|
HC Z STENT URETERAL
|
Facility
|
OP
|
$1,212.86
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.05 |
| Max. Negotiated Rate |
$1,091.57 |
| Rate for Payer: Aetna Commercial |
$1,030.93
|
| Rate for Payer: Aetna Medicare |
$315.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.02
|
| Rate for Payer: BCBS Complete |
$485.14
|
| Rate for Payer: BCBS MAPPO |
$303.21
|
| Rate for Payer: BCBS Trust/PPO |
$997.09
|
| Rate for Payer: BCN Commercial |
$943.00
|
| Rate for Payer: BCN Medicare Advantage |
$303.21
|
| Rate for Payer: Cash Price |
$970.29
|
| Rate for Payer: Cofinity Commercial |
$1,043.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$970.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.21
|
| Rate for Payer: Healthscope Commercial |
$1,091.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$909.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$348.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.93
|
| Rate for Payer: Nomi Health Commercial |
$994.55
|
| Rate for Payer: PACE Senior Care Partners |
$288.05
|
| Rate for Payer: PACE SWMI |
$303.21
|
| Rate for Payer: PHP Commercial |
$1,030.93
|
| Rate for Payer: PHP Medicare Advantage |
$303.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.36
|
| Rate for Payer: Priority Health HMO/PPO |
$1,055.19
|
| Rate for Payer: Priority Health Medicare |
$306.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$812.62
|
| Rate for Payer: Railroad Medicare Medicare |
$303.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,067.32
|
| Rate for Payer: UHC Core |
$1,012.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.21
|
| Rate for Payer: UHC Exchange |
$303.21
|
| Rate for Payer: UHC Medicare Advantage |
$303.21
|
| Rate for Payer: VA VA |
$303.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$909.64
|
|
|
HC Z STENT URETERAL
|
Facility
|
IP
|
$1,212.86
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$788.36 |
| Max. Negotiated Rate |
$1,091.57 |
| Rate for Payer: Aetna Commercial |
$1,030.93
|
| Rate for Payer: BCBS Trust/PPO |
$990.06
|
| Rate for Payer: BCN Commercial |
$937.30
|
| Rate for Payer: Cash Price |
$970.29
|
| Rate for Payer: Cofinity Commercial |
$1,043.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$970.29
|
| Rate for Payer: Healthscope Commercial |
$1,091.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$909.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.93
|
| Rate for Payer: Nomi Health Commercial |
$994.55
|
| Rate for Payer: PHP Commercial |
$1,030.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.36
|
| Rate for Payer: Priority Health HMO/PPO |
$1,055.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$812.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,067.32
|
| Rate for Payer: UHC Core |
$1,012.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$909.64
|
|
|
HC Z TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$1,756.94
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$417.27 |
| Max. Negotiated Rate |
$1,581.25 |
| Rate for Payer: Aetna Commercial |
$1,493.40
|
| Rate for Payer: Aetna Medicare |
$456.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$549.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$549.04
|
| Rate for Payer: BCBS Complete |
$702.78
|
| Rate for Payer: BCBS MAPPO |
$439.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,444.38
|
| Rate for Payer: BCN Commercial |
$1,366.02
|
| Rate for Payer: BCN Medicare Advantage |
$439.24
|
| Rate for Payer: Cash Price |
$1,405.55
|
| Rate for Payer: Cofinity Commercial |
$1,510.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.24
|
| Rate for Payer: Healthscope Commercial |
$1,581.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,317.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$505.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.40
|
| Rate for Payer: Nomi Health Commercial |
$1,440.69
|
| Rate for Payer: PACE Senior Care Partners |
$417.27
|
| Rate for Payer: PACE SWMI |
$439.24
|
| Rate for Payer: PHP Commercial |
$1,493.40
|
| Rate for Payer: PHP Medicare Advantage |
$439.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.01
|
| Rate for Payer: Priority Health HMO/PPO |
$1,528.54
|
| Rate for Payer: Priority Health Medicare |
$443.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,177.15
|
| Rate for Payer: Railroad Medicare Medicare |
$439.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,546.11
|
| Rate for Payer: UHC Core |
$1,467.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$439.24
|
| Rate for Payer: UHC Exchange |
$439.24
|
| Rate for Payer: UHC Medicare Advantage |
$439.24
|
| Rate for Payer: VA VA |
$439.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,317.70
|
|
|
HC Z TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$1,756.94
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,142.01 |
| Max. Negotiated Rate |
$1,581.25 |
| Rate for Payer: Aetna Commercial |
$1,493.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,434.19
|
| Rate for Payer: BCN Commercial |
$1,357.76
|
| Rate for Payer: Cash Price |
$1,405.55
|
| Rate for Payer: Cofinity Commercial |
$1,510.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.55
|
| Rate for Payer: Healthscope Commercial |
$1,581.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,317.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.40
|
| Rate for Payer: Nomi Health Commercial |
$1,440.69
|
| Rate for Payer: PHP Commercial |
$1,493.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.01
|
| Rate for Payer: Priority Health HMO/PPO |
$1,528.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,177.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,546.11
|
| Rate for Payer: UHC Core |
$1,467.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,317.70
|
|
|
HC Z VACUUM BIOPSY DEVICE
|
Facility
|
OP
|
$646.29
|
|
| Hospital Charge Code |
27200129
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$153.49 |
| Max. Negotiated Rate |
$581.66 |
| Rate for Payer: Aetna Commercial |
$549.35
|
| Rate for Payer: Aetna Medicare |
$168.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$201.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$201.97
|
| Rate for Payer: BCBS Complete |
$258.52
|
| Rate for Payer: BCBS MAPPO |
$161.57
|
| Rate for Payer: BCBS Trust/PPO |
$531.32
|
| Rate for Payer: BCN Commercial |
$502.49
|
| Rate for Payer: BCN Medicare Advantage |
$161.57
|
| Rate for Payer: Cash Price |
$517.03
|
| Rate for Payer: Cofinity Commercial |
$555.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$517.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.57
|
| Rate for Payer: Healthscope Commercial |
$581.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$484.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$185.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$549.35
|
| Rate for Payer: Nomi Health Commercial |
$529.96
|
| Rate for Payer: PACE Senior Care Partners |
$153.49
|
| Rate for Payer: PACE SWMI |
$161.57
|
| Rate for Payer: PHP Commercial |
$549.35
|
| Rate for Payer: PHP Medicare Advantage |
$161.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.09
|
| Rate for Payer: Priority Health HMO/PPO |
$562.27
|
| Rate for Payer: Priority Health Medicare |
$163.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$433.01
|
| Rate for Payer: Railroad Medicare Medicare |
$161.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$568.74
|
| Rate for Payer: UHC Core |
$539.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.57
|
| Rate for Payer: UHC Exchange |
$161.57
|
| Rate for Payer: UHC Medicare Advantage |
$161.57
|
| Rate for Payer: VA VA |
$161.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$484.72
|
|
|
HC Z VACUUM BIOPSY DEVICE
|
Facility
|
IP
|
$646.29
|
|
| Hospital Charge Code |
27200129
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$420.09 |
| Max. Negotiated Rate |
$581.66 |
| Rate for Payer: Aetna Commercial |
$549.35
|
| Rate for Payer: BCBS Trust/PPO |
$527.57
|
| Rate for Payer: BCN Commercial |
$499.45
|
| Rate for Payer: Cash Price |
$517.03
|
| Rate for Payer: Cofinity Commercial |
$555.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$517.03
|
| Rate for Payer: Healthscope Commercial |
$581.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$484.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$549.35
|
| Rate for Payer: Nomi Health Commercial |
$529.96
|
| Rate for Payer: PHP Commercial |
$549.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.09
|
| Rate for Payer: Priority Health HMO/PPO |
$562.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$433.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$568.74
|
| Rate for Payer: UHC Core |
$539.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$484.72
|
|
|
HC Z VASCULAR CLOSURE
|
Facility
|
OP
|
$1,020.90
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200098
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$242.46 |
| Max. Negotiated Rate |
$918.81 |
| Rate for Payer: Aetna Commercial |
$867.76
|
| Rate for Payer: Aetna Medicare |
$265.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$319.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$319.03
|
| Rate for Payer: BCBS Complete |
$408.36
|
| Rate for Payer: BCBS MAPPO |
$255.22
|
| Rate for Payer: BCBS Trust/PPO |
$839.28
|
| Rate for Payer: BCN Commercial |
$793.75
|
| Rate for Payer: BCN Medicare Advantage |
$255.22
|
| Rate for Payer: Cash Price |
$816.72
|
| Rate for Payer: Cofinity Commercial |
$877.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.22
|
| Rate for Payer: Healthscope Commercial |
$918.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$293.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.76
|
| Rate for Payer: Nomi Health Commercial |
$837.14
|
| Rate for Payer: PACE Senior Care Partners |
$242.46
|
| Rate for Payer: PACE SWMI |
$255.22
|
| Rate for Payer: PHP Commercial |
$867.76
|
| Rate for Payer: PHP Medicare Advantage |
$255.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.59
|
| Rate for Payer: Priority Health HMO/PPO |
$888.18
|
| Rate for Payer: Priority Health Medicare |
$257.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.00
|
| Rate for Payer: Railroad Medicare Medicare |
$255.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$898.39
|
| Rate for Payer: UHC Core |
$852.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$255.22
|
| Rate for Payer: UHC Exchange |
$255.22
|
| Rate for Payer: UHC Medicare Advantage |
$255.22
|
| Rate for Payer: VA VA |
$255.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.67
|
|
|
HC Z VASCULAR CLOSURE
|
Facility
|
IP
|
$1,020.90
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200098
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$663.59 |
| Max. Negotiated Rate |
$918.81 |
| Rate for Payer: Aetna Commercial |
$867.76
|
| Rate for Payer: BCBS Trust/PPO |
$833.36
|
| Rate for Payer: BCN Commercial |
$788.95
|
| Rate for Payer: Cash Price |
$816.72
|
| Rate for Payer: Cofinity Commercial |
$877.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.72
|
| Rate for Payer: Healthscope Commercial |
$918.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.76
|
| Rate for Payer: Nomi Health Commercial |
$837.14
|
| Rate for Payer: PHP Commercial |
$867.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.59
|
| Rate for Payer: Priority Health HMO/PPO |
$888.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$898.39
|
| Rate for Payer: UHC Core |
$852.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.67
|
|
|
HC Z VENA CAVA FILTER
|
Facility
|
IP
|
$5,871.33
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,816.36 |
| Max. Negotiated Rate |
$5,284.20 |
| Rate for Payer: Aetna Commercial |
$4,990.63
|
| Rate for Payer: BCBS Trust/PPO |
$4,792.77
|
| Rate for Payer: BCN Commercial |
$4,537.36
|
| Rate for Payer: Cash Price |
$4,697.06
|
| Rate for Payer: Cofinity Commercial |
$5,049.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,697.06
|
| Rate for Payer: Healthscope Commercial |
$5,284.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,403.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,990.63
|
| Rate for Payer: Nomi Health Commercial |
$4,814.49
|
| Rate for Payer: PHP Commercial |
$4,990.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,816.36
|
| Rate for Payer: Priority Health HMO/PPO |
$5,108.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,933.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,166.77
|
| Rate for Payer: UHC Core |
$4,902.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,403.50
|
|
|
HC Z VENA CAVA FILTER
|
Facility
|
OP
|
$5,871.33
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,394.44 |
| Max. Negotiated Rate |
$5,284.20 |
| Rate for Payer: Aetna Commercial |
$4,990.63
|
| Rate for Payer: Aetna Medicare |
$1,526.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,834.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,834.79
|
| Rate for Payer: BCBS Complete |
$2,348.53
|
| Rate for Payer: BCBS MAPPO |
$1,467.83
|
| Rate for Payer: BCBS Trust/PPO |
$4,826.82
|
| Rate for Payer: BCN Commercial |
$4,564.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,467.83
|
| Rate for Payer: Cash Price |
$4,697.06
|
| Rate for Payer: Cofinity Commercial |
$5,049.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,697.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,467.83
|
| Rate for Payer: Healthscope Commercial |
$5,284.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,403.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,541.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,688.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,990.63
|
| Rate for Payer: Nomi Health Commercial |
$4,814.49
|
| Rate for Payer: PACE Senior Care Partners |
$1,394.44
|
| Rate for Payer: PACE SWMI |
$1,467.83
|
| Rate for Payer: PHP Commercial |
$4,990.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,467.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,816.36
|
| Rate for Payer: Priority Health HMO/PPO |
$5,108.06
|
| Rate for Payer: Priority Health Medicare |
$1,482.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,933.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,467.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,166.77
|
| Rate for Payer: UHC Core |
$4,902.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,467.83
|
| Rate for Payer: UHC Exchange |
$1,467.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,467.83
|
| Rate for Payer: VA VA |
$1,467.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,403.50
|
|
|
HEARING AID RESTOCKING FEE
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 00663
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$53.20 |
| Max. Negotiated Rate |
$86.45 |
| Rate for Payer: Aetna Medicare |
$66.50
|
| Rate for Payer: BCBS Complete |
$53.20
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.45
|
|
|
HEMORRHOIDECTOMY, INTERNAL, BY RUBBER BAND LIGATION(S)
|
Facility
|
OP
|
$692.17
|
|
|
Service Code
|
CPT 46221
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$659.17 |
| Max. Negotiated Rate |
$692.17 |
| Rate for Payer: BCBS Complete |
$692.17
|
| Rate for Payer: Mclaren Medicaid |
$659.17
|
| Rate for Payer: Meridian Medicaid |
$692.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$659.17
|
| Rate for Payer: UHCCP Medicaid |
$659.17
|
|
|
HEPARIN CELLSAVER SOLUTION (BLH INTRA-OP)
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
NDC 09900000709
|
| Hospital Charge Code |
151009
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: BCBS Trust/PPO |
$122.44
|
| Rate for Payer: BCN Commercial |
$115.92
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.50
|
| Rate for Payer: Nomi Health Commercial |
$123.00
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.50
|
| Rate for Payer: Priority Health HMO/PPO |
$130.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.00
|
| Rate for Payer: UHC Core |
$125.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
|
HEPARIN CELLSAVER SOLUTION (BLH INTRA-OP)
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
NDC 09900000709
|
| Hospital Charge Code |
151009
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$35.62 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna Medicare |
$39.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.88
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: BCBS MAPPO |
$37.50
|
| Rate for Payer: BCBS Trust/PPO |
$123.31
|
| Rate for Payer: BCN Commercial |
$116.62
|
| Rate for Payer: BCN Medicare Advantage |
$37.50
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.50
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.50
|
| Rate for Payer: Nomi Health Commercial |
$123.00
|
| Rate for Payer: PACE Senior Care Partners |
$35.62
|
| Rate for Payer: PACE SWMI |
$37.50
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: PHP Medicare Advantage |
$37.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.50
|
| Rate for Payer: Priority Health HMO/PPO |
$130.50
|
| Rate for Payer: Priority Health Medicare |
$37.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.50
|
| Rate for Payer: Railroad Medicare Medicare |
$37.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.00
|
| Rate for Payer: UHC Core |
$125.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.50
|
| Rate for Payer: UHC Exchange |
$37.50
|
| Rate for Payer: UHC Medicare Advantage |
$37.50
|
| Rate for Payer: VA VA |
$37.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
|
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$21.71
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
112939
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.16 |
| Max. Negotiated Rate |
$19.54 |
| Rate for Payer: Aetna Commercial |
$18.45
|
| Rate for Payer: Aetna Medicare |
$5.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.78
|
| Rate for Payer: BCBS Complete |
$8.68
|
| Rate for Payer: BCBS MAPPO |
$5.43
|
| Rate for Payer: BCBS Trust/PPO |
$17.85
|
| Rate for Payer: BCN Commercial |
$16.88
|
| Rate for Payer: BCN Medicare Advantage |
$5.43
|
| Rate for Payer: Cash Price |
$17.37
|
| Rate for Payer: Cofinity Commercial |
$18.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.43
|
| Rate for Payer: Healthscope Commercial |
$19.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.45
|
| Rate for Payer: Nomi Health Commercial |
$17.80
|
| Rate for Payer: PACE Senior Care Partners |
$5.16
|
| Rate for Payer: PACE SWMI |
$5.43
|
| Rate for Payer: PHP Commercial |
$18.45
|
| Rate for Payer: PHP Medicare Advantage |
$5.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.11
|
| Rate for Payer: Priority Health HMO/PPO |
$18.89
|
| Rate for Payer: Priority Health Medicare |
$5.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.55
|
| Rate for Payer: Railroad Medicare Medicare |
$5.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.10
|
| Rate for Payer: UHC Core |
$18.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.43
|
| Rate for Payer: UHC Exchange |
$5.43
|
| Rate for Payer: UHC Medicare Advantage |
$5.43
|
| Rate for Payer: VA VA |
$5.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.28
|
|
|
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$21.71
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
112939
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.11 |
| Max. Negotiated Rate |
$19.54 |
| Rate for Payer: Aetna Commercial |
$18.45
|
| Rate for Payer: BCBS Trust/PPO |
$17.72
|
| Rate for Payer: BCN Commercial |
$16.78
|
| Rate for Payer: Cash Price |
$17.37
|
| Rate for Payer: Cofinity Commercial |
$18.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.37
|
| Rate for Payer: Healthscope Commercial |
$19.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.45
|
| Rate for Payer: Nomi Health Commercial |
$17.80
|
| Rate for Payer: PHP Commercial |
$18.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.11
|
| Rate for Payer: Priority Health HMO/PPO |
$18.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.10
|
| Rate for Payer: UHC Core |
$18.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.28
|
|
|
HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$21.84
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
3626
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.20 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: BCBS Trust/PPO |
$17.83
|
| Rate for Payer: BCN Commercial |
$16.88
|
| Rate for Payer: Cash Price |
$17.47
|
| Rate for Payer: Cofinity Commercial |
$18.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.47
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.56
|
| Rate for Payer: Nomi Health Commercial |
$17.91
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health HMO/PPO |
$19.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.22
|
| Rate for Payer: UHC Core |
$18.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.38
|
|
|
HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$21.84
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
3626
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.19 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: Aetna Medicare |
$5.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.83
|
| Rate for Payer: BCBS Complete |
$8.74
|
| Rate for Payer: BCBS MAPPO |
$5.46
|
| Rate for Payer: BCBS Trust/PPO |
$17.95
|
| Rate for Payer: BCN Commercial |
$16.98
|
| Rate for Payer: BCN Medicare Advantage |
$5.46
|
| Rate for Payer: Cash Price |
$17.47
|
| Rate for Payer: Cofinity Commercial |
$18.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.46
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.56
|
| Rate for Payer: Nomi Health Commercial |
$17.91
|
| Rate for Payer: PACE Senior Care Partners |
$5.19
|
| Rate for Payer: PACE SWMI |
$5.46
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Medicare Advantage |
$5.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health HMO/PPO |
$19.00
|
| Rate for Payer: Priority Health Medicare |
$5.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.63
|
| Rate for Payer: Railroad Medicare Medicare |
$5.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.22
|
| Rate for Payer: UHC Core |
$18.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.46
|
| Rate for Payer: UHC Exchange |
$5.46
|
| Rate for Payer: UHC Medicare Advantage |
$5.46
|
| Rate for Payer: VA VA |
$5.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.38
|
|
|
HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$27.84
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10176
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.10 |
| Max. Negotiated Rate |
$25.06 |
| Rate for Payer: BCBS Trust/PPO |
$9.35
|
| Rate for Payer: BCBS Trust/PPO |
$13.78
|
| Rate for Payer: BCN Commercial |
$15.58
|
| Rate for Payer: BCN Commercial |
$14.91
|
| Rate for Payer: BCN Commercial |
$8.85
|
| Rate for Payer: BCN Commercial |
$13.04
|
| Rate for Payer: BCN Commercial |
$21.51
|
| Rate for Payer: BCN Commercial |
$12.13
|
| Rate for Payer: Cash Price |
$22.27
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$15.43
|
| Rate for Payer: Cash Price |
$9.16
|
| Rate for Payer: Cash Price |
$16.13
|
| Rate for Payer: Cofinity Commercial |
$17.34
|
| Rate for Payer: Cofinity Commercial |
$13.49
|
| Rate for Payer: Cofinity Commercial |
$14.52
|
| Rate for Payer: Cofinity Commercial |
$16.59
|
| Rate for Payer: Cofinity Commercial |
$9.85
|
| Rate for Payer: Cofinity Commercial |
$23.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.27
|
| Rate for Payer: Healthscope Commercial |
$10.30
|
| Rate for Payer: Healthscope Commercial |
$14.12
|
| Rate for Payer: Healthscope Commercial |
$18.14
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Healthscope Commercial |
$17.36
|
| Rate for Payer: Healthscope Commercial |
$15.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.66
|
| Rate for Payer: Aetna Commercial |
$23.66
|
| Rate for Payer: Aetna Commercial |
$9.73
|
| Rate for Payer: Aetna Commercial |
$14.35
|
| Rate for Payer: Aetna Commercial |
$13.34
|
| Rate for Payer: Aetna Commercial |
$16.40
|
| Rate for Payer: Aetna Commercial |
$17.14
|
| Rate for Payer: BCBS Trust/PPO |
$22.73
|
| Rate for Payer: BCBS Trust/PPO |
$15.75
|
| Rate for Payer: BCBS Trust/PPO |
$16.46
|
| Rate for Payer: BCBS Trust/PPO |
$12.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.35
|
| Rate for Payer: Nomi Health Commercial |
$16.53
|
| Rate for Payer: Nomi Health Commercial |
$9.39
|
| Rate for Payer: Nomi Health Commercial |
$12.87
|
| Rate for Payer: Nomi Health Commercial |
$15.82
|
| Rate for Payer: Nomi Health Commercial |
$13.84
|
| Rate for Payer: Nomi Health Commercial |
$22.83
|
| Rate for Payer: PHP Commercial |
$17.14
|
| Rate for Payer: PHP Commercial |
$23.66
|
| Rate for Payer: PHP Commercial |
$13.34
|
| Rate for Payer: PHP Commercial |
$9.73
|
| Rate for Payer: PHP Commercial |
$14.35
|
| Rate for Payer: PHP Commercial |
$16.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.97
|
| Rate for Payer: Priority Health HMO/PPO |
$9.96
|
| Rate for Payer: Priority Health HMO/PPO |
$13.65
|
| Rate for Payer: Priority Health HMO/PPO |
$16.78
|
| Rate for Payer: Priority Health HMO/PPO |
$17.54
|
| Rate for Payer: Priority Health HMO/PPO |
$14.69
|
| Rate for Payer: Priority Health HMO/PPO |
$24.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.50
|
| Rate for Payer: UHC Core |
$23.25
|
| Rate for Payer: UHC Core |
$13.10
|
| Rate for Payer: UHC Core |
$14.09
|
| Rate for Payer: UHC Core |
$16.83
|
| Rate for Payer: UHC Core |
$16.11
|
| Rate for Payer: UHC Core |
$9.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.59
|
|
|
HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$16.88
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10176
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.01 |
| Max. Negotiated Rate |
$15.19 |
| Rate for Payer: Aetna Commercial |
$14.35
|
| Rate for Payer: Aetna Commercial |
$23.66
|
| Rate for Payer: Aetna Commercial |
$17.14
|
| Rate for Payer: Aetna Commercial |
$13.34
|
| Rate for Payer: Aetna Commercial |
$9.73
|
| Rate for Payer: Aetna Commercial |
$16.40
|
| Rate for Payer: Aetna Medicare |
$5.24
|
| Rate for Payer: Aetna Medicare |
$4.39
|
| Rate for Payer: Aetna Medicare |
$4.08
|
| Rate for Payer: Aetna Medicare |
$2.98
|
| Rate for Payer: Aetna Medicare |
$5.02
|
| Rate for Payer: Aetna Medicare |
$7.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.58
|
| Rate for Payer: BCBS Complete |
$6.75
|
| Rate for Payer: BCBS Complete |
$8.06
|
| Rate for Payer: BCBS Complete |
$6.28
|
| Rate for Payer: BCBS Complete |
$4.58
|
| Rate for Payer: BCBS Complete |
$7.72
|
| Rate for Payer: BCBS Complete |
$11.14
|
| Rate for Payer: BCBS MAPPO |
$4.82
|
| Rate for Payer: BCBS MAPPO |
$2.86
|
| Rate for Payer: BCBS MAPPO |
$3.92
|
| Rate for Payer: BCBS MAPPO |
$6.96
|
| Rate for Payer: BCBS MAPPO |
$5.04
|
| Rate for Payer: BCBS MAPPO |
$4.22
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCBS Trust/PPO |
$12.90
|
| Rate for Payer: BCBS Trust/PPO |
$9.41
|
| Rate for Payer: BCBS Trust/PPO |
$16.57
|
| Rate for Payer: BCBS Trust/PPO |
$22.89
|
| Rate for Payer: BCBS Trust/PPO |
$13.88
|
| Rate for Payer: BCN Commercial |
$15.00
|
| Rate for Payer: BCN Commercial |
$12.20
|
| Rate for Payer: BCN Commercial |
$8.90
|
| Rate for Payer: BCN Commercial |
$21.65
|
| Rate for Payer: BCN Commercial |
$15.67
|
| Rate for Payer: BCN Commercial |
$13.12
|
| Rate for Payer: BCN Medicare Advantage |
$4.22
|
| Rate for Payer: BCN Medicare Advantage |
$4.82
|
| Rate for Payer: BCN Medicare Advantage |
$3.92
|
| Rate for Payer: BCN Medicare Advantage |
$2.86
|
| Rate for Payer: BCN Medicare Advantage |
$6.96
|
| Rate for Payer: BCN Medicare Advantage |
$5.04
|
| Rate for Payer: Cash Price |
$16.13
|
| Rate for Payer: Cash Price |
$22.27
|
| Rate for Payer: Cash Price |
$15.43
|
| Rate for Payer: Cash Price |
$9.16
|
| Rate for Payer: Cash Price |
$12.55
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cofinity Commercial |
$23.94
|
| Rate for Payer: Cofinity Commercial |
$14.52
|
| Rate for Payer: Cofinity Commercial |
$13.49
|
| Rate for Payer: Cofinity Commercial |
$9.85
|
| Rate for Payer: Cofinity Commercial |
$17.34
|
| Rate for Payer: Cofinity Commercial |
$16.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.04
|
| Rate for Payer: Healthscope Commercial |
$10.30
|
| Rate for Payer: Healthscope Commercial |
$14.12
|
| Rate for Payer: Healthscope Commercial |
$15.19
|
| Rate for Payer: Healthscope Commercial |
$17.36
|
| Rate for Payer: Healthscope Commercial |
$18.14
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.40
|
| Rate for Payer: Nomi Health Commercial |
$9.39
|
| Rate for Payer: Nomi Health Commercial |
$16.53
|
| Rate for Payer: Nomi Health Commercial |
$12.87
|
| Rate for Payer: Nomi Health Commercial |
$13.84
|
| Rate for Payer: Nomi Health Commercial |
$22.83
|
| Rate for Payer: Nomi Health Commercial |
$15.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.61
|
| Rate for Payer: PACE Senior Care Partners |
$4.58
|
| Rate for Payer: PACE Senior Care Partners |
$3.73
|
| Rate for Payer: PACE Senior Care Partners |
$2.72
|
| Rate for Payer: PACE Senior Care Partners |
$4.01
|
| Rate for Payer: PACE Senior Care Partners |
$4.79
|
| Rate for Payer: PACE SWMI |
$4.82
|
| Rate for Payer: PACE SWMI |
$4.22
|
| Rate for Payer: PACE SWMI |
$6.96
|
| Rate for Payer: PACE SWMI |
$3.92
|
| Rate for Payer: PACE SWMI |
$5.04
|
| Rate for Payer: PACE SWMI |
$2.86
|
| Rate for Payer: PHP Commercial |
$23.66
|
| Rate for Payer: PHP Commercial |
$14.35
|
| Rate for Payer: PHP Commercial |
$17.14
|
| Rate for Payer: PHP Commercial |
$9.73
|
| Rate for Payer: PHP Commercial |
$13.34
|
| Rate for Payer: PHP Commercial |
$16.40
|
| Rate for Payer: PHP Medicare Advantage |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$4.82
|
| Rate for Payer: PHP Medicare Advantage |
$5.04
|
| Rate for Payer: PHP Medicare Advantage |
$6.96
|
| Rate for Payer: PHP Medicare Advantage |
$4.22
|
| Rate for Payer: PHP Medicare Advantage |
$3.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.10
|
| Rate for Payer: Priority Health HMO/PPO |
$14.69
|
| Rate for Payer: Priority Health HMO/PPO |
$13.65
|
| Rate for Payer: Priority Health HMO/PPO |
$24.22
|
| Rate for Payer: Priority Health HMO/PPO |
$16.78
|
| Rate for Payer: Priority Health HMO/PPO |
$9.96
|
| Rate for Payer: Priority Health HMO/PPO |
$17.54
|
| Rate for Payer: Priority Health Medicare |
$7.03
|
| Rate for Payer: Priority Health Medicare |
$5.09
|
| Rate for Payer: Priority Health Medicare |
$2.89
|
| Rate for Payer: Priority Health Medicare |
$3.96
|
| Rate for Payer: Priority Health Medicare |
$4.26
|
| Rate for Payer: Priority Health Medicare |
$4.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.51
|
| Rate for Payer: Railroad Medicare Medicare |
$5.04
|
| Rate for Payer: Railroad Medicare Medicare |
$4.22
|
| Rate for Payer: Railroad Medicare Medicare |
$6.96
|
| Rate for Payer: Railroad Medicare Medicare |
$4.82
|
| Rate for Payer: Railroad Medicare Medicare |
$3.92
|
| Rate for Payer: Railroad Medicare Medicare |
$2.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.81
|
| Rate for Payer: UHC Core |
$16.83
|
| Rate for Payer: UHC Core |
$16.11
|
| Rate for Payer: UHC Core |
$13.10
|
| Rate for Payer: UHC Core |
$9.56
|
| Rate for Payer: UHC Core |
$14.09
|
| Rate for Payer: UHC Core |
$23.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.86
|
| Rate for Payer: UHC Exchange |
$5.04
|
| Rate for Payer: UHC Exchange |
$3.92
|
| Rate for Payer: UHC Exchange |
$4.22
|
| Rate for Payer: UHC Exchange |
$2.86
|
| Rate for Payer: UHC Exchange |
$6.96
|
| Rate for Payer: UHC Exchange |
$4.82
|
| Rate for Payer: UHC Medicare Advantage |
$4.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.96
|
| Rate for Payer: UHC Medicare Advantage |
$3.92
|
| Rate for Payer: UHC Medicare Advantage |
$5.04
|
| Rate for Payer: UHC Medicare Advantage |
$2.86
|
| Rate for Payer: UHC Medicare Advantage |
$4.82
|
| Rate for Payer: VA VA |
$4.82
|
| Rate for Payer: VA VA |
$2.86
|
| Rate for Payer: VA VA |
$4.22
|
| Rate for Payer: VA VA |
$3.92
|
| Rate for Payer: VA VA |
$6.96
|
| Rate for Payer: VA VA |
$5.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.12
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV
|
Facility
|
IP
|
$73.44
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15846
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$47.74 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: BCBS Trust/PPO |
$59.95
|
| Rate for Payer: BCN Commercial |
$56.75
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.74
|
| Rate for Payer: Priority Health HMO/PPO |
$63.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.63
|
| Rate for Payer: UHC Core |
$61.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.08
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV
|
Facility
|
OP
|
$73.44
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15846
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.44 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna Medicare |
$19.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.95
|
| Rate for Payer: BCBS Complete |
$29.38
|
| Rate for Payer: BCBS MAPPO |
$18.36
|
| Rate for Payer: BCBS Trust/PPO |
$60.38
|
| Rate for Payer: BCN Commercial |
$57.10
|
| Rate for Payer: BCN Medicare Advantage |
$18.36
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.36
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: PACE Senior Care Partners |
$17.44
|
| Rate for Payer: PACE SWMI |
$18.36
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: PHP Medicare Advantage |
$18.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.74
|
| Rate for Payer: Priority Health HMO/PPO |
$63.89
|
| Rate for Payer: Priority Health Medicare |
$18.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.20
|
| Rate for Payer: Railroad Medicare Medicare |
$18.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.63
|
| Rate for Payer: UHC Core |
$61.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.36
|
| Rate for Payer: UHC Exchange |
$18.36
|
| Rate for Payer: UHC Medicare Advantage |
$18.36
|
| Rate for Payer: VA VA |
$18.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.08
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) INFUSION CUSTOM
|
Facility
|
IP
|
$87.73
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
180233
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$57.02 |
| Max. Negotiated Rate |
$78.96 |
| Rate for Payer: Aetna Commercial |
$74.57
|
| Rate for Payer: BCBS Trust/PPO |
$71.61
|
| Rate for Payer: BCN Commercial |
$67.80
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cofinity Commercial |
$75.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Healthscope Commercial |
$78.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.57
|
| Rate for Payer: Nomi Health Commercial |
$71.94
|
| Rate for Payer: PHP Commercial |
$74.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.02
|
| Rate for Payer: Priority Health HMO/PPO |
$76.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.20
|
| Rate for Payer: UHC Core |
$73.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.80
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) INFUSION CUSTOM
|
Facility
|
OP
|
$87.73
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
180233
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.84 |
| Max. Negotiated Rate |
$78.96 |
| Rate for Payer: Aetna Commercial |
$74.57
|
| Rate for Payer: Aetna Medicare |
$22.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.42
|
| Rate for Payer: BCBS Complete |
$35.09
|
| Rate for Payer: BCBS MAPPO |
$21.93
|
| Rate for Payer: BCBS Trust/PPO |
$72.12
|
| Rate for Payer: BCN Commercial |
$68.21
|
| Rate for Payer: BCN Medicare Advantage |
$21.93
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cofinity Commercial |
$75.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.93
|
| Rate for Payer: Healthscope Commercial |
$78.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.57
|
| Rate for Payer: Nomi Health Commercial |
$71.94
|
| Rate for Payer: PACE Senior Care Partners |
$20.84
|
| Rate for Payer: PACE SWMI |
$21.93
|
| Rate for Payer: PHP Commercial |
$74.57
|
| Rate for Payer: PHP Medicare Advantage |
$21.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.02
|
| Rate for Payer: Priority Health HMO/PPO |
$76.33
|
| Rate for Payer: Priority Health Medicare |
$22.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.78
|
| Rate for Payer: Railroad Medicare Medicare |
$21.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.20
|
| Rate for Payer: UHC Core |
$73.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.93
|
| Rate for Payer: UHC Exchange |
$21.93
|
| Rate for Payer: UHC Medicare Advantage |
$21.93
|
| Rate for Payer: VA VA |
$21.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.80
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15849
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.80 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Commercial |
$64.38
|
| Rate for Payer: Aetna Medicare |
$23.87
|
| Rate for Payer: Aetna Medicare |
$19.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.67
|
| Rate for Payer: BCBS Complete |
$30.30
|
| Rate for Payer: BCBS Complete |
$36.72
|
| Rate for Payer: BCBS MAPPO |
$18.93
|
| Rate for Payer: BCBS MAPPO |
$22.95
|
| Rate for Payer: BCBS Trust/PPO |
$75.47
|
| Rate for Payer: BCBS Trust/PPO |
$62.27
|
| Rate for Payer: BCN Commercial |
$71.37
|
| Rate for Payer: BCN Commercial |
$58.89
|
| Rate for Payer: BCN Medicare Advantage |
$22.95
|
| Rate for Payer: BCN Medicare Advantage |
$18.93
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$60.59
|
| Rate for Payer: Cofinity Commercial |
$65.14
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.95
|
| Rate for Payer: Healthscope Commercial |
$68.17
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.38
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: Nomi Health Commercial |
$62.11
|
| Rate for Payer: PACE Senior Care Partners |
$21.80
|
| Rate for Payer: PACE Senior Care Partners |
$17.99
|
| Rate for Payer: PACE SWMI |
$22.95
|
| Rate for Payer: PACE SWMI |
$18.93
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Commercial |
$64.38
|
| Rate for Payer: PHP Medicare Advantage |
$18.93
|
| Rate for Payer: PHP Medicare Advantage |
$22.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.23
|
| Rate for Payer: Priority Health HMO/PPO |
$65.89
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Medicare |
$23.18
|
| Rate for Payer: Priority Health Medicare |
$19.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.75
|
| Rate for Payer: Railroad Medicare Medicare |
$18.93
|
| Rate for Payer: Railroad Medicare Medicare |
$22.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: UHC Core |
$63.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.93
|
| Rate for Payer: UHC Exchange |
$18.93
|
| Rate for Payer: UHC Exchange |
$22.95
|
| Rate for Payer: UHC Medicare Advantage |
$18.93
|
| Rate for Payer: UHC Medicare Advantage |
$22.95
|
| Rate for Payer: VA VA |
$18.93
|
| Rate for Payer: VA VA |
$22.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.80
|
|
