|
INHALER, ASSIST DEVICES, ACCESSORIES
|
Facility
|
IP
|
$25.87
|
|
|
Service Code
|
NDC 08373081111
|
| Hospital Charge Code |
118717
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$18.01 |
| Max. Negotiated Rate |
$23.28 |
| Rate for Payer: Aetna Commercial |
$21.99
|
| Rate for Payer: BCBS Trust/PPO |
$21.37
|
| Rate for Payer: BCN Commercial |
$21.37
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cofinity Commercial |
$22.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.70
|
| Rate for Payer: Healthscope Commercial |
$23.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.99
|
| Rate for Payer: Nomi Health Commercial |
$21.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.40
|
| Rate for Payer: PHP Commercial |
$21.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.77
|
| Rate for Payer: UHC Core |
$21.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.40
|
|
|
INHALER, ASSIST DEVICES, ACCESSORIES
|
Facility
|
OP
|
$25.87
|
|
|
Service Code
|
NDC 08373081111
|
| Hospital Charge Code |
118717
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.56 |
| Max. Negotiated Rate |
$23.28 |
| Rate for Payer: Aetna Commercial |
$21.99
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.08
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cofinity Commercial |
$22.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.40
|
| Rate for Payer: Mclaren Medicaid |
$4.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.99
|
| Rate for Payer: Nomi Health Commercial |
$21.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.40
|
| Rate for Payer: PACE Senior Care Partners |
$6.14
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$21.99
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.51
|
| Rate for Payer: Priority Health Medicare |
$6.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.77
|
| Rate for Payer: UHC Core |
$21.60
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.56
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.56
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.40
|
|
|
INHALER, ASSIST DEVICES, ACCESSORIES
|
Facility
|
IP
|
$24.83
|
|
|
Service Code
|
NDC 08373081211
|
| Hospital Charge Code |
118717
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$17.28 |
| Max. Negotiated Rate |
$22.35 |
| Rate for Payer: Aetna Commercial |
$21.11
|
| Rate for Payer: BCBS Trust/PPO |
$20.51
|
| Rate for Payer: BCN Commercial |
$20.51
|
| Rate for Payer: Cash Price |
$19.86
|
| Rate for Payer: Cofinity Commercial |
$21.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.86
|
| Rate for Payer: Healthscope Commercial |
$22.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.11
|
| Rate for Payer: Nomi Health Commercial |
$20.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.62
|
| Rate for Payer: PHP Commercial |
$21.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.85
|
| Rate for Payer: UHC Core |
$20.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.62
|
|
|
INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES
|
Facility
|
IP
|
$36,901.87
|
|
|
Service Code
|
APR-DRG 1764
|
| Min. Negotiated Rate |
$35,144.64 |
| Max. Negotiated Rate |
$36,901.87 |
| Rate for Payer: BCBS Complete |
$36,901.87
|
| Rate for Payer: Mclaren Medicaid |
$35,144.64
|
| Rate for Payer: Meridian Medicaid |
$36,901.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$35,144.64
|
| Rate for Payer: UHC Medicaid |
$35,144.64
|
| Rate for Payer: UHCCP Medicaid |
$35,144.64
|
|
|
INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES
|
Facility
|
IP
|
$25,021.57
|
|
|
Service Code
|
APR-DRG 1763
|
| Min. Negotiated Rate |
$23,830.07 |
| Max. Negotiated Rate |
$25,021.57 |
| Rate for Payer: BCBS Complete |
$25,021.57
|
| Rate for Payer: Mclaren Medicaid |
$23,830.07
|
| Rate for Payer: Meridian Medicaid |
$25,021.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$23,830.07
|
| Rate for Payer: UHC Medicaid |
$23,830.07
|
| Rate for Payer: UHCCP Medicaid |
$23,830.07
|
|
|
INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES
|
Facility
|
IP
|
$20,023.99
|
|
|
Service Code
|
APR-DRG 1762
|
| Min. Negotiated Rate |
$19,070.46 |
| Max. Negotiated Rate |
$20,023.99 |
| Rate for Payer: BCBS Complete |
$20,023.99
|
| Rate for Payer: Mclaren Medicaid |
$19,070.46
|
| Rate for Payer: Meridian Medicaid |
$20,023.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$19,070.46
|
| Rate for Payer: UHC Medicaid |
$19,070.46
|
| Rate for Payer: UHCCP Medicaid |
$19,070.46
|
|
|
INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES
|
Facility
|
IP
|
$9,769.06
|
|
|
Service Code
|
APR-DRG 1761
|
| Min. Negotiated Rate |
$9,303.86 |
| Max. Negotiated Rate |
$9,769.06 |
| Rate for Payer: BCBS Complete |
$9,769.06
|
| Rate for Payer: Mclaren Medicaid |
$9,303.86
|
| Rate for Payer: Meridian Medicaid |
$9,769.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,303.86
|
| Rate for Payer: UHC Medicaid |
$9,303.86
|
| Rate for Payer: UHCCP Medicaid |
$9,303.86
|
|
|
INSULIN 5 UNIT/5 ML IV PUSH 5 ML
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
NDC 09900001138
|
| Hospital Charge Code |
300205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Aetna Commercial |
$17.00
|
| Rate for Payer: BCBS Trust/PPO |
$16.52
|
| Rate for Payer: BCN Commercial |
$16.52
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$17.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.00
|
| Rate for Payer: Healthscope Commercial |
$18.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.00
|
| Rate for Payer: Nomi Health Commercial |
$16.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.00
|
| Rate for Payer: PHP Commercial |
$17.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.60
|
| Rate for Payer: UHC Core |
$16.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.00
|
|
|
INSULIN 5 UNIT/5 ML IV PUSH 5 ML
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
NDC 09900001138
|
| Hospital Charge Code |
300205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.53 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Aetna Commercial |
$17.00
|
| Rate for Payer: Aetna Medicare |
$5.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.25
|
| Rate for Payer: BCBS Complete |
$3.70
|
| Rate for Payer: BCBS MAPPO |
$5.00
|
| Rate for Payer: BCBS Trust/PPO |
$16.44
|
| Rate for Payer: BCN Commercial |
$16.44
|
| Rate for Payer: BCN Medicare Advantage |
$5.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$17.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.00
|
| Rate for Payer: Healthscope Commercial |
$18.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.00
|
| Rate for Payer: Mclaren Medicaid |
$3.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.25
|
| Rate for Payer: Meridian Medicaid |
$3.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.00
|
| Rate for Payer: Nomi Health Commercial |
$16.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.00
|
| Rate for Payer: PACE Senior Care Partners |
$4.75
|
| Rate for Payer: PACE SWMI |
$5.00
|
| Rate for Payer: PHP Commercial |
$17.00
|
| Rate for Payer: PHP Medicare Advantage |
$5.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.40
|
| Rate for Payer: Priority Health Medicare |
$5.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.92
|
| Rate for Payer: Railroad Medicare Medicare |
$5.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.60
|
| Rate for Payer: UHC Core |
$16.70
|
| Rate for Payer: UHC Exchange |
$5.00
|
| Rate for Payer: UHC Medicaid |
$3.53
|
| Rate for Payer: UHC Medicare Advantage |
$5.00
|
| Rate for Payer: UHCCP Medicaid |
$3.53
|
| Rate for Payer: VA VA |
$5.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.00
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) HIGH DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
OP
|
$115.64
|
|
|
Service Code
|
NDC 73070010315
|
| Hospital Charge Code |
300798
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.39 |
| Max. Negotiated Rate |
$104.08 |
| Rate for Payer: Aetna Commercial |
$98.29
|
| Rate for Payer: Aetna Medicare |
$30.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.14
|
| Rate for Payer: BCBS Complete |
$21.40
|
| Rate for Payer: BCBS MAPPO |
$28.91
|
| Rate for Payer: BCBS Trust/PPO |
$95.07
|
| Rate for Payer: BCN Commercial |
$95.07
|
| Rate for Payer: BCN Medicare Advantage |
$28.91
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$99.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.91
|
| Rate for Payer: Healthscope Commercial |
$104.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.73
|
| Rate for Payer: Mclaren Medicaid |
$20.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.36
|
| Rate for Payer: Meridian Medicaid |
$21.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: PACE Senior Care Partners |
$27.46
|
| Rate for Payer: PACE SWMI |
$28.91
|
| Rate for Payer: PHP Commercial |
$98.29
|
| Rate for Payer: PHP Medicare Advantage |
$28.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$100.61
|
| Rate for Payer: Priority Health Medicare |
$29.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.49
|
| Rate for Payer: Railroad Medicare Medicare |
$28.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.76
|
| Rate for Payer: UHC Core |
$96.56
|
| Rate for Payer: UHC Exchange |
$28.91
|
| Rate for Payer: UHC Medicaid |
$20.39
|
| Rate for Payer: UHC Medicare Advantage |
$28.91
|
| Rate for Payer: UHCCP Medicaid |
$20.39
|
| Rate for Payer: VA VA |
$28.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.73
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) HIGH DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
IP
|
$63.94
|
|
|
Service Code
|
NDC 00169633910
|
| Hospital Charge Code |
300798
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$44.50 |
| Max. Negotiated Rate |
$57.55 |
| Rate for Payer: Aetna Commercial |
$54.35
|
| Rate for Payer: BCBS Trust/PPO |
$52.81
|
| Rate for Payer: BCN Commercial |
$52.81
|
| Rate for Payer: Cash Price |
$51.15
|
| Rate for Payer: Cofinity Commercial |
$54.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.15
|
| Rate for Payer: Healthscope Commercial |
$57.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.35
|
| Rate for Payer: Nomi Health Commercial |
$52.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.95
|
| Rate for Payer: PHP Commercial |
$54.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.27
|
| Rate for Payer: UHC Core |
$53.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.95
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) HIGH DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
IP
|
$115.64
|
|
|
Service Code
|
NDC 73070010315
|
| Hospital Charge Code |
300798
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$80.49 |
| Max. Negotiated Rate |
$104.08 |
| Rate for Payer: Aetna Commercial |
$98.29
|
| Rate for Payer: BCBS Trust/PPO |
$95.51
|
| Rate for Payer: BCN Commercial |
$95.51
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$99.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Healthscope Commercial |
$104.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: PHP Commercial |
$98.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$100.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.76
|
| Rate for Payer: UHC Core |
$96.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.73
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) HIGH DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
OP
|
$63.94
|
|
|
Service Code
|
NDC 00169633910
|
| Hospital Charge Code |
300798
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.27 |
| Max. Negotiated Rate |
$57.55 |
| Rate for Payer: Aetna Commercial |
$54.35
|
| Rate for Payer: Aetna Medicare |
$16.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.98
|
| Rate for Payer: BCBS Complete |
$11.84
|
| Rate for Payer: BCBS MAPPO |
$15.98
|
| Rate for Payer: BCBS Trust/PPO |
$52.57
|
| Rate for Payer: BCN Commercial |
$52.57
|
| Rate for Payer: BCN Medicare Advantage |
$15.98
|
| Rate for Payer: Cash Price |
$51.15
|
| Rate for Payer: Cofinity Commercial |
$54.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.98
|
| Rate for Payer: Healthscope Commercial |
$57.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.95
|
| Rate for Payer: Mclaren Medicaid |
$11.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.78
|
| Rate for Payer: Meridian Medicaid |
$11.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.35
|
| Rate for Payer: Nomi Health Commercial |
$52.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.95
|
| Rate for Payer: PACE Senior Care Partners |
$15.19
|
| Rate for Payer: PACE SWMI |
$15.98
|
| Rate for Payer: PHP Commercial |
$54.35
|
| Rate for Payer: PHP Medicare Advantage |
$15.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.63
|
| Rate for Payer: Priority Health Medicare |
$16.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.50
|
| Rate for Payer: Railroad Medicare Medicare |
$15.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.27
|
| Rate for Payer: UHC Core |
$53.39
|
| Rate for Payer: UHC Exchange |
$15.98
|
| Rate for Payer: UHC Medicaid |
$11.27
|
| Rate for Payer: UHC Medicare Advantage |
$15.98
|
| Rate for Payer: UHCCP Medicaid |
$11.27
|
| Rate for Payer: VA VA |
$15.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.95
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) HIGH DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
IP
|
$115.64
|
|
|
Service Code
|
NDC 73070010310
|
| Hospital Charge Code |
300798
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$80.49 |
| Max. Negotiated Rate |
$104.08 |
| Rate for Payer: Aetna Commercial |
$98.29
|
| Rate for Payer: BCBS Trust/PPO |
$95.51
|
| Rate for Payer: BCN Commercial |
$95.51
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$99.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Healthscope Commercial |
$104.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: PHP Commercial |
$98.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$100.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.76
|
| Rate for Payer: UHC Core |
$96.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.73
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) HIGH DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
OP
|
$115.64
|
|
|
Service Code
|
NDC 73070010310
|
| Hospital Charge Code |
300798
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.39 |
| Max. Negotiated Rate |
$104.08 |
| Rate for Payer: Aetna Commercial |
$98.29
|
| Rate for Payer: Aetna Medicare |
$30.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.14
|
| Rate for Payer: BCBS Complete |
$21.40
|
| Rate for Payer: BCBS MAPPO |
$28.91
|
| Rate for Payer: BCBS Trust/PPO |
$95.07
|
| Rate for Payer: BCN Commercial |
$95.07
|
| Rate for Payer: BCN Medicare Advantage |
$28.91
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$99.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.91
|
| Rate for Payer: Healthscope Commercial |
$104.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.73
|
| Rate for Payer: Mclaren Medicaid |
$20.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.36
|
| Rate for Payer: Meridian Medicaid |
$21.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: PACE Senior Care Partners |
$27.46
|
| Rate for Payer: PACE SWMI |
$28.91
|
| Rate for Payer: PHP Commercial |
$98.29
|
| Rate for Payer: PHP Medicare Advantage |
$28.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$100.61
|
| Rate for Payer: Priority Health Medicare |
$29.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.49
|
| Rate for Payer: Railroad Medicare Medicare |
$28.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.76
|
| Rate for Payer: UHC Core |
$96.56
|
| Rate for Payer: UHC Exchange |
$28.91
|
| Rate for Payer: UHC Medicaid |
$20.39
|
| Rate for Payer: UHC Medicare Advantage |
$28.91
|
| Rate for Payer: UHCCP Medicaid |
$20.39
|
| Rate for Payer: VA VA |
$28.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.73
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) LOW DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
OP
|
$63.94
|
|
|
Service Code
|
NDC 00169633910
|
| Hospital Charge Code |
300796
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.27 |
| Max. Negotiated Rate |
$57.55 |
| Rate for Payer: Aetna Commercial |
$54.35
|
| Rate for Payer: Aetna Medicare |
$16.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.98
|
| Rate for Payer: BCBS Complete |
$11.84
|
| Rate for Payer: BCBS MAPPO |
$15.98
|
| Rate for Payer: BCBS Trust/PPO |
$52.57
|
| Rate for Payer: BCN Commercial |
$52.57
|
| Rate for Payer: BCN Medicare Advantage |
$15.98
|
| Rate for Payer: Cash Price |
$51.15
|
| Rate for Payer: Cofinity Commercial |
$54.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.98
|
| Rate for Payer: Healthscope Commercial |
$57.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.95
|
| Rate for Payer: Mclaren Medicaid |
$11.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.78
|
| Rate for Payer: Meridian Medicaid |
$11.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.35
|
| Rate for Payer: Nomi Health Commercial |
$52.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.95
|
| Rate for Payer: PACE Senior Care Partners |
$15.19
|
| Rate for Payer: PACE SWMI |
$15.98
|
| Rate for Payer: PHP Commercial |
$54.35
|
| Rate for Payer: PHP Medicare Advantage |
$15.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.63
|
| Rate for Payer: Priority Health Medicare |
$16.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.50
|
| Rate for Payer: Railroad Medicare Medicare |
$15.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.27
|
| Rate for Payer: UHC Core |
$53.39
|
| Rate for Payer: UHC Exchange |
$15.98
|
| Rate for Payer: UHC Medicaid |
$11.27
|
| Rate for Payer: UHC Medicare Advantage |
$15.98
|
| Rate for Payer: UHCCP Medicaid |
$11.27
|
| Rate for Payer: VA VA |
$15.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.95
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) LOW DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
IP
|
$63.94
|
|
|
Service Code
|
NDC 00169633910
|
| Hospital Charge Code |
300796
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$44.50 |
| Max. Negotiated Rate |
$57.55 |
| Rate for Payer: Aetna Commercial |
$54.35
|
| Rate for Payer: BCBS Trust/PPO |
$52.81
|
| Rate for Payer: BCN Commercial |
$52.81
|
| Rate for Payer: Cash Price |
$51.15
|
| Rate for Payer: Cofinity Commercial |
$54.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.15
|
| Rate for Payer: Healthscope Commercial |
$57.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.35
|
| Rate for Payer: Nomi Health Commercial |
$52.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.95
|
| Rate for Payer: PHP Commercial |
$54.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.27
|
| Rate for Payer: UHC Core |
$53.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.95
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) LOW DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
OP
|
$115.64
|
|
|
Service Code
|
NDC 73070010315
|
| Hospital Charge Code |
300796
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.39 |
| Max. Negotiated Rate |
$104.08 |
| Rate for Payer: Aetna Commercial |
$98.29
|
| Rate for Payer: Aetna Medicare |
$30.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.14
|
| Rate for Payer: BCBS Complete |
$21.40
|
| Rate for Payer: BCBS MAPPO |
$28.91
|
| Rate for Payer: BCBS Trust/PPO |
$95.07
|
| Rate for Payer: BCN Commercial |
$95.07
|
| Rate for Payer: BCN Medicare Advantage |
$28.91
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$99.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.91
|
| Rate for Payer: Healthscope Commercial |
$104.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.73
|
| Rate for Payer: Mclaren Medicaid |
$20.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.36
|
| Rate for Payer: Meridian Medicaid |
$21.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: PACE Senior Care Partners |
$27.46
|
| Rate for Payer: PACE SWMI |
$28.91
|
| Rate for Payer: PHP Commercial |
$98.29
|
| Rate for Payer: PHP Medicare Advantage |
$28.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$100.61
|
| Rate for Payer: Priority Health Medicare |
$29.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.49
|
| Rate for Payer: Railroad Medicare Medicare |
$28.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.76
|
| Rate for Payer: UHC Core |
$96.56
|
| Rate for Payer: UHC Exchange |
$28.91
|
| Rate for Payer: UHC Medicaid |
$20.39
|
| Rate for Payer: UHC Medicare Advantage |
$28.91
|
| Rate for Payer: UHCCP Medicaid |
$20.39
|
| Rate for Payer: VA VA |
$28.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.73
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) LOW DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
OP
|
$115.64
|
|
|
Service Code
|
NDC 73070010310
|
| Hospital Charge Code |
300796
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.39 |
| Max. Negotiated Rate |
$104.08 |
| Rate for Payer: Aetna Commercial |
$98.29
|
| Rate for Payer: Aetna Medicare |
$30.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.14
|
| Rate for Payer: BCBS Complete |
$21.40
|
| Rate for Payer: BCBS MAPPO |
$28.91
|
| Rate for Payer: BCBS Trust/PPO |
$95.07
|
| Rate for Payer: BCN Commercial |
$95.07
|
| Rate for Payer: BCN Medicare Advantage |
$28.91
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$99.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.91
|
| Rate for Payer: Healthscope Commercial |
$104.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.73
|
| Rate for Payer: Mclaren Medicaid |
$20.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.36
|
| Rate for Payer: Meridian Medicaid |
$21.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: PACE Senior Care Partners |
$27.46
|
| Rate for Payer: PACE SWMI |
$28.91
|
| Rate for Payer: PHP Commercial |
$98.29
|
| Rate for Payer: PHP Medicare Advantage |
$28.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$100.61
|
| Rate for Payer: Priority Health Medicare |
$29.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.49
|
| Rate for Payer: Railroad Medicare Medicare |
$28.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.76
|
| Rate for Payer: UHC Core |
$96.56
|
| Rate for Payer: UHC Exchange |
$28.91
|
| Rate for Payer: UHC Medicaid |
$20.39
|
| Rate for Payer: UHC Medicare Advantage |
$28.91
|
| Rate for Payer: UHCCP Medicaid |
$20.39
|
| Rate for Payer: VA VA |
$28.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.73
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) LOW DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
IP
|
$115.64
|
|
|
Service Code
|
NDC 73070010315
|
| Hospital Charge Code |
300796
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$80.49 |
| Max. Negotiated Rate |
$104.08 |
| Rate for Payer: Aetna Commercial |
$98.29
|
| Rate for Payer: BCBS Trust/PPO |
$95.51
|
| Rate for Payer: BCN Commercial |
$95.51
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$99.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Healthscope Commercial |
$104.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: PHP Commercial |
$98.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$100.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.76
|
| Rate for Payer: UHC Core |
$96.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.73
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) LOW DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
IP
|
$115.64
|
|
|
Service Code
|
NDC 73070010310
|
| Hospital Charge Code |
300796
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$80.49 |
| Max. Negotiated Rate |
$104.08 |
| Rate for Payer: Aetna Commercial |
$98.29
|
| Rate for Payer: BCBS Trust/PPO |
$95.51
|
| Rate for Payer: BCN Commercial |
$95.51
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$99.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Healthscope Commercial |
$104.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: PHP Commercial |
$98.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$100.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.76
|
| Rate for Payer: UHC Core |
$96.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.73
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) MEDIUM DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
IP
|
$63.94
|
|
|
Service Code
|
NDC 00169633910
|
| Hospital Charge Code |
300797
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$44.50 |
| Max. Negotiated Rate |
$57.55 |
| Rate for Payer: Aetna Commercial |
$54.35
|
| Rate for Payer: BCBS Trust/PPO |
$52.81
|
| Rate for Payer: BCN Commercial |
$52.81
|
| Rate for Payer: Cash Price |
$51.15
|
| Rate for Payer: Cofinity Commercial |
$54.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.15
|
| Rate for Payer: Healthscope Commercial |
$57.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.35
|
| Rate for Payer: Nomi Health Commercial |
$52.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.95
|
| Rate for Payer: PHP Commercial |
$54.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.27
|
| Rate for Payer: UHC Core |
$53.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.95
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) MEDIUM DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
IP
|
$115.64
|
|
|
Service Code
|
NDC 73070010315
|
| Hospital Charge Code |
300797
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$80.49 |
| Max. Negotiated Rate |
$104.08 |
| Rate for Payer: Aetna Commercial |
$98.29
|
| Rate for Payer: BCBS Trust/PPO |
$95.51
|
| Rate for Payer: BCN Commercial |
$95.51
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$99.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Healthscope Commercial |
$104.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: PHP Commercial |
$98.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$100.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.76
|
| Rate for Payer: UHC Core |
$96.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.73
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) MEDIUM DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
OP
|
$115.64
|
|
|
Service Code
|
NDC 73070010310
|
| Hospital Charge Code |
300797
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.39 |
| Max. Negotiated Rate |
$104.08 |
| Rate for Payer: Aetna Commercial |
$98.29
|
| Rate for Payer: Aetna Medicare |
$30.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.14
|
| Rate for Payer: BCBS Complete |
$21.40
|
| Rate for Payer: BCBS MAPPO |
$28.91
|
| Rate for Payer: BCBS Trust/PPO |
$95.07
|
| Rate for Payer: BCN Commercial |
$95.07
|
| Rate for Payer: BCN Medicare Advantage |
$28.91
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$99.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.91
|
| Rate for Payer: Healthscope Commercial |
$104.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.73
|
| Rate for Payer: Mclaren Medicaid |
$20.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.36
|
| Rate for Payer: Meridian Medicaid |
$21.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: PACE Senior Care Partners |
$27.46
|
| Rate for Payer: PACE SWMI |
$28.91
|
| Rate for Payer: PHP Commercial |
$98.29
|
| Rate for Payer: PHP Medicare Advantage |
$28.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$100.61
|
| Rate for Payer: Priority Health Medicare |
$29.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.49
|
| Rate for Payer: Railroad Medicare Medicare |
$28.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.76
|
| Rate for Payer: UHC Core |
$96.56
|
| Rate for Payer: UHC Exchange |
$28.91
|
| Rate for Payer: UHC Medicaid |
$20.39
|
| Rate for Payer: UHC Medicare Advantage |
$28.91
|
| Rate for Payer: UHCCP Medicaid |
$20.39
|
| Rate for Payer: VA VA |
$28.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.73
|
|
|
INSULIN ASPART (U-100) 100 UNIT/ML (3 ML) MEDIUM DOSE SUBCUTANEOUS PEN CUSTOM
|
Facility
|
OP
|
$115.64
|
|
|
Service Code
|
NDC 73070010315
|
| Hospital Charge Code |
300797
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.39 |
| Max. Negotiated Rate |
$104.08 |
| Rate for Payer: Aetna Commercial |
$98.29
|
| Rate for Payer: Aetna Medicare |
$30.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.14
|
| Rate for Payer: BCBS Complete |
$21.40
|
| Rate for Payer: BCBS MAPPO |
$28.91
|
| Rate for Payer: BCBS Trust/PPO |
$95.07
|
| Rate for Payer: BCN Commercial |
$95.07
|
| Rate for Payer: BCN Medicare Advantage |
$28.91
|
| Rate for Payer: Cash Price |
$92.51
|
| Rate for Payer: Cofinity Commercial |
$99.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.91
|
| Rate for Payer: Healthscope Commercial |
$104.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.73
|
| Rate for Payer: Mclaren Medicaid |
$20.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.36
|
| Rate for Payer: Meridian Medicaid |
$21.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.29
|
| Rate for Payer: Nomi Health Commercial |
$94.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.73
|
| Rate for Payer: PACE Senior Care Partners |
$27.46
|
| Rate for Payer: PACE SWMI |
$28.91
|
| Rate for Payer: PHP Commercial |
$98.29
|
| Rate for Payer: PHP Medicare Advantage |
$28.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$100.61
|
| Rate for Payer: Priority Health Medicare |
$29.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.49
|
| Rate for Payer: Railroad Medicare Medicare |
$28.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.76
|
| Rate for Payer: UHC Core |
$96.56
|
| Rate for Payer: UHC Exchange |
$28.91
|
| Rate for Payer: UHC Medicaid |
$20.39
|
| Rate for Payer: UHC Medicare Advantage |
$28.91
|
| Rate for Payer: UHCCP Medicaid |
$20.39
|
| Rate for Payer: VA VA |
$28.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.73
|
|
