|
HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE
|
Facility
|
IP
|
$9,783.25
|
|
|
Service Code
|
APR-DRG 0553
|
| Min. Negotiated Rate |
$9,317.38 |
| Max. Negotiated Rate |
$9,783.25 |
| Rate for Payer: BCBS Complete |
$9,783.25
|
| Rate for Payer: Mclaren Medicaid |
$9,317.38
|
| Rate for Payer: Meridian Medicaid |
$9,783.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,317.38
|
| Rate for Payer: UHC Medicaid |
$9,317.38
|
| Rate for Payer: UHCCP Medicaid |
$9,317.38
|
|
|
HEARING AID RESTOCKING FEE
|
Professional
|
Both
|
$137.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$54.80 |
| Max. Negotiated Rate |
$102.75 |
| Rate for Payer: Aetna Medicare |
$68.50
|
| Rate for Payer: BCBS Complete |
$54.80
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.75
|
|
|
HEART FAILURE
|
Facility
|
IP
|
$5,456.12
|
|
|
Service Code
|
APR-DRG 1943
|
| Min. Negotiated Rate |
$5,196.30 |
| Max. Negotiated Rate |
$5,456.12 |
| Rate for Payer: BCBS Complete |
$5,456.12
|
| Rate for Payer: Mclaren Medicaid |
$5,196.30
|
| Rate for Payer: Meridian Medicaid |
$5,456.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,196.30
|
| Rate for Payer: UHC Medicaid |
$5,196.30
|
| Rate for Payer: UHCCP Medicaid |
$5,196.30
|
|
|
HEART FAILURE
|
Facility
|
IP
|
$4,022.15
|
|
|
Service Code
|
APR-DRG 1942
|
| Min. Negotiated Rate |
$3,830.62 |
| Max. Negotiated Rate |
$4,022.15 |
| Rate for Payer: BCBS Complete |
$4,022.15
|
| Rate for Payer: Mclaren Medicaid |
$3,830.62
|
| Rate for Payer: Meridian Medicaid |
$4,022.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,830.62
|
| Rate for Payer: UHC Medicaid |
$3,830.62
|
| Rate for Payer: UHCCP Medicaid |
$3,830.62
|
|
|
HEART FAILURE
|
Facility
|
IP
|
$12,778.44
|
|
|
Service Code
|
APR-DRG 1944
|
| Min. Negotiated Rate |
$12,169.94 |
| Max. Negotiated Rate |
$12,778.44 |
| Rate for Payer: BCBS Complete |
$12,778.44
|
| Rate for Payer: Mclaren Medicaid |
$12,169.94
|
| Rate for Payer: Meridian Medicaid |
$12,778.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,169.94
|
| Rate for Payer: UHC Medicaid |
$12,169.94
|
| Rate for Payer: UHCCP Medicaid |
$12,169.94
|
|
|
HEART FAILURE
|
Facility
|
IP
|
$2,966.79
|
|
|
Service Code
|
APR-DRG 1941
|
| Min. Negotiated Rate |
$2,825.51 |
| Max. Negotiated Rate |
$2,966.79 |
| Rate for Payer: BCBS Complete |
$2,966.79
|
| Rate for Payer: Mclaren Medicaid |
$2,825.51
|
| Rate for Payer: Meridian Medicaid |
$2,966.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.51
|
| Rate for Payer: UHC Medicaid |
$2,825.51
|
| Rate for Payer: UHCCP Medicaid |
$2,825.51
|
|
|
HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION
|
Facility
|
IP
|
$3,054.60
|
|
|
Service Code
|
APR-DRG 8101
|
| Min. Negotiated Rate |
$2,909.15 |
| Max. Negotiated Rate |
$3,054.60 |
| Rate for Payer: BCBS Complete |
$3,054.60
|
| Rate for Payer: Mclaren Medicaid |
$2,909.15
|
| Rate for Payer: Meridian Medicaid |
$3,054.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,909.15
|
| Rate for Payer: UHC Medicaid |
$2,909.15
|
| Rate for Payer: UHCCP Medicaid |
$2,909.15
|
|
|
HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION
|
Facility
|
IP
|
$4,249.31
|
|
|
Service Code
|
APR-DRG 8102
|
| Min. Negotiated Rate |
$4,046.96 |
| Max. Negotiated Rate |
$4,249.31 |
| Rate for Payer: BCBS Complete |
$4,249.31
|
| Rate for Payer: Mclaren Medicaid |
$4,046.96
|
| Rate for Payer: Meridian Medicaid |
$4,249.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,046.96
|
| Rate for Payer: UHC Medicaid |
$4,046.96
|
| Rate for Payer: UHCCP Medicaid |
$4,046.96
|
|
|
HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION
|
Facility
|
IP
|
$6,610.33
|
|
|
Service Code
|
APR-DRG 8103
|
| Min. Negotiated Rate |
$6,295.56 |
| Max. Negotiated Rate |
$6,610.33 |
| Rate for Payer: BCBS Complete |
$6,610.33
|
| Rate for Payer: Mclaren Medicaid |
$6,295.56
|
| Rate for Payer: Meridian Medicaid |
$6,610.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,295.56
|
| Rate for Payer: UHC Medicaid |
$6,295.56
|
| Rate for Payer: UHCCP Medicaid |
$6,295.56
|
|
|
HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION
|
Facility
|
IP
|
$12,524.46
|
|
|
Service Code
|
APR-DRG 8104
|
| Min. Negotiated Rate |
$11,928.05 |
| Max. Negotiated Rate |
$12,524.46 |
| Rate for Payer: BCBS Complete |
$12,524.46
|
| Rate for Payer: Mclaren Medicaid |
$11,928.05
|
| Rate for Payer: Meridian Medicaid |
$12,524.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,928.05
|
| Rate for Payer: UHC Medicaid |
$11,928.05
|
| Rate for Payer: UHCCP Medicaid |
$11,928.05
|
|
|
HEPARIN CELLSAVER SOLUTION (BLH INTRA-OP)
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
NDC 09900000709
|
| Hospital Charge Code |
151009
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$26.45 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna Medicare |
$39.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.88
|
| Rate for Payer: BCBS Complete |
$27.77
|
| Rate for Payer: BCBS MAPPO |
$37.50
|
| Rate for Payer: BCBS Trust/PPO |
$123.31
|
| Rate for Payer: BCN Commercial |
$123.31
|
| Rate for Payer: BCN Medicare Advantage |
$37.50
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.50
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: Mclaren Medicaid |
$26.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.38
|
| Rate for Payer: Meridian Medicaid |
$27.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.50
|
| Rate for Payer: Nomi Health Commercial |
$123.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$112.50
|
| Rate for Payer: PACE Senior Care Partners |
$35.62
|
| Rate for Payer: PACE SWMI |
$37.50
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: PHP Medicare Advantage |
$37.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$130.50
|
| Rate for Payer: Priority Health Medicare |
$37.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.40
|
| Rate for Payer: Railroad Medicare Medicare |
$37.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.00
|
| Rate for Payer: UHC Core |
$125.25
|
| Rate for Payer: UHC Exchange |
$37.50
|
| Rate for Payer: UHC Medicaid |
$26.45
|
| Rate for Payer: UHC Medicare Advantage |
$37.50
|
| Rate for Payer: UHCCP Medicaid |
$26.45
|
| Rate for Payer: VA VA |
$37.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
|
HEPARIN CELLSAVER SOLUTION (BLH INTRA-OP)
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
NDC 09900000709
|
| Hospital Charge Code |
151009
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$104.40 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: BCBS Trust/PPO |
$123.89
|
| Rate for Payer: BCN Commercial |
$123.89
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.50
|
| Rate for Payer: Nomi Health Commercial |
$123.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$112.50
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$130.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.00
|
| Rate for Payer: UHC Core |
$125.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
|
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$21.71
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
112939
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.11 |
| Max. Negotiated Rate |
$19.54 |
| Rate for Payer: Aetna Commercial |
$18.45
|
| Rate for Payer: BCBS Trust/PPO |
$17.93
|
| Rate for Payer: BCN Commercial |
$17.93
|
| Rate for Payer: Cash Price |
$17.37
|
| Rate for Payer: Cofinity Commercial |
$18.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.37
|
| Rate for Payer: Healthscope Commercial |
$19.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.45
|
| Rate for Payer: Nomi Health Commercial |
$17.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.28
|
| Rate for Payer: PHP Commercial |
$18.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.10
|
| Rate for Payer: UHC Core |
$18.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.28
|
|
|
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$21.71
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
112939
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.83 |
| Max. Negotiated Rate |
$19.54 |
| Rate for Payer: Aetna Commercial |
$18.45
|
| Rate for Payer: Aetna Medicare |
$5.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.78
|
| Rate for Payer: BCBS Complete |
$4.02
|
| Rate for Payer: BCBS MAPPO |
$5.43
|
| Rate for Payer: BCBS Trust/PPO |
$17.85
|
| Rate for Payer: BCN Commercial |
$17.85
|
| Rate for Payer: BCN Medicare Advantage |
$5.43
|
| Rate for Payer: Cash Price |
$17.37
|
| Rate for Payer: Cofinity Commercial |
$18.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.43
|
| Rate for Payer: Healthscope Commercial |
$19.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.28
|
| Rate for Payer: Mclaren Medicaid |
$3.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.70
|
| Rate for Payer: Meridian Medicaid |
$4.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.45
|
| Rate for Payer: Nomi Health Commercial |
$17.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.28
|
| Rate for Payer: PACE Senior Care Partners |
$5.16
|
| Rate for Payer: PACE SWMI |
$5.43
|
| Rate for Payer: PHP Commercial |
$18.45
|
| Rate for Payer: PHP Medicare Advantage |
$5.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.89
|
| Rate for Payer: Priority Health Medicare |
$5.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.11
|
| Rate for Payer: Railroad Medicare Medicare |
$5.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.10
|
| Rate for Payer: UHC Core |
$18.13
|
| Rate for Payer: UHC Exchange |
$5.43
|
| Rate for Payer: UHC Medicaid |
$3.83
|
| Rate for Payer: UHC Medicare Advantage |
$5.43
|
| Rate for Payer: UHCCP Medicaid |
$3.83
|
| Rate for Payer: VA VA |
$5.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.28
|
|
|
HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$21.84
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
3626
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: BCBS Trust/PPO |
$18.04
|
| Rate for Payer: BCN Commercial |
$18.04
|
| Rate for Payer: Cash Price |
$17.47
|
| Rate for Payer: Cofinity Commercial |
$18.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.47
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.56
|
| Rate for Payer: Nomi Health Commercial |
$17.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.38
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.22
|
| Rate for Payer: UHC Core |
$18.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.38
|
|
|
HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$21.84
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
3626
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: Aetna Medicare |
$5.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.83
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$5.46
|
| Rate for Payer: BCBS Trust/PPO |
$17.95
|
| Rate for Payer: BCN Commercial |
$17.95
|
| Rate for Payer: BCN Medicare Advantage |
$5.46
|
| Rate for Payer: Cash Price |
$17.47
|
| Rate for Payer: Cofinity Commercial |
$18.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.46
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.38
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.73
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.56
|
| Rate for Payer: Nomi Health Commercial |
$17.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.38
|
| Rate for Payer: PACE Senior Care Partners |
$5.19
|
| Rate for Payer: PACE SWMI |
$5.46
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Medicare Advantage |
$5.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.00
|
| Rate for Payer: Priority Health Medicare |
$5.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.20
|
| Rate for Payer: Railroad Medicare Medicare |
$5.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.22
|
| Rate for Payer: UHC Core |
$18.24
|
| Rate for Payer: UHC Exchange |
$5.46
|
| Rate for Payer: UHC Medicaid |
$3.85
|
| Rate for Payer: UHC Medicare Advantage |
$5.46
|
| Rate for Payer: UHCCP Medicaid |
$3.85
|
| Rate for Payer: VA VA |
$5.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.38
|
|
|
HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$27.84
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10176
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.91 |
| Max. Negotiated Rate |
$25.06 |
| Rate for Payer: Aetna Commercial |
$23.66
|
| Rate for Payer: Aetna Commercial |
$17.14
|
| Rate for Payer: Aetna Commercial |
$9.73
|
| Rate for Payer: Aetna Commercial |
$19.25
|
| Rate for Payer: Aetna Commercial |
$16.40
|
| Rate for Payer: Aetna Commercial |
$13.34
|
| Rate for Payer: Aetna Medicare |
$5.24
|
| Rate for Payer: Aetna Medicare |
$4.08
|
| Rate for Payer: Aetna Medicare |
$2.98
|
| Rate for Payer: Aetna Medicare |
$7.24
|
| Rate for Payer: Aetna Medicare |
$5.02
|
| Rate for Payer: Aetna Medicare |
$5.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.30
|
| Rate for Payer: BCBS Complete |
$3.57
|
| Rate for Payer: BCBS Complete |
$4.19
|
| Rate for Payer: BCBS Complete |
$2.90
|
| Rate for Payer: BCBS Complete |
$2.12
|
| Rate for Payer: BCBS Complete |
$5.15
|
| Rate for Payer: BCBS Complete |
$3.73
|
| Rate for Payer: BCBS MAPPO |
$5.04
|
| Rate for Payer: BCBS MAPPO |
$6.96
|
| Rate for Payer: BCBS MAPPO |
$5.66
|
| Rate for Payer: BCBS MAPPO |
$3.92
|
| Rate for Payer: BCBS MAPPO |
$2.86
|
| Rate for Payer: BCBS MAPPO |
$4.82
|
| Rate for Payer: BCBS Trust/PPO |
$9.41
|
| Rate for Payer: BCBS Trust/PPO |
$18.62
|
| Rate for Payer: BCBS Trust/PPO |
$12.90
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCBS Trust/PPO |
$16.57
|
| Rate for Payer: BCBS Trust/PPO |
$22.89
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Commercial |
$16.57
|
| Rate for Payer: BCN Commercial |
$9.41
|
| Rate for Payer: BCN Commercial |
$12.90
|
| Rate for Payer: BCN Commercial |
$18.62
|
| Rate for Payer: BCN Commercial |
$22.89
|
| Rate for Payer: BCN Medicare Advantage |
$5.66
|
| Rate for Payer: BCN Medicare Advantage |
$6.96
|
| Rate for Payer: BCN Medicare Advantage |
$4.82
|
| Rate for Payer: BCN Medicare Advantage |
$2.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$3.92
|
| Rate for Payer: Cash Price |
$16.13
|
| Rate for Payer: Cash Price |
$9.16
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Cash Price |
$22.27
|
| Rate for Payer: Cash Price |
$18.12
|
| Rate for Payer: Cash Price |
$15.43
|
| Rate for Payer: Cofinity Commercial |
$17.34
|
| Rate for Payer: Cofinity Commercial |
$16.59
|
| Rate for Payer: Cofinity Commercial |
$9.85
|
| Rate for Payer: Cofinity Commercial |
$13.49
|
| Rate for Payer: Cofinity Commercial |
$23.94
|
| Rate for Payer: Cofinity Commercial |
$19.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.92
|
| Rate for Payer: Healthscope Commercial |
$18.14
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Healthscope Commercial |
$17.36
|
| Rate for Payer: Healthscope Commercial |
$14.12
|
| Rate for Payer: Healthscope Commercial |
$10.30
|
| Rate for Payer: Healthscope Commercial |
$20.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.47
|
| Rate for Payer: Mclaren Medicaid |
$2.77
|
| Rate for Payer: Mclaren Medicaid |
$2.02
|
| Rate for Payer: Mclaren Medicaid |
$3.40
|
| Rate for Payer: Mclaren Medicaid |
$3.55
|
| Rate for Payer: Mclaren Medicaid |
$3.99
|
| Rate for Payer: Mclaren Medicaid |
$4.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.06
|
| Rate for Payer: Meridian Medicaid |
$4.19
|
| Rate for Payer: Meridian Medicaid |
$5.15
|
| Rate for Payer: Meridian Medicaid |
$2.90
|
| Rate for Payer: Meridian Medicaid |
$2.12
|
| Rate for Payer: Meridian Medicaid |
$3.57
|
| Rate for Payer: Meridian Medicaid |
$3.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.66
|
| Rate for Payer: Nomi Health Commercial |
$15.82
|
| Rate for Payer: Nomi Health Commercial |
$16.53
|
| Rate for Payer: Nomi Health Commercial |
$9.39
|
| Rate for Payer: Nomi Health Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$22.83
|
| Rate for Payer: Nomi Health Commercial |
$12.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.77
|
| Rate for Payer: PACE Senior Care Partners |
$4.58
|
| Rate for Payer: PACE Senior Care Partners |
$3.73
|
| Rate for Payer: PACE Senior Care Partners |
$4.79
|
| Rate for Payer: PACE Senior Care Partners |
$5.38
|
| Rate for Payer: PACE Senior Care Partners |
$2.72
|
| Rate for Payer: PACE Senior Care Partners |
$6.61
|
| Rate for Payer: PACE SWMI |
$3.92
|
| Rate for Payer: PACE SWMI |
$5.04
|
| Rate for Payer: PACE SWMI |
$6.96
|
| Rate for Payer: PACE SWMI |
$2.86
|
| Rate for Payer: PACE SWMI |
$5.66
|
| Rate for Payer: PACE SWMI |
$4.82
|
| Rate for Payer: PHP Commercial |
$16.40
|
| Rate for Payer: PHP Commercial |
$13.34
|
| Rate for Payer: PHP Commercial |
$17.14
|
| Rate for Payer: PHP Commercial |
$19.25
|
| Rate for Payer: PHP Commercial |
$23.66
|
| Rate for Payer: PHP Commercial |
$9.73
|
| Rate for Payer: PHP Medicare Advantage |
$6.96
|
| Rate for Payer: PHP Medicare Advantage |
$3.92
|
| Rate for Payer: PHP Medicare Advantage |
$5.66
|
| Rate for Payer: PHP Medicare Advantage |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.04
|
| Rate for Payer: PHP Medicare Advantage |
$4.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.22
|
| Rate for Payer: Priority Health Medicare |
$2.89
|
| Rate for Payer: Priority Health Medicare |
$7.03
|
| Rate for Payer: Priority Health Medicare |
$3.96
|
| Rate for Payer: Priority Health Medicare |
$5.09
|
| Rate for Payer: Priority Health Medicare |
$4.87
|
| Rate for Payer: Priority Health Medicare |
$5.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.03
|
| Rate for Payer: Railroad Medicare Medicare |
$2.86
|
| Rate for Payer: Railroad Medicare Medicare |
$5.66
|
| Rate for Payer: Railroad Medicare Medicare |
$5.04
|
| Rate for Payer: Railroad Medicare Medicare |
$3.92
|
| Rate for Payer: Railroad Medicare Medicare |
$4.82
|
| Rate for Payer: Railroad Medicare Medicare |
$6.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.08
|
| Rate for Payer: UHC Core |
$16.11
|
| Rate for Payer: UHC Core |
$18.91
|
| Rate for Payer: UHC Core |
$16.83
|
| Rate for Payer: UHC Core |
$23.25
|
| Rate for Payer: UHC Core |
$9.56
|
| Rate for Payer: UHC Core |
$13.10
|
| Rate for Payer: UHC Exchange |
$3.92
|
| Rate for Payer: UHC Exchange |
$2.86
|
| Rate for Payer: UHC Exchange |
$5.04
|
| Rate for Payer: UHC Exchange |
$4.82
|
| Rate for Payer: UHC Exchange |
$5.66
|
| Rate for Payer: UHC Exchange |
$6.96
|
| Rate for Payer: UHC Medicaid |
$3.99
|
| Rate for Payer: UHC Medicaid |
$3.55
|
| Rate for Payer: UHC Medicaid |
$2.77
|
| Rate for Payer: UHC Medicaid |
$3.40
|
| Rate for Payer: UHC Medicaid |
$2.02
|
| Rate for Payer: UHC Medicaid |
$4.91
|
| Rate for Payer: UHC Medicare Advantage |
$3.92
|
| Rate for Payer: UHC Medicare Advantage |
$5.66
|
| Rate for Payer: UHC Medicare Advantage |
$5.04
|
| Rate for Payer: UHC Medicare Advantage |
$4.82
|
| Rate for Payer: UHC Medicare Advantage |
$2.86
|
| Rate for Payer: UHC Medicare Advantage |
$6.96
|
| Rate for Payer: UHCCP Medicaid |
$3.99
|
| Rate for Payer: UHCCP Medicaid |
$3.55
|
| Rate for Payer: UHCCP Medicaid |
$3.40
|
| Rate for Payer: UHCCP Medicaid |
$2.77
|
| Rate for Payer: UHCCP Medicaid |
$2.02
|
| Rate for Payer: UHCCP Medicaid |
$4.91
|
| Rate for Payer: VA VA |
$4.82
|
| Rate for Payer: VA VA |
$3.92
|
| Rate for Payer: VA VA |
$5.66
|
| Rate for Payer: VA VA |
$5.04
|
| Rate for Payer: VA VA |
$2.86
|
| Rate for Payer: VA VA |
$6.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.47
|
|
|
HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$27.84
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10176
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.38 |
| Max. Negotiated Rate |
$25.06 |
| Rate for Payer: Aetna Commercial |
$23.66
|
| Rate for Payer: Aetna Commercial |
$9.73
|
| Rate for Payer: Aetna Commercial |
$16.40
|
| Rate for Payer: Aetna Commercial |
$13.34
|
| Rate for Payer: Aetna Commercial |
$17.14
|
| Rate for Payer: Aetna Commercial |
$19.25
|
| Rate for Payer: BCBS Trust/PPO |
$22.99
|
| Rate for Payer: BCBS Trust/PPO |
$16.65
|
| Rate for Payer: BCBS Trust/PPO |
$18.71
|
| Rate for Payer: BCBS Trust/PPO |
$12.96
|
| Rate for Payer: BCBS Trust/PPO |
$9.46
|
| Rate for Payer: BCBS Trust/PPO |
$15.93
|
| Rate for Payer: BCN Commercial |
$18.71
|
| Rate for Payer: BCN Commercial |
$16.65
|
| Rate for Payer: BCN Commercial |
$9.46
|
| Rate for Payer: BCN Commercial |
$15.93
|
| Rate for Payer: BCN Commercial |
$22.99
|
| Rate for Payer: BCN Commercial |
$12.96
|
| Rate for Payer: Cash Price |
$22.27
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Cash Price |
$15.43
|
| Rate for Payer: Cash Price |
$16.13
|
| Rate for Payer: Cash Price |
$9.16
|
| Rate for Payer: Cash Price |
$18.12
|
| Rate for Payer: Cofinity Commercial |
$19.48
|
| Rate for Payer: Cofinity Commercial |
$13.49
|
| Rate for Payer: Cofinity Commercial |
$16.59
|
| Rate for Payer: Cofinity Commercial |
$17.34
|
| Rate for Payer: Cofinity Commercial |
$9.85
|
| Rate for Payer: Cofinity Commercial |
$23.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.27
|
| Rate for Payer: Healthscope Commercial |
$10.30
|
| Rate for Payer: Healthscope Commercial |
$14.12
|
| Rate for Payer: Healthscope Commercial |
$20.39
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Healthscope Commercial |
$18.14
|
| Rate for Payer: Healthscope Commercial |
$17.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.40
|
| Rate for Payer: Nomi Health Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$9.39
|
| Rate for Payer: Nomi Health Commercial |
$12.87
|
| Rate for Payer: Nomi Health Commercial |
$16.53
|
| Rate for Payer: Nomi Health Commercial |
$15.82
|
| Rate for Payer: Nomi Health Commercial |
$22.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.12
|
| Rate for Payer: PHP Commercial |
$19.25
|
| Rate for Payer: PHP Commercial |
$23.66
|
| Rate for Payer: PHP Commercial |
$17.14
|
| Rate for Payer: PHP Commercial |
$9.73
|
| Rate for Payer: PHP Commercial |
$13.34
|
| Rate for Payer: PHP Commercial |
$16.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.50
|
| Rate for Payer: UHC Core |
$23.25
|
| Rate for Payer: UHC Core |
$13.10
|
| Rate for Payer: UHC Core |
$16.11
|
| Rate for Payer: UHC Core |
$18.91
|
| Rate for Payer: UHC Core |
$16.83
|
| Rate for Payer: UHC Core |
$9.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.59
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV
|
Facility
|
IP
|
$73.44
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15846
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$51.11 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna Commercial |
$81.93
|
| Rate for Payer: BCBS Trust/PPO |
$60.65
|
| Rate for Payer: BCBS Trust/PPO |
$79.61
|
| Rate for Payer: BCN Commercial |
$60.65
|
| Rate for Payer: BCN Commercial |
$79.61
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cofinity Commercial |
$82.90
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Healthscope Commercial |
$86.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.93
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: Nomi Health Commercial |
$79.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.29
|
| Rate for Payer: PHP Commercial |
$81.93
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.82
|
| Rate for Payer: UHC Core |
$61.32
|
| Rate for Payer: UHC Core |
$80.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.29
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV
|
Facility
|
OP
|
$73.44
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15846
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna Commercial |
$81.93
|
| Rate for Payer: Aetna Medicare |
$25.06
|
| Rate for Payer: Aetna Medicare |
$19.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.12
|
| Rate for Payer: BCBS Complete |
$13.59
|
| Rate for Payer: BCBS Complete |
$17.84
|
| Rate for Payer: BCBS MAPPO |
$18.36
|
| Rate for Payer: BCBS MAPPO |
$24.10
|
| Rate for Payer: BCBS Trust/PPO |
$60.38
|
| Rate for Payer: BCBS Trust/PPO |
$79.24
|
| Rate for Payer: BCN Commercial |
$79.24
|
| Rate for Payer: BCN Commercial |
$60.38
|
| Rate for Payer: BCN Medicare Advantage |
$24.10
|
| Rate for Payer: BCN Medicare Advantage |
$18.36
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Cofinity Commercial |
$82.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.36
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Healthscope Commercial |
$86.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.29
|
| Rate for Payer: Mclaren Medicaid |
$16.99
|
| Rate for Payer: Mclaren Medicaid |
$12.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.28
|
| Rate for Payer: Meridian Medicaid |
$13.59
|
| Rate for Payer: Meridian Medicaid |
$17.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Nomi Health Commercial |
$79.04
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.29
|
| Rate for Payer: PACE Senior Care Partners |
$22.89
|
| Rate for Payer: PACE Senior Care Partners |
$17.44
|
| Rate for Payer: PACE SWMI |
$24.10
|
| Rate for Payer: PACE SWMI |
$18.36
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: PHP Commercial |
$81.93
|
| Rate for Payer: PHP Medicare Advantage |
$18.36
|
| Rate for Payer: PHP Medicare Advantage |
$24.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.89
|
| Rate for Payer: Priority Health Medicare |
$24.34
|
| Rate for Payer: Priority Health Medicare |
$18.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.09
|
| Rate for Payer: Railroad Medicare Medicare |
$18.36
|
| Rate for Payer: Railroad Medicare Medicare |
$24.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.82
|
| Rate for Payer: UHC Core |
$80.49
|
| Rate for Payer: UHC Core |
$61.32
|
| Rate for Payer: UHC Exchange |
$24.10
|
| Rate for Payer: UHC Exchange |
$18.36
|
| Rate for Payer: UHC Medicaid |
$16.99
|
| Rate for Payer: UHC Medicaid |
$12.95
|
| Rate for Payer: UHC Medicare Advantage |
$18.36
|
| Rate for Payer: UHC Medicare Advantage |
$24.10
|
| Rate for Payer: UHCCP Medicaid |
$12.95
|
| Rate for Payer: UHCCP Medicaid |
$16.99
|
| Rate for Payer: VA VA |
$18.36
|
| Rate for Payer: VA VA |
$24.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.08
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) INFUSION CUSTOM
|
Facility
|
OP
|
$87.73
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
180233
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.47 |
| Max. Negotiated Rate |
$78.96 |
| Rate for Payer: Aetna Commercial |
$74.57
|
| Rate for Payer: Aetna Medicare |
$22.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.42
|
| Rate for Payer: BCBS Complete |
$16.24
|
| Rate for Payer: BCBS MAPPO |
$21.93
|
| Rate for Payer: BCBS Trust/PPO |
$72.12
|
| Rate for Payer: BCN Commercial |
$72.12
|
| Rate for Payer: BCN Medicare Advantage |
$21.93
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cofinity Commercial |
$75.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.93
|
| Rate for Payer: Healthscope Commercial |
$78.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.80
|
| Rate for Payer: Mclaren Medicaid |
$15.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.03
|
| Rate for Payer: Meridian Medicaid |
$16.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.57
|
| Rate for Payer: Nomi Health Commercial |
$71.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.80
|
| Rate for Payer: PACE Senior Care Partners |
$20.84
|
| Rate for Payer: PACE SWMI |
$21.93
|
| Rate for Payer: PHP Commercial |
$74.57
|
| Rate for Payer: PHP Medicare Advantage |
$21.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$76.33
|
| Rate for Payer: Priority Health Medicare |
$22.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.06
|
| Rate for Payer: Railroad Medicare Medicare |
$21.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.20
|
| Rate for Payer: UHC Core |
$73.25
|
| Rate for Payer: UHC Exchange |
$21.93
|
| Rate for Payer: UHC Medicaid |
$15.47
|
| Rate for Payer: UHC Medicare Advantage |
$21.93
|
| Rate for Payer: UHCCP Medicaid |
$15.47
|
| Rate for Payer: VA VA |
$21.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.80
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) INFUSION CUSTOM
|
Facility
|
IP
|
$87.73
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
180233
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$61.06 |
| Max. Negotiated Rate |
$78.96 |
| Rate for Payer: Aetna Commercial |
$74.57
|
| Rate for Payer: BCBS Trust/PPO |
$72.46
|
| Rate for Payer: BCN Commercial |
$72.46
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cofinity Commercial |
$75.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Healthscope Commercial |
$78.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.57
|
| Rate for Payer: Nomi Health Commercial |
$71.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.80
|
| Rate for Payer: PHP Commercial |
$74.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$76.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.20
|
| Rate for Payer: UHC Core |
$73.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.80
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN
|
Facility
|
IP
|
$75.74
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15849
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$52.72 |
| Max. Negotiated Rate |
$68.17 |
| Rate for Payer: Aetna Commercial |
$64.38
|
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: BCBS Trust/PPO |
$62.55
|
| Rate for Payer: BCBS Trust/PPO |
$75.82
|
| Rate for Payer: BCN Commercial |
$62.55
|
| Rate for Payer: BCN Commercial |
$75.82
|
| Rate for Payer: Cash Price |
$60.59
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Cofinity Commercial |
$65.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.59
|
| Rate for Payer: Healthscope Commercial |
$68.17
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$62.11
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.85
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Commercial |
$64.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$63.24
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN
|
Facility
|
OP
|
$75.74
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15849
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.35 |
| Max. Negotiated Rate |
$68.17 |
| Rate for Payer: Aetna Commercial |
$64.38
|
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$23.87
|
| Rate for Payer: Aetna Medicare |
$19.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.69
|
| Rate for Payer: BCBS Complete |
$14.02
|
| Rate for Payer: BCBS Complete |
$16.99
|
| Rate for Payer: BCBS MAPPO |
$18.93
|
| Rate for Payer: BCBS MAPPO |
$22.95
|
| Rate for Payer: BCBS Trust/PPO |
$62.27
|
| Rate for Payer: BCBS Trust/PPO |
$75.47
|
| Rate for Payer: BCN Commercial |
$75.47
|
| Rate for Payer: BCN Commercial |
$62.27
|
| Rate for Payer: BCN Medicare Advantage |
$22.95
|
| Rate for Payer: BCN Medicare Advantage |
$18.93
|
| Rate for Payer: Cash Price |
$60.59
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$65.14
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.93
|
| Rate for Payer: Healthscope Commercial |
$68.17
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$16.18
|
| Rate for Payer: Mclaren Medicaid |
$13.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.88
|
| Rate for Payer: Meridian Medicaid |
$14.02
|
| Rate for Payer: Meridian Medicaid |
$16.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.38
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: Nomi Health Commercial |
$62.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.85
|
| Rate for Payer: PACE Senior Care Partners |
$21.80
|
| Rate for Payer: PACE Senior Care Partners |
$17.99
|
| Rate for Payer: PACE SWMI |
$22.95
|
| Rate for Payer: PACE SWMI |
$18.93
|
| Rate for Payer: PHP Commercial |
$64.38
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Medicare Advantage |
$18.93
|
| Rate for Payer: PHP Medicare Advantage |
$22.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.89
|
| Rate for Payer: Priority Health Medicare |
$23.18
|
| Rate for Payer: Priority Health Medicare |
$19.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.89
|
| Rate for Payer: Railroad Medicare Medicare |
$18.93
|
| Rate for Payer: Railroad Medicare Medicare |
$22.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: UHC Core |
$63.24
|
| Rate for Payer: UHC Exchange |
$22.95
|
| Rate for Payer: UHC Exchange |
$18.93
|
| Rate for Payer: UHC Medicaid |
$16.18
|
| Rate for Payer: UHC Medicaid |
$13.35
|
| Rate for Payer: UHC Medicare Advantage |
$18.93
|
| Rate for Payer: UHC Medicare Advantage |
$22.95
|
| Rate for Payer: UHCCP Medicaid |
$13.35
|
| Rate for Payer: UHCCP Medicaid |
$16.18
|
| Rate for Payer: VA VA |
$18.93
|
| Rate for Payer: VA VA |
$22.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.80
|
|
|
HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
HCPCS J1643
|
| Hospital Charge Code |
10181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.65 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$11.46
|
| Rate for Payer: BCN Commercial |
$11.46
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.79
|
| Rate for Payer: Nomi Health Commercial |
$11.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.40
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
