|
LIDOCAINE IN D5W (PF) 4 MG/ML (0.4 %) IV (CODE)
|
Facility
|
OP
|
$22.20
|
|
|
Service Code
|
HCPCS J2001
|
| Hospital Charge Code |
163705
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.91 |
| Max. Negotiated Rate |
$19.98 |
| Rate for Payer: Aetna Commercial |
$18.87
|
| Rate for Payer: Aetna Medicare |
$5.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.94
|
| Rate for Payer: BCBS Complete |
$4.11
|
| Rate for Payer: BCBS MAPPO |
$5.55
|
| Rate for Payer: BCBS Trust/PPO |
$18.25
|
| Rate for Payer: BCN Commercial |
$18.25
|
| Rate for Payer: BCN Medicare Advantage |
$5.55
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$19.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.55
|
| Rate for Payer: Healthscope Commercial |
$19.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.65
|
| Rate for Payer: Mclaren Medicaid |
$3.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.83
|
| Rate for Payer: Meridian Medicaid |
$4.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.87
|
| Rate for Payer: Nomi Health Commercial |
$18.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.65
|
| Rate for Payer: PACE Senior Care Partners |
$5.27
|
| Rate for Payer: PACE SWMI |
$5.55
|
| Rate for Payer: PHP Commercial |
$18.87
|
| Rate for Payer: PHP Medicare Advantage |
$5.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.31
|
| Rate for Payer: Priority Health Medicare |
$5.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.45
|
| Rate for Payer: Railroad Medicare Medicare |
$5.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.54
|
| Rate for Payer: UHC Core |
$18.54
|
| Rate for Payer: UHC Exchange |
$5.55
|
| Rate for Payer: UHC Medicaid |
$3.91
|
| Rate for Payer: UHC Medicare Advantage |
$5.55
|
| Rate for Payer: UHCCP Medicaid |
$3.91
|
| Rate for Payer: VA VA |
$5.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.65
|
|
|
LIDOCAINE IN D5W (PF) 4 MG/ML (0.4 %) IV (CODE)
|
Facility
|
IP
|
$22.20
|
|
|
Service Code
|
HCPCS J2001
|
| Hospital Charge Code |
163705
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.45 |
| Max. Negotiated Rate |
$19.98 |
| Rate for Payer: Aetna Commercial |
$18.87
|
| Rate for Payer: BCBS Trust/PPO |
$18.33
|
| Rate for Payer: BCN Commercial |
$18.33
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$19.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.76
|
| Rate for Payer: Healthscope Commercial |
$19.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.87
|
| Rate for Payer: Nomi Health Commercial |
$18.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.65
|
| Rate for Payer: PHP Commercial |
$18.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.54
|
| Rate for Payer: UHC Core |
$18.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.65
|
|
|
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$25.79
|
|
|
Service Code
|
HCPCS J2003
|
| Hospital Charge Code |
4459
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.95 |
| Max. Negotiated Rate |
$23.21 |
| Rate for Payer: Aetna Commercial |
$21.92
|
| Rate for Payer: Aetna Commercial |
$22.87
|
| Rate for Payer: Aetna Commercial |
$25.52
|
| Rate for Payer: BCBS Trust/PPO |
$22.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.30
|
| Rate for Payer: BCBS Trust/PPO |
$24.79
|
| Rate for Payer: BCN Commercial |
$22.22
|
| Rate for Payer: BCN Commercial |
$21.30
|
| Rate for Payer: BCN Commercial |
$24.79
|
| Rate for Payer: Cash Price |
$20.63
|
| Rate for Payer: Cash Price |
$24.02
|
| Rate for Payer: Cash Price |
$21.53
|
| Rate for Payer: Cofinity Commercial |
$25.82
|
| Rate for Payer: Cofinity Commercial |
$23.14
|
| Rate for Payer: Cofinity Commercial |
$22.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.02
|
| Rate for Payer: Healthscope Commercial |
$24.22
|
| Rate for Payer: Healthscope Commercial |
$23.21
|
| Rate for Payer: Healthscope Commercial |
$27.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.52
|
| Rate for Payer: Nomi Health Commercial |
$21.15
|
| Rate for Payer: Nomi Health Commercial |
$22.07
|
| Rate for Payer: Nomi Health Commercial |
$24.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.52
|
| Rate for Payer: PHP Commercial |
$21.92
|
| Rate for Payer: PHP Commercial |
$25.52
|
| Rate for Payer: PHP Commercial |
$22.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.70
|
| Rate for Payer: UHC Core |
$21.53
|
| Rate for Payer: UHC Core |
$25.07
|
| Rate for Payer: UHC Core |
$22.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.18
|
|
|
LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$25.79
|
|
|
Service Code
|
HCPCS J2003
|
| Hospital Charge Code |
4459
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.55 |
| Max. Negotiated Rate |
$23.21 |
| Rate for Payer: Aetna Commercial |
$21.92
|
| Rate for Payer: Aetna Commercial |
$25.52
|
| Rate for Payer: Aetna Commercial |
$22.87
|
| Rate for Payer: Aetna Medicare |
$7.81
|
| Rate for Payer: Aetna Medicare |
$6.71
|
| Rate for Payer: Aetna Medicare |
$7.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.38
|
| Rate for Payer: BCBS Complete |
$4.98
|
| Rate for Payer: BCBS Complete |
$4.77
|
| Rate for Payer: BCBS Complete |
$5.56
|
| Rate for Payer: BCBS MAPPO |
$7.50
|
| Rate for Payer: BCBS MAPPO |
$6.45
|
| Rate for Payer: BCBS MAPPO |
$6.73
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCBS Trust/PPO |
$22.12
|
| Rate for Payer: BCBS Trust/PPO |
$24.68
|
| Rate for Payer: BCN Commercial |
$22.12
|
| Rate for Payer: BCN Commercial |
$24.68
|
| Rate for Payer: BCN Commercial |
$21.20
|
| Rate for Payer: BCN Medicare Advantage |
$7.50
|
| Rate for Payer: BCN Medicare Advantage |
$6.73
|
| Rate for Payer: BCN Medicare Advantage |
$6.45
|
| Rate for Payer: Cash Price |
$24.02
|
| Rate for Payer: Cash Price |
$21.53
|
| Rate for Payer: Cash Price |
$20.63
|
| Rate for Payer: Cofinity Commercial |
$22.18
|
| Rate for Payer: Cofinity Commercial |
$23.14
|
| Rate for Payer: Cofinity Commercial |
$25.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.45
|
| Rate for Payer: Healthscope Commercial |
$24.22
|
| Rate for Payer: Healthscope Commercial |
$23.21
|
| Rate for Payer: Healthscope Commercial |
$27.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.18
|
| Rate for Payer: Mclaren Medicaid |
$4.55
|
| Rate for Payer: Mclaren Medicaid |
$5.29
|
| Rate for Payer: Mclaren Medicaid |
$4.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.88
|
| Rate for Payer: Meridian Medicaid |
$5.56
|
| Rate for Payer: Meridian Medicaid |
$4.77
|
| Rate for Payer: Meridian Medicaid |
$4.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.87
|
| Rate for Payer: Nomi Health Commercial |
$24.62
|
| Rate for Payer: Nomi Health Commercial |
$22.07
|
| Rate for Payer: Nomi Health Commercial |
$21.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.34
|
| Rate for Payer: PACE Senior Care Partners |
$6.39
|
| Rate for Payer: PACE Senior Care Partners |
$6.13
|
| Rate for Payer: PACE Senior Care Partners |
$7.13
|
| Rate for Payer: PACE SWMI |
$7.50
|
| Rate for Payer: PACE SWMI |
$6.73
|
| Rate for Payer: PACE SWMI |
$6.45
|
| Rate for Payer: PHP Commercial |
$21.92
|
| Rate for Payer: PHP Commercial |
$25.52
|
| Rate for Payer: PHP Commercial |
$22.87
|
| Rate for Payer: PHP Medicare Advantage |
$6.73
|
| Rate for Payer: PHP Medicare Advantage |
$6.45
|
| Rate for Payer: PHP Medicare Advantage |
$7.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.12
|
| Rate for Payer: Priority Health Medicare |
$7.58
|
| Rate for Payer: Priority Health Medicare |
$6.79
|
| Rate for Payer: Priority Health Medicare |
$6.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.95
|
| Rate for Payer: Railroad Medicare Medicare |
$6.73
|
| Rate for Payer: Railroad Medicare Medicare |
$7.50
|
| Rate for Payer: Railroad Medicare Medicare |
$6.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.70
|
| Rate for Payer: UHC Core |
$21.53
|
| Rate for Payer: UHC Core |
$25.07
|
| Rate for Payer: UHC Core |
$22.47
|
| Rate for Payer: UHC Exchange |
$7.50
|
| Rate for Payer: UHC Exchange |
$6.73
|
| Rate for Payer: UHC Exchange |
$6.45
|
| Rate for Payer: UHC Medicaid |
$4.55
|
| Rate for Payer: UHC Medicaid |
$5.29
|
| Rate for Payer: UHC Medicaid |
$4.74
|
| Rate for Payer: UHC Medicare Advantage |
$6.73
|
| Rate for Payer: UHC Medicare Advantage |
$6.45
|
| Rate for Payer: UHC Medicare Advantage |
$7.50
|
| Rate for Payer: UHCCP Medicaid |
$4.74
|
| Rate for Payer: UHCCP Medicaid |
$4.55
|
| Rate for Payer: UHCCP Medicaid |
$5.29
|
| Rate for Payer: VA VA |
$6.45
|
| Rate for Payer: VA VA |
$7.50
|
| Rate for Payer: VA VA |
$6.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.52
|
|
|
LIDOCAINE (PF) 100 MG/5 ML (2 %) IV SYRINGE (CODE)
|
Facility
|
IP
|
$26.91
|
|
|
Service Code
|
NDC 00409132305
|
| Hospital Charge Code |
163704
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.73 |
| Max. Negotiated Rate |
$24.22 |
| Rate for Payer: Aetna Commercial |
$22.87
|
| Rate for Payer: BCBS Trust/PPO |
$22.22
|
| Rate for Payer: BCN Commercial |
$22.22
|
| Rate for Payer: Cash Price |
$21.53
|
| Rate for Payer: Cofinity Commercial |
$23.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.53
|
| Rate for Payer: Healthscope Commercial |
$24.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.87
|
| Rate for Payer: Nomi Health Commercial |
$22.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.18
|
| Rate for Payer: PHP Commercial |
$22.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.68
|
| Rate for Payer: UHC Core |
$22.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.18
|
|
|
LIDOCAINE (PF) 100 MG/5 ML (2 %) IV SYRINGE (CODE)
|
Facility
|
OP
|
$26.91
|
|
|
Service Code
|
NDC 00409132305
|
| Hospital Charge Code |
163704
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$24.22 |
| Rate for Payer: Aetna Commercial |
$22.87
|
| Rate for Payer: Aetna Medicare |
$7.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.41
|
| Rate for Payer: BCBS Complete |
$4.98
|
| Rate for Payer: BCBS MAPPO |
$6.73
|
| Rate for Payer: BCBS Trust/PPO |
$22.12
|
| Rate for Payer: BCN Commercial |
$22.12
|
| Rate for Payer: BCN Medicare Advantage |
$6.73
|
| Rate for Payer: Cash Price |
$21.53
|
| Rate for Payer: Cofinity Commercial |
$23.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.73
|
| Rate for Payer: Healthscope Commercial |
$24.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.18
|
| Rate for Payer: Mclaren Medicaid |
$4.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.06
|
| Rate for Payer: Meridian Medicaid |
$4.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.87
|
| Rate for Payer: Nomi Health Commercial |
$22.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.18
|
| Rate for Payer: PACE Senior Care Partners |
$6.39
|
| Rate for Payer: PACE SWMI |
$6.73
|
| Rate for Payer: PHP Commercial |
$22.87
|
| Rate for Payer: PHP Medicare Advantage |
$6.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.41
|
| Rate for Payer: Priority Health Medicare |
$6.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.73
|
| Rate for Payer: Railroad Medicare Medicare |
$6.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.68
|
| Rate for Payer: UHC Core |
$22.47
|
| Rate for Payer: UHC Exchange |
$6.73
|
| Rate for Payer: UHC Medicaid |
$4.74
|
| Rate for Payer: UHC Medicare Advantage |
$6.73
|
| Rate for Payer: UHCCP Medicaid |
$4.74
|
| Rate for Payer: VA VA |
$6.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.18
|
|
|
LIDOCAINE (PF) 100 MG/5 ML (2 %) IV SYRINGE (CODE)
|
Facility
|
OP
|
$25.79
|
|
|
Service Code
|
NDC 00409490334
|
| Hospital Charge Code |
163704
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.55 |
| Max. Negotiated Rate |
$23.21 |
| Rate for Payer: Aetna Commercial |
$21.92
|
| Rate for Payer: Aetna Medicare |
$6.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.06
|
| Rate for Payer: BCBS Complete |
$4.77
|
| Rate for Payer: BCBS MAPPO |
$6.45
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCN Commercial |
$21.20
|
| Rate for Payer: BCN Medicare Advantage |
$6.45
|
| Rate for Payer: Cash Price |
$20.63
|
| Rate for Payer: Cofinity Commercial |
$22.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.45
|
| Rate for Payer: Healthscope Commercial |
$23.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.34
|
| Rate for Payer: Mclaren Medicaid |
$4.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.77
|
| Rate for Payer: Meridian Medicaid |
$4.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.92
|
| Rate for Payer: Nomi Health Commercial |
$21.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.34
|
| Rate for Payer: PACE Senior Care Partners |
$6.13
|
| Rate for Payer: PACE SWMI |
$6.45
|
| Rate for Payer: PHP Commercial |
$21.92
|
| Rate for Payer: PHP Medicare Advantage |
$6.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.44
|
| Rate for Payer: Priority Health Medicare |
$6.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.95
|
| Rate for Payer: Railroad Medicare Medicare |
$6.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.70
|
| Rate for Payer: UHC Core |
$21.53
|
| Rate for Payer: UHC Exchange |
$6.45
|
| Rate for Payer: UHC Medicaid |
$4.55
|
| Rate for Payer: UHC Medicare Advantage |
$6.45
|
| Rate for Payer: UHCCP Medicaid |
$4.55
|
| Rate for Payer: VA VA |
$6.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.34
|
|
|
LIDOCAINE (PF) 100 MG/5 ML (2 %) IV SYRINGE (CODE)
|
Facility
|
IP
|
$25.79
|
|
|
Service Code
|
NDC 00409490334
|
| Hospital Charge Code |
163704
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.95 |
| Max. Negotiated Rate |
$23.21 |
| Rate for Payer: Aetna Commercial |
$21.92
|
| Rate for Payer: BCBS Trust/PPO |
$21.30
|
| Rate for Payer: BCN Commercial |
$21.30
|
| Rate for Payer: Cash Price |
$20.63
|
| Rate for Payer: Cofinity Commercial |
$22.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.63
|
| Rate for Payer: Healthscope Commercial |
$23.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.92
|
| Rate for Payer: Nomi Health Commercial |
$21.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.34
|
| Rate for Payer: PHP Commercial |
$21.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.70
|
| Rate for Payer: UHC Core |
$21.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.34
|
|
|
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION
|
Facility
|
IP
|
$14.29
|
|
|
Service Code
|
HCPCS J2003
|
| Hospital Charge Code |
103888
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.95 |
| Max. Negotiated Rate |
$12.86 |
| Rate for Payer: Aetna Commercial |
$12.15
|
| Rate for Payer: Aetna Commercial |
$13.86
|
| Rate for Payer: Aetna Commercial |
$10.35
|
| Rate for Payer: Aetna Commercial |
$19.60
|
| Rate for Payer: Aetna Commercial |
$21.55
|
| Rate for Payer: Aetna Commercial |
$14.79
|
| Rate for Payer: Aetna Commercial |
$22.99
|
| Rate for Payer: Aetna Commercial |
$23.30
|
| Rate for Payer: Aetna Commercial |
$24.28
|
| Rate for Payer: Aetna Commercial |
$39.38
|
| Rate for Payer: Aetna Commercial |
$12.95
|
| Rate for Payer: BCBS Trust/PPO |
$20.94
|
| Rate for Payer: BCBS Trust/PPO |
$22.34
|
| Rate for Payer: BCBS Trust/PPO |
$12.58
|
| Rate for Payer: BCBS Trust/PPO |
$38.26
|
| Rate for Payer: BCBS Trust/PPO |
$19.05
|
| Rate for Payer: BCBS Trust/PPO |
$13.46
|
| Rate for Payer: BCBS Trust/PPO |
$11.80
|
| Rate for Payer: BCBS Trust/PPO |
$10.06
|
| Rate for Payer: BCBS Trust/PPO |
$23.60
|
| Rate for Payer: BCBS Trust/PPO |
$14.37
|
| Rate for Payer: BCBS Trust/PPO |
$22.64
|
| Rate for Payer: BCN Commercial |
$13.46
|
| Rate for Payer: BCN Commercial |
$19.05
|
| Rate for Payer: BCN Commercial |
$20.94
|
| Rate for Payer: BCN Commercial |
$14.37
|
| Rate for Payer: BCN Commercial |
$22.64
|
| Rate for Payer: BCN Commercial |
$23.60
|
| Rate for Payer: BCN Commercial |
$38.26
|
| Rate for Payer: BCN Commercial |
$22.34
|
| Rate for Payer: BCN Commercial |
$12.58
|
| Rate for Payer: BCN Commercial |
$10.06
|
| Rate for Payer: BCN Commercial |
$11.80
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cash Price |
$11.43
|
| Rate for Payer: Cash Price |
$12.18
|
| Rate for Payer: Cash Price |
$13.04
|
| Rate for Payer: Cash Price |
$9.74
|
| Rate for Payer: Cash Price |
$37.06
|
| Rate for Payer: Cash Price |
$22.86
|
| Rate for Payer: Cash Price |
$21.93
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cash Price |
$13.92
|
| Rate for Payer: Cash Price |
$20.28
|
| Rate for Payer: Cofinity Commercial |
$10.47
|
| Rate for Payer: Cofinity Commercial |
$21.80
|
| Rate for Payer: Cofinity Commercial |
$19.83
|
| Rate for Payer: Cofinity Commercial |
$39.84
|
| Rate for Payer: Cofinity Commercial |
$14.02
|
| Rate for Payer: Cofinity Commercial |
$23.57
|
| Rate for Payer: Cofinity Commercial |
$23.26
|
| Rate for Payer: Cofinity Commercial |
$12.29
|
| Rate for Payer: Cofinity Commercial |
$14.96
|
| Rate for Payer: Cofinity Commercial |
$24.57
|
| Rate for Payer: Cofinity Commercial |
$13.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.45
|
| Rate for Payer: Healthscope Commercial |
$24.67
|
| Rate for Payer: Healthscope Commercial |
$25.71
|
| Rate for Payer: Healthscope Commercial |
$10.96
|
| Rate for Payer: Healthscope Commercial |
$13.71
|
| Rate for Payer: Healthscope Commercial |
$12.86
|
| Rate for Payer: Healthscope Commercial |
$22.82
|
| Rate for Payer: Healthscope Commercial |
$24.34
|
| Rate for Payer: Healthscope Commercial |
$41.70
|
| Rate for Payer: Healthscope Commercial |
$15.66
|
| Rate for Payer: Healthscope Commercial |
$20.75
|
| Rate for Payer: Healthscope Commercial |
$14.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.38
|
| Rate for Payer: Nomi Health Commercial |
$13.37
|
| Rate for Payer: Nomi Health Commercial |
$22.48
|
| Rate for Payer: Nomi Health Commercial |
$18.91
|
| Rate for Payer: Nomi Health Commercial |
$14.27
|
| Rate for Payer: Nomi Health Commercial |
$22.18
|
| Rate for Payer: Nomi Health Commercial |
$20.79
|
| Rate for Payer: Nomi Health Commercial |
$23.43
|
| Rate for Payer: Nomi Health Commercial |
$37.99
|
| Rate for Payer: Nomi Health Commercial |
$9.99
|
| Rate for Payer: Nomi Health Commercial |
$11.72
|
| Rate for Payer: Nomi Health Commercial |
$12.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.56
|
| Rate for Payer: PHP Commercial |
$10.35
|
| Rate for Payer: PHP Commercial |
$23.30
|
| Rate for Payer: PHP Commercial |
$14.79
|
| Rate for Payer: PHP Commercial |
$21.55
|
| Rate for Payer: PHP Commercial |
$19.60
|
| Rate for Payer: PHP Commercial |
$22.99
|
| Rate for Payer: PHP Commercial |
$24.28
|
| Rate for Payer: PHP Commercial |
$13.86
|
| Rate for Payer: PHP Commercial |
$12.15
|
| Rate for Payer: PHP Commercial |
$12.95
|
| Rate for Payer: PHP Commercial |
$39.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.80
|
| Rate for Payer: UHC Core |
$22.89
|
| Rate for Payer: UHC Core |
$11.93
|
| Rate for Payer: UHC Core |
$38.69
|
| Rate for Payer: UHC Core |
$22.59
|
| Rate for Payer: UHC Core |
$12.72
|
| Rate for Payer: UHC Core |
$19.26
|
| Rate for Payer: UHC Core |
$23.86
|
| Rate for Payer: UHC Core |
$10.17
|
| Rate for Payer: UHC Core |
$13.61
|
| Rate for Payer: UHC Core |
$21.17
|
| Rate for Payer: UHC Core |
$14.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.30
|
|
|
LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION
|
Facility
|
OP
|
$46.33
|
|
|
Service Code
|
HCPCS J2003
|
| Hospital Charge Code |
103888
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$41.70 |
| Rate for Payer: Aetna Commercial |
$39.38
|
| Rate for Payer: Aetna Commercial |
$19.60
|
| Rate for Payer: Aetna Commercial |
$12.95
|
| Rate for Payer: Aetna Commercial |
$24.28
|
| Rate for Payer: Aetna Commercial |
$12.15
|
| Rate for Payer: Aetna Commercial |
$14.79
|
| Rate for Payer: Aetna Commercial |
$23.30
|
| Rate for Payer: Aetna Commercial |
$22.99
|
| Rate for Payer: Aetna Commercial |
$13.86
|
| Rate for Payer: Aetna Commercial |
$21.55
|
| Rate for Payer: Aetna Commercial |
$10.35
|
| Rate for Payer: Aetna Medicare |
$3.72
|
| Rate for Payer: Aetna Medicare |
$3.17
|
| Rate for Payer: Aetna Medicare |
$7.03
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Aetna Medicare |
$7.43
|
| Rate for Payer: Aetna Medicare |
$4.24
|
| Rate for Payer: Aetna Medicare |
$3.96
|
| Rate for Payer: Aetna Medicare |
$7.13
|
| Rate for Payer: Aetna Medicare |
$6.00
|
| Rate for Payer: Aetna Medicare |
$6.59
|
| Rate for Payer: Aetna Medicare |
$4.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.57
|
| Rate for Payer: BCBS Complete |
$5.07
|
| Rate for Payer: BCBS Complete |
$2.25
|
| Rate for Payer: BCBS Complete |
$2.65
|
| Rate for Payer: BCBS Complete |
$3.02
|
| Rate for Payer: BCBS Complete |
$5.29
|
| Rate for Payer: BCBS Complete |
$4.69
|
| Rate for Payer: BCBS Complete |
$3.22
|
| Rate for Payer: BCBS Complete |
$4.27
|
| Rate for Payer: BCBS Complete |
$5.01
|
| Rate for Payer: BCBS Complete |
$2.82
|
| Rate for Payer: BCBS Complete |
$8.58
|
| Rate for Payer: BCBS MAPPO |
$4.35
|
| Rate for Payer: BCBS MAPPO |
$6.34
|
| Rate for Payer: BCBS MAPPO |
$7.14
|
| Rate for Payer: BCBS MAPPO |
$6.76
|
| Rate for Payer: BCBS MAPPO |
$3.04
|
| Rate for Payer: BCBS MAPPO |
$3.81
|
| Rate for Payer: BCBS MAPPO |
$4.08
|
| Rate for Payer: BCBS MAPPO |
$11.58
|
| Rate for Payer: BCBS MAPPO |
$6.85
|
| Rate for Payer: BCBS MAPPO |
$5.76
|
| Rate for Payer: BCBS MAPPO |
$3.57
|
| Rate for Payer: BCBS Trust/PPO |
$10.01
|
| Rate for Payer: BCBS Trust/PPO |
$38.09
|
| Rate for Payer: BCBS Trust/PPO |
$20.84
|
| Rate for Payer: BCBS Trust/PPO |
$23.49
|
| Rate for Payer: BCBS Trust/PPO |
$18.96
|
| Rate for Payer: BCBS Trust/PPO |
$14.30
|
| Rate for Payer: BCBS Trust/PPO |
$13.40
|
| Rate for Payer: BCBS Trust/PPO |
$22.24
|
| Rate for Payer: BCBS Trust/PPO |
$12.52
|
| Rate for Payer: BCBS Trust/PPO |
$11.75
|
| Rate for Payer: BCBS Trust/PPO |
$22.53
|
| Rate for Payer: BCN Commercial |
$38.09
|
| Rate for Payer: BCN Commercial |
$11.75
|
| Rate for Payer: BCN Commercial |
$10.01
|
| Rate for Payer: BCN Commercial |
$20.84
|
| Rate for Payer: BCN Commercial |
$22.24
|
| Rate for Payer: BCN Commercial |
$18.96
|
| Rate for Payer: BCN Commercial |
$22.53
|
| Rate for Payer: BCN Commercial |
$12.52
|
| Rate for Payer: BCN Commercial |
$14.30
|
| Rate for Payer: BCN Commercial |
$23.49
|
| Rate for Payer: BCN Commercial |
$13.40
|
| Rate for Payer: BCN Medicare Advantage |
$4.08
|
| Rate for Payer: BCN Medicare Advantage |
$6.85
|
| Rate for Payer: BCN Medicare Advantage |
$5.76
|
| Rate for Payer: BCN Medicare Advantage |
$4.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.76
|
| Rate for Payer: BCN Medicare Advantage |
$6.34
|
| Rate for Payer: BCN Medicare Advantage |
$7.14
|
| Rate for Payer: BCN Medicare Advantage |
$3.04
|
| Rate for Payer: BCN Medicare Advantage |
$3.57
|
| Rate for Payer: BCN Medicare Advantage |
$11.58
|
| Rate for Payer: BCN Medicare Advantage |
$3.81
|
| Rate for Payer: Cash Price |
$9.74
|
| Rate for Payer: Cash Price |
$12.18
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cash Price |
$21.93
|
| Rate for Payer: Cash Price |
$11.43
|
| Rate for Payer: Cash Price |
$37.06
|
| Rate for Payer: Cash Price |
$20.28
|
| Rate for Payer: Cash Price |
$13.04
|
| Rate for Payer: Cash Price |
$22.86
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cash Price |
$13.92
|
| Rate for Payer: Cofinity Commercial |
$12.29
|
| Rate for Payer: Cofinity Commercial |
$14.02
|
| Rate for Payer: Cofinity Commercial |
$13.10
|
| Rate for Payer: Cofinity Commercial |
$23.26
|
| Rate for Payer: Cofinity Commercial |
$21.80
|
| Rate for Payer: Cofinity Commercial |
$10.47
|
| Rate for Payer: Cofinity Commercial |
$24.57
|
| Rate for Payer: Cofinity Commercial |
$23.57
|
| Rate for Payer: Cofinity Commercial |
$39.84
|
| Rate for Payer: Cofinity Commercial |
$19.83
|
| Rate for Payer: Cofinity Commercial |
$14.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.34
|
| Rate for Payer: Healthscope Commercial |
$25.71
|
| Rate for Payer: Healthscope Commercial |
$24.67
|
| Rate for Payer: Healthscope Commercial |
$10.96
|
| Rate for Payer: Healthscope Commercial |
$12.86
|
| Rate for Payer: Healthscope Commercial |
$22.82
|
| Rate for Payer: Healthscope Commercial |
$14.67
|
| Rate for Payer: Healthscope Commercial |
$24.34
|
| Rate for Payer: Healthscope Commercial |
$20.75
|
| Rate for Payer: Healthscope Commercial |
$41.70
|
| Rate for Payer: Healthscope Commercial |
$13.71
|
| Rate for Payer: Healthscope Commercial |
$15.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.01
|
| Rate for Payer: Mclaren Medicaid |
$8.17
|
| Rate for Payer: Mclaren Medicaid |
$4.07
|
| Rate for Payer: Mclaren Medicaid |
$4.47
|
| Rate for Payer: Mclaren Medicaid |
$4.83
|
| Rate for Payer: Mclaren Medicaid |
$3.07
|
| Rate for Payer: Mclaren Medicaid |
$2.87
|
| Rate for Payer: Mclaren Medicaid |
$2.52
|
| Rate for Payer: Mclaren Medicaid |
$2.15
|
| Rate for Payer: Mclaren Medicaid |
$2.69
|
| Rate for Payer: Mclaren Medicaid |
$4.77
|
| Rate for Payer: Mclaren Medicaid |
$5.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.57
|
| Rate for Payer: Meridian Medicaid |
$2.65
|
| Rate for Payer: Meridian Medicaid |
$3.22
|
| Rate for Payer: Meridian Medicaid |
$3.02
|
| Rate for Payer: Meridian Medicaid |
$5.01
|
| Rate for Payer: Meridian Medicaid |
$2.82
|
| Rate for Payer: Meridian Medicaid |
$4.27
|
| Rate for Payer: Meridian Medicaid |
$4.69
|
| Rate for Payer: Meridian Medicaid |
$8.58
|
| Rate for Payer: Meridian Medicaid |
$5.07
|
| Rate for Payer: Meridian Medicaid |
$5.29
|
| Rate for Payer: Meridian Medicaid |
$2.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.38
|
| Rate for Payer: Nomi Health Commercial |
$23.43
|
| Rate for Payer: Nomi Health Commercial |
$18.91
|
| Rate for Payer: Nomi Health Commercial |
$14.27
|
| Rate for Payer: Nomi Health Commercial |
$37.99
|
| Rate for Payer: Nomi Health Commercial |
$11.72
|
| Rate for Payer: Nomi Health Commercial |
$22.48
|
| Rate for Payer: Nomi Health Commercial |
$12.49
|
| Rate for Payer: Nomi Health Commercial |
$22.18
|
| Rate for Payer: Nomi Health Commercial |
$13.37
|
| Rate for Payer: Nomi Health Commercial |
$9.99
|
| Rate for Payer: Nomi Health Commercial |
$20.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.75
|
| Rate for Payer: PACE Senior Care Partners |
$6.51
|
| Rate for Payer: PACE Senior Care Partners |
$11.00
|
| Rate for Payer: PACE Senior Care Partners |
$6.79
|
| Rate for Payer: PACE Senior Care Partners |
$5.48
|
| Rate for Payer: PACE Senior Care Partners |
$3.87
|
| Rate for Payer: PACE Senior Care Partners |
$3.62
|
| Rate for Payer: PACE Senior Care Partners |
$6.42
|
| Rate for Payer: PACE Senior Care Partners |
$3.39
|
| Rate for Payer: PACE Senior Care Partners |
$2.89
|
| Rate for Payer: PACE Senior Care Partners |
$4.13
|
| Rate for Payer: PACE Senior Care Partners |
$6.02
|
| Rate for Payer: PACE SWMI |
$7.14
|
| Rate for Payer: PACE SWMI |
$3.57
|
| Rate for Payer: PACE SWMI |
$3.04
|
| Rate for Payer: PACE SWMI |
$3.81
|
| Rate for Payer: PACE SWMI |
$4.08
|
| Rate for Payer: PACE SWMI |
$4.35
|
| Rate for Payer: PACE SWMI |
$5.76
|
| Rate for Payer: PACE SWMI |
$6.34
|
| Rate for Payer: PACE SWMI |
$6.76
|
| Rate for Payer: PACE SWMI |
$6.85
|
| Rate for Payer: PACE SWMI |
$11.58
|
| Rate for Payer: PHP Commercial |
$22.99
|
| Rate for Payer: PHP Commercial |
$19.60
|
| Rate for Payer: PHP Commercial |
$12.95
|
| Rate for Payer: PHP Commercial |
$13.86
|
| Rate for Payer: PHP Commercial |
$12.15
|
| Rate for Payer: PHP Commercial |
$21.55
|
| Rate for Payer: PHP Commercial |
$23.30
|
| Rate for Payer: PHP Commercial |
$14.79
|
| Rate for Payer: PHP Commercial |
$24.28
|
| Rate for Payer: PHP Commercial |
$10.35
|
| Rate for Payer: PHP Commercial |
$39.38
|
| Rate for Payer: PHP Medicare Advantage |
$6.76
|
| Rate for Payer: PHP Medicare Advantage |
$6.85
|
| Rate for Payer: PHP Medicare Advantage |
$3.04
|
| Rate for Payer: PHP Medicare Advantage |
$5.76
|
| Rate for Payer: PHP Medicare Advantage |
$3.81
|
| Rate for Payer: PHP Medicare Advantage |
$11.58
|
| Rate for Payer: PHP Medicare Advantage |
$4.08
|
| Rate for Payer: PHP Medicare Advantage |
$3.57
|
| Rate for Payer: PHP Medicare Advantage |
$4.35
|
| Rate for Payer: PHP Medicare Advantage |
$7.14
|
| Rate for Payer: PHP Medicare Advantage |
$6.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.06
|
| Rate for Payer: Priority Health Medicare |
$5.82
|
| Rate for Payer: Priority Health Medicare |
$4.12
|
| Rate for Payer: Priority Health Medicare |
$6.92
|
| Rate for Payer: Priority Health Medicare |
$11.70
|
| Rate for Payer: Priority Health Medicare |
$7.21
|
| Rate for Payer: Priority Health Medicare |
$3.85
|
| Rate for Payer: Priority Health Medicare |
$4.39
|
| Rate for Payer: Priority Health Medicare |
$3.61
|
| Rate for Payer: Priority Health Medicare |
$6.83
|
| Rate for Payer: Priority Health Medicare |
$3.08
|
| Rate for Payer: Priority Health Medicare |
$6.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.60
|
| Rate for Payer: Railroad Medicare Medicare |
$4.35
|
| Rate for Payer: Railroad Medicare Medicare |
$6.76
|
| Rate for Payer: Railroad Medicare Medicare |
$5.76
|
| Rate for Payer: Railroad Medicare Medicare |
$11.58
|
| Rate for Payer: Railroad Medicare Medicare |
$3.04
|
| Rate for Payer: Railroad Medicare Medicare |
$4.08
|
| Rate for Payer: Railroad Medicare Medicare |
$6.85
|
| Rate for Payer: Railroad Medicare Medicare |
$6.34
|
| Rate for Payer: Railroad Medicare Medicare |
$7.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3.57
|
| Rate for Payer: Railroad Medicare Medicare |
$3.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.29
|
| Rate for Payer: UHC Core |
$21.17
|
| Rate for Payer: UHC Core |
$22.89
|
| Rate for Payer: UHC Core |
$23.86
|
| Rate for Payer: UHC Core |
$13.61
|
| Rate for Payer: UHC Core |
$22.59
|
| Rate for Payer: UHC Core |
$14.53
|
| Rate for Payer: UHC Core |
$12.72
|
| Rate for Payer: UHC Core |
$11.93
|
| Rate for Payer: UHC Core |
$19.26
|
| Rate for Payer: UHC Core |
$38.69
|
| Rate for Payer: UHC Core |
$10.17
|
| Rate for Payer: UHC Exchange |
$4.08
|
| Rate for Payer: UHC Exchange |
$6.85
|
| Rate for Payer: UHC Exchange |
$3.57
|
| Rate for Payer: UHC Exchange |
$5.76
|
| Rate for Payer: UHC Exchange |
$6.76
|
| Rate for Payer: UHC Exchange |
$3.04
|
| Rate for Payer: UHC Exchange |
$3.81
|
| Rate for Payer: UHC Exchange |
$7.14
|
| Rate for Payer: UHC Exchange |
$6.34
|
| Rate for Payer: UHC Exchange |
$11.58
|
| Rate for Payer: UHC Exchange |
$4.35
|
| Rate for Payer: UHC Medicaid |
$2.87
|
| Rate for Payer: UHC Medicaid |
$4.07
|
| Rate for Payer: UHC Medicaid |
$4.77
|
| Rate for Payer: UHC Medicaid |
$3.07
|
| Rate for Payer: UHC Medicaid |
$4.47
|
| Rate for Payer: UHC Medicaid |
$4.83
|
| Rate for Payer: UHC Medicaid |
$2.69
|
| Rate for Payer: UHC Medicaid |
$2.52
|
| Rate for Payer: UHC Medicaid |
$5.04
|
| Rate for Payer: UHC Medicaid |
$2.15
|
| Rate for Payer: UHC Medicaid |
$8.17
|
| Rate for Payer: UHC Medicare Advantage |
$4.08
|
| Rate for Payer: UHC Medicare Advantage |
$6.76
|
| Rate for Payer: UHC Medicare Advantage |
$6.85
|
| Rate for Payer: UHC Medicare Advantage |
$3.04
|
| Rate for Payer: UHC Medicare Advantage |
$4.35
|
| Rate for Payer: UHC Medicare Advantage |
$7.14
|
| Rate for Payer: UHC Medicare Advantage |
$6.34
|
| Rate for Payer: UHC Medicare Advantage |
$11.58
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: UHC Medicare Advantage |
$5.76
|
| Rate for Payer: UHC Medicare Advantage |
$3.81
|
| Rate for Payer: UHCCP Medicaid |
$5.04
|
| Rate for Payer: UHCCP Medicaid |
$4.07
|
| Rate for Payer: UHCCP Medicaid |
$2.52
|
| Rate for Payer: UHCCP Medicaid |
$4.83
|
| Rate for Payer: UHCCP Medicaid |
$2.15
|
| Rate for Payer: UHCCP Medicaid |
$4.47
|
| Rate for Payer: UHCCP Medicaid |
$2.87
|
| Rate for Payer: UHCCP Medicaid |
$3.07
|
| Rate for Payer: UHCCP Medicaid |
$2.69
|
| Rate for Payer: UHCCP Medicaid |
$4.77
|
| Rate for Payer: UHCCP Medicaid |
$8.17
|
| Rate for Payer: VA VA |
$4.08
|
| Rate for Payer: VA VA |
$6.34
|
| Rate for Payer: VA VA |
$3.57
|
| Rate for Payer: VA VA |
$4.35
|
| Rate for Payer: VA VA |
$5.76
|
| Rate for Payer: VA VA |
$3.04
|
| Rate for Payer: VA VA |
$6.76
|
| Rate for Payer: VA VA |
$7.14
|
| Rate for Payer: VA VA |
$11.58
|
| Rate for Payer: VA VA |
$6.85
|
| Rate for Payer: VA VA |
$3.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.30
|
|
|
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION
|
Facility
|
OP
|
$12.11
|
|
|
Service Code
|
HCPCS J2003
|
| Hospital Charge Code |
103889
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.13 |
| Max. Negotiated Rate |
$10.90 |
| Rate for Payer: Aetna Commercial |
$10.29
|
| Rate for Payer: Aetna Commercial |
$13.50
|
| Rate for Payer: Aetna Commercial |
$24.16
|
| Rate for Payer: Aetna Commercial |
$11.16
|
| Rate for Payer: Aetna Medicare |
$3.41
|
| Rate for Payer: Aetna Medicare |
$3.15
|
| Rate for Payer: Aetna Medicare |
$4.13
|
| Rate for Payer: Aetna Medicare |
$7.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.78
|
| Rate for Payer: BCBS Complete |
$5.26
|
| Rate for Payer: BCBS Complete |
$2.43
|
| Rate for Payer: BCBS Complete |
$2.24
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$3.03
|
| Rate for Payer: BCBS MAPPO |
$3.28
|
| Rate for Payer: BCBS MAPPO |
$7.11
|
| Rate for Payer: BCBS MAPPO |
$3.97
|
| Rate for Payer: BCBS Trust/PPO |
$13.05
|
| Rate for Payer: BCBS Trust/PPO |
$9.96
|
| Rate for Payer: BCBS Trust/PPO |
$23.36
|
| Rate for Payer: BCBS Trust/PPO |
$10.79
|
| Rate for Payer: BCN Commercial |
$13.05
|
| Rate for Payer: BCN Commercial |
$23.36
|
| Rate for Payer: BCN Commercial |
$10.79
|
| Rate for Payer: BCN Commercial |
$9.96
|
| Rate for Payer: BCN Medicare Advantage |
$3.97
|
| Rate for Payer: BCN Medicare Advantage |
$3.28
|
| Rate for Payer: BCN Medicare Advantage |
$7.11
|
| Rate for Payer: BCN Medicare Advantage |
$3.03
|
| Rate for Payer: Cash Price |
$22.74
|
| Rate for Payer: Cash Price |
$12.70
|
| Rate for Payer: Cash Price |
$9.69
|
| Rate for Payer: Cash Price |
$10.50
|
| Rate for Payer: Cofinity Commercial |
$11.29
|
| Rate for Payer: Cofinity Commercial |
$10.41
|
| Rate for Payer: Cofinity Commercial |
$13.66
|
| Rate for Payer: Cofinity Commercial |
$24.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.97
|
| Rate for Payer: Healthscope Commercial |
$10.90
|
| Rate for Payer: Healthscope Commercial |
$25.58
|
| Rate for Payer: Healthscope Commercial |
$14.29
|
| Rate for Payer: Healthscope Commercial |
$11.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.08
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicaid |
$2.31
|
| Rate for Payer: Mclaren Medicaid |
$2.13
|
| Rate for Payer: Mclaren Medicaid |
$5.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.18
|
| Rate for Payer: Meridian Medicaid |
$2.24
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: Meridian Medicaid |
$5.26
|
| Rate for Payer: Meridian Medicaid |
$2.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.16
|
| Rate for Payer: Nomi Health Commercial |
$13.02
|
| Rate for Payer: Nomi Health Commercial |
$9.93
|
| Rate for Payer: Nomi Health Commercial |
$10.77
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.08
|
| Rate for Payer: PACE Senior Care Partners |
$3.77
|
| Rate for Payer: PACE Senior Care Partners |
$6.75
|
| Rate for Payer: PACE Senior Care Partners |
$2.88
|
| Rate for Payer: PACE Senior Care Partners |
$3.12
|
| Rate for Payer: PACE SWMI |
$3.03
|
| Rate for Payer: PACE SWMI |
$7.11
|
| Rate for Payer: PACE SWMI |
$3.28
|
| Rate for Payer: PACE SWMI |
$3.97
|
| Rate for Payer: PHP Commercial |
$10.29
|
| Rate for Payer: PHP Commercial |
$11.16
|
| Rate for Payer: PHP Commercial |
$13.50
|
| Rate for Payer: PHP Commercial |
$24.16
|
| Rate for Payer: PHP Medicare Advantage |
$3.03
|
| Rate for Payer: PHP Medicare Advantage |
$7.11
|
| Rate for Payer: PHP Medicare Advantage |
$3.28
|
| Rate for Payer: PHP Medicare Advantage |
$3.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.54
|
| Rate for Payer: Priority Health Medicare |
$3.32
|
| Rate for Payer: Priority Health Medicare |
$3.06
|
| Rate for Payer: Priority Health Medicare |
$4.01
|
| Rate for Payer: Priority Health Medicare |
$7.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3.97
|
| Rate for Payer: Railroad Medicare Medicare |
$3.03
|
| Rate for Payer: Railroad Medicare Medicare |
$7.11
|
| Rate for Payer: Railroad Medicare Medicare |
$3.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.01
|
| Rate for Payer: UHC Core |
$10.11
|
| Rate for Payer: UHC Core |
$13.26
|
| Rate for Payer: UHC Core |
$10.96
|
| Rate for Payer: UHC Core |
$23.73
|
| Rate for Payer: UHC Exchange |
$3.97
|
| Rate for Payer: UHC Exchange |
$3.28
|
| Rate for Payer: UHC Exchange |
$7.11
|
| Rate for Payer: UHC Exchange |
$3.03
|
| Rate for Payer: UHC Medicaid |
$2.13
|
| Rate for Payer: UHC Medicaid |
$2.31
|
| Rate for Payer: UHC Medicaid |
$2.80
|
| Rate for Payer: UHC Medicaid |
$5.01
|
| Rate for Payer: UHC Medicare Advantage |
$3.28
|
| Rate for Payer: UHC Medicare Advantage |
$3.03
|
| Rate for Payer: UHC Medicare Advantage |
$7.11
|
| Rate for Payer: UHC Medicare Advantage |
$3.97
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UHCCP Medicaid |
$5.01
|
| Rate for Payer: UHCCP Medicaid |
$2.31
|
| Rate for Payer: UHCCP Medicaid |
$2.13
|
| Rate for Payer: VA VA |
$3.03
|
| Rate for Payer: VA VA |
$7.11
|
| Rate for Payer: VA VA |
$3.97
|
| Rate for Payer: VA VA |
$3.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.32
|
|
|
LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION
|
Facility
|
IP
|
$15.88
|
|
|
Service Code
|
HCPCS J2003
|
| Hospital Charge Code |
103889
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.05 |
| Max. Negotiated Rate |
$14.29 |
| Rate for Payer: Aetna Commercial |
$13.50
|
| Rate for Payer: Aetna Commercial |
$11.16
|
| Rate for Payer: Aetna Commercial |
$10.29
|
| Rate for Payer: Aetna Commercial |
$24.16
|
| Rate for Payer: BCBS Trust/PPO |
$13.12
|
| Rate for Payer: BCBS Trust/PPO |
$23.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.84
|
| Rate for Payer: BCBS Trust/PPO |
$10.00
|
| Rate for Payer: BCN Commercial |
$13.12
|
| Rate for Payer: BCN Commercial |
$10.00
|
| Rate for Payer: BCN Commercial |
$23.47
|
| Rate for Payer: BCN Commercial |
$10.84
|
| Rate for Payer: Cash Price |
$10.50
|
| Rate for Payer: Cash Price |
$12.70
|
| Rate for Payer: Cash Price |
$22.74
|
| Rate for Payer: Cash Price |
$9.69
|
| Rate for Payer: Cofinity Commercial |
$10.41
|
| Rate for Payer: Cofinity Commercial |
$24.44
|
| Rate for Payer: Cofinity Commercial |
$13.66
|
| Rate for Payer: Cofinity Commercial |
$11.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.74
|
| Rate for Payer: Healthscope Commercial |
$25.58
|
| Rate for Payer: Healthscope Commercial |
$11.82
|
| Rate for Payer: Healthscope Commercial |
$14.29
|
| Rate for Payer: Healthscope Commercial |
$10.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.16
|
| Rate for Payer: Nomi Health Commercial |
$9.93
|
| Rate for Payer: Nomi Health Commercial |
$10.77
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: Nomi Health Commercial |
$13.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.32
|
| Rate for Payer: PHP Commercial |
$24.16
|
| Rate for Payer: PHP Commercial |
$10.29
|
| Rate for Payer: PHP Commercial |
$11.16
|
| Rate for Payer: PHP Commercial |
$13.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.97
|
| Rate for Payer: UHC Core |
$13.26
|
| Rate for Payer: UHC Core |
$23.73
|
| Rate for Payer: UHC Core |
$10.96
|
| Rate for Payer: UHC Core |
$10.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.91
|
|
|
LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION
|
Facility
|
OP
|
$21.24
|
|
|
Service Code
|
HCPCS J2003
|
| Hospital Charge Code |
4455
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$19.12 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna Medicare |
$9.55
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.47
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS MAPPO |
$9.18
|
| Rate for Payer: BCBS Trust/PPO |
$17.46
|
| Rate for Payer: BCBS Trust/PPO |
$30.19
|
| Rate for Payer: BCN Commercial |
$30.19
|
| Rate for Payer: BCN Commercial |
$17.46
|
| Rate for Payer: BCN Medicare Advantage |
$9.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.99
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$18.27
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$6.47
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.58
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: Meridian Medicaid |
$6.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$30.11
|
| Rate for Payer: Nomi Health Commercial |
$17.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.54
|
| Rate for Payer: PACE Senior Care Partners |
$8.72
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$9.18
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: PHP Medicare Advantage |
$9.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.48
|
| Rate for Payer: Priority Health Medicare |
$9.27
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.56
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: Railroad Medicare Medicare |
$9.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.31
|
| Rate for Payer: UHC Core |
$30.66
|
| Rate for Payer: UHC Core |
$17.74
|
| Rate for Payer: UHC Exchange |
$9.18
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UHC Medicaid |
$6.47
|
| Rate for Payer: UHC Medicaid |
$3.74
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHC Medicare Advantage |
$9.18
|
| Rate for Payer: UHCCP Medicaid |
$3.74
|
| Rate for Payer: UHCCP Medicaid |
$6.47
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: VA VA |
$9.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.93
|
|
|
LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION
|
Facility
|
IP
|
$21.24
|
|
|
Service Code
|
HCPCS J2003
|
| Hospital Charge Code |
4455
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.12 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: BCBS Trust/PPO |
$17.54
|
| Rate for Payer: BCBS Trust/PPO |
$30.33
|
| Rate for Payer: BCN Commercial |
$17.54
|
| Rate for Payer: BCN Commercial |
$30.33
|
| Rate for Payer: Cash Price |
$16.99
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Cofinity Commercial |
$18.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.99
|
| Rate for Payer: Healthscope Commercial |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.21
|
| Rate for Payer: Nomi Health Commercial |
$17.42
|
| Rate for Payer: Nomi Health Commercial |
$30.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.54
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.31
|
| Rate for Payer: UHC Core |
$17.74
|
| Rate for Payer: UHC Core |
$30.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
LIDOCAINE (PF) 40 MG/ML (4 %) NEBULIZED SOLUTION
|
Facility
|
IP
|
$21.24
|
|
|
Service Code
|
NDC 00409428301
|
| Hospital Charge Code |
168979
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.12 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.54
|
| Rate for Payer: BCN Commercial |
$17.54
|
| Rate for Payer: Cash Price |
$16.99
|
| Rate for Payer: Cofinity Commercial |
$18.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.99
|
| Rate for Payer: Healthscope Commercial |
$19.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.93
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.69
|
| Rate for Payer: UHC Core |
$17.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.93
|
|
|
LIDOCAINE (PF) 40 MG/ML (4 %) NEBULIZED SOLUTION
|
Facility
|
OP
|
$21.24
|
|
|
Service Code
|
NDC 00409428301
|
| Hospital Charge Code |
168979
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$19.12 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.64
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$17.46
|
| Rate for Payer: BCN Commercial |
$17.46
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.99
|
| Rate for Payer: Cofinity Commercial |
$18.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.93
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.58
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.93
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.48
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.69
|
| Rate for Payer: UHC Core |
$17.74
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UHC Medicaid |
$3.74
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$3.74
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.93
|
|
|
LIDOCAINE (PF) 4 MG/ML (0.4 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.20
|
|
|
Service Code
|
HCPCS J2002
|
| Hospital Charge Code |
14868
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.45 |
| Max. Negotiated Rate |
$19.98 |
| Rate for Payer: Aetna Commercial |
$18.87
|
| Rate for Payer: BCBS Trust/PPO |
$18.33
|
| Rate for Payer: BCN Commercial |
$18.33
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$19.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.76
|
| Rate for Payer: Healthscope Commercial |
$19.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.87
|
| Rate for Payer: Nomi Health Commercial |
$18.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.65
|
| Rate for Payer: PHP Commercial |
$18.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.54
|
| Rate for Payer: UHC Core |
$18.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.65
|
|
|
LIDOCAINE (PF) 4 MG/ML (0.4 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$22.20
|
|
|
Service Code
|
HCPCS J2002
|
| Hospital Charge Code |
14868
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.91 |
| Max. Negotiated Rate |
$19.98 |
| Rate for Payer: Aetna Commercial |
$18.87
|
| Rate for Payer: Aetna Medicare |
$5.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.94
|
| Rate for Payer: BCBS Complete |
$4.11
|
| Rate for Payer: BCBS MAPPO |
$5.55
|
| Rate for Payer: BCBS Trust/PPO |
$18.25
|
| Rate for Payer: BCN Commercial |
$18.25
|
| Rate for Payer: BCN Medicare Advantage |
$5.55
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$19.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.55
|
| Rate for Payer: Healthscope Commercial |
$19.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.65
|
| Rate for Payer: Mclaren Medicaid |
$3.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.83
|
| Rate for Payer: Meridian Medicaid |
$4.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.87
|
| Rate for Payer: Nomi Health Commercial |
$18.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.65
|
| Rate for Payer: PACE Senior Care Partners |
$5.27
|
| Rate for Payer: PACE SWMI |
$5.55
|
| Rate for Payer: PHP Commercial |
$18.87
|
| Rate for Payer: PHP Medicare Advantage |
$5.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.31
|
| Rate for Payer: Priority Health Medicare |
$5.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.45
|
| Rate for Payer: Railroad Medicare Medicare |
$5.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.54
|
| Rate for Payer: UHC Core |
$18.54
|
| Rate for Payer: UHC Exchange |
$5.55
|
| Rate for Payer: UHC Medicaid |
$3.91
|
| Rate for Payer: UHC Medicare Advantage |
$5.55
|
| Rate for Payer: UHCCP Medicaid |
$3.91
|
| Rate for Payer: VA VA |
$5.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.65
|
|
|
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION
|
Facility
|
IP
|
$15.91
|
|
|
Service Code
|
HCPCS J2003
|
| Hospital Charge Code |
105635
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$14.32 |
| Rate for Payer: Aetna Commercial |
$13.52
|
| Rate for Payer: Aetna Commercial |
$48.42
|
| Rate for Payer: BCBS Trust/PPO |
$13.14
|
| Rate for Payer: BCBS Trust/PPO |
$47.04
|
| Rate for Payer: BCN Commercial |
$13.14
|
| Rate for Payer: BCN Commercial |
$47.04
|
| Rate for Payer: Cash Price |
$12.73
|
| Rate for Payer: Cash Price |
$45.57
|
| Rate for Payer: Cofinity Commercial |
$48.99
|
| Rate for Payer: Cofinity Commercial |
$13.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.73
|
| Rate for Payer: Healthscope Commercial |
$14.32
|
| Rate for Payer: Healthscope Commercial |
$51.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.42
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Nomi Health Commercial |
$46.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.72
|
| Rate for Payer: PHP Commercial |
$48.42
|
| Rate for Payer: PHP Commercial |
$13.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.12
|
| Rate for Payer: UHC Core |
$13.28
|
| Rate for Payer: UHC Core |
$47.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.72
|
|
|
LIDOCAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION
|
Facility
|
OP
|
$15.91
|
|
|
Service Code
|
HCPCS J2003
|
| Hospital Charge Code |
105635
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$14.32 |
| Rate for Payer: Aetna Commercial |
$13.52
|
| Rate for Payer: Aetna Commercial |
$48.42
|
| Rate for Payer: Aetna Medicare |
$14.81
|
| Rate for Payer: Aetna Medicare |
$4.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.80
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS Complete |
$10.54
|
| Rate for Payer: BCBS MAPPO |
$3.98
|
| Rate for Payer: BCBS MAPPO |
$14.24
|
| Rate for Payer: BCBS Trust/PPO |
$13.08
|
| Rate for Payer: BCBS Trust/PPO |
$46.83
|
| Rate for Payer: BCN Commercial |
$46.83
|
| Rate for Payer: BCN Commercial |
$13.08
|
| Rate for Payer: BCN Medicare Advantage |
$14.24
|
| Rate for Payer: BCN Medicare Advantage |
$3.98
|
| Rate for Payer: Cash Price |
$12.73
|
| Rate for Payer: Cash Price |
$45.57
|
| Rate for Payer: Cofinity Commercial |
$13.68
|
| Rate for Payer: Cofinity Commercial |
$48.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.98
|
| Rate for Payer: Healthscope Commercial |
$14.32
|
| Rate for Payer: Healthscope Commercial |
$51.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.72
|
| Rate for Payer: Mclaren Medicaid |
$10.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.18
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: Meridian Medicaid |
$10.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.52
|
| Rate for Payer: Nomi Health Commercial |
$46.71
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.72
|
| Rate for Payer: PACE Senior Care Partners |
$13.53
|
| Rate for Payer: PACE Senior Care Partners |
$3.78
|
| Rate for Payer: PACE SWMI |
$14.24
|
| Rate for Payer: PACE SWMI |
$3.98
|
| Rate for Payer: PHP Commercial |
$13.52
|
| Rate for Payer: PHP Commercial |
$48.42
|
| Rate for Payer: PHP Medicare Advantage |
$3.98
|
| Rate for Payer: PHP Medicare Advantage |
$14.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.84
|
| Rate for Payer: Priority Health Medicare |
$14.38
|
| Rate for Payer: Priority Health Medicare |
$4.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.64
|
| Rate for Payer: Railroad Medicare Medicare |
$3.98
|
| Rate for Payer: Railroad Medicare Medicare |
$14.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.12
|
| Rate for Payer: UHC Core |
$47.56
|
| Rate for Payer: UHC Core |
$13.28
|
| Rate for Payer: UHC Exchange |
$14.24
|
| Rate for Payer: UHC Exchange |
$3.98
|
| Rate for Payer: UHC Medicaid |
$10.04
|
| Rate for Payer: UHC Medicaid |
$2.80
|
| Rate for Payer: UHC Medicare Advantage |
$3.98
|
| Rate for Payer: UHC Medicare Advantage |
$14.24
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UHCCP Medicaid |
$10.04
|
| Rate for Payer: VA VA |
$3.98
|
| Rate for Payer: VA VA |
$14.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.93
|
|
|
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT
|
Facility
|
OP
|
$14.89
|
|
|
Service Code
|
NDC 00496088207
|
| Hospital Charge Code |
30183
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.63 |
| Max. Negotiated Rate |
$13.40 |
| Rate for Payer: Aetna Commercial |
$12.66
|
| Rate for Payer: Aetna Medicare |
$3.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.65
|
| Rate for Payer: BCBS Complete |
$2.76
|
| Rate for Payer: BCBS MAPPO |
$3.72
|
| Rate for Payer: BCBS Trust/PPO |
$12.24
|
| Rate for Payer: BCN Commercial |
$12.24
|
| Rate for Payer: BCN Medicare Advantage |
$3.72
|
| Rate for Payer: Cash Price |
$11.91
|
| Rate for Payer: Cofinity Commercial |
$12.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.72
|
| Rate for Payer: Healthscope Commercial |
$13.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.17
|
| Rate for Payer: Mclaren Medicaid |
$2.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.91
|
| Rate for Payer: Meridian Medicaid |
$2.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.66
|
| Rate for Payer: Nomi Health Commercial |
$12.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.17
|
| Rate for Payer: PACE Senior Care Partners |
$3.54
|
| Rate for Payer: PACE SWMI |
$3.72
|
| Rate for Payer: PHP Commercial |
$12.66
|
| Rate for Payer: PHP Medicare Advantage |
$3.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.95
|
| Rate for Payer: Priority Health Medicare |
$3.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.36
|
| Rate for Payer: Railroad Medicare Medicare |
$3.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.10
|
| Rate for Payer: UHC Core |
$12.43
|
| Rate for Payer: UHC Exchange |
$3.72
|
| Rate for Payer: UHC Medicaid |
$2.63
|
| Rate for Payer: UHC Medicare Advantage |
$3.72
|
| Rate for Payer: UHCCP Medicaid |
$2.63
|
| Rate for Payer: VA VA |
$3.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.17
|
|
|
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT
|
Facility
|
IP
|
$14.89
|
|
|
Service Code
|
NDC 00496088207
|
| Hospital Charge Code |
30183
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$10.36 |
| Max. Negotiated Rate |
$13.40 |
| Rate for Payer: Aetna Commercial |
$12.66
|
| Rate for Payer: BCBS Trust/PPO |
$12.30
|
| Rate for Payer: BCN Commercial |
$12.30
|
| Rate for Payer: Cash Price |
$11.91
|
| Rate for Payer: Cofinity Commercial |
$12.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.91
|
| Rate for Payer: Healthscope Commercial |
$13.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.66
|
| Rate for Payer: Nomi Health Commercial |
$12.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.17
|
| Rate for Payer: PHP Commercial |
$12.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.10
|
| Rate for Payer: UHC Core |
$12.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.17
|
|
|
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT
|
Facility
|
IP
|
$10.40
|
|
|
Service Code
|
NDC 00496088205
|
| Hospital Charge Code |
30183
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Aetna Commercial |
$8.84
|
| Rate for Payer: BCBS Trust/PPO |
$8.59
|
| Rate for Payer: BCN Commercial |
$8.59
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cofinity Commercial |
$8.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$9.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.84
|
| Rate for Payer: Nomi Health Commercial |
$8.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.80
|
| Rate for Payer: PHP Commercial |
$8.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.15
|
| Rate for Payer: UHC Core |
$8.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.80
|
|
|
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT
|
Facility
|
OP
|
$10.40
|
|
|
Service Code
|
NDC 00496088205
|
| Hospital Charge Code |
30183
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Aetna Commercial |
$8.84
|
| Rate for Payer: Aetna Medicare |
$2.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.25
|
| Rate for Payer: BCBS Complete |
$1.93
|
| Rate for Payer: BCBS MAPPO |
$2.60
|
| Rate for Payer: BCBS Trust/PPO |
$8.55
|
| Rate for Payer: BCN Commercial |
$8.55
|
| Rate for Payer: BCN Medicare Advantage |
$2.60
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cofinity Commercial |
$8.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.60
|
| Rate for Payer: Healthscope Commercial |
$9.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.80
|
| Rate for Payer: Mclaren Medicaid |
$1.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.73
|
| Rate for Payer: Meridian Medicaid |
$1.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.84
|
| Rate for Payer: Nomi Health Commercial |
$8.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.80
|
| Rate for Payer: PACE Senior Care Partners |
$2.47
|
| Rate for Payer: PACE SWMI |
$2.60
|
| Rate for Payer: PHP Commercial |
$8.84
|
| Rate for Payer: PHP Medicare Advantage |
$2.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.05
|
| Rate for Payer: Priority Health Medicare |
$2.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.24
|
| Rate for Payer: Railroad Medicare Medicare |
$2.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.15
|
| Rate for Payer: UHC Core |
$8.68
|
| Rate for Payer: UHC Exchange |
$2.60
|
| Rate for Payer: UHC Medicaid |
$1.83
|
| Rate for Payer: UHC Medicare Advantage |
$2.60
|
| Rate for Payer: UHCCP Medicaid |
$1.83
|
| Rate for Payer: VA VA |
$2.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.80
|
|
|
LINAGLIPTIN 5 MG TABLET
|
Facility
|
IP
|
$5,420.50
|
|
|
Service Code
|
NDC 00597014061
|
| Hospital Charge Code |
152649
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3,772.67 |
| Max. Negotiated Rate |
$4,878.45 |
| Rate for Payer: Aetna Commercial |
$4,607.43
|
| Rate for Payer: BCBS Trust/PPO |
$4,476.79
|
| Rate for Payer: BCN Commercial |
$4,476.79
|
| Rate for Payer: Cash Price |
$4,336.40
|
| Rate for Payer: Cofinity Commercial |
$4,661.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,336.40
|
| Rate for Payer: Healthscope Commercial |
$4,878.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,065.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,607.43
|
| Rate for Payer: Nomi Health Commercial |
$4,444.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,065.38
|
| Rate for Payer: PHP Commercial |
$4,607.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,715.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,772.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,770.04
|
| Rate for Payer: UHC Core |
$4,526.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,065.38
|
|
