|
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY
|
Facility
|
IP
|
$15,442.34
|
|
|
Service Code
|
APR-DRG 4423
|
| Min. Negotiated Rate |
$14,706.99 |
| Max. Negotiated Rate |
$15,442.34 |
| Rate for Payer: BCBS Complete |
$15,442.34
|
| Rate for Payer: Mclaren Medicaid |
$14,706.99
|
| Rate for Payer: Meridian Medicaid |
$15,442.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,706.99
|
| Rate for Payer: UHC Medicaid |
$14,706.99
|
| Rate for Payer: UHCCP Medicaid |
$14,706.99
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY
|
Facility
|
IP
|
$26,128.46
|
|
|
Service Code
|
APR-DRG 4424
|
| Min. Negotiated Rate |
$24,884.25 |
| Max. Negotiated Rate |
$26,128.46 |
| Rate for Payer: BCBS Complete |
$26,128.46
|
| Rate for Payer: Mclaren Medicaid |
$24,884.25
|
| Rate for Payer: Meridian Medicaid |
$26,128.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$24,884.25
|
| Rate for Payer: UHC Medicaid |
$24,884.25
|
| Rate for Payer: UHCCP Medicaid |
$24,884.25
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY
|
Facility
|
IP
|
$8,393.46
|
|
|
Service Code
|
APR-DRG 4431
|
| Min. Negotiated Rate |
$7,993.77 |
| Max. Negotiated Rate |
$8,393.46 |
| Rate for Payer: BCBS Complete |
$8,393.46
|
| Rate for Payer: Mclaren Medicaid |
$7,993.77
|
| Rate for Payer: Meridian Medicaid |
$8,393.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,993.77
|
| Rate for Payer: UHC Medicaid |
$7,993.77
|
| Rate for Payer: UHCCP Medicaid |
$7,993.77
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY
|
Facility
|
IP
|
$11,058.94
|
|
|
Service Code
|
APR-DRG 4433
|
| Min. Negotiated Rate |
$10,532.32 |
| Max. Negotiated Rate |
$11,058.94 |
| Rate for Payer: BCBS Complete |
$11,058.94
|
| Rate for Payer: Mclaren Medicaid |
$10,532.32
|
| Rate for Payer: Meridian Medicaid |
$11,058.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,532.32
|
| Rate for Payer: UHC Medicaid |
$10,532.32
|
| Rate for Payer: UHCCP Medicaid |
$10,532.32
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY
|
Facility
|
IP
|
$19,264.67
|
|
|
Service Code
|
APR-DRG 4434
|
| Min. Negotiated Rate |
$18,347.31 |
| Max. Negotiated Rate |
$19,264.67 |
| Rate for Payer: BCBS Complete |
$19,264.67
|
| Rate for Payer: Mclaren Medicaid |
$18,347.31
|
| Rate for Payer: Meridian Medicaid |
$19,264.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$18,347.31
|
| Rate for Payer: UHC Medicaid |
$18,347.31
|
| Rate for Payer: UHCCP Medicaid |
$18,347.31
|
|
|
KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY
|
Facility
|
IP
|
$9,663.89
|
|
|
Service Code
|
APR-DRG 4432
|
| Min. Negotiated Rate |
$9,203.70 |
| Max. Negotiated Rate |
$9,663.89 |
| Rate for Payer: BCBS Complete |
$9,663.89
|
| Rate for Payer: Mclaren Medicaid |
$9,203.70
|
| Rate for Payer: Meridian Medicaid |
$9,663.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,203.70
|
| Rate for Payer: UHC Medicaid |
$9,203.70
|
| Rate for Payer: UHCCP Medicaid |
$9,203.70
|
|
|
KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT
|
Facility
|
IP
|
$13,583.50
|
|
|
Service Code
|
APR-DRG 3133
|
| Min. Negotiated Rate |
$12,936.67 |
| Max. Negotiated Rate |
$13,583.50 |
| Rate for Payer: BCBS Complete |
$13,583.50
|
| Rate for Payer: Mclaren Medicaid |
$12,936.67
|
| Rate for Payer: Meridian Medicaid |
$13,583.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,936.67
|
| Rate for Payer: UHC Medicaid |
$12,936.67
|
| Rate for Payer: UHCCP Medicaid |
$12,936.67
|
|
|
KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT
|
Facility
|
IP
|
$22,682.11
|
|
|
Service Code
|
APR-DRG 3134
|
| Min. Negotiated Rate |
$21,602.01 |
| Max. Negotiated Rate |
$22,682.11 |
| Rate for Payer: BCBS Complete |
$22,682.11
|
| Rate for Payer: Mclaren Medicaid |
$21,602.01
|
| Rate for Payer: Meridian Medicaid |
$22,682.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,602.01
|
| Rate for Payer: UHC Medicaid |
$21,602.01
|
| Rate for Payer: UHCCP Medicaid |
$21,602.01
|
|
|
KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT
|
Facility
|
IP
|
$8,906.15
|
|
|
Service Code
|
APR-DRG 3131
|
| Min. Negotiated Rate |
$8,482.05 |
| Max. Negotiated Rate |
$8,906.15 |
| Rate for Payer: BCBS Complete |
$8,906.15
|
| Rate for Payer: Mclaren Medicaid |
$8,482.05
|
| Rate for Payer: Meridian Medicaid |
$8,906.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,482.05
|
| Rate for Payer: UHC Medicaid |
$8,482.05
|
| Rate for Payer: UHCCP Medicaid |
$8,482.05
|
|
|
KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT
|
Facility
|
IP
|
$11,272.43
|
|
|
Service Code
|
APR-DRG 3132
|
| Min. Negotiated Rate |
$10,735.65 |
| Max. Negotiated Rate |
$11,272.43 |
| Rate for Payer: BCBS Complete |
$11,272.43
|
| Rate for Payer: Mclaren Medicaid |
$10,735.65
|
| Rate for Payer: Meridian Medicaid |
$11,272.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,735.65
|
| Rate for Payer: UHC Medicaid |
$10,735.65
|
| Rate for Payer: UHCCP Medicaid |
$10,735.65
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
IP
|
$221.35
|
|
|
Service Code
|
NDC 00904710961
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$154.06 |
| Max. Negotiated Rate |
$199.22 |
| Rate for Payer: Aetna Commercial |
$188.15
|
| Rate for Payer: BCBS Trust/PPO |
$182.81
|
| Rate for Payer: BCN Commercial |
$182.81
|
| Rate for Payer: Cash Price |
$177.08
|
| Rate for Payer: Cofinity Commercial |
$190.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.08
|
| Rate for Payer: Healthscope Commercial |
$199.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.15
|
| Rate for Payer: Nomi Health Commercial |
$181.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.01
|
| Rate for Payer: PHP Commercial |
$188.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$192.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$194.79
|
| Rate for Payer: UHC Core |
$184.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.01
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
OP
|
$221.35
|
|
|
Service Code
|
NDC 00904710961
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.02 |
| Max. Negotiated Rate |
$199.22 |
| Rate for Payer: Aetna Commercial |
$188.15
|
| Rate for Payer: Aetna Medicare |
$57.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.17
|
| Rate for Payer: BCBS Complete |
$40.97
|
| Rate for Payer: BCBS MAPPO |
$55.34
|
| Rate for Payer: BCBS Trust/PPO |
$181.97
|
| Rate for Payer: BCN Commercial |
$181.97
|
| Rate for Payer: BCN Medicare Advantage |
$55.34
|
| Rate for Payer: Cash Price |
$177.08
|
| Rate for Payer: Cofinity Commercial |
$190.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.34
|
| Rate for Payer: Healthscope Commercial |
$199.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.01
|
| Rate for Payer: Mclaren Medicaid |
$39.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.10
|
| Rate for Payer: Meridian Medicaid |
$40.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.15
|
| Rate for Payer: Nomi Health Commercial |
$181.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.01
|
| Rate for Payer: PACE Senior Care Partners |
$52.57
|
| Rate for Payer: PACE SWMI |
$55.34
|
| Rate for Payer: PHP Commercial |
$188.15
|
| Rate for Payer: PHP Medicare Advantage |
$55.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$192.57
|
| Rate for Payer: Priority Health Medicare |
$55.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.06
|
| Rate for Payer: Railroad Medicare Medicare |
$55.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$194.79
|
| Rate for Payer: UHC Core |
$184.83
|
| Rate for Payer: UHC Exchange |
$55.34
|
| Rate for Payer: UHC Medicaid |
$39.02
|
| Rate for Payer: UHC Medicare Advantage |
$55.34
|
| Rate for Payer: UHCCP Medicaid |
$39.02
|
| Rate for Payer: VA VA |
$55.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.01
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
OP
|
$439.45
|
|
|
Service Code
|
NDC 68382079801
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$77.48 |
| Max. Negotiated Rate |
$395.50 |
| Rate for Payer: Aetna Commercial |
$373.53
|
| Rate for Payer: Aetna Medicare |
$114.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.33
|
| Rate for Payer: BCBS Complete |
$81.34
|
| Rate for Payer: BCBS MAPPO |
$109.86
|
| Rate for Payer: BCBS Trust/PPO |
$361.27
|
| Rate for Payer: BCN Commercial |
$361.27
|
| Rate for Payer: BCN Medicare Advantage |
$109.86
|
| Rate for Payer: Cash Price |
$351.56
|
| Rate for Payer: Cofinity Commercial |
$377.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.86
|
| Rate for Payer: Healthscope Commercial |
$395.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.59
|
| Rate for Payer: Mclaren Medicaid |
$77.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.36
|
| Rate for Payer: Meridian Medicaid |
$81.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.53
|
| Rate for Payer: Nomi Health Commercial |
$360.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$329.59
|
| Rate for Payer: PACE Senior Care Partners |
$104.37
|
| Rate for Payer: PACE SWMI |
$109.86
|
| Rate for Payer: PHP Commercial |
$373.53
|
| Rate for Payer: PHP Medicare Advantage |
$109.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$382.32
|
| Rate for Payer: Priority Health Medicare |
$110.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$305.86
|
| Rate for Payer: Railroad Medicare Medicare |
$109.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.72
|
| Rate for Payer: UHC Core |
$366.94
|
| Rate for Payer: UHC Exchange |
$109.86
|
| Rate for Payer: UHC Medicaid |
$77.48
|
| Rate for Payer: UHC Medicare Advantage |
$109.86
|
| Rate for Payer: UHCCP Medicaid |
$77.48
|
| Rate for Payer: VA VA |
$109.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.59
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
IP
|
$3.74
|
|
|
Service Code
|
NDC 60687043911
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.60 |
| Max. Negotiated Rate |
$3.37 |
| Rate for Payer: Aetna Commercial |
$3.18
|
| Rate for Payer: BCBS Trust/PPO |
$3.09
|
| Rate for Payer: BCN Commercial |
$3.09
|
| Rate for Payer: Cash Price |
$2.99
|
| Rate for Payer: Cofinity Commercial |
$3.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.99
|
| Rate for Payer: Healthscope Commercial |
$3.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.18
|
| Rate for Payer: Nomi Health Commercial |
$3.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.81
|
| Rate for Payer: PHP Commercial |
$3.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.29
|
| Rate for Payer: UHC Core |
$3.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.81
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
IP
|
$439.45
|
|
|
Service Code
|
NDC 68382079801
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$305.86 |
| Max. Negotiated Rate |
$395.50 |
| Rate for Payer: Aetna Commercial |
$373.53
|
| Rate for Payer: BCBS Trust/PPO |
$362.94
|
| Rate for Payer: BCN Commercial |
$362.94
|
| Rate for Payer: Cash Price |
$351.56
|
| Rate for Payer: Cofinity Commercial |
$377.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.56
|
| Rate for Payer: Healthscope Commercial |
$395.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.53
|
| Rate for Payer: Nomi Health Commercial |
$360.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$329.59
|
| Rate for Payer: PHP Commercial |
$373.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$382.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$305.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.72
|
| Rate for Payer: UHC Core |
$366.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.59
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
IP
|
$340.10
|
|
|
Service Code
|
NDC 00904745161
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$236.71 |
| Max. Negotiated Rate |
$306.09 |
| Rate for Payer: Aetna Commercial |
$289.08
|
| Rate for Payer: BCBS Trust/PPO |
$280.89
|
| Rate for Payer: BCN Commercial |
$280.89
|
| Rate for Payer: Cash Price |
$272.08
|
| Rate for Payer: Cofinity Commercial |
$292.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.08
|
| Rate for Payer: Healthscope Commercial |
$306.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.08
|
| Rate for Payer: Nomi Health Commercial |
$278.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.07
|
| Rate for Payer: PHP Commercial |
$289.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$295.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$236.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.29
|
| Rate for Payer: UHC Core |
$283.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.07
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
OP
|
$373.35
|
|
|
Service Code
|
NDC 60687043901
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$65.82 |
| Max. Negotiated Rate |
$336.01 |
| Rate for Payer: Aetna Commercial |
$317.35
|
| Rate for Payer: Aetna Medicare |
$97.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$116.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$116.67
|
| Rate for Payer: BCBS Complete |
$69.11
|
| Rate for Payer: BCBS MAPPO |
$93.34
|
| Rate for Payer: BCBS Trust/PPO |
$306.93
|
| Rate for Payer: BCN Commercial |
$306.93
|
| Rate for Payer: BCN Medicare Advantage |
$93.34
|
| Rate for Payer: Cash Price |
$298.68
|
| Rate for Payer: Cofinity Commercial |
$321.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.34
|
| Rate for Payer: Healthscope Commercial |
$336.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.01
|
| Rate for Payer: Mclaren Medicaid |
$65.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.00
|
| Rate for Payer: Meridian Medicaid |
$69.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.35
|
| Rate for Payer: Nomi Health Commercial |
$306.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.01
|
| Rate for Payer: PACE Senior Care Partners |
$88.67
|
| Rate for Payer: PACE SWMI |
$93.34
|
| Rate for Payer: PHP Commercial |
$317.35
|
| Rate for Payer: PHP Medicare Advantage |
$93.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$324.81
|
| Rate for Payer: Priority Health Medicare |
$94.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$259.85
|
| Rate for Payer: Railroad Medicare Medicare |
$93.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.55
|
| Rate for Payer: UHC Core |
$311.75
|
| Rate for Payer: UHC Exchange |
$93.34
|
| Rate for Payer: UHC Medicaid |
$65.82
|
| Rate for Payer: UHC Medicare Advantage |
$93.34
|
| Rate for Payer: UHCCP Medicaid |
$65.82
|
| Rate for Payer: VA VA |
$93.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.01
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
OP
|
$3.74
|
|
|
Service Code
|
NDC 60687043911
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.66 |
| Max. Negotiated Rate |
$3.37 |
| Rate for Payer: Aetna Commercial |
$3.18
|
| Rate for Payer: Aetna Medicare |
$0.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.17
|
| Rate for Payer: BCBS Complete |
$0.69
|
| Rate for Payer: BCBS MAPPO |
$0.94
|
| Rate for Payer: BCBS Trust/PPO |
$3.07
|
| Rate for Payer: BCN Commercial |
$3.07
|
| Rate for Payer: BCN Medicare Advantage |
$0.94
|
| Rate for Payer: Cash Price |
$2.99
|
| Rate for Payer: Cofinity Commercial |
$3.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.94
|
| Rate for Payer: Healthscope Commercial |
$3.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.81
|
| Rate for Payer: Mclaren Medicaid |
$0.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.98
|
| Rate for Payer: Meridian Medicaid |
$0.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.18
|
| Rate for Payer: Nomi Health Commercial |
$3.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.81
|
| Rate for Payer: PACE Senior Care Partners |
$0.89
|
| Rate for Payer: PACE SWMI |
$0.94
|
| Rate for Payer: PHP Commercial |
$3.18
|
| Rate for Payer: PHP Medicare Advantage |
$0.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.25
|
| Rate for Payer: Priority Health Medicare |
$0.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.60
|
| Rate for Payer: Railroad Medicare Medicare |
$0.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.29
|
| Rate for Payer: UHC Core |
$3.12
|
| Rate for Payer: UHC Exchange |
$0.94
|
| Rate for Payer: UHC Medicaid |
$0.66
|
| Rate for Payer: UHC Medicare Advantage |
$0.94
|
| Rate for Payer: UHCCP Medicaid |
$0.66
|
| Rate for Payer: VA VA |
$0.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.81
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
IP
|
$373.35
|
|
|
Service Code
|
NDC 60687043901
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$259.85 |
| Max. Negotiated Rate |
$336.01 |
| Rate for Payer: Aetna Commercial |
$317.35
|
| Rate for Payer: BCBS Trust/PPO |
$308.35
|
| Rate for Payer: BCN Commercial |
$308.35
|
| Rate for Payer: Cash Price |
$298.68
|
| Rate for Payer: Cofinity Commercial |
$321.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.68
|
| Rate for Payer: Healthscope Commercial |
$336.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.35
|
| Rate for Payer: Nomi Health Commercial |
$306.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.01
|
| Rate for Payer: PHP Commercial |
$317.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$324.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$259.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.55
|
| Rate for Payer: UHC Core |
$311.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.01
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
OP
|
$340.10
|
|
|
Service Code
|
NDC 00904745161
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$59.96 |
| Max. Negotiated Rate |
$306.09 |
| Rate for Payer: Aetna Commercial |
$289.08
|
| Rate for Payer: Aetna Medicare |
$88.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.28
|
| Rate for Payer: BCBS Complete |
$62.95
|
| Rate for Payer: BCBS MAPPO |
$85.03
|
| Rate for Payer: BCBS Trust/PPO |
$279.60
|
| Rate for Payer: BCN Commercial |
$279.60
|
| Rate for Payer: BCN Medicare Advantage |
$85.03
|
| Rate for Payer: Cash Price |
$272.08
|
| Rate for Payer: Cofinity Commercial |
$292.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.03
|
| Rate for Payer: Healthscope Commercial |
$306.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.07
|
| Rate for Payer: Mclaren Medicaid |
$59.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.28
|
| Rate for Payer: Meridian Medicaid |
$62.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.08
|
| Rate for Payer: Nomi Health Commercial |
$278.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.07
|
| Rate for Payer: PACE Senior Care Partners |
$80.77
|
| Rate for Payer: PACE SWMI |
$85.03
|
| Rate for Payer: PHP Commercial |
$289.08
|
| Rate for Payer: PHP Medicare Advantage |
$85.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$295.89
|
| Rate for Payer: Priority Health Medicare |
$85.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$236.71
|
| Rate for Payer: Railroad Medicare Medicare |
$85.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.29
|
| Rate for Payer: UHC Core |
$283.98
|
| Rate for Payer: UHC Exchange |
$85.03
|
| Rate for Payer: UHC Medicaid |
$59.96
|
| Rate for Payer: UHC Medicare Advantage |
$85.03
|
| Rate for Payer: UHCCP Medicaid |
$59.96
|
| Rate for Payer: VA VA |
$85.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.07
|
|
|
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$28.79
|
|
|
Service Code
|
HCPCS J1920
|
| Hospital Charge Code |
155884
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.04 |
| Max. Negotiated Rate |
$25.91 |
| Rate for Payer: Aetna Commercial |
$24.47
|
| Rate for Payer: BCBS Trust/PPO |
$23.78
|
| Rate for Payer: BCN Commercial |
$23.78
|
| Rate for Payer: Cash Price |
$23.03
|
| Rate for Payer: Cofinity Commercial |
$24.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.03
|
| Rate for Payer: Healthscope Commercial |
$25.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.47
|
| Rate for Payer: Nomi Health Commercial |
$23.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.59
|
| Rate for Payer: PHP Commercial |
$24.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.34
|
| Rate for Payer: UHC Core |
$24.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.59
|
|
|
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$28.79
|
|
|
Service Code
|
HCPCS J1920
|
| Hospital Charge Code |
155884
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$25.91 |
| Rate for Payer: Aetna Commercial |
$24.47
|
| Rate for Payer: Aetna Medicare |
$7.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.00
|
| Rate for Payer: BCBS Complete |
$5.33
|
| Rate for Payer: BCBS MAPPO |
$7.20
|
| Rate for Payer: BCBS Trust/PPO |
$23.67
|
| Rate for Payer: BCN Commercial |
$23.67
|
| Rate for Payer: BCN Medicare Advantage |
$7.20
|
| Rate for Payer: Cash Price |
$23.03
|
| Rate for Payer: Cofinity Commercial |
$24.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.20
|
| Rate for Payer: Healthscope Commercial |
$25.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.59
|
| Rate for Payer: Mclaren Medicaid |
$5.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.56
|
| Rate for Payer: Meridian Medicaid |
$5.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.47
|
| Rate for Payer: Nomi Health Commercial |
$23.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.59
|
| Rate for Payer: PACE Senior Care Partners |
$6.84
|
| Rate for Payer: PACE SWMI |
$7.20
|
| Rate for Payer: PHP Commercial |
$24.47
|
| Rate for Payer: PHP Medicare Advantage |
$7.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.05
|
| Rate for Payer: Priority Health Medicare |
$7.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.04
|
| Rate for Payer: Railroad Medicare Medicare |
$7.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.34
|
| Rate for Payer: UHC Core |
$24.04
|
| Rate for Payer: UHC Exchange |
$7.20
|
| Rate for Payer: UHC Medicaid |
$5.08
|
| Rate for Payer: UHC Medicare Advantage |
$7.20
|
| Rate for Payer: UHCCP Medicaid |
$5.08
|
| Rate for Payer: VA VA |
$7.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.59
|
|
|
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$59.50
|
|
|
Service Code
|
HCPCS J1920
|
| Hospital Charge Code |
10372
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.41 |
| Max. Negotiated Rate |
$53.55 |
| Rate for Payer: Aetna Commercial |
$50.58
|
| Rate for Payer: Aetna Commercial |
$39.10
|
| Rate for Payer: Aetna Commercial |
$40.14
|
| Rate for Payer: Aetna Commercial |
$42.08
|
| Rate for Payer: Aetna Commercial |
$133.45
|
| Rate for Payer: BCBS Trust/PPO |
$40.88
|
| Rate for Payer: BCBS Trust/PPO |
$49.14
|
| Rate for Payer: BCBS Trust/PPO |
$39.00
|
| Rate for Payer: BCBS Trust/PPO |
$37.99
|
| Rate for Payer: BCBS Trust/PPO |
$129.67
|
| Rate for Payer: BCN Commercial |
$40.88
|
| Rate for Payer: BCN Commercial |
$39.00
|
| Rate for Payer: BCN Commercial |
$129.67
|
| Rate for Payer: BCN Commercial |
$37.99
|
| Rate for Payer: BCN Commercial |
$49.14
|
| Rate for Payer: Cash Price |
$125.60
|
| Rate for Payer: Cash Price |
$47.60
|
| Rate for Payer: Cash Price |
$37.78
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cofinity Commercial |
$51.17
|
| Rate for Payer: Cofinity Commercial |
$135.02
|
| Rate for Payer: Cofinity Commercial |
$42.57
|
| Rate for Payer: Cofinity Commercial |
$40.61
|
| Rate for Payer: Cofinity Commercial |
$39.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.60
|
| Rate for Payer: Healthscope Commercial |
$41.40
|
| Rate for Payer: Healthscope Commercial |
$42.50
|
| Rate for Payer: Healthscope Commercial |
$141.30
|
| Rate for Payer: Healthscope Commercial |
$44.55
|
| Rate for Payer: Healthscope Commercial |
$53.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.08
|
| Rate for Payer: Nomi Health Commercial |
$128.74
|
| Rate for Payer: Nomi Health Commercial |
$37.72
|
| Rate for Payer: Nomi Health Commercial |
$38.72
|
| Rate for Payer: Nomi Health Commercial |
$40.59
|
| Rate for Payer: Nomi Health Commercial |
$48.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.62
|
| Rate for Payer: PHP Commercial |
$39.10
|
| Rate for Payer: PHP Commercial |
$40.14
|
| Rate for Payer: PHP Commercial |
$50.58
|
| Rate for Payer: PHP Commercial |
$42.08
|
| Rate for Payer: PHP Commercial |
$133.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$136.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.56
|
| Rate for Payer: UHC Core |
$131.09
|
| Rate for Payer: UHC Core |
$38.41
|
| Rate for Payer: UHC Core |
$41.33
|
| Rate for Payer: UHC Core |
$49.68
|
| Rate for Payer: UHC Core |
$39.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.12
|
|
|
LABETALOL 5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$59.50
|
|
|
Service Code
|
HCPCS J1920
|
| Hospital Charge Code |
10372
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.49 |
| Max. Negotiated Rate |
$53.55 |
| Rate for Payer: Aetna Commercial |
$50.58
|
| Rate for Payer: Aetna Commercial |
$39.10
|
| Rate for Payer: Aetna Commercial |
$42.08
|
| Rate for Payer: Aetna Commercial |
$133.45
|
| Rate for Payer: Aetna Commercial |
$40.14
|
| Rate for Payer: Aetna Medicare |
$11.96
|
| Rate for Payer: Aetna Medicare |
$15.47
|
| Rate for Payer: Aetna Medicare |
$12.28
|
| Rate for Payer: Aetna Medicare |
$40.82
|
| Rate for Payer: Aetna Medicare |
$12.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.47
|
| Rate for Payer: BCBS Complete |
$8.51
|
| Rate for Payer: BCBS Complete |
$29.06
|
| Rate for Payer: BCBS Complete |
$8.74
|
| Rate for Payer: BCBS Complete |
$11.01
|
| Rate for Payer: BCBS Complete |
$9.16
|
| Rate for Payer: BCBS MAPPO |
$14.88
|
| Rate for Payer: BCBS MAPPO |
$11.50
|
| Rate for Payer: BCBS MAPPO |
$39.25
|
| Rate for Payer: BCBS MAPPO |
$11.80
|
| Rate for Payer: BCBS MAPPO |
$12.38
|
| Rate for Payer: BCBS Trust/PPO |
$38.82
|
| Rate for Payer: BCBS Trust/PPO |
$129.07
|
| Rate for Payer: BCBS Trust/PPO |
$37.82
|
| Rate for Payer: BCBS Trust/PPO |
$48.91
|
| Rate for Payer: BCBS Trust/PPO |
$40.69
|
| Rate for Payer: BCN Commercial |
$38.82
|
| Rate for Payer: BCN Commercial |
$37.82
|
| Rate for Payer: BCN Commercial |
$129.07
|
| Rate for Payer: BCN Commercial |
$48.91
|
| Rate for Payer: BCN Commercial |
$40.69
|
| Rate for Payer: BCN Medicare Advantage |
$14.88
|
| Rate for Payer: BCN Medicare Advantage |
$12.38
|
| Rate for Payer: BCN Medicare Advantage |
$11.80
|
| Rate for Payer: BCN Medicare Advantage |
$11.50
|
| Rate for Payer: BCN Medicare Advantage |
$39.25
|
| Rate for Payer: Cash Price |
$125.60
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$47.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$37.78
|
| Rate for Payer: Cofinity Commercial |
$42.57
|
| Rate for Payer: Cofinity Commercial |
$40.61
|
| Rate for Payer: Cofinity Commercial |
$51.17
|
| Rate for Payer: Cofinity Commercial |
$135.02
|
| Rate for Payer: Cofinity Commercial |
$39.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.80
|
| Rate for Payer: Healthscope Commercial |
$141.30
|
| Rate for Payer: Healthscope Commercial |
$53.55
|
| Rate for Payer: Healthscope Commercial |
$44.55
|
| Rate for Payer: Healthscope Commercial |
$41.40
|
| Rate for Payer: Healthscope Commercial |
$42.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.41
|
| Rate for Payer: Mclaren Medicaid |
$8.11
|
| Rate for Payer: Mclaren Medicaid |
$8.73
|
| Rate for Payer: Mclaren Medicaid |
$8.32
|
| Rate for Payer: Mclaren Medicaid |
$10.49
|
| Rate for Payer: Mclaren Medicaid |
$27.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.40
|
| Rate for Payer: Meridian Medicaid |
$8.51
|
| Rate for Payer: Meridian Medicaid |
$29.06
|
| Rate for Payer: Meridian Medicaid |
$8.74
|
| Rate for Payer: Meridian Medicaid |
$9.16
|
| Rate for Payer: Meridian Medicaid |
$11.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.58
|
| Rate for Payer: Nomi Health Commercial |
$48.79
|
| Rate for Payer: Nomi Health Commercial |
$38.72
|
| Rate for Payer: Nomi Health Commercial |
$40.59
|
| Rate for Payer: Nomi Health Commercial |
$128.74
|
| Rate for Payer: Nomi Health Commercial |
$37.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.62
|
| Rate for Payer: PACE Senior Care Partners |
$37.29
|
| Rate for Payer: PACE Senior Care Partners |
$10.93
|
| Rate for Payer: PACE Senior Care Partners |
$14.13
|
| Rate for Payer: PACE Senior Care Partners |
$11.76
|
| Rate for Payer: PACE Senior Care Partners |
$11.21
|
| Rate for Payer: PACE SWMI |
$39.25
|
| Rate for Payer: PACE SWMI |
$11.50
|
| Rate for Payer: PACE SWMI |
$11.80
|
| Rate for Payer: PACE SWMI |
$12.38
|
| Rate for Payer: PACE SWMI |
$14.88
|
| Rate for Payer: PHP Commercial |
$42.08
|
| Rate for Payer: PHP Commercial |
$133.45
|
| Rate for Payer: PHP Commercial |
$40.14
|
| Rate for Payer: PHP Commercial |
$39.10
|
| Rate for Payer: PHP Commercial |
$50.58
|
| Rate for Payer: PHP Medicare Advantage |
$11.50
|
| Rate for Payer: PHP Medicare Advantage |
$14.88
|
| Rate for Payer: PHP Medicare Advantage |
$39.25
|
| Rate for Payer: PHP Medicare Advantage |
$12.38
|
| Rate for Payer: PHP Medicare Advantage |
$11.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$136.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.02
|
| Rate for Payer: Priority Health Medicare |
$11.62
|
| Rate for Payer: Priority Health Medicare |
$15.02
|
| Rate for Payer: Priority Health Medicare |
$39.64
|
| Rate for Payer: Priority Health Medicare |
$12.50
|
| Rate for Payer: Priority Health Medicare |
$11.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.27
|
| Rate for Payer: Railroad Medicare Medicare |
$14.88
|
| Rate for Payer: Railroad Medicare Medicare |
$12.38
|
| Rate for Payer: Railroad Medicare Medicare |
$11.80
|
| Rate for Payer: Railroad Medicare Medicare |
$39.25
|
| Rate for Payer: Railroad Medicare Medicare |
$11.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.36
|
| Rate for Payer: UHC Core |
$41.33
|
| Rate for Payer: UHC Core |
$131.09
|
| Rate for Payer: UHC Core |
$49.68
|
| Rate for Payer: UHC Core |
$39.43
|
| Rate for Payer: UHC Core |
$38.41
|
| Rate for Payer: UHC Exchange |
$39.25
|
| Rate for Payer: UHC Exchange |
$12.38
|
| Rate for Payer: UHC Exchange |
$11.50
|
| Rate for Payer: UHC Exchange |
$14.88
|
| Rate for Payer: UHC Exchange |
$11.80
|
| Rate for Payer: UHC Medicaid |
$10.49
|
| Rate for Payer: UHC Medicaid |
$8.73
|
| Rate for Payer: UHC Medicaid |
$8.11
|
| Rate for Payer: UHC Medicaid |
$8.32
|
| Rate for Payer: UHC Medicaid |
$27.68
|
| Rate for Payer: UHC Medicare Advantage |
$11.80
|
| Rate for Payer: UHC Medicare Advantage |
$39.25
|
| Rate for Payer: UHC Medicare Advantage |
$14.88
|
| Rate for Payer: UHC Medicare Advantage |
$11.50
|
| Rate for Payer: UHC Medicare Advantage |
$12.38
|
| Rate for Payer: UHCCP Medicaid |
$8.73
|
| Rate for Payer: UHCCP Medicaid |
$10.49
|
| Rate for Payer: UHCCP Medicaid |
$8.32
|
| Rate for Payer: UHCCP Medicaid |
$27.68
|
| Rate for Payer: UHCCP Medicaid |
$8.11
|
| Rate for Payer: VA VA |
$14.88
|
| Rate for Payer: VA VA |
$39.25
|
| Rate for Payer: VA VA |
$12.38
|
| Rate for Payer: VA VA |
$11.50
|
| Rate for Payer: VA VA |
$11.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.75
|
|
|
LACOSAMIDE 100 MG TABLET
|
Facility
|
IP
|
$3,997.78
|
|
|
Service Code
|
NDC 00131247835
|
| Hospital Charge Code |
96969
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,782.45 |
| Max. Negotiated Rate |
$3,598.00 |
| Rate for Payer: Aetna Commercial |
$3,398.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,301.77
|
| Rate for Payer: BCN Commercial |
$3,301.77
|
| Rate for Payer: Cash Price |
$3,198.22
|
| Rate for Payer: Cofinity Commercial |
$3,438.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,198.22
|
| Rate for Payer: Healthscope Commercial |
$3,598.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,998.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,398.11
|
| Rate for Payer: Nomi Health Commercial |
$3,278.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,998.34
|
| Rate for Payer: PHP Commercial |
$3,398.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,478.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,782.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,518.05
|
| Rate for Payer: UHC Core |
$3,338.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,998.34
|
|
