|
METFORMIN 500 MG TABLET
|
Facility
|
OP
|
$2.31
|
|
|
Service Code
|
NDC 60687015511
|
| Hospital Charge Code |
10544
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.41 |
| Max. Negotiated Rate |
$2.08 |
| Rate for Payer: Aetna Commercial |
$1.96
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.72
|
| Rate for Payer: BCBS Complete |
$0.43
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS Trust/PPO |
$1.90
|
| Rate for Payer: BCN Commercial |
$1.90
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: Cash Price |
$1.85
|
| Rate for Payer: Cofinity Commercial |
$1.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Healthscope Commercial |
$2.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.73
|
| Rate for Payer: Mclaren Medicaid |
$0.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Medicaid |
$0.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.96
|
| Rate for Payer: Nomi Health Commercial |
$1.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.73
|
| Rate for Payer: PACE Senior Care Partners |
$0.55
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PHP Commercial |
$1.96
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.01
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.61
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.03
|
| Rate for Payer: UHC Core |
$1.93
|
| Rate for Payer: UHC Exchange |
$0.58
|
| Rate for Payer: UHC Medicaid |
$0.41
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHCCP Medicaid |
$0.41
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.73
|
|
|
METFORMIN 500 MG TABLET
|
Facility
|
OP
|
$51.70
|
|
|
Service Code
|
NDC 70010006301
|
| Hospital Charge Code |
10544
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.11 |
| Max. Negotiated Rate |
$46.53 |
| Rate for Payer: Aetna Commercial |
$43.95
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.16
|
| Rate for Payer: BCBS Complete |
$9.57
|
| Rate for Payer: BCBS MAPPO |
$12.93
|
| Rate for Payer: BCBS Trust/PPO |
$42.50
|
| Rate for Payer: BCN Commercial |
$42.50
|
| Rate for Payer: BCN Medicare Advantage |
$12.93
|
| Rate for Payer: Cash Price |
$41.36
|
| Rate for Payer: Cofinity Commercial |
$44.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.93
|
| Rate for Payer: Healthscope Commercial |
$46.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.77
|
| Rate for Payer: Mclaren Medicaid |
$9.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.57
|
| Rate for Payer: Meridian Medicaid |
$9.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.95
|
| Rate for Payer: Nomi Health Commercial |
$42.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.77
|
| Rate for Payer: PACE Senior Care Partners |
$12.28
|
| Rate for Payer: PACE SWMI |
$12.93
|
| Rate for Payer: PHP Commercial |
$43.95
|
| Rate for Payer: PHP Medicare Advantage |
$12.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.98
|
| Rate for Payer: Priority Health Medicare |
$13.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.98
|
| Rate for Payer: Railroad Medicare Medicare |
$12.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.50
|
| Rate for Payer: UHC Core |
$43.17
|
| Rate for Payer: UHC Exchange |
$12.93
|
| Rate for Payer: UHC Medicaid |
$9.11
|
| Rate for Payer: UHC Medicare Advantage |
$12.93
|
| Rate for Payer: UHCCP Medicaid |
$9.11
|
| Rate for Payer: VA VA |
$12.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.77
|
|
|
METFORMIN 500 MG TABLET
|
Facility
|
OP
|
$162.15
|
|
|
Service Code
|
NDC 00904716261
|
| Hospital Charge Code |
10544
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$28.59 |
| Max. Negotiated Rate |
$145.94 |
| Rate for Payer: Aetna Commercial |
$137.83
|
| Rate for Payer: Aetna Medicare |
$42.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.67
|
| Rate for Payer: BCBS Complete |
$30.01
|
| Rate for Payer: BCBS MAPPO |
$40.54
|
| Rate for Payer: BCBS Trust/PPO |
$133.30
|
| Rate for Payer: BCN Commercial |
$133.30
|
| Rate for Payer: BCN Medicare Advantage |
$40.54
|
| 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: Health Alliance Plan Medicare Advantage |
$40.54
|
| Rate for Payer: Healthscope Commercial |
$145.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.61
|
| Rate for Payer: Mclaren Medicaid |
$28.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.56
|
| Rate for Payer: Meridian Medicaid |
$30.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.59
|
| 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: PACE Senior Care Partners |
$38.51
|
| Rate for Payer: PACE SWMI |
$40.54
|
| Rate for Payer: PHP Commercial |
$137.83
|
| Rate for Payer: PHP Medicare Advantage |
$40.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$141.07
|
| Rate for Payer: Priority Health Medicare |
$40.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.86
|
| Rate for Payer: Railroad Medicare Medicare |
$40.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.69
|
| Rate for Payer: UHC Core |
$135.40
|
| Rate for Payer: UHC Exchange |
$40.54
|
| Rate for Payer: UHC Medicaid |
$28.59
|
| Rate for Payer: UHC Medicare Advantage |
$40.54
|
| Rate for Payer: UHCCP Medicaid |
$28.59
|
| Rate for Payer: VA VA |
$40.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.61
|
|
|
METFORMIN 500 MG TABLET
|
Facility
|
IP
|
$230.30
|
|
|
Service Code
|
NDC 60687015501
|
| Hospital Charge Code |
10544
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$160.29 |
| Max. Negotiated Rate |
$207.27 |
| Rate for Payer: Aetna Commercial |
$195.75
|
| Rate for Payer: BCBS Trust/PPO |
$190.20
|
| Rate for Payer: BCN Commercial |
$190.20
|
| 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: Healthscope Commercial |
$207.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.72
|
| 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: PHP Commercial |
$195.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$200.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.66
|
| Rate for Payer: UHC Core |
$192.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.72
|
|
|
METFORMIN 500 MG TABLET
|
Facility
|
IP
|
$2.31
|
|
|
Service Code
|
NDC 60687015511
|
| Hospital Charge Code |
10544
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.61 |
| Max. Negotiated Rate |
$2.08 |
| Rate for Payer: Aetna Commercial |
$1.96
|
| Rate for Payer: BCBS Trust/PPO |
$1.91
|
| Rate for Payer: BCN Commercial |
$1.91
|
| Rate for Payer: Cash Price |
$1.85
|
| Rate for Payer: Cofinity Commercial |
$1.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.85
|
| Rate for Payer: Healthscope Commercial |
$2.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.96
|
| Rate for Payer: Nomi Health Commercial |
$1.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.73
|
| Rate for Payer: PHP Commercial |
$1.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.03
|
| Rate for Payer: UHC Core |
$1.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.73
|
|
|
METFORMIN 500 MG TABLET
|
Facility
|
IP
|
$51.70
|
|
|
Service Code
|
NDC 70010006301
|
| Hospital Charge Code |
10544
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$35.98 |
| Max. Negotiated Rate |
$46.53 |
| Rate for Payer: Aetna Commercial |
$43.95
|
| Rate for Payer: BCBS Trust/PPO |
$42.70
|
| Rate for Payer: BCN Commercial |
$42.70
|
| Rate for Payer: Cash Price |
$41.36
|
| Rate for Payer: Cofinity Commercial |
$44.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.36
|
| Rate for Payer: Healthscope Commercial |
$46.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.95
|
| Rate for Payer: Nomi Health Commercial |
$42.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.77
|
| Rate for Payer: PHP Commercial |
$43.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.50
|
| Rate for Payer: UHC Core |
$43.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.77
|
|
|
METFORMIN 850 MG TABLET
|
Facility
|
IP
|
$432.40
|
|
|
Service Code
|
NDC 00904716361
|
| Hospital Charge Code |
14719
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$300.95 |
| Max. Negotiated Rate |
$389.16 |
| Rate for Payer: Aetna Commercial |
$367.54
|
| Rate for Payer: BCBS Trust/PPO |
$357.12
|
| Rate for Payer: BCN Commercial |
$357.12
|
| Rate for Payer: Cash Price |
$345.92
|
| Rate for Payer: Cofinity Commercial |
$371.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$345.92
|
| Rate for Payer: Healthscope Commercial |
$389.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$324.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.54
|
| Rate for Payer: Nomi Health Commercial |
$354.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$324.30
|
| Rate for Payer: PHP Commercial |
$367.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$376.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$300.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$380.51
|
| Rate for Payer: UHC Core |
$361.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$324.30
|
|
|
METFORMIN 850 MG TABLET
|
Facility
|
OP
|
$191.90
|
|
|
Service Code
|
NDC 60687014301
|
| Hospital Charge Code |
14719
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$33.83 |
| Max. Negotiated Rate |
$172.71 |
| Rate for Payer: Aetna Commercial |
$163.12
|
| Rate for Payer: Aetna Medicare |
$49.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.97
|
| Rate for Payer: BCBS Complete |
$35.52
|
| Rate for Payer: BCBS MAPPO |
$47.98
|
| Rate for Payer: BCBS Trust/PPO |
$157.76
|
| Rate for Payer: BCN Commercial |
$157.76
|
| Rate for Payer: BCN Medicare Advantage |
$47.98
|
| Rate for Payer: Cash Price |
$153.52
|
| Rate for Payer: Cofinity Commercial |
$165.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.98
|
| Rate for Payer: Healthscope Commercial |
$172.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.93
|
| Rate for Payer: Mclaren Medicaid |
$33.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.37
|
| Rate for Payer: Meridian Medicaid |
$35.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$52.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$163.12
|
| Rate for Payer: Nomi Health Commercial |
$157.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.93
|
| Rate for Payer: PACE Senior Care Partners |
$45.58
|
| Rate for Payer: PACE SWMI |
$47.98
|
| Rate for Payer: PHP Commercial |
$163.12
|
| Rate for Payer: PHP Medicare Advantage |
$47.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$166.95
|
| Rate for Payer: Priority Health Medicare |
$48.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.56
|
| Rate for Payer: Railroad Medicare Medicare |
$47.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.87
|
| Rate for Payer: UHC Core |
$160.24
|
| Rate for Payer: UHC Exchange |
$47.98
|
| Rate for Payer: UHC Medicaid |
$33.83
|
| Rate for Payer: UHC Medicare Advantage |
$47.98
|
| Rate for Payer: UHCCP Medicaid |
$33.83
|
| Rate for Payer: VA VA |
$47.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.93
|
|
|
METFORMIN 850 MG TABLET
|
Facility
|
OP
|
$1.92
|
|
|
Service Code
|
NDC 60687014311
|
| Hospital Charge Code |
14719
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$1.73 |
| Rate for Payer: Aetna Commercial |
$1.63
|
| Rate for Payer: Aetna Medicare |
$0.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.60
|
| Rate for Payer: BCBS Complete |
$0.36
|
| Rate for Payer: BCBS MAPPO |
$0.48
|
| Rate for Payer: BCBS Trust/PPO |
$1.58
|
| Rate for Payer: BCN Commercial |
$1.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.48
|
| Rate for Payer: Cash Price |
$1.54
|
| Rate for Payer: Cofinity Commercial |
$1.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.48
|
| Rate for Payer: Healthscope Commercial |
$1.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.44
|
| Rate for Payer: Mclaren Medicaid |
$0.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.50
|
| Rate for Payer: Meridian Medicaid |
$0.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.63
|
| Rate for Payer: Nomi Health Commercial |
$1.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.44
|
| Rate for Payer: PACE Senior Care Partners |
$0.46
|
| Rate for Payer: PACE SWMI |
$0.48
|
| Rate for Payer: PHP Commercial |
$1.63
|
| Rate for Payer: PHP Medicare Advantage |
$0.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.67
|
| Rate for Payer: Priority Health Medicare |
$0.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.34
|
| Rate for Payer: Railroad Medicare Medicare |
$0.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.69
|
| Rate for Payer: UHC Core |
$1.60
|
| Rate for Payer: UHC Exchange |
$0.48
|
| Rate for Payer: UHC Medicaid |
$0.34
|
| Rate for Payer: UHC Medicare Advantage |
$0.48
|
| Rate for Payer: UHCCP Medicaid |
$0.34
|
| Rate for Payer: VA VA |
$0.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.44
|
|
|
METFORMIN 850 MG TABLET
|
Facility
|
OP
|
$432.40
|
|
|
Service Code
|
NDC 00904716361
|
| Hospital Charge Code |
14719
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$76.23 |
| Max. Negotiated Rate |
$389.16 |
| Rate for Payer: Aetna Commercial |
$367.54
|
| Rate for Payer: Aetna Medicare |
$112.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$135.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$135.12
|
| Rate for Payer: BCBS Complete |
$80.04
|
| Rate for Payer: BCBS MAPPO |
$108.10
|
| Rate for Payer: BCBS Trust/PPO |
$355.48
|
| Rate for Payer: BCN Commercial |
$355.48
|
| Rate for Payer: BCN Medicare Advantage |
$108.10
|
| Rate for Payer: Cash Price |
$345.92
|
| Rate for Payer: Cofinity Commercial |
$371.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$345.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.10
|
| Rate for Payer: Healthscope Commercial |
$389.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$324.30
|
| Rate for Payer: Mclaren Medicaid |
$76.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.50
|
| Rate for Payer: Meridian Medicaid |
$80.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$124.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.54
|
| Rate for Payer: Nomi Health Commercial |
$354.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$324.30
|
| Rate for Payer: PACE Senior Care Partners |
$102.69
|
| Rate for Payer: PACE SWMI |
$108.10
|
| Rate for Payer: PHP Commercial |
$367.54
|
| Rate for Payer: PHP Medicare Advantage |
$108.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$376.19
|
| Rate for Payer: Priority Health Medicare |
$109.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$300.95
|
| Rate for Payer: Railroad Medicare Medicare |
$108.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$380.51
|
| Rate for Payer: UHC Core |
$361.05
|
| Rate for Payer: UHC Exchange |
$108.10
|
| Rate for Payer: UHC Medicaid |
$76.23
|
| Rate for Payer: UHC Medicare Advantage |
$108.10
|
| Rate for Payer: UHCCP Medicaid |
$76.23
|
| Rate for Payer: VA VA |
$108.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$324.30
|
|
|
METFORMIN 850 MG TABLET
|
Facility
|
IP
|
$1.92
|
|
|
Service Code
|
NDC 60687014311
|
| Hospital Charge Code |
14719
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.34 |
| Max. Negotiated Rate |
$1.73 |
| Rate for Payer: Aetna Commercial |
$1.63
|
| Rate for Payer: BCBS Trust/PPO |
$1.59
|
| Rate for Payer: BCN Commercial |
$1.59
|
| Rate for Payer: Cash Price |
$1.54
|
| Rate for Payer: Cofinity Commercial |
$1.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.54
|
| Rate for Payer: Healthscope Commercial |
$1.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.63
|
| Rate for Payer: Nomi Health Commercial |
$1.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.44
|
| Rate for Payer: PHP Commercial |
$1.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.69
|
| Rate for Payer: UHC Core |
$1.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.44
|
|
|
METFORMIN 850 MG TABLET
|
Facility
|
IP
|
$191.90
|
|
|
Service Code
|
NDC 60687014301
|
| Hospital Charge Code |
14719
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$133.56 |
| Max. Negotiated Rate |
$172.71 |
| Rate for Payer: Aetna Commercial |
$163.12
|
| Rate for Payer: BCBS Trust/PPO |
$158.49
|
| Rate for Payer: BCN Commercial |
$158.49
|
| Rate for Payer: Cash Price |
$153.52
|
| Rate for Payer: Cofinity Commercial |
$165.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.52
|
| Rate for Payer: Healthscope Commercial |
$172.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$163.12
|
| Rate for Payer: Nomi Health Commercial |
$157.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.93
|
| Rate for Payer: PHP Commercial |
$163.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$166.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.87
|
| Rate for Payer: UHC Core |
$160.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.93
|
|
|
METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$4.17
|
|
|
Service Code
|
NDC 50268055011
|
| Hospital Charge Code |
28995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.90 |
| Max. Negotiated Rate |
$3.75 |
| Rate for Payer: Aetna Commercial |
$3.54
|
| Rate for Payer: BCBS Trust/PPO |
$3.44
|
| Rate for Payer: BCN Commercial |
$3.44
|
| Rate for Payer: Cash Price |
$3.34
|
| Rate for Payer: Cofinity Commercial |
$3.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.34
|
| Rate for Payer: Healthscope Commercial |
$3.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.54
|
| Rate for Payer: Nomi Health Commercial |
$3.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.13
|
| Rate for Payer: PHP Commercial |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.67
|
| Rate for Payer: UHC Core |
$3.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.13
|
|
|
METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$3.71
|
|
|
Service Code
|
NDC 60687064011
|
| Hospital Charge Code |
28995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.65 |
| Max. Negotiated Rate |
$3.34 |
| Rate for Payer: Aetna Commercial |
$3.15
|
| Rate for Payer: Aetna Medicare |
$0.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.16
|
| Rate for Payer: BCBS Complete |
$0.69
|
| Rate for Payer: BCBS MAPPO |
$0.93
|
| Rate for Payer: BCBS Trust/PPO |
$3.05
|
| Rate for Payer: BCN Commercial |
$3.05
|
| Rate for Payer: BCN Medicare Advantage |
$0.93
|
| Rate for Payer: Cash Price |
$2.97
|
| Rate for Payer: Cofinity Commercial |
$3.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.93
|
| Rate for Payer: Healthscope Commercial |
$3.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.78
|
| Rate for Payer: Mclaren Medicaid |
$0.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.97
|
| Rate for Payer: Meridian Medicaid |
$0.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.15
|
| Rate for Payer: Nomi Health Commercial |
$3.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.78
|
| Rate for Payer: PACE Senior Care Partners |
$0.88
|
| Rate for Payer: PACE SWMI |
$0.93
|
| Rate for Payer: PHP Commercial |
$3.15
|
| Rate for Payer: PHP Medicare Advantage |
$0.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.23
|
| Rate for Payer: Priority Health Medicare |
$0.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.26
|
| Rate for Payer: UHC Core |
$3.10
|
| Rate for Payer: UHC Exchange |
$0.93
|
| Rate for Payer: UHC Medicaid |
$0.65
|
| Rate for Payer: UHC Medicare Advantage |
$0.93
|
| Rate for Payer: UHCCP Medicaid |
$0.65
|
| Rate for Payer: VA VA |
$0.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.78
|
|
|
METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$208.05
|
|
|
Service Code
|
NDC 50268055015
|
| Hospital Charge Code |
28995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$36.68 |
| Max. Negotiated Rate |
$187.25 |
| Rate for Payer: Aetna Commercial |
$176.84
|
| Rate for Payer: Aetna Medicare |
$54.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.02
|
| Rate for Payer: BCBS Complete |
$38.51
|
| Rate for Payer: BCBS MAPPO |
$52.01
|
| Rate for Payer: BCBS Trust/PPO |
$171.04
|
| Rate for Payer: BCN Commercial |
$171.04
|
| Rate for Payer: BCN Medicare Advantage |
$52.01
|
| Rate for Payer: Cash Price |
$166.44
|
| Rate for Payer: Cofinity Commercial |
$178.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.01
|
| Rate for Payer: Healthscope Commercial |
$187.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.04
|
| Rate for Payer: Mclaren Medicaid |
$36.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.61
|
| Rate for Payer: Meridian Medicaid |
$38.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.84
|
| Rate for Payer: Nomi Health Commercial |
$170.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.04
|
| Rate for Payer: PACE Senior Care Partners |
$49.41
|
| Rate for Payer: PACE SWMI |
$52.01
|
| Rate for Payer: PHP Commercial |
$176.84
|
| Rate for Payer: PHP Medicare Advantage |
$52.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$181.00
|
| Rate for Payer: Priority Health Medicare |
$52.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.80
|
| Rate for Payer: Railroad Medicare Medicare |
$52.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.08
|
| Rate for Payer: UHC Core |
$173.72
|
| Rate for Payer: UHC Exchange |
$52.01
|
| Rate for Payer: UHC Medicaid |
$36.68
|
| Rate for Payer: UHC Medicare Advantage |
$52.01
|
| Rate for Payer: UHCCP Medicaid |
$36.68
|
| Rate for Payer: VA VA |
$52.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.04
|
|
|
METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$190.35
|
|
|
Service Code
|
NDC 62756014201
|
| Hospital Charge Code |
28995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$132.48 |
| Max. Negotiated Rate |
$171.31 |
| Rate for Payer: Aetna Commercial |
$161.80
|
| Rate for Payer: BCBS Trust/PPO |
$157.21
|
| Rate for Payer: BCN Commercial |
$157.21
|
| Rate for Payer: Cash Price |
$152.28
|
| Rate for Payer: Cofinity Commercial |
$163.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.28
|
| Rate for Payer: Healthscope Commercial |
$171.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.80
|
| Rate for Payer: Nomi Health Commercial |
$156.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.76
|
| Rate for Payer: PHP Commercial |
$161.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$165.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.51
|
| Rate for Payer: UHC Core |
$158.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.76
|
|
|
METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$190.35
|
|
|
Service Code
|
NDC 62756014201
|
| Hospital Charge Code |
28995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$33.56 |
| Max. Negotiated Rate |
$171.31 |
| Rate for Payer: Aetna Commercial |
$161.80
|
| Rate for Payer: Aetna Medicare |
$49.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.48
|
| Rate for Payer: BCBS Complete |
$35.23
|
| Rate for Payer: BCBS MAPPO |
$47.59
|
| Rate for Payer: BCBS Trust/PPO |
$156.49
|
| Rate for Payer: BCN Commercial |
$156.49
|
| Rate for Payer: BCN Medicare Advantage |
$47.59
|
| Rate for Payer: Cash Price |
$152.28
|
| Rate for Payer: Cofinity Commercial |
$163.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.59
|
| Rate for Payer: Healthscope Commercial |
$171.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.76
|
| Rate for Payer: Mclaren Medicaid |
$33.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.97
|
| Rate for Payer: Meridian Medicaid |
$35.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$52.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.80
|
| Rate for Payer: Nomi Health Commercial |
$156.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.76
|
| Rate for Payer: PACE Senior Care Partners |
$45.21
|
| Rate for Payer: PACE SWMI |
$47.59
|
| Rate for Payer: PHP Commercial |
$161.80
|
| Rate for Payer: PHP Medicare Advantage |
$47.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$165.60
|
| Rate for Payer: Priority Health Medicare |
$48.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.48
|
| Rate for Payer: Railroad Medicare Medicare |
$47.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.51
|
| Rate for Payer: UHC Core |
$158.94
|
| Rate for Payer: UHC Exchange |
$47.59
|
| Rate for Payer: UHC Medicaid |
$33.56
|
| Rate for Payer: UHC Medicare Advantage |
$47.59
|
| Rate for Payer: UHCCP Medicaid |
$33.56
|
| Rate for Payer: VA VA |
$47.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.76
|
|
|
METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$208.05
|
|
|
Service Code
|
NDC 50268055015
|
| Hospital Charge Code |
28995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$144.80 |
| Max. Negotiated Rate |
$187.25 |
| Rate for Payer: Aetna Commercial |
$176.84
|
| Rate for Payer: BCBS Trust/PPO |
$171.83
|
| Rate for Payer: BCN Commercial |
$171.83
|
| Rate for Payer: Cash Price |
$166.44
|
| Rate for Payer: Cofinity Commercial |
$178.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.44
|
| Rate for Payer: Healthscope Commercial |
$187.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.84
|
| Rate for Payer: Nomi Health Commercial |
$170.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.04
|
| Rate for Payer: PHP Commercial |
$176.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$181.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.08
|
| Rate for Payer: UHC Core |
$173.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.04
|
|
|
METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$370.50
|
|
|
Service Code
|
NDC 60687064001
|
| Hospital Charge Code |
28995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$257.87 |
| Max. Negotiated Rate |
$333.45 |
| Rate for Payer: Aetna Commercial |
$314.93
|
| Rate for Payer: BCBS Trust/PPO |
$306.00
|
| Rate for Payer: BCN Commercial |
$306.00
|
| Rate for Payer: Cash Price |
$296.40
|
| Rate for Payer: Cofinity Commercial |
$318.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.40
|
| Rate for Payer: Healthscope Commercial |
$333.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.93
|
| Rate for Payer: Nomi Health Commercial |
$303.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.88
|
| Rate for Payer: PHP Commercial |
$314.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$322.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$257.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.04
|
| Rate for Payer: UHC Core |
$309.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.88
|
|
|
METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$370.50
|
|
|
Service Code
|
NDC 60687064001
|
| Hospital Charge Code |
28995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$65.32 |
| Max. Negotiated Rate |
$333.45 |
| Rate for Payer: Aetna Commercial |
$314.93
|
| Rate for Payer: Aetna Medicare |
$96.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.78
|
| Rate for Payer: BCBS Complete |
$68.58
|
| Rate for Payer: BCBS MAPPO |
$92.62
|
| Rate for Payer: BCBS Trust/PPO |
$304.59
|
| Rate for Payer: BCN Commercial |
$304.59
|
| Rate for Payer: BCN Medicare Advantage |
$92.62
|
| Rate for Payer: Cash Price |
$296.40
|
| Rate for Payer: Cofinity Commercial |
$318.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.62
|
| Rate for Payer: Healthscope Commercial |
$333.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.88
|
| Rate for Payer: Mclaren Medicaid |
$65.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.26
|
| Rate for Payer: Meridian Medicaid |
$68.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$101.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.93
|
| Rate for Payer: Nomi Health Commercial |
$303.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.88
|
| Rate for Payer: PACE Senior Care Partners |
$87.99
|
| Rate for Payer: PACE SWMI |
$92.62
|
| Rate for Payer: PHP Commercial |
$314.93
|
| Rate for Payer: PHP Medicare Advantage |
$92.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$322.33
|
| Rate for Payer: Priority Health Medicare |
$93.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$257.87
|
| Rate for Payer: Railroad Medicare Medicare |
$92.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.04
|
| Rate for Payer: UHC Core |
$309.37
|
| Rate for Payer: UHC Exchange |
$92.62
|
| Rate for Payer: UHC Medicaid |
$65.32
|
| Rate for Payer: UHC Medicare Advantage |
$92.62
|
| Rate for Payer: UHCCP Medicaid |
$65.32
|
| Rate for Payer: VA VA |
$92.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.88
|
|
|
METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$4.17
|
|
|
Service Code
|
NDC 50268055011
|
| Hospital Charge Code |
28995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$3.75 |
| Rate for Payer: Aetna Commercial |
$3.54
|
| Rate for Payer: Aetna Medicare |
$1.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.30
|
| Rate for Payer: BCBS Complete |
$0.77
|
| Rate for Payer: BCBS MAPPO |
$1.04
|
| Rate for Payer: BCBS Trust/PPO |
$3.43
|
| Rate for Payer: BCN Commercial |
$3.43
|
| Rate for Payer: BCN Medicare Advantage |
$1.04
|
| Rate for Payer: Cash Price |
$3.34
|
| Rate for Payer: Cofinity Commercial |
$3.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.04
|
| Rate for Payer: Healthscope Commercial |
$3.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.13
|
| Rate for Payer: Mclaren Medicaid |
$0.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.09
|
| Rate for Payer: Meridian Medicaid |
$0.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.54
|
| Rate for Payer: Nomi Health Commercial |
$3.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.13
|
| Rate for Payer: PACE Senior Care Partners |
$0.99
|
| Rate for Payer: PACE SWMI |
$1.04
|
| Rate for Payer: PHP Commercial |
$3.54
|
| Rate for Payer: PHP Medicare Advantage |
$1.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.63
|
| Rate for Payer: Priority Health Medicare |
$1.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.67
|
| Rate for Payer: UHC Core |
$3.48
|
| Rate for Payer: UHC Exchange |
$1.04
|
| Rate for Payer: UHC Medicaid |
$0.74
|
| Rate for Payer: UHC Medicare Advantage |
$1.04
|
| Rate for Payer: UHCCP Medicaid |
$0.74
|
| Rate for Payer: VA VA |
$1.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.13
|
|
|
METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$89.30
|
|
|
Service Code
|
NDC 67877015901
|
| Hospital Charge Code |
28995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$15.74 |
| Max. Negotiated Rate |
$80.37 |
| Rate for Payer: Aetna Commercial |
$75.91
|
| Rate for Payer: Aetna Medicare |
$23.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.91
|
| Rate for Payer: BCBS Complete |
$16.53
|
| Rate for Payer: BCBS MAPPO |
$22.32
|
| Rate for Payer: BCBS Trust/PPO |
$73.41
|
| Rate for Payer: BCN Commercial |
$73.41
|
| Rate for Payer: BCN Medicare Advantage |
$22.32
|
| Rate for Payer: Cash Price |
$71.44
|
| Rate for Payer: Cofinity Commercial |
$76.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.32
|
| Rate for Payer: Healthscope Commercial |
$80.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.97
|
| Rate for Payer: Mclaren Medicaid |
$15.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.44
|
| Rate for Payer: Meridian Medicaid |
$16.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.91
|
| Rate for Payer: Nomi Health Commercial |
$73.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.97
|
| Rate for Payer: PACE Senior Care Partners |
$21.21
|
| Rate for Payer: PACE SWMI |
$22.32
|
| Rate for Payer: PHP Commercial |
$75.91
|
| Rate for Payer: PHP Medicare Advantage |
$22.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.69
|
| Rate for Payer: Priority Health Medicare |
$22.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.15
|
| Rate for Payer: Railroad Medicare Medicare |
$22.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.58
|
| Rate for Payer: UHC Core |
$74.57
|
| Rate for Payer: UHC Exchange |
$22.32
|
| Rate for Payer: UHC Medicaid |
$15.74
|
| Rate for Payer: UHC Medicare Advantage |
$22.32
|
| Rate for Payer: UHCCP Medicaid |
$15.74
|
| Rate for Payer: VA VA |
$22.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.97
|
|
|
METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$89.30
|
|
|
Service Code
|
NDC 67877015901
|
| Hospital Charge Code |
28995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$62.15 |
| Max. Negotiated Rate |
$80.37 |
| Rate for Payer: Aetna Commercial |
$75.91
|
| Rate for Payer: BCBS Trust/PPO |
$73.75
|
| Rate for Payer: BCN Commercial |
$73.75
|
| Rate for Payer: Cash Price |
$71.44
|
| Rate for Payer: Cofinity Commercial |
$76.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.44
|
| Rate for Payer: Healthscope Commercial |
$80.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.91
|
| Rate for Payer: Nomi Health Commercial |
$73.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.97
|
| Rate for Payer: PHP Commercial |
$75.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.58
|
| Rate for Payer: UHC Core |
$74.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.97
|
|
|
METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$3.71
|
|
|
Service Code
|
NDC 60687064011
|
| Hospital Charge Code |
28995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$3.34 |
| Rate for Payer: Aetna Commercial |
$3.15
|
| Rate for Payer: BCBS Trust/PPO |
$3.06
|
| Rate for Payer: BCN Commercial |
$3.06
|
| Rate for Payer: Cash Price |
$2.97
|
| Rate for Payer: Cofinity Commercial |
$3.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.97
|
| Rate for Payer: Healthscope Commercial |
$3.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.15
|
| Rate for Payer: Nomi Health Commercial |
$3.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.78
|
| Rate for Payer: PHP Commercial |
$3.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.26
|
| Rate for Payer: UHC Core |
$3.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.78
|
|
|
METHADONE 10 MG/ML ORAL CONCENTRATE
|
Facility
|
IP
|
$131.88
|
|
|
Service Code
|
NDC 00527192736
|
| Hospital Charge Code |
15996
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$91.79 |
| Max. Negotiated Rate |
$118.69 |
| Rate for Payer: Aetna Commercial |
$112.10
|
| Rate for Payer: BCBS Trust/PPO |
$108.92
|
| Rate for Payer: BCN Commercial |
$108.92
|
| Rate for Payer: Cash Price |
$105.50
|
| Rate for Payer: Cofinity Commercial |
$113.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.50
|
| Rate for Payer: Healthscope Commercial |
$118.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.10
|
| Rate for Payer: Nomi Health Commercial |
$108.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.91
|
| Rate for Payer: PHP Commercial |
$112.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$114.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.05
|
| Rate for Payer: UHC Core |
$110.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.91
|
|
