|
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
|
OP
|
$334.40
|
|
|
Service Code
|
NDC 00904733761
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$58.95 |
| Max. Negotiated Rate |
$300.96 |
| Rate for Payer: Aetna Commercial |
$284.24
|
| Rate for Payer: Aetna Medicare |
$86.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.50
|
| Rate for Payer: BCBS Complete |
$61.90
|
| Rate for Payer: BCBS MAPPO |
$83.60
|
| Rate for Payer: BCBS Trust/PPO |
$274.91
|
| Rate for Payer: BCN Commercial |
$274.91
|
| Rate for Payer: BCN Medicare Advantage |
$83.60
|
| Rate for Payer: Cash Price |
$267.52
|
| Rate for Payer: Cofinity Commercial |
$287.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.60
|
| Rate for Payer: Healthscope Commercial |
$300.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.80
|
| Rate for Payer: Mclaren Medicaid |
$58.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.78
|
| Rate for Payer: Meridian Medicaid |
$61.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$91.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$284.24
|
| Rate for Payer: Nomi Health Commercial |
$274.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$250.80
|
| Rate for Payer: PACE Senior Care Partners |
$79.42
|
| Rate for Payer: PACE SWMI |
$83.60
|
| Rate for Payer: PHP Commercial |
$284.24
|
| Rate for Payer: PHP Medicare Advantage |
$83.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$290.93
|
| Rate for Payer: Priority Health Medicare |
$84.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.74
|
| Rate for Payer: Railroad Medicare Medicare |
$83.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$294.27
|
| Rate for Payer: UHC Core |
$279.22
|
| Rate for Payer: UHC Exchange |
$83.60
|
| Rate for Payer: UHC Medicaid |
$58.95
|
| Rate for Payer: UHC Medicare Advantage |
$83.60
|
| Rate for Payer: UHCCP Medicaid |
$58.95
|
| Rate for Payer: VA VA |
$83.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.80
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
OP
|
$368.60
|
|
|
Service Code
|
NDC 60687016301
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$64.98 |
| Max. Negotiated Rate |
$331.74 |
| Rate for Payer: Aetna Commercial |
$313.31
|
| Rate for Payer: Aetna Medicare |
$95.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.19
|
| Rate for Payer: BCBS Complete |
$68.23
|
| Rate for Payer: BCBS MAPPO |
$92.15
|
| Rate for Payer: BCBS Trust/PPO |
$303.03
|
| Rate for Payer: BCN Commercial |
$303.03
|
| Rate for Payer: BCN Medicare Advantage |
$92.15
|
| 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: Health Alliance Plan Medicare Advantage |
$92.15
|
| Rate for Payer: Healthscope Commercial |
$331.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.45
|
| Rate for Payer: Mclaren Medicaid |
$64.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.76
|
| Rate for Payer: Meridian Medicaid |
$68.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$101.36
|
| 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: PACE Senior Care Partners |
$87.54
|
| Rate for Payer: PACE SWMI |
$92.15
|
| Rate for Payer: PHP Commercial |
$313.31
|
| Rate for Payer: PHP Medicare Advantage |
$92.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$320.68
|
| Rate for Payer: Priority Health Medicare |
$93.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.55
|
| Rate for Payer: Railroad Medicare Medicare |
$92.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.37
|
| Rate for Payer: UHC Core |
$307.78
|
| Rate for Payer: UHC Exchange |
$92.15
|
| Rate for Payer: UHC Medicaid |
$64.98
|
| Rate for Payer: UHC Medicare Advantage |
$92.15
|
| Rate for Payer: UHCCP Medicaid |
$64.98
|
| Rate for Payer: VA VA |
$92.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.45
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
OP
|
$2.34
|
|
|
Service Code
|
NDC 00904733735
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.41 |
| Max. Negotiated Rate |
$2.11 |
| Rate for Payer: Aetna Commercial |
$1.99
|
| Rate for Payer: Aetna Medicare |
$0.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: BCBS Complete |
$0.43
|
| Rate for Payer: BCBS MAPPO |
$0.59
|
| Rate for Payer: BCBS Trust/PPO |
$1.92
|
| Rate for Payer: BCN Commercial |
$1.92
|
| Rate for Payer: BCN Medicare Advantage |
$0.59
|
| 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: Health Alliance Plan Medicare Advantage |
$0.59
|
| Rate for Payer: Healthscope Commercial |
$2.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.75
|
| Rate for Payer: Mclaren Medicaid |
$0.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Medicaid |
$0.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.64
|
| 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: PACE Senior Care Partners |
$0.56
|
| Rate for Payer: PACE SWMI |
$0.59
|
| Rate for Payer: PHP Commercial |
$1.99
|
| Rate for Payer: PHP Medicare Advantage |
$0.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.04
|
| Rate for Payer: Priority Health Medicare |
$0.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.63
|
| Rate for Payer: Railroad Medicare Medicare |
$0.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.06
|
| Rate for Payer: UHC Core |
$1.95
|
| Rate for Payer: UHC Exchange |
$0.59
|
| Rate for Payer: UHC Medicaid |
$0.41
|
| Rate for Payer: UHC Medicare Advantage |
$0.59
|
| Rate for Payer: UHCCP Medicaid |
$0.41
|
| Rate for Payer: VA VA |
$0.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.75
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
OP
|
$336.05
|
|
|
Service Code
|
NDC 67877021901
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$59.25 |
| Max. Negotiated Rate |
$302.44 |
| Rate for Payer: Aetna Commercial |
$285.64
|
| Rate for Payer: Aetna Medicare |
$87.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$105.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$105.02
|
| Rate for Payer: BCBS Complete |
$62.20
|
| Rate for Payer: BCBS MAPPO |
$84.01
|
| Rate for Payer: BCBS Trust/PPO |
$276.27
|
| Rate for Payer: BCN Commercial |
$276.27
|
| Rate for Payer: BCN Medicare Advantage |
$84.01
|
| Rate for Payer: Cash Price |
$268.84
|
| Rate for Payer: Cofinity Commercial |
$289.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.01
|
| Rate for Payer: Healthscope Commercial |
$302.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$252.04
|
| Rate for Payer: Mclaren Medicaid |
$59.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.21
|
| Rate for Payer: Meridian Medicaid |
$62.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.64
|
| Rate for Payer: Nomi Health Commercial |
$275.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.04
|
| Rate for Payer: PACE Senior Care Partners |
$79.81
|
| Rate for Payer: PACE SWMI |
$84.01
|
| Rate for Payer: PHP Commercial |
$285.64
|
| Rate for Payer: PHP Medicare Advantage |
$84.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$292.36
|
| Rate for Payer: Priority Health Medicare |
$84.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.89
|
| Rate for Payer: Railroad Medicare Medicare |
$84.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.72
|
| Rate for Payer: UHC Core |
$280.60
|
| Rate for Payer: UHC Exchange |
$84.01
|
| Rate for Payer: UHC Medicaid |
$59.25
|
| Rate for Payer: UHC Medicare Advantage |
$84.01
|
| Rate for Payer: UHCCP Medicaid |
$59.25
|
| Rate for Payer: VA VA |
$84.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$252.04
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
OP
|
$2.59
|
|
|
Service Code
|
NDC 50268015211
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.46 |
| Max. Negotiated Rate |
$2.33 |
| Rate for Payer: Aetna Commercial |
$2.20
|
| Rate for Payer: Aetna Medicare |
$0.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.81
|
| Rate for Payer: BCBS Complete |
$0.48
|
| Rate for Payer: BCBS MAPPO |
$0.65
|
| Rate for Payer: BCBS Trust/PPO |
$2.13
|
| Rate for Payer: BCN Commercial |
$2.13
|
| Rate for Payer: BCN Medicare Advantage |
$0.65
|
| Rate for Payer: Cash Price |
$2.07
|
| Rate for Payer: Cofinity Commercial |
$2.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.65
|
| Rate for Payer: Healthscope Commercial |
$2.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.94
|
| Rate for Payer: Mclaren Medicaid |
$0.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.68
|
| Rate for Payer: Meridian Medicaid |
$0.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.20
|
| Rate for Payer: Nomi Health Commercial |
$2.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.94
|
| Rate for Payer: PACE Senior Care Partners |
$0.62
|
| Rate for Payer: PACE SWMI |
$0.65
|
| Rate for Payer: PHP Commercial |
$2.20
|
| Rate for Payer: PHP Medicare Advantage |
$0.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.25
|
| Rate for Payer: Priority Health Medicare |
$0.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.80
|
| Rate for Payer: Railroad Medicare Medicare |
$0.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.28
|
| Rate for Payer: UHC Core |
$2.16
|
| Rate for Payer: UHC Exchange |
$0.65
|
| Rate for Payer: UHC Medicaid |
$0.46
|
| Rate for Payer: UHC Medicare Advantage |
$0.65
|
| Rate for Payer: UHCCP Medicaid |
$0.46
|
| Rate for Payer: VA VA |
$0.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.94
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
IP
|
$3.69
|
|
|
Service Code
|
NDC 60687016311
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$3.32 |
| Rate for Payer: Aetna Commercial |
$3.14
|
| Rate for Payer: BCBS Trust/PPO |
$3.05
|
| Rate for Payer: BCN Commercial |
$3.05
|
| Rate for Payer: Cash Price |
$2.95
|
| Rate for Payer: Cofinity Commercial |
$3.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.95
|
| Rate for Payer: Healthscope Commercial |
$3.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.14
|
| Rate for Payer: Nomi Health Commercial |
$3.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.77
|
| Rate for Payer: PHP Commercial |
$3.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.25
|
| Rate for Payer: UHC Core |
$3.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.77
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
IP
|
$129.20
|
|
|
Service Code
|
NDC 50268015215
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$89.92 |
| Max. Negotiated Rate |
$116.28 |
| Rate for Payer: Aetna Commercial |
$109.82
|
| Rate for Payer: BCBS Trust/PPO |
$106.71
|
| Rate for Payer: BCN Commercial |
$106.71
|
| Rate for Payer: Cash Price |
$103.36
|
| Rate for Payer: Cofinity Commercial |
$111.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.36
|
| Rate for Payer: Healthscope Commercial |
$116.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.82
|
| Rate for Payer: Nomi Health Commercial |
$105.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.90
|
| Rate for Payer: PHP Commercial |
$109.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$112.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.70
|
| Rate for Payer: UHC Core |
$107.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.90
|
|
|
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
|
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
|
$336.05
|
|
|
Service Code
|
NDC 67877021901
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$233.89 |
| Max. Negotiated Rate |
$302.44 |
| Rate for Payer: Aetna Commercial |
$285.64
|
| Rate for Payer: BCBS Trust/PPO |
$277.54
|
| Rate for Payer: BCN Commercial |
$277.54
|
| Rate for Payer: Cash Price |
$268.84
|
| Rate for Payer: Cofinity Commercial |
$289.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.84
|
| Rate for Payer: Healthscope Commercial |
$302.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$252.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.64
|
| Rate for Payer: Nomi Health Commercial |
$275.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.04
|
| Rate for Payer: PHP Commercial |
$285.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$292.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.72
|
| Rate for Payer: UHC Core |
$280.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$252.04
|
|
|
CEPHALEXIN 500 MG CAPSULE
|
Facility
|
OP
|
$3.69
|
|
|
Service Code
|
NDC 60687016311
|
| Hospital Charge Code |
9500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.65 |
| Max. Negotiated Rate |
$3.32 |
| Rate for Payer: Aetna Commercial |
$3.14
|
| Rate for Payer: Aetna Medicare |
$0.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.15
|
| Rate for Payer: BCBS Complete |
$0.68
|
| Rate for Payer: BCBS MAPPO |
$0.92
|
| Rate for Payer: BCBS Trust/PPO |
$3.03
|
| Rate for Payer: BCN Commercial |
$3.03
|
| Rate for Payer: BCN Medicare Advantage |
$0.92
|
| Rate for Payer: Cash Price |
$2.95
|
| Rate for Payer: Cofinity Commercial |
$3.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.92
|
| Rate for Payer: Healthscope Commercial |
$3.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.77
|
| Rate for Payer: Mclaren Medicaid |
$0.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.97
|
| Rate for Payer: Meridian Medicaid |
$0.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.14
|
| Rate for Payer: Nomi Health Commercial |
$3.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.77
|
| Rate for Payer: PACE Senior Care Partners |
$0.88
|
| Rate for Payer: PACE SWMI |
$0.92
|
| Rate for Payer: PHP Commercial |
$3.14
|
| Rate for Payer: PHP Medicare Advantage |
$0.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.21
|
| Rate for Payer: Priority Health Medicare |
$0.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.57
|
| Rate for Payer: Railroad Medicare Medicare |
$0.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.25
|
| Rate for Payer: UHC Core |
$3.08
|
| Rate for Payer: UHC Exchange |
$0.92
|
| Rate for Payer: UHC Medicaid |
$0.65
|
| Rate for Payer: UHC Medicare Advantage |
$0.92
|
| Rate for Payer: UHCCP Medicaid |
$0.65
|
| Rate for Payer: VA VA |
$0.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.77
|
|
|
CESAREAN SECTION WITHOUT STERILIZATION
|
Facility
|
IP
|
$5,405.64
|
|
|
Service Code
|
APR-DRG 5402
|
| Min. Negotiated Rate |
$5,148.22 |
| Max. Negotiated Rate |
$5,405.64 |
| Rate for Payer: BCBS Complete |
$5,405.64
|
| Rate for Payer: Mclaren Medicaid |
$5,148.22
|
| Rate for Payer: Meridian Medicaid |
$5,405.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,148.22
|
| Rate for Payer: UHC Medicaid |
$5,148.22
|
| Rate for Payer: UHCCP Medicaid |
$5,148.22
|
|
|
CESAREAN SECTION WITHOUT STERILIZATION
|
Facility
|
IP
|
$15,702.11
|
|
|
Service Code
|
APR-DRG 5404
|
| Min. Negotiated Rate |
$14,954.39 |
| Max. Negotiated Rate |
$15,702.11 |
| Rate for Payer: BCBS Complete |
$15,702.11
|
| Rate for Payer: Mclaren Medicaid |
$14,954.39
|
| Rate for Payer: Meridian Medicaid |
$15,702.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,954.39
|
| Rate for Payer: UHC Medicaid |
$14,954.39
|
| Rate for Payer: UHCCP Medicaid |
$14,954.39
|
|
|
CESAREAN SECTION WITHOUT STERILIZATION
|
Facility
|
IP
|
$4,185.16
|
|
|
Service Code
|
APR-DRG 5401
|
| Min. Negotiated Rate |
$3,985.87 |
| Max. Negotiated Rate |
$4,185.16 |
| Rate for Payer: BCBS Complete |
$4,185.16
|
| Rate for Payer: Mclaren Medicaid |
$3,985.87
|
| Rate for Payer: Meridian Medicaid |
$4,185.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,985.87
|
| Rate for Payer: UHC Medicaid |
$3,985.87
|
| Rate for Payer: UHCCP Medicaid |
$3,985.87
|
|
|
CESAREAN SECTION WITHOUT STERILIZATION
|
Facility
|
IP
|
$6,453.63
|
|
|
Service Code
|
APR-DRG 5403
|
| Min. Negotiated Rate |
$6,146.32 |
| Max. Negotiated Rate |
$6,453.63 |
| Rate for Payer: BCBS Complete |
$6,453.63
|
| Rate for Payer: Mclaren Medicaid |
$6,146.32
|
| Rate for Payer: Meridian Medicaid |
$6,453.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,146.32
|
| Rate for Payer: UHC Medicaid |
$6,146.32
|
| Rate for Payer: UHCCP Medicaid |
$6,146.32
|
|
|
CESAREAN SECTION WITH STERILIZATION
|
Facility
|
IP
|
$14,422.21
|
|
|
Service Code
|
APR-DRG 5394
|
| Min. Negotiated Rate |
$13,735.44 |
| Max. Negotiated Rate |
$14,422.21 |
| Rate for Payer: BCBS Complete |
$14,422.21
|
| Rate for Payer: Mclaren Medicaid |
$13,735.44
|
| Rate for Payer: Meridian Medicaid |
$14,422.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,735.44
|
| Rate for Payer: UHC Medicaid |
$13,735.44
|
| Rate for Payer: UHCCP Medicaid |
$13,735.44
|
|
|
CESAREAN SECTION WITH STERILIZATION
|
Facility
|
IP
|
$2,674.42
|
|
|
Service Code
|
APR-DRG 5391
|
| Min. Negotiated Rate |
$2,547.07 |
| Max. Negotiated Rate |
$2,674.42 |
| Rate for Payer: BCBS Complete |
$2,674.42
|
| Rate for Payer: Mclaren Medicaid |
$2,547.07
|
| Rate for Payer: Meridian Medicaid |
$2,674.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,547.07
|
| Rate for Payer: UHC Medicaid |
$2,547.07
|
| Rate for Payer: UHCCP Medicaid |
$2,547.07
|
|
|
CESAREAN SECTION WITH STERILIZATION
|
Facility
|
IP
|
$3,487.90
|
|
|
Service Code
|
APR-DRG 5392
|
| Min. Negotiated Rate |
$3,321.81 |
| Max. Negotiated Rate |
$3,487.90 |
| Rate for Payer: BCBS Complete |
$3,487.90
|
| Rate for Payer: Mclaren Medicaid |
$3,321.81
|
| Rate for Payer: Meridian Medicaid |
$3,487.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,321.81
|
| Rate for Payer: UHC Medicaid |
$3,321.81
|
| Rate for Payer: UHCCP Medicaid |
$3,321.81
|
|
|
CESAREAN SECTION WITH STERILIZATION
|
Facility
|
IP
|
$6,727.07
|
|
|
Service Code
|
APR-DRG 5393
|
| Min. Negotiated Rate |
$6,406.73 |
| Max. Negotiated Rate |
$6,727.07 |
| Rate for Payer: BCBS Complete |
$6,727.07
|
| Rate for Payer: Mclaren Medicaid |
$6,406.73
|
| Rate for Payer: Meridian Medicaid |
$6,727.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,406.73
|
| Rate for Payer: UHC Medicaid |
$6,406.73
|
| Rate for Payer: UHCCP Medicaid |
$6,406.73
|
|
|
CHEMICAL PEELS
|
Professional
|
Both
|
$79.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Aetna Medicare |
$39.50
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.25
|
|
|
CHEMOTHERAPY FOR ACUTE LEUKEMIA
|
Facility
|
IP
|
$14,467.96
|
|
|
Service Code
|
APR-DRG 6953
|
| Min. Negotiated Rate |
$13,779.01 |
| Max. Negotiated Rate |
$14,467.96 |
| Rate for Payer: BCBS Complete |
$14,467.96
|
| Rate for Payer: Mclaren Medicaid |
$13,779.01
|
| Rate for Payer: Meridian Medicaid |
$14,467.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,779.01
|
| Rate for Payer: UHC Medicaid |
$13,779.01
|
| Rate for Payer: UHCCP Medicaid |
$13,779.01
|
|
|
CHEMOTHERAPY FOR ACUTE LEUKEMIA
|
Facility
|
IP
|
$31,739.70
|
|
|
Service Code
|
APR-DRG 6954
|
| Min. Negotiated Rate |
$30,228.29 |
| Max. Negotiated Rate |
$31,739.70 |
| Rate for Payer: BCBS Complete |
$31,739.70
|
| Rate for Payer: Mclaren Medicaid |
$30,228.29
|
| Rate for Payer: Meridian Medicaid |
$31,739.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$30,228.29
|
| Rate for Payer: UHC Medicaid |
$30,228.29
|
| Rate for Payer: UHCCP Medicaid |
$30,228.29
|
|
|
CHEMOTHERAPY FOR ACUTE LEUKEMIA
|
Facility
|
IP
|
$6,031.38
|
|
|
Service Code
|
APR-DRG 6952
|
| Min. Negotiated Rate |
$5,744.18 |
| Max. Negotiated Rate |
$6,031.38 |
| Rate for Payer: BCBS Complete |
$6,031.38
|
| Rate for Payer: Mclaren Medicaid |
$5,744.18
|
| Rate for Payer: Meridian Medicaid |
$6,031.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,744.18
|
| Rate for Payer: UHC Medicaid |
$5,744.18
|
| Rate for Payer: UHCCP Medicaid |
$5,744.18
|
|
|
CHEMOTHERAPY FOR ACUTE LEUKEMIA
|
Facility
|
IP
|
$4,692.07
|
|
|
Service Code
|
APR-DRG 6951
|
| Min. Negotiated Rate |
$4,468.64 |
| Max. Negotiated Rate |
$4,692.07 |
| Rate for Payer: BCBS Complete |
$4,692.07
|
| Rate for Payer: Mclaren Medicaid |
$4,468.64
|
| Rate for Payer: Meridian Medicaid |
$4,692.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,468.64
|
| Rate for Payer: UHC Medicaid |
$4,468.64
|
| Rate for Payer: UHCCP Medicaid |
$4,468.64
|
|
