|
ACYCLOVIR 200 MG CAPSULE
|
Facility
|
OP
|
$298.45
|
|
|
Service Code
|
NDC 00904578961
|
| Hospital Charge Code |
8969
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.62 |
| Max. Negotiated Rate |
$268.61 |
| Rate for Payer: Aetna Commercial |
$253.68
|
| Rate for Payer: Aetna Medicare |
$77.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.27
|
| Rate for Payer: BCBS Complete |
$55.24
|
| Rate for Payer: BCBS MAPPO |
$74.61
|
| Rate for Payer: BCBS Trust/PPO |
$245.36
|
| Rate for Payer: BCN Commercial |
$245.36
|
| Rate for Payer: BCN Medicare Advantage |
$74.61
|
| Rate for Payer: Cash Price |
$238.76
|
| Rate for Payer: Cofinity Commercial |
$256.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.61
|
| Rate for Payer: Healthscope Commercial |
$268.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.84
|
| Rate for Payer: Mclaren Medicaid |
$52.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.34
|
| Rate for Payer: Meridian Medicaid |
$55.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.68
|
| Rate for Payer: Nomi Health Commercial |
$244.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.84
|
| Rate for Payer: PACE Senior Care Partners |
$70.88
|
| Rate for Payer: PACE SWMI |
$74.61
|
| Rate for Payer: PHP Commercial |
$253.68
|
| Rate for Payer: PHP Medicare Advantage |
$74.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$259.65
|
| Rate for Payer: Priority Health Medicare |
$75.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.72
|
| Rate for Payer: Railroad Medicare Medicare |
$74.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.64
|
| Rate for Payer: UHC Core |
$249.21
|
| Rate for Payer: UHC Exchange |
$74.61
|
| Rate for Payer: UHC Medicaid |
$52.62
|
| Rate for Payer: UHC Medicare Advantage |
$74.61
|
| Rate for Payer: UHCCP Medicaid |
$52.62
|
| Rate for Payer: VA VA |
$74.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.84
|
|
|
ACYCLOVIR 200 MG CAPSULE
|
Facility
|
IP
|
$2.62
|
|
|
Service Code
|
NDC 68084010711
|
| Hospital Charge Code |
8969
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$2.36 |
| Rate for Payer: Aetna Commercial |
$2.23
|
| Rate for Payer: BCBS Trust/PPO |
$2.16
|
| Rate for Payer: BCN Commercial |
$2.16
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cofinity Commercial |
$2.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.10
|
| Rate for Payer: Healthscope Commercial |
$2.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.23
|
| Rate for Payer: Nomi Health Commercial |
$2.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.97
|
| Rate for Payer: PHP Commercial |
$2.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.31
|
| Rate for Payer: UHC Core |
$2.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.97
|
|
|
ACYCLOVIR 200 MG CAPSULE
|
Facility
|
IP
|
$298.45
|
|
|
Service Code
|
NDC 00904578961
|
| Hospital Charge Code |
8969
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$207.72 |
| Max. Negotiated Rate |
$268.61 |
| Rate for Payer: Aetna Commercial |
$253.68
|
| Rate for Payer: BCBS Trust/PPO |
$246.49
|
| Rate for Payer: BCN Commercial |
$246.49
|
| Rate for Payer: Cash Price |
$238.76
|
| Rate for Payer: Cofinity Commercial |
$256.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.76
|
| Rate for Payer: Healthscope Commercial |
$268.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.68
|
| Rate for Payer: Nomi Health Commercial |
$244.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.84
|
| Rate for Payer: PHP Commercial |
$253.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$259.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.64
|
| Rate for Payer: UHC Core |
$249.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.84
|
|
|
ACYCLOVIR 200 MG CAPSULE
|
Facility
|
IP
|
$261.25
|
|
|
Service Code
|
NDC 68084010701
|
| Hospital Charge Code |
8969
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$181.83 |
| Max. Negotiated Rate |
$235.12 |
| Rate for Payer: Aetna Commercial |
$222.06
|
| Rate for Payer: BCBS Trust/PPO |
$215.77
|
| Rate for Payer: BCN Commercial |
$215.77
|
| Rate for Payer: Cash Price |
$209.00
|
| Rate for Payer: Cofinity Commercial |
$224.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.00
|
| Rate for Payer: Healthscope Commercial |
$235.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.06
|
| Rate for Payer: Nomi Health Commercial |
$214.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.94
|
| Rate for Payer: PHP Commercial |
$222.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$227.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.90
|
| Rate for Payer: UHC Core |
$218.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.94
|
|
|
ACYCLOVIR 200 MG CAPSULE
|
Facility
|
OP
|
$282.00
|
|
|
Service Code
|
NDC 72578000201
|
| Hospital Charge Code |
8969
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.72 |
| Max. Negotiated Rate |
$253.80 |
| Rate for Payer: Aetna Commercial |
$239.70
|
| Rate for Payer: Aetna Medicare |
$73.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.12
|
| Rate for Payer: BCBS Complete |
$52.20
|
| Rate for Payer: BCBS MAPPO |
$70.50
|
| Rate for Payer: BCBS Trust/PPO |
$231.83
|
| Rate for Payer: BCN Commercial |
$231.83
|
| Rate for Payer: BCN Medicare Advantage |
$70.50
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$242.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.50
|
| Rate for Payer: Healthscope Commercial |
$253.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.50
|
| Rate for Payer: Mclaren Medicaid |
$49.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.03
|
| Rate for Payer: Meridian Medicaid |
$52.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.70
|
| Rate for Payer: Nomi Health Commercial |
$231.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.50
|
| Rate for Payer: PACE Senior Care Partners |
$66.97
|
| Rate for Payer: PACE SWMI |
$70.50
|
| Rate for Payer: PHP Commercial |
$239.70
|
| Rate for Payer: PHP Medicare Advantage |
$70.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$245.34
|
| Rate for Payer: Priority Health Medicare |
$71.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.27
|
| Rate for Payer: Railroad Medicare Medicare |
$70.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.16
|
| Rate for Payer: UHC Core |
$235.47
|
| Rate for Payer: UHC Exchange |
$70.50
|
| Rate for Payer: UHC Medicaid |
$49.72
|
| Rate for Payer: UHC Medicare Advantage |
$70.50
|
| Rate for Payer: UHCCP Medicaid |
$49.72
|
| Rate for Payer: VA VA |
$70.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.50
|
|
|
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20.06
|
|
|
Service Code
|
HCPCS J0133
|
| Hospital Charge Code |
23128
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.96 |
| Max. Negotiated Rate |
$18.05 |
| Rate for Payer: Aetna Commercial |
$17.05
|
| Rate for Payer: Aetna Commercial |
$19.25
|
| Rate for Payer: Aetna Commercial |
$21.14
|
| Rate for Payer: BCBS Trust/PPO |
$18.71
|
| Rate for Payer: BCBS Trust/PPO |
$16.57
|
| Rate for Payer: BCBS Trust/PPO |
$20.54
|
| Rate for Payer: BCN Commercial |
$18.71
|
| Rate for Payer: BCN Commercial |
$16.57
|
| Rate for Payer: BCN Commercial |
$20.54
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cash Price |
$19.90
|
| Rate for Payer: Cash Price |
$18.12
|
| Rate for Payer: Cofinity Commercial |
$21.39
|
| Rate for Payer: Cofinity Commercial |
$19.48
|
| Rate for Payer: Cofinity Commercial |
$17.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.90
|
| Rate for Payer: Healthscope Commercial |
$20.39
|
| Rate for Payer: Healthscope Commercial |
$18.05
|
| Rate for Payer: Healthscope Commercial |
$22.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.14
|
| Rate for Payer: Nomi Health Commercial |
$16.45
|
| Rate for Payer: Nomi Health Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$20.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.65
|
| Rate for Payer: PHP Commercial |
$17.05
|
| Rate for Payer: PHP Commercial |
$21.14
|
| Rate for Payer: PHP Commercial |
$19.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.65
|
| Rate for Payer: UHC Core |
$16.75
|
| Rate for Payer: UHC Core |
$20.77
|
| Rate for Payer: UHC Core |
$18.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.99
|
|
|
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.06
|
|
|
Service Code
|
HCPCS J0133
|
| Hospital Charge Code |
23128
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$18.05 |
| Rate for Payer: Aetna Commercial |
$17.05
|
| Rate for Payer: Aetna Commercial |
$21.14
|
| Rate for Payer: Aetna Commercial |
$19.25
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Aetna Medicare |
$5.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.77
|
| Rate for Payer: BCBS Complete |
$4.19
|
| Rate for Payer: BCBS Complete |
$3.71
|
| Rate for Payer: BCBS Complete |
$4.60
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS MAPPO |
$5.01
|
| Rate for Payer: BCBS MAPPO |
$5.66
|
| Rate for Payer: BCBS Trust/PPO |
$16.49
|
| Rate for Payer: BCBS Trust/PPO |
$18.62
|
| Rate for Payer: BCBS Trust/PPO |
$20.45
|
| Rate for Payer: BCN Commercial |
$18.62
|
| Rate for Payer: BCN Commercial |
$20.45
|
| Rate for Payer: BCN Commercial |
$16.49
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.66
|
| Rate for Payer: BCN Medicare Advantage |
$5.01
|
| Rate for Payer: Cash Price |
$19.90
|
| Rate for Payer: Cash Price |
$18.12
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cofinity Commercial |
$17.25
|
| Rate for Payer: Cofinity Commercial |
$19.48
|
| Rate for Payer: Cofinity Commercial |
$21.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.01
|
| Rate for Payer: Healthscope Commercial |
$20.39
|
| Rate for Payer: Healthscope Commercial |
$18.05
|
| Rate for Payer: Healthscope Commercial |
$22.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.99
|
| Rate for Payer: Mclaren Medicaid |
$3.54
|
| Rate for Payer: Mclaren Medicaid |
$4.38
|
| Rate for Payer: Mclaren Medicaid |
$3.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: Meridian Medicaid |
$4.60
|
| Rate for Payer: Meridian Medicaid |
$3.71
|
| Rate for Payer: Meridian Medicaid |
$4.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.25
|
| Rate for Payer: Nomi Health Commercial |
$20.39
|
| Rate for Payer: Nomi Health Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$16.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.04
|
| Rate for Payer: PACE Senior Care Partners |
$5.38
|
| Rate for Payer: PACE Senior Care Partners |
$4.76
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PACE SWMI |
$5.66
|
| Rate for Payer: PACE SWMI |
$5.01
|
| Rate for Payer: PHP Commercial |
$17.05
|
| Rate for Payer: PHP Commercial |
$21.14
|
| Rate for Payer: PHP Commercial |
$19.25
|
| Rate for Payer: PHP Medicare Advantage |
$5.66
|
| Rate for Payer: PHP Medicare Advantage |
$5.01
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.64
|
| Rate for Payer: Priority Health Medicare |
$6.28
|
| Rate for Payer: Priority Health Medicare |
$5.72
|
| Rate for Payer: Priority Health Medicare |
$5.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.96
|
| Rate for Payer: Railroad Medicare Medicare |
$5.66
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: Railroad Medicare Medicare |
$5.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.65
|
| Rate for Payer: UHC Core |
$16.75
|
| Rate for Payer: UHC Core |
$20.77
|
| Rate for Payer: UHC Core |
$18.91
|
| Rate for Payer: UHC Exchange |
$6.22
|
| Rate for Payer: UHC Exchange |
$5.66
|
| Rate for Payer: UHC Exchange |
$5.01
|
| Rate for Payer: UHC Medicaid |
$3.54
|
| Rate for Payer: UHC Medicaid |
$4.38
|
| Rate for Payer: UHC Medicaid |
$3.99
|
| Rate for Payer: UHC Medicare Advantage |
$5.66
|
| Rate for Payer: UHC Medicare Advantage |
$5.01
|
| Rate for Payer: UHC Medicare Advantage |
$6.22
|
| Rate for Payer: UHCCP Medicaid |
$3.99
|
| Rate for Payer: UHCCP Medicaid |
$3.54
|
| Rate for Payer: UHCCP Medicaid |
$4.38
|
| Rate for Payer: VA VA |
$5.01
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: VA VA |
$5.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.65
|
|
|
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$18.05
|
|
|
Service Code
|
HCPCS J0153
|
| Hospital Charge Code |
8975
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$16.25 |
| Rate for Payer: Aetna Commercial |
$15.34
|
| Rate for Payer: Aetna Commercial |
$21.47
|
| Rate for Payer: Aetna Commercial |
$21.03
|
| Rate for Payer: Aetna Medicare |
$6.57
|
| Rate for Payer: Aetna Medicare |
$4.69
|
| Rate for Payer: Aetna Medicare |
$6.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.89
|
| Rate for Payer: BCBS Complete |
$4.58
|
| Rate for Payer: BCBS Complete |
$3.34
|
| Rate for Payer: BCBS Complete |
$4.68
|
| Rate for Payer: BCBS MAPPO |
$6.32
|
| Rate for Payer: BCBS MAPPO |
$4.51
|
| Rate for Payer: BCBS MAPPO |
$6.18
|
| Rate for Payer: BCBS Trust/PPO |
$14.84
|
| Rate for Payer: BCBS Trust/PPO |
$20.34
|
| Rate for Payer: BCBS Trust/PPO |
$20.77
|
| Rate for Payer: BCN Commercial |
$20.34
|
| Rate for Payer: BCN Commercial |
$20.77
|
| Rate for Payer: BCN Commercial |
$14.84
|
| Rate for Payer: BCN Medicare Advantage |
$6.32
|
| Rate for Payer: BCN Medicare Advantage |
$6.18
|
| Rate for Payer: BCN Medicare Advantage |
$4.51
|
| Rate for Payer: Cash Price |
$20.21
|
| Rate for Payer: Cash Price |
$19.79
|
| Rate for Payer: Cash Price |
$14.44
|
| Rate for Payer: Cofinity Commercial |
$15.52
|
| Rate for Payer: Cofinity Commercial |
$21.28
|
| Rate for Payer: Cofinity Commercial |
$21.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.51
|
| Rate for Payer: Healthscope Commercial |
$22.27
|
| Rate for Payer: Healthscope Commercial |
$16.25
|
| Rate for Payer: Healthscope Commercial |
$22.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.55
|
| Rate for Payer: Mclaren Medicaid |
$3.18
|
| Rate for Payer: Mclaren Medicaid |
$4.45
|
| Rate for Payer: Mclaren Medicaid |
$4.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.63
|
| Rate for Payer: Meridian Medicaid |
$4.68
|
| Rate for Payer: Meridian Medicaid |
$3.34
|
| Rate for Payer: Meridian Medicaid |
$4.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.03
|
| Rate for Payer: Nomi Health Commercial |
$20.71
|
| Rate for Payer: Nomi Health Commercial |
$20.29
|
| Rate for Payer: Nomi Health Commercial |
$14.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.54
|
| Rate for Payer: PACE Senior Care Partners |
$5.88
|
| Rate for Payer: PACE Senior Care Partners |
$4.29
|
| Rate for Payer: PACE Senior Care Partners |
$6.00
|
| Rate for Payer: PACE SWMI |
$6.32
|
| Rate for Payer: PACE SWMI |
$6.18
|
| Rate for Payer: PACE SWMI |
$4.51
|
| Rate for Payer: PHP Commercial |
$15.34
|
| Rate for Payer: PHP Commercial |
$21.47
|
| Rate for Payer: PHP Commercial |
$21.03
|
| Rate for Payer: PHP Medicare Advantage |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$4.51
|
| Rate for Payer: PHP Medicare Advantage |
$6.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.98
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Medicare |
$6.25
|
| Rate for Payer: Priority Health Medicare |
$4.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.56
|
| Rate for Payer: Railroad Medicare Medicare |
$6.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.32
|
| Rate for Payer: Railroad Medicare Medicare |
$4.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.88
|
| Rate for Payer: UHC Core |
$15.07
|
| Rate for Payer: UHC Core |
$21.09
|
| Rate for Payer: UHC Core |
$20.66
|
| Rate for Payer: UHC Exchange |
$6.32
|
| Rate for Payer: UHC Exchange |
$6.18
|
| Rate for Payer: UHC Exchange |
$4.51
|
| Rate for Payer: UHC Medicaid |
$3.18
|
| Rate for Payer: UHC Medicaid |
$4.45
|
| Rate for Payer: UHC Medicaid |
$4.36
|
| Rate for Payer: UHC Medicare Advantage |
$6.18
|
| Rate for Payer: UHC Medicare Advantage |
$4.51
|
| Rate for Payer: UHC Medicare Advantage |
$6.32
|
| Rate for Payer: UHCCP Medicaid |
$4.36
|
| Rate for Payer: UHCCP Medicaid |
$3.18
|
| Rate for Payer: UHCCP Medicaid |
$4.45
|
| Rate for Payer: VA VA |
$4.51
|
| Rate for Payer: VA VA |
$6.32
|
| Rate for Payer: VA VA |
$6.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.95
|
|
|
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$18.05
|
|
|
Service Code
|
HCPCS J0153
|
| Hospital Charge Code |
8975
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.56 |
| Max. Negotiated Rate |
$16.25 |
| Rate for Payer: Aetna Commercial |
$15.34
|
| Rate for Payer: Aetna Commercial |
$21.03
|
| Rate for Payer: Aetna Commercial |
$21.47
|
| Rate for Payer: BCBS Trust/PPO |
$20.43
|
| Rate for Payer: BCBS Trust/PPO |
$14.91
|
| Rate for Payer: BCBS Trust/PPO |
$20.86
|
| Rate for Payer: BCN Commercial |
$20.43
|
| Rate for Payer: BCN Commercial |
$14.91
|
| Rate for Payer: BCN Commercial |
$20.86
|
| Rate for Payer: Cash Price |
$14.44
|
| Rate for Payer: Cash Price |
$20.21
|
| Rate for Payer: Cash Price |
$19.79
|
| Rate for Payer: Cofinity Commercial |
$21.72
|
| Rate for Payer: Cofinity Commercial |
$21.28
|
| Rate for Payer: Cofinity Commercial |
$15.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.21
|
| Rate for Payer: Healthscope Commercial |
$22.27
|
| Rate for Payer: Healthscope Commercial |
$16.25
|
| Rate for Payer: Healthscope Commercial |
$22.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.47
|
| Rate for Payer: Nomi Health Commercial |
$14.80
|
| Rate for Payer: Nomi Health Commercial |
$20.29
|
| Rate for Payer: Nomi Health Commercial |
$20.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.95
|
| Rate for Payer: PHP Commercial |
$15.34
|
| Rate for Payer: PHP Commercial |
$21.47
|
| Rate for Payer: PHP Commercial |
$21.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.88
|
| Rate for Payer: UHC Core |
$15.07
|
| Rate for Payer: UHC Core |
$21.09
|
| Rate for Payer: UHC Core |
$20.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.55
|
|
|
ADENOSINE 3 MG/ML IV (CODE)
|
Facility
|
OP
|
$18.05
|
|
|
Service Code
|
HCPCS J0153
|
| Hospital Charge Code |
163702
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$16.25 |
| Rate for Payer: Aetna Commercial |
$15.34
|
| Rate for Payer: Aetna Medicare |
$4.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.64
|
| Rate for Payer: BCBS Complete |
$3.34
|
| Rate for Payer: BCBS MAPPO |
$4.51
|
| Rate for Payer: BCBS Trust/PPO |
$14.84
|
| Rate for Payer: BCN Commercial |
$14.84
|
| Rate for Payer: BCN Medicare Advantage |
$4.51
|
| Rate for Payer: Cash Price |
$14.44
|
| Rate for Payer: Cofinity Commercial |
$15.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.51
|
| Rate for Payer: Healthscope Commercial |
$16.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.54
|
| Rate for Payer: Mclaren Medicaid |
$3.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.74
|
| Rate for Payer: Meridian Medicaid |
$3.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.34
|
| Rate for Payer: Nomi Health Commercial |
$14.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.54
|
| Rate for Payer: PACE Senior Care Partners |
$4.29
|
| Rate for Payer: PACE SWMI |
$4.51
|
| Rate for Payer: PHP Commercial |
$15.34
|
| Rate for Payer: PHP Medicare Advantage |
$4.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.70
|
| Rate for Payer: Priority Health Medicare |
$4.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.56
|
| Rate for Payer: Railroad Medicare Medicare |
$4.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.88
|
| Rate for Payer: UHC Core |
$15.07
|
| Rate for Payer: UHC Exchange |
$4.51
|
| Rate for Payer: UHC Medicaid |
$3.18
|
| Rate for Payer: UHC Medicare Advantage |
$4.51
|
| Rate for Payer: UHCCP Medicaid |
$3.18
|
| Rate for Payer: VA VA |
$4.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.54
|
|
|
ADENOSINE 3 MG/ML IV (CODE)
|
Facility
|
IP
|
$18.05
|
|
|
Service Code
|
HCPCS J0153
|
| Hospital Charge Code |
163702
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.56 |
| Max. Negotiated Rate |
$16.25 |
| Rate for Payer: Aetna Commercial |
$15.34
|
| Rate for Payer: BCBS Trust/PPO |
$14.91
|
| Rate for Payer: BCN Commercial |
$14.91
|
| Rate for Payer: Cash Price |
$14.44
|
| Rate for Payer: Cofinity Commercial |
$15.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.44
|
| Rate for Payer: Healthscope Commercial |
$16.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.34
|
| Rate for Payer: Nomi Health Commercial |
$14.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.54
|
| Rate for Payer: PHP Commercial |
$15.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.88
|
| Rate for Payer: UHC Core |
$15.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.54
|
|
|
ADJUSTMENT DISORDERS
|
Facility
|
IP
|
$3,332.25
|
|
|
Service Code
|
APR-DRG 7552
|
| Min. Negotiated Rate |
$3,173.57 |
| Max. Negotiated Rate |
$3,332.25 |
| Rate for Payer: BCBS Complete |
$3,332.25
|
| Rate for Payer: Mclaren Medicaid |
$3,173.57
|
| Rate for Payer: Meridian Medicaid |
$3,332.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,173.57
|
| Rate for Payer: UHC Medicaid |
$3,173.57
|
| Rate for Payer: UHCCP Medicaid |
$3,173.57
|
|
|
ADJUSTMENT DISORDERS
|
Facility
|
IP
|
$5,993.00
|
|
|
Service Code
|
APR-DRG 7553
|
| Min. Negotiated Rate |
$5,707.62 |
| Max. Negotiated Rate |
$5,993.00 |
| Rate for Payer: BCBS Complete |
$5,993.00
|
| Rate for Payer: Mclaren Medicaid |
$5,707.62
|
| Rate for Payer: Meridian Medicaid |
$5,993.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,707.62
|
| Rate for Payer: UHC Medicaid |
$5,707.62
|
| Rate for Payer: UHCCP Medicaid |
$5,707.62
|
|
|
ADJUSTMENT DISORDERS
|
Facility
|
IP
|
$6,138.13
|
|
|
Service Code
|
APR-DRG 7554
|
| Min. Negotiated Rate |
$5,845.84 |
| Max. Negotiated Rate |
$6,138.13 |
| Rate for Payer: BCBS Complete |
$6,138.13
|
| Rate for Payer: Mclaren Medicaid |
$5,845.84
|
| Rate for Payer: Meridian Medicaid |
$6,138.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,845.84
|
| Rate for Payer: UHC Medicaid |
$5,845.84
|
| Rate for Payer: UHCCP Medicaid |
$5,845.84
|
|
|
ADJUSTMENT DISORDERS
|
Facility
|
IP
|
$2,765.92
|
|
|
Service Code
|
APR-DRG 7551
|
| Min. Negotiated Rate |
$2,634.21 |
| Max. Negotiated Rate |
$2,765.92 |
| Rate for Payer: BCBS Complete |
$2,765.92
|
| Rate for Payer: Mclaren Medicaid |
$2,634.21
|
| Rate for Payer: Meridian Medicaid |
$2,765.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,634.21
|
| Rate for Payer: UHC Medicaid |
$2,634.21
|
| Rate for Payer: UHCCP Medicaid |
$2,634.21
|
|
|
ADRENAL PROCEDURES
|
Facility
|
IP
|
$26,794.70
|
|
|
Service Code
|
APR-DRG 4014
|
| Min. Negotiated Rate |
$25,518.76 |
| Max. Negotiated Rate |
$26,794.70 |
| Rate for Payer: BCBS Complete |
$26,794.70
|
| Rate for Payer: Mclaren Medicaid |
$25,518.76
|
| Rate for Payer: Meridian Medicaid |
$26,794.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$25,518.76
|
| Rate for Payer: UHC Medicaid |
$25,518.76
|
| Rate for Payer: UHCCP Medicaid |
$25,518.76
|
|
|
ADRENAL PROCEDURES
|
Facility
|
IP
|
$11,451.74
|
|
|
Service Code
|
APR-DRG 4012
|
| Min. Negotiated Rate |
$10,906.42 |
| Max. Negotiated Rate |
$11,451.74 |
| Rate for Payer: BCBS Complete |
$11,451.74
|
| Rate for Payer: Mclaren Medicaid |
$10,906.42
|
| Rate for Payer: Meridian Medicaid |
$11,451.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,906.42
|
| Rate for Payer: UHC Medicaid |
$10,906.42
|
| Rate for Payer: UHCCP Medicaid |
$10,906.42
|
|
|
ADRENAL PROCEDURES
|
Facility
|
IP
|
$16,253.71
|
|
|
Service Code
|
APR-DRG 4013
|
| Min. Negotiated Rate |
$15,479.73 |
| Max. Negotiated Rate |
$16,253.71 |
| Rate for Payer: BCBS Complete |
$16,253.71
|
| Rate for Payer: Mclaren Medicaid |
$15,479.73
|
| Rate for Payer: Meridian Medicaid |
$16,253.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,479.73
|
| Rate for Payer: UHC Medicaid |
$15,479.73
|
| Rate for Payer: UHCCP Medicaid |
$15,479.73
|
|
|
ADRENAL PROCEDURES
|
Facility
|
IP
|
$7,904.95
|
|
|
Service Code
|
APR-DRG 4011
|
| Min. Negotiated Rate |
$7,528.53 |
| Max. Negotiated Rate |
$7,904.95 |
| Rate for Payer: BCBS Complete |
$7,904.95
|
| Rate for Payer: Mclaren Medicaid |
$7,528.53
|
| Rate for Payer: Meridian Medicaid |
$7,904.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,528.53
|
| Rate for Payer: UHC Medicaid |
$7,528.53
|
| Rate for Payer: UHCCP Medicaid |
$7,528.53
|
|
|
ALBENDAZOLE 200 MG TABLET
|
Facility
|
OP
|
$99.16
|
|
|
Service Code
|
NDC 00591271202
|
| Hospital Charge Code |
8979
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$17.48 |
| Max. Negotiated Rate |
$89.24 |
| Rate for Payer: Aetna Commercial |
$84.29
|
| Rate for Payer: Aetna Medicare |
$25.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.99
|
| Rate for Payer: BCBS Complete |
$18.35
|
| Rate for Payer: BCBS MAPPO |
$24.79
|
| Rate for Payer: BCBS Trust/PPO |
$81.52
|
| Rate for Payer: BCN Commercial |
$81.52
|
| Rate for Payer: BCN Medicare Advantage |
$24.79
|
| Rate for Payer: Cash Price |
$79.33
|
| Rate for Payer: Cofinity Commercial |
$85.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.79
|
| Rate for Payer: Healthscope Commercial |
$89.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.37
|
| Rate for Payer: Mclaren Medicaid |
$17.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.03
|
| Rate for Payer: Meridian Medicaid |
$18.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.29
|
| Rate for Payer: Nomi Health Commercial |
$81.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.37
|
| Rate for Payer: PACE Senior Care Partners |
$23.55
|
| Rate for Payer: PACE SWMI |
$24.79
|
| Rate for Payer: PHP Commercial |
$84.29
|
| Rate for Payer: PHP Medicare Advantage |
$24.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.27
|
| Rate for Payer: Priority Health Medicare |
$25.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.02
|
| Rate for Payer: Railroad Medicare Medicare |
$24.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.26
|
| Rate for Payer: UHC Core |
$82.80
|
| Rate for Payer: UHC Exchange |
$24.79
|
| Rate for Payer: UHC Medicaid |
$17.48
|
| Rate for Payer: UHC Medicare Advantage |
$24.79
|
| Rate for Payer: UHCCP Medicaid |
$17.48
|
| Rate for Payer: VA VA |
$24.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.37
|
|
|
ALBENDAZOLE 200 MG TABLET
|
Facility
|
IP
|
$99.16
|
|
|
Service Code
|
NDC 00591271202
|
| Hospital Charge Code |
8979
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$69.02 |
| Max. Negotiated Rate |
$89.24 |
| Rate for Payer: Aetna Commercial |
$84.29
|
| Rate for Payer: BCBS Trust/PPO |
$81.90
|
| Rate for Payer: BCN Commercial |
$81.90
|
| Rate for Payer: Cash Price |
$79.33
|
| Rate for Payer: Cofinity Commercial |
$85.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.33
|
| Rate for Payer: Healthscope Commercial |
$89.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.29
|
| Rate for Payer: Nomi Health Commercial |
$81.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.37
|
| Rate for Payer: PHP Commercial |
$84.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.26
|
| Rate for Payer: UHC Core |
$82.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.37
|
|
|
ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$178.00
|
|
|
Service Code
|
HCPCS P9047
|
| Hospital Charge Code |
8981
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$123.89 |
| Max. Negotiated Rate |
$160.20 |
| Rate for Payer: Aetna Commercial |
$151.30
|
| Rate for Payer: Aetna Commercial |
$241.40
|
| Rate for Payer: BCBS Trust/PPO |
$147.01
|
| Rate for Payer: BCBS Trust/PPO |
$234.56
|
| Rate for Payer: BCN Commercial |
$147.01
|
| Rate for Payer: BCN Commercial |
$234.56
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cofinity Commercial |
$244.24
|
| Rate for Payer: Cofinity Commercial |
$153.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.40
|
| Rate for Payer: Healthscope Commercial |
$160.20
|
| Rate for Payer: Healthscope Commercial |
$255.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.40
|
| Rate for Payer: Nomi Health Commercial |
$145.96
|
| Rate for Payer: Nomi Health Commercial |
$232.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$133.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.00
|
| Rate for Payer: PHP Commercial |
$241.40
|
| Rate for Payer: PHP Commercial |
$151.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$247.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$154.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.92
|
| Rate for Payer: UHC Core |
$148.63
|
| Rate for Payer: UHC Core |
$237.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.00
|
|
|
ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$178.00
|
|
|
Service Code
|
HCPCS P9047
|
| Hospital Charge Code |
8981
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$31.38 |
| Max. Negotiated Rate |
$160.20 |
| Rate for Payer: Aetna Commercial |
$151.30
|
| Rate for Payer: Aetna Commercial |
$241.40
|
| Rate for Payer: Aetna Medicare |
$73.84
|
| Rate for Payer: Aetna Medicare |
$46.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.75
|
| Rate for Payer: BCBS Complete |
$32.95
|
| Rate for Payer: BCBS Complete |
$52.57
|
| Rate for Payer: BCBS MAPPO |
$44.50
|
| Rate for Payer: BCBS MAPPO |
$71.00
|
| Rate for Payer: BCBS Trust/PPO |
$146.33
|
| Rate for Payer: BCBS Trust/PPO |
$233.48
|
| Rate for Payer: BCN Commercial |
$233.48
|
| Rate for Payer: BCN Commercial |
$146.33
|
| Rate for Payer: BCN Medicare Advantage |
$71.00
|
| Rate for Payer: BCN Medicare Advantage |
$44.50
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cofinity Commercial |
$153.08
|
| Rate for Payer: Cofinity Commercial |
$244.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.50
|
| Rate for Payer: Healthscope Commercial |
$160.20
|
| Rate for Payer: Healthscope Commercial |
$255.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.00
|
| Rate for Payer: Mclaren Medicaid |
$50.07
|
| Rate for Payer: Mclaren Medicaid |
$31.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.73
|
| Rate for Payer: Meridian Medicaid |
$32.95
|
| Rate for Payer: Meridian Medicaid |
$52.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.30
|
| Rate for Payer: Nomi Health Commercial |
$232.88
|
| Rate for Payer: Nomi Health Commercial |
$145.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$133.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.00
|
| Rate for Payer: PACE Senior Care Partners |
$67.45
|
| Rate for Payer: PACE Senior Care Partners |
$42.27
|
| Rate for Payer: PACE SWMI |
$71.00
|
| Rate for Payer: PACE SWMI |
$44.50
|
| Rate for Payer: PHP Commercial |
$151.30
|
| Rate for Payer: PHP Commercial |
$241.40
|
| Rate for Payer: PHP Medicare Advantage |
$44.50
|
| Rate for Payer: PHP Medicare Advantage |
$71.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$247.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$154.86
|
| Rate for Payer: Priority Health Medicare |
$71.71
|
| Rate for Payer: Priority Health Medicare |
$44.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.66
|
| Rate for Payer: Railroad Medicare Medicare |
$44.50
|
| Rate for Payer: Railroad Medicare Medicare |
$71.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.92
|
| Rate for Payer: UHC Core |
$237.14
|
| Rate for Payer: UHC Core |
$148.63
|
| Rate for Payer: UHC Exchange |
$71.00
|
| Rate for Payer: UHC Exchange |
$44.50
|
| Rate for Payer: UHC Medicaid |
$50.07
|
| Rate for Payer: UHC Medicaid |
$31.38
|
| Rate for Payer: UHC Medicare Advantage |
$44.50
|
| Rate for Payer: UHC Medicare Advantage |
$71.00
|
| Rate for Payer: UHCCP Medicaid |
$31.38
|
| Rate for Payer: UHCCP Medicaid |
$50.07
|
| Rate for Payer: VA VA |
$44.50
|
| Rate for Payer: VA VA |
$71.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.50
|
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION
|
Facility
|
OP
|
$2.57
|
|
|
Service Code
|
HCPCS J7613
|
| Hospital Charge Code |
250
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$2.31 |
| Rate for Payer: Aetna Commercial |
$2.18
|
| Rate for Payer: Aetna Commercial |
$3.72
|
| Rate for Payer: Aetna Commercial |
$2.86
|
| Rate for Payer: Aetna Medicare |
$1.14
|
| Rate for Payer: Aetna Medicare |
$0.67
|
| Rate for Payer: Aetna Medicare |
$0.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.37
|
| Rate for Payer: BCBS Complete |
$0.62
|
| Rate for Payer: BCBS Complete |
$0.48
|
| Rate for Payer: BCBS Complete |
$0.81
|
| Rate for Payer: BCBS MAPPO |
$1.09
|
| Rate for Payer: BCBS MAPPO |
$0.64
|
| Rate for Payer: BCBS MAPPO |
$0.84
|
| Rate for Payer: BCBS Trust/PPO |
$2.11
|
| Rate for Payer: BCBS Trust/PPO |
$2.77
|
| Rate for Payer: BCBS Trust/PPO |
$3.60
|
| Rate for Payer: BCN Commercial |
$2.77
|
| Rate for Payer: BCN Commercial |
$3.60
|
| Rate for Payer: BCN Commercial |
$2.11
|
| Rate for Payer: BCN Medicare Advantage |
$1.09
|
| Rate for Payer: BCN Medicare Advantage |
$0.84
|
| Rate for Payer: BCN Medicare Advantage |
$0.64
|
| Rate for Payer: Cash Price |
$3.50
|
| Rate for Payer: Cash Price |
$2.70
|
| Rate for Payer: Cash Price |
$2.06
|
| Rate for Payer: Cofinity Commercial |
$2.21
|
| Rate for Payer: Cofinity Commercial |
$2.90
|
| Rate for Payer: Cofinity Commercial |
$3.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.64
|
| Rate for Payer: Healthscope Commercial |
$3.03
|
| Rate for Payer: Healthscope Commercial |
$2.31
|
| Rate for Payer: Healthscope Commercial |
$3.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.53
|
| Rate for Payer: Mclaren Medicaid |
$0.45
|
| Rate for Payer: Mclaren Medicaid |
$0.77
|
| Rate for Payer: Mclaren Medicaid |
$0.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.15
|
| Rate for Payer: Meridian Medicaid |
$0.81
|
| Rate for Payer: Meridian Medicaid |
$0.48
|
| Rate for Payer: Meridian Medicaid |
$0.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.86
|
| Rate for Payer: Nomi Health Commercial |
$3.59
|
| Rate for Payer: Nomi Health Commercial |
$2.76
|
| Rate for Payer: Nomi Health Commercial |
$2.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.93
|
| Rate for Payer: PACE Senior Care Partners |
$0.80
|
| Rate for Payer: PACE Senior Care Partners |
$0.61
|
| Rate for Payer: PACE Senior Care Partners |
$1.04
|
| Rate for Payer: PACE SWMI |
$1.09
|
| Rate for Payer: PACE SWMI |
$0.84
|
| Rate for Payer: PACE SWMI |
$0.64
|
| Rate for Payer: PHP Commercial |
$2.18
|
| Rate for Payer: PHP Commercial |
$3.72
|
| Rate for Payer: PHP Commercial |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$0.84
|
| Rate for Payer: PHP Medicare Advantage |
$0.64
|
| Rate for Payer: PHP Medicare Advantage |
$1.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.81
|
| Rate for Payer: Priority Health Medicare |
$1.11
|
| Rate for Payer: Priority Health Medicare |
$0.85
|
| Rate for Payer: Priority Health Medicare |
$0.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.79
|
| Rate for Payer: Railroad Medicare Medicare |
$0.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1.09
|
| Rate for Payer: Railroad Medicare Medicare |
$0.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.26
|
| Rate for Payer: UHC Core |
$2.15
|
| Rate for Payer: UHC Core |
$3.66
|
| Rate for Payer: UHC Core |
$2.81
|
| Rate for Payer: UHC Exchange |
$1.09
|
| Rate for Payer: UHC Exchange |
$0.84
|
| Rate for Payer: UHC Exchange |
$0.64
|
| Rate for Payer: UHC Medicaid |
$0.45
|
| Rate for Payer: UHC Medicaid |
$0.77
|
| Rate for Payer: UHC Medicaid |
$0.59
|
| Rate for Payer: UHC Medicare Advantage |
$0.84
|
| Rate for Payer: UHC Medicare Advantage |
$0.64
|
| Rate for Payer: UHC Medicare Advantage |
$1.09
|
| Rate for Payer: UHCCP Medicaid |
$0.59
|
| Rate for Payer: UHCCP Medicaid |
$0.45
|
| Rate for Payer: UHCCP Medicaid |
$0.77
|
| Rate for Payer: VA VA |
$0.64
|
| Rate for Payer: VA VA |
$1.09
|
| Rate for Payer: VA VA |
$0.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.29
|
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION
|
Facility
|
IP
|
$2.57
|
|
|
Service Code
|
HCPCS J7613
|
| Hospital Charge Code |
250
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$2.31 |
| Rate for Payer: Aetna Commercial |
$2.18
|
| Rate for Payer: Aetna Commercial |
$2.86
|
| Rate for Payer: Aetna Commercial |
$3.72
|
| Rate for Payer: BCBS Trust/PPO |
$2.78
|
| Rate for Payer: BCBS Trust/PPO |
$2.12
|
| Rate for Payer: BCBS Trust/PPO |
$3.62
|
| Rate for Payer: BCN Commercial |
$2.78
|
| Rate for Payer: BCN Commercial |
$2.12
|
| Rate for Payer: BCN Commercial |
$3.62
|
| Rate for Payer: Cash Price |
$2.06
|
| Rate for Payer: Cash Price |
$3.50
|
| Rate for Payer: Cash Price |
$2.70
|
| Rate for Payer: Cofinity Commercial |
$3.77
|
| Rate for Payer: Cofinity Commercial |
$2.90
|
| Rate for Payer: Cofinity Commercial |
$2.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.50
|
| Rate for Payer: Healthscope Commercial |
$3.03
|
| Rate for Payer: Healthscope Commercial |
$2.31
|
| Rate for Payer: Healthscope Commercial |
$3.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.72
|
| Rate for Payer: Nomi Health Commercial |
$2.11
|
| Rate for Payer: Nomi Health Commercial |
$2.76
|
| Rate for Payer: Nomi Health Commercial |
$3.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.29
|
| Rate for Payer: PHP Commercial |
$2.18
|
| Rate for Payer: PHP Commercial |
$3.72
|
| Rate for Payer: PHP Commercial |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.26
|
| Rate for Payer: UHC Core |
$2.15
|
| Rate for Payer: UHC Core |
$3.66
|
| Rate for Payer: UHC Core |
$2.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.53
|
|
