|
CEFAZOLIN INJECTION (DISCOGRAPHY)
|
Facility
|
IP
|
$23.43
|
|
|
Service Code
|
HCPCS J0690
|
| Hospital Charge Code |
158561
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.31 |
| Max. Negotiated Rate |
$21.09 |
| Rate for Payer: Aetna Commercial |
$19.92
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: Cash Price |
$18.74
|
| Rate for Payer: Cofinity Commercial |
$20.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.74
|
| Rate for Payer: Healthscope Commercial |
$21.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.92
|
| Rate for Payer: Nomi Health Commercial |
$19.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.57
|
| Rate for Payer: PHP Commercial |
$19.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.62
|
| Rate for Payer: UHC Core |
$19.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.57
|
|
|
CEFAZOLIN INJECTION (DISCOGRAPHY)
|
Facility
|
OP
|
$23.43
|
|
|
Service Code
|
HCPCS J0690
|
| Hospital Charge Code |
158561
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$21.09 |
| Rate for Payer: Aetna Commercial |
$19.92
|
| Rate for Payer: Aetna Medicare |
$6.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.32
|
| Rate for Payer: BCBS Complete |
$4.34
|
| Rate for Payer: BCBS MAPPO |
$5.86
|
| Rate for Payer: BCBS Trust/PPO |
$19.26
|
| Rate for Payer: BCN Commercial |
$19.26
|
| Rate for Payer: BCN Medicare Advantage |
$5.86
|
| Rate for Payer: Cash Price |
$18.74
|
| Rate for Payer: Cofinity Commercial |
$20.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.86
|
| Rate for Payer: Healthscope Commercial |
$21.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.57
|
| Rate for Payer: Mclaren Medicaid |
$4.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.15
|
| Rate for Payer: Meridian Medicaid |
$4.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.92
|
| Rate for Payer: Nomi Health Commercial |
$19.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.57
|
| Rate for Payer: PACE Senior Care Partners |
$5.56
|
| Rate for Payer: PACE SWMI |
$5.86
|
| Rate for Payer: PHP Commercial |
$19.92
|
| Rate for Payer: PHP Medicare Advantage |
$5.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.38
|
| Rate for Payer: Priority Health Medicare |
$5.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.31
|
| Rate for Payer: Railroad Medicare Medicare |
$5.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.62
|
| Rate for Payer: UHC Core |
$19.56
|
| Rate for Payer: UHC Exchange |
$5.86
|
| Rate for Payer: UHC Medicaid |
$4.13
|
| Rate for Payer: UHC Medicare Advantage |
$5.86
|
| Rate for Payer: UHCCP Medicaid |
$4.13
|
| Rate for Payer: VA VA |
$5.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.57
|
|
|
CEFAZOLIN IV SYRINGE 1 G PMX
|
Facility
|
OP
|
$23.83
|
|
|
Service Code
|
HCPCS J0690
|
| Hospital Charge Code |
500535
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.20 |
| Max. Negotiated Rate |
$21.45 |
| Rate for Payer: Aetna Commercial |
$20.26
|
| Rate for Payer: Aetna Commercial |
$2.57
|
| Rate for Payer: Aetna Medicare |
$0.79
|
| Rate for Payer: Aetna Medicare |
$6.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.94
|
| Rate for Payer: BCBS Complete |
$4.41
|
| Rate for Payer: BCBS Complete |
$0.56
|
| Rate for Payer: BCBS MAPPO |
$5.96
|
| Rate for Payer: BCBS MAPPO |
$0.76
|
| Rate for Payer: BCBS Trust/PPO |
$19.59
|
| Rate for Payer: BCBS Trust/PPO |
$2.48
|
| Rate for Payer: BCN Commercial |
$2.48
|
| Rate for Payer: BCN Commercial |
$19.59
|
| Rate for Payer: BCN Medicare Advantage |
$0.76
|
| Rate for Payer: BCN Medicare Advantage |
$5.96
|
| Rate for Payer: Cash Price |
$19.06
|
| Rate for Payer: Cash Price |
$2.42
|
| Rate for Payer: Cofinity Commercial |
$20.49
|
| Rate for Payer: Cofinity Commercial |
$2.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.96
|
| Rate for Payer: Healthscope Commercial |
$21.45
|
| Rate for Payer: Healthscope Commercial |
$2.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.27
|
| Rate for Payer: Mclaren Medicaid |
$0.53
|
| Rate for Payer: Mclaren Medicaid |
$4.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.26
|
| Rate for Payer: Meridian Medicaid |
$4.41
|
| Rate for Payer: Meridian Medicaid |
$0.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.26
|
| Rate for Payer: Nomi Health Commercial |
$2.48
|
| Rate for Payer: Nomi Health Commercial |
$19.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.27
|
| Rate for Payer: PACE Senior Care Partners |
$0.72
|
| Rate for Payer: PACE Senior Care Partners |
$5.66
|
| Rate for Payer: PACE SWMI |
$0.76
|
| Rate for Payer: PACE SWMI |
$5.96
|
| Rate for Payer: PHP Commercial |
$20.26
|
| Rate for Payer: PHP Commercial |
$2.57
|
| Rate for Payer: PHP Medicare Advantage |
$5.96
|
| Rate for Payer: PHP Medicare Advantage |
$0.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.73
|
| Rate for Payer: Priority Health Medicare |
$0.76
|
| Rate for Payer: Priority Health Medicare |
$6.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.10
|
| Rate for Payer: Railroad Medicare Medicare |
$5.96
|
| Rate for Payer: Railroad Medicare Medicare |
$0.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.66
|
| Rate for Payer: UHC Core |
$2.52
|
| Rate for Payer: UHC Core |
$19.90
|
| Rate for Payer: UHC Exchange |
$0.76
|
| Rate for Payer: UHC Exchange |
$5.96
|
| Rate for Payer: UHC Medicaid |
$0.53
|
| Rate for Payer: UHC Medicaid |
$4.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.96
|
| Rate for Payer: UHC Medicare Advantage |
$0.76
|
| Rate for Payer: UHCCP Medicaid |
$4.20
|
| Rate for Payer: UHCCP Medicaid |
$0.53
|
| Rate for Payer: VA VA |
$5.96
|
| Rate for Payer: VA VA |
$0.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.87
|
|
|
CEFAZOLIN IV SYRINGE 1 G PMX
|
Facility
|
IP
|
$23.83
|
|
|
Service Code
|
HCPCS J0690
|
| Hospital Charge Code |
500535
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.59 |
| Max. Negotiated Rate |
$21.45 |
| Rate for Payer: Aetna Commercial |
$20.26
|
| Rate for Payer: Aetna Commercial |
$2.57
|
| Rate for Payer: BCBS Trust/PPO |
$19.68
|
| Rate for Payer: BCBS Trust/PPO |
$2.49
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Commercial |
$2.49
|
| Rate for Payer: Cash Price |
$19.06
|
| Rate for Payer: Cash Price |
$2.42
|
| Rate for Payer: Cofinity Commercial |
$2.60
|
| Rate for Payer: Cofinity Commercial |
$20.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.06
|
| Rate for Payer: Healthscope Commercial |
$21.45
|
| Rate for Payer: Healthscope Commercial |
$2.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.57
|
| Rate for Payer: Nomi Health Commercial |
$19.54
|
| Rate for Payer: Nomi Health Commercial |
$2.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.27
|
| Rate for Payer: PHP Commercial |
$2.57
|
| Rate for Payer: PHP Commercial |
$20.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.66
|
| Rate for Payer: UHC Core |
$19.90
|
| Rate for Payer: UHC Core |
$2.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.27
|
|
|
CEFAZOLIN IV SYRINGE 2 G PMX
|
Facility
|
IP
|
$6.04
|
|
|
Service Code
|
HCPCS J0690
|
| Hospital Charge Code |
500665
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.20 |
| Max. Negotiated Rate |
$5.44 |
| Rate for Payer: Aetna Commercial |
$5.13
|
| Rate for Payer: BCBS Trust/PPO |
$4.99
|
| Rate for Payer: BCN Commercial |
$4.99
|
| Rate for Payer: Cash Price |
$4.83
|
| Rate for Payer: Cofinity Commercial |
$5.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.83
|
| Rate for Payer: Healthscope Commercial |
$5.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.13
|
| Rate for Payer: Nomi Health Commercial |
$4.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.53
|
| Rate for Payer: PHP Commercial |
$5.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.32
|
| Rate for Payer: UHC Core |
$5.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.53
|
|
|
CEFAZOLIN IV SYRINGE 2 G PMX
|
Facility
|
OP
|
$6.04
|
|
|
Service Code
|
HCPCS J0690
|
| Hospital Charge Code |
500665
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$5.44 |
| Rate for Payer: Aetna Commercial |
$5.13
|
| Rate for Payer: Aetna Medicare |
$1.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.89
|
| Rate for Payer: BCBS Complete |
$1.12
|
| Rate for Payer: BCBS MAPPO |
$1.51
|
| Rate for Payer: BCBS Trust/PPO |
$4.97
|
| Rate for Payer: BCN Commercial |
$4.97
|
| Rate for Payer: BCN Medicare Advantage |
$1.51
|
| Rate for Payer: Cash Price |
$4.83
|
| Rate for Payer: Cofinity Commercial |
$5.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.51
|
| Rate for Payer: Healthscope Commercial |
$5.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.53
|
| Rate for Payer: Mclaren Medicaid |
$1.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.59
|
| Rate for Payer: Meridian Medicaid |
$1.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.13
|
| Rate for Payer: Nomi Health Commercial |
$4.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.53
|
| Rate for Payer: PACE Senior Care Partners |
$1.43
|
| Rate for Payer: PACE SWMI |
$1.51
|
| Rate for Payer: PHP Commercial |
$5.13
|
| Rate for Payer: PHP Medicare Advantage |
$1.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.25
|
| Rate for Payer: Priority Health Medicare |
$1.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.32
|
| Rate for Payer: UHC Core |
$5.04
|
| Rate for Payer: UHC Exchange |
$1.51
|
| Rate for Payer: UHC Medicaid |
$1.06
|
| Rate for Payer: UHC Medicare Advantage |
$1.51
|
| Rate for Payer: UHCCP Medicaid |
$1.06
|
| Rate for Payer: VA VA |
$1.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.53
|
|
|
CEFDINIR 125 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$221.37
|
|
|
Service Code
|
NDC 67877054798
|
| Hospital Charge Code |
22290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$154.07 |
| Max. Negotiated Rate |
$199.23 |
| Rate for Payer: Aetna Commercial |
$188.16
|
| Rate for Payer: BCBS Trust/PPO |
$182.83
|
| Rate for Payer: BCN Commercial |
$182.83
|
| Rate for Payer: Cash Price |
$177.10
|
| Rate for Payer: Cofinity Commercial |
$190.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.10
|
| Rate for Payer: Healthscope Commercial |
$199.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.16
|
| Rate for Payer: Nomi Health Commercial |
$181.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.03
|
| Rate for Payer: PHP Commercial |
$188.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$192.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$194.81
|
| Rate for Payer: UHC Core |
$184.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.03
|
|
|
CEFDINIR 125 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$176.70
|
|
|
Service Code
|
NDC 65862021860
|
| Hospital Charge Code |
22290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$122.98 |
| Max. Negotiated Rate |
$159.03 |
| Rate for Payer: Aetna Commercial |
$150.19
|
| Rate for Payer: BCBS Trust/PPO |
$145.94
|
| Rate for Payer: BCN Commercial |
$145.94
|
| Rate for Payer: Cash Price |
$141.36
|
| Rate for Payer: Cofinity Commercial |
$151.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.36
|
| Rate for Payer: Healthscope Commercial |
$159.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.19
|
| Rate for Payer: Nomi Health Commercial |
$144.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.53
|
| Rate for Payer: PHP Commercial |
$150.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$153.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$122.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.50
|
| Rate for Payer: UHC Core |
$147.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.53
|
|
|
CEFDINIR 125 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$176.70
|
|
|
Service Code
|
NDC 65862021860
|
| Hospital Charge Code |
22290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.15 |
| Max. Negotiated Rate |
$159.03 |
| Rate for Payer: Aetna Commercial |
$150.19
|
| Rate for Payer: Aetna Medicare |
$45.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.22
|
| Rate for Payer: BCBS Complete |
$32.71
|
| Rate for Payer: BCBS MAPPO |
$44.17
|
| Rate for Payer: BCBS Trust/PPO |
$145.27
|
| Rate for Payer: BCN Commercial |
$145.27
|
| Rate for Payer: BCN Medicare Advantage |
$44.17
|
| Rate for Payer: Cash Price |
$141.36
|
| Rate for Payer: Cofinity Commercial |
$151.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.17
|
| Rate for Payer: Healthscope Commercial |
$159.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.53
|
| Rate for Payer: Mclaren Medicaid |
$31.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.38
|
| Rate for Payer: Meridian Medicaid |
$32.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.19
|
| Rate for Payer: Nomi Health Commercial |
$144.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.53
|
| Rate for Payer: PACE Senior Care Partners |
$41.97
|
| Rate for Payer: PACE SWMI |
$44.17
|
| Rate for Payer: PHP Commercial |
$150.19
|
| Rate for Payer: PHP Medicare Advantage |
$44.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$153.73
|
| Rate for Payer: Priority Health Medicare |
$44.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$122.98
|
| Rate for Payer: Railroad Medicare Medicare |
$44.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.50
|
| Rate for Payer: UHC Core |
$147.54
|
| Rate for Payer: UHC Exchange |
$44.17
|
| Rate for Payer: UHC Medicaid |
$31.15
|
| Rate for Payer: UHC Medicare Advantage |
$44.17
|
| Rate for Payer: UHCCP Medicaid |
$31.15
|
| Rate for Payer: VA VA |
$44.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.53
|
|
|
CEFDINIR 125 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$176.70
|
|
|
Service Code
|
NDC 68180072204
|
| Hospital Charge Code |
22290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$122.98 |
| Max. Negotiated Rate |
$159.03 |
| Rate for Payer: Aetna Commercial |
$150.19
|
| Rate for Payer: BCBS Trust/PPO |
$145.94
|
| Rate for Payer: BCN Commercial |
$145.94
|
| Rate for Payer: Cash Price |
$141.36
|
| Rate for Payer: Cofinity Commercial |
$151.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.36
|
| Rate for Payer: Healthscope Commercial |
$159.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.19
|
| Rate for Payer: Nomi Health Commercial |
$144.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.53
|
| Rate for Payer: PHP Commercial |
$150.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$153.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$122.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.50
|
| Rate for Payer: UHC Core |
$147.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.53
|
|
|
CEFDINIR 125 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$176.70
|
|
|
Service Code
|
NDC 68180072204
|
| Hospital Charge Code |
22290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.15 |
| Max. Negotiated Rate |
$159.03 |
| Rate for Payer: Aetna Commercial |
$150.19
|
| Rate for Payer: Aetna Medicare |
$45.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.22
|
| Rate for Payer: BCBS Complete |
$32.71
|
| Rate for Payer: BCBS MAPPO |
$44.17
|
| Rate for Payer: BCBS Trust/PPO |
$145.27
|
| Rate for Payer: BCN Commercial |
$145.27
|
| Rate for Payer: BCN Medicare Advantage |
$44.17
|
| Rate for Payer: Cash Price |
$141.36
|
| Rate for Payer: Cofinity Commercial |
$151.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.17
|
| Rate for Payer: Healthscope Commercial |
$159.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.53
|
| Rate for Payer: Mclaren Medicaid |
$31.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.38
|
| Rate for Payer: Meridian Medicaid |
$32.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.19
|
| Rate for Payer: Nomi Health Commercial |
$144.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.53
|
| Rate for Payer: PACE Senior Care Partners |
$41.97
|
| Rate for Payer: PACE SWMI |
$44.17
|
| Rate for Payer: PHP Commercial |
$150.19
|
| Rate for Payer: PHP Medicare Advantage |
$44.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$153.73
|
| Rate for Payer: Priority Health Medicare |
$44.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$122.98
|
| Rate for Payer: Railroad Medicare Medicare |
$44.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.50
|
| Rate for Payer: UHC Core |
$147.54
|
| Rate for Payer: UHC Exchange |
$44.17
|
| Rate for Payer: UHC Medicaid |
$31.15
|
| Rate for Payer: UHC Medicare Advantage |
$44.17
|
| Rate for Payer: UHCCP Medicaid |
$31.15
|
| Rate for Payer: VA VA |
$44.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.53
|
|
|
CEFDINIR 125 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$221.37
|
|
|
Service Code
|
NDC 67877054798
|
| Hospital Charge Code |
22290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.03 |
| Max. Negotiated Rate |
$199.23 |
| Rate for Payer: Aetna Commercial |
$188.16
|
| Rate for Payer: Aetna Medicare |
$57.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.18
|
| Rate for Payer: BCBS Complete |
$40.98
|
| Rate for Payer: BCBS MAPPO |
$55.34
|
| Rate for Payer: BCBS Trust/PPO |
$181.99
|
| Rate for Payer: BCN Commercial |
$181.99
|
| Rate for Payer: BCN Medicare Advantage |
$55.34
|
| Rate for Payer: Cash Price |
$177.10
|
| Rate for Payer: Cofinity Commercial |
$190.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.34
|
| Rate for Payer: Healthscope Commercial |
$199.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.03
|
| Rate for Payer: Mclaren Medicaid |
$39.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.11
|
| Rate for Payer: Meridian Medicaid |
$40.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.16
|
| Rate for Payer: Nomi Health Commercial |
$181.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.03
|
| Rate for Payer: PACE Senior Care Partners |
$52.58
|
| Rate for Payer: PACE SWMI |
$55.34
|
| Rate for Payer: PHP Commercial |
$188.16
|
| Rate for Payer: PHP Medicare Advantage |
$55.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$192.59
|
| Rate for Payer: Priority Health Medicare |
$55.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.07
|
| Rate for Payer: Railroad Medicare Medicare |
$55.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$194.81
|
| Rate for Payer: UHC Core |
$184.84
|
| Rate for Payer: UHC Exchange |
$55.34
|
| Rate for Payer: UHC Medicaid |
$39.03
|
| Rate for Payer: UHC Medicare Advantage |
$55.34
|
| Rate for Payer: UHCCP Medicaid |
$39.03
|
| Rate for Payer: VA VA |
$55.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.03
|
|
|
CEFDINIR 300 MG CAPSULE
|
Facility
|
OP
|
$262.20
|
|
|
Service Code
|
NDC 65862017760
|
| Hospital Charge Code |
22289
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$46.23 |
| Max. Negotiated Rate |
$235.98 |
| Rate for Payer: Aetna Commercial |
$222.87
|
| Rate for Payer: Aetna Medicare |
$68.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.94
|
| Rate for Payer: BCBS Complete |
$48.53
|
| Rate for Payer: BCBS MAPPO |
$65.55
|
| Rate for Payer: BCBS Trust/PPO |
$215.55
|
| Rate for Payer: BCN Commercial |
$215.55
|
| Rate for Payer: BCN Medicare Advantage |
$65.55
|
| Rate for Payer: Cash Price |
$209.76
|
| Rate for Payer: Cofinity Commercial |
$225.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.55
|
| Rate for Payer: Healthscope Commercial |
$235.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.65
|
| Rate for Payer: Mclaren Medicaid |
$46.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.83
|
| Rate for Payer: Meridian Medicaid |
$48.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.87
|
| Rate for Payer: Nomi Health Commercial |
$215.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.65
|
| Rate for Payer: PACE Senior Care Partners |
$62.27
|
| Rate for Payer: PACE SWMI |
$65.55
|
| Rate for Payer: PHP Commercial |
$222.87
|
| Rate for Payer: PHP Medicare Advantage |
$65.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.11
|
| Rate for Payer: Priority Health Medicare |
$66.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.49
|
| Rate for Payer: Railroad Medicare Medicare |
$65.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.74
|
| Rate for Payer: UHC Core |
$218.94
|
| Rate for Payer: UHC Exchange |
$65.55
|
| Rate for Payer: UHC Medicaid |
$46.23
|
| Rate for Payer: UHC Medicare Advantage |
$65.55
|
| Rate for Payer: UHCCP Medicaid |
$46.23
|
| Rate for Payer: VA VA |
$65.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.65
|
|
|
CEFDINIR 300 MG CAPSULE
|
Facility
|
OP
|
$418.70
|
|
|
Service Code
|
NDC 60687069921
|
| Hospital Charge Code |
22289
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$73.82 |
| Max. Negotiated Rate |
$376.83 |
| Rate for Payer: Aetna Commercial |
$355.89
|
| Rate for Payer: Aetna Medicare |
$108.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.84
|
| Rate for Payer: BCBS Complete |
$77.50
|
| Rate for Payer: BCBS MAPPO |
$104.67
|
| Rate for Payer: BCBS Trust/PPO |
$344.21
|
| Rate for Payer: BCN Commercial |
$344.21
|
| Rate for Payer: BCN Medicare Advantage |
$104.67
|
| Rate for Payer: Cash Price |
$334.96
|
| Rate for Payer: Cofinity Commercial |
$360.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$334.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.67
|
| Rate for Payer: Healthscope Commercial |
$376.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.02
|
| Rate for Payer: Mclaren Medicaid |
$73.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.91
|
| Rate for Payer: Meridian Medicaid |
$77.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$120.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$355.89
|
| Rate for Payer: Nomi Health Commercial |
$343.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.02
|
| Rate for Payer: PACE Senior Care Partners |
$99.44
|
| Rate for Payer: PACE SWMI |
$104.67
|
| Rate for Payer: PHP Commercial |
$355.89
|
| Rate for Payer: PHP Medicare Advantage |
$104.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$364.27
|
| Rate for Payer: Priority Health Medicare |
$105.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$291.42
|
| Rate for Payer: Railroad Medicare Medicare |
$104.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$368.46
|
| Rate for Payer: UHC Core |
$349.61
|
| Rate for Payer: UHC Exchange |
$104.67
|
| Rate for Payer: UHC Medicaid |
$73.82
|
| Rate for Payer: UHC Medicare Advantage |
$104.67
|
| Rate for Payer: UHCCP Medicaid |
$73.82
|
| Rate for Payer: VA VA |
$104.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.02
|
|
|
CEFDINIR 300 MG CAPSULE
|
Facility
|
IP
|
$418.70
|
|
|
Service Code
|
NDC 60687069921
|
| Hospital Charge Code |
22289
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$291.42 |
| Max. Negotiated Rate |
$376.83 |
| Rate for Payer: Aetna Commercial |
$355.89
|
| Rate for Payer: BCBS Trust/PPO |
$345.80
|
| Rate for Payer: BCN Commercial |
$345.80
|
| Rate for Payer: Cash Price |
$334.96
|
| Rate for Payer: Cofinity Commercial |
$360.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$334.96
|
| Rate for Payer: Healthscope Commercial |
$376.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$355.89
|
| Rate for Payer: Nomi Health Commercial |
$343.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$314.02
|
| Rate for Payer: PHP Commercial |
$355.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$364.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$291.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$368.46
|
| Rate for Payer: UHC Core |
$349.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.02
|
|
|
CEFDINIR 300 MG CAPSULE
|
Facility
|
IP
|
$262.20
|
|
|
Service Code
|
NDC 65862017760
|
| Hospital Charge Code |
22289
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$182.49 |
| Max. Negotiated Rate |
$235.98 |
| Rate for Payer: Aetna Commercial |
$222.87
|
| Rate for Payer: BCBS Trust/PPO |
$216.55
|
| Rate for Payer: BCN Commercial |
$216.55
|
| Rate for Payer: Cash Price |
$209.76
|
| Rate for Payer: Cofinity Commercial |
$225.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.76
|
| Rate for Payer: Healthscope Commercial |
$235.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.87
|
| Rate for Payer: Nomi Health Commercial |
$215.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.65
|
| Rate for Payer: PHP Commercial |
$222.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.74
|
| Rate for Payer: UHC Core |
$218.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.65
|
|
|
CEFDINIR 300 MG CAPSULE
|
Facility
|
IP
|
$13.96
|
|
|
Service Code
|
NDC 60687069911
|
| Hospital Charge Code |
22289
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.72 |
| Max. Negotiated Rate |
$12.56 |
| Rate for Payer: Aetna Commercial |
$11.87
|
| Rate for Payer: BCBS Trust/PPO |
$11.53
|
| Rate for Payer: BCN Commercial |
$11.53
|
| Rate for Payer: Cash Price |
$11.17
|
| Rate for Payer: Cofinity Commercial |
$12.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.17
|
| Rate for Payer: Healthscope Commercial |
$12.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.87
|
| Rate for Payer: Nomi Health Commercial |
$11.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.47
|
| Rate for Payer: PHP Commercial |
$11.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.28
|
| Rate for Payer: UHC Core |
$11.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.47
|
|
|
CEFDINIR 300 MG CAPSULE
|
Facility
|
OP
|
$13.96
|
|
|
Service Code
|
NDC 60687069911
|
| Hospital Charge Code |
22289
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.46 |
| Max. Negotiated Rate |
$12.56 |
| Rate for Payer: Aetna Commercial |
$11.87
|
| Rate for Payer: Aetna Medicare |
$3.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.36
|
| Rate for Payer: BCBS Complete |
$2.58
|
| Rate for Payer: BCBS MAPPO |
$3.49
|
| Rate for Payer: BCBS Trust/PPO |
$11.48
|
| Rate for Payer: BCN Commercial |
$11.48
|
| Rate for Payer: BCN Medicare Advantage |
$3.49
|
| Rate for Payer: Cash Price |
$11.17
|
| Rate for Payer: Cofinity Commercial |
$12.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.49
|
| Rate for Payer: Healthscope Commercial |
$12.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.47
|
| Rate for Payer: Mclaren Medicaid |
$2.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.66
|
| Rate for Payer: Meridian Medicaid |
$2.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.87
|
| Rate for Payer: Nomi Health Commercial |
$11.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.47
|
| Rate for Payer: PACE Senior Care Partners |
$3.32
|
| Rate for Payer: PACE SWMI |
$3.49
|
| Rate for Payer: PHP Commercial |
$11.87
|
| Rate for Payer: PHP Medicare Advantage |
$3.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.15
|
| Rate for Payer: Priority Health Medicare |
$3.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.72
|
| Rate for Payer: Railroad Medicare Medicare |
$3.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.28
|
| Rate for Payer: UHC Core |
$11.66
|
| Rate for Payer: UHC Exchange |
$3.49
|
| Rate for Payer: UHC Medicaid |
$2.46
|
| Rate for Payer: UHC Medicare Advantage |
$3.49
|
| Rate for Payer: UHCCP Medicaid |
$2.46
|
| Rate for Payer: VA VA |
$3.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.47
|
|
|
CEFEPIME 1 GRAM SOLUTION FOR INJECTION
|
Facility
|
IP
|
$22.39
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
16369
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.58 |
| Max. Negotiated Rate |
$20.15 |
| Rate for Payer: Aetna Commercial |
$19.03
|
| Rate for Payer: Aetna Commercial |
$15.37
|
| Rate for Payer: Aetna Commercial |
$17.26
|
| Rate for Payer: Aetna Commercial |
$17.54
|
| Rate for Payer: Aetna Commercial |
$14.75
|
| Rate for Payer: BCBS Trust/PPO |
$17.05
|
| Rate for Payer: BCBS Trust/PPO |
$18.49
|
| Rate for Payer: BCBS Trust/PPO |
$16.77
|
| Rate for Payer: BCBS Trust/PPO |
$14.93
|
| Rate for Payer: BCBS Trust/PPO |
$14.33
|
| Rate for Payer: BCN Commercial |
$17.05
|
| Rate for Payer: BCN Commercial |
$16.77
|
| Rate for Payer: BCN Commercial |
$14.33
|
| Rate for Payer: BCN Commercial |
$14.93
|
| Rate for Payer: BCN Commercial |
$18.49
|
| Rate for Payer: Cash Price |
$13.88
|
| Rate for Payer: Cash Price |
$17.91
|
| Rate for Payer: Cash Price |
$16.25
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cofinity Commercial |
$19.26
|
| Rate for Payer: Cofinity Commercial |
$14.92
|
| Rate for Payer: Cofinity Commercial |
$17.75
|
| Rate for Payer: Cofinity Commercial |
$17.47
|
| Rate for Payer: Cofinity Commercial |
$15.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.91
|
| Rate for Payer: Healthscope Commercial |
$16.27
|
| Rate for Payer: Healthscope Commercial |
$18.28
|
| Rate for Payer: Healthscope Commercial |
$15.62
|
| Rate for Payer: Healthscope Commercial |
$18.58
|
| Rate for Payer: Healthscope Commercial |
$20.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.54
|
| Rate for Payer: Nomi Health Commercial |
$14.23
|
| Rate for Payer: Nomi Health Commercial |
$14.83
|
| Rate for Payer: Nomi Health Commercial |
$16.65
|
| Rate for Payer: Nomi Health Commercial |
$16.92
|
| Rate for Payer: Nomi Health Commercial |
$18.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.79
|
| Rate for Payer: PHP Commercial |
$15.37
|
| Rate for Payer: PHP Commercial |
$17.26
|
| Rate for Payer: PHP Commercial |
$19.03
|
| Rate for Payer: PHP Commercial |
$17.54
|
| Rate for Payer: PHP Commercial |
$14.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.16
|
| Rate for Payer: UHC Core |
$14.49
|
| Rate for Payer: UHC Core |
$15.10
|
| Rate for Payer: UHC Core |
$17.23
|
| Rate for Payer: UHC Core |
$18.70
|
| Rate for Payer: UHC Core |
$16.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.48
|
|
|
CEFEPIME 1 GRAM SOLUTION FOR INJECTION
|
Facility
|
OP
|
$22.39
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
16369
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.95 |
| Max. Negotiated Rate |
$20.15 |
| Rate for Payer: Aetna Commercial |
$19.03
|
| Rate for Payer: Aetna Commercial |
$15.37
|
| Rate for Payer: Aetna Commercial |
$17.54
|
| Rate for Payer: Aetna Commercial |
$14.75
|
| Rate for Payer: Aetna Commercial |
$17.26
|
| Rate for Payer: Aetna Medicare |
$4.70
|
| Rate for Payer: Aetna Medicare |
$5.82
|
| Rate for Payer: Aetna Medicare |
$5.28
|
| Rate for Payer: Aetna Medicare |
$4.51
|
| Rate for Payer: Aetna Medicare |
$5.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.45
|
| Rate for Payer: BCBS Complete |
$3.35
|
| Rate for Payer: BCBS Complete |
$3.21
|
| Rate for Payer: BCBS Complete |
$3.76
|
| Rate for Payer: BCBS Complete |
$4.14
|
| Rate for Payer: BCBS Complete |
$3.82
|
| Rate for Payer: BCBS MAPPO |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$4.52
|
| Rate for Payer: BCBS MAPPO |
$4.34
|
| Rate for Payer: BCBS MAPPO |
$5.08
|
| Rate for Payer: BCBS MAPPO |
$5.16
|
| Rate for Payer: BCBS Trust/PPO |
$16.70
|
| Rate for Payer: BCBS Trust/PPO |
$14.26
|
| Rate for Payer: BCBS Trust/PPO |
$14.86
|
| Rate for Payer: BCBS Trust/PPO |
$18.41
|
| Rate for Payer: BCBS Trust/PPO |
$16.97
|
| Rate for Payer: BCN Commercial |
$16.70
|
| Rate for Payer: BCN Commercial |
$14.86
|
| Rate for Payer: BCN Commercial |
$14.26
|
| Rate for Payer: BCN Commercial |
$18.41
|
| Rate for Payer: BCN Commercial |
$16.97
|
| Rate for Payer: BCN Medicare Advantage |
$5.60
|
| Rate for Payer: BCN Medicare Advantage |
$5.16
|
| Rate for Payer: BCN Medicare Advantage |
$5.08
|
| Rate for Payer: BCN Medicare Advantage |
$4.52
|
| Rate for Payer: BCN Medicare Advantage |
$4.34
|
| Rate for Payer: Cash Price |
$13.88
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cash Price |
$17.91
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cash Price |
$16.25
|
| Rate for Payer: Cofinity Commercial |
$17.75
|
| Rate for Payer: Cofinity Commercial |
$17.47
|
| Rate for Payer: Cofinity Commercial |
$19.26
|
| Rate for Payer: Cofinity Commercial |
$14.92
|
| Rate for Payer: Cofinity Commercial |
$15.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.08
|
| Rate for Payer: Healthscope Commercial |
$15.62
|
| Rate for Payer: Healthscope Commercial |
$20.15
|
| Rate for Payer: Healthscope Commercial |
$18.58
|
| Rate for Payer: Healthscope Commercial |
$16.27
|
| Rate for Payer: Healthscope Commercial |
$18.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.23
|
| Rate for Payer: Mclaren Medicaid |
$3.19
|
| Rate for Payer: Mclaren Medicaid |
$3.64
|
| Rate for Payer: Mclaren Medicaid |
$3.58
|
| Rate for Payer: Mclaren Medicaid |
$3.95
|
| Rate for Payer: Mclaren Medicaid |
$3.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.33
|
| Rate for Payer: Meridian Medicaid |
$3.35
|
| Rate for Payer: Meridian Medicaid |
$3.21
|
| Rate for Payer: Meridian Medicaid |
$3.76
|
| Rate for Payer: Meridian Medicaid |
$3.82
|
| Rate for Payer: Meridian Medicaid |
$4.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.03
|
| Rate for Payer: Nomi Health Commercial |
$18.36
|
| Rate for Payer: Nomi Health Commercial |
$16.65
|
| Rate for Payer: Nomi Health Commercial |
$16.92
|
| Rate for Payer: Nomi Health Commercial |
$14.23
|
| Rate for Payer: Nomi Health Commercial |
$14.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.79
|
| Rate for Payer: PACE Senior Care Partners |
$4.12
|
| Rate for Payer: PACE Senior Care Partners |
$4.29
|
| Rate for Payer: PACE Senior Care Partners |
$5.32
|
| Rate for Payer: PACE Senior Care Partners |
$4.90
|
| Rate for Payer: PACE Senior Care Partners |
$4.82
|
| Rate for Payer: PACE SWMI |
$4.34
|
| Rate for Payer: PACE SWMI |
$4.52
|
| Rate for Payer: PACE SWMI |
$5.08
|
| Rate for Payer: PACE SWMI |
$5.16
|
| Rate for Payer: PACE SWMI |
$5.60
|
| Rate for Payer: PHP Commercial |
$17.54
|
| Rate for Payer: PHP Commercial |
$14.75
|
| Rate for Payer: PHP Commercial |
$17.26
|
| Rate for Payer: PHP Commercial |
$15.37
|
| Rate for Payer: PHP Commercial |
$19.03
|
| Rate for Payer: PHP Medicare Advantage |
$4.52
|
| Rate for Payer: PHP Medicare Advantage |
$5.60
|
| Rate for Payer: PHP Medicare Advantage |
$4.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.73
|
| Rate for Payer: Priority Health Medicare |
$4.57
|
| Rate for Payer: Priority Health Medicare |
$5.65
|
| Rate for Payer: Priority Health Medicare |
$4.38
|
| Rate for Payer: Priority Health Medicare |
$5.21
|
| Rate for Payer: Priority Health Medicare |
$5.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.08
|
| Rate for Payer: Railroad Medicare Medicare |
$5.60
|
| Rate for Payer: Railroad Medicare Medicare |
$5.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.08
|
| Rate for Payer: Railroad Medicare Medicare |
$4.34
|
| Rate for Payer: Railroad Medicare Medicare |
$4.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.70
|
| Rate for Payer: UHC Core |
$17.23
|
| Rate for Payer: UHC Core |
$14.49
|
| Rate for Payer: UHC Core |
$18.70
|
| Rate for Payer: UHC Core |
$16.96
|
| Rate for Payer: UHC Core |
$15.10
|
| Rate for Payer: UHC Exchange |
$4.34
|
| Rate for Payer: UHC Exchange |
$5.16
|
| Rate for Payer: UHC Exchange |
$4.52
|
| Rate for Payer: UHC Exchange |
$5.60
|
| Rate for Payer: UHC Exchange |
$5.08
|
| Rate for Payer: UHC Medicaid |
$3.95
|
| Rate for Payer: UHC Medicaid |
$3.64
|
| Rate for Payer: UHC Medicaid |
$3.19
|
| Rate for Payer: UHC Medicaid |
$3.58
|
| Rate for Payer: UHC Medicaid |
$3.06
|
| Rate for Payer: UHC Medicare Advantage |
$5.08
|
| Rate for Payer: UHC Medicare Advantage |
$4.34
|
| Rate for Payer: UHC Medicare Advantage |
$5.60
|
| Rate for Payer: UHC Medicare Advantage |
$4.52
|
| Rate for Payer: UHC Medicare Advantage |
$5.16
|
| Rate for Payer: UHCCP Medicaid |
$3.64
|
| Rate for Payer: UHCCP Medicaid |
$3.95
|
| Rate for Payer: UHCCP Medicaid |
$3.58
|
| Rate for Payer: UHCCP Medicaid |
$3.06
|
| Rate for Payer: UHCCP Medicaid |
$3.19
|
| Rate for Payer: VA VA |
$5.60
|
| Rate for Payer: VA VA |
$4.34
|
| Rate for Payer: VA VA |
$5.16
|
| Rate for Payer: VA VA |
$4.52
|
| Rate for Payer: VA VA |
$5.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.01
|
|
|
CEFEPIME 1 GRAM SOLUTION MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$18.08
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
301730
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.19 |
| Max. Negotiated Rate |
$16.27 |
| Rate for Payer: Aetna Commercial |
$15.37
|
| Rate for Payer: Aetna Medicare |
$4.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.65
|
| Rate for Payer: BCBS Complete |
$3.35
|
| Rate for Payer: BCBS MAPPO |
$4.52
|
| Rate for Payer: BCBS Trust/PPO |
$14.86
|
| Rate for Payer: BCN Commercial |
$14.86
|
| Rate for Payer: BCN Medicare Advantage |
$4.52
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cofinity Commercial |
$15.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.52
|
| Rate for Payer: Healthscope Commercial |
$16.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.56
|
| Rate for Payer: Mclaren Medicaid |
$3.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.75
|
| Rate for Payer: Meridian Medicaid |
$3.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.37
|
| Rate for Payer: Nomi Health Commercial |
$14.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.56
|
| Rate for Payer: PACE Senior Care Partners |
$4.29
|
| Rate for Payer: PACE SWMI |
$4.52
|
| Rate for Payer: PHP Commercial |
$15.37
|
| Rate for Payer: PHP Medicare Advantage |
$4.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.73
|
| Rate for Payer: Priority Health Medicare |
$4.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.58
|
| Rate for Payer: Railroad Medicare Medicare |
$4.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.91
|
| Rate for Payer: UHC Core |
$15.10
|
| Rate for Payer: UHC Exchange |
$4.52
|
| Rate for Payer: UHC Medicaid |
$3.19
|
| Rate for Payer: UHC Medicare Advantage |
$4.52
|
| Rate for Payer: UHCCP Medicaid |
$3.19
|
| Rate for Payer: VA VA |
$4.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.56
|
|
|
CEFEPIME 1 GRAM SOLUTION MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$18.08
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
301730
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.58 |
| Max. Negotiated Rate |
$16.27 |
| Rate for Payer: Aetna Commercial |
$15.37
|
| Rate for Payer: BCBS Trust/PPO |
$14.93
|
| Rate for Payer: BCN Commercial |
$14.93
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cofinity Commercial |
$15.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$16.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.37
|
| Rate for Payer: Nomi Health Commercial |
$14.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.56
|
| Rate for Payer: PHP Commercial |
$15.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.91
|
| Rate for Payer: UHC Core |
$15.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.56
|
|
|
CEFEPIME 2 GRAM SOLUTION FOR INJECTION
|
Facility
|
IP
|
$32.43
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
16371
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.57 |
| Max. Negotiated Rate |
$29.19 |
| Rate for Payer: Aetna Commercial |
$27.57
|
| Rate for Payer: Aetna Commercial |
$25.55
|
| Rate for Payer: Aetna Commercial |
$21.81
|
| Rate for Payer: Aetna Commercial |
$16.29
|
| Rate for Payer: Aetna Commercial |
$21.41
|
| Rate for Payer: Aetna Commercial |
$23.28
|
| Rate for Payer: Aetna Commercial |
$36.77
|
| Rate for Payer: Aetna Commercial |
$28.08
|
| Rate for Payer: BCBS Trust/PPO |
$27.28
|
| Rate for Payer: BCBS Trust/PPO |
$24.83
|
| Rate for Payer: BCBS Trust/PPO |
$26.78
|
| Rate for Payer: BCBS Trust/PPO |
$15.83
|
| Rate for Payer: BCBS Trust/PPO |
$35.73
|
| Rate for Payer: BCBS Trust/PPO |
$20.80
|
| Rate for Payer: BCBS Trust/PPO |
$22.62
|
| Rate for Payer: BCBS Trust/PPO |
$21.19
|
| Rate for Payer: BCN Commercial |
$21.19
|
| Rate for Payer: BCN Commercial |
$15.83
|
| Rate for Payer: BCN Commercial |
$22.62
|
| Rate for Payer: BCN Commercial |
$20.80
|
| Rate for Payer: BCN Commercial |
$26.78
|
| Rate for Payer: BCN Commercial |
$35.73
|
| Rate for Payer: BCN Commercial |
$24.83
|
| Rate for Payer: BCN Commercial |
$27.28
|
| Rate for Payer: Cash Price |
$26.42
|
| Rate for Payer: Cash Price |
$20.53
|
| Rate for Payer: Cash Price |
$24.05
|
| Rate for Payer: Cash Price |
$20.15
|
| Rate for Payer: Cash Price |
$15.34
|
| Rate for Payer: Cash Price |
$21.91
|
| Rate for Payer: Cash Price |
$34.61
|
| Rate for Payer: Cash Price |
$25.94
|
| Rate for Payer: Cofinity Commercial |
$23.56
|
| Rate for Payer: Cofinity Commercial |
$16.49
|
| Rate for Payer: Cofinity Commercial |
$22.07
|
| Rate for Payer: Cofinity Commercial |
$21.66
|
| Rate for Payer: Cofinity Commercial |
$25.85
|
| Rate for Payer: Cofinity Commercial |
$27.89
|
| Rate for Payer: Cofinity Commercial |
$28.41
|
| Rate for Payer: Cofinity Commercial |
$37.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.15
|
| Rate for Payer: Healthscope Commercial |
$17.25
|
| Rate for Payer: Healthscope Commercial |
$38.93
|
| Rate for Payer: Healthscope Commercial |
$29.73
|
| Rate for Payer: Healthscope Commercial |
$24.65
|
| Rate for Payer: Healthscope Commercial |
$22.67
|
| Rate for Payer: Healthscope Commercial |
$23.09
|
| Rate for Payer: Healthscope Commercial |
$29.19
|
| Rate for Payer: Healthscope Commercial |
$27.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.08
|
| Rate for Payer: Nomi Health Commercial |
$27.08
|
| Rate for Payer: Nomi Health Commercial |
$24.65
|
| Rate for Payer: Nomi Health Commercial |
$26.59
|
| Rate for Payer: Nomi Health Commercial |
$35.47
|
| Rate for Payer: Nomi Health Commercial |
$15.72
|
| Rate for Payer: Nomi Health Commercial |
$20.66
|
| Rate for Payer: Nomi Health Commercial |
$22.46
|
| Rate for Payer: Nomi Health Commercial |
$21.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.32
|
| Rate for Payer: PHP Commercial |
$16.29
|
| Rate for Payer: PHP Commercial |
$25.55
|
| Rate for Payer: PHP Commercial |
$23.28
|
| Rate for Payer: PHP Commercial |
$27.57
|
| Rate for Payer: PHP Commercial |
$21.41
|
| Rate for Payer: PHP Commercial |
$21.81
|
| Rate for Payer: PHP Commercial |
$28.08
|
| Rate for Payer: PHP Commercial |
$36.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.17
|
| Rate for Payer: UHC Core |
$22.87
|
| Rate for Payer: UHC Core |
$16.01
|
| Rate for Payer: UHC Core |
$27.08
|
| Rate for Payer: UHC Core |
$21.03
|
| Rate for Payer: UHC Core |
$25.10
|
| Rate for Payer: UHC Core |
$36.12
|
| Rate for Payer: UHC Core |
$27.58
|
| Rate for Payer: UHC Core |
$21.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.55
|
|
|
CEFEPIME 2 GRAM SOLUTION FOR INJECTION
|
Facility
|
OP
|
$19.17
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
16371
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Aetna Commercial |
$16.29
|
| Rate for Payer: Aetna Commercial |
$21.41
|
| Rate for Payer: Aetna Commercial |
$21.81
|
| Rate for Payer: Aetna Commercial |
$23.28
|
| Rate for Payer: Aetna Commercial |
$25.55
|
| Rate for Payer: Aetna Commercial |
$27.57
|
| Rate for Payer: Aetna Commercial |
$28.08
|
| Rate for Payer: Aetna Commercial |
$36.77
|
| Rate for Payer: Aetna Medicare |
$8.43
|
| Rate for Payer: Aetna Medicare |
$7.82
|
| Rate for Payer: Aetna Medicare |
$11.25
|
| Rate for Payer: Aetna Medicare |
$8.59
|
| Rate for Payer: Aetna Medicare |
$6.67
|
| Rate for Payer: Aetna Medicare |
$7.12
|
| Rate for Payer: Aetna Medicare |
$4.98
|
| Rate for Payer: Aetna Medicare |
$6.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.02
|
| Rate for Payer: BCBS Complete |
$5.56
|
| Rate for Payer: BCBS Complete |
$4.66
|
| Rate for Payer: BCBS Complete |
$4.75
|
| Rate for Payer: BCBS Complete |
$5.07
|
| Rate for Payer: BCBS Complete |
$3.55
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS Complete |
$6.11
|
| Rate for Payer: BCBS Complete |
$8.01
|
| Rate for Payer: BCBS MAPPO |
$6.30
|
| Rate for Payer: BCBS MAPPO |
$7.51
|
| Rate for Payer: BCBS MAPPO |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$10.81
|
| Rate for Payer: BCBS MAPPO |
$8.26
|
| Rate for Payer: BCBS MAPPO |
$6.42
|
| Rate for Payer: BCBS MAPPO |
$6.85
|
| Rate for Payer: BCBS MAPPO |
$8.11
|
| Rate for Payer: BCBS Trust/PPO |
$27.15
|
| Rate for Payer: BCBS Trust/PPO |
$24.71
|
| Rate for Payer: BCBS Trust/PPO |
$20.71
|
| Rate for Payer: BCBS Trust/PPO |
$22.52
|
| Rate for Payer: BCBS Trust/PPO |
$15.76
|
| Rate for Payer: BCBS Trust/PPO |
$35.56
|
| Rate for Payer: BCBS Trust/PPO |
$26.66
|
| Rate for Payer: BCBS Trust/PPO |
$21.10
|
| Rate for Payer: BCN Commercial |
$27.15
|
| Rate for Payer: BCN Commercial |
$15.76
|
| Rate for Payer: BCN Commercial |
$24.71
|
| Rate for Payer: BCN Commercial |
$22.52
|
| Rate for Payer: BCN Commercial |
$20.71
|
| Rate for Payer: BCN Commercial |
$26.66
|
| Rate for Payer: BCN Commercial |
$35.56
|
| Rate for Payer: BCN Commercial |
$21.10
|
| Rate for Payer: BCN Medicare Advantage |
$6.30
|
| Rate for Payer: BCN Medicare Advantage |
$4.79
|
| Rate for Payer: BCN Medicare Advantage |
$8.11
|
| Rate for Payer: BCN Medicare Advantage |
$6.85
|
| Rate for Payer: BCN Medicare Advantage |
$6.42
|
| Rate for Payer: BCN Medicare Advantage |
$7.51
|
| Rate for Payer: BCN Medicare Advantage |
$8.26
|
| Rate for Payer: BCN Medicare Advantage |
$10.81
|
| Rate for Payer: Cash Price |
$20.53
|
| Rate for Payer: Cash Price |
$24.05
|
| Rate for Payer: Cash Price |
$15.34
|
| Rate for Payer: Cash Price |
$25.94
|
| Rate for Payer: Cash Price |
$34.61
|
| Rate for Payer: Cash Price |
$20.15
|
| Rate for Payer: Cash Price |
$26.42
|
| Rate for Payer: Cash Price |
$21.91
|
| Rate for Payer: Cofinity Commercial |
$27.89
|
| Rate for Payer: Cofinity Commercial |
$37.20
|
| Rate for Payer: Cofinity Commercial |
$28.41
|
| Rate for Payer: Cofinity Commercial |
$22.07
|
| Rate for Payer: Cofinity Commercial |
$16.49
|
| Rate for Payer: Cofinity Commercial |
$21.66
|
| Rate for Payer: Cofinity Commercial |
$23.56
|
| Rate for Payer: Cofinity Commercial |
$25.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.42
|
| Rate for Payer: Healthscope Commercial |
$38.93
|
| Rate for Payer: Healthscope Commercial |
$29.73
|
| Rate for Payer: Healthscope Commercial |
$23.09
|
| Rate for Payer: Healthscope Commercial |
$22.67
|
| Rate for Payer: Healthscope Commercial |
$27.05
|
| Rate for Payer: Healthscope Commercial |
$24.65
|
| Rate for Payer: Healthscope Commercial |
$29.19
|
| Rate for Payer: Healthscope Commercial |
$17.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.32
|
| Rate for Payer: Mclaren Medicaid |
$7.63
|
| Rate for Payer: Mclaren Medicaid |
$4.52
|
| Rate for Payer: Mclaren Medicaid |
$5.82
|
| Rate for Payer: Mclaren Medicaid |
$5.72
|
| Rate for Payer: Mclaren Medicaid |
$4.44
|
| Rate for Payer: Mclaren Medicaid |
$4.83
|
| Rate for Payer: Mclaren Medicaid |
$5.30
|
| Rate for Payer: Mclaren Medicaid |
$3.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.61
|
| Rate for Payer: Meridian Medicaid |
$4.66
|
| Rate for Payer: Meridian Medicaid |
$5.07
|
| Rate for Payer: Meridian Medicaid |
$6.00
|
| Rate for Payer: Meridian Medicaid |
$5.56
|
| Rate for Payer: Meridian Medicaid |
$3.55
|
| Rate for Payer: Meridian Medicaid |
$4.75
|
| Rate for Payer: Meridian Medicaid |
$8.01
|
| Rate for Payer: Meridian Medicaid |
$6.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.77
|
| Rate for Payer: Nomi Health Commercial |
$21.04
|
| Rate for Payer: Nomi Health Commercial |
$15.72
|
| Rate for Payer: Nomi Health Commercial |
$22.46
|
| Rate for Payer: Nomi Health Commercial |
$27.08
|
| Rate for Payer: Nomi Health Commercial |
$26.59
|
| Rate for Payer: Nomi Health Commercial |
$35.47
|
| Rate for Payer: Nomi Health Commercial |
$20.66
|
| Rate for Payer: Nomi Health Commercial |
$24.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.32
|
| Rate for Payer: PACE Senior Care Partners |
$7.70
|
| Rate for Payer: PACE Senior Care Partners |
$10.27
|
| Rate for Payer: PACE Senior Care Partners |
$5.98
|
| Rate for Payer: PACE Senior Care Partners |
$7.14
|
| Rate for Payer: PACE Senior Care Partners |
$4.55
|
| Rate for Payer: PACE Senior Care Partners |
$7.84
|
| Rate for Payer: PACE Senior Care Partners |
$6.09
|
| Rate for Payer: PACE Senior Care Partners |
$6.51
|
| Rate for Payer: PACE SWMI |
$7.51
|
| Rate for Payer: PACE SWMI |
$6.85
|
| Rate for Payer: PACE SWMI |
$4.79
|
| Rate for Payer: PACE SWMI |
$6.30
|
| Rate for Payer: PACE SWMI |
$10.81
|
| Rate for Payer: PACE SWMI |
$8.11
|
| Rate for Payer: PACE SWMI |
$6.42
|
| Rate for Payer: PACE SWMI |
$8.26
|
| Rate for Payer: PHP Commercial |
$21.81
|
| Rate for Payer: PHP Commercial |
$16.29
|
| Rate for Payer: PHP Commercial |
$25.55
|
| Rate for Payer: PHP Commercial |
$23.28
|
| Rate for Payer: PHP Commercial |
$27.57
|
| Rate for Payer: PHP Commercial |
$36.77
|
| Rate for Payer: PHP Commercial |
$21.41
|
| Rate for Payer: PHP Commercial |
$28.08
|
| Rate for Payer: PHP Medicare Advantage |
$6.30
|
| Rate for Payer: PHP Medicare Advantage |
$6.85
|
| Rate for Payer: PHP Medicare Advantage |
$7.51
|
| Rate for Payer: PHP Medicare Advantage |
$6.42
|
| Rate for Payer: PHP Medicare Advantage |
$8.11
|
| Rate for Payer: PHP Medicare Advantage |
$8.26
|
| Rate for Payer: PHP Medicare Advantage |
$4.79
|
| Rate for Payer: PHP Medicare Advantage |
$10.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.74
|
| Rate for Payer: Priority Health Medicare |
$10.92
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health Medicare |
$4.84
|
| Rate for Payer: Priority Health Medicare |
$6.92
|
| Rate for Payer: Priority Health Medicare |
$7.59
|
| Rate for Payer: Priority Health Medicare |
$8.19
|
| Rate for Payer: Priority Health Medicare |
$8.34
|
| Rate for Payer: Priority Health Medicare |
$6.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.11
|
| Rate for Payer: Railroad Medicare Medicare |
$6.42
|
| Rate for Payer: Railroad Medicare Medicare |
$8.26
|
| Rate for Payer: Railroad Medicare Medicare |
$10.81
|
| Rate for Payer: Railroad Medicare Medicare |
$4.79
|
| Rate for Payer: Railroad Medicare Medicare |
$8.11
|
| Rate for Payer: Railroad Medicare Medicare |
$6.30
|
| Rate for Payer: Railroad Medicare Medicare |
$6.85
|
| Rate for Payer: Railroad Medicare Medicare |
$7.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.07
|
| Rate for Payer: UHC Core |
$21.03
|
| Rate for Payer: UHC Core |
$22.87
|
| Rate for Payer: UHC Core |
$25.10
|
| Rate for Payer: UHC Core |
$21.43
|
| Rate for Payer: UHC Core |
$27.58
|
| Rate for Payer: UHC Core |
$36.12
|
| Rate for Payer: UHC Core |
$16.01
|
| Rate for Payer: UHC Core |
$27.08
|
| Rate for Payer: UHC Exchange |
$6.42
|
| Rate for Payer: UHC Exchange |
$8.26
|
| Rate for Payer: UHC Exchange |
$7.51
|
| Rate for Payer: UHC Exchange |
$6.30
|
| Rate for Payer: UHC Exchange |
$4.79
|
| Rate for Payer: UHC Exchange |
$10.81
|
| Rate for Payer: UHC Exchange |
$8.11
|
| Rate for Payer: UHC Exchange |
$6.85
|
| Rate for Payer: UHC Medicaid |
$5.72
|
| Rate for Payer: UHC Medicaid |
$5.82
|
| Rate for Payer: UHC Medicaid |
$5.30
|
| Rate for Payer: UHC Medicaid |
$4.52
|
| Rate for Payer: UHC Medicaid |
$3.38
|
| Rate for Payer: UHC Medicaid |
$7.63
|
| Rate for Payer: UHC Medicaid |
$4.44
|
| Rate for Payer: UHC Medicaid |
$4.83
|
| Rate for Payer: UHC Medicare Advantage |
$4.79
|
| Rate for Payer: UHC Medicare Advantage |
$8.26
|
| Rate for Payer: UHC Medicare Advantage |
$6.42
|
| Rate for Payer: UHC Medicare Advantage |
$10.81
|
| Rate for Payer: UHC Medicare Advantage |
$8.11
|
| Rate for Payer: UHC Medicare Advantage |
$6.30
|
| Rate for Payer: UHC Medicare Advantage |
$6.85
|
| Rate for Payer: UHC Medicare Advantage |
$7.51
|
| Rate for Payer: UHCCP Medicaid |
$5.30
|
| Rate for Payer: UHCCP Medicaid |
$3.38
|
| Rate for Payer: UHCCP Medicaid |
$5.72
|
| Rate for Payer: UHCCP Medicaid |
$4.52
|
| Rate for Payer: UHCCP Medicaid |
$4.44
|
| Rate for Payer: UHCCP Medicaid |
$4.83
|
| Rate for Payer: UHCCP Medicaid |
$7.63
|
| Rate for Payer: UHCCP Medicaid |
$5.82
|
| Rate for Payer: VA VA |
$6.42
|
| Rate for Payer: VA VA |
$10.81
|
| Rate for Payer: VA VA |
$8.11
|
| Rate for Payer: VA VA |
$8.26
|
| Rate for Payer: VA VA |
$4.79
|
| Rate for Payer: VA VA |
$6.85
|
| Rate for Payer: VA VA |
$6.30
|
| Rate for Payer: VA VA |
$7.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.25
|
|
|
CEFEPIME 2 GRAM SOLUTION MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$25.66
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
301707
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.52 |
| Max. Negotiated Rate |
$23.09 |
| Rate for Payer: Aetna Commercial |
$21.81
|
| Rate for Payer: Aetna Medicare |
$6.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.02
|
| Rate for Payer: BCBS Complete |
$4.75
|
| Rate for Payer: BCBS MAPPO |
$6.42
|
| Rate for Payer: BCBS Trust/PPO |
$21.10
|
| Rate for Payer: BCN Commercial |
$21.10
|
| Rate for Payer: BCN Medicare Advantage |
$6.42
|
| Rate for Payer: Cash Price |
$20.53
|
| Rate for Payer: Cofinity Commercial |
$22.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.42
|
| Rate for Payer: Healthscope Commercial |
$23.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.25
|
| Rate for Payer: Mclaren Medicaid |
$4.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.74
|
| Rate for Payer: Meridian Medicaid |
$4.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.81
|
| Rate for Payer: Nomi Health Commercial |
$21.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.25
|
| Rate for Payer: PACE Senior Care Partners |
$6.09
|
| Rate for Payer: PACE SWMI |
$6.42
|
| Rate for Payer: PHP Commercial |
$21.81
|
| Rate for Payer: PHP Medicare Advantage |
$6.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.32
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.86
|
| Rate for Payer: Railroad Medicare Medicare |
$6.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.58
|
| Rate for Payer: UHC Core |
$21.43
|
| Rate for Payer: UHC Exchange |
$6.42
|
| Rate for Payer: UHC Medicaid |
$4.52
|
| Rate for Payer: UHC Medicare Advantage |
$6.42
|
| Rate for Payer: UHCCP Medicaid |
$4.52
|
| Rate for Payer: VA VA |
$6.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.25
|
|
