|
KETAMINE 50 MG/5 ML (10 MG/ML) IV SYRINGE
|
Facility
|
IP
|
$19.39
|
|
|
Service Code
|
NDC 70092911944
|
| Hospital Charge Code |
118700
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$17.45 |
| Rate for Payer: Aetna Commercial |
$16.48
|
| Rate for Payer: BCBS Trust/PPO |
$16.01
|
| Rate for Payer: BCN Commercial |
$16.01
|
| Rate for Payer: Cash Price |
$15.51
|
| Rate for Payer: Cofinity Commercial |
$16.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.51
|
| Rate for Payer: Healthscope Commercial |
$17.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.48
|
| Rate for Payer: Nomi Health Commercial |
$15.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.54
|
| Rate for Payer: PHP Commercial |
$16.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.06
|
| Rate for Payer: UHC Core |
$16.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.54
|
|
|
KETAMINE 50 MG/5 ML (10 MG/ML) IV SYRINGE
|
Facility
|
OP
|
$19.39
|
|
|
Service Code
|
NDC 70092911944
|
| Hospital Charge Code |
118700
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.42 |
| Max. Negotiated Rate |
$17.45 |
| Rate for Payer: Aetna Commercial |
$16.48
|
| Rate for Payer: Aetna Medicare |
$5.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.06
|
| Rate for Payer: BCBS Complete |
$3.59
|
| Rate for Payer: BCBS MAPPO |
$4.85
|
| Rate for Payer: BCBS Trust/PPO |
$15.94
|
| Rate for Payer: BCN Commercial |
$15.94
|
| Rate for Payer: BCN Medicare Advantage |
$4.85
|
| Rate for Payer: Cash Price |
$15.51
|
| Rate for Payer: Cofinity Commercial |
$16.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.85
|
| Rate for Payer: Healthscope Commercial |
$17.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.54
|
| Rate for Payer: Mclaren Medicaid |
$3.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.09
|
| Rate for Payer: Meridian Medicaid |
$3.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.48
|
| Rate for Payer: Nomi Health Commercial |
$15.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.54
|
| Rate for Payer: PACE Senior Care Partners |
$4.61
|
| Rate for Payer: PACE SWMI |
$4.85
|
| Rate for Payer: PHP Commercial |
$16.48
|
| Rate for Payer: PHP Medicare Advantage |
$4.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.87
|
| Rate for Payer: Priority Health Medicare |
$4.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.50
|
| Rate for Payer: Railroad Medicare Medicare |
$4.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.06
|
| Rate for Payer: UHC Core |
$16.19
|
| Rate for Payer: UHC Exchange |
$4.85
|
| Rate for Payer: UHC Medicaid |
$3.42
|
| Rate for Payer: UHC Medicare Advantage |
$4.85
|
| Rate for Payer: UHCCP Medicaid |
$3.42
|
| Rate for Payer: VA VA |
$4.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.54
|
|
|
KETAMINE 50 MG/5 ML (10 MG/ML) IV SYRINGE
|
Facility
|
IP
|
$32.20
|
|
|
Service Code
|
NDC 70092111944
|
| Hospital Charge Code |
118700
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$22.41 |
| Max. Negotiated Rate |
$28.98 |
| Rate for Payer: Aetna Commercial |
$27.37
|
| Rate for Payer: BCBS Trust/PPO |
$26.59
|
| Rate for Payer: BCN Commercial |
$26.59
|
| Rate for Payer: Cash Price |
$25.76
|
| Rate for Payer: Cofinity Commercial |
$27.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.76
|
| Rate for Payer: Healthscope Commercial |
$28.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.37
|
| Rate for Payer: Nomi Health Commercial |
$26.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.15
|
| Rate for Payer: PHP Commercial |
$27.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.34
|
| Rate for Payer: UHC Core |
$26.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.15
|
|
|
KETAMINE 50 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$39.06
|
|
|
Service Code
|
NDC 00143950801
|
| Hospital Charge Code |
4238
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$27.19 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Aetna Commercial |
$33.20
|
| Rate for Payer: BCBS Trust/PPO |
$32.26
|
| Rate for Payer: BCN Commercial |
$32.26
|
| Rate for Payer: Cash Price |
$31.25
|
| Rate for Payer: Cofinity Commercial |
$33.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.25
|
| Rate for Payer: Healthscope Commercial |
$35.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.20
|
| Rate for Payer: Nomi Health Commercial |
$32.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.30
|
| Rate for Payer: PHP Commercial |
$33.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.37
|
| Rate for Payer: UHC Core |
$32.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.30
|
|
|
KETAMINE 50 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$39.06
|
|
|
Service Code
|
NDC 00143950810
|
| Hospital Charge Code |
4238
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$27.19 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Aetna Commercial |
$33.20
|
| Rate for Payer: BCBS Trust/PPO |
$32.26
|
| Rate for Payer: BCN Commercial |
$32.26
|
| Rate for Payer: Cash Price |
$31.25
|
| Rate for Payer: Cofinity Commercial |
$33.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.25
|
| Rate for Payer: Healthscope Commercial |
$35.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.20
|
| Rate for Payer: Nomi Health Commercial |
$32.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.30
|
| Rate for Payer: PHP Commercial |
$33.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.37
|
| Rate for Payer: UHC Core |
$32.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.30
|
|
|
KETAMINE 50 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$39.06
|
|
|
Service Code
|
NDC 00143950801
|
| Hospital Charge Code |
4238
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Aetna Commercial |
$33.20
|
| Rate for Payer: Aetna Medicare |
$10.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.21
|
| Rate for Payer: BCBS Complete |
$7.23
|
| Rate for Payer: BCBS MAPPO |
$9.77
|
| Rate for Payer: BCBS Trust/PPO |
$32.11
|
| Rate for Payer: BCN Commercial |
$32.11
|
| Rate for Payer: BCN Medicare Advantage |
$9.77
|
| Rate for Payer: Cash Price |
$31.25
|
| Rate for Payer: Cofinity Commercial |
$33.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.77
|
| Rate for Payer: Healthscope Commercial |
$35.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.30
|
| Rate for Payer: Mclaren Medicaid |
$6.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.25
|
| Rate for Payer: Meridian Medicaid |
$7.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.20
|
| Rate for Payer: Nomi Health Commercial |
$32.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.30
|
| Rate for Payer: PACE Senior Care Partners |
$9.28
|
| Rate for Payer: PACE SWMI |
$9.77
|
| Rate for Payer: PHP Commercial |
$33.20
|
| Rate for Payer: PHP Medicare Advantage |
$9.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.98
|
| Rate for Payer: Priority Health Medicare |
$9.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.19
|
| Rate for Payer: Railroad Medicare Medicare |
$9.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.37
|
| Rate for Payer: UHC Core |
$32.62
|
| Rate for Payer: UHC Exchange |
$9.77
|
| Rate for Payer: UHC Medicaid |
$6.89
|
| Rate for Payer: UHC Medicare Advantage |
$9.77
|
| Rate for Payer: UHCCP Medicaid |
$6.89
|
| Rate for Payer: VA VA |
$9.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.30
|
|
|
KETAMINE 50 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$39.06
|
|
|
Service Code
|
NDC 00143950810
|
| Hospital Charge Code |
4238
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Aetna Commercial |
$33.20
|
| Rate for Payer: Aetna Medicare |
$10.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.21
|
| Rate for Payer: BCBS Complete |
$7.23
|
| Rate for Payer: BCBS MAPPO |
$9.77
|
| Rate for Payer: BCBS Trust/PPO |
$32.11
|
| Rate for Payer: BCN Commercial |
$32.11
|
| Rate for Payer: BCN Medicare Advantage |
$9.77
|
| Rate for Payer: Cash Price |
$31.25
|
| Rate for Payer: Cofinity Commercial |
$33.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.77
|
| Rate for Payer: Healthscope Commercial |
$35.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.30
|
| Rate for Payer: Mclaren Medicaid |
$6.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.25
|
| Rate for Payer: Meridian Medicaid |
$7.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.20
|
| Rate for Payer: Nomi Health Commercial |
$32.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.30
|
| Rate for Payer: PACE Senior Care Partners |
$9.28
|
| Rate for Payer: PACE SWMI |
$9.77
|
| Rate for Payer: PHP Commercial |
$33.20
|
| Rate for Payer: PHP Medicare Advantage |
$9.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.98
|
| Rate for Payer: Priority Health Medicare |
$9.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.19
|
| Rate for Payer: Railroad Medicare Medicare |
$9.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.37
|
| Rate for Payer: UHC Core |
$32.62
|
| Rate for Payer: UHC Exchange |
$9.77
|
| Rate for Payer: UHC Medicaid |
$6.89
|
| Rate for Payer: UHC Medicare Advantage |
$9.77
|
| Rate for Payer: UHCCP Medicaid |
$6.89
|
| Rate for Payer: VA VA |
$9.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.30
|
|
|
KETOCONAZOLE 2 % TOPICAL CREAM
|
Facility
|
OP
|
$20.59
|
|
|
Service Code
|
NDC 00168009915
|
| Hospital Charge Code |
10368
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$18.53 |
| Rate for Payer: Aetna Commercial |
$17.50
|
| Rate for Payer: Aetna Medicare |
$5.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.43
|
| Rate for Payer: BCBS Complete |
$3.81
|
| Rate for Payer: BCBS MAPPO |
$5.15
|
| Rate for Payer: BCBS Trust/PPO |
$16.93
|
| Rate for Payer: BCN Commercial |
$16.93
|
| Rate for Payer: BCN Medicare Advantage |
$5.15
|
| Rate for Payer: Cash Price |
$16.47
|
| Rate for Payer: Cofinity Commercial |
$17.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.15
|
| Rate for Payer: Healthscope Commercial |
$18.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.44
|
| Rate for Payer: Mclaren Medicaid |
$3.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.40
|
| Rate for Payer: Meridian Medicaid |
$3.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.50
|
| Rate for Payer: Nomi Health Commercial |
$16.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.44
|
| Rate for Payer: PACE Senior Care Partners |
$4.89
|
| Rate for Payer: PACE SWMI |
$5.15
|
| Rate for Payer: PHP Commercial |
$17.50
|
| Rate for Payer: PHP Medicare Advantage |
$5.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.91
|
| Rate for Payer: Priority Health Medicare |
$5.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.33
|
| Rate for Payer: Railroad Medicare Medicare |
$5.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.12
|
| Rate for Payer: UHC Core |
$17.19
|
| Rate for Payer: UHC Exchange |
$5.15
|
| Rate for Payer: UHC Medicaid |
$3.63
|
| Rate for Payer: UHC Medicare Advantage |
$5.15
|
| Rate for Payer: UHCCP Medicaid |
$3.63
|
| Rate for Payer: VA VA |
$5.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.44
|
|
|
KETOCONAZOLE 2 % TOPICAL CREAM
|
Facility
|
OP
|
$73.82
|
|
|
Service Code
|
NDC 51672129801
|
| Hospital Charge Code |
10368
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$66.44 |
| Rate for Payer: Aetna Commercial |
$62.75
|
| Rate for Payer: Aetna Medicare |
$19.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.07
|
| Rate for Payer: BCBS Complete |
$13.66
|
| Rate for Payer: BCBS MAPPO |
$18.45
|
| Rate for Payer: BCBS Trust/PPO |
$60.69
|
| Rate for Payer: BCN Commercial |
$60.69
|
| Rate for Payer: BCN Medicare Advantage |
$18.45
|
| Rate for Payer: Cash Price |
$59.06
|
| Rate for Payer: Cofinity Commercial |
$63.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.45
|
| Rate for Payer: Healthscope Commercial |
$66.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.37
|
| Rate for Payer: Mclaren Medicaid |
$13.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.38
|
| Rate for Payer: Meridian Medicaid |
$13.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.75
|
| Rate for Payer: Nomi Health Commercial |
$60.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.37
|
| Rate for Payer: PACE Senior Care Partners |
$17.53
|
| Rate for Payer: PACE SWMI |
$18.45
|
| Rate for Payer: PHP Commercial |
$62.75
|
| Rate for Payer: PHP Medicare Advantage |
$18.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64.22
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.38
|
| Rate for Payer: Railroad Medicare Medicare |
$18.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.96
|
| Rate for Payer: UHC Core |
$61.64
|
| Rate for Payer: UHC Exchange |
$18.45
|
| Rate for Payer: UHC Medicaid |
$13.01
|
| Rate for Payer: UHC Medicare Advantage |
$18.45
|
| Rate for Payer: UHCCP Medicaid |
$13.01
|
| Rate for Payer: VA VA |
$18.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.37
|
|
|
KETOCONAZOLE 2 % TOPICAL CREAM
|
Facility
|
IP
|
$73.82
|
|
|
Service Code
|
NDC 51672129801
|
| Hospital Charge Code |
10368
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$51.38 |
| Max. Negotiated Rate |
$66.44 |
| Rate for Payer: Aetna Commercial |
$62.75
|
| Rate for Payer: BCBS Trust/PPO |
$60.97
|
| Rate for Payer: BCN Commercial |
$60.97
|
| Rate for Payer: Cash Price |
$59.06
|
| Rate for Payer: Cofinity Commercial |
$63.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.06
|
| Rate for Payer: Healthscope Commercial |
$66.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.75
|
| Rate for Payer: Nomi Health Commercial |
$60.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.37
|
| Rate for Payer: PHP Commercial |
$62.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.96
|
| Rate for Payer: UHC Core |
$61.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.37
|
|
|
KETOCONAZOLE 2 % TOPICAL CREAM
|
Facility
|
IP
|
$20.59
|
|
|
Service Code
|
NDC 00168009915
|
| Hospital Charge Code |
10368
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$14.33 |
| Max. Negotiated Rate |
$18.53 |
| Rate for Payer: Aetna Commercial |
$17.50
|
| Rate for Payer: BCBS Trust/PPO |
$17.01
|
| Rate for Payer: BCN Commercial |
$17.01
|
| Rate for Payer: Cash Price |
$16.47
|
| Rate for Payer: Cofinity Commercial |
$17.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.47
|
| Rate for Payer: Healthscope Commercial |
$18.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.50
|
| Rate for Payer: Nomi Health Commercial |
$16.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.44
|
| Rate for Payer: PHP Commercial |
$17.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.12
|
| Rate for Payer: UHC Core |
$17.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.44
|
|
|
KETOROLAC 15 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$6.50
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
22472
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.52 |
| Max. Negotiated Rate |
$5.85 |
| Rate for Payer: Aetna Commercial |
$5.53
|
| Rate for Payer: Aetna Commercial |
$11.21
|
| Rate for Payer: Aetna Commercial |
$13.05
|
| Rate for Payer: Aetna Commercial |
$12.04
|
| Rate for Payer: Aetna Commercial |
$17.59
|
| Rate for Payer: Aetna Commercial |
$20.67
|
| Rate for Payer: BCBS Trust/PPO |
$5.37
|
| Rate for Payer: BCBS Trust/PPO |
$17.10
|
| Rate for Payer: BCBS Trust/PPO |
$20.09
|
| Rate for Payer: BCBS Trust/PPO |
$11.69
|
| Rate for Payer: BCBS Trust/PPO |
$10.89
|
| Rate for Payer: BCBS Trust/PPO |
$12.68
|
| Rate for Payer: BCN Commercial |
$20.09
|
| Rate for Payer: BCN Commercial |
$17.10
|
| Rate for Payer: BCN Commercial |
$10.89
|
| Rate for Payer: BCN Commercial |
$12.68
|
| Rate for Payer: BCN Commercial |
$5.37
|
| Rate for Payer: BCN Commercial |
$11.69
|
| Rate for Payer: Cash Price |
$5.20
|
| Rate for Payer: Cash Price |
$11.33
|
| Rate for Payer: Cash Price |
$12.28
|
| Rate for Payer: Cash Price |
$16.56
|
| Rate for Payer: Cash Price |
$10.55
|
| Rate for Payer: Cash Price |
$19.46
|
| Rate for Payer: Cofinity Commercial |
$20.92
|
| Rate for Payer: Cofinity Commercial |
$12.18
|
| Rate for Payer: Cofinity Commercial |
$13.20
|
| Rate for Payer: Cofinity Commercial |
$17.80
|
| Rate for Payer: Cofinity Commercial |
$11.34
|
| Rate for Payer: Cofinity Commercial |
$5.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$11.87
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$21.89
|
| Rate for Payer: Healthscope Commercial |
$5.85
|
| Rate for Payer: Healthscope Commercial |
$18.63
|
| Rate for Payer: Healthscope Commercial |
$13.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.05
|
| Rate for Payer: Nomi Health Commercial |
$19.94
|
| Rate for Payer: Nomi Health Commercial |
$10.82
|
| Rate for Payer: Nomi Health Commercial |
$11.61
|
| Rate for Payer: Nomi Health Commercial |
$16.97
|
| Rate for Payer: Nomi Health Commercial |
$12.59
|
| Rate for Payer: Nomi Health Commercial |
$5.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.53
|
| Rate for Payer: PHP Commercial |
$20.67
|
| Rate for Payer: PHP Commercial |
$5.53
|
| Rate for Payer: PHP Commercial |
$17.59
|
| Rate for Payer: PHP Commercial |
$11.21
|
| Rate for Payer: PHP Commercial |
$12.04
|
| Rate for Payer: PHP Commercial |
$13.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.72
|
| Rate for Payer: UHC Core |
$5.43
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: UHC Core |
$12.82
|
| Rate for Payer: UHC Core |
$20.31
|
| Rate for Payer: UHC Core |
$17.28
|
| Rate for Payer: UHC Core |
$11.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.89
|
|
|
KETOROLAC 15 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$6.50
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
22472
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.15 |
| Max. Negotiated Rate |
$5.85 |
| Rate for Payer: Aetna Commercial |
$5.53
|
| Rate for Payer: Aetna Commercial |
$17.59
|
| Rate for Payer: Aetna Commercial |
$11.21
|
| Rate for Payer: Aetna Commercial |
$20.67
|
| Rate for Payer: Aetna Commercial |
$13.05
|
| Rate for Payer: Aetna Commercial |
$12.04
|
| Rate for Payer: Aetna Medicare |
$5.38
|
| Rate for Payer: Aetna Medicare |
$3.68
|
| Rate for Payer: Aetna Medicare |
$3.43
|
| Rate for Payer: Aetna Medicare |
$1.69
|
| Rate for Payer: Aetna Medicare |
$3.99
|
| Rate for Payer: Aetna Medicare |
$6.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: BCBS Complete |
$2.84
|
| Rate for Payer: BCBS Complete |
$4.50
|
| Rate for Payer: BCBS Complete |
$2.62
|
| Rate for Payer: BCBS Complete |
$2.44
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: BCBS Complete |
$3.83
|
| Rate for Payer: BCBS MAPPO |
$5.17
|
| Rate for Payer: BCBS MAPPO |
$1.62
|
| Rate for Payer: BCBS MAPPO |
$6.08
|
| Rate for Payer: BCBS MAPPO |
$3.54
|
| Rate for Payer: BCBS MAPPO |
$3.30
|
| Rate for Payer: BCBS MAPPO |
$3.84
|
| Rate for Payer: BCBS Trust/PPO |
$10.84
|
| Rate for Payer: BCBS Trust/PPO |
$19.99
|
| Rate for Payer: BCBS Trust/PPO |
$11.64
|
| Rate for Payer: BCBS Trust/PPO |
$12.62
|
| Rate for Payer: BCBS Trust/PPO |
$17.02
|
| Rate for Payer: BCBS Trust/PPO |
$5.34
|
| Rate for Payer: BCN Commercial |
$12.62
|
| Rate for Payer: BCN Commercial |
$17.02
|
| Rate for Payer: BCN Commercial |
$10.84
|
| Rate for Payer: BCN Commercial |
$11.64
|
| Rate for Payer: BCN Commercial |
$19.99
|
| Rate for Payer: BCN Commercial |
$5.34
|
| Rate for Payer: BCN Medicare Advantage |
$6.08
|
| Rate for Payer: BCN Medicare Advantage |
$1.62
|
| Rate for Payer: BCN Medicare Advantage |
$3.84
|
| Rate for Payer: BCN Medicare Advantage |
$3.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.17
|
| Rate for Payer: BCN Medicare Advantage |
$3.54
|
| Rate for Payer: Cash Price |
$16.56
|
| Rate for Payer: Cash Price |
$10.55
|
| Rate for Payer: Cash Price |
$11.33
|
| Rate for Payer: Cash Price |
$5.20
|
| Rate for Payer: Cash Price |
$19.46
|
| Rate for Payer: Cash Price |
$12.28
|
| Rate for Payer: Cofinity Commercial |
$17.80
|
| Rate for Payer: Cofinity Commercial |
$13.20
|
| Rate for Payer: Cofinity Commercial |
$11.34
|
| Rate for Payer: Cofinity Commercial |
$12.18
|
| Rate for Payer: Cofinity Commercial |
$5.59
|
| Rate for Payer: Cofinity Commercial |
$20.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.54
|
| Rate for Payer: Healthscope Commercial |
$18.63
|
| Rate for Payer: Healthscope Commercial |
$5.85
|
| Rate for Payer: Healthscope Commercial |
$13.81
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$11.87
|
| Rate for Payer: Healthscope Commercial |
$21.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.51
|
| Rate for Payer: Mclaren Medicaid |
$2.50
|
| Rate for Payer: Mclaren Medicaid |
$2.33
|
| Rate for Payer: Mclaren Medicaid |
$2.71
|
| Rate for Payer: Mclaren Medicaid |
$3.65
|
| Rate for Payer: Mclaren Medicaid |
$4.29
|
| Rate for Payer: Mclaren Medicaid |
$1.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.03
|
| Rate for Payer: Meridian Medicaid |
$4.50
|
| Rate for Payer: Meridian Medicaid |
$1.20
|
| Rate for Payer: Meridian Medicaid |
$2.62
|
| Rate for Payer: Meridian Medicaid |
$2.44
|
| Rate for Payer: Meridian Medicaid |
$2.84
|
| Rate for Payer: Meridian Medicaid |
$3.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.53
|
| Rate for Payer: Nomi Health Commercial |
$12.59
|
| Rate for Payer: Nomi Health Commercial |
$16.97
|
| Rate for Payer: Nomi Health Commercial |
$10.82
|
| Rate for Payer: Nomi Health Commercial |
$19.94
|
| Rate for Payer: Nomi Health Commercial |
$5.33
|
| Rate for Payer: Nomi Health Commercial |
$11.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.62
|
| Rate for Payer: PACE Senior Care Partners |
$3.65
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE Senior Care Partners |
$4.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.78
|
| Rate for Payer: PACE Senior Care Partners |
$3.13
|
| Rate for Payer: PACE Senior Care Partners |
$1.54
|
| Rate for Payer: PACE SWMI |
$3.54
|
| Rate for Payer: PACE SWMI |
$5.17
|
| Rate for Payer: PACE SWMI |
$1.62
|
| Rate for Payer: PACE SWMI |
$3.30
|
| Rate for Payer: PACE SWMI |
$6.08
|
| Rate for Payer: PACE SWMI |
$3.84
|
| Rate for Payer: PHP Commercial |
$13.05
|
| Rate for Payer: PHP Commercial |
$12.04
|
| Rate for Payer: PHP Commercial |
$17.59
|
| Rate for Payer: PHP Commercial |
$20.67
|
| Rate for Payer: PHP Commercial |
$5.53
|
| Rate for Payer: PHP Commercial |
$11.21
|
| Rate for Payer: PHP Medicare Advantage |
$1.62
|
| Rate for Payer: PHP Medicare Advantage |
$3.54
|
| Rate for Payer: PHP Medicare Advantage |
$6.08
|
| Rate for Payer: PHP Medicare Advantage |
$3.30
|
| Rate for Payer: PHP Medicare Advantage |
$5.17
|
| Rate for Payer: PHP Medicare Advantage |
$3.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.66
|
| Rate for Payer: Priority Health Medicare |
$3.33
|
| Rate for Payer: Priority Health Medicare |
$1.64
|
| Rate for Payer: Priority Health Medicare |
$3.58
|
| Rate for Payer: Priority Health Medicare |
$5.23
|
| Rate for Payer: Priority Health Medicare |
$3.88
|
| Rate for Payer: Priority Health Medicare |
$6.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.41
|
| Rate for Payer: Railroad Medicare Medicare |
$3.30
|
| Rate for Payer: Railroad Medicare Medicare |
$6.08
|
| Rate for Payer: Railroad Medicare Medicare |
$5.17
|
| Rate for Payer: Railroad Medicare Medicare |
$3.54
|
| Rate for Payer: Railroad Medicare Medicare |
$3.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.61
|
| Rate for Payer: UHC Core |
$12.82
|
| Rate for Payer: UHC Core |
$20.31
|
| Rate for Payer: UHC Core |
$17.28
|
| Rate for Payer: UHC Core |
$5.43
|
| Rate for Payer: UHC Core |
$11.01
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: UHC Exchange |
$3.54
|
| Rate for Payer: UHC Exchange |
$3.30
|
| Rate for Payer: UHC Exchange |
$5.17
|
| Rate for Payer: UHC Exchange |
$3.84
|
| Rate for Payer: UHC Exchange |
$6.08
|
| Rate for Payer: UHC Exchange |
$1.62
|
| Rate for Payer: UHC Medicaid |
$4.29
|
| Rate for Payer: UHC Medicaid |
$3.65
|
| Rate for Payer: UHC Medicaid |
$2.50
|
| Rate for Payer: UHC Medicaid |
$2.71
|
| Rate for Payer: UHC Medicaid |
$2.33
|
| Rate for Payer: UHC Medicaid |
$1.15
|
| Rate for Payer: UHC Medicare Advantage |
$3.54
|
| Rate for Payer: UHC Medicare Advantage |
$6.08
|
| Rate for Payer: UHC Medicare Advantage |
$5.17
|
| Rate for Payer: UHC Medicare Advantage |
$3.84
|
| Rate for Payer: UHC Medicare Advantage |
$3.30
|
| Rate for Payer: UHC Medicare Advantage |
$1.62
|
| Rate for Payer: UHCCP Medicaid |
$4.29
|
| Rate for Payer: UHCCP Medicaid |
$3.65
|
| Rate for Payer: UHCCP Medicaid |
$2.71
|
| Rate for Payer: UHCCP Medicaid |
$2.50
|
| Rate for Payer: UHCCP Medicaid |
$2.33
|
| Rate for Payer: UHCCP Medicaid |
$1.15
|
| Rate for Payer: VA VA |
$3.84
|
| Rate for Payer: VA VA |
$3.54
|
| Rate for Payer: VA VA |
$6.08
|
| Rate for Payer: VA VA |
$5.17
|
| Rate for Payer: VA VA |
$3.30
|
| Rate for Payer: VA VA |
$1.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.51
|
|
|
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
IP
|
$8.15
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
22473
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.67 |
| Max. Negotiated Rate |
$7.33 |
| Rate for Payer: Aetna Commercial |
$6.93
|
| Rate for Payer: Aetna Commercial |
$10.73
|
| Rate for Payer: Aetna Commercial |
$13.43
|
| Rate for Payer: Aetna Commercial |
$18.79
|
| Rate for Payer: Aetna Commercial |
$9.89
|
| Rate for Payer: BCBS Trust/PPO |
$18.25
|
| Rate for Payer: BCBS Trust/PPO |
$6.73
|
| Rate for Payer: BCBS Trust/PPO |
$13.05
|
| Rate for Payer: BCBS Trust/PPO |
$10.42
|
| Rate for Payer: BCBS Trust/PPO |
$9.61
|
| Rate for Payer: BCN Commercial |
$18.25
|
| Rate for Payer: BCN Commercial |
$13.05
|
| Rate for Payer: BCN Commercial |
$9.61
|
| Rate for Payer: BCN Commercial |
$10.42
|
| Rate for Payer: BCN Commercial |
$6.73
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Cash Price |
$6.52
|
| Rate for Payer: Cash Price |
$12.64
|
| Rate for Payer: Cash Price |
$10.10
|
| Rate for Payer: Cash Price |
$17.68
|
| Rate for Payer: Cofinity Commercial |
$7.01
|
| Rate for Payer: Cofinity Commercial |
$10.00
|
| Rate for Payer: Cofinity Commercial |
$19.01
|
| Rate for Payer: Cofinity Commercial |
$13.59
|
| Rate for Payer: Cofinity Commercial |
$10.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.52
|
| Rate for Payer: Healthscope Commercial |
$11.36
|
| Rate for Payer: Healthscope Commercial |
$14.22
|
| Rate for Payer: Healthscope Commercial |
$10.47
|
| Rate for Payer: Healthscope Commercial |
$19.89
|
| Rate for Payer: Healthscope Commercial |
$7.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.79
|
| Rate for Payer: Nomi Health Commercial |
$9.54
|
| Rate for Payer: Nomi Health Commercial |
$10.35
|
| Rate for Payer: Nomi Health Commercial |
$12.96
|
| Rate for Payer: Nomi Health Commercial |
$18.12
|
| Rate for Payer: Nomi Health Commercial |
$6.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.11
|
| Rate for Payer: PHP Commercial |
$10.73
|
| Rate for Payer: PHP Commercial |
$13.43
|
| Rate for Payer: PHP Commercial |
$6.93
|
| Rate for Payer: PHP Commercial |
$18.79
|
| Rate for Payer: PHP Commercial |
$9.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.45
|
| Rate for Payer: UHC Core |
$9.71
|
| Rate for Payer: UHC Core |
$10.54
|
| Rate for Payer: UHC Core |
$18.45
|
| Rate for Payer: UHC Core |
$6.81
|
| Rate for Payer: UHC Core |
$13.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.57
|
|
|
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
OP
|
$8.15
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
22473
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.44 |
| Max. Negotiated Rate |
$7.33 |
| Rate for Payer: Aetna Commercial |
$6.93
|
| Rate for Payer: Aetna Commercial |
$10.73
|
| Rate for Payer: Aetna Commercial |
$18.79
|
| Rate for Payer: Aetna Commercial |
$9.89
|
| Rate for Payer: Aetna Commercial |
$13.43
|
| Rate for Payer: Aetna Medicare |
$3.28
|
| Rate for Payer: Aetna Medicare |
$2.12
|
| Rate for Payer: Aetna Medicare |
$4.11
|
| Rate for Payer: Aetna Medicare |
$3.02
|
| Rate for Payer: Aetna Medicare |
$5.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.91
|
| Rate for Payer: BCBS Complete |
$2.34
|
| Rate for Payer: BCBS Complete |
$2.15
|
| Rate for Payer: BCBS Complete |
$2.92
|
| Rate for Payer: BCBS Complete |
$1.51
|
| Rate for Payer: BCBS Complete |
$4.09
|
| Rate for Payer: BCBS MAPPO |
$2.04
|
| Rate for Payer: BCBS MAPPO |
$3.15
|
| Rate for Payer: BCBS MAPPO |
$2.91
|
| Rate for Payer: BCBS MAPPO |
$3.95
|
| Rate for Payer: BCBS MAPPO |
$5.53
|
| Rate for Payer: BCBS Trust/PPO |
$12.99
|
| Rate for Payer: BCBS Trust/PPO |
$9.56
|
| Rate for Payer: BCBS Trust/PPO |
$10.37
|
| Rate for Payer: BCBS Trust/PPO |
$6.70
|
| Rate for Payer: BCBS Trust/PPO |
$18.17
|
| Rate for Payer: BCN Commercial |
$12.99
|
| Rate for Payer: BCN Commercial |
$10.37
|
| Rate for Payer: BCN Commercial |
$9.56
|
| Rate for Payer: BCN Commercial |
$6.70
|
| Rate for Payer: BCN Commercial |
$18.17
|
| Rate for Payer: BCN Medicare Advantage |
$2.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.53
|
| Rate for Payer: BCN Medicare Advantage |
$3.95
|
| Rate for Payer: BCN Medicare Advantage |
$3.15
|
| Rate for Payer: BCN Medicare Advantage |
$2.91
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Cash Price |
$10.10
|
| Rate for Payer: Cash Price |
$6.52
|
| Rate for Payer: Cash Price |
$17.68
|
| Rate for Payer: Cash Price |
$12.64
|
| Rate for Payer: Cofinity Commercial |
$19.01
|
| Rate for Payer: Cofinity Commercial |
$13.59
|
| Rate for Payer: Cofinity Commercial |
$7.01
|
| Rate for Payer: Cofinity Commercial |
$10.00
|
| Rate for Payer: Cofinity Commercial |
$10.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.95
|
| Rate for Payer: Healthscope Commercial |
$10.47
|
| Rate for Payer: Healthscope Commercial |
$7.33
|
| Rate for Payer: Healthscope Commercial |
$19.89
|
| Rate for Payer: Healthscope Commercial |
$11.36
|
| Rate for Payer: Healthscope Commercial |
$14.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.85
|
| Rate for Payer: Mclaren Medicaid |
$2.22
|
| Rate for Payer: Mclaren Medicaid |
$3.90
|
| Rate for Payer: Mclaren Medicaid |
$2.79
|
| Rate for Payer: Mclaren Medicaid |
$1.44
|
| Rate for Payer: Mclaren Medicaid |
$2.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.15
|
| Rate for Payer: Meridian Medicaid |
$2.34
|
| Rate for Payer: Meridian Medicaid |
$2.15
|
| Rate for Payer: Meridian Medicaid |
$2.92
|
| Rate for Payer: Meridian Medicaid |
$4.09
|
| Rate for Payer: Meridian Medicaid |
$1.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.93
|
| Rate for Payer: Nomi Health Commercial |
$6.68
|
| Rate for Payer: Nomi Health Commercial |
$12.96
|
| Rate for Payer: Nomi Health Commercial |
$18.12
|
| Rate for Payer: Nomi Health Commercial |
$9.54
|
| Rate for Payer: Nomi Health Commercial |
$10.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.11
|
| Rate for Payer: PACE Senior Care Partners |
$2.76
|
| Rate for Payer: PACE Senior Care Partners |
$3.00
|
| Rate for Payer: PACE Senior Care Partners |
$1.94
|
| Rate for Payer: PACE Senior Care Partners |
$5.25
|
| Rate for Payer: PACE Senior Care Partners |
$3.75
|
| Rate for Payer: PACE SWMI |
$2.91
|
| Rate for Payer: PACE SWMI |
$3.15
|
| Rate for Payer: PACE SWMI |
$3.95
|
| Rate for Payer: PACE SWMI |
$5.53
|
| Rate for Payer: PACE SWMI |
$2.04
|
| Rate for Payer: PHP Commercial |
$18.79
|
| Rate for Payer: PHP Commercial |
$9.89
|
| Rate for Payer: PHP Commercial |
$13.43
|
| Rate for Payer: PHP Commercial |
$10.73
|
| Rate for Payer: PHP Commercial |
$6.93
|
| Rate for Payer: PHP Medicare Advantage |
$3.15
|
| Rate for Payer: PHP Medicare Advantage |
$2.04
|
| Rate for Payer: PHP Medicare Advantage |
$2.91
|
| Rate for Payer: PHP Medicare Advantage |
$5.53
|
| Rate for Payer: PHP Medicare Advantage |
$3.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.98
|
| Rate for Payer: Priority Health Medicare |
$3.19
|
| Rate for Payer: Priority Health Medicare |
$2.06
|
| Rate for Payer: Priority Health Medicare |
$2.94
|
| Rate for Payer: Priority Health Medicare |
$5.58
|
| Rate for Payer: Priority Health Medicare |
$3.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.09
|
| Rate for Payer: Railroad Medicare Medicare |
$2.04
|
| Rate for Payer: Railroad Medicare Medicare |
$5.53
|
| Rate for Payer: Railroad Medicare Medicare |
$3.95
|
| Rate for Payer: Railroad Medicare Medicare |
$2.91
|
| Rate for Payer: Railroad Medicare Medicare |
$3.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.17
|
| Rate for Payer: UHC Core |
$18.45
|
| Rate for Payer: UHC Core |
$9.71
|
| Rate for Payer: UHC Core |
$6.81
|
| Rate for Payer: UHC Core |
$13.19
|
| Rate for Payer: UHC Core |
$10.54
|
| Rate for Payer: UHC Exchange |
$2.91
|
| Rate for Payer: UHC Exchange |
$5.53
|
| Rate for Payer: UHC Exchange |
$3.15
|
| Rate for Payer: UHC Exchange |
$2.04
|
| Rate for Payer: UHC Exchange |
$3.95
|
| Rate for Payer: UHC Medicaid |
$1.44
|
| Rate for Payer: UHC Medicaid |
$3.90
|
| Rate for Payer: UHC Medicaid |
$2.22
|
| Rate for Payer: UHC Medicaid |
$2.79
|
| Rate for Payer: UHC Medicaid |
$2.05
|
| Rate for Payer: UHC Medicare Advantage |
$3.95
|
| Rate for Payer: UHC Medicare Advantage |
$2.91
|
| Rate for Payer: UHC Medicare Advantage |
$2.04
|
| Rate for Payer: UHC Medicare Advantage |
$3.15
|
| Rate for Payer: UHC Medicare Advantage |
$5.53
|
| Rate for Payer: UHCCP Medicaid |
$3.90
|
| Rate for Payer: UHCCP Medicaid |
$1.44
|
| Rate for Payer: UHCCP Medicaid |
$2.79
|
| Rate for Payer: UHCCP Medicaid |
$2.05
|
| Rate for Payer: UHCCP Medicaid |
$2.22
|
| Rate for Payer: VA VA |
$2.04
|
| Rate for Payer: VA VA |
$2.91
|
| Rate for Payer: VA VA |
$5.53
|
| Rate for Payer: VA VA |
$3.15
|
| Rate for Payer: VA VA |
$3.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.72
|
|
|
KIDNEY AND URINARY TRACT INFECTIONS
|
Facility
|
IP
|
$3,512.61
|
|
|
Service Code
|
APR-DRG 4632
|
| Min. Negotiated Rate |
$3,345.34 |
| Max. Negotiated Rate |
$3,512.61 |
| Rate for Payer: BCBS Complete |
$3,512.61
|
| Rate for Payer: Mclaren Medicaid |
$3,345.34
|
| Rate for Payer: Meridian Medicaid |
$3,512.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,345.34
|
| Rate for Payer: UHC Medicaid |
$3,345.34
|
| Rate for Payer: UHCCP Medicaid |
$3,345.34
|
|
|
KIDNEY AND URINARY TRACT INFECTIONS
|
Facility
|
IP
|
$2,812.72
|
|
|
Service Code
|
APR-DRG 4631
|
| Min. Negotiated Rate |
$2,678.78 |
| Max. Negotiated Rate |
$2,812.72 |
| Rate for Payer: BCBS Complete |
$2,812.72
|
| Rate for Payer: Mclaren Medicaid |
$2,678.78
|
| Rate for Payer: Meridian Medicaid |
$2,812.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,678.78
|
| Rate for Payer: UHC Medicaid |
$2,678.78
|
| Rate for Payer: UHCCP Medicaid |
$2,678.78
|
|
|
KIDNEY AND URINARY TRACT INFECTIONS
|
Facility
|
IP
|
$5,040.70
|
|
|
Service Code
|
APR-DRG 4633
|
| Min. Negotiated Rate |
$4,800.67 |
| Max. Negotiated Rate |
$5,040.70 |
| Rate for Payer: BCBS Complete |
$5,040.70
|
| Rate for Payer: Mclaren Medicaid |
$4,800.67
|
| Rate for Payer: Meridian Medicaid |
$5,040.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,800.67
|
| Rate for Payer: UHC Medicaid |
$4,800.67
|
| Rate for Payer: UHCCP Medicaid |
$4,800.67
|
|
|
KIDNEY AND URINARY TRACT INFECTIONS
|
Facility
|
IP
|
$7,581.04
|
|
|
Service Code
|
APR-DRG 4634
|
| Min. Negotiated Rate |
$7,220.03 |
| Max. Negotiated Rate |
$7,581.04 |
| Rate for Payer: BCBS Complete |
$7,581.04
|
| Rate for Payer: Mclaren Medicaid |
$7,220.03
|
| Rate for Payer: Meridian Medicaid |
$7,581.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,220.03
|
| Rate for Payer: UHC Medicaid |
$7,220.03
|
| Rate for Payer: UHCCP Medicaid |
$7,220.03
|
|
|
KIDNEY AND URINARY TRACT MALIGNANCY
|
Facility
|
IP
|
$7,513.20
|
|
|
Service Code
|
APR-DRG 4613
|
| Min. Negotiated Rate |
$7,155.43 |
| Max. Negotiated Rate |
$7,513.20 |
| Rate for Payer: BCBS Complete |
$7,513.20
|
| Rate for Payer: Mclaren Medicaid |
$7,155.43
|
| Rate for Payer: Meridian Medicaid |
$7,513.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,155.43
|
| Rate for Payer: UHC Medicaid |
$7,155.43
|
| Rate for Payer: UHCCP Medicaid |
$7,155.43
|
|
|
KIDNEY AND URINARY TRACT MALIGNANCY
|
Facility
|
IP
|
$13,965.26
|
|
|
Service Code
|
APR-DRG 4614
|
| Min. Negotiated Rate |
$13,300.25 |
| Max. Negotiated Rate |
$13,965.26 |
| Rate for Payer: BCBS Complete |
$13,965.26
|
| Rate for Payer: Mclaren Medicaid |
$13,300.25
|
| Rate for Payer: Meridian Medicaid |
$13,965.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,300.25
|
| Rate for Payer: UHC Medicaid |
$13,300.25
|
| Rate for Payer: UHCCP Medicaid |
$13,300.25
|
|
|
KIDNEY AND URINARY TRACT MALIGNANCY
|
Facility
|
IP
|
$5,544.46
|
|
|
Service Code
|
APR-DRG 4612
|
| Min. Negotiated Rate |
$5,280.44 |
| Max. Negotiated Rate |
$5,544.46 |
| Rate for Payer: BCBS Complete |
$5,544.46
|
| Rate for Payer: Mclaren Medicaid |
$5,280.44
|
| Rate for Payer: Meridian Medicaid |
$5,544.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,280.44
|
| Rate for Payer: UHC Medicaid |
$5,280.44
|
| Rate for Payer: UHCCP Medicaid |
$5,280.44
|
|
|
KIDNEY AND URINARY TRACT MALIGNANCY
|
Facility
|
IP
|
$4,846.67
|
|
|
Service Code
|
APR-DRG 4611
|
| Min. Negotiated Rate |
$4,615.87 |
| Max. Negotiated Rate |
$4,846.67 |
| Rate for Payer: BCBS Complete |
$4,846.67
|
| Rate for Payer: Mclaren Medicaid |
$4,615.87
|
| Rate for Payer: Meridian Medicaid |
$4,846.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,615.87
|
| Rate for Payer: UHC Medicaid |
$4,615.87
|
| Rate for Payer: UHCCP Medicaid |
$4,615.87
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY
|
Facility
|
IP
|
$8,632.19
|
|
|
Service Code
|
APR-DRG 4421
|
| Min. Negotiated Rate |
$8,221.13 |
| Max. Negotiated Rate |
$8,632.19 |
| Rate for Payer: BCBS Complete |
$8,632.19
|
| Rate for Payer: Mclaren Medicaid |
$8,221.13
|
| Rate for Payer: Meridian Medicaid |
$8,632.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,221.13
|
| Rate for Payer: UHC Medicaid |
$8,221.13
|
| Rate for Payer: UHCCP Medicaid |
$8,221.13
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY
|
Facility
|
IP
|
$10,081.40
|
|
|
Service Code
|
APR-DRG 4422
|
| Min. Negotiated Rate |
$9,601.34 |
| Max. Negotiated Rate |
$10,081.40 |
| Rate for Payer: BCBS Complete |
$10,081.40
|
| Rate for Payer: Mclaren Medicaid |
$9,601.34
|
| Rate for Payer: Meridian Medicaid |
$10,081.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,601.34
|
| Rate for Payer: UHC Medicaid |
$9,601.34
|
| Rate for Payer: UHCCP Medicaid |
$9,601.34
|
|
