|
CELLULITIS AND OTHER SKIN INFECTIONS
|
Facility
|
IP
|
$5,768.46
|
|
|
Service Code
|
APR-DRG 3833
|
| Min. Negotiated Rate |
$5,493.78 |
| Max. Negotiated Rate |
$5,768.46 |
| Rate for Payer: BCBS Complete |
$5,768.46
|
| Rate for Payer: Mclaren Medicaid |
$5,493.78
|
| Rate for Payer: Meridian Medicaid |
$5,768.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,493.78
|
| Rate for Payer: UHC Medicaid |
$5,493.78
|
| Rate for Payer: UHCCP Medicaid |
$5,493.78
|
|
|
CELLULITIS AND OTHER SKIN INFECTIONS
|
Facility
|
IP
|
$8,742.09
|
|
|
Service Code
|
APR-DRG 3834
|
| Min. Negotiated Rate |
$8,325.80 |
| Max. Negotiated Rate |
$8,742.09 |
| Rate for Payer: BCBS Complete |
$8,742.09
|
| Rate for Payer: Mclaren Medicaid |
$8,325.80
|
| Rate for Payer: Meridian Medicaid |
$8,742.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,325.80
|
| Rate for Payer: UHC Medicaid |
$8,325.80
|
| Rate for Payer: UHCCP Medicaid |
$8,325.80
|
|
|
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
|
|
|
CELLULOSE, OXIDIZED 2" X 3" MISC
|
Facility
|
IP
|
$159.91
|
|
|
Service Code
|
NDC 09900000603
|
| Hospital Charge Code |
169203
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$111.30 |
| Max. Negotiated Rate |
$143.92 |
| Rate for Payer: Aetna Commercial |
$135.92
|
| Rate for Payer: BCBS Trust/PPO |
$132.07
|
| Rate for Payer: BCN Commercial |
$132.07
|
| Rate for Payer: Cash Price |
$127.93
|
| Rate for Payer: Cofinity Commercial |
$137.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.93
|
| Rate for Payer: Healthscope Commercial |
$143.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.92
|
| Rate for Payer: Nomi Health Commercial |
$131.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.93
|
| Rate for Payer: PHP Commercial |
$135.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.72
|
| Rate for Payer: UHC Core |
$133.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.93
|
|
|
CELLULOSE, OXIDIZED 2" X 3" MISC
|
Facility
|
OP
|
$159.91
|
|
|
Service Code
|
NDC 09900000603
|
| Hospital Charge Code |
169203
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$28.19 |
| Max. Negotiated Rate |
$143.92 |
| Rate for Payer: Aetna Commercial |
$135.92
|
| Rate for Payer: Aetna Medicare |
$41.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.97
|
| Rate for Payer: BCBS Complete |
$29.60
|
| Rate for Payer: BCBS MAPPO |
$39.98
|
| Rate for Payer: BCBS Trust/PPO |
$131.46
|
| Rate for Payer: BCN Commercial |
$131.46
|
| Rate for Payer: BCN Medicare Advantage |
$39.98
|
| Rate for Payer: Cash Price |
$127.93
|
| Rate for Payer: Cofinity Commercial |
$137.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$143.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.93
|
| Rate for Payer: Mclaren Medicaid |
$28.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.98
|
| Rate for Payer: Meridian Medicaid |
$29.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.92
|
| Rate for Payer: Nomi Health Commercial |
$131.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.93
|
| Rate for Payer: PACE Senior Care Partners |
$37.98
|
| Rate for Payer: PACE SWMI |
$39.98
|
| Rate for Payer: PHP Commercial |
$135.92
|
| Rate for Payer: PHP Medicare Advantage |
$39.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.12
|
| Rate for Payer: Priority Health Medicare |
$40.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.30
|
| Rate for Payer: Railroad Medicare Medicare |
$39.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.72
|
| Rate for Payer: UHC Core |
$133.52
|
| Rate for Payer: UHC Exchange |
$39.98
|
| Rate for Payer: UHC Medicaid |
$28.19
|
| Rate for Payer: UHC Medicare Advantage |
$39.98
|
| Rate for Payer: UHCCP Medicaid |
$28.19
|
| Rate for Payer: VA VA |
$39.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.93
|
|
|
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$354.85
|
|
|
Service Code
|
NDC 68180044101
|
| Hospital Charge Code |
9502
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$246.98 |
| Max. Negotiated Rate |
$319.37 |
| Rate for Payer: Aetna Commercial |
$301.62
|
| Rate for Payer: BCBS Trust/PPO |
$293.07
|
| Rate for Payer: BCN Commercial |
$293.07
|
| Rate for Payer: Cash Price |
$283.88
|
| Rate for Payer: Cofinity Commercial |
$305.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.88
|
| Rate for Payer: Healthscope Commercial |
$319.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.62
|
| Rate for Payer: Nomi Health Commercial |
$290.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$266.14
|
| Rate for Payer: PHP Commercial |
$301.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$308.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.27
|
| Rate for Payer: UHC Core |
$296.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.14
|
|
|
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$354.85
|
|
|
Service Code
|
NDC 68180044101
|
| Hospital Charge Code |
9502
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$62.56 |
| Max. Negotiated Rate |
$319.37 |
| Rate for Payer: Aetna Commercial |
$301.62
|
| Rate for Payer: Aetna Medicare |
$92.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$110.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$110.89
|
| Rate for Payer: BCBS Complete |
$65.68
|
| Rate for Payer: BCBS MAPPO |
$88.71
|
| Rate for Payer: BCBS Trust/PPO |
$291.72
|
| Rate for Payer: BCN Commercial |
$291.72
|
| Rate for Payer: BCN Medicare Advantage |
$88.71
|
| Rate for Payer: Cash Price |
$283.88
|
| Rate for Payer: Cofinity Commercial |
$305.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.71
|
| Rate for Payer: Healthscope Commercial |
$319.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.14
|
| Rate for Payer: Mclaren Medicaid |
$62.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.15
|
| Rate for Payer: Meridian Medicaid |
$65.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$97.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.62
|
| Rate for Payer: Nomi Health Commercial |
$290.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$266.14
|
| Rate for Payer: PACE Senior Care Partners |
$84.28
|
| Rate for Payer: PACE SWMI |
$88.71
|
| Rate for Payer: PHP Commercial |
$301.62
|
| Rate for Payer: PHP Medicare Advantage |
$88.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$308.72
|
| Rate for Payer: Priority Health Medicare |
$89.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.98
|
| Rate for Payer: Railroad Medicare Medicare |
$88.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.27
|
| Rate for Payer: UHC Core |
$296.30
|
| Rate for Payer: UHC Exchange |
$88.71
|
| Rate for Payer: UHC Medicaid |
$62.56
|
| Rate for Payer: UHC Medicare Advantage |
$88.71
|
| Rate for Payer: UHCCP Medicaid |
$62.56
|
| Rate for Payer: VA VA |
$88.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.14
|
|
|
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$282.00
|
|
|
Service Code
|
NDC 67877054588
|
| Hospital Charge Code |
9502
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$196.27 |
| Max. Negotiated Rate |
$253.80 |
| Rate for Payer: Aetna Commercial |
$239.70
|
| Rate for Payer: BCBS Trust/PPO |
$232.90
|
| Rate for Payer: BCN Commercial |
$232.90
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$242.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.60
|
| Rate for Payer: Healthscope Commercial |
$253.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.70
|
| Rate for Payer: Nomi Health Commercial |
$231.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.50
|
| Rate for Payer: PHP Commercial |
$239.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$245.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.16
|
| Rate for Payer: UHC Core |
$235.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.50
|
|
|
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$203.30
|
|
|
Service Code
|
NDC 00093417773
|
| Hospital Charge Code |
9502
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$35.84 |
| Max. Negotiated Rate |
$182.97 |
| Rate for Payer: Aetna Commercial |
$172.81
|
| Rate for Payer: Aetna Medicare |
$52.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.53
|
| Rate for Payer: BCBS Complete |
$37.63
|
| Rate for Payer: BCBS MAPPO |
$50.83
|
| Rate for Payer: BCBS Trust/PPO |
$167.13
|
| Rate for Payer: BCN Commercial |
$167.13
|
| Rate for Payer: BCN Medicare Advantage |
$50.83
|
| Rate for Payer: Cash Price |
$162.64
|
| Rate for Payer: Cofinity Commercial |
$174.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.83
|
| Rate for Payer: Healthscope Commercial |
$182.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.47
|
| Rate for Payer: Mclaren Medicaid |
$35.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.37
|
| Rate for Payer: Meridian Medicaid |
$37.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.81
|
| Rate for Payer: Nomi Health Commercial |
$166.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.47
|
| Rate for Payer: PACE Senior Care Partners |
$48.28
|
| Rate for Payer: PACE SWMI |
$50.83
|
| Rate for Payer: PHP Commercial |
$172.81
|
| Rate for Payer: PHP Medicare Advantage |
$50.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$176.87
|
| Rate for Payer: Priority Health Medicare |
$51.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.50
|
| Rate for Payer: Railroad Medicare Medicare |
$50.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.90
|
| Rate for Payer: UHC Core |
$169.76
|
| Rate for Payer: UHC Exchange |
$50.83
|
| Rate for Payer: UHC Medicaid |
$35.84
|
| Rate for Payer: UHC Medicare Advantage |
$50.83
|
| Rate for Payer: UHCCP Medicaid |
$35.84
|
| Rate for Payer: VA VA |
$50.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.47
|
|
|
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$203.30
|
|
|
Service Code
|
NDC 00093417773
|
| Hospital Charge Code |
9502
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$141.50 |
| Max. Negotiated Rate |
$182.97 |
| Rate for Payer: Aetna Commercial |
$172.81
|
| Rate for Payer: BCBS Trust/PPO |
$167.91
|
| Rate for Payer: BCN Commercial |
$167.91
|
| Rate for Payer: Cash Price |
$162.64
|
| Rate for Payer: Cofinity Commercial |
$174.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.64
|
| Rate for Payer: Healthscope Commercial |
$182.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.81
|
| Rate for Payer: Nomi Health Commercial |
$166.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.47
|
| Rate for Payer: PHP Commercial |
$172.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$176.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.90
|
| Rate for Payer: UHC Core |
$169.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.47
|
|
|
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$282.00
|
|
|
Service Code
|
NDC 67877054588
|
| Hospital Charge Code |
9502
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.72 |
| Max. Negotiated Rate |
$253.80 |
| Rate for Payer: Aetna Commercial |
$239.70
|
| Rate for Payer: Aetna Medicare |
$73.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.12
|
| Rate for Payer: BCBS Complete |
$52.20
|
| Rate for Payer: BCBS MAPPO |
$70.50
|
| Rate for Payer: BCBS Trust/PPO |
$231.83
|
| Rate for Payer: BCN Commercial |
$231.83
|
| Rate for Payer: BCN Medicare Advantage |
$70.50
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$242.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.50
|
| Rate for Payer: Healthscope Commercial |
$253.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.50
|
| Rate for Payer: Mclaren Medicaid |
$49.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.03
|
| Rate for Payer: Meridian Medicaid |
$52.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.70
|
| Rate for Payer: Nomi Health Commercial |
$231.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.50
|
| Rate for Payer: PACE Senior Care Partners |
$66.97
|
| Rate for Payer: PACE SWMI |
$70.50
|
| Rate for Payer: PHP Commercial |
$239.70
|
| Rate for Payer: PHP Medicare Advantage |
$70.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$245.34
|
| Rate for Payer: Priority Health Medicare |
$71.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.27
|
| Rate for Payer: Railroad Medicare Medicare |
$70.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.16
|
| Rate for Payer: UHC Core |
$235.47
|
| Rate for Payer: UHC Exchange |
$70.50
|
| Rate for Payer: UHC Medicaid |
$49.72
|
| Rate for Payer: UHC Medicare Advantage |
$70.50
|
| Rate for Payer: UHCCP Medicaid |
$49.72
|
| Rate for Payer: VA VA |
$70.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.50
|
|
|
CEPHALEXIN 250 MG CAPSULE
|
Facility
|
OP
|
$262.20
|
|
|
Service Code
|
NDC 00904733661
|
| Hospital Charge Code |
9499
|
|
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
|
|
|
CEPHALEXIN 250 MG CAPSULE
|
Facility
|
OP
|
$289.05
|
|
|
Service Code
|
NDC 00093314501
|
| Hospital Charge Code |
9499
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$50.96 |
| Max. Negotiated Rate |
$260.14 |
| Rate for Payer: Aetna Commercial |
$245.69
|
| Rate for Payer: Aetna Medicare |
$75.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$90.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$90.33
|
| Rate for Payer: BCBS Complete |
$53.50
|
| Rate for Payer: BCBS MAPPO |
$72.26
|
| Rate for Payer: BCBS Trust/PPO |
$237.63
|
| Rate for Payer: BCN Commercial |
$237.63
|
| Rate for Payer: BCN Medicare Advantage |
$72.26
|
| Rate for Payer: Cash Price |
$231.24
|
| Rate for Payer: Cofinity Commercial |
$248.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.26
|
| Rate for Payer: Healthscope Commercial |
$260.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$216.79
|
| Rate for Payer: Mclaren Medicaid |
$50.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.88
|
| Rate for Payer: Meridian Medicaid |
$53.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$79.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.69
|
| Rate for Payer: Nomi Health Commercial |
$237.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.79
|
| Rate for Payer: PACE Senior Care Partners |
$68.65
|
| Rate for Payer: PACE SWMI |
$72.26
|
| Rate for Payer: PHP Commercial |
$245.69
|
| Rate for Payer: PHP Medicare Advantage |
$72.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$251.47
|
| Rate for Payer: Priority Health Medicare |
$72.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.18
|
| Rate for Payer: Railroad Medicare Medicare |
$72.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.36
|
| Rate for Payer: UHC Core |
$241.36
|
| Rate for Payer: UHC Exchange |
$72.26
|
| Rate for Payer: UHC Medicaid |
$50.96
|
| Rate for Payer: UHC Medicare Advantage |
$72.26
|
| Rate for Payer: UHCCP Medicaid |
$50.96
|
| Rate for Payer: VA VA |
$72.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$216.79
|
|
|
CEPHALEXIN 250 MG CAPSULE
|
Facility
|
IP
|
$289.05
|
|
|
Service Code
|
NDC 00093314501
|
| Hospital Charge Code |
9499
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$201.18 |
| Max. Negotiated Rate |
$260.14 |
| Rate for Payer: Aetna Commercial |
$245.69
|
| Rate for Payer: BCBS Trust/PPO |
$238.73
|
| Rate for Payer: BCN Commercial |
$238.73
|
| Rate for Payer: Cash Price |
$231.24
|
| Rate for Payer: Cofinity Commercial |
$248.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.24
|
| Rate for Payer: Healthscope Commercial |
$260.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$216.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.69
|
| Rate for Payer: Nomi Health Commercial |
$237.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.79
|
| Rate for Payer: PHP Commercial |
$245.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$251.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.36
|
| Rate for Payer: UHC Core |
$241.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$216.79
|
|
|
CEPHALEXIN 250 MG CAPSULE
|
Facility
|
IP
|
$286.90
|
|
|
Service Code
|
NDC 60687015201
|
| Hospital Charge Code |
9499
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$199.68 |
| Max. Negotiated Rate |
$258.21 |
| Rate for Payer: Aetna Commercial |
$243.87
|
| Rate for Payer: BCBS Trust/PPO |
$236.95
|
| Rate for Payer: BCN Commercial |
$236.95
|
| Rate for Payer: Cash Price |
$229.52
|
| Rate for Payer: Cofinity Commercial |
$246.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.52
|
| Rate for Payer: Healthscope Commercial |
$258.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.87
|
| Rate for Payer: Nomi Health Commercial |
$235.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.18
|
| Rate for Payer: PHP Commercial |
$243.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.47
|
| Rate for Payer: UHC Core |
$239.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.18
|
|
|
CEPHALEXIN 250 MG CAPSULE
|
Facility
|
OP
|
$286.90
|
|
|
Service Code
|
NDC 60687015201
|
| Hospital Charge Code |
9499
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$50.58 |
| Max. Negotiated Rate |
$258.21 |
| Rate for Payer: Aetna Commercial |
$243.87
|
| Rate for Payer: Aetna Medicare |
$74.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.66
|
| Rate for Payer: BCBS Complete |
$53.11
|
| Rate for Payer: BCBS MAPPO |
$71.72
|
| Rate for Payer: BCBS Trust/PPO |
$235.86
|
| Rate for Payer: BCN Commercial |
$235.86
|
| Rate for Payer: BCN Medicare Advantage |
$71.72
|
| Rate for Payer: Cash Price |
$229.52
|
| Rate for Payer: Cofinity Commercial |
$246.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.72
|
| Rate for Payer: Healthscope Commercial |
$258.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.18
|
| Rate for Payer: Mclaren Medicaid |
$50.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.31
|
| Rate for Payer: Meridian Medicaid |
$53.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.87
|
| Rate for Payer: Nomi Health Commercial |
$235.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.18
|
| Rate for Payer: PACE Senior Care Partners |
$68.14
|
| Rate for Payer: PACE SWMI |
$71.72
|
| Rate for Payer: PHP Commercial |
$243.87
|
| Rate for Payer: PHP Medicare Advantage |
$71.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.60
|
| Rate for Payer: Priority Health Medicare |
$72.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.68
|
| Rate for Payer: Railroad Medicare Medicare |
$71.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.47
|
| Rate for Payer: UHC Core |
$239.56
|
| Rate for Payer: UHC Exchange |
$71.72
|
| Rate for Payer: UHC Medicaid |
$50.58
|
| Rate for Payer: UHC Medicare Advantage |
$71.72
|
| Rate for Payer: UHCCP Medicaid |
$50.58
|
| Rate for Payer: VA VA |
$71.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.18
|
|
|
CEPHALEXIN 250 MG CAPSULE
|
Facility
|
OP
|
$312.55
|
|
|
Service Code
|
NDC 67877022001
|
| Hospital Charge Code |
9499
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$55.10 |
| Max. Negotiated Rate |
$281.30 |
| Rate for Payer: Aetna Commercial |
$265.67
|
| Rate for Payer: Aetna Medicare |
$81.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$97.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$97.67
|
| Rate for Payer: BCBS Complete |
$57.85
|
| Rate for Payer: BCBS MAPPO |
$78.14
|
| Rate for Payer: BCBS Trust/PPO |
$256.95
|
| Rate for Payer: BCN Commercial |
$256.95
|
| Rate for Payer: BCN Medicare Advantage |
$78.14
|
| Rate for Payer: Cash Price |
$250.04
|
| Rate for Payer: Cofinity Commercial |
$268.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.14
|
| Rate for Payer: Healthscope Commercial |
$281.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.41
|
| Rate for Payer: Mclaren Medicaid |
$55.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.04
|
| Rate for Payer: Meridian Medicaid |
$57.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.67
|
| Rate for Payer: Nomi Health Commercial |
$256.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.41
|
| Rate for Payer: PACE Senior Care Partners |
$74.23
|
| Rate for Payer: PACE SWMI |
$78.14
|
| Rate for Payer: PHP Commercial |
$265.67
|
| Rate for Payer: PHP Medicare Advantage |
$78.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$271.92
|
| Rate for Payer: Priority Health Medicare |
$78.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.53
|
| Rate for Payer: Railroad Medicare Medicare |
$78.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.04
|
| Rate for Payer: UHC Core |
$260.98
|
| Rate for Payer: UHC Exchange |
$78.14
|
| Rate for Payer: UHC Medicaid |
$55.10
|
| Rate for Payer: UHC Medicare Advantage |
$78.14
|
| Rate for Payer: UHCCP Medicaid |
$55.10
|
| Rate for Payer: VA VA |
$78.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.41
|
|
|
CEPHALEXIN 250 MG CAPSULE
|
Facility
|
IP
|
$2.87
|
|
|
Service Code
|
NDC 60687015211
|
| Hospital Charge Code |
9499
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$2.58 |
| Rate for Payer: Aetna Commercial |
$2.44
|
| Rate for Payer: BCBS Trust/PPO |
$2.37
|
| Rate for Payer: BCN Commercial |
$2.37
|
| Rate for Payer: Cash Price |
$2.30
|
| Rate for Payer: Cofinity Commercial |
$2.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.30
|
| Rate for Payer: Healthscope Commercial |
$2.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.44
|
| Rate for Payer: Nomi Health Commercial |
$2.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.15
|
| Rate for Payer: PHP Commercial |
$2.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.53
|
| Rate for Payer: UHC Core |
$2.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.15
|
|
|
CEPHALEXIN 250 MG CAPSULE
|
Facility
|
IP
|
$312.55
|
|
|
Service Code
|
NDC 67877022001
|
| Hospital Charge Code |
9499
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$217.53 |
| Max. Negotiated Rate |
$281.30 |
| Rate for Payer: Aetna Commercial |
$265.67
|
| Rate for Payer: BCBS Trust/PPO |
$258.14
|
| Rate for Payer: BCN Commercial |
$258.14
|
| Rate for Payer: Cash Price |
$250.04
|
| Rate for Payer: Cofinity Commercial |
$268.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.04
|
| Rate for Payer: Healthscope Commercial |
$281.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.67
|
| Rate for Payer: Nomi Health Commercial |
$256.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.41
|
| Rate for Payer: PHP Commercial |
$265.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$271.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.04
|
| Rate for Payer: UHC Core |
$260.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.41
|
|
|
CEPHALEXIN 250 MG CAPSULE
|
Facility
|
OP
|
$2.87
|
|
|
Service Code
|
NDC 60687015211
|
| Hospital Charge Code |
9499
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.51 |
| Max. Negotiated Rate |
$2.58 |
| Rate for Payer: Aetna Commercial |
$2.44
|
| Rate for Payer: Aetna Medicare |
$0.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.90
|
| Rate for Payer: BCBS Complete |
$0.53
|
| Rate for Payer: BCBS MAPPO |
$0.72
|
| Rate for Payer: BCBS Trust/PPO |
$2.36
|
| Rate for Payer: BCN Commercial |
$2.36
|
| Rate for Payer: BCN Medicare Advantage |
$0.72
|
| Rate for Payer: Cash Price |
$2.30
|
| Rate for Payer: Cofinity Commercial |
$2.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.72
|
| Rate for Payer: Healthscope Commercial |
$2.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.15
|
| Rate for Payer: Mclaren Medicaid |
$0.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.75
|
| Rate for Payer: Meridian Medicaid |
$0.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.44
|
| Rate for Payer: Nomi Health Commercial |
$2.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.15
|
| Rate for Payer: PACE Senior Care Partners |
$0.68
|
| Rate for Payer: PACE SWMI |
$0.72
|
| Rate for Payer: PHP Commercial |
$2.44
|
| Rate for Payer: PHP Medicare Advantage |
$0.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.50
|
| Rate for Payer: Priority Health Medicare |
$0.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.00
|
| Rate for Payer: Railroad Medicare Medicare |
$0.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.53
|
| Rate for Payer: UHC Core |
$2.40
|
| Rate for Payer: UHC Exchange |
$0.72
|
| Rate for Payer: UHC Medicaid |
$0.51
|
| Rate for Payer: UHC Medicare Advantage |
$0.72
|
| Rate for Payer: UHCCP Medicaid |
$0.51
|
| Rate for Payer: VA VA |
$0.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.15
|
|
|
CEPHALEXIN 250 MG CAPSULE
|
Facility
|
IP
|
$262.20
|
|
|
Service Code
|
NDC 00904733661
|
| Hospital Charge Code |
9499
|
|
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
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
IP
|
$368.60
|
|
|
Service Code
|
NDC 60687016301
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$256.55 |
| Max. Negotiated Rate |
$331.74 |
| Rate for Payer: Aetna Commercial |
$313.31
|
| Rate for Payer: BCBS Trust/PPO |
$304.43
|
| Rate for Payer: BCN Commercial |
$304.43
|
| Rate for Payer: Cash Price |
$294.88
|
| Rate for Payer: Cofinity Commercial |
$317.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.88
|
| Rate for Payer: Healthscope Commercial |
$331.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.31
|
| Rate for Payer: Nomi Health Commercial |
$302.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.45
|
| Rate for Payer: PHP Commercial |
$313.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$320.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.37
|
| Rate for Payer: UHC Core |
$307.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.45
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
IP
|
$192.85
|
|
|
Service Code
|
NDC 00093314701
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$134.22 |
| Max. Negotiated Rate |
$173.56 |
| Rate for Payer: Aetna Commercial |
$163.92
|
| Rate for Payer: BCBS Trust/PPO |
$159.27
|
| Rate for Payer: BCN Commercial |
$159.27
|
| Rate for Payer: Cash Price |
$154.28
|
| Rate for Payer: Cofinity Commercial |
$165.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.28
|
| Rate for Payer: Healthscope Commercial |
$173.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$163.92
|
| Rate for Payer: Nomi Health Commercial |
$158.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$144.64
|
| Rate for Payer: PHP Commercial |
$163.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$167.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.71
|
| Rate for Payer: UHC Core |
$161.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.64
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
IP
|
$2.34
|
|
|
Service Code
|
NDC 00904733735
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.63 |
| Max. Negotiated Rate |
$2.11 |
| Rate for Payer: Aetna Commercial |
$1.99
|
| Rate for Payer: BCBS Trust/PPO |
$1.93
|
| Rate for Payer: BCN Commercial |
$1.93
|
| Rate for Payer: Cash Price |
$1.87
|
| Rate for Payer: Cofinity Commercial |
$2.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.87
|
| Rate for Payer: Healthscope Commercial |
$2.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.99
|
| Rate for Payer: Nomi Health Commercial |
$1.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.75
|
| Rate for Payer: PHP Commercial |
$1.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.06
|
| Rate for Payer: UHC Core |
$1.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.75
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
OP
|
$192.85
|
|
|
Service Code
|
NDC 00093314701
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$173.56 |
| Rate for Payer: Aetna Commercial |
$163.92
|
| Rate for Payer: Aetna Medicare |
$50.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.27
|
| Rate for Payer: BCBS Complete |
$35.70
|
| Rate for Payer: BCBS MAPPO |
$48.21
|
| Rate for Payer: BCBS Trust/PPO |
$158.54
|
| Rate for Payer: BCN Commercial |
$158.54
|
| Rate for Payer: BCN Medicare Advantage |
$48.21
|
| Rate for Payer: Cash Price |
$154.28
|
| Rate for Payer: Cofinity Commercial |
$165.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.21
|
| Rate for Payer: Healthscope Commercial |
$173.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.64
|
| Rate for Payer: Mclaren Medicaid |
$34.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.62
|
| Rate for Payer: Meridian Medicaid |
$35.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$163.92
|
| Rate for Payer: Nomi Health Commercial |
$158.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$144.64
|
| Rate for Payer: PACE Senior Care Partners |
$45.80
|
| Rate for Payer: PACE SWMI |
$48.21
|
| Rate for Payer: PHP Commercial |
$163.92
|
| Rate for Payer: PHP Medicare Advantage |
$48.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$167.78
|
| Rate for Payer: Priority Health Medicare |
$48.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.22
|
| Rate for Payer: Railroad Medicare Medicare |
$48.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.71
|
| Rate for Payer: UHC Core |
$161.03
|
| Rate for Payer: UHC Exchange |
$48.21
|
| Rate for Payer: UHC Medicaid |
$34.00
|
| Rate for Payer: UHC Medicare Advantage |
$48.21
|
| Rate for Payer: UHCCP Medicaid |
$34.00
|
| Rate for Payer: VA VA |
$48.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.64
|
|
