|
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION
|
Facility
|
OP
|
$13.27
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
9487
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$11.94 |
| Rate for Payer: Aetna Commercial |
$11.28
|
| Rate for Payer: Aetna Commercial |
$19.72
|
| Rate for Payer: Aetna Commercial |
$15.13
|
| Rate for Payer: Aetna Medicare |
$6.03
|
| Rate for Payer: Aetna Medicare |
$3.45
|
| Rate for Payer: Aetna Medicare |
$4.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.25
|
| Rate for Payer: BCBS Complete |
$3.29
|
| Rate for Payer: BCBS Complete |
$2.46
|
| Rate for Payer: BCBS Complete |
$4.29
|
| Rate for Payer: BCBS MAPPO |
$5.80
|
| Rate for Payer: BCBS MAPPO |
$3.32
|
| Rate for Payer: BCBS MAPPO |
$4.45
|
| Rate for Payer: BCBS Trust/PPO |
$10.91
|
| Rate for Payer: BCBS Trust/PPO |
$14.63
|
| Rate for Payer: BCBS Trust/PPO |
$19.07
|
| Rate for Payer: BCN Commercial |
$14.63
|
| Rate for Payer: BCN Commercial |
$19.07
|
| Rate for Payer: BCN Commercial |
$10.91
|
| Rate for Payer: BCN Medicare Advantage |
$5.80
|
| Rate for Payer: BCN Medicare Advantage |
$4.45
|
| Rate for Payer: BCN Medicare Advantage |
$3.32
|
| Rate for Payer: Cash Price |
$18.56
|
| Rate for Payer: Cash Price |
$14.24
|
| Rate for Payer: Cash Price |
$10.62
|
| Rate for Payer: Cofinity Commercial |
$11.41
|
| Rate for Payer: Cofinity Commercial |
$15.31
|
| Rate for Payer: Cofinity Commercial |
$19.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.32
|
| Rate for Payer: Healthscope Commercial |
$16.02
|
| Rate for Payer: Healthscope Commercial |
$11.94
|
| Rate for Payer: Healthscope Commercial |
$20.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.35
|
| Rate for Payer: Mclaren Medicaid |
$2.34
|
| Rate for Payer: Mclaren Medicaid |
$4.09
|
| Rate for Payer: Mclaren Medicaid |
$3.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.09
|
| Rate for Payer: Meridian Medicaid |
$4.29
|
| Rate for Payer: Meridian Medicaid |
$2.46
|
| Rate for Payer: Meridian Medicaid |
$3.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.13
|
| Rate for Payer: Nomi Health Commercial |
$19.02
|
| Rate for Payer: Nomi Health Commercial |
$14.60
|
| Rate for Payer: Nomi Health Commercial |
$10.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.95
|
| Rate for Payer: PACE Senior Care Partners |
$4.23
|
| Rate for Payer: PACE Senior Care Partners |
$3.15
|
| Rate for Payer: PACE Senior Care Partners |
$5.51
|
| Rate for Payer: PACE SWMI |
$5.80
|
| Rate for Payer: PACE SWMI |
$4.45
|
| Rate for Payer: PACE SWMI |
$3.32
|
| Rate for Payer: PHP Commercial |
$11.28
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Commercial |
$15.13
|
| Rate for Payer: PHP Medicare Advantage |
$4.45
|
| Rate for Payer: PHP Medicare Advantage |
$3.32
|
| Rate for Payer: PHP Medicare Advantage |
$5.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.18
|
| Rate for Payer: Priority Health Medicare |
$5.86
|
| Rate for Payer: Priority Health Medicare |
$4.49
|
| Rate for Payer: Priority Health Medicare |
$3.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.24
|
| Rate for Payer: Railroad Medicare Medicare |
$4.45
|
| Rate for Payer: Railroad Medicare Medicare |
$5.80
|
| Rate for Payer: Railroad Medicare Medicare |
$3.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.68
|
| Rate for Payer: UHC Core |
$11.08
|
| Rate for Payer: UHC Core |
$19.37
|
| Rate for Payer: UHC Core |
$14.86
|
| Rate for Payer: UHC Exchange |
$5.80
|
| Rate for Payer: UHC Exchange |
$4.45
|
| Rate for Payer: UHC Exchange |
$3.32
|
| Rate for Payer: UHC Medicaid |
$2.34
|
| Rate for Payer: UHC Medicaid |
$4.09
|
| Rate for Payer: UHC Medicaid |
$3.14
|
| Rate for Payer: UHC Medicare Advantage |
$4.45
|
| Rate for Payer: UHC Medicare Advantage |
$3.32
|
| Rate for Payer: UHC Medicare Advantage |
$5.80
|
| Rate for Payer: UHCCP Medicaid |
$3.14
|
| Rate for Payer: UHCCP Medicaid |
$2.34
|
| Rate for Payer: UHCCP Medicaid |
$4.09
|
| Rate for Payer: VA VA |
$3.32
|
| Rate for Payer: VA VA |
$5.80
|
| Rate for Payer: VA VA |
$4.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.40
|
|
|
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION
|
Facility
|
IP
|
$13.27
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
9487
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.24 |
| Max. Negotiated Rate |
$11.94 |
| Rate for Payer: Aetna Commercial |
$11.28
|
| Rate for Payer: Aetna Commercial |
$15.13
|
| Rate for Payer: Aetna Commercial |
$19.72
|
| Rate for Payer: BCBS Trust/PPO |
$14.70
|
| Rate for Payer: BCBS Trust/PPO |
$10.96
|
| Rate for Payer: BCBS Trust/PPO |
$19.16
|
| Rate for Payer: BCN Commercial |
$14.70
|
| Rate for Payer: BCN Commercial |
$10.96
|
| Rate for Payer: BCN Commercial |
$19.16
|
| Rate for Payer: Cash Price |
$10.62
|
| Rate for Payer: Cash Price |
$18.56
|
| Rate for Payer: Cash Price |
$14.24
|
| Rate for Payer: Cofinity Commercial |
$19.95
|
| Rate for Payer: Cofinity Commercial |
$15.31
|
| Rate for Payer: Cofinity Commercial |
$11.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.56
|
| Rate for Payer: Healthscope Commercial |
$16.02
|
| Rate for Payer: Healthscope Commercial |
$11.94
|
| Rate for Payer: Healthscope Commercial |
$20.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.72
|
| Rate for Payer: Nomi Health Commercial |
$10.88
|
| Rate for Payer: Nomi Health Commercial |
$14.60
|
| Rate for Payer: Nomi Health Commercial |
$19.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.40
|
| Rate for Payer: PHP Commercial |
$11.28
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Commercial |
$15.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.68
|
| Rate for Payer: UHC Core |
$11.08
|
| Rate for Payer: UHC Core |
$19.37
|
| Rate for Payer: UHC Core |
$14.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.35
|
|
|
CEFTRIAXONE 1 GRAM SOLUTION MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$13.27
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
301708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.24 |
| Max. Negotiated Rate |
$11.94 |
| Rate for Payer: Aetna Commercial |
$11.28
|
| Rate for Payer: BCBS Trust/PPO |
$10.96
|
| Rate for Payer: BCN Commercial |
$10.96
|
| Rate for Payer: Cash Price |
$10.62
|
| Rate for Payer: Cofinity Commercial |
$11.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.62
|
| Rate for Payer: Healthscope Commercial |
$11.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.28
|
| Rate for Payer: Nomi Health Commercial |
$10.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.95
|
| Rate for Payer: PHP Commercial |
$11.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.68
|
| Rate for Payer: UHC Core |
$11.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.95
|
|
|
CEFTRIAXONE 1 GRAM SOLUTION MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$13.27
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
301708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$11.94 |
| Rate for Payer: Aetna Commercial |
$11.28
|
| Rate for Payer: Aetna Medicare |
$3.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.15
|
| Rate for Payer: BCBS Complete |
$2.46
|
| Rate for Payer: BCBS MAPPO |
$3.32
|
| Rate for Payer: BCBS Trust/PPO |
$10.91
|
| Rate for Payer: BCN Commercial |
$10.91
|
| Rate for Payer: BCN Medicare Advantage |
$3.32
|
| Rate for Payer: Cash Price |
$10.62
|
| Rate for Payer: Cofinity Commercial |
$11.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.32
|
| Rate for Payer: Healthscope Commercial |
$11.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.95
|
| Rate for Payer: Mclaren Medicaid |
$2.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.48
|
| Rate for Payer: Meridian Medicaid |
$2.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.28
|
| Rate for Payer: Nomi Health Commercial |
$10.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.95
|
| Rate for Payer: PACE Senior Care Partners |
$3.15
|
| Rate for Payer: PACE SWMI |
$3.32
|
| Rate for Payer: PHP Commercial |
$11.28
|
| Rate for Payer: PHP Medicare Advantage |
$3.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.54
|
| Rate for Payer: Priority Health Medicare |
$3.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.24
|
| Rate for Payer: Railroad Medicare Medicare |
$3.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.68
|
| Rate for Payer: UHC Core |
$11.08
|
| Rate for Payer: UHC Exchange |
$3.32
|
| Rate for Payer: UHC Medicaid |
$2.34
|
| Rate for Payer: UHC Medicare Advantage |
$3.32
|
| Rate for Payer: UHCCP Medicaid |
$2.34
|
| Rate for Payer: VA VA |
$3.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.95
|
|
|
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION
|
Facility
|
IP
|
$16.47
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
9488
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.46 |
| Max. Negotiated Rate |
$14.82 |
| Rate for Payer: Aetna Commercial |
$14.00
|
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna Commercial |
$21.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.65
|
| Rate for Payer: BCBS Trust/PPO |
$13.60
|
| Rate for Payer: BCBS Trust/PPO |
$21.02
|
| Rate for Payer: BCN Commercial |
$20.65
|
| Rate for Payer: BCN Commercial |
$13.60
|
| Rate for Payer: BCN Commercial |
$21.02
|
| Rate for Payer: Cash Price |
$13.18
|
| Rate for Payer: Cash Price |
$20.36
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$21.89
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Cofinity Commercial |
$14.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.36
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Healthscope Commercial |
$14.82
|
| Rate for Payer: Healthscope Commercial |
$22.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.63
|
| Rate for Payer: Nomi Health Commercial |
$13.51
|
| Rate for Payer: Nomi Health Commercial |
$20.50
|
| Rate for Payer: Nomi Health Commercial |
$20.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.09
|
| Rate for Payer: PHP Commercial |
$14.00
|
| Rate for Payer: PHP Commercial |
$21.63
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.49
|
| Rate for Payer: UHC Core |
$13.75
|
| Rate for Payer: UHC Core |
$21.25
|
| Rate for Payer: UHC Core |
$20.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
|
|
CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION
|
Facility
|
OP
|
$16.47
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
9488
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.90 |
| Max. Negotiated Rate |
$14.82 |
| Rate for Payer: Aetna Commercial |
$14.00
|
| Rate for Payer: Aetna Commercial |
$21.63
|
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna Medicare |
$6.62
|
| Rate for Payer: Aetna Medicare |
$4.28
|
| Rate for Payer: Aetna Medicare |
$6.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.95
|
| Rate for Payer: BCBS Complete |
$4.63
|
| Rate for Payer: BCBS Complete |
$3.05
|
| Rate for Payer: BCBS Complete |
$4.71
|
| Rate for Payer: BCBS MAPPO |
$6.36
|
| Rate for Payer: BCBS MAPPO |
$4.12
|
| Rate for Payer: BCBS MAPPO |
$6.25
|
| Rate for Payer: BCBS Trust/PPO |
$13.54
|
| Rate for Payer: BCBS Trust/PPO |
$20.55
|
| Rate for Payer: BCBS Trust/PPO |
$20.92
|
| Rate for Payer: BCN Commercial |
$20.55
|
| Rate for Payer: BCN Commercial |
$20.92
|
| Rate for Payer: BCN Commercial |
$13.54
|
| Rate for Payer: BCN Medicare Advantage |
$6.36
|
| Rate for Payer: BCN Medicare Advantage |
$6.25
|
| Rate for Payer: BCN Medicare Advantage |
$4.12
|
| Rate for Payer: Cash Price |
$20.36
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$13.18
|
| Rate for Payer: Cofinity Commercial |
$14.16
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Cofinity Commercial |
$21.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.12
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Healthscope Commercial |
$14.82
|
| Rate for Payer: Healthscope Commercial |
$22.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: Mclaren Medicaid |
$2.90
|
| Rate for Payer: Mclaren Medicaid |
$4.49
|
| Rate for Payer: Mclaren Medicaid |
$4.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.68
|
| Rate for Payer: Meridian Medicaid |
$4.71
|
| Rate for Payer: Meridian Medicaid |
$3.05
|
| Rate for Payer: Meridian Medicaid |
$4.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.25
|
| Rate for Payer: Nomi Health Commercial |
$20.87
|
| Rate for Payer: Nomi Health Commercial |
$20.50
|
| Rate for Payer: Nomi Health Commercial |
$13.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.35
|
| Rate for Payer: PACE Senior Care Partners |
$5.94
|
| Rate for Payer: PACE Senior Care Partners |
$3.91
|
| Rate for Payer: PACE Senior Care Partners |
$6.04
|
| Rate for Payer: PACE SWMI |
$6.36
|
| Rate for Payer: PACE SWMI |
$6.25
|
| Rate for Payer: PACE SWMI |
$4.12
|
| Rate for Payer: PHP Commercial |
$14.00
|
| Rate for Payer: PHP Commercial |
$21.63
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: PHP Medicare Advantage |
$6.25
|
| Rate for Payer: PHP Medicare Advantage |
$4.12
|
| Rate for Payer: PHP Medicare Advantage |
$6.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.14
|
| Rate for Payer: Priority Health Medicare |
$6.43
|
| Rate for Payer: Priority Health Medicare |
$6.31
|
| Rate for Payer: Priority Health Medicare |
$4.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.25
|
| Rate for Payer: Railroad Medicare Medicare |
$6.36
|
| Rate for Payer: Railroad Medicare Medicare |
$4.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.49
|
| Rate for Payer: UHC Core |
$13.75
|
| Rate for Payer: UHC Core |
$21.25
|
| Rate for Payer: UHC Core |
$20.88
|
| Rate for Payer: UHC Exchange |
$6.36
|
| Rate for Payer: UHC Exchange |
$6.25
|
| Rate for Payer: UHC Exchange |
$4.12
|
| Rate for Payer: UHC Medicaid |
$2.90
|
| Rate for Payer: UHC Medicaid |
$4.49
|
| Rate for Payer: UHC Medicaid |
$4.41
|
| Rate for Payer: UHC Medicare Advantage |
$6.25
|
| Rate for Payer: UHC Medicare Advantage |
$4.12
|
| Rate for Payer: UHC Medicare Advantage |
$6.36
|
| Rate for Payer: UHCCP Medicaid |
$4.41
|
| Rate for Payer: UHCCP Medicaid |
$2.90
|
| Rate for Payer: UHCCP Medicaid |
$4.49
|
| Rate for Payer: VA VA |
$4.12
|
| Rate for Payer: VA VA |
$6.36
|
| Rate for Payer: VA VA |
$6.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.09
|
|
|
CEFTRIAXONE 2 GRAM SOLUTION MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$45.82
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
301709
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$41.24 |
| Rate for Payer: Aetna Commercial |
$38.95
|
| Rate for Payer: Aetna Medicare |
$11.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.32
|
| Rate for Payer: BCBS Complete |
$8.48
|
| Rate for Payer: BCBS MAPPO |
$11.46
|
| Rate for Payer: BCBS Trust/PPO |
$37.67
|
| Rate for Payer: BCN Commercial |
$37.67
|
| Rate for Payer: BCN Medicare Advantage |
$11.46
|
| Rate for Payer: Cash Price |
$36.66
|
| Rate for Payer: Cofinity Commercial |
$39.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.46
|
| Rate for Payer: Healthscope Commercial |
$41.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.37
|
| Rate for Payer: Mclaren Medicaid |
$8.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.03
|
| Rate for Payer: Meridian Medicaid |
$8.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.95
|
| Rate for Payer: Nomi Health Commercial |
$37.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.37
|
| Rate for Payer: PACE Senior Care Partners |
$10.88
|
| Rate for Payer: PACE SWMI |
$11.46
|
| Rate for Payer: PHP Commercial |
$38.95
|
| Rate for Payer: PHP Medicare Advantage |
$11.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.86
|
| Rate for Payer: Priority Health Medicare |
$11.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.32
|
| Rate for Payer: UHC Core |
$38.26
|
| Rate for Payer: UHC Exchange |
$11.46
|
| Rate for Payer: UHC Medicaid |
$8.08
|
| Rate for Payer: UHC Medicare Advantage |
$11.46
|
| Rate for Payer: UHCCP Medicaid |
$8.08
|
| Rate for Payer: VA VA |
$11.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.37
|
|
|
CEFTRIAXONE 2 GRAM SOLUTION MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$45.82
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
301709
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$31.89 |
| Max. Negotiated Rate |
$41.24 |
| Rate for Payer: Aetna Commercial |
$38.95
|
| Rate for Payer: BCBS Trust/PPO |
$37.84
|
| Rate for Payer: BCN Commercial |
$37.84
|
| Rate for Payer: Cash Price |
$36.66
|
| Rate for Payer: Cofinity Commercial |
$39.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.66
|
| Rate for Payer: Healthscope Commercial |
$41.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.95
|
| Rate for Payer: Nomi Health Commercial |
$37.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.37
|
| Rate for Payer: PHP Commercial |
$38.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.32
|
| Rate for Payer: UHC Core |
$38.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.37
|
|
|
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION
|
Facility
|
OP
|
$11.95
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
9490
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$10.76 |
| Rate for Payer: Aetna Commercial |
$10.16
|
| Rate for Payer: Aetna Commercial |
$4.04
|
| Rate for Payer: Aetna Commercial |
$7.31
|
| Rate for Payer: Aetna Commercial |
$2.58
|
| Rate for Payer: Aetna Medicare |
$0.79
|
| Rate for Payer: Aetna Medicare |
$3.11
|
| Rate for Payer: Aetna Medicare |
$1.24
|
| Rate for Payer: Aetna Medicare |
$2.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.73
|
| Rate for Payer: BCBS Complete |
$1.59
|
| Rate for Payer: BCBS Complete |
$0.56
|
| Rate for Payer: BCBS Complete |
$2.21
|
| Rate for Payer: BCBS Complete |
$0.88
|
| Rate for Payer: BCBS MAPPO |
$2.99
|
| Rate for Payer: BCBS MAPPO |
$0.76
|
| Rate for Payer: BCBS MAPPO |
$2.15
|
| Rate for Payer: BCBS MAPPO |
$1.19
|
| Rate for Payer: BCBS Trust/PPO |
$3.90
|
| Rate for Payer: BCBS Trust/PPO |
$9.82
|
| Rate for Payer: BCBS Trust/PPO |
$7.07
|
| Rate for Payer: BCBS Trust/PPO |
$2.50
|
| Rate for Payer: BCN Commercial |
$3.90
|
| Rate for Payer: BCN Commercial |
$7.07
|
| Rate for Payer: BCN Commercial |
$2.50
|
| Rate for Payer: BCN Commercial |
$9.82
|
| Rate for Payer: BCN Medicare Advantage |
$1.19
|
| Rate for Payer: BCN Medicare Advantage |
$0.76
|
| Rate for Payer: BCN Medicare Advantage |
$2.15
|
| Rate for Payer: BCN Medicare Advantage |
$2.99
|
| Rate for Payer: Cash Price |
$6.88
|
| Rate for Payer: Cash Price |
$3.80
|
| Rate for Payer: Cash Price |
$9.56
|
| Rate for Payer: Cash Price |
$2.43
|
| Rate for Payer: Cofinity Commercial |
$2.61
|
| Rate for Payer: Cofinity Commercial |
$10.28
|
| Rate for Payer: Cofinity Commercial |
$4.08
|
| Rate for Payer: Cofinity Commercial |
$7.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.19
|
| Rate for Payer: Healthscope Commercial |
$10.76
|
| Rate for Payer: Healthscope Commercial |
$7.74
|
| Rate for Payer: Healthscope Commercial |
$4.28
|
| Rate for Payer: Healthscope Commercial |
$2.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.96
|
| Rate for Payer: Mclaren Medicaid |
$0.84
|
| Rate for Payer: Mclaren Medicaid |
$0.54
|
| Rate for Payer: Mclaren Medicaid |
$2.11
|
| Rate for Payer: Mclaren Medicaid |
$1.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.14
|
| Rate for Payer: Meridian Medicaid |
$2.21
|
| Rate for Payer: Meridian Medicaid |
$0.88
|
| Rate for Payer: Meridian Medicaid |
$1.59
|
| Rate for Payer: Meridian Medicaid |
$0.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.31
|
| Rate for Payer: Nomi Health Commercial |
$3.90
|
| Rate for Payer: Nomi Health Commercial |
$9.80
|
| Rate for Payer: Nomi Health Commercial |
$2.49
|
| Rate for Payer: Nomi Health Commercial |
$7.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.96
|
| Rate for Payer: PACE Senior Care Partners |
$1.13
|
| Rate for Payer: PACE Senior Care Partners |
$2.04
|
| Rate for Payer: PACE Senior Care Partners |
$2.84
|
| Rate for Payer: PACE Senior Care Partners |
$0.72
|
| Rate for Payer: PACE SWMI |
$2.99
|
| Rate for Payer: PACE SWMI |
$2.15
|
| Rate for Payer: PACE SWMI |
$0.76
|
| Rate for Payer: PACE SWMI |
$1.19
|
| Rate for Payer: PHP Commercial |
$10.16
|
| Rate for Payer: PHP Commercial |
$2.58
|
| Rate for Payer: PHP Commercial |
$4.04
|
| Rate for Payer: PHP Commercial |
$7.31
|
| Rate for Payer: PHP Medicare Advantage |
$2.99
|
| Rate for Payer: PHP Medicare Advantage |
$2.15
|
| Rate for Payer: PHP Medicare Advantage |
$0.76
|
| Rate for Payer: PHP Medicare Advantage |
$1.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.40
|
| Rate for Payer: Priority Health Medicare |
$0.77
|
| Rate for Payer: Priority Health Medicare |
$3.02
|
| Rate for Payer: Priority Health Medicare |
$1.20
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.32
|
| Rate for Payer: Railroad Medicare Medicare |
$1.19
|
| Rate for Payer: Railroad Medicare Medicare |
$2.99
|
| Rate for Payer: Railroad Medicare Medicare |
$2.15
|
| Rate for Payer: Railroad Medicare Medicare |
$0.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.57
|
| Rate for Payer: UHC Core |
$9.98
|
| Rate for Payer: UHC Core |
$3.97
|
| Rate for Payer: UHC Core |
$2.54
|
| Rate for Payer: UHC Core |
$7.18
|
| Rate for Payer: UHC Exchange |
$1.19
|
| Rate for Payer: UHC Exchange |
$0.76
|
| Rate for Payer: UHC Exchange |
$2.15
|
| Rate for Payer: UHC Exchange |
$2.99
|
| Rate for Payer: UHC Medicaid |
$2.11
|
| Rate for Payer: UHC Medicaid |
$0.54
|
| Rate for Payer: UHC Medicaid |
$0.84
|
| Rate for Payer: UHC Medicaid |
$1.52
|
| Rate for Payer: UHC Medicare Advantage |
$0.76
|
| Rate for Payer: UHC Medicare Advantage |
$2.99
|
| Rate for Payer: UHC Medicare Advantage |
$2.15
|
| Rate for Payer: UHC Medicare Advantage |
$1.19
|
| Rate for Payer: UHCCP Medicaid |
$0.84
|
| Rate for Payer: UHCCP Medicaid |
$1.52
|
| Rate for Payer: UHCCP Medicaid |
$0.54
|
| Rate for Payer: UHCCP Medicaid |
$2.11
|
| Rate for Payer: VA VA |
$2.99
|
| Rate for Payer: VA VA |
$2.15
|
| Rate for Payer: VA VA |
$1.19
|
| Rate for Payer: VA VA |
$0.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.45
|
|
|
CEFTRIAXONE 500 MG SOLUTION FOR INJECTION
|
Facility
|
IP
|
$4.75
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
9490
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.31 |
| Max. Negotiated Rate |
$4.28 |
| Rate for Payer: Aetna Commercial |
$4.04
|
| Rate for Payer: Aetna Commercial |
$2.58
|
| Rate for Payer: Aetna Commercial |
$10.16
|
| Rate for Payer: Aetna Commercial |
$7.31
|
| Rate for Payer: BCBS Trust/PPO |
$3.92
|
| Rate for Payer: BCBS Trust/PPO |
$7.10
|
| Rate for Payer: BCBS Trust/PPO |
$2.51
|
| Rate for Payer: BCBS Trust/PPO |
$9.87
|
| Rate for Payer: BCN Commercial |
$3.92
|
| Rate for Payer: BCN Commercial |
$9.87
|
| Rate for Payer: BCN Commercial |
$7.10
|
| Rate for Payer: BCN Commercial |
$2.51
|
| Rate for Payer: Cash Price |
$2.43
|
| Rate for Payer: Cash Price |
$3.80
|
| Rate for Payer: Cash Price |
$6.88
|
| Rate for Payer: Cash Price |
$9.56
|
| Rate for Payer: Cofinity Commercial |
$10.28
|
| Rate for Payer: Cofinity Commercial |
$7.40
|
| Rate for Payer: Cofinity Commercial |
$4.08
|
| Rate for Payer: Cofinity Commercial |
$2.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.88
|
| Rate for Payer: Healthscope Commercial |
$7.74
|
| Rate for Payer: Healthscope Commercial |
$2.74
|
| Rate for Payer: Healthscope Commercial |
$4.28
|
| Rate for Payer: Healthscope Commercial |
$10.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.31
|
| Rate for Payer: Nomi Health Commercial |
$9.80
|
| Rate for Payer: Nomi Health Commercial |
$2.49
|
| Rate for Payer: Nomi Health Commercial |
$7.05
|
| Rate for Payer: Nomi Health Commercial |
$3.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.45
|
| Rate for Payer: PHP Commercial |
$7.31
|
| Rate for Payer: PHP Commercial |
$10.16
|
| Rate for Payer: PHP Commercial |
$2.58
|
| Rate for Payer: PHP Commercial |
$4.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.18
|
| Rate for Payer: UHC Core |
$3.97
|
| Rate for Payer: UHC Core |
$7.18
|
| Rate for Payer: UHC Core |
$2.54
|
| Rate for Payer: UHC Core |
$9.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.56
|
|
|
CELECOXIB 100 MG CAPSULE
|
Facility
|
IP
|
$465.60
|
|
|
Service Code
|
NDC 60687043601
|
| Hospital Charge Code |
24500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$324.06 |
| Max. Negotiated Rate |
$419.04 |
| Rate for Payer: Aetna Commercial |
$395.76
|
| Rate for Payer: BCBS Trust/PPO |
$384.54
|
| Rate for Payer: BCN Commercial |
$384.54
|
| Rate for Payer: Cash Price |
$372.48
|
| Rate for Payer: Cofinity Commercial |
$400.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$372.48
|
| Rate for Payer: Healthscope Commercial |
$419.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$349.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$395.76
|
| Rate for Payer: Nomi Health Commercial |
$381.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$349.20
|
| Rate for Payer: PHP Commercial |
$395.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$405.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$324.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$409.73
|
| Rate for Payer: UHC Core |
$388.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$349.20
|
|
|
CELECOXIB 100 MG CAPSULE
|
Facility
|
OP
|
$365.28
|
|
|
Service Code
|
NDC 00904650261
|
| Hospital Charge Code |
24500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$64.40 |
| Max. Negotiated Rate |
$328.75 |
| Rate for Payer: Aetna Commercial |
$310.49
|
| Rate for Payer: Aetna Medicare |
$94.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.15
|
| Rate for Payer: BCBS Complete |
$67.61
|
| Rate for Payer: BCBS MAPPO |
$91.32
|
| Rate for Payer: BCBS Trust/PPO |
$300.30
|
| Rate for Payer: BCN Commercial |
$300.30
|
| Rate for Payer: BCN Medicare Advantage |
$91.32
|
| Rate for Payer: Cash Price |
$292.22
|
| Rate for Payer: Cofinity Commercial |
$314.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.32
|
| Rate for Payer: Healthscope Commercial |
$328.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.96
|
| Rate for Payer: Mclaren Medicaid |
$64.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.89
|
| Rate for Payer: Meridian Medicaid |
$67.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.49
|
| Rate for Payer: Nomi Health Commercial |
$299.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.96
|
| Rate for Payer: PACE Senior Care Partners |
$86.75
|
| Rate for Payer: PACE SWMI |
$91.32
|
| Rate for Payer: PHP Commercial |
$310.49
|
| Rate for Payer: PHP Medicare Advantage |
$91.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$317.79
|
| Rate for Payer: Priority Health Medicare |
$92.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.23
|
| Rate for Payer: Railroad Medicare Medicare |
$91.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.45
|
| Rate for Payer: UHC Core |
$305.01
|
| Rate for Payer: UHC Exchange |
$91.32
|
| Rate for Payer: UHC Medicaid |
$64.40
|
| Rate for Payer: UHC Medicare Advantage |
$91.32
|
| Rate for Payer: UHCCP Medicaid |
$64.40
|
| Rate for Payer: VA VA |
$91.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.96
|
|
|
CELECOXIB 100 MG CAPSULE
|
Facility
|
IP
|
$365.28
|
|
|
Service Code
|
NDC 00904650261
|
| Hospital Charge Code |
24500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$254.23 |
| Max. Negotiated Rate |
$328.75 |
| Rate for Payer: Aetna Commercial |
$310.49
|
| Rate for Payer: BCBS Trust/PPO |
$301.68
|
| Rate for Payer: BCN Commercial |
$301.68
|
| Rate for Payer: Cash Price |
$292.22
|
| Rate for Payer: Cofinity Commercial |
$314.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.22
|
| Rate for Payer: Healthscope Commercial |
$328.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.49
|
| Rate for Payer: Nomi Health Commercial |
$299.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.96
|
| Rate for Payer: PHP Commercial |
$310.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$317.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.45
|
| Rate for Payer: UHC Core |
$305.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.96
|
|
|
CELECOXIB 100 MG CAPSULE
|
Facility
|
IP
|
$4.66
|
|
|
Service Code
|
NDC 60687043611
|
| Hospital Charge Code |
24500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$4.19 |
| Rate for Payer: Aetna Commercial |
$3.96
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: Cash Price |
$3.73
|
| Rate for Payer: Cofinity Commercial |
$4.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.73
|
| Rate for Payer: Healthscope Commercial |
$4.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.96
|
| Rate for Payer: Nomi Health Commercial |
$3.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.50
|
| Rate for Payer: PHP Commercial |
$3.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.10
|
| Rate for Payer: UHC Core |
$3.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.50
|
|
|
CELECOXIB 100 MG CAPSULE
|
Facility
|
OP
|
$465.60
|
|
|
Service Code
|
NDC 60687043601
|
| Hospital Charge Code |
24500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.09 |
| Max. Negotiated Rate |
$419.04 |
| Rate for Payer: Aetna Commercial |
$395.76
|
| Rate for Payer: Aetna Medicare |
$121.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$145.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$145.50
|
| Rate for Payer: BCBS Complete |
$86.18
|
| Rate for Payer: BCBS MAPPO |
$116.40
|
| Rate for Payer: BCBS Trust/PPO |
$382.77
|
| Rate for Payer: BCN Commercial |
$382.77
|
| Rate for Payer: BCN Medicare Advantage |
$116.40
|
| Rate for Payer: Cash Price |
$372.48
|
| Rate for Payer: Cofinity Commercial |
$400.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$372.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.40
|
| Rate for Payer: Healthscope Commercial |
$419.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$349.20
|
| Rate for Payer: Mclaren Medicaid |
$82.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.22
|
| Rate for Payer: Meridian Medicaid |
$86.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$133.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$128.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$395.76
|
| Rate for Payer: Nomi Health Commercial |
$381.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$349.20
|
| Rate for Payer: PACE Senior Care Partners |
$110.58
|
| Rate for Payer: PACE SWMI |
$116.40
|
| Rate for Payer: PHP Commercial |
$395.76
|
| Rate for Payer: PHP Medicare Advantage |
$116.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$405.07
|
| Rate for Payer: Priority Health Medicare |
$117.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$324.06
|
| Rate for Payer: Railroad Medicare Medicare |
$116.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$409.73
|
| Rate for Payer: UHC Core |
$388.78
|
| Rate for Payer: UHC Exchange |
$116.40
|
| Rate for Payer: UHC Medicaid |
$82.09
|
| Rate for Payer: UHC Medicare Advantage |
$116.40
|
| Rate for Payer: UHCCP Medicaid |
$82.09
|
| Rate for Payer: VA VA |
$116.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$349.20
|
|
|
CELECOXIB 100 MG CAPSULE
|
Facility
|
OP
|
$4.66
|
|
|
Service Code
|
NDC 60687043611
|
| Hospital Charge Code |
24500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$4.19 |
| Rate for Payer: Aetna Commercial |
$3.96
|
| Rate for Payer: Aetna Medicare |
$1.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.46
|
| Rate for Payer: BCBS Complete |
$0.86
|
| Rate for Payer: BCBS MAPPO |
$1.17
|
| Rate for Payer: BCBS Trust/PPO |
$3.83
|
| Rate for Payer: BCN Commercial |
$3.83
|
| Rate for Payer: BCN Medicare Advantage |
$1.17
|
| Rate for Payer: Cash Price |
$3.73
|
| Rate for Payer: Cofinity Commercial |
$4.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.17
|
| Rate for Payer: Healthscope Commercial |
$4.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.50
|
| Rate for Payer: Mclaren Medicaid |
$0.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.22
|
| Rate for Payer: Meridian Medicaid |
$0.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.96
|
| Rate for Payer: Nomi Health Commercial |
$3.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.50
|
| Rate for Payer: PACE Senior Care Partners |
$1.11
|
| Rate for Payer: PACE SWMI |
$1.17
|
| Rate for Payer: PHP Commercial |
$3.96
|
| Rate for Payer: PHP Medicare Advantage |
$1.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.05
|
| Rate for Payer: Priority Health Medicare |
$1.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.10
|
| Rate for Payer: UHC Core |
$3.89
|
| Rate for Payer: UHC Exchange |
$1.17
|
| Rate for Payer: UHC Medicaid |
$0.82
|
| Rate for Payer: UHC Medicare Advantage |
$1.17
|
| Rate for Payer: UHCCP Medicaid |
$0.82
|
| Rate for Payer: VA VA |
$1.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.50
|
|
|
CELECOXIB 100 MG CAPSULE
|
Facility
|
IP
|
$277.30
|
|
|
Service Code
|
NDC 69097042207
|
| Hospital Charge Code |
24500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$193.00 |
| Max. Negotiated Rate |
$249.57 |
| Rate for Payer: Aetna Commercial |
$235.71
|
| Rate for Payer: BCBS Trust/PPO |
$229.02
|
| Rate for Payer: BCN Commercial |
$229.02
|
| Rate for Payer: Cash Price |
$221.84
|
| Rate for Payer: Cofinity Commercial |
$238.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.84
|
| Rate for Payer: Healthscope Commercial |
$249.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.71
|
| Rate for Payer: Nomi Health Commercial |
$227.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.97
|
| Rate for Payer: PHP Commercial |
$235.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$241.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.02
|
| Rate for Payer: UHC Core |
$231.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.97
|
|
|
CELECOXIB 100 MG CAPSULE
|
Facility
|
OP
|
$277.30
|
|
|
Service Code
|
NDC 69097042207
|
| Hospital Charge Code |
24500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.89 |
| Max. Negotiated Rate |
$249.57 |
| Rate for Payer: Aetna Commercial |
$235.71
|
| Rate for Payer: Aetna Medicare |
$72.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.66
|
| Rate for Payer: BCBS Complete |
$51.33
|
| Rate for Payer: BCBS MAPPO |
$69.33
|
| Rate for Payer: BCBS Trust/PPO |
$227.97
|
| Rate for Payer: BCN Commercial |
$227.97
|
| Rate for Payer: BCN Medicare Advantage |
$69.33
|
| Rate for Payer: Cash Price |
$221.84
|
| Rate for Payer: Cofinity Commercial |
$238.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.33
|
| Rate for Payer: Healthscope Commercial |
$249.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.97
|
| Rate for Payer: Mclaren Medicaid |
$48.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.79
|
| Rate for Payer: Meridian Medicaid |
$51.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.71
|
| Rate for Payer: Nomi Health Commercial |
$227.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.97
|
| Rate for Payer: PACE Senior Care Partners |
$65.86
|
| Rate for Payer: PACE SWMI |
$69.33
|
| Rate for Payer: PHP Commercial |
$235.71
|
| Rate for Payer: PHP Medicare Advantage |
$69.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$241.25
|
| Rate for Payer: Priority Health Medicare |
$70.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.00
|
| Rate for Payer: Railroad Medicare Medicare |
$69.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.02
|
| Rate for Payer: UHC Core |
$231.55
|
| Rate for Payer: UHC Exchange |
$69.33
|
| Rate for Payer: UHC Medicaid |
$48.89
|
| Rate for Payer: UHC Medicare Advantage |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$48.89
|
| Rate for Payer: VA VA |
$69.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.97
|
|
|
CELECOXIB 200 MG CAPSULE
|
Facility
|
OP
|
$7.63
|
|
|
Service Code
|
NDC 60687044711
|
| Hospital Charge Code |
24501
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$6.87 |
| Rate for Payer: Aetna Commercial |
$6.49
|
| Rate for Payer: Aetna Medicare |
$1.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.38
|
| Rate for Payer: BCBS Complete |
$1.41
|
| Rate for Payer: BCBS MAPPO |
$1.91
|
| Rate for Payer: BCBS Trust/PPO |
$6.27
|
| Rate for Payer: BCN Commercial |
$6.27
|
| Rate for Payer: BCN Medicare Advantage |
$1.91
|
| Rate for Payer: Cash Price |
$6.10
|
| Rate for Payer: Cofinity Commercial |
$6.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.91
|
| Rate for Payer: Healthscope Commercial |
$6.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.72
|
| Rate for Payer: Mclaren Medicaid |
$1.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.00
|
| Rate for Payer: Meridian Medicaid |
$1.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.49
|
| Rate for Payer: Nomi Health Commercial |
$6.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.72
|
| Rate for Payer: PACE Senior Care Partners |
$1.81
|
| Rate for Payer: PACE SWMI |
$1.91
|
| Rate for Payer: PHP Commercial |
$6.49
|
| Rate for Payer: PHP Medicare Advantage |
$1.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6.64
|
| Rate for Payer: Priority Health Medicare |
$1.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.71
|
| Rate for Payer: UHC Core |
$6.37
|
| Rate for Payer: UHC Exchange |
$1.91
|
| Rate for Payer: UHC Medicaid |
$1.35
|
| Rate for Payer: UHC Medicare Advantage |
$1.91
|
| Rate for Payer: UHCCP Medicaid |
$1.35
|
| Rate for Payer: VA VA |
$1.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.72
|
|
|
CELECOXIB 200 MG CAPSULE
|
Facility
|
OP
|
$762.24
|
|
|
Service Code
|
NDC 60687044701
|
| Hospital Charge Code |
24501
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$134.38 |
| Max. Negotiated Rate |
$686.02 |
| Rate for Payer: Aetna Commercial |
$647.90
|
| Rate for Payer: Aetna Medicare |
$198.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$238.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$238.20
|
| Rate for Payer: BCBS Complete |
$141.09
|
| Rate for Payer: BCBS MAPPO |
$190.56
|
| Rate for Payer: BCBS Trust/PPO |
$626.64
|
| Rate for Payer: BCN Commercial |
$626.64
|
| Rate for Payer: BCN Medicare Advantage |
$190.56
|
| Rate for Payer: Cash Price |
$609.79
|
| Rate for Payer: Cofinity Commercial |
$655.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$609.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.56
|
| Rate for Payer: Healthscope Commercial |
$686.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$571.68
|
| Rate for Payer: Mclaren Medicaid |
$134.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$200.09
|
| Rate for Payer: Meridian Medicaid |
$141.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$219.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$209.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$647.90
|
| Rate for Payer: Nomi Health Commercial |
$625.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$571.68
|
| Rate for Payer: PACE Senior Care Partners |
$181.03
|
| Rate for Payer: PACE SWMI |
$190.56
|
| Rate for Payer: PHP Commercial |
$647.90
|
| Rate for Payer: PHP Medicare Advantage |
$190.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$663.15
|
| Rate for Payer: Priority Health Medicare |
$192.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$530.52
|
| Rate for Payer: Railroad Medicare Medicare |
$190.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$670.77
|
| Rate for Payer: UHC Core |
$636.47
|
| Rate for Payer: UHC Exchange |
$190.56
|
| Rate for Payer: UHC Medicaid |
$134.38
|
| Rate for Payer: UHC Medicare Advantage |
$190.56
|
| Rate for Payer: UHCCP Medicaid |
$134.38
|
| Rate for Payer: VA VA |
$190.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$571.68
|
|
|
CELECOXIB 200 MG CAPSULE
|
Facility
|
IP
|
$762.24
|
|
|
Service Code
|
NDC 60687044701
|
| Hospital Charge Code |
24501
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$530.52 |
| Max. Negotiated Rate |
$686.02 |
| Rate for Payer: Aetna Commercial |
$647.90
|
| Rate for Payer: BCBS Trust/PPO |
$629.53
|
| Rate for Payer: BCN Commercial |
$629.53
|
| Rate for Payer: Cash Price |
$609.79
|
| Rate for Payer: Cofinity Commercial |
$655.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$609.79
|
| Rate for Payer: Healthscope Commercial |
$686.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$571.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$647.90
|
| Rate for Payer: Nomi Health Commercial |
$625.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$571.68
|
| Rate for Payer: PHP Commercial |
$647.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$663.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$530.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$670.77
|
| Rate for Payer: UHC Core |
$636.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$571.68
|
|
|
CELECOXIB 200 MG CAPSULE
|
Facility
|
OP
|
$506.40
|
|
|
Service Code
|
NDC 00904650361
|
| Hospital Charge Code |
24501
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$89.28 |
| Max. Negotiated Rate |
$455.76 |
| Rate for Payer: Aetna Commercial |
$430.44
|
| Rate for Payer: Aetna Medicare |
$131.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$158.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$158.25
|
| Rate for Payer: BCBS Complete |
$93.73
|
| Rate for Payer: BCBS MAPPO |
$126.60
|
| Rate for Payer: BCBS Trust/PPO |
$416.31
|
| Rate for Payer: BCN Commercial |
$416.31
|
| Rate for Payer: BCN Medicare Advantage |
$126.60
|
| Rate for Payer: Cash Price |
$405.12
|
| Rate for Payer: Cofinity Commercial |
$435.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$405.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.60
|
| Rate for Payer: Healthscope Commercial |
$455.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$379.80
|
| Rate for Payer: Mclaren Medicaid |
$89.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.93
|
| Rate for Payer: Meridian Medicaid |
$93.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$430.44
|
| Rate for Payer: Nomi Health Commercial |
$415.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$379.80
|
| Rate for Payer: PACE Senior Care Partners |
$120.27
|
| Rate for Payer: PACE SWMI |
$126.60
|
| Rate for Payer: PHP Commercial |
$430.44
|
| Rate for Payer: PHP Medicare Advantage |
$126.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$440.57
|
| Rate for Payer: Priority Health Medicare |
$127.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$352.45
|
| Rate for Payer: Railroad Medicare Medicare |
$126.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$445.63
|
| Rate for Payer: UHC Core |
$422.84
|
| Rate for Payer: UHC Exchange |
$126.60
|
| Rate for Payer: UHC Medicaid |
$89.28
|
| Rate for Payer: UHC Medicare Advantage |
$126.60
|
| Rate for Payer: UHCCP Medicaid |
$89.28
|
| Rate for Payer: VA VA |
$126.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$379.80
|
|
|
CELECOXIB 200 MG CAPSULE
|
Facility
|
IP
|
$7.63
|
|
|
Service Code
|
NDC 60687044711
|
| Hospital Charge Code |
24501
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.31 |
| Max. Negotiated Rate |
$6.87 |
| Rate for Payer: Aetna Commercial |
$6.49
|
| Rate for Payer: BCBS Trust/PPO |
$6.30
|
| Rate for Payer: BCN Commercial |
$6.30
|
| Rate for Payer: Cash Price |
$6.10
|
| Rate for Payer: Cofinity Commercial |
$6.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.10
|
| Rate for Payer: Healthscope Commercial |
$6.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.49
|
| Rate for Payer: Nomi Health Commercial |
$6.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.72
|
| Rate for Payer: PHP Commercial |
$6.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.71
|
| Rate for Payer: UHC Core |
$6.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.72
|
|
|
CELECOXIB 200 MG CAPSULE
|
Facility
|
IP
|
$506.40
|
|
|
Service Code
|
NDC 00904650361
|
| Hospital Charge Code |
24501
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$352.45 |
| Max. Negotiated Rate |
$455.76 |
| Rate for Payer: Aetna Commercial |
$430.44
|
| Rate for Payer: BCBS Trust/PPO |
$418.24
|
| Rate for Payer: BCN Commercial |
$418.24
|
| Rate for Payer: Cash Price |
$405.12
|
| Rate for Payer: Cofinity Commercial |
$435.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$405.12
|
| Rate for Payer: Healthscope Commercial |
$455.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$379.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$430.44
|
| Rate for Payer: Nomi Health Commercial |
$415.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$379.80
|
| Rate for Payer: PHP Commercial |
$430.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$440.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$352.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$445.63
|
| Rate for Payer: UHC Core |
$422.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$379.80
|
|
|
CELLULITIS AND OTHER SKIN INFECTIONS
|
Facility
|
IP
|
$3,864.92
|
|
|
Service Code
|
APR-DRG 3832
|
| Min. Negotiated Rate |
$3,680.88 |
| Max. Negotiated Rate |
$3,864.92 |
| Rate for Payer: BCBS Complete |
$3,864.92
|
| Rate for Payer: Mclaren Medicaid |
$3,680.88
|
| Rate for Payer: Meridian Medicaid |
$3,864.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,680.88
|
| Rate for Payer: UHC Medicaid |
$3,680.88
|
| Rate for Payer: UHCCP Medicaid |
$3,680.88
|
|
