|
HYDROMORPHONE 0.5 MG/0.5 ML INJECTION SYRINGE
|
Facility
|
OP
|
$14.07
|
|
|
Service Code
|
HCPCS J1171
|
| Hospital Charge Code |
166819
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$12.66 |
| Rate for Payer: Aetna Commercial |
$11.96
|
| Rate for Payer: Aetna Commercial |
$17.16
|
| Rate for Payer: Aetna Commercial |
$18.20
|
| Rate for Payer: Aetna Commercial |
$14.01
|
| Rate for Payer: Aetna Medicare |
$4.28
|
| Rate for Payer: Aetna Medicare |
$3.66
|
| Rate for Payer: Aetna Medicare |
$5.25
|
| Rate for Payer: Aetna Medicare |
$5.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.40
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS Complete |
$3.05
|
| Rate for Payer: BCBS Complete |
$2.60
|
| Rate for Payer: BCBS Complete |
$3.74
|
| Rate for Payer: BCBS MAPPO |
$3.52
|
| Rate for Payer: BCBS MAPPO |
$4.12
|
| Rate for Payer: BCBS MAPPO |
$5.35
|
| Rate for Payer: BCBS MAPPO |
$5.05
|
| Rate for Payer: BCBS Trust/PPO |
$16.60
|
| Rate for Payer: BCBS Trust/PPO |
$11.57
|
| Rate for Payer: BCBS Trust/PPO |
$17.60
|
| Rate for Payer: BCBS Trust/PPO |
$13.55
|
| Rate for Payer: BCN Commercial |
$16.60
|
| Rate for Payer: BCN Commercial |
$17.60
|
| Rate for Payer: BCN Commercial |
$13.55
|
| Rate for Payer: BCN Commercial |
$11.57
|
| Rate for Payer: BCN Medicare Advantage |
$5.05
|
| Rate for Payer: BCN Medicare Advantage |
$4.12
|
| Rate for Payer: BCN Medicare Advantage |
$5.35
|
| Rate for Payer: BCN Medicare Advantage |
$3.52
|
| Rate for Payer: Cash Price |
$17.13
|
| Rate for Payer: Cash Price |
$16.15
|
| Rate for Payer: Cash Price |
$11.26
|
| Rate for Payer: Cash Price |
$13.18
|
| Rate for Payer: Cofinity Commercial |
$14.17
|
| Rate for Payer: Cofinity Commercial |
$12.10
|
| Rate for Payer: Cofinity Commercial |
$17.36
|
| Rate for Payer: Cofinity Commercial |
$18.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.05
|
| Rate for Payer: Healthscope Commercial |
$12.66
|
| Rate for Payer: Healthscope Commercial |
$19.27
|
| Rate for Payer: Healthscope Commercial |
$18.17
|
| Rate for Payer: Healthscope Commercial |
$14.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.55
|
| Rate for Payer: Mclaren Medicaid |
$3.56
|
| Rate for Payer: Mclaren Medicaid |
$2.91
|
| Rate for Payer: Mclaren Medicaid |
$2.48
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.69
|
| Rate for Payer: Meridian Medicaid |
$2.60
|
| Rate for Payer: Meridian Medicaid |
$3.74
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: Meridian Medicaid |
$3.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.20
|
| Rate for Payer: Nomi Health Commercial |
$16.56
|
| Rate for Payer: Nomi Health Commercial |
$11.54
|
| Rate for Payer: Nomi Health Commercial |
$13.51
|
| Rate for Payer: Nomi Health Commercial |
$17.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.55
|
| Rate for Payer: PACE Senior Care Partners |
$4.80
|
| Rate for Payer: PACE Senior Care Partners |
$5.08
|
| Rate for Payer: PACE Senior Care Partners |
$3.34
|
| Rate for Payer: PACE Senior Care Partners |
$3.91
|
| Rate for Payer: PACE SWMI |
$3.52
|
| Rate for Payer: PACE SWMI |
$5.35
|
| Rate for Payer: PACE SWMI |
$4.12
|
| Rate for Payer: PACE SWMI |
$5.05
|
| Rate for Payer: PHP Commercial |
$11.96
|
| Rate for Payer: PHP Commercial |
$14.01
|
| Rate for Payer: PHP Commercial |
$17.16
|
| Rate for Payer: PHP Commercial |
$18.20
|
| Rate for Payer: PHP Medicare Advantage |
$3.52
|
| Rate for Payer: PHP Medicare Advantage |
$5.35
|
| Rate for Payer: PHP Medicare Advantage |
$4.12
|
| Rate for Payer: PHP Medicare Advantage |
$5.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.24
|
| Rate for Payer: Priority Health Medicare |
$4.16
|
| Rate for Payer: Priority Health Medicare |
$3.55
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Medicare |
$5.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.79
|
| Rate for Payer: Railroad Medicare Medicare |
$5.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3.52
|
| Rate for Payer: Railroad Medicare Medicare |
$5.35
|
| Rate for Payer: Railroad Medicare Medicare |
$4.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.84
|
| Rate for Payer: UHC Core |
$11.75
|
| Rate for Payer: UHC Core |
$16.86
|
| Rate for Payer: UHC Core |
$13.76
|
| Rate for Payer: UHC Core |
$17.88
|
| Rate for Payer: UHC Exchange |
$5.05
|
| Rate for Payer: UHC Exchange |
$4.12
|
| Rate for Payer: UHC Exchange |
$5.35
|
| Rate for Payer: UHC Exchange |
$3.52
|
| Rate for Payer: UHC Medicaid |
$2.48
|
| Rate for Payer: UHC Medicaid |
$2.91
|
| Rate for Payer: UHC Medicaid |
$3.56
|
| Rate for Payer: UHC Medicaid |
$3.77
|
| Rate for Payer: UHC Medicare Advantage |
$4.12
|
| Rate for Payer: UHC Medicare Advantage |
$3.52
|
| Rate for Payer: UHC Medicare Advantage |
$5.35
|
| Rate for Payer: UHC Medicare Advantage |
$5.05
|
| Rate for Payer: UHCCP Medicaid |
$3.56
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: UHCCP Medicaid |
$2.91
|
| Rate for Payer: UHCCP Medicaid |
$2.48
|
| Rate for Payer: VA VA |
$3.52
|
| Rate for Payer: VA VA |
$5.35
|
| Rate for Payer: VA VA |
$5.05
|
| Rate for Payer: VA VA |
$4.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
|
HYDROMORPHONE 0.5 MG/0.5 ML INJECTION SYRINGE
|
Facility
|
IP
|
$20.19
|
|
|
Service Code
|
HCPCS J1171
|
| Hospital Charge Code |
166819
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.05 |
| Max. Negotiated Rate |
$18.17 |
| Rate for Payer: Aetna Commercial |
$17.16
|
| Rate for Payer: Aetna Commercial |
$14.01
|
| Rate for Payer: Aetna Commercial |
$11.96
|
| Rate for Payer: Aetna Commercial |
$18.20
|
| Rate for Payer: BCBS Trust/PPO |
$16.67
|
| Rate for Payer: BCBS Trust/PPO |
$17.68
|
| Rate for Payer: BCBS Trust/PPO |
$13.61
|
| Rate for Payer: BCBS Trust/PPO |
$11.62
|
| Rate for Payer: BCN Commercial |
$16.67
|
| Rate for Payer: BCN Commercial |
$11.62
|
| Rate for Payer: BCN Commercial |
$17.68
|
| Rate for Payer: BCN Commercial |
$13.61
|
| Rate for Payer: Cash Price |
$13.18
|
| Rate for Payer: Cash Price |
$16.15
|
| Rate for Payer: Cash Price |
$17.13
|
| Rate for Payer: Cash Price |
$11.26
|
| Rate for Payer: Cofinity Commercial |
$12.10
|
| Rate for Payer: Cofinity Commercial |
$18.41
|
| Rate for Payer: Cofinity Commercial |
$17.36
|
| Rate for Payer: Cofinity Commercial |
$14.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.13
|
| Rate for Payer: Healthscope Commercial |
$19.27
|
| Rate for Payer: Healthscope Commercial |
$14.83
|
| Rate for Payer: Healthscope Commercial |
$18.17
|
| Rate for Payer: Healthscope Commercial |
$12.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.20
|
| Rate for Payer: Nomi Health Commercial |
$11.54
|
| Rate for Payer: Nomi Health Commercial |
$13.51
|
| Rate for Payer: Nomi Health Commercial |
$17.56
|
| Rate for Payer: Nomi Health Commercial |
$16.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.06
|
| Rate for Payer: PHP Commercial |
$18.20
|
| Rate for Payer: PHP Commercial |
$11.96
|
| Rate for Payer: PHP Commercial |
$14.01
|
| Rate for Payer: PHP Commercial |
$17.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.77
|
| Rate for Payer: UHC Core |
$16.86
|
| Rate for Payer: UHC Core |
$17.88
|
| Rate for Payer: UHC Core |
$13.76
|
| Rate for Payer: UHC Core |
$11.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.14
|
|
|
HYDROMORPHONE 1 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$27.28
|
|
|
Service Code
|
HCPCS J1171
|
| Hospital Charge Code |
112193
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.99 |
| Max. Negotiated Rate |
$24.55 |
| Rate for Payer: Aetna Commercial |
$23.19
|
| Rate for Payer: Aetna Commercial |
$18.59
|
| Rate for Payer: Aetna Commercial |
$15.83
|
| Rate for Payer: Aetna Commercial |
$27.17
|
| Rate for Payer: BCBS Trust/PPO |
$22.53
|
| Rate for Payer: BCBS Trust/PPO |
$26.40
|
| Rate for Payer: BCBS Trust/PPO |
$18.06
|
| Rate for Payer: BCBS Trust/PPO |
$15.38
|
| Rate for Payer: BCN Commercial |
$22.53
|
| Rate for Payer: BCN Commercial |
$15.38
|
| Rate for Payer: BCN Commercial |
$26.40
|
| Rate for Payer: BCN Commercial |
$18.06
|
| Rate for Payer: Cash Price |
$17.50
|
| Rate for Payer: Cash Price |
$21.82
|
| Rate for Payer: Cash Price |
$25.58
|
| Rate for Payer: Cash Price |
$14.90
|
| Rate for Payer: Cofinity Commercial |
$16.01
|
| Rate for Payer: Cofinity Commercial |
$27.49
|
| Rate for Payer: Cofinity Commercial |
$23.46
|
| Rate for Payer: Cofinity Commercial |
$18.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.58
|
| Rate for Payer: Healthscope Commercial |
$28.77
|
| Rate for Payer: Healthscope Commercial |
$19.68
|
| Rate for Payer: Healthscope Commercial |
$24.55
|
| Rate for Payer: Healthscope Commercial |
$16.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.17
|
| Rate for Payer: Nomi Health Commercial |
$15.27
|
| Rate for Payer: Nomi Health Commercial |
$17.93
|
| Rate for Payer: Nomi Health Commercial |
$26.22
|
| Rate for Payer: Nomi Health Commercial |
$22.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.98
|
| Rate for Payer: PHP Commercial |
$27.17
|
| Rate for Payer: PHP Commercial |
$15.83
|
| Rate for Payer: PHP Commercial |
$18.59
|
| Rate for Payer: PHP Commercial |
$23.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.01
|
| Rate for Payer: UHC Core |
$22.78
|
| Rate for Payer: UHC Core |
$26.69
|
| Rate for Payer: UHC Core |
$18.26
|
| Rate for Payer: UHC Core |
$15.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.46
|
|
|
HYDROMORPHONE 1 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$18.62
|
|
|
Service Code
|
HCPCS J1171
|
| Hospital Charge Code |
112193
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$16.76 |
| Rate for Payer: Aetna Commercial |
$15.83
|
| Rate for Payer: Aetna Commercial |
$23.19
|
| Rate for Payer: Aetna Commercial |
$27.17
|
| Rate for Payer: Aetna Commercial |
$18.59
|
| Rate for Payer: Aetna Medicare |
$5.69
|
| Rate for Payer: Aetna Medicare |
$4.84
|
| Rate for Payer: Aetna Medicare |
$7.09
|
| Rate for Payer: Aetna Medicare |
$8.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.82
|
| Rate for Payer: BCBS Complete |
$5.92
|
| Rate for Payer: BCBS Complete |
$4.05
|
| Rate for Payer: BCBS Complete |
$3.45
|
| Rate for Payer: BCBS Complete |
$5.05
|
| Rate for Payer: BCBS MAPPO |
$4.66
|
| Rate for Payer: BCBS MAPPO |
$5.47
|
| Rate for Payer: BCBS MAPPO |
$7.99
|
| Rate for Payer: BCBS MAPPO |
$6.82
|
| Rate for Payer: BCBS Trust/PPO |
$22.43
|
| Rate for Payer: BCBS Trust/PPO |
$15.31
|
| Rate for Payer: BCBS Trust/PPO |
$26.28
|
| Rate for Payer: BCBS Trust/PPO |
$17.98
|
| Rate for Payer: BCN Commercial |
$22.43
|
| Rate for Payer: BCN Commercial |
$26.28
|
| Rate for Payer: BCN Commercial |
$17.98
|
| Rate for Payer: BCN Commercial |
$15.31
|
| Rate for Payer: BCN Medicare Advantage |
$6.82
|
| Rate for Payer: BCN Medicare Advantage |
$5.47
|
| Rate for Payer: BCN Medicare Advantage |
$7.99
|
| Rate for Payer: BCN Medicare Advantage |
$4.66
|
| Rate for Payer: Cash Price |
$25.58
|
| Rate for Payer: Cash Price |
$21.82
|
| Rate for Payer: Cash Price |
$14.90
|
| Rate for Payer: Cash Price |
$17.50
|
| Rate for Payer: Cofinity Commercial |
$18.81
|
| Rate for Payer: Cofinity Commercial |
$16.01
|
| Rate for Payer: Cofinity Commercial |
$23.46
|
| Rate for Payer: Cofinity Commercial |
$27.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.82
|
| Rate for Payer: Healthscope Commercial |
$16.76
|
| Rate for Payer: Healthscope Commercial |
$28.77
|
| Rate for Payer: Healthscope Commercial |
$24.55
|
| Rate for Payer: Healthscope Commercial |
$19.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.96
|
| Rate for Payer: Mclaren Medicaid |
$4.81
|
| Rate for Payer: Mclaren Medicaid |
$3.86
|
| Rate for Payer: Mclaren Medicaid |
$3.28
|
| Rate for Payer: Mclaren Medicaid |
$5.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.89
|
| Rate for Payer: Meridian Medicaid |
$3.45
|
| Rate for Payer: Meridian Medicaid |
$5.05
|
| Rate for Payer: Meridian Medicaid |
$5.92
|
| Rate for Payer: Meridian Medicaid |
$4.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.17
|
| Rate for Payer: Nomi Health Commercial |
$22.37
|
| Rate for Payer: Nomi Health Commercial |
$15.27
|
| Rate for Payer: Nomi Health Commercial |
$17.93
|
| Rate for Payer: Nomi Health Commercial |
$26.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.96
|
| Rate for Payer: PACE Senior Care Partners |
$6.48
|
| Rate for Payer: PACE Senior Care Partners |
$7.59
|
| Rate for Payer: PACE Senior Care Partners |
$4.42
|
| Rate for Payer: PACE Senior Care Partners |
$5.19
|
| Rate for Payer: PACE SWMI |
$4.66
|
| Rate for Payer: PACE SWMI |
$7.99
|
| Rate for Payer: PACE SWMI |
$5.47
|
| Rate for Payer: PACE SWMI |
$6.82
|
| Rate for Payer: PHP Commercial |
$15.83
|
| Rate for Payer: PHP Commercial |
$18.59
|
| Rate for Payer: PHP Commercial |
$23.19
|
| Rate for Payer: PHP Commercial |
$27.17
|
| Rate for Payer: PHP Medicare Advantage |
$4.66
|
| Rate for Payer: PHP Medicare Advantage |
$7.99
|
| Rate for Payer: PHP Medicare Advantage |
$5.47
|
| Rate for Payer: PHP Medicare Advantage |
$6.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.20
|
| Rate for Payer: Priority Health Medicare |
$5.52
|
| Rate for Payer: Priority Health Medicare |
$4.70
|
| Rate for Payer: Priority Health Medicare |
$6.89
|
| Rate for Payer: Priority Health Medicare |
$8.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.96
|
| Rate for Payer: Railroad Medicare Medicare |
$6.82
|
| Rate for Payer: Railroad Medicare Medicare |
$4.66
|
| Rate for Payer: Railroad Medicare Medicare |
$7.99
|
| Rate for Payer: Railroad Medicare Medicare |
$5.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.13
|
| Rate for Payer: UHC Core |
$15.55
|
| Rate for Payer: UHC Core |
$22.78
|
| Rate for Payer: UHC Core |
$18.26
|
| Rate for Payer: UHC Core |
$26.69
|
| Rate for Payer: UHC Exchange |
$6.82
|
| Rate for Payer: UHC Exchange |
$5.47
|
| Rate for Payer: UHC Exchange |
$7.99
|
| Rate for Payer: UHC Exchange |
$4.66
|
| Rate for Payer: UHC Medicaid |
$3.28
|
| Rate for Payer: UHC Medicaid |
$3.86
|
| Rate for Payer: UHC Medicaid |
$4.81
|
| Rate for Payer: UHC Medicaid |
$5.64
|
| Rate for Payer: UHC Medicare Advantage |
$5.47
|
| Rate for Payer: UHC Medicare Advantage |
$4.66
|
| Rate for Payer: UHC Medicare Advantage |
$7.99
|
| Rate for Payer: UHC Medicare Advantage |
$6.82
|
| Rate for Payer: UHCCP Medicaid |
$4.81
|
| Rate for Payer: UHCCP Medicaid |
$5.64
|
| Rate for Payer: UHCCP Medicaid |
$3.86
|
| Rate for Payer: UHCCP Medicaid |
$3.28
|
| Rate for Payer: VA VA |
$4.66
|
| Rate for Payer: VA VA |
$7.99
|
| Rate for Payer: VA VA |
$6.82
|
| Rate for Payer: VA VA |
$5.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.98
|
|
|
HYDROMORPHONE 2 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$22.51
|
|
|
Service Code
|
HCPCS J1171
|
| Hospital Charge Code |
110943
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.67 |
| Max. Negotiated Rate |
$20.26 |
| Rate for Payer: Aetna Commercial |
$19.13
|
| Rate for Payer: Aetna Commercial |
$28.91
|
| Rate for Payer: Aetna Commercial |
$31.16
|
| Rate for Payer: BCBS Trust/PPO |
$28.09
|
| Rate for Payer: BCBS Trust/PPO |
$18.59
|
| Rate for Payer: BCBS Trust/PPO |
$30.28
|
| Rate for Payer: BCN Commercial |
$28.09
|
| Rate for Payer: BCN Commercial |
$18.59
|
| Rate for Payer: BCN Commercial |
$30.28
|
| Rate for Payer: Cash Price |
$18.01
|
| Rate for Payer: Cash Price |
$29.33
|
| Rate for Payer: Cash Price |
$27.21
|
| Rate for Payer: Cofinity Commercial |
$31.53
|
| Rate for Payer: Cofinity Commercial |
$29.25
|
| Rate for Payer: Cofinity Commercial |
$19.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.33
|
| Rate for Payer: Healthscope Commercial |
$30.61
|
| Rate for Payer: Healthscope Commercial |
$20.26
|
| Rate for Payer: Healthscope Commercial |
$32.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.16
|
| Rate for Payer: Nomi Health Commercial |
$18.46
|
| Rate for Payer: Nomi Health Commercial |
$27.89
|
| Rate for Payer: Nomi Health Commercial |
$30.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.50
|
| Rate for Payer: PHP Commercial |
$19.13
|
| Rate for Payer: PHP Commercial |
$31.16
|
| Rate for Payer: PHP Commercial |
$28.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.81
|
| Rate for Payer: UHC Core |
$18.80
|
| Rate for Payer: UHC Core |
$30.61
|
| Rate for Payer: UHC Core |
$28.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.51
|
|
|
HYDROMORPHONE 2 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$22.51
|
|
|
Service Code
|
HCPCS J1171
|
| Hospital Charge Code |
110943
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$20.26 |
| Rate for Payer: Aetna Commercial |
$19.13
|
| Rate for Payer: Aetna Commercial |
$31.16
|
| Rate for Payer: Aetna Commercial |
$28.91
|
| Rate for Payer: Aetna Medicare |
$9.53
|
| Rate for Payer: Aetna Medicare |
$5.85
|
| Rate for Payer: Aetna Medicare |
$8.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.46
|
| Rate for Payer: BCBS Complete |
$6.30
|
| Rate for Payer: BCBS Complete |
$4.17
|
| Rate for Payer: BCBS Complete |
$6.79
|
| Rate for Payer: BCBS MAPPO |
$9.16
|
| Rate for Payer: BCBS MAPPO |
$5.63
|
| Rate for Payer: BCBS MAPPO |
$8.50
|
| Rate for Payer: BCBS Trust/PPO |
$18.51
|
| Rate for Payer: BCBS Trust/PPO |
$27.96
|
| Rate for Payer: BCBS Trust/PPO |
$30.14
|
| Rate for Payer: BCN Commercial |
$27.96
|
| Rate for Payer: BCN Commercial |
$30.14
|
| Rate for Payer: BCN Commercial |
$18.51
|
| Rate for Payer: BCN Medicare Advantage |
$9.16
|
| Rate for Payer: BCN Medicare Advantage |
$8.50
|
| Rate for Payer: BCN Medicare Advantage |
$5.63
|
| Rate for Payer: Cash Price |
$29.33
|
| Rate for Payer: Cash Price |
$27.21
|
| Rate for Payer: Cash Price |
$18.01
|
| Rate for Payer: Cofinity Commercial |
$19.36
|
| Rate for Payer: Cofinity Commercial |
$29.25
|
| Rate for Payer: Cofinity Commercial |
$31.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.63
|
| Rate for Payer: Healthscope Commercial |
$30.61
|
| Rate for Payer: Healthscope Commercial |
$20.26
|
| Rate for Payer: Healthscope Commercial |
$32.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.51
|
| Rate for Payer: Mclaren Medicaid |
$3.97
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicaid |
$6.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.62
|
| Rate for Payer: Meridian Medicaid |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$4.17
|
| Rate for Payer: Meridian Medicaid |
$6.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.91
|
| Rate for Payer: Nomi Health Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$27.89
|
| Rate for Payer: Nomi Health Commercial |
$18.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.88
|
| Rate for Payer: PACE Senior Care Partners |
$8.08
|
| Rate for Payer: PACE Senior Care Partners |
$5.35
|
| Rate for Payer: PACE Senior Care Partners |
$8.71
|
| Rate for Payer: PACE SWMI |
$9.16
|
| Rate for Payer: PACE SWMI |
$8.50
|
| Rate for Payer: PACE SWMI |
$5.63
|
| Rate for Payer: PHP Commercial |
$19.13
|
| Rate for Payer: PHP Commercial |
$31.16
|
| Rate for Payer: PHP Commercial |
$28.91
|
| Rate for Payer: PHP Medicare Advantage |
$8.50
|
| Rate for Payer: PHP Medicare Advantage |
$5.63
|
| Rate for Payer: PHP Medicare Advantage |
$9.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.89
|
| Rate for Payer: Priority Health Medicare |
$9.26
|
| Rate for Payer: Priority Health Medicare |
$8.59
|
| Rate for Payer: Priority Health Medicare |
$5.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.67
|
| Rate for Payer: Railroad Medicare Medicare |
$8.50
|
| Rate for Payer: Railroad Medicare Medicare |
$9.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.81
|
| Rate for Payer: UHC Core |
$18.80
|
| Rate for Payer: UHC Core |
$30.61
|
| Rate for Payer: UHC Core |
$28.40
|
| Rate for Payer: UHC Exchange |
$9.16
|
| Rate for Payer: UHC Exchange |
$8.50
|
| Rate for Payer: UHC Exchange |
$5.63
|
| Rate for Payer: UHC Medicaid |
$3.97
|
| Rate for Payer: UHC Medicaid |
$6.46
|
| Rate for Payer: UHC Medicaid |
$6.00
|
| Rate for Payer: UHC Medicare Advantage |
$8.50
|
| Rate for Payer: UHC Medicare Advantage |
$5.63
|
| Rate for Payer: UHC Medicare Advantage |
$9.16
|
| Rate for Payer: UHCCP Medicaid |
$6.00
|
| Rate for Payer: UHCCP Medicaid |
$3.97
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: VA VA |
$5.63
|
| Rate for Payer: VA VA |
$9.16
|
| Rate for Payer: VA VA |
$8.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.50
|
|
|
HYDROMORPHONE 2 MG TABLET
|
Facility
|
IP
|
$271.25
|
|
|
Service Code
|
NDC 42858030125
|
| Hospital Charge Code |
3760
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$188.79 |
| Max. Negotiated Rate |
$244.12 |
| Rate for Payer: Aetna Commercial |
$230.56
|
| Rate for Payer: BCBS Trust/PPO |
$224.03
|
| Rate for Payer: BCN Commercial |
$224.03
|
| Rate for Payer: Cash Price |
$217.00
|
| Rate for Payer: Cofinity Commercial |
$233.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.00
|
| Rate for Payer: Healthscope Commercial |
$244.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.56
|
| Rate for Payer: Nomi Health Commercial |
$222.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$203.44
|
| Rate for Payer: PHP Commercial |
$230.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$235.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.70
|
| Rate for Payer: UHC Core |
$226.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.44
|
|
|
HYDROMORPHONE 2 MG TABLET
|
Facility
|
OP
|
$6.02
|
|
|
Service Code
|
NDC 60687057911
|
| Hospital Charge Code |
3760
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$5.42 |
| Rate for Payer: Aetna Commercial |
$5.12
|
| Rate for Payer: Aetna Medicare |
$1.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.88
|
| Rate for Payer: BCBS Complete |
$1.11
|
| Rate for Payer: BCBS MAPPO |
$1.50
|
| Rate for Payer: BCBS Trust/PPO |
$4.95
|
| Rate for Payer: BCN Commercial |
$4.95
|
| Rate for Payer: BCN Medicare Advantage |
$1.50
|
| Rate for Payer: Cash Price |
$4.82
|
| Rate for Payer: Cofinity Commercial |
$5.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.50
|
| Rate for Payer: Healthscope Commercial |
$5.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.51
|
| Rate for Payer: Mclaren Medicaid |
$1.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.58
|
| Rate for Payer: Meridian Medicaid |
$1.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.12
|
| Rate for Payer: Nomi Health Commercial |
$4.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.51
|
| Rate for Payer: PACE Senior Care Partners |
$1.43
|
| Rate for Payer: PACE SWMI |
$1.50
|
| Rate for Payer: PHP Commercial |
$5.12
|
| Rate for Payer: PHP Medicare Advantage |
$1.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.24
|
| Rate for Payer: Priority Health Medicare |
$1.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.19
|
| Rate for Payer: Railroad Medicare Medicare |
$1.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.30
|
| Rate for Payer: UHC Core |
$5.03
|
| Rate for Payer: UHC Exchange |
$1.50
|
| Rate for Payer: UHC Medicaid |
$1.06
|
| Rate for Payer: UHC Medicare Advantage |
$1.50
|
| Rate for Payer: UHCCP Medicaid |
$1.06
|
| Rate for Payer: VA VA |
$1.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.51
|
|
|
HYDROMORPHONE 2 MG TABLET
|
Facility
|
IP
|
$602.00
|
|
|
Service Code
|
NDC 60687057901
|
| Hospital Charge Code |
3760
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$418.99 |
| Max. Negotiated Rate |
$541.80 |
| Rate for Payer: Aetna Commercial |
$511.70
|
| Rate for Payer: BCBS Trust/PPO |
$497.19
|
| Rate for Payer: BCN Commercial |
$497.19
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Cofinity Commercial |
$517.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.60
|
| Rate for Payer: Healthscope Commercial |
$541.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$451.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$511.70
|
| Rate for Payer: Nomi Health Commercial |
$493.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$451.50
|
| Rate for Payer: PHP Commercial |
$511.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$523.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$418.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.76
|
| Rate for Payer: UHC Core |
$502.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$451.50
|
|
|
HYDROMORPHONE 2 MG TABLET
|
Facility
|
OP
|
$602.00
|
|
|
Service Code
|
NDC 60687057901
|
| Hospital Charge Code |
3760
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$106.13 |
| Max. Negotiated Rate |
$541.80 |
| Rate for Payer: Aetna Commercial |
$511.70
|
| Rate for Payer: Aetna Medicare |
$156.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$188.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$188.12
|
| Rate for Payer: BCBS Complete |
$111.43
|
| Rate for Payer: BCBS MAPPO |
$150.50
|
| Rate for Payer: BCBS Trust/PPO |
$494.90
|
| Rate for Payer: BCN Commercial |
$494.90
|
| Rate for Payer: BCN Medicare Advantage |
$150.50
|
| Rate for Payer: Cash Price |
$481.60
|
| Rate for Payer: Cofinity Commercial |
$517.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.50
|
| Rate for Payer: Healthscope Commercial |
$541.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$451.50
|
| Rate for Payer: Mclaren Medicaid |
$106.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.03
|
| Rate for Payer: Meridian Medicaid |
$111.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$173.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$165.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$511.70
|
| Rate for Payer: Nomi Health Commercial |
$493.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$451.50
|
| Rate for Payer: PACE Senior Care Partners |
$142.97
|
| Rate for Payer: PACE SWMI |
$150.50
|
| Rate for Payer: PHP Commercial |
$511.70
|
| Rate for Payer: PHP Medicare Advantage |
$150.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$523.74
|
| Rate for Payer: Priority Health Medicare |
$152.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$418.99
|
| Rate for Payer: Railroad Medicare Medicare |
$150.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.76
|
| Rate for Payer: UHC Core |
$502.67
|
| Rate for Payer: UHC Exchange |
$150.50
|
| Rate for Payer: UHC Medicaid |
$106.13
|
| Rate for Payer: UHC Medicare Advantage |
$150.50
|
| Rate for Payer: UHCCP Medicaid |
$106.13
|
| Rate for Payer: VA VA |
$150.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$451.50
|
|
|
HYDROMORPHONE 2 MG TABLET
|
Facility
|
OP
|
$271.25
|
|
|
Service Code
|
NDC 42858030125
|
| Hospital Charge Code |
3760
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$47.82 |
| Max. Negotiated Rate |
$244.12 |
| Rate for Payer: Aetna Commercial |
$230.56
|
| Rate for Payer: Aetna Medicare |
$70.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.77
|
| Rate for Payer: BCBS Complete |
$50.21
|
| Rate for Payer: BCBS MAPPO |
$67.81
|
| Rate for Payer: BCBS Trust/PPO |
$222.99
|
| Rate for Payer: BCN Commercial |
$222.99
|
| Rate for Payer: BCN Medicare Advantage |
$67.81
|
| Rate for Payer: Cash Price |
$217.00
|
| Rate for Payer: Cofinity Commercial |
$233.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.81
|
| Rate for Payer: Healthscope Commercial |
$244.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.44
|
| Rate for Payer: Mclaren Medicaid |
$47.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.20
|
| Rate for Payer: Meridian Medicaid |
$50.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.56
|
| Rate for Payer: Nomi Health Commercial |
$222.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$203.44
|
| Rate for Payer: PACE Senior Care Partners |
$64.42
|
| Rate for Payer: PACE SWMI |
$67.81
|
| Rate for Payer: PHP Commercial |
$230.56
|
| Rate for Payer: PHP Medicare Advantage |
$67.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$235.99
|
| Rate for Payer: Priority Health Medicare |
$68.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.79
|
| Rate for Payer: Railroad Medicare Medicare |
$67.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.70
|
| Rate for Payer: UHC Core |
$226.49
|
| Rate for Payer: UHC Exchange |
$67.81
|
| Rate for Payer: UHC Medicaid |
$47.82
|
| Rate for Payer: UHC Medicare Advantage |
$67.81
|
| Rate for Payer: UHCCP Medicaid |
$47.82
|
| Rate for Payer: VA VA |
$67.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.44
|
|
|
HYDROMORPHONE 2 MG TABLET
|
Facility
|
IP
|
$6.02
|
|
|
Service Code
|
NDC 60687057911
|
| Hospital Charge Code |
3760
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$5.42 |
| Rate for Payer: Aetna Commercial |
$5.12
|
| Rate for Payer: BCBS Trust/PPO |
$4.97
|
| Rate for Payer: BCN Commercial |
$4.97
|
| Rate for Payer: Cash Price |
$4.82
|
| Rate for Payer: Cofinity Commercial |
$5.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.82
|
| Rate for Payer: Healthscope Commercial |
$5.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.12
|
| Rate for Payer: Nomi Health Commercial |
$4.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.51
|
| Rate for Payer: PHP Commercial |
$5.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.30
|
| Rate for Payer: UHC Core |
$5.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.51
|
|
|
HYDROMORPHONE 4 MG TABLET
|
Facility
|
OP
|
$429.40
|
|
|
Service Code
|
NDC 60687059001
|
| Hospital Charge Code |
3761
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$75.70 |
| Max. Negotiated Rate |
$386.46 |
| Rate for Payer: Aetna Commercial |
$364.99
|
| Rate for Payer: Aetna Medicare |
$111.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.19
|
| Rate for Payer: BCBS Complete |
$79.48
|
| Rate for Payer: BCBS MAPPO |
$107.35
|
| Rate for Payer: BCBS Trust/PPO |
$353.01
|
| Rate for Payer: BCN Commercial |
$353.01
|
| Rate for Payer: BCN Medicare Advantage |
$107.35
|
| Rate for Payer: Cash Price |
$343.52
|
| Rate for Payer: Cofinity Commercial |
$369.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.35
|
| Rate for Payer: Healthscope Commercial |
$386.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.05
|
| Rate for Payer: Mclaren Medicaid |
$75.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.72
|
| Rate for Payer: Meridian Medicaid |
$79.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.99
|
| Rate for Payer: Nomi Health Commercial |
$352.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$322.05
|
| Rate for Payer: PACE Senior Care Partners |
$101.98
|
| Rate for Payer: PACE SWMI |
$107.35
|
| Rate for Payer: PHP Commercial |
$364.99
|
| Rate for Payer: PHP Medicare Advantage |
$107.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$373.58
|
| Rate for Payer: Priority Health Medicare |
$108.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$298.86
|
| Rate for Payer: Railroad Medicare Medicare |
$107.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.87
|
| Rate for Payer: UHC Core |
$358.55
|
| Rate for Payer: UHC Exchange |
$107.35
|
| Rate for Payer: UHC Medicaid |
$75.70
|
| Rate for Payer: UHC Medicare Advantage |
$107.35
|
| Rate for Payer: UHCCP Medicaid |
$75.70
|
| Rate for Payer: VA VA |
$107.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.05
|
|
|
HYDROMORPHONE 4 MG TABLET
|
Facility
|
IP
|
$429.40
|
|
|
Service Code
|
NDC 60687059001
|
| Hospital Charge Code |
3761
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$298.86 |
| Max. Negotiated Rate |
$386.46 |
| Rate for Payer: Aetna Commercial |
$364.99
|
| Rate for Payer: BCBS Trust/PPO |
$354.64
|
| Rate for Payer: BCN Commercial |
$354.64
|
| Rate for Payer: Cash Price |
$343.52
|
| Rate for Payer: Cofinity Commercial |
$369.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.52
|
| Rate for Payer: Healthscope Commercial |
$386.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.99
|
| Rate for Payer: Nomi Health Commercial |
$352.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$322.05
|
| Rate for Payer: PHP Commercial |
$364.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$373.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$298.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.87
|
| Rate for Payer: UHC Core |
$358.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.05
|
|
|
HYDROMORPHONE 4 MG TABLET
|
Facility
|
IP
|
$193.80
|
|
|
Service Code
|
NDC 42858030225
|
| Hospital Charge Code |
3761
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$134.88 |
| Max. Negotiated Rate |
$174.42 |
| Rate for Payer: Aetna Commercial |
$164.73
|
| Rate for Payer: BCBS Trust/PPO |
$160.06
|
| Rate for Payer: BCN Commercial |
$160.06
|
| Rate for Payer: Cash Price |
$155.04
|
| Rate for Payer: Cofinity Commercial |
$166.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.04
|
| Rate for Payer: Healthscope Commercial |
$174.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.73
|
| Rate for Payer: Nomi Health Commercial |
$158.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.35
|
| Rate for Payer: PHP Commercial |
$164.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$168.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.54
|
| Rate for Payer: UHC Core |
$161.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.35
|
|
|
HYDROMORPHONE 4 MG TABLET
|
Facility
|
OP
|
$193.80
|
|
|
Service Code
|
NDC 42858030225
|
| Hospital Charge Code |
3761
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$34.17 |
| Max. Negotiated Rate |
$174.42 |
| Rate for Payer: Aetna Commercial |
$164.73
|
| Rate for Payer: Aetna Medicare |
$50.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.56
|
| Rate for Payer: BCBS Complete |
$35.87
|
| Rate for Payer: BCBS MAPPO |
$48.45
|
| Rate for Payer: BCBS Trust/PPO |
$159.32
|
| Rate for Payer: BCN Commercial |
$159.32
|
| Rate for Payer: BCN Medicare Advantage |
$48.45
|
| Rate for Payer: Cash Price |
$155.04
|
| Rate for Payer: Cofinity Commercial |
$166.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.45
|
| Rate for Payer: Healthscope Commercial |
$174.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.35
|
| Rate for Payer: Mclaren Medicaid |
$34.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.87
|
| Rate for Payer: Meridian Medicaid |
$35.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.73
|
| Rate for Payer: Nomi Health Commercial |
$158.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.35
|
| Rate for Payer: PACE Senior Care Partners |
$46.03
|
| Rate for Payer: PACE SWMI |
$48.45
|
| Rate for Payer: PHP Commercial |
$164.73
|
| Rate for Payer: PHP Medicare Advantage |
$48.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$168.61
|
| Rate for Payer: Priority Health Medicare |
$48.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.88
|
| Rate for Payer: Railroad Medicare Medicare |
$48.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.54
|
| Rate for Payer: UHC Core |
$161.82
|
| Rate for Payer: UHC Exchange |
$48.45
|
| Rate for Payer: UHC Medicaid |
$34.17
|
| Rate for Payer: UHC Medicare Advantage |
$48.45
|
| Rate for Payer: UHCCP Medicaid |
$34.17
|
| Rate for Payer: VA VA |
$48.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.35
|
|
|
HYDROMORPHONE 4 MG TABLET
|
Facility
|
IP
|
$4.30
|
|
|
Service Code
|
NDC 60687059011
|
| Hospital Charge Code |
3761
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$3.87 |
| Rate for Payer: Aetna Commercial |
$3.65
|
| Rate for Payer: BCBS Trust/PPO |
$3.55
|
| Rate for Payer: BCN Commercial |
$3.55
|
| Rate for Payer: Cash Price |
$3.44
|
| Rate for Payer: Cofinity Commercial |
$3.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.44
|
| Rate for Payer: Healthscope Commercial |
$3.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.65
|
| Rate for Payer: Nomi Health Commercial |
$3.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.23
|
| Rate for Payer: PHP Commercial |
$3.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.78
|
| Rate for Payer: UHC Core |
$3.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.23
|
|
|
HYDROMORPHONE 4 MG TABLET
|
Facility
|
OP
|
$4.30
|
|
|
Service Code
|
NDC 60687059011
|
| Hospital Charge Code |
3761
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.76 |
| Max. Negotiated Rate |
$3.87 |
| Rate for Payer: Aetna Commercial |
$3.65
|
| Rate for Payer: Aetna Medicare |
$1.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.34
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: BCBS MAPPO |
$1.07
|
| Rate for Payer: BCBS Trust/PPO |
$3.54
|
| Rate for Payer: BCN Commercial |
$3.54
|
| Rate for Payer: BCN Medicare Advantage |
$1.07
|
| Rate for Payer: Cash Price |
$3.44
|
| Rate for Payer: Cofinity Commercial |
$3.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.07
|
| Rate for Payer: Healthscope Commercial |
$3.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.23
|
| Rate for Payer: Mclaren Medicaid |
$0.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.13
|
| Rate for Payer: Meridian Medicaid |
$0.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.65
|
| Rate for Payer: Nomi Health Commercial |
$3.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.23
|
| Rate for Payer: PACE Senior Care Partners |
$1.02
|
| Rate for Payer: PACE SWMI |
$1.07
|
| Rate for Payer: PHP Commercial |
$3.65
|
| Rate for Payer: PHP Medicare Advantage |
$1.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.74
|
| Rate for Payer: Priority Health Medicare |
$1.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.78
|
| Rate for Payer: UHC Core |
$3.59
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UHC Medicaid |
$0.76
|
| Rate for Payer: UHC Medicare Advantage |
$1.07
|
| Rate for Payer: UHCCP Medicaid |
$0.76
|
| Rate for Payer: VA VA |
$1.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.23
|
|
|
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$40.50
|
|
|
Service Code
|
HCPCS J1171
|
| Hospital Charge Code |
10224
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.19 |
| Max. Negotiated Rate |
$36.45 |
| Rate for Payer: Aetna Commercial |
$34.42
|
| Rate for Payer: BCBS Trust/PPO |
$33.45
|
| Rate for Payer: BCN Commercial |
$33.45
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cofinity Commercial |
$34.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.40
|
| Rate for Payer: Healthscope Commercial |
$36.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.42
|
| Rate for Payer: Nomi Health Commercial |
$33.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.38
|
| Rate for Payer: PHP Commercial |
$34.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.64
|
| Rate for Payer: UHC Core |
$33.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.38
|
|
|
HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$40.50
|
|
|
Service Code
|
HCPCS J1171
|
| Hospital Charge Code |
10224
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.14 |
| Max. Negotiated Rate |
$36.45 |
| Rate for Payer: Aetna Commercial |
$34.42
|
| Rate for Payer: Aetna Medicare |
$10.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.66
|
| Rate for Payer: BCBS Complete |
$7.50
|
| Rate for Payer: BCBS MAPPO |
$10.12
|
| Rate for Payer: BCBS Trust/PPO |
$33.30
|
| Rate for Payer: BCN Commercial |
$33.30
|
| Rate for Payer: BCN Medicare Advantage |
$10.12
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cofinity Commercial |
$34.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.12
|
| Rate for Payer: Healthscope Commercial |
$36.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.38
|
| Rate for Payer: Mclaren Medicaid |
$7.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.63
|
| Rate for Payer: Meridian Medicaid |
$7.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.42
|
| Rate for Payer: Nomi Health Commercial |
$33.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.38
|
| Rate for Payer: PACE Senior Care Partners |
$9.62
|
| Rate for Payer: PACE SWMI |
$10.12
|
| Rate for Payer: PHP Commercial |
$34.42
|
| Rate for Payer: PHP Medicare Advantage |
$10.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.23
|
| Rate for Payer: Priority Health Medicare |
$10.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.19
|
| Rate for Payer: Railroad Medicare Medicare |
$10.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.64
|
| Rate for Payer: UHC Core |
$33.82
|
| Rate for Payer: UHC Exchange |
$10.12
|
| Rate for Payer: UHC Medicaid |
$7.14
|
| Rate for Payer: UHC Medicare Advantage |
$10.12
|
| Rate for Payer: UHCCP Medicaid |
$7.14
|
| Rate for Payer: VA VA |
$10.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.38
|
|
|
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$26.89
|
|
|
Service Code
|
HCPCS J1171
|
| Hospital Charge Code |
117123
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$24.20 |
| Rate for Payer: Aetna Commercial |
$22.86
|
| Rate for Payer: Aetna Medicare |
$6.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.40
|
| Rate for Payer: BCBS Complete |
$4.98
|
| Rate for Payer: BCBS MAPPO |
$6.72
|
| Rate for Payer: BCBS Trust/PPO |
$22.11
|
| Rate for Payer: BCN Commercial |
$22.11
|
| Rate for Payer: BCN Medicare Advantage |
$6.72
|
| Rate for Payer: Cash Price |
$21.51
|
| Rate for Payer: Cofinity Commercial |
$23.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.72
|
| Rate for Payer: Healthscope Commercial |
$24.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.17
|
| Rate for Payer: Mclaren Medicaid |
$4.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.06
|
| Rate for Payer: Meridian Medicaid |
$4.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.86
|
| Rate for Payer: Nomi Health Commercial |
$22.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.17
|
| Rate for Payer: PACE Senior Care Partners |
$6.39
|
| Rate for Payer: PACE SWMI |
$6.72
|
| Rate for Payer: PHP Commercial |
$22.86
|
| Rate for Payer: PHP Medicare Advantage |
$6.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.39
|
| Rate for Payer: Priority Health Medicare |
$6.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.72
|
| Rate for Payer: Railroad Medicare Medicare |
$6.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.66
|
| Rate for Payer: UHC Core |
$22.45
|
| Rate for Payer: UHC Exchange |
$6.72
|
| Rate for Payer: UHC Medicaid |
$4.74
|
| Rate for Payer: UHC Medicare Advantage |
$6.72
|
| Rate for Payer: UHCCP Medicaid |
$4.74
|
| Rate for Payer: VA VA |
$6.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.17
|
|
|
HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$26.89
|
|
|
Service Code
|
HCPCS J1171
|
| Hospital Charge Code |
117123
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.72 |
| Max. Negotiated Rate |
$24.20 |
| Rate for Payer: Aetna Commercial |
$22.86
|
| Rate for Payer: BCBS Trust/PPO |
$22.21
|
| Rate for Payer: BCN Commercial |
$22.21
|
| Rate for Payer: Cash Price |
$21.51
|
| Rate for Payer: Cofinity Commercial |
$23.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.51
|
| Rate for Payer: Healthscope Commercial |
$24.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.86
|
| Rate for Payer: Nomi Health Commercial |
$22.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.17
|
| Rate for Payer: PHP Commercial |
$22.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.66
|
| Rate for Payer: UHC Core |
$22.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.17
|
|
|
HYDROMORPHONE VARIABLE DOSE
|
Facility
|
OP
|
$14.07
|
|
|
Service Code
|
HCPCS J1171
|
| Hospital Charge Code |
150712
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$12.66 |
| Rate for Payer: Aetna Commercial |
$11.96
|
| Rate for Payer: Aetna Medicare |
$3.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.40
|
| Rate for Payer: BCBS Complete |
$2.60
|
| Rate for Payer: BCBS MAPPO |
$3.52
|
| Rate for Payer: BCBS Trust/PPO |
$11.57
|
| Rate for Payer: BCN Commercial |
$11.57
|
| Rate for Payer: BCN Medicare Advantage |
$3.52
|
| Rate for Payer: Cash Price |
$11.26
|
| Rate for Payer: Cofinity Commercial |
$12.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.52
|
| Rate for Payer: Healthscope Commercial |
$12.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.55
|
| Rate for Payer: Mclaren Medicaid |
$2.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.69
|
| Rate for Payer: Meridian Medicaid |
$2.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.96
|
| Rate for Payer: Nomi Health Commercial |
$11.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.55
|
| Rate for Payer: PACE Senior Care Partners |
$3.34
|
| Rate for Payer: PACE SWMI |
$3.52
|
| Rate for Payer: PHP Commercial |
$11.96
|
| Rate for Payer: PHP Medicare Advantage |
$3.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.24
|
| Rate for Payer: Priority Health Medicare |
$3.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.79
|
| Rate for Payer: Railroad Medicare Medicare |
$3.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.38
|
| Rate for Payer: UHC Core |
$11.75
|
| Rate for Payer: UHC Exchange |
$3.52
|
| Rate for Payer: UHC Medicaid |
$2.48
|
| Rate for Payer: UHC Medicare Advantage |
$3.52
|
| Rate for Payer: UHCCP Medicaid |
$2.48
|
| Rate for Payer: VA VA |
$3.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.55
|
|
|
HYDROMORPHONE VARIABLE DOSE
|
Facility
|
IP
|
$14.07
|
|
|
Service Code
|
HCPCS J1171
|
| Hospital Charge Code |
150712
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$12.66 |
| Rate for Payer: Aetna Commercial |
$11.96
|
| Rate for Payer: BCBS Trust/PPO |
$11.62
|
| Rate for Payer: BCN Commercial |
$11.62
|
| Rate for Payer: Cash Price |
$11.26
|
| Rate for Payer: Cofinity Commercial |
$12.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.26
|
| Rate for Payer: Healthscope Commercial |
$12.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.96
|
| Rate for Payer: Nomi Health Commercial |
$11.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.55
|
| Rate for Payer: PHP Commercial |
$11.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.38
|
| Rate for Payer: UHC Core |
$11.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.55
|
|
|
HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$3,118.85
|
|
|
Service Code
|
HCPCS J3424
|
| Hospital Charge Code |
155400
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,170.72 |
| Max. Negotiated Rate |
$2,806.97 |
| Rate for Payer: Aetna Commercial |
$2,651.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,575.86
|
| Rate for Payer: BCN Commercial |
$2,575.86
|
| Rate for Payer: Cash Price |
$2,495.08
|
| Rate for Payer: Cofinity Commercial |
$2,682.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,495.08
|
| Rate for Payer: Healthscope Commercial |
$2,806.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,339.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,651.02
|
| Rate for Payer: Nomi Health Commercial |
$2,557.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,339.14
|
| Rate for Payer: PHP Commercial |
$2,651.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,713.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,170.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,744.59
|
| Rate for Payer: UHC Core |
$2,604.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,339.14
|
|
