Cash Price |
$200.64
|
| Rate for Payer: Cofinity Commercial |
$215.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.64
|
| Rate for Payer: Healthscope Commercial |
$225.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$213.18
|
| Rate for Payer: PHP Commercial |
$213.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.70
|
| Rate for Payer: UHC Core |
$209.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.10
|
|
|
ACYCLOVIR 200 MG CAPSULE
|
Facility
IP
|
$2.51
|
|
|
Service Code
|
NDC 68084-107-11
|
| Hospital Charge Code |
8969
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$2.26 |
| Rate for Payer: Aetna Commercial |
$2.13
|
| Rate for Payer: BCBS Trust/PPO |
$1.94
|
| Rate for Payer: BCN Commercial |
$1.94
|
| Rate for Payer: Cash Price |
$2.01
|
| Rate for Payer: Cofinity Commercial |
$2.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.01
|
| Rate for Payer: Healthscope Commercial |
$2.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.13
|
| Rate for Payer: PHP Commercial |
$2.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.21
|
| Rate for Payer: UHC Core |
$2.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.88
|
|
|
ACYCLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION
|
Facility
IP
|
$19.18
|
|
|
Service Code
|
HCPCS J0133
|
| Hospital Charge Code |
8974
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.70 |
| Max. Negotiated Rate |
$17.26 |
| Rate for Payer: Aetna Commercial |
$16.30
|
| Rate for Payer: BCBS Trust/PPO |
$14.82
|
| Rate for Payer: BCN Commercial |
$14.82
|
| Rate for Payer: Cash Price |
$15.34
|
| Rate for Payer: Cofinity Commercial |
$16.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.34
|
| Rate for Payer: Healthscope Commercial |
$17.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.30
|
| Rate for Payer: PHP Commercial |
$16.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.88
|
| Rate for Payer: UHC Core |
$16.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.38
|
|
|
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION
|
Facility
IP
|
$16.65
|
|
|
Service Code
|
HCPCS J0133
|
| Hospital Charge Code |
23128
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$14.98 |
| Rate for Payer: Aetna Commercial |
$14.15
|
| Rate for Payer: Aetna Commercial |
$19.25
|
| Rate for Payer: Aetna Commercial |
$17.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.50
|
| Rate for Payer: BCBS Trust/PPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$15.50
|
| Rate for Payer: BCN Commercial |
$15.50
|
| Rate for Payer: BCN Commercial |
$12.87
|
| Rate for Payer: BCN Commercial |
$17.50
|
| Rate for Payer: Cash Price |
$18.12
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cofinity Commercial |
$17.25
|
| Rate for Payer: Cofinity Commercial |
$19.48
|
| Rate for Payer: Cofinity Commercial |
$14.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.12
|
| Rate for Payer: Healthscope Commercial |
$20.38
|
| Rate for Payer: Healthscope Commercial |
$14.98
|
| Rate for Payer: Healthscope Commercial |
$18.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.05
|
| Rate for Payer: PHP Commercial |
$17.05
|
| Rate for Payer: PHP Commercial |
$19.25
|
| Rate for Payer: PHP Commercial |
$14.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.65
|
| Rate for Payer: UHC Core |
$13.90
|
| Rate for Payer: UHC Core |
$16.75
|
| Rate for Payer: UHC Core |
$18.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.49
|
|
