|
MEMANTINE 5 MG TABLET
|
Facility
|
OP
|
$368.60
|
|
|
Service Code
|
NDC 00591387044
|
| Hospital Charge Code |
37170
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$64.98 |
| Max. Negotiated Rate |
$331.74 |
| Rate for Payer: Aetna Commercial |
$313.31
|
| Rate for Payer: Aetna Medicare |
$95.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.19
|
| Rate for Payer: BCBS Complete |
$68.23
|
| Rate for Payer: BCBS MAPPO |
$92.15
|
| Rate for Payer: BCBS Trust/PPO |
$303.03
|
| Rate for Payer: BCN Commercial |
$303.03
|
| Rate for Payer: BCN Medicare Advantage |
$92.15
|
| Rate for Payer: Cash Price |
$294.88
|
| Rate for Payer: Cofinity Commercial |
$317.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.15
|
| Rate for Payer: Healthscope Commercial |
$331.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.45
|
| Rate for Payer: Mclaren Medicaid |
$64.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.76
|
| Rate for Payer: Meridian Medicaid |
$68.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$101.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.31
|
| Rate for Payer: Nomi Health Commercial |
$302.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.45
|
| Rate for Payer: PACE Senior Care Partners |
$87.54
|
| Rate for Payer: PACE SWMI |
$92.15
|
| Rate for Payer: PHP Commercial |
$313.31
|
| Rate for Payer: PHP Medicare Advantage |
$92.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$320.68
|
| Rate for Payer: Priority Health Medicare |
$93.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.55
|
| Rate for Payer: Railroad Medicare Medicare |
$92.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.37
|
| Rate for Payer: UHC Core |
$307.78
|
| Rate for Payer: UHC Exchange |
$92.15
|
| Rate for Payer: UHC Medicaid |
$64.98
|
| Rate for Payer: UHC Medicare Advantage |
$92.15
|
| Rate for Payer: UHCCP Medicaid |
$64.98
|
| Rate for Payer: VA VA |
$92.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.45
|
|
|
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS
|
Facility
|
IP
|
$2,927.88
|
|
|
Service Code
|
APR-DRG 5322
|
| Min. Negotiated Rate |
$2,788.45 |
| Max. Negotiated Rate |
$2,927.88 |
| Rate for Payer: BCBS Complete |
$2,927.88
|
| Rate for Payer: Mclaren Medicaid |
$2,788.45
|
| Rate for Payer: Meridian Medicaid |
$2,927.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,788.45
|
| Rate for Payer: UHC Medicaid |
$2,788.45
|
| Rate for Payer: UHCCP Medicaid |
$2,788.45
|
|
|
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS
|
Facility
|
IP
|
$2,122.29
|
|
|
Service Code
|
APR-DRG 5321
|
| Min. Negotiated Rate |
$2,021.23 |
| Max. Negotiated Rate |
$2,122.29 |
| Rate for Payer: BCBS Complete |
$2,122.29
|
| Rate for Payer: Mclaren Medicaid |
$2,021.23
|
| Rate for Payer: Meridian Medicaid |
$2,122.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,021.23
|
| Rate for Payer: UHC Medicaid |
$2,021.23
|
| Rate for Payer: UHCCP Medicaid |
$2,021.23
|
|
|
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS
|
Facility
|
IP
|
$6,013.51
|
|
|
Service Code
|
APR-DRG 5323
|
| Min. Negotiated Rate |
$5,727.15 |
| Max. Negotiated Rate |
$6,013.51 |
| Rate for Payer: BCBS Complete |
$6,013.51
|
| Rate for Payer: Mclaren Medicaid |
$5,727.15
|
| Rate for Payer: Meridian Medicaid |
$6,013.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,727.15
|
| Rate for Payer: UHC Medicaid |
$5,727.15
|
| Rate for Payer: UHCCP Medicaid |
$5,727.15
|
|
|
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS
|
Facility
|
IP
|
$11,242.99
|
|
|
Service Code
|
APR-DRG 5324
|
| Min. Negotiated Rate |
$10,707.60 |
| Max. Negotiated Rate |
$11,242.99 |
| Rate for Payer: BCBS Complete |
$11,242.99
|
| Rate for Payer: Mclaren Medicaid |
$10,707.60
|
| Rate for Payer: Meridian Medicaid |
$11,242.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,707.60
|
| Rate for Payer: UHC Medicaid |
$10,707.60
|
| Rate for Payer: UHCCP Medicaid |
$10,707.60
|
|
|
MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$30,433.52
|
|
|
Service Code
|
APR-DRG 7404
|
| Min. Negotiated Rate |
$28,984.30 |
| Max. Negotiated Rate |
$30,433.52 |
| Rate for Payer: BCBS Complete |
$30,433.52
|
| Rate for Payer: Mclaren Medicaid |
$28,984.30
|
| Rate for Payer: Meridian Medicaid |
$30,433.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$28,984.30
|
| Rate for Payer: UHC Medicaid |
$28,984.30
|
| Rate for Payer: UHCCP Medicaid |
$28,984.30
|
|
|
MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$5,216.86
|
|
|
Service Code
|
APR-DRG 7401
|
| Min. Negotiated Rate |
$4,968.44 |
| Max. Negotiated Rate |
$5,216.86 |
| Rate for Payer: BCBS Complete |
$5,216.86
|
| Rate for Payer: Mclaren Medicaid |
$4,968.44
|
| Rate for Payer: Meridian Medicaid |
$5,216.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,968.44
|
| Rate for Payer: UHC Medicaid |
$4,968.44
|
| Rate for Payer: UHCCP Medicaid |
$4,968.44
|
|
|
MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$8,769.96
|
|
|
Service Code
|
APR-DRG 7402
|
| Min. Negotiated Rate |
$8,352.34 |
| Max. Negotiated Rate |
$8,769.96 |
| Rate for Payer: BCBS Complete |
$8,769.96
|
| Rate for Payer: Mclaren Medicaid |
$8,352.34
|
| Rate for Payer: Meridian Medicaid |
$8,769.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,352.34
|
| Rate for Payer: UHC Medicaid |
$8,352.34
|
| Rate for Payer: UHCCP Medicaid |
$8,352.34
|
|
|
MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$16,253.71
|
|
|
Service Code
|
APR-DRG 7403
|
| 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
|
|
|
MEPERIDINE (PF) 50 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$41.21
|
|
|
Service Code
|
HCPCS J2175
|
| Hospital Charge Code |
116146
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.68 |
| Max. Negotiated Rate |
$37.09 |
| Rate for Payer: Aetna Commercial |
$35.03
|
| Rate for Payer: BCBS Trust/PPO |
$34.04
|
| Rate for Payer: BCN Commercial |
$34.04
|
| Rate for Payer: Cash Price |
$32.97
|
| Rate for Payer: Cofinity Commercial |
$35.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.97
|
| Rate for Payer: Healthscope Commercial |
$37.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.03
|
| Rate for Payer: Nomi Health Commercial |
$33.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.91
|
| Rate for Payer: PHP Commercial |
$35.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.26
|
| Rate for Payer: UHC Core |
$34.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.91
|
|
|
MEPERIDINE (PF) 50 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$41.21
|
|
|
Service Code
|
HCPCS J2175
|
| Hospital Charge Code |
116146
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.27 |
| Max. Negotiated Rate |
$37.09 |
| Rate for Payer: Aetna Commercial |
$35.03
|
| Rate for Payer: Aetna Medicare |
$10.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.88
|
| Rate for Payer: BCBS Complete |
$7.63
|
| Rate for Payer: BCBS MAPPO |
$10.30
|
| Rate for Payer: BCBS Trust/PPO |
$33.88
|
| Rate for Payer: BCN Commercial |
$33.88
|
| Rate for Payer: BCN Medicare Advantage |
$10.30
|
| Rate for Payer: Cash Price |
$32.97
|
| Rate for Payer: Cofinity Commercial |
$35.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.30
|
| Rate for Payer: Healthscope Commercial |
$37.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.91
|
| Rate for Payer: Mclaren Medicaid |
$7.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.82
|
| Rate for Payer: Meridian Medicaid |
$7.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.03
|
| Rate for Payer: Nomi Health Commercial |
$33.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.91
|
| Rate for Payer: PACE Senior Care Partners |
$9.79
|
| Rate for Payer: PACE SWMI |
$10.30
|
| Rate for Payer: PHP Commercial |
$35.03
|
| Rate for Payer: PHP Medicare Advantage |
$10.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.85
|
| Rate for Payer: Priority Health Medicare |
$10.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.68
|
| Rate for Payer: Railroad Medicare Medicare |
$10.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.26
|
| Rate for Payer: UHC Core |
$34.41
|
| Rate for Payer: UHC Exchange |
$10.30
|
| Rate for Payer: UHC Medicaid |
$7.27
|
| Rate for Payer: UHC Medicare Advantage |
$10.30
|
| Rate for Payer: UHCCP Medicaid |
$7.27
|
| Rate for Payer: VA VA |
$10.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.91
|
|
|
MEPIVACAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION
|
Facility
|
IP
|
$27.86
|
|
|
Service Code
|
HCPCS J0670
|
| Hospital Charge Code |
105638
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.39 |
| Max. Negotiated Rate |
$25.07 |
| Rate for Payer: Aetna Commercial |
$23.68
|
| Rate for Payer: BCBS Trust/PPO |
$23.01
|
| Rate for Payer: BCN Commercial |
$23.01
|
| Rate for Payer: Cash Price |
$22.29
|
| Rate for Payer: Cofinity Commercial |
$23.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.29
|
| Rate for Payer: Healthscope Commercial |
$25.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.68
|
| Rate for Payer: Nomi Health Commercial |
$22.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.89
|
| Rate for Payer: PHP Commercial |
$23.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.52
|
| Rate for Payer: UHC Core |
$23.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.89
|
|
|
MEPIVACAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION
|
Facility
|
OP
|
$27.86
|
|
|
Service Code
|
HCPCS J0670
|
| Hospital Charge Code |
105638
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.91 |
| Max. Negotiated Rate |
$25.07 |
| Rate for Payer: Aetna Commercial |
$23.68
|
| Rate for Payer: Aetna Medicare |
$7.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.71
|
| Rate for Payer: BCBS Complete |
$5.16
|
| Rate for Payer: BCBS MAPPO |
$6.96
|
| Rate for Payer: BCBS Trust/PPO |
$22.90
|
| Rate for Payer: BCN Commercial |
$22.90
|
| Rate for Payer: BCN Medicare Advantage |
$6.96
|
| Rate for Payer: Cash Price |
$22.29
|
| Rate for Payer: Cofinity Commercial |
$23.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.96
|
| Rate for Payer: Healthscope Commercial |
$25.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.89
|
| Rate for Payer: Mclaren Medicaid |
$4.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.31
|
| Rate for Payer: Meridian Medicaid |
$5.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.68
|
| Rate for Payer: Nomi Health Commercial |
$22.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.89
|
| Rate for Payer: PACE Senior Care Partners |
$6.62
|
| Rate for Payer: PACE SWMI |
$6.96
|
| Rate for Payer: PHP Commercial |
$23.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.24
|
| Rate for Payer: Priority Health Medicare |
$7.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.39
|
| Rate for Payer: Railroad Medicare Medicare |
$6.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.52
|
| Rate for Payer: UHC Core |
$23.26
|
| Rate for Payer: UHC Exchange |
$6.96
|
| Rate for Payer: UHC Medicaid |
$4.91
|
| Rate for Payer: UHC Medicare Advantage |
$6.96
|
| Rate for Payer: UHCCP Medicaid |
$4.91
|
| Rate for Payer: VA VA |
$6.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.89
|
|
|
MEROPENEM 1 GRAM/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$80.77
|
|
|
Service Code
|
HCPCS J2184
|
| Hospital Charge Code |
175972
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$56.22 |
| Max. Negotiated Rate |
$72.69 |
| Rate for Payer: Aetna Commercial |
$68.65
|
| Rate for Payer: BCBS Trust/PPO |
$66.71
|
| Rate for Payer: BCN Commercial |
$66.71
|
| Rate for Payer: Cash Price |
$64.62
|
| Rate for Payer: Cofinity Commercial |
$69.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.62
|
| Rate for Payer: Healthscope Commercial |
$72.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.65
|
| Rate for Payer: Nomi Health Commercial |
$66.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.58
|
| Rate for Payer: PHP Commercial |
$68.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$70.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.08
|
| Rate for Payer: UHC Core |
$67.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.58
|
|
|
MEROPENEM 1 GRAM/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$80.77
|
|
|
Service Code
|
HCPCS J2184
|
| Hospital Charge Code |
175972
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.24 |
| Max. Negotiated Rate |
$72.69 |
| Rate for Payer: Aetna Commercial |
$68.65
|
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.24
|
| Rate for Payer: BCBS Complete |
$14.95
|
| Rate for Payer: BCBS MAPPO |
$20.19
|
| Rate for Payer: BCBS Trust/PPO |
$66.40
|
| Rate for Payer: BCN Commercial |
$66.40
|
| Rate for Payer: BCN Medicare Advantage |
$20.19
|
| Rate for Payer: Cash Price |
$64.62
|
| Rate for Payer: Cofinity Commercial |
$69.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.19
|
| Rate for Payer: Healthscope Commercial |
$72.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.58
|
| Rate for Payer: Mclaren Medicaid |
$14.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.20
|
| Rate for Payer: Meridian Medicaid |
$14.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.65
|
| Rate for Payer: Nomi Health Commercial |
$66.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.58
|
| Rate for Payer: PACE Senior Care Partners |
$19.18
|
| Rate for Payer: PACE SWMI |
$20.19
|
| Rate for Payer: PHP Commercial |
$68.65
|
| Rate for Payer: PHP Medicare Advantage |
$20.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$70.27
|
| Rate for Payer: Priority Health Medicare |
$20.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.22
|
| Rate for Payer: Railroad Medicare Medicare |
$20.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.08
|
| Rate for Payer: UHC Core |
$67.44
|
| Rate for Payer: UHC Exchange |
$20.19
|
| Rate for Payer: UHC Medicaid |
$14.24
|
| Rate for Payer: UHC Medicare Advantage |
$20.19
|
| Rate for Payer: UHCCP Medicaid |
$14.24
|
| Rate for Payer: VA VA |
$20.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.58
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$21.17
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.73 |
| Max. Negotiated Rate |
$19.05 |
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.62
|
| Rate for Payer: BCBS Complete |
$3.92
|
| Rate for Payer: BCBS MAPPO |
$5.29
|
| Rate for Payer: BCBS Trust/PPO |
$17.40
|
| Rate for Payer: BCN Commercial |
$17.40
|
| Rate for Payer: BCN Medicare Advantage |
$5.29
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.29
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.88
|
| Rate for Payer: Mclaren Medicaid |
$3.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.56
|
| Rate for Payer: Meridian Medicaid |
$3.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.99
|
| Rate for Payer: Nomi Health Commercial |
$17.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.88
|
| Rate for Payer: PACE Senior Care Partners |
$5.03
|
| Rate for Payer: PACE SWMI |
$5.29
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: PHP Medicare Advantage |
$5.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.42
|
| Rate for Payer: Priority Health Medicare |
$5.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.73
|
| Rate for Payer: Railroad Medicare Medicare |
$5.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.63
|
| Rate for Payer: UHC Core |
$17.68
|
| Rate for Payer: UHC Exchange |
$5.29
|
| Rate for Payer: UHC Medicaid |
$3.73
|
| Rate for Payer: UHC Medicare Advantage |
$5.29
|
| Rate for Payer: UHCCP Medicaid |
$3.73
|
| Rate for Payer: VA VA |
$5.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.88
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$21.17
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.73 |
| Max. Negotiated Rate |
$19.05 |
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: BCBS Trust/PPO |
$17.48
|
| Rate for Payer: BCN Commercial |
$17.48
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.99
|
| Rate for Payer: Nomi Health Commercial |
$17.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.88
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.63
|
| Rate for Payer: UHC Core |
$17.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.88
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$18.59
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17380
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.94 |
| Max. Negotiated Rate |
$16.73 |
| Rate for Payer: Aetna Commercial |
$15.80
|
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: BCBS Trust/PPO |
$15.35
|
| Rate for Payer: BCBS Trust/PPO |
$17.48
|
| Rate for Payer: BCN Commercial |
$15.35
|
| Rate for Payer: BCN Commercial |
$17.48
|
| Rate for Payer: Cash Price |
$14.87
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$15.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.87
|
| Rate for Payer: Healthscope Commercial |
$16.73
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.99
|
| Rate for Payer: Nomi Health Commercial |
$15.24
|
| Rate for Payer: Nomi Health Commercial |
$17.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.88
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: PHP Commercial |
$15.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.63
|
| Rate for Payer: UHC Core |
$15.52
|
| Rate for Payer: UHC Core |
$17.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.88
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$18.59
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17380
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$16.73 |
| Rate for Payer: Aetna Commercial |
$15.80
|
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: Aetna Medicare |
$4.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.62
|
| Rate for Payer: BCBS Complete |
$3.44
|
| Rate for Payer: BCBS Complete |
$3.92
|
| Rate for Payer: BCBS MAPPO |
$4.65
|
| Rate for Payer: BCBS MAPPO |
$5.29
|
| Rate for Payer: BCBS Trust/PPO |
$15.28
|
| Rate for Payer: BCBS Trust/PPO |
$17.40
|
| Rate for Payer: BCN Commercial |
$17.40
|
| Rate for Payer: BCN Commercial |
$15.28
|
| Rate for Payer: BCN Medicare Advantage |
$5.29
|
| Rate for Payer: BCN Medicare Advantage |
$4.65
|
| Rate for Payer: Cash Price |
$14.87
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Commercial |
$15.99
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.65
|
| Rate for Payer: Healthscope Commercial |
$16.73
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.88
|
| Rate for Payer: Mclaren Medicaid |
$3.73
|
| Rate for Payer: Mclaren Medicaid |
$3.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.88
|
| Rate for Payer: Meridian Medicaid |
$3.44
|
| Rate for Payer: Meridian Medicaid |
$3.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.80
|
| Rate for Payer: Nomi Health Commercial |
$17.36
|
| Rate for Payer: Nomi Health Commercial |
$15.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.88
|
| Rate for Payer: PACE Senior Care Partners |
$5.03
|
| Rate for Payer: PACE Senior Care Partners |
$4.42
|
| Rate for Payer: PACE SWMI |
$5.29
|
| Rate for Payer: PACE SWMI |
$4.65
|
| Rate for Payer: PHP Commercial |
$15.80
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: PHP Medicare Advantage |
$4.65
|
| Rate for Payer: PHP Medicare Advantage |
$5.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.17
|
| Rate for Payer: Priority Health Medicare |
$5.35
|
| Rate for Payer: Priority Health Medicare |
$4.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.73
|
| Rate for Payer: Railroad Medicare Medicare |
$4.65
|
| Rate for Payer: Railroad Medicare Medicare |
$5.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.63
|
| Rate for Payer: UHC Core |
$17.68
|
| Rate for Payer: UHC Core |
$15.52
|
| Rate for Payer: UHC Exchange |
$5.29
|
| Rate for Payer: UHC Exchange |
$4.65
|
| Rate for Payer: UHC Medicaid |
$3.73
|
| Rate for Payer: UHC Medicaid |
$3.28
|
| Rate for Payer: UHC Medicare Advantage |
$4.65
|
| Rate for Payer: UHC Medicare Advantage |
$5.29
|
| Rate for Payer: UHCCP Medicaid |
$3.28
|
| Rate for Payer: UHCCP Medicaid |
$3.73
|
| Rate for Payer: VA VA |
$4.65
|
| Rate for Payer: VA VA |
$5.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.94
|
|
|
MESALAMINE 800 MG TABLET,DELAYED RELEASE
|
Facility
|
OP
|
$1,570.10
|
|
|
Service Code
|
NDC 60687040825
|
| Hospital Charge Code |
96949
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$276.81 |
| Max. Negotiated Rate |
$1,413.09 |
| Rate for Payer: Aetna Commercial |
$1,334.59
|
| Rate for Payer: Aetna Medicare |
$408.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$490.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$490.66
|
| Rate for Payer: BCBS Complete |
$290.63
|
| Rate for Payer: BCBS MAPPO |
$392.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.78
|
| Rate for Payer: BCN Commercial |
$1,290.78
|
| Rate for Payer: BCN Medicare Advantage |
$392.52
|
| Rate for Payer: Cash Price |
$1,256.08
|
| Rate for Payer: Cofinity Commercial |
$1,350.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,256.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.52
|
| Rate for Payer: Healthscope Commercial |
$1,413.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,177.58
|
| Rate for Payer: Mclaren Medicaid |
$276.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$412.15
|
| Rate for Payer: Meridian Medicaid |
$290.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$451.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$431.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,334.59
|
| Rate for Payer: Nomi Health Commercial |
$1,287.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,177.58
|
| Rate for Payer: PACE Senior Care Partners |
$372.90
|
| Rate for Payer: PACE SWMI |
$392.52
|
| Rate for Payer: PHP Commercial |
$1,334.59
|
| Rate for Payer: PHP Medicare Advantage |
$392.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,365.99
|
| Rate for Payer: Priority Health Medicare |
$396.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,092.79
|
| Rate for Payer: Railroad Medicare Medicare |
$392.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,381.69
|
| Rate for Payer: UHC Core |
$1,311.03
|
| Rate for Payer: UHC Exchange |
$392.52
|
| Rate for Payer: UHC Medicaid |
$276.81
|
| Rate for Payer: UHC Medicare Advantage |
$392.52
|
| Rate for Payer: UHCCP Medicaid |
$276.81
|
| Rate for Payer: VA VA |
$392.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,177.58
|
|
|
MESALAMINE 800 MG TABLET,DELAYED RELEASE
|
Facility
|
IP
|
$52.34
|
|
|
Service Code
|
NDC 60687040895
|
| Hospital Charge Code |
96949
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$36.43 |
| Max. Negotiated Rate |
$47.11 |
| Rate for Payer: Aetna Commercial |
$44.49
|
| Rate for Payer: BCBS Trust/PPO |
$43.23
|
| Rate for Payer: BCN Commercial |
$43.23
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cofinity Commercial |
$45.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.87
|
| Rate for Payer: Healthscope Commercial |
$47.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.49
|
| Rate for Payer: Nomi Health Commercial |
$42.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.26
|
| Rate for Payer: PHP Commercial |
$44.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.06
|
| Rate for Payer: UHC Core |
$43.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.26
|
|
|
MESALAMINE 800 MG TABLET,DELAYED RELEASE
|
Facility
|
IP
|
$1,570.10
|
|
|
Service Code
|
NDC 60687040825
|
| Hospital Charge Code |
96949
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,092.79 |
| Max. Negotiated Rate |
$1,413.09 |
| Rate for Payer: Aetna Commercial |
$1,334.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,296.75
|
| Rate for Payer: BCN Commercial |
$1,296.75
|
| Rate for Payer: Cash Price |
$1,256.08
|
| Rate for Payer: Cofinity Commercial |
$1,350.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,256.08
|
| Rate for Payer: Healthscope Commercial |
$1,413.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,177.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,334.59
|
| Rate for Payer: Nomi Health Commercial |
$1,287.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,177.58
|
| Rate for Payer: PHP Commercial |
$1,334.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,365.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,092.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,381.69
|
| Rate for Payer: UHC Core |
$1,311.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,177.58
|
|
|
MESALAMINE 800 MG TABLET,DELAYED RELEASE
|
Facility
|
OP
|
$52.34
|
|
|
Service Code
|
NDC 60687040895
|
| Hospital Charge Code |
96949
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$47.11 |
| Rate for Payer: Aetna Commercial |
$44.49
|
| Rate for Payer: Aetna Medicare |
$13.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.36
|
| Rate for Payer: BCBS Complete |
$9.69
|
| Rate for Payer: BCBS MAPPO |
$13.09
|
| Rate for Payer: BCBS Trust/PPO |
$43.03
|
| Rate for Payer: BCN Commercial |
$43.03
|
| Rate for Payer: BCN Medicare Advantage |
$13.09
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cofinity Commercial |
$45.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.09
|
| Rate for Payer: Healthscope Commercial |
$47.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.26
|
| Rate for Payer: Mclaren Medicaid |
$9.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.74
|
| Rate for Payer: Meridian Medicaid |
$9.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.49
|
| Rate for Payer: Nomi Health Commercial |
$42.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.26
|
| Rate for Payer: PACE Senior Care Partners |
$12.43
|
| Rate for Payer: PACE SWMI |
$13.09
|
| Rate for Payer: PHP Commercial |
$44.49
|
| Rate for Payer: PHP Medicare Advantage |
$13.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.54
|
| Rate for Payer: Priority Health Medicare |
$13.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.43
|
| Rate for Payer: Railroad Medicare Medicare |
$13.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.06
|
| Rate for Payer: UHC Core |
$43.70
|
| Rate for Payer: UHC Exchange |
$13.09
|
| Rate for Payer: UHC Medicaid |
$9.23
|
| Rate for Payer: UHC Medicare Advantage |
$13.09
|
| Rate for Payer: UHCCP Medicaid |
$9.23
|
| Rate for Payer: VA VA |
$13.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.26
|
|
|
METFORMIN 500 MG TABLET
|
Facility
|
OP
|
$230.30
|
|
|
Service Code
|
NDC 60687015501
|
| Hospital Charge Code |
10544
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$207.27 |
| Rate for Payer: Aetna Commercial |
$195.75
|
| Rate for Payer: Aetna Medicare |
$59.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.97
|
| Rate for Payer: BCBS Complete |
$42.63
|
| Rate for Payer: BCBS MAPPO |
$57.58
|
| Rate for Payer: BCBS Trust/PPO |
$189.33
|
| Rate for Payer: BCN Commercial |
$189.33
|
| Rate for Payer: BCN Medicare Advantage |
$57.58
|
| Rate for Payer: Cash Price |
$184.24
|
| Rate for Payer: Cofinity Commercial |
$198.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.58
|
| Rate for Payer: Healthscope Commercial |
$207.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.72
|
| Rate for Payer: Mclaren Medicaid |
$40.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.45
|
| Rate for Payer: Meridian Medicaid |
$42.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.75
|
| Rate for Payer: Nomi Health Commercial |
$188.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.72
|
| Rate for Payer: PACE Senior Care Partners |
$54.70
|
| Rate for Payer: PACE SWMI |
$57.58
|
| Rate for Payer: PHP Commercial |
$195.75
|
| Rate for Payer: PHP Medicare Advantage |
$57.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$200.36
|
| Rate for Payer: Priority Health Medicare |
$58.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.29
|
| Rate for Payer: Railroad Medicare Medicare |
$57.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.66
|
| Rate for Payer: UHC Core |
$192.30
|
| Rate for Payer: UHC Exchange |
$57.58
|
| Rate for Payer: UHC Medicaid |
$40.60
|
| Rate for Payer: UHC Medicare Advantage |
$57.58
|
| Rate for Payer: UHCCP Medicaid |
$40.60
|
| Rate for Payer: VA VA |
$57.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.72
|
|
|
METFORMIN 500 MG TABLET
|
Facility
|
IP
|
$162.15
|
|
|
Service Code
|
NDC 00904716261
|
| Hospital Charge Code |
10544
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$112.86 |
| Max. Negotiated Rate |
$145.94 |
| Rate for Payer: Aetna Commercial |
$137.83
|
| Rate for Payer: BCBS Trust/PPO |
$133.92
|
| Rate for Payer: BCN Commercial |
$133.92
|
| Rate for Payer: Cash Price |
$129.72
|
| Rate for Payer: Cofinity Commercial |
$139.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.72
|
| Rate for Payer: Healthscope Commercial |
$145.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.83
|
| Rate for Payer: Nomi Health Commercial |
$132.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.61
|
| Rate for Payer: PHP Commercial |
$137.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$141.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.69
|
| Rate for Payer: UHC Core |
$135.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.61
|
|
