|
HYDROCORTISONE 2.5 % TOPICAL CREAM WITH PERINEAL APPLICATOR
|
Facility
|
OP
|
$225.54
|
|
|
Service Code
|
NDC 62559043130
|
| Hospital Charge Code |
28824
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$53.57 |
| Max. Negotiated Rate |
$202.99 |
| Rate for Payer: Aetna Commercial |
$191.71
|
| Rate for Payer: Aetna Medicare |
$58.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.48
|
| Rate for Payer: BCBS Complete |
$90.22
|
| Rate for Payer: BCBS MAPPO |
$56.38
|
| Rate for Payer: BCBS Trust/PPO |
$185.42
|
| Rate for Payer: BCN Commercial |
$175.36
|
| Rate for Payer: BCN Medicare Advantage |
$56.38
|
| Rate for Payer: Cash Price |
$180.43
|
| Rate for Payer: Cofinity Commercial |
$193.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.38
|
| Rate for Payer: Healthscope Commercial |
$202.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.71
|
| Rate for Payer: Nomi Health Commercial |
$184.94
|
| Rate for Payer: PACE Senior Care Partners |
$53.57
|
| Rate for Payer: PACE SWMI |
$56.38
|
| Rate for Payer: PHP Commercial |
$191.71
|
| Rate for Payer: PHP Medicare Advantage |
$56.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.60
|
| Rate for Payer: Priority Health HMO/PPO |
$196.22
|
| Rate for Payer: Priority Health Medicare |
$56.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.11
|
| Rate for Payer: Railroad Medicare Medicare |
$56.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.48
|
| Rate for Payer: UHC Core |
$188.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.38
|
| Rate for Payer: UHC Exchange |
$56.38
|
| Rate for Payer: UHC Medicare Advantage |
$56.38
|
| Rate for Payer: VA VA |
$56.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.16
|
|
|
HYDROCORTISONE 2.5 % TOPICAL CREAM WITH PERINEAL APPLICATOR
|
Facility
|
OP
|
$29.40
|
|
|
Service Code
|
NDC 64980032430
|
| Hospital Charge Code |
28824
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$26.46 |
| Rate for Payer: Aetna Commercial |
$24.99
|
| Rate for Payer: Aetna Medicare |
$7.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.19
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$7.35
|
| Rate for Payer: BCBS Trust/PPO |
$24.17
|
| Rate for Payer: BCN Commercial |
$22.86
|
| Rate for Payer: BCN Medicare Advantage |
$7.35
|
| Rate for Payer: Cash Price |
$23.52
|
| Rate for Payer: Cofinity Commercial |
$25.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.35
|
| Rate for Payer: Healthscope Commercial |
$26.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.99
|
| Rate for Payer: Nomi Health Commercial |
$24.11
|
| Rate for Payer: PACE Senior Care Partners |
$6.98
|
| Rate for Payer: PACE SWMI |
$7.35
|
| Rate for Payer: PHP Commercial |
$24.99
|
| Rate for Payer: PHP Medicare Advantage |
$7.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.11
|
| Rate for Payer: Priority Health HMO/PPO |
$25.58
|
| Rate for Payer: Priority Health Medicare |
$7.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.70
|
| Rate for Payer: Railroad Medicare Medicare |
$7.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.87
|
| Rate for Payer: UHC Core |
$24.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.35
|
| Rate for Payer: UHC Exchange |
$7.35
|
| Rate for Payer: UHC Medicare Advantage |
$7.35
|
| Rate for Payer: VA VA |
$7.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.05
|
|
|
HYDROCORTISONE 2.5 % TOPICAL CREAM WITH PERINEAL APPLICATOR
|
Facility
|
IP
|
$29.40
|
|
|
Service Code
|
NDC 64980032430
|
| Hospital Charge Code |
28824
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$19.11 |
| Max. Negotiated Rate |
$26.46 |
| Rate for Payer: Aetna Commercial |
$24.99
|
| Rate for Payer: BCBS Trust/PPO |
$24.00
|
| Rate for Payer: BCN Commercial |
$22.72
|
| Rate for Payer: Cash Price |
$23.52
|
| Rate for Payer: Cofinity Commercial |
$25.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.52
|
| Rate for Payer: Healthscope Commercial |
$26.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.99
|
| Rate for Payer: Nomi Health Commercial |
$24.11
|
| Rate for Payer: PHP Commercial |
$24.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.11
|
| Rate for Payer: Priority Health HMO/PPO |
$25.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.87
|
| Rate for Payer: UHC Core |
$24.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.05
|
|
|
HYDROCORTISONE 2.5 % TOPICAL CREAM WITH PERINEAL APPLICATOR
|
Facility
|
OP
|
$155.30
|
|
|
Service Code
|
NDC 64980030130
|
| Hospital Charge Code |
28824
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$36.88 |
| Max. Negotiated Rate |
$139.77 |
| Rate for Payer: Aetna Commercial |
$132.00
|
| Rate for Payer: Aetna Medicare |
$40.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.53
|
| Rate for Payer: BCBS Complete |
$62.12
|
| Rate for Payer: BCBS MAPPO |
$38.83
|
| Rate for Payer: BCBS Trust/PPO |
$127.67
|
| Rate for Payer: BCN Commercial |
$120.75
|
| Rate for Payer: BCN Medicare Advantage |
$38.83
|
| Rate for Payer: Cash Price |
$124.24
|
| Rate for Payer: Cofinity Commercial |
$133.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.83
|
| Rate for Payer: Healthscope Commercial |
$139.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.00
|
| Rate for Payer: Nomi Health Commercial |
$127.35
|
| Rate for Payer: PACE Senior Care Partners |
$36.88
|
| Rate for Payer: PACE SWMI |
$38.83
|
| Rate for Payer: PHP Commercial |
$132.00
|
| Rate for Payer: PHP Medicare Advantage |
$38.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.94
|
| Rate for Payer: Priority Health HMO/PPO |
$135.11
|
| Rate for Payer: Priority Health Medicare |
$39.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.05
|
| Rate for Payer: Railroad Medicare Medicare |
$38.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.66
|
| Rate for Payer: UHC Core |
$129.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.83
|
| Rate for Payer: UHC Exchange |
$38.83
|
| Rate for Payer: UHC Medicare Advantage |
$38.83
|
| Rate for Payer: VA VA |
$38.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.47
|
|
|
HYDROCORTISONE 5 MG TABLET
|
Facility
|
IP
|
$226.78
|
|
|
Service Code
|
NDC 00115169606
|
| Hospital Charge Code |
10209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$147.41 |
| Max. Negotiated Rate |
$204.10 |
| Rate for Payer: Aetna Commercial |
$192.76
|
| Rate for Payer: BCBS Trust/PPO |
$185.12
|
| Rate for Payer: BCN Commercial |
$175.26
|
| Rate for Payer: Cash Price |
$181.42
|
| Rate for Payer: Cofinity Commercial |
$195.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.42
|
| Rate for Payer: Healthscope Commercial |
$204.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.76
|
| Rate for Payer: Nomi Health Commercial |
$185.96
|
| Rate for Payer: PHP Commercial |
$192.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.41
|
| Rate for Payer: Priority Health HMO/PPO |
$197.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.57
|
| Rate for Payer: UHC Core |
$189.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.09
|
|
|
HYDROCORTISONE 5 MG TABLET
|
Facility
|
OP
|
$226.78
|
|
|
Service Code
|
NDC 00115169606
|
| Hospital Charge Code |
10209
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$53.86 |
| Max. Negotiated Rate |
$204.10 |
| Rate for Payer: Aetna Commercial |
$192.76
|
| Rate for Payer: Aetna Medicare |
$58.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.87
|
| Rate for Payer: BCBS Complete |
$90.71
|
| Rate for Payer: BCBS MAPPO |
$56.70
|
| Rate for Payer: BCBS Trust/PPO |
$186.44
|
| Rate for Payer: BCN Commercial |
$176.32
|
| Rate for Payer: BCN Medicare Advantage |
$56.70
|
| Rate for Payer: Cash Price |
$181.42
|
| Rate for Payer: Cofinity Commercial |
$195.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.70
|
| Rate for Payer: Healthscope Commercial |
$204.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.76
|
| Rate for Payer: Nomi Health Commercial |
$185.96
|
| Rate for Payer: PACE Senior Care Partners |
$53.86
|
| Rate for Payer: PACE SWMI |
$56.70
|
| Rate for Payer: PHP Commercial |
$192.76
|
| Rate for Payer: PHP Medicare Advantage |
$56.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.41
|
| Rate for Payer: Priority Health HMO/PPO |
$197.30
|
| Rate for Payer: Priority Health Medicare |
$57.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.94
|
| Rate for Payer: Railroad Medicare Medicare |
$56.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.57
|
| Rate for Payer: UHC Core |
$189.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.70
|
| Rate for Payer: UHC Exchange |
$56.70
|
| Rate for Payer: UHC Medicare Advantage |
$56.70
|
| Rate for Payer: VA VA |
$56.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.09
|
|
|
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$89.17
|
|
|
Service Code
|
NDC 16571067621
|
| Hospital Charge Code |
3738
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$21.18 |
| Max. Negotiated Rate |
$80.25 |
| Rate for Payer: Aetna Commercial |
$75.79
|
| Rate for Payer: Aetna Medicare |
$23.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.87
|
| Rate for Payer: BCBS Complete |
$35.67
|
| Rate for Payer: BCBS MAPPO |
$22.29
|
| Rate for Payer: BCBS Trust/PPO |
$73.31
|
| Rate for Payer: BCN Commercial |
$69.33
|
| Rate for Payer: BCN Medicare Advantage |
$22.29
|
| Rate for Payer: Cash Price |
$71.34
|
| Rate for Payer: Cofinity Commercial |
$76.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.29
|
| Rate for Payer: Healthscope Commercial |
$80.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.79
|
| Rate for Payer: Nomi Health Commercial |
$73.12
|
| Rate for Payer: PACE Senior Care Partners |
$21.18
|
| Rate for Payer: PACE SWMI |
$22.29
|
| Rate for Payer: PHP Commercial |
$75.79
|
| Rate for Payer: PHP Medicare Advantage |
$22.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.96
|
| Rate for Payer: Priority Health HMO/PPO |
$77.58
|
| Rate for Payer: Priority Health Medicare |
$22.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.74
|
| Rate for Payer: Railroad Medicare Medicare |
$22.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.47
|
| Rate for Payer: UHC Core |
$74.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.29
|
| Rate for Payer: UHC Exchange |
$22.29
|
| Rate for Payer: UHC Medicare Advantage |
$22.29
|
| Rate for Payer: VA VA |
$22.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.88
|
|
|
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$89.17
|
|
|
Service Code
|
NDC 16571067621
|
| Hospital Charge Code |
3738
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$57.96 |
| Max. Negotiated Rate |
$80.25 |
| Rate for Payer: Aetna Commercial |
$75.79
|
| Rate for Payer: BCBS Trust/PPO |
$72.79
|
| Rate for Payer: BCN Commercial |
$68.91
|
| Rate for Payer: Cash Price |
$71.34
|
| Rate for Payer: Cofinity Commercial |
$76.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.34
|
| Rate for Payer: Healthscope Commercial |
$80.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.79
|
| Rate for Payer: Nomi Health Commercial |
$73.12
|
| Rate for Payer: PHP Commercial |
$75.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.96
|
| Rate for Payer: Priority Health HMO/PPO |
$77.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.47
|
| Rate for Payer: UHC Core |
$74.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.88
|
|
|
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$476.55
|
|
|
Service Code
|
NDC 00574709012
|
| Hospital Charge Code |
3738
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$309.76 |
| Max. Negotiated Rate |
$428.89 |
| Rate for Payer: Aetna Commercial |
$405.07
|
| Rate for Payer: BCBS Trust/PPO |
$389.01
|
| Rate for Payer: BCN Commercial |
$368.28
|
| Rate for Payer: Cash Price |
$381.24
|
| Rate for Payer: Cofinity Commercial |
$409.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$381.24
|
| Rate for Payer: Healthscope Commercial |
$428.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$357.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$405.07
|
| Rate for Payer: Nomi Health Commercial |
$390.77
|
| Rate for Payer: PHP Commercial |
$405.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$309.76
|
| Rate for Payer: Priority Health HMO/PPO |
$414.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$319.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$419.36
|
| Rate for Payer: UHC Core |
$397.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$357.41
|
|
|
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$476.55
|
|
|
Service Code
|
NDC 00574709012
|
| Hospital Charge Code |
3738
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$113.18 |
| Max. Negotiated Rate |
$428.89 |
| Rate for Payer: Aetna Commercial |
$405.07
|
| Rate for Payer: Aetna Medicare |
$123.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$148.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$148.92
|
| Rate for Payer: BCBS Complete |
$190.62
|
| Rate for Payer: BCBS MAPPO |
$119.14
|
| Rate for Payer: BCBS Trust/PPO |
$391.77
|
| Rate for Payer: BCN Commercial |
$370.52
|
| Rate for Payer: BCN Medicare Advantage |
$119.14
|
| Rate for Payer: Cash Price |
$381.24
|
| Rate for Payer: Cofinity Commercial |
$409.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$381.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.14
|
| Rate for Payer: Healthscope Commercial |
$428.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$357.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$137.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$405.07
|
| Rate for Payer: Nomi Health Commercial |
$390.77
|
| Rate for Payer: PACE Senior Care Partners |
$113.18
|
| Rate for Payer: PACE SWMI |
$119.14
|
| Rate for Payer: PHP Commercial |
$405.07
|
| Rate for Payer: PHP Medicare Advantage |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$309.76
|
| Rate for Payer: Priority Health HMO/PPO |
$414.60
|
| Rate for Payer: Priority Health Medicare |
$120.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$319.29
|
| Rate for Payer: Railroad Medicare Medicare |
$119.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$419.36
|
| Rate for Payer: UHC Core |
$397.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.14
|
| Rate for Payer: UHC Exchange |
$119.14
|
| Rate for Payer: UHC Medicare Advantage |
$119.14
|
| Rate for Payer: VA VA |
$119.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$357.41
|
|
|
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$474.82
|
|
|
Service Code
|
NDC 00713050312
|
| Hospital Charge Code |
3738
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$112.77 |
| Max. Negotiated Rate |
$427.34 |
| Rate for Payer: Aetna Commercial |
$403.60
|
| Rate for Payer: Aetna Medicare |
$123.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$148.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$148.38
|
| Rate for Payer: BCBS Complete |
$189.93
|
| Rate for Payer: BCBS MAPPO |
$118.70
|
| Rate for Payer: BCBS Trust/PPO |
$390.35
|
| Rate for Payer: BCN Commercial |
$369.17
|
| Rate for Payer: BCN Medicare Advantage |
$118.70
|
| Rate for Payer: Cash Price |
$379.86
|
| Rate for Payer: Cofinity Commercial |
$408.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$379.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.70
|
| Rate for Payer: Healthscope Commercial |
$427.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$136.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$403.60
|
| Rate for Payer: Nomi Health Commercial |
$389.35
|
| Rate for Payer: PACE Senior Care Partners |
$112.77
|
| Rate for Payer: PACE SWMI |
$118.70
|
| Rate for Payer: PHP Commercial |
$403.60
|
| Rate for Payer: PHP Medicare Advantage |
$118.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.63
|
| Rate for Payer: Priority Health HMO/PPO |
$413.09
|
| Rate for Payer: Priority Health Medicare |
$119.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$318.13
|
| Rate for Payer: Railroad Medicare Medicare |
$118.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$417.84
|
| Rate for Payer: UHC Core |
$396.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.70
|
| Rate for Payer: UHC Exchange |
$118.70
|
| Rate for Payer: UHC Medicare Advantage |
$118.70
|
| Rate for Payer: VA VA |
$118.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.12
|
|
|
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$474.82
|
|
|
Service Code
|
NDC 00713050312
|
| Hospital Charge Code |
3738
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$308.63 |
| Max. Negotiated Rate |
$427.34 |
| Rate for Payer: Aetna Commercial |
$403.60
|
| Rate for Payer: BCBS Trust/PPO |
$387.60
|
| Rate for Payer: BCN Commercial |
$366.94
|
| Rate for Payer: Cash Price |
$379.86
|
| Rate for Payer: Cofinity Commercial |
$408.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$379.86
|
| Rate for Payer: Healthscope Commercial |
$427.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$403.60
|
| Rate for Payer: Nomi Health Commercial |
$389.35
|
| Rate for Payer: PHP Commercial |
$403.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.63
|
| Rate for Payer: Priority Health HMO/PPO |
$413.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$318.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$417.84
|
| Rate for Payer: UHC Core |
$396.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.12
|
|
|
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$7.44
|
|
|
Service Code
|
NDC 16571067616
|
| Hospital Charge Code |
3738
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.77 |
| Max. Negotiated Rate |
$6.70 |
| Rate for Payer: Aetna Commercial |
$6.32
|
| Rate for Payer: Aetna Medicare |
$1.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.33
|
| Rate for Payer: BCBS Complete |
$2.98
|
| Rate for Payer: BCBS MAPPO |
$1.86
|
| Rate for Payer: BCBS Trust/PPO |
$6.12
|
| Rate for Payer: BCN Commercial |
$5.78
|
| Rate for Payer: BCN Medicare Advantage |
$1.86
|
| Rate for Payer: Cash Price |
$5.95
|
| Rate for Payer: Cofinity Commercial |
$6.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.86
|
| Rate for Payer: Healthscope Commercial |
$6.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.32
|
| Rate for Payer: Nomi Health Commercial |
$6.10
|
| Rate for Payer: PACE Senior Care Partners |
$1.77
|
| Rate for Payer: PACE SWMI |
$1.86
|
| Rate for Payer: PHP Commercial |
$6.32
|
| Rate for Payer: PHP Medicare Advantage |
$1.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.84
|
| Rate for Payer: Priority Health HMO/PPO |
$6.47
|
| Rate for Payer: Priority Health Medicare |
$1.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.55
|
| Rate for Payer: UHC Core |
$6.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.86
|
| Rate for Payer: UHC Exchange |
$1.86
|
| Rate for Payer: UHC Medicare Advantage |
$1.86
|
| Rate for Payer: VA VA |
$1.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.58
|
|
|
HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$7.44
|
|
|
Service Code
|
NDC 16571067616
|
| Hospital Charge Code |
3738
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$6.70 |
| Rate for Payer: Aetna Commercial |
$6.32
|
| Rate for Payer: BCBS Trust/PPO |
$6.07
|
| Rate for Payer: BCN Commercial |
$5.75
|
| Rate for Payer: Cash Price |
$5.95
|
| Rate for Payer: Cofinity Commercial |
$6.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.95
|
| Rate for Payer: Healthscope Commercial |
$6.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.32
|
| Rate for Payer: Nomi Health Commercial |
$6.10
|
| Rate for Payer: PHP Commercial |
$6.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.84
|
| Rate for Payer: Priority Health HMO/PPO |
$6.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.55
|
| Rate for Payer: UHC Core |
$6.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.58
|
|
|
HYDROCORTISONE-ACETIC ACID 1 %-2 % EAR DROPS
|
Facility
|
OP
|
$248.92
|
|
|
Service Code
|
NDC 50383090110
|
| Hospital Charge Code |
24385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$59.12 |
| Max. Negotiated Rate |
$224.03 |
| Rate for Payer: Aetna Commercial |
$211.58
|
| Rate for Payer: Aetna Medicare |
$64.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.79
|
| Rate for Payer: BCBS Complete |
$99.57
|
| Rate for Payer: BCBS MAPPO |
$62.23
|
| Rate for Payer: BCBS Trust/PPO |
$204.64
|
| Rate for Payer: BCN Commercial |
$193.54
|
| Rate for Payer: BCN Medicare Advantage |
$62.23
|
| Rate for Payer: Cash Price |
$199.14
|
| Rate for Payer: Cofinity Commercial |
$214.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.23
|
| Rate for Payer: Healthscope Commercial |
$224.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.58
|
| Rate for Payer: Nomi Health Commercial |
$204.11
|
| Rate for Payer: PACE Senior Care Partners |
$59.12
|
| Rate for Payer: PACE SWMI |
$62.23
|
| Rate for Payer: PHP Commercial |
$211.58
|
| Rate for Payer: PHP Medicare Advantage |
$62.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.80
|
| Rate for Payer: Priority Health HMO/PPO |
$216.56
|
| Rate for Payer: Priority Health Medicare |
$62.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.78
|
| Rate for Payer: Railroad Medicare Medicare |
$62.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.05
|
| Rate for Payer: UHC Core |
$207.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.23
|
| Rate for Payer: UHC Exchange |
$62.23
|
| Rate for Payer: UHC Medicare Advantage |
$62.23
|
| Rate for Payer: VA VA |
$62.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.69
|
|
|
HYDROCORTISONE-ACETIC ACID 1 %-2 % EAR DROPS
|
Facility
|
IP
|
$248.92
|
|
|
Service Code
|
NDC 50383090110
|
| Hospital Charge Code |
24385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$161.80 |
| Max. Negotiated Rate |
$224.03 |
| Rate for Payer: Aetna Commercial |
$211.58
|
| Rate for Payer: BCBS Trust/PPO |
$203.19
|
| Rate for Payer: BCN Commercial |
$192.37
|
| Rate for Payer: Cash Price |
$199.14
|
| Rate for Payer: Cofinity Commercial |
$214.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.14
|
| Rate for Payer: Healthscope Commercial |
$224.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.58
|
| Rate for Payer: Nomi Health Commercial |
$204.11
|
| Rate for Payer: PHP Commercial |
$211.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.80
|
| Rate for Payer: Priority Health HMO/PPO |
$216.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.05
|
| Rate for Payer: UHC Core |
$207.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.69
|
|
|
HYDROCORTISONE-ALOE VERA 1 % TOPICAL CREAM
|
Facility
|
OP
|
$11.00
|
|
|
Service Code
|
NDC 51672201302
|
| Hospital Charge Code |
14190
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$9.90 |
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: Aetna Medicare |
$2.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.44
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$2.75
|
| Rate for Payer: BCBS Trust/PPO |
$9.04
|
| Rate for Payer: BCN Commercial |
$8.55
|
| Rate for Payer: BCN Medicare Advantage |
$2.75
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.75
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: Nomi Health Commercial |
$9.02
|
| Rate for Payer: PACE Senior Care Partners |
$2.61
|
| Rate for Payer: PACE SWMI |
$2.75
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: PHP Medicare Advantage |
$2.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
| Rate for Payer: Priority Health HMO/PPO |
$9.57
|
| Rate for Payer: Priority Health Medicare |
$2.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.37
|
| Rate for Payer: Railroad Medicare Medicare |
$2.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.68
|
| Rate for Payer: UHC Core |
$9.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.75
|
| Rate for Payer: UHC Exchange |
$2.75
|
| Rate for Payer: UHC Medicare Advantage |
$2.75
|
| Rate for Payer: VA VA |
$2.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.25
|
|
|
HYDROCORTISONE-ALOE VERA 1 % TOPICAL CREAM
|
Facility
|
IP
|
$11.00
|
|
|
Service Code
|
NDC 51672201302
|
| Hospital Charge Code |
14190
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.15 |
| Max. Negotiated Rate |
$9.90 |
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: BCBS Trust/PPO |
$8.98
|
| Rate for Payer: BCN Commercial |
$8.50
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: Nomi Health Commercial |
$9.02
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
| Rate for Payer: Priority Health HMO/PPO |
$9.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.68
|
| Rate for Payer: UHC Core |
$9.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.25
|
|
|
HYDROCORTISONE-ALOE VERA 1 % TOPICAL CREAM
|
Facility
|
OP
|
$7.90
|
|
|
Service Code
|
NDC 00536140795
|
| Hospital Charge Code |
14190
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.88 |
| Max. Negotiated Rate |
$7.11 |
| Rate for Payer: Aetna Commercial |
$6.71
|
| Rate for Payer: Aetna Medicare |
$2.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.47
|
| Rate for Payer: BCBS Complete |
$3.16
|
| Rate for Payer: BCBS MAPPO |
$1.98
|
| Rate for Payer: BCBS Trust/PPO |
$6.49
|
| Rate for Payer: BCN Commercial |
$6.14
|
| Rate for Payer: BCN Medicare Advantage |
$1.98
|
| Rate for Payer: Cash Price |
$6.32
|
| Rate for Payer: Cofinity Commercial |
$6.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.98
|
| Rate for Payer: Healthscope Commercial |
$7.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.71
|
| Rate for Payer: Nomi Health Commercial |
$6.48
|
| Rate for Payer: PACE Senior Care Partners |
$1.88
|
| Rate for Payer: PACE SWMI |
$1.98
|
| Rate for Payer: PHP Commercial |
$6.71
|
| Rate for Payer: PHP Medicare Advantage |
$1.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.13
|
| Rate for Payer: Priority Health HMO/PPO |
$6.87
|
| Rate for Payer: Priority Health Medicare |
$1.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.95
|
| Rate for Payer: UHC Core |
$6.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.98
|
| Rate for Payer: UHC Exchange |
$1.98
|
| Rate for Payer: UHC Medicare Advantage |
$1.98
|
| Rate for Payer: VA VA |
$1.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.92
|
|
|
HYDROCORTISONE-ALOE VERA 1 % TOPICAL CREAM
|
Facility
|
IP
|
$7.90
|
|
|
Service Code
|
NDC 00536140795
|
| Hospital Charge Code |
14190
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$7.11 |
| Rate for Payer: Aetna Commercial |
$6.71
|
| Rate for Payer: BCBS Trust/PPO |
$6.45
|
| Rate for Payer: BCN Commercial |
$6.11
|
| Rate for Payer: Cash Price |
$6.32
|
| Rate for Payer: Cofinity Commercial |
$6.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.32
|
| Rate for Payer: Healthscope Commercial |
$7.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.71
|
| Rate for Payer: Nomi Health Commercial |
$6.48
|
| Rate for Payer: PHP Commercial |
$6.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.13
|
| Rate for Payer: Priority Health HMO/PPO |
$6.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.95
|
| Rate for Payer: UHC Core |
$6.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.92
|
|
|
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION
|
Facility
|
IP
|
$97.58
|
|
|
Service Code
|
HCPCS J1720
|
| Hospital Charge Code |
119665
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$63.43 |
| Max. Negotiated Rate |
$87.82 |
| Rate for Payer: Aetna Commercial |
$82.94
|
| Rate for Payer: Aetna Commercial |
$83.60
|
| Rate for Payer: BCBS Trust/PPO |
$79.65
|
| Rate for Payer: BCBS Trust/PPO |
$80.28
|
| Rate for Payer: BCN Commercial |
$75.41
|
| Rate for Payer: BCN Commercial |
$76.00
|
| Rate for Payer: Cash Price |
$78.06
|
| Rate for Payer: Cash Price |
$78.68
|
| Rate for Payer: Cofinity Commercial |
$84.58
|
| Rate for Payer: Cofinity Commercial |
$83.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.06
|
| Rate for Payer: Healthscope Commercial |
$87.82
|
| Rate for Payer: Healthscope Commercial |
$88.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.60
|
| Rate for Payer: Nomi Health Commercial |
$80.02
|
| Rate for Payer: Nomi Health Commercial |
$80.65
|
| Rate for Payer: PHP Commercial |
$82.94
|
| Rate for Payer: PHP Commercial |
$83.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.43
|
| Rate for Payer: Priority Health HMO/PPO |
$85.56
|
| Rate for Payer: Priority Health HMO/PPO |
$84.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.55
|
| Rate for Payer: UHC Core |
$81.48
|
| Rate for Payer: UHC Core |
$82.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.76
|
|
|
HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION
|
Facility
|
OP
|
$98.35
|
|
|
Service Code
|
HCPCS J1720
|
| Hospital Charge Code |
119665
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.36 |
| Max. Negotiated Rate |
$88.52 |
| Rate for Payer: Aetna Commercial |
$83.60
|
| Rate for Payer: Aetna Commercial |
$82.94
|
| Rate for Payer: Aetna Medicare |
$25.57
|
| Rate for Payer: Aetna Medicare |
$25.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.49
|
| Rate for Payer: BCBS Complete |
$39.03
|
| Rate for Payer: BCBS Complete |
$39.34
|
| Rate for Payer: BCBS MAPPO |
$24.39
|
| Rate for Payer: BCBS MAPPO |
$24.59
|
| Rate for Payer: BCBS Trust/PPO |
$80.85
|
| Rate for Payer: BCBS Trust/PPO |
$80.22
|
| Rate for Payer: BCN Commercial |
$76.47
|
| Rate for Payer: BCN Commercial |
$75.87
|
| Rate for Payer: BCN Medicare Advantage |
$24.59
|
| Rate for Payer: BCN Medicare Advantage |
$24.39
|
| Rate for Payer: Cash Price |
$78.68
|
| Rate for Payer: Cash Price |
$78.06
|
| Rate for Payer: Cofinity Commercial |
$83.92
|
| Rate for Payer: Cofinity Commercial |
$84.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.59
|
| Rate for Payer: Healthscope Commercial |
$87.82
|
| Rate for Payer: Healthscope Commercial |
$88.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.94
|
| Rate for Payer: Nomi Health Commercial |
$80.65
|
| Rate for Payer: Nomi Health Commercial |
$80.02
|
| Rate for Payer: PACE Senior Care Partners |
$23.36
|
| Rate for Payer: PACE Senior Care Partners |
$23.18
|
| Rate for Payer: PACE SWMI |
$24.59
|
| Rate for Payer: PACE SWMI |
$24.39
|
| Rate for Payer: PHP Commercial |
$83.60
|
| Rate for Payer: PHP Commercial |
$82.94
|
| Rate for Payer: PHP Medicare Advantage |
$24.39
|
| Rate for Payer: PHP Medicare Advantage |
$24.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.43
|
| Rate for Payer: Priority Health HMO/PPO |
$84.89
|
| Rate for Payer: Priority Health HMO/PPO |
$85.56
|
| Rate for Payer: Priority Health Medicare |
$24.83
|
| Rate for Payer: Priority Health Medicare |
$24.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.38
|
| Rate for Payer: Railroad Medicare Medicare |
$24.39
|
| Rate for Payer: Railroad Medicare Medicare |
$24.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.55
|
| Rate for Payer: UHC Core |
$82.12
|
| Rate for Payer: UHC Core |
$81.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.39
|
| Rate for Payer: UHC Exchange |
$24.39
|
| Rate for Payer: UHC Exchange |
$24.59
|
| Rate for Payer: UHC Medicare Advantage |
$24.39
|
| Rate for Payer: UHC Medicare Advantage |
$24.59
|
| Rate for Payer: VA VA |
$24.39
|
| Rate for Payer: VA VA |
$24.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.19
|
|
|
HYDROMORPHONE 0.5 MG/0.5 ML INJECTION SYRINGE
|
Facility
|
OP
|
$14.07
|
|
|
Service Code
|
HCPCS J1171
|
| Hospital Charge Code |
166819
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.34 |
| Max. Negotiated Rate |
$12.66 |
| Rate for Payer: Aetna Commercial |
$11.96
|
| Rate for Payer: Aetna Commercial |
$18.20
|
| Rate for Payer: Aetna Commercial |
$14.01
|
| Rate for Payer: Aetna Commercial |
$13.09
|
| Rate for Payer: Aetna Medicare |
$4.00
|
| Rate for Payer: Aetna Medicare |
$3.66
|
| Rate for Payer: Aetna Medicare |
$4.28
|
| Rate for Payer: Aetna Medicare |
$5.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.40
|
| Rate for Payer: BCBS Complete |
$5.63
|
| Rate for Payer: BCBS Complete |
$6.16
|
| Rate for Payer: BCBS Complete |
$8.56
|
| Rate for Payer: BCBS Complete |
$6.59
|
| Rate for Payer: BCBS MAPPO |
$3.52
|
| Rate for Payer: BCBS MAPPO |
$3.85
|
| Rate for Payer: BCBS MAPPO |
$5.35
|
| Rate for Payer: BCBS MAPPO |
$4.12
|
| Rate for Payer: BCBS Trust/PPO |
$11.57
|
| Rate for Payer: BCBS Trust/PPO |
$17.60
|
| Rate for Payer: BCBS Trust/PPO |
$12.66
|
| Rate for Payer: BCBS Trust/PPO |
$13.55
|
| Rate for Payer: BCN Commercial |
$10.94
|
| Rate for Payer: BCN Commercial |
$12.81
|
| Rate for Payer: BCN Commercial |
$11.97
|
| Rate for Payer: BCN Commercial |
$16.65
|
| Rate for Payer: BCN Medicare Advantage |
$3.85
|
| Rate for Payer: BCN Medicare Advantage |
$5.35
|
| Rate for Payer: BCN Medicare Advantage |
$3.52
|
| Rate for Payer: BCN Medicare Advantage |
$4.12
|
| Rate for Payer: Cash Price |
$11.26
|
| Rate for Payer: Cash Price |
$17.13
|
| Rate for Payer: Cash Price |
$13.18
|
| Rate for Payer: Cash Price |
$12.32
|
| Rate for Payer: Cofinity Commercial |
$18.41
|
| Rate for Payer: Cofinity Commercial |
$13.24
|
| Rate for Payer: Cofinity Commercial |
$12.10
|
| Rate for Payer: Cofinity Commercial |
$14.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.12
|
| Rate for Payer: Healthscope Commercial |
$12.66
|
| Rate for Payer: Healthscope Commercial |
$19.27
|
| Rate for Payer: Healthscope Commercial |
$14.83
|
| Rate for Payer: Healthscope Commercial |
$13.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.01
|
| Rate for Payer: Nomi Health Commercial |
$13.51
|
| Rate for Payer: Nomi Health Commercial |
$17.56
|
| Rate for Payer: Nomi Health Commercial |
$11.54
|
| Rate for Payer: Nomi Health Commercial |
$12.63
|
| Rate for Payer: PACE Senior Care Partners |
$3.34
|
| Rate for Payer: PACE Senior Care Partners |
$3.91
|
| Rate for Payer: PACE Senior Care Partners |
$5.08
|
| Rate for Payer: PACE Senior Care Partners |
$3.66
|
| Rate for Payer: PACE SWMI |
$3.85
|
| Rate for Payer: PACE SWMI |
$3.52
|
| Rate for Payer: PACE SWMI |
$4.12
|
| Rate for Payer: PACE SWMI |
$5.35
|
| Rate for Payer: PHP Commercial |
$14.01
|
| Rate for Payer: PHP Commercial |
$18.20
|
| Rate for Payer: PHP Commercial |
$13.09
|
| Rate for Payer: PHP Commercial |
$11.96
|
| Rate for Payer: PHP Medicare Advantage |
$3.85
|
| Rate for Payer: PHP Medicare Advantage |
$3.52
|
| Rate for Payer: PHP Medicare Advantage |
$5.35
|
| Rate for Payer: PHP Medicare Advantage |
$4.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.15
|
| Rate for Payer: Priority Health HMO/PPO |
$13.40
|
| Rate for Payer: Priority Health HMO/PPO |
$18.63
|
| Rate for Payer: Priority Health HMO/PPO |
$14.34
|
| Rate for Payer: Priority Health HMO/PPO |
$12.24
|
| Rate for Payer: Priority Health Medicare |
$4.16
|
| Rate for Payer: Priority Health Medicare |
$3.55
|
| Rate for Payer: Priority Health Medicare |
$3.89
|
| Rate for Payer: Priority Health Medicare |
$5.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3.85
|
| Rate for Payer: Railroad Medicare Medicare |
$4.12
|
| Rate for Payer: Railroad Medicare Medicare |
$3.52
|
| Rate for Payer: Railroad Medicare Medicare |
$5.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.55
|
| Rate for Payer: UHC Core |
$11.75
|
| Rate for Payer: UHC Core |
$17.88
|
| Rate for Payer: UHC Core |
$12.86
|
| Rate for Payer: UHC Core |
$13.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.85
|
| Rate for Payer: UHC Exchange |
$5.35
|
| Rate for Payer: UHC Exchange |
$3.85
|
| Rate for Payer: UHC Exchange |
$3.52
|
| Rate for Payer: UHC Exchange |
$4.12
|
| Rate for Payer: UHC Medicare Advantage |
$5.35
|
| Rate for Payer: UHC Medicare Advantage |
$3.52
|
| Rate for Payer: UHC Medicare Advantage |
$4.12
|
| Rate for Payer: UHC Medicare Advantage |
$3.85
|
| Rate for Payer: VA VA |
$3.85
|
| Rate for Payer: VA VA |
$5.35
|
| Rate for Payer: VA VA |
$4.12
|
| Rate for Payer: VA VA |
$3.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.36
|
|
|
HYDROMORPHONE 0.5 MG/0.5 ML INJECTION SYRINGE
|
Facility
|
IP
|
$16.48
|
|
|
Service Code
|
HCPCS J1171
|
| Hospital Charge Code |
166819
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.71 |
| Max. Negotiated Rate |
$14.83 |
| Rate for Payer: Aetna Commercial |
$14.01
|
| Rate for Payer: Aetna Commercial |
$13.09
|
| Rate for Payer: Aetna Commercial |
$11.96
|
| Rate for Payer: Aetna Commercial |
$18.20
|
| Rate for Payer: BCBS Trust/PPO |
$13.45
|
| Rate for Payer: BCBS Trust/PPO |
$17.48
|
| Rate for Payer: BCBS Trust/PPO |
$12.57
|
| Rate for Payer: BCBS Trust/PPO |
$11.49
|
| Rate for Payer: BCN Commercial |
$12.74
|
| Rate for Payer: BCN Commercial |
$10.87
|
| Rate for Payer: BCN Commercial |
$16.55
|
| Rate for Payer: BCN Commercial |
$11.90
|
| Rate for Payer: Cash Price |
$12.32
|
| Rate for Payer: Cash Price |
$13.18
|
| Rate for Payer: Cash Price |
$17.13
|
| Rate for Payer: Cash Price |
$11.26
|
| Rate for Payer: Cofinity Commercial |
$12.10
|
| Rate for Payer: Cofinity Commercial |
$18.41
|
| Rate for Payer: Cofinity Commercial |
$14.17
|
| Rate for Payer: Cofinity Commercial |
$13.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.13
|
| Rate for Payer: Healthscope Commercial |
$19.27
|
| Rate for Payer: Healthscope Commercial |
$13.86
|
| Rate for Payer: Healthscope Commercial |
$14.83
|
| Rate for Payer: Healthscope Commercial |
$12.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.20
|
| Rate for Payer: Nomi Health Commercial |
$11.54
|
| Rate for Payer: Nomi Health Commercial |
$12.63
|
| Rate for Payer: Nomi Health Commercial |
$17.56
|
| Rate for Payer: Nomi Health Commercial |
$13.51
|
| Rate for Payer: PHP Commercial |
$13.09
|
| Rate for Payer: PHP Commercial |
$11.96
|
| Rate for Payer: PHP Commercial |
$14.01
|
| Rate for Payer: PHP Commercial |
$18.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO |
$14.34
|
| Rate for Payer: Priority Health HMO/PPO |
$18.63
|
| Rate for Payer: Priority Health HMO/PPO |
$12.24
|
| Rate for Payer: Priority Health HMO/PPO |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.50
|
| Rate for Payer: UHC Core |
$13.76
|
| Rate for Payer: UHC Core |
$17.88
|
| Rate for Payer: UHC Core |
$12.86
|
| Rate for Payer: UHC Core |
$11.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.36
|
|
|
HYDROMORPHONE 1 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$17.06
|
|
|
Service Code
|
HCPCS J1171
|
| Hospital Charge Code |
112193
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.05 |
| Max. Negotiated Rate |
$15.35 |
| Rate for Payer: Aetna Commercial |
$14.50
|
| Rate for Payer: Aetna Commercial |
$27.17
|
| Rate for Payer: Aetna Commercial |
$18.82
|
| Rate for Payer: Aetna Commercial |
$18.59
|
| Rate for Payer: Aetna Medicare |
$5.69
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna Medicare |
$5.76
|
| Rate for Payer: Aetna Medicare |
$8.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.33
|
| Rate for Payer: BCBS Complete |
$6.82
|
| Rate for Payer: BCBS Complete |
$8.75
|
| Rate for Payer: BCBS Complete |
$12.79
|
| Rate for Payer: BCBS Complete |
$8.86
|
| Rate for Payer: BCBS MAPPO |
$4.26
|
| Rate for Payer: BCBS MAPPO |
$5.47
|
| Rate for Payer: BCBS MAPPO |
$7.99
|
| Rate for Payer: BCBS MAPPO |
$5.54
|
| Rate for Payer: BCBS Trust/PPO |
$14.03
|
| Rate for Payer: BCBS Trust/PPO |
$26.28
|
| Rate for Payer: BCBS Trust/PPO |
$17.98
|
| Rate for Payer: BCBS Trust/PPO |
$18.20
|
| Rate for Payer: BCN Commercial |
$13.26
|
| Rate for Payer: BCN Commercial |
$17.21
|
| Rate for Payer: BCN Commercial |
$17.00
|
| Rate for Payer: BCN Commercial |
$24.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.47
|
| Rate for Payer: BCN Medicare Advantage |
$7.99
|
| Rate for Payer: BCN Medicare Advantage |
$4.26
|
| Rate for Payer: BCN Medicare Advantage |
$5.54
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Cash Price |
$25.58
|
| Rate for Payer: Cash Price |
$17.71
|
| Rate for Payer: Cash Price |
$17.50
|
| Rate for Payer: Cofinity Commercial |
$27.49
|
| Rate for Payer: Cofinity Commercial |
$18.81
|
| Rate for Payer: Cofinity Commercial |
$14.67
|
| Rate for Payer: Cofinity Commercial |
$19.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.54
|
| Rate for Payer: Healthscope Commercial |
$15.35
|
| Rate for Payer: Healthscope Commercial |
$28.77
|
| Rate for Payer: Healthscope Commercial |
$19.93
|
| Rate for Payer: Healthscope Commercial |
$19.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.82
|
| Rate for Payer: Nomi Health Commercial |
$18.15
|
| Rate for Payer: Nomi Health Commercial |
$26.22
|
| Rate for Payer: Nomi Health Commercial |
$13.99
|
| Rate for Payer: Nomi Health Commercial |
$17.93
|
| Rate for Payer: PACE Senior Care Partners |
$4.05
|
| Rate for Payer: PACE Senior Care Partners |
$5.26
|
| Rate for Payer: PACE Senior Care Partners |
$7.59
|
| Rate for Payer: PACE Senior Care Partners |
$5.19
|
| Rate for Payer: PACE SWMI |
$5.47
|
| Rate for Payer: PACE SWMI |
$4.26
|
| Rate for Payer: PACE SWMI |
$5.54
|
| Rate for Payer: PACE SWMI |
$7.99
|
| Rate for Payer: PHP Commercial |
$18.82
|
| Rate for Payer: PHP Commercial |
$27.17
|
| Rate for Payer: PHP Commercial |
$18.59
|
| Rate for Payer: PHP Commercial |
$14.50
|
| Rate for Payer: PHP Medicare Advantage |
$5.47
|
| Rate for Payer: PHP Medicare Advantage |
$4.26
|
| Rate for Payer: PHP Medicare Advantage |
$7.99
|
| Rate for Payer: PHP Medicare Advantage |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.09
|
| Rate for Payer: Priority Health HMO/PPO |
$19.03
|
| Rate for Payer: Priority Health HMO/PPO |
$27.81
|
| Rate for Payer: Priority Health HMO/PPO |
$19.26
|
| Rate for Payer: Priority Health HMO/PPO |
$14.84
|
| Rate for Payer: Priority Health Medicare |
$5.59
|
| Rate for Payer: Priority Health Medicare |
$4.31
|
| Rate for Payer: Priority Health Medicare |
$5.52
|
| Rate for Payer: Priority Health Medicare |
$8.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.43
|
| Rate for Payer: Railroad Medicare Medicare |
$5.47
|
| Rate for Payer: Railroad Medicare Medicare |
$5.54
|
| Rate for Payer: Railroad Medicare Medicare |
$4.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.25
|
| Rate for Payer: UHC Core |
$14.25
|
| Rate for Payer: UHC Core |
$26.69
|
| Rate for Payer: UHC Core |
$18.26
|
| Rate for Payer: UHC Core |
$18.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.47
|
| Rate for Payer: UHC Exchange |
$7.99
|
| Rate for Payer: UHC Exchange |
$5.47
|
| Rate for Payer: UHC Exchange |
$4.26
|
| Rate for Payer: UHC Exchange |
$5.54
|
| Rate for Payer: UHC Medicare Advantage |
$7.99
|
| Rate for Payer: UHC Medicare Advantage |
$4.26
|
| Rate for Payer: UHC Medicare Advantage |
$5.54
|
| Rate for Payer: UHC Medicare Advantage |
$5.47
|
| Rate for Payer: VA VA |
$5.47
|
| Rate for Payer: VA VA |
$7.99
|
| Rate for Payer: VA VA |
$5.54
|
| Rate for Payer: VA VA |
$4.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.61
|
|
