|
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$590.90
|
|
|
Service Code
|
NDC 17478050410
|
| Hospital Charge Code |
4985
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$140.34 |
| Max. Negotiated Rate |
$531.81 |
| Rate for Payer: Aetna Commercial |
$502.26
|
| Rate for Payer: Aetna Medicare |
$153.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$184.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$184.66
|
| Rate for Payer: BCBS Complete |
$236.36
|
| Rate for Payer: BCBS MAPPO |
$147.72
|
| Rate for Payer: BCBS Trust/PPO |
$485.78
|
| Rate for Payer: BCN Commercial |
$459.42
|
| Rate for Payer: BCN Medicare Advantage |
$147.72
|
| Rate for Payer: Cash Price |
$472.72
|
| Rate for Payer: Cofinity Commercial |
$508.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$472.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.72
|
| Rate for Payer: Healthscope Commercial |
$531.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$443.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$502.26
|
| Rate for Payer: Nomi Health Commercial |
$484.54
|
| Rate for Payer: PACE Senior Care Partners |
$140.34
|
| Rate for Payer: PACE SWMI |
$147.72
|
| Rate for Payer: PHP Commercial |
$502.26
|
| Rate for Payer: PHP Medicare Advantage |
$147.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.08
|
| Rate for Payer: Priority Health HMO/PPO |
$514.08
|
| Rate for Payer: Priority Health Medicare |
$149.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$395.90
|
| Rate for Payer: Railroad Medicare Medicare |
$147.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.99
|
| Rate for Payer: UHC Core |
$493.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.72
|
| Rate for Payer: UHC Exchange |
$147.72
|
| Rate for Payer: UHC Medicare Advantage |
$147.72
|
| Rate for Payer: VA VA |
$147.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$443.18
|
|
|
METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$590.90
|
|
|
Service Code
|
NDC 17478050410
|
| Hospital Charge Code |
4985
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$384.08 |
| Max. Negotiated Rate |
$531.81 |
| Rate for Payer: Aetna Commercial |
$502.26
|
| Rate for Payer: BCBS Trust/PPO |
$482.35
|
| Rate for Payer: BCN Commercial |
$456.65
|
| Rate for Payer: Cash Price |
$472.72
|
| Rate for Payer: Cofinity Commercial |
$508.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$472.72
|
| Rate for Payer: Healthscope Commercial |
$531.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$443.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$502.26
|
| Rate for Payer: Nomi Health Commercial |
$484.54
|
| Rate for Payer: PHP Commercial |
$502.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.08
|
| Rate for Payer: Priority Health HMO/PPO |
$514.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$395.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.99
|
| Rate for Payer: UHC Core |
$493.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$443.18
|
|
|
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$330.15
|
|
|
Service Code
|
NDC 00517037401
|
| Hospital Charge Code |
180747
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$214.60 |
| Max. Negotiated Rate |
$297.13 |
| Rate for Payer: Aetna Commercial |
$280.63
|
| Rate for Payer: BCBS Trust/PPO |
$269.50
|
| Rate for Payer: BCN Commercial |
$255.14
|
| Rate for Payer: Cash Price |
$264.12
|
| Rate for Payer: Cofinity Commercial |
$283.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.12
|
| Rate for Payer: Healthscope Commercial |
$297.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.63
|
| Rate for Payer: Nomi Health Commercial |
$270.72
|
| Rate for Payer: PHP Commercial |
$280.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.60
|
| Rate for Payer: Priority Health HMO/PPO |
$287.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$221.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.53
|
| Rate for Payer: UHC Core |
$275.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.61
|
|
|
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$330.15
|
|
|
Service Code
|
NDC 00517037405
|
| Hospital Charge Code |
180747
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$214.60 |
| Max. Negotiated Rate |
$297.13 |
| Rate for Payer: Aetna Commercial |
$280.63
|
| Rate for Payer: BCBS Trust/PPO |
$269.50
|
| Rate for Payer: BCN Commercial |
$255.14
|
| Rate for Payer: Cash Price |
$264.12
|
| Rate for Payer: Cofinity Commercial |
$283.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.12
|
| Rate for Payer: Healthscope Commercial |
$297.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.63
|
| Rate for Payer: Nomi Health Commercial |
$270.72
|
| Rate for Payer: PHP Commercial |
$280.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.60
|
| Rate for Payer: Priority Health HMO/PPO |
$287.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$221.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.53
|
| Rate for Payer: UHC Core |
$275.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.61
|
|
|
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$330.15
|
|
|
Service Code
|
NDC 00517037405
|
| Hospital Charge Code |
180747
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$78.41 |
| Max. Negotiated Rate |
$297.13 |
| Rate for Payer: Aetna Commercial |
$280.63
|
| Rate for Payer: Aetna Medicare |
$85.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.17
|
| Rate for Payer: BCBS Complete |
$132.06
|
| Rate for Payer: BCBS MAPPO |
$82.54
|
| Rate for Payer: BCBS Trust/PPO |
$271.42
|
| Rate for Payer: BCN Commercial |
$256.69
|
| Rate for Payer: BCN Medicare Advantage |
$82.54
|
| Rate for Payer: Cash Price |
$264.12
|
| Rate for Payer: Cofinity Commercial |
$283.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.54
|
| Rate for Payer: Healthscope Commercial |
$297.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.63
|
| Rate for Payer: Nomi Health Commercial |
$270.72
|
| Rate for Payer: PACE Senior Care Partners |
$78.41
|
| Rate for Payer: PACE SWMI |
$82.54
|
| Rate for Payer: PHP Commercial |
$280.63
|
| Rate for Payer: PHP Medicare Advantage |
$82.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.60
|
| Rate for Payer: Priority Health HMO/PPO |
$287.23
|
| Rate for Payer: Priority Health Medicare |
$83.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$221.20
|
| Rate for Payer: Railroad Medicare Medicare |
$82.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.53
|
| Rate for Payer: UHC Core |
$275.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.54
|
| Rate for Payer: UHC Exchange |
$82.54
|
| Rate for Payer: UHC Medicare Advantage |
$82.54
|
| Rate for Payer: VA VA |
$82.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.61
|
|
|
METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$330.15
|
|
|
Service Code
|
NDC 00517037401
|
| Hospital Charge Code |
180747
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$78.41 |
| Max. Negotiated Rate |
$297.13 |
| Rate for Payer: Aetna Commercial |
$280.63
|
| Rate for Payer: Aetna Medicare |
$85.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.17
|
| Rate for Payer: BCBS Complete |
$132.06
|
| Rate for Payer: BCBS MAPPO |
$82.54
|
| Rate for Payer: BCBS Trust/PPO |
$271.42
|
| Rate for Payer: BCN Commercial |
$256.69
|
| Rate for Payer: BCN Medicare Advantage |
$82.54
|
| Rate for Payer: Cash Price |
$264.12
|
| Rate for Payer: Cofinity Commercial |
$283.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.54
|
| Rate for Payer: Healthscope Commercial |
$297.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.63
|
| Rate for Payer: Nomi Health Commercial |
$270.72
|
| Rate for Payer: PACE Senior Care Partners |
$78.41
|
| Rate for Payer: PACE SWMI |
$82.54
|
| Rate for Payer: PHP Commercial |
$280.63
|
| Rate for Payer: PHP Medicare Advantage |
$82.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.60
|
| Rate for Payer: Priority Health HMO/PPO |
$287.23
|
| Rate for Payer: Priority Health Medicare |
$83.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$221.20
|
| Rate for Payer: Railroad Medicare Medicare |
$82.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.53
|
| Rate for Payer: UHC Core |
$275.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.54
|
| Rate for Payer: UHC Exchange |
$82.54
|
| Rate for Payer: UHC Medicare Advantage |
$82.54
|
| Rate for Payer: VA VA |
$82.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.61
|
|
|
METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
OP
|
$68.08
|
|
|
Service Code
|
HCPCS J2210
|
| Hospital Charge Code |
10571
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.17 |
| Max. Negotiated Rate |
$61.27 |
| Rate for Payer: Aetna Commercial |
$57.87
|
| Rate for Payer: Aetna Commercial |
$25.95
|
| Rate for Payer: Aetna Medicare |
$17.70
|
| Rate for Payer: Aetna Medicare |
$7.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.54
|
| Rate for Payer: BCBS Complete |
$12.21
|
| Rate for Payer: BCBS Complete |
$27.23
|
| Rate for Payer: BCBS MAPPO |
$7.63
|
| Rate for Payer: BCBS MAPPO |
$17.02
|
| Rate for Payer: BCBS Trust/PPO |
$55.97
|
| Rate for Payer: BCBS Trust/PPO |
$25.10
|
| Rate for Payer: BCN Commercial |
$52.93
|
| Rate for Payer: BCN Commercial |
$23.74
|
| Rate for Payer: BCN Medicare Advantage |
$17.02
|
| Rate for Payer: BCN Medicare Advantage |
$7.63
|
| Rate for Payer: Cash Price |
$54.46
|
| Rate for Payer: Cash Price |
$24.42
|
| Rate for Payer: Cofinity Commercial |
$26.26
|
| Rate for Payer: Cofinity Commercial |
$58.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.02
|
| Rate for Payer: Healthscope Commercial |
$27.48
|
| Rate for Payer: Healthscope Commercial |
$61.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.95
|
| Rate for Payer: Nomi Health Commercial |
$55.83
|
| Rate for Payer: Nomi Health Commercial |
$25.03
|
| Rate for Payer: PACE Senior Care Partners |
$16.17
|
| Rate for Payer: PACE Senior Care Partners |
$7.25
|
| Rate for Payer: PACE SWMI |
$17.02
|
| Rate for Payer: PACE SWMI |
$7.63
|
| Rate for Payer: PHP Commercial |
$57.87
|
| Rate for Payer: PHP Commercial |
$25.95
|
| Rate for Payer: PHP Medicare Advantage |
$7.63
|
| Rate for Payer: PHP Medicare Advantage |
$17.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.84
|
| Rate for Payer: Priority Health HMO/PPO |
$26.56
|
| Rate for Payer: Priority Health HMO/PPO |
$59.23
|
| Rate for Payer: Priority Health Medicare |
$17.19
|
| Rate for Payer: Priority Health Medicare |
$7.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.46
|
| Rate for Payer: Railroad Medicare Medicare |
$7.63
|
| Rate for Payer: Railroad Medicare Medicare |
$17.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.91
|
| Rate for Payer: UHC Core |
$56.85
|
| Rate for Payer: UHC Core |
$25.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.63
|
| Rate for Payer: UHC Exchange |
$7.63
|
| Rate for Payer: UHC Exchange |
$17.02
|
| Rate for Payer: UHC Medicare Advantage |
$7.63
|
| Rate for Payer: UHC Medicare Advantage |
$17.02
|
| Rate for Payer: VA VA |
$7.63
|
| Rate for Payer: VA VA |
$17.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.90
|
|
|
METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
IP
|
$30.53
|
|
|
Service Code
|
HCPCS J2210
|
| Hospital Charge Code |
10571
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.84 |
| Max. Negotiated Rate |
$27.48 |
| Rate for Payer: Aetna Commercial |
$25.95
|
| Rate for Payer: Aetna Commercial |
$57.87
|
| Rate for Payer: BCBS Trust/PPO |
$24.92
|
| Rate for Payer: BCBS Trust/PPO |
$55.57
|
| Rate for Payer: BCN Commercial |
$23.59
|
| Rate for Payer: BCN Commercial |
$52.61
|
| Rate for Payer: Cash Price |
$24.42
|
| Rate for Payer: Cash Price |
$54.46
|
| Rate for Payer: Cofinity Commercial |
$58.55
|
| Rate for Payer: Cofinity Commercial |
$26.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.42
|
| Rate for Payer: Healthscope Commercial |
$27.48
|
| Rate for Payer: Healthscope Commercial |
$61.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.87
|
| Rate for Payer: Nomi Health Commercial |
$25.03
|
| Rate for Payer: Nomi Health Commercial |
$55.83
|
| Rate for Payer: PHP Commercial |
$25.95
|
| Rate for Payer: PHP Commercial |
$57.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.84
|
| Rate for Payer: Priority Health HMO/PPO |
$59.23
|
| Rate for Payer: Priority Health HMO/PPO |
$26.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.91
|
| Rate for Payer: UHC Core |
$25.49
|
| Rate for Payer: UHC Core |
$56.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.06
|
|
|
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION
|
Facility
|
OP
|
$529.24
|
|
|
Service Code
|
HCPCS J2212
|
| Hospital Charge Code |
91651
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$125.69 |
| Max. Negotiated Rate |
$476.32 |
| Rate for Payer: Aetna Commercial |
$449.85
|
| Rate for Payer: Aetna Medicare |
$137.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.39
|
| Rate for Payer: BCBS Complete |
$211.70
|
| Rate for Payer: BCBS MAPPO |
$132.31
|
| Rate for Payer: BCBS Trust/PPO |
$435.09
|
| Rate for Payer: BCN Commercial |
$411.48
|
| Rate for Payer: BCN Medicare Advantage |
$132.31
|
| Rate for Payer: Cash Price |
$423.39
|
| Rate for Payer: Cofinity Commercial |
$455.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.31
|
| Rate for Payer: Healthscope Commercial |
$476.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$396.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$449.85
|
| Rate for Payer: Nomi Health Commercial |
$433.98
|
| Rate for Payer: PACE Senior Care Partners |
$125.69
|
| Rate for Payer: PACE SWMI |
$132.31
|
| Rate for Payer: PHP Commercial |
$449.85
|
| Rate for Payer: PHP Medicare Advantage |
$132.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.01
|
| Rate for Payer: Priority Health HMO/PPO |
$460.44
|
| Rate for Payer: Priority Health Medicare |
$133.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$354.59
|
| Rate for Payer: Railroad Medicare Medicare |
$132.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$465.73
|
| Rate for Payer: UHC Core |
$441.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$132.31
|
| Rate for Payer: UHC Exchange |
$132.31
|
| Rate for Payer: UHC Medicare Advantage |
$132.31
|
| Rate for Payer: VA VA |
$132.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$396.93
|
|
|
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION
|
Facility
|
IP
|
$529.24
|
|
|
Service Code
|
HCPCS J2212
|
| Hospital Charge Code |
91651
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$344.01 |
| Max. Negotiated Rate |
$476.32 |
| Rate for Payer: Aetna Commercial |
$449.85
|
| Rate for Payer: BCBS Trust/PPO |
$432.02
|
| Rate for Payer: BCN Commercial |
$409.00
|
| Rate for Payer: Cash Price |
$423.39
|
| Rate for Payer: Cofinity Commercial |
$455.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.39
|
| Rate for Payer: Healthscope Commercial |
$476.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$396.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$449.85
|
| Rate for Payer: Nomi Health Commercial |
$433.98
|
| Rate for Payer: PHP Commercial |
$449.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.01
|
| Rate for Payer: Priority Health HMO/PPO |
$460.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$354.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$465.73
|
| Rate for Payer: UHC Core |
$441.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$396.93
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
IP
|
$320.25
|
|
|
Service Code
|
NDC 00406114201
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$208.16 |
| Max. Negotiated Rate |
$288.23 |
| Rate for Payer: Aetna Commercial |
$272.21
|
| Rate for Payer: BCBS Trust/PPO |
$261.42
|
| Rate for Payer: BCN Commercial |
$247.49
|
| Rate for Payer: Cash Price |
$256.20
|
| Rate for Payer: Cofinity Commercial |
$275.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.20
|
| Rate for Payer: Healthscope Commercial |
$288.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.21
|
| Rate for Payer: Nomi Health Commercial |
$262.61
|
| Rate for Payer: PHP Commercial |
$272.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.16
|
| Rate for Payer: Priority Health HMO/PPO |
$278.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.82
|
| Rate for Payer: UHC Core |
$267.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.19
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
OP
|
$320.25
|
|
|
Service Code
|
NDC 00406114201
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$76.06 |
| Max. Negotiated Rate |
$288.23 |
| Rate for Payer: Aetna Commercial |
$272.21
|
| Rate for Payer: Aetna Medicare |
$83.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.08
|
| Rate for Payer: BCBS Complete |
$128.10
|
| Rate for Payer: BCBS MAPPO |
$80.06
|
| Rate for Payer: BCBS Trust/PPO |
$263.28
|
| Rate for Payer: BCN Commercial |
$248.99
|
| Rate for Payer: BCN Medicare Advantage |
$80.06
|
| Rate for Payer: Cash Price |
$256.20
|
| Rate for Payer: Cofinity Commercial |
$275.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.06
|
| Rate for Payer: Healthscope Commercial |
$288.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.21
|
| Rate for Payer: Nomi Health Commercial |
$262.61
|
| Rate for Payer: PACE Senior Care Partners |
$76.06
|
| Rate for Payer: PACE SWMI |
$80.06
|
| Rate for Payer: PHP Commercial |
$272.21
|
| Rate for Payer: PHP Medicare Advantage |
$80.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.16
|
| Rate for Payer: Priority Health HMO/PPO |
$278.62
|
| Rate for Payer: Priority Health Medicare |
$80.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.57
|
| Rate for Payer: Railroad Medicare Medicare |
$80.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.82
|
| Rate for Payer: UHC Core |
$267.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.06
|
| Rate for Payer: UHC Exchange |
$80.06
|
| Rate for Payer: UHC Medicare Advantage |
$80.06
|
| Rate for Payer: VA VA |
$80.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.19
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
OP
|
$394.59
|
|
|
Service Code
|
NDC 68084080521
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$93.72 |
| Max. Negotiated Rate |
$355.13 |
| Rate for Payer: Aetna Commercial |
$335.40
|
| Rate for Payer: Aetna Medicare |
$102.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.31
|
| Rate for Payer: BCBS Complete |
$157.84
|
| Rate for Payer: BCBS MAPPO |
$98.65
|
| Rate for Payer: BCBS Trust/PPO |
$324.39
|
| Rate for Payer: BCN Commercial |
$306.79
|
| Rate for Payer: BCN Medicare Advantage |
$98.65
|
| Rate for Payer: Cash Price |
$315.67
|
| Rate for Payer: Cofinity Commercial |
$339.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.65
|
| Rate for Payer: Healthscope Commercial |
$355.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.40
|
| Rate for Payer: Nomi Health Commercial |
$323.56
|
| Rate for Payer: PACE Senior Care Partners |
$93.72
|
| Rate for Payer: PACE SWMI |
$98.65
|
| Rate for Payer: PHP Commercial |
$335.40
|
| Rate for Payer: PHP Medicare Advantage |
$98.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.48
|
| Rate for Payer: Priority Health HMO/PPO |
$343.29
|
| Rate for Payer: Priority Health Medicare |
$99.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$264.38
|
| Rate for Payer: Railroad Medicare Medicare |
$98.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$347.24
|
| Rate for Payer: UHC Core |
$329.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.65
|
| Rate for Payer: UHC Exchange |
$98.65
|
| Rate for Payer: UHC Medicare Advantage |
$98.65
|
| Rate for Payer: VA VA |
$98.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.94
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
IP
|
$168.00
|
|
|
Service Code
|
NDC 10702010001
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$109.20 |
| Max. Negotiated Rate |
$151.20 |
| Rate for Payer: Aetna Commercial |
$142.80
|
| Rate for Payer: BCBS Trust/PPO |
$137.14
|
| Rate for Payer: BCN Commercial |
$129.83
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$144.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.40
|
| Rate for Payer: Healthscope Commercial |
$151.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.80
|
| Rate for Payer: Nomi Health Commercial |
$137.76
|
| Rate for Payer: PHP Commercial |
$142.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health HMO/PPO |
$146.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.84
|
| Rate for Payer: UHC Core |
$140.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.00
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
OP
|
$168.00
|
|
|
Service Code
|
NDC 10702010001
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.90 |
| Max. Negotiated Rate |
$151.20 |
| Rate for Payer: Aetna Commercial |
$142.80
|
| Rate for Payer: Aetna Medicare |
$43.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.50
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: BCBS MAPPO |
$42.00
|
| Rate for Payer: BCBS Trust/PPO |
$138.11
|
| Rate for Payer: BCN Commercial |
$130.62
|
| Rate for Payer: BCN Medicare Advantage |
$42.00
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$144.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.00
|
| Rate for Payer: Healthscope Commercial |
$151.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.80
|
| Rate for Payer: Nomi Health Commercial |
$137.76
|
| Rate for Payer: PACE Senior Care Partners |
$39.90
|
| Rate for Payer: PACE SWMI |
$42.00
|
| Rate for Payer: PHP Commercial |
$142.80
|
| Rate for Payer: PHP Medicare Advantage |
$42.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health HMO/PPO |
$146.16
|
| Rate for Payer: Priority Health Medicare |
$42.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.56
|
| Rate for Payer: Railroad Medicare Medicare |
$42.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.84
|
| Rate for Payer: UHC Core |
$140.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.00
|
| Rate for Payer: UHC Exchange |
$42.00
|
| Rate for Payer: UHC Medicare Advantage |
$42.00
|
| Rate for Payer: VA VA |
$42.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.00
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
IP
|
$13.16
|
|
|
Service Code
|
NDC 68084080511
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8.55 |
| Max. Negotiated Rate |
$11.84 |
| Rate for Payer: Aetna Commercial |
$11.19
|
| Rate for Payer: BCBS Trust/PPO |
$10.74
|
| Rate for Payer: BCN Commercial |
$10.17
|
| Rate for Payer: Cash Price |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$11.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.53
|
| Rate for Payer: Healthscope Commercial |
$11.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.19
|
| Rate for Payer: Nomi Health Commercial |
$10.79
|
| Rate for Payer: PHP Commercial |
$11.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.55
|
| Rate for Payer: Priority Health HMO/PPO |
$11.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.58
|
| Rate for Payer: UHC Core |
$10.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.87
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
OP
|
$13.16
|
|
|
Service Code
|
NDC 68084080511
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.13 |
| Max. Negotiated Rate |
$11.84 |
| Rate for Payer: Aetna Commercial |
$11.19
|
| Rate for Payer: Aetna Medicare |
$3.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.11
|
| Rate for Payer: BCBS Complete |
$5.26
|
| Rate for Payer: BCBS MAPPO |
$3.29
|
| Rate for Payer: BCBS Trust/PPO |
$10.82
|
| Rate for Payer: BCN Commercial |
$10.23
|
| Rate for Payer: BCN Medicare Advantage |
$3.29
|
| Rate for Payer: Cash Price |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$11.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.29
|
| Rate for Payer: Healthscope Commercial |
$11.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.19
|
| Rate for Payer: Nomi Health Commercial |
$10.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.13
|
| Rate for Payer: PACE SWMI |
$3.29
|
| Rate for Payer: PHP Commercial |
$11.19
|
| Rate for Payer: PHP Medicare Advantage |
$3.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.55
|
| Rate for Payer: Priority Health HMO/PPO |
$11.45
|
| Rate for Payer: Priority Health Medicare |
$3.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.82
|
| Rate for Payer: Railroad Medicare Medicare |
$3.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.58
|
| Rate for Payer: UHC Core |
$10.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.29
|
| Rate for Payer: UHC Exchange |
$3.29
|
| Rate for Payer: UHC Medicare Advantage |
$3.29
|
| Rate for Payer: VA VA |
$3.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.87
|
|
|
METHYLPHENIDATE 5 MG TABLET
|
Facility
|
IP
|
$394.59
|
|
|
Service Code
|
NDC 68084080521
|
| Hospital Charge Code |
4988
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$256.48 |
| Max. Negotiated Rate |
$355.13 |
| Rate for Payer: Aetna Commercial |
$335.40
|
| Rate for Payer: BCBS Trust/PPO |
$322.10
|
| Rate for Payer: BCN Commercial |
$304.94
|
| Rate for Payer: Cash Price |
$315.67
|
| Rate for Payer: Cofinity Commercial |
$339.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.67
|
| Rate for Payer: Healthscope Commercial |
$355.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.40
|
| Rate for Payer: Nomi Health Commercial |
$323.56
|
| Rate for Payer: PHP Commercial |
$335.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.48
|
| Rate for Payer: Priority Health HMO/PPO |
$343.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$264.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$347.24
|
| Rate for Payer: UHC Core |
$329.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.94
|
|
|
METHYLPREDNISOLONE 4 MG TABLET
|
Facility
|
OP
|
$282.15
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
4993
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$67.01 |
| Max. Negotiated Rate |
$253.94 |
| Rate for Payer: Aetna Commercial |
$239.83
|
| Rate for Payer: Aetna Commercial |
$553.66
|
| Rate for Payer: Aetna Commercial |
$240.63
|
| Rate for Payer: Aetna Medicare |
$169.35
|
| Rate for Payer: Aetna Medicare |
$73.36
|
| Rate for Payer: Aetna Medicare |
$73.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$203.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$203.55
|
| Rate for Payer: BCBS Complete |
$113.24
|
| Rate for Payer: BCBS Complete |
$112.86
|
| Rate for Payer: BCBS Complete |
$260.54
|
| Rate for Payer: BCBS MAPPO |
$162.84
|
| Rate for Payer: BCBS MAPPO |
$70.54
|
| Rate for Payer: BCBS MAPPO |
$70.78
|
| Rate for Payer: BCBS Trust/PPO |
$232.74
|
| Rate for Payer: BCBS Trust/PPO |
$231.96
|
| Rate for Payer: BCBS Trust/PPO |
$535.48
|
| Rate for Payer: BCN Commercial |
$220.11
|
| Rate for Payer: BCN Commercial |
$506.43
|
| Rate for Payer: BCN Commercial |
$219.37
|
| Rate for Payer: BCN Medicare Advantage |
$70.54
|
| Rate for Payer: BCN Medicare Advantage |
$70.78
|
| Rate for Payer: BCN Medicare Advantage |
$162.84
|
| Rate for Payer: Cash Price |
$226.48
|
| Rate for Payer: Cash Price |
$521.09
|
| Rate for Payer: Cash Price |
$225.72
|
| Rate for Payer: Cofinity Commercial |
$560.17
|
| Rate for Payer: Cofinity Commercial |
$242.65
|
| Rate for Payer: Cofinity Commercial |
$243.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$521.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.54
|
| Rate for Payer: Healthscope Commercial |
$254.79
|
| Rate for Payer: Healthscope Commercial |
$253.94
|
| Rate for Payer: Healthscope Commercial |
$586.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$488.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.83
|
| Rate for Payer: Nomi Health Commercial |
$534.12
|
| Rate for Payer: Nomi Health Commercial |
$231.36
|
| Rate for Payer: Nomi Health Commercial |
$232.14
|
| Rate for Payer: PACE Senior Care Partners |
$154.70
|
| Rate for Payer: PACE Senior Care Partners |
$67.01
|
| Rate for Payer: PACE Senior Care Partners |
$67.24
|
| Rate for Payer: PACE SWMI |
$70.78
|
| Rate for Payer: PACE SWMI |
$70.54
|
| Rate for Payer: PACE SWMI |
$162.84
|
| Rate for Payer: PHP Commercial |
$553.66
|
| Rate for Payer: PHP Commercial |
$240.63
|
| Rate for Payer: PHP Commercial |
$239.83
|
| Rate for Payer: PHP Medicare Advantage |
$70.78
|
| Rate for Payer: PHP Medicare Advantage |
$162.84
|
| Rate for Payer: PHP Medicare Advantage |
$70.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.01
|
| Rate for Payer: Priority Health HMO/PPO |
$566.68
|
| Rate for Payer: Priority Health HMO/PPO |
$245.47
|
| Rate for Payer: Priority Health HMO/PPO |
$246.30
|
| Rate for Payer: Priority Health Medicare |
$71.24
|
| Rate for Payer: Priority Health Medicare |
$164.47
|
| Rate for Payer: Priority Health Medicare |
$71.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$436.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.04
|
| Rate for Payer: Railroad Medicare Medicare |
$70.78
|
| Rate for Payer: Railroad Medicare Medicare |
$162.84
|
| Rate for Payer: Railroad Medicare Medicare |
$70.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$573.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.29
|
| Rate for Payer: UHC Core |
$543.89
|
| Rate for Payer: UHC Core |
$236.39
|
| Rate for Payer: UHC Core |
$235.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.78
|
| Rate for Payer: UHC Exchange |
$70.78
|
| Rate for Payer: UHC Exchange |
$70.54
|
| Rate for Payer: UHC Exchange |
$162.84
|
| Rate for Payer: UHC Medicare Advantage |
$70.54
|
| Rate for Payer: UHC Medicare Advantage |
$70.78
|
| Rate for Payer: UHC Medicare Advantage |
$162.84
|
| Rate for Payer: VA VA |
$70.78
|
| Rate for Payer: VA VA |
$162.84
|
| Rate for Payer: VA VA |
$70.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$488.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.32
|
|
|
METHYLPREDNISOLONE 4 MG TABLET
|
Facility
|
IP
|
$282.15
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
4993
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$183.40 |
| Max. Negotiated Rate |
$253.94 |
| Rate for Payer: Aetna Commercial |
$239.83
|
| Rate for Payer: Aetna Commercial |
$240.63
|
| Rate for Payer: Aetna Commercial |
$553.66
|
| Rate for Payer: BCBS Trust/PPO |
$231.09
|
| Rate for Payer: BCBS Trust/PPO |
$230.32
|
| Rate for Payer: BCBS Trust/PPO |
$531.71
|
| Rate for Payer: BCN Commercial |
$218.78
|
| Rate for Payer: BCN Commercial |
$218.05
|
| Rate for Payer: BCN Commercial |
$503.37
|
| Rate for Payer: Cash Price |
$225.72
|
| Rate for Payer: Cash Price |
$521.09
|
| Rate for Payer: Cash Price |
$226.48
|
| Rate for Payer: Cofinity Commercial |
$560.17
|
| Rate for Payer: Cofinity Commercial |
$243.47
|
| Rate for Payer: Cofinity Commercial |
$242.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$521.09
|
| Rate for Payer: Healthscope Commercial |
$254.79
|
| Rate for Payer: Healthscope Commercial |
$253.94
|
| Rate for Payer: Healthscope Commercial |
$586.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$488.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.66
|
| Rate for Payer: Nomi Health Commercial |
$231.36
|
| Rate for Payer: Nomi Health Commercial |
$232.14
|
| Rate for Payer: Nomi Health Commercial |
$534.12
|
| Rate for Payer: PHP Commercial |
$240.63
|
| Rate for Payer: PHP Commercial |
$239.83
|
| Rate for Payer: PHP Commercial |
$553.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.01
|
| Rate for Payer: Priority Health HMO/PPO |
$566.68
|
| Rate for Payer: Priority Health HMO/PPO |
$246.30
|
| Rate for Payer: Priority Health HMO/PPO |
$245.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$436.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$573.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.29
|
| Rate for Payer: UHC Core |
$235.60
|
| Rate for Payer: UHC Core |
$543.89
|
| Rate for Payer: UHC Core |
$236.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$488.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.32
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION
|
Facility
|
IP
|
$30.63
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
4995
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$27.57 |
| Rate for Payer: Aetna Commercial |
$26.04
|
| Rate for Payer: Aetna Commercial |
$26.03
|
| Rate for Payer: Aetna Commercial |
$22.96
|
| Rate for Payer: Aetna Commercial |
$30.61
|
| Rate for Payer: BCBS Trust/PPO |
$25.00
|
| Rate for Payer: BCBS Trust/PPO |
$29.39
|
| Rate for Payer: BCBS Trust/PPO |
$25.00
|
| Rate for Payer: BCBS Trust/PPO |
$22.05
|
| Rate for Payer: BCN Commercial |
$23.67
|
| Rate for Payer: BCN Commercial |
$20.87
|
| Rate for Payer: BCN Commercial |
$27.83
|
| Rate for Payer: BCN Commercial |
$23.66
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cash Price |
$28.81
|
| Rate for Payer: Cash Price |
$21.61
|
| Rate for Payer: Cofinity Commercial |
$23.23
|
| Rate for Payer: Cofinity Commercial |
$30.97
|
| Rate for Payer: Cofinity Commercial |
$26.34
|
| Rate for Payer: Cofinity Commercial |
$26.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.81
|
| Rate for Payer: Healthscope Commercial |
$32.41
|
| Rate for Payer: Healthscope Commercial |
$27.56
|
| Rate for Payer: Healthscope Commercial |
$27.57
|
| Rate for Payer: Healthscope Commercial |
$24.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.61
|
| Rate for Payer: Nomi Health Commercial |
$22.15
|
| Rate for Payer: Nomi Health Commercial |
$25.11
|
| Rate for Payer: Nomi Health Commercial |
$29.53
|
| Rate for Payer: Nomi Health Commercial |
$25.12
|
| Rate for Payer: PHP Commercial |
$26.03
|
| Rate for Payer: PHP Commercial |
$22.96
|
| Rate for Payer: PHP Commercial |
$26.04
|
| Rate for Payer: PHP Commercial |
$30.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.91
|
| Rate for Payer: Priority Health HMO/PPO |
$26.65
|
| Rate for Payer: Priority Health HMO/PPO |
$31.33
|
| Rate for Payer: Priority Health HMO/PPO |
$23.50
|
| Rate for Payer: Priority Health HMO/PPO |
$26.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.95
|
| Rate for Payer: UHC Core |
$25.58
|
| Rate for Payer: UHC Core |
$30.07
|
| Rate for Payer: UHC Core |
$25.57
|
| Rate for Payer: UHC Core |
$22.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.97
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION
|
Facility
|
OP
|
$27.01
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
4995
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$24.31 |
| Rate for Payer: Aetna Commercial |
$22.96
|
| Rate for Payer: Aetna Commercial |
$26.04
|
| Rate for Payer: Aetna Commercial |
$30.61
|
| Rate for Payer: Aetna Commercial |
$26.03
|
| Rate for Payer: Aetna Medicare |
$7.02
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Aetna Medicare |
$9.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.25
|
| Rate for Payer: BCBS Complete |
$0.09
|
| Rate for Payer: BCBS Complete |
$0.09
|
| Rate for Payer: BCBS Complete |
$0.09
|
| Rate for Payer: BCBS Complete |
$0.09
|
| Rate for Payer: BCBS MAPPO |
$6.75
|
| Rate for Payer: BCBS MAPPO |
$7.66
|
| Rate for Payer: BCBS MAPPO |
$9.00
|
| Rate for Payer: BCBS MAPPO |
$7.66
|
| Rate for Payer: BCBS Trust/PPO |
$25.17
|
| Rate for Payer: BCBS Trust/PPO |
$29.60
|
| Rate for Payer: BCBS Trust/PPO |
$25.18
|
| Rate for Payer: BCBS Trust/PPO |
$22.20
|
| Rate for Payer: BCN Commercial |
$23.81
|
| Rate for Payer: BCN Commercial |
$23.81
|
| Rate for Payer: BCN Commercial |
$21.00
|
| Rate for Payer: BCN Commercial |
$28.00
|
| Rate for Payer: BCN Medicare Advantage |
$6.75
|
| Rate for Payer: BCN Medicare Advantage |
$7.66
|
| Rate for Payer: BCN Medicare Advantage |
$9.00
|
| Rate for Payer: BCN Medicare Advantage |
$7.66
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cash Price |
$21.61
|
| Rate for Payer: Cash Price |
$28.81
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cash Price |
$21.61
|
| Rate for Payer: Cash Price |
$28.81
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cofinity Commercial |
$23.23
|
| Rate for Payer: Cofinity Commercial |
$26.33
|
| Rate for Payer: Cofinity Commercial |
$30.97
|
| Rate for Payer: Cofinity Commercial |
$26.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.66
|
| Rate for Payer: Healthscope Commercial |
$24.31
|
| Rate for Payer: Healthscope Commercial |
$27.57
|
| Rate for Payer: Healthscope Commercial |
$32.41
|
| Rate for Payer: Healthscope Commercial |
$27.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.97
|
| Rate for Payer: Mclaren Medicaid |
$0.09
|
| Rate for Payer: Mclaren Medicaid |
$0.09
|
| Rate for Payer: Mclaren Medicaid |
$0.09
|
| Rate for Payer: Mclaren Medicaid |
$0.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.45
|
| Rate for Payer: Meridian Medicaid |
$0.09
|
| Rate for Payer: Meridian Medicaid |
$0.09
|
| Rate for Payer: Meridian Medicaid |
$0.09
|
| Rate for Payer: Meridian Medicaid |
$0.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.61
|
| Rate for Payer: Nomi Health Commercial |
$25.11
|
| Rate for Payer: Nomi Health Commercial |
$29.53
|
| Rate for Payer: Nomi Health Commercial |
$25.12
|
| Rate for Payer: Nomi Health Commercial |
$22.15
|
| Rate for Payer: PACE Senior Care Partners |
$7.27
|
| Rate for Payer: PACE Senior Care Partners |
$8.55
|
| Rate for Payer: PACE Senior Care Partners |
$7.27
|
| Rate for Payer: PACE Senior Care Partners |
$6.41
|
| Rate for Payer: PACE SWMI |
$9.00
|
| Rate for Payer: PACE SWMI |
$7.66
|
| Rate for Payer: PACE SWMI |
$6.75
|
| Rate for Payer: PACE SWMI |
$7.66
|
| Rate for Payer: PHP Commercial |
$30.61
|
| Rate for Payer: PHP Commercial |
$26.03
|
| Rate for Payer: PHP Commercial |
$22.96
|
| Rate for Payer: PHP Commercial |
$26.04
|
| Rate for Payer: PHP Medicare Advantage |
$9.00
|
| Rate for Payer: PHP Medicare Advantage |
$7.66
|
| Rate for Payer: PHP Medicare Advantage |
$7.66
|
| Rate for Payer: PHP Medicare Advantage |
$6.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.56
|
| Rate for Payer: Priority Health HMO/PPO |
$31.33
|
| Rate for Payer: Priority Health HMO/PPO |
$26.64
|
| Rate for Payer: Priority Health HMO/PPO |
$26.65
|
| Rate for Payer: Priority Health HMO/PPO |
$23.50
|
| Rate for Payer: Priority Health Medicare |
$9.09
|
| Rate for Payer: Priority Health Medicare |
$7.73
|
| Rate for Payer: Priority Health Medicare |
$7.73
|
| Rate for Payer: Priority Health Medicare |
$6.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.10
|
| Rate for Payer: Railroad Medicare Medicare |
$7.66
|
| Rate for Payer: Railroad Medicare Medicare |
$7.66
|
| Rate for Payer: Railroad Medicare Medicare |
$6.75
|
| Rate for Payer: Railroad Medicare Medicare |
$9.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.95
|
| Rate for Payer: UHC Core |
$22.55
|
| Rate for Payer: UHC Core |
$30.07
|
| Rate for Payer: UHC Core |
$25.58
|
| Rate for Payer: UHC Core |
$25.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.66
|
| Rate for Payer: UHC Exchange |
$6.75
|
| Rate for Payer: UHC Exchange |
$7.66
|
| Rate for Payer: UHC Exchange |
$7.66
|
| Rate for Payer: UHC Exchange |
$9.00
|
| Rate for Payer: UHC Medicare Advantage |
$9.00
|
| Rate for Payer: UHC Medicare Advantage |
$7.66
|
| Rate for Payer: UHC Medicare Advantage |
$6.75
|
| Rate for Payer: UHC Medicare Advantage |
$7.66
|
| Rate for Payer: UHCCP Medicaid |
$0.09
|
| Rate for Payer: UHCCP Medicaid |
$0.09
|
| Rate for Payer: UHCCP Medicaid |
$0.09
|
| Rate for Payer: UHCCP Medicaid |
$0.09
|
| Rate for Payer: VA VA |
$9.00
|
| Rate for Payer: VA VA |
$6.75
|
| Rate for Payer: VA VA |
$7.66
|
| Rate for Payer: VA VA |
$7.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.26
|
|
|
METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION
|
Facility
|
OP
|
$199.14
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
4996
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$179.23 |
| Rate for Payer: Aetna Commercial |
$169.27
|
| Rate for Payer: Aetna Commercial |
$49.86
|
| Rate for Payer: Aetna Commercial |
$50.31
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$51.78
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Aetna Medicare |
$15.25
|
| Rate for Payer: Aetna Medicare |
$15.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.50
|
| Rate for Payer: BCBS Complete |
$0.09
|
| Rate for Payer: BCBS Complete |
$0.09
|
| Rate for Payer: BCBS Complete |
$0.09
|
| Rate for Payer: BCBS Complete |
$0.09
|
| Rate for Payer: BCBS MAPPO |
$49.78
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS MAPPO |
$14.80
|
| Rate for Payer: BCBS MAPPO |
$14.66
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCBS Trust/PPO |
$48.66
|
| Rate for Payer: BCBS Trust/PPO |
$48.22
|
| Rate for Payer: BCBS Trust/PPO |
$163.71
|
| Rate for Payer: BCN Commercial |
$20.14
|
| Rate for Payer: BCN Commercial |
$45.61
|
| Rate for Payer: BCN Commercial |
$154.83
|
| Rate for Payer: BCN Commercial |
$46.02
|
| Rate for Payer: BCN Medicare Advantage |
$49.78
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: BCN Medicare Advantage |
$14.80
|
| Rate for Payer: BCN Medicare Advantage |
$14.66
|
| Rate for Payer: Cash Price |
$46.93
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$159.31
|
| Rate for Payer: Cash Price |
$47.35
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$159.31
|
| Rate for Payer: Cash Price |
$47.35
|
| Rate for Payer: Cash Price |
$46.93
|
| Rate for Payer: Cofinity Commercial |
$171.26
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Cofinity Commercial |
$50.90
|
| Rate for Payer: Cofinity Commercial |
$50.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.66
|
| Rate for Payer: Healthscope Commercial |
$179.23
|
| Rate for Payer: Healthscope Commercial |
$52.79
|
| Rate for Payer: Healthscope Commercial |
$53.27
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.99
|
| Rate for Payer: Mclaren Medicaid |
$0.09
|
| Rate for Payer: Mclaren Medicaid |
$0.09
|
| Rate for Payer: Mclaren Medicaid |
$0.09
|
| Rate for Payer: Mclaren Medicaid |
$0.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.54
|
| Rate for Payer: Meridian Medicaid |
$0.09
|
| Rate for Payer: Meridian Medicaid |
$0.09
|
| Rate for Payer: Meridian Medicaid |
$0.09
|
| Rate for Payer: Meridian Medicaid |
$0.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.31
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Nomi Health Commercial |
$48.54
|
| Rate for Payer: Nomi Health Commercial |
$48.10
|
| Rate for Payer: Nomi Health Commercial |
$163.29
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE Senior Care Partners |
$14.06
|
| Rate for Payer: PACE Senior Care Partners |
$13.93
|
| Rate for Payer: PACE Senior Care Partners |
$47.30
|
| Rate for Payer: PACE SWMI |
$14.80
|
| Rate for Payer: PACE SWMI |
$14.66
|
| Rate for Payer: PACE SWMI |
$49.78
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$50.31
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Commercial |
$169.27
|
| Rate for Payer: PHP Commercial |
$49.86
|
| Rate for Payer: PHP Medicare Advantage |
$14.80
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: PHP Medicare Advantage |
$14.66
|
| Rate for Payer: PHP Medicare Advantage |
$49.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.44
|
| Rate for Payer: Priority Health HMO/PPO |
$51.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health HMO/PPO |
$51.03
|
| Rate for Payer: Priority Health HMO/PPO |
$173.25
|
| Rate for Payer: Priority Health Medicare |
$14.95
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Medicare |
$14.81
|
| Rate for Payer: Priority Health Medicare |
$50.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.42
|
| Rate for Payer: Railroad Medicare Medicare |
$14.66
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: Railroad Medicare Medicare |
$49.78
|
| Rate for Payer: Railroad Medicare Medicare |
$14.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$166.28
|
| Rate for Payer: UHC Core |
$49.42
|
| Rate for Payer: UHC Core |
$48.98
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.66
|
| Rate for Payer: UHC Exchange |
$49.78
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Exchange |
$14.66
|
| Rate for Payer: UHC Exchange |
$14.80
|
| Rate for Payer: UHC Medicare Advantage |
$14.80
|
| Rate for Payer: UHC Medicare Advantage |
$14.66
|
| Rate for Payer: UHC Medicare Advantage |
$49.78
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$0.09
|
| Rate for Payer: UHCCP Medicaid |
$0.09
|
| Rate for Payer: UHCCP Medicaid |
$0.09
|
| Rate for Payer: UHCCP Medicaid |
$0.09
|
| Rate for Payer: VA VA |
$14.80
|
| Rate for Payer: VA VA |
$49.78
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: VA VA |
$14.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.35
|
|
|
METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION
|
Facility
|
IP
|
$58.66
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
4996
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$52.79 |
| Rate for Payer: Aetna Commercial |
$49.86
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Commercial |
$169.27
|
| Rate for Payer: Aetna Commercial |
$50.31
|
| Rate for Payer: BCBS Trust/PPO |
$47.88
|
| Rate for Payer: BCBS Trust/PPO |
$48.32
|
| Rate for Payer: BCBS Trust/PPO |
$21.14
|
| Rate for Payer: BCBS Trust/PPO |
$162.56
|
| Rate for Payer: BCN Commercial |
$45.33
|
| Rate for Payer: BCN Commercial |
$153.90
|
| Rate for Payer: BCN Commercial |
$45.74
|
| Rate for Payer: BCN Commercial |
$20.02
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$46.93
|
| Rate for Payer: Cash Price |
$47.35
|
| Rate for Payer: Cash Price |
$159.31
|
| Rate for Payer: Cofinity Commercial |
$171.26
|
| Rate for Payer: Cofinity Commercial |
$50.90
|
| Rate for Payer: Cofinity Commercial |
$50.45
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.35
|
| Rate for Payer: Healthscope Commercial |
$53.27
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Healthscope Commercial |
$52.79
|
| Rate for Payer: Healthscope Commercial |
$179.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.31
|
| Rate for Payer: Nomi Health Commercial |
$163.29
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Nomi Health Commercial |
$48.54
|
| Rate for Payer: Nomi Health Commercial |
$48.10
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Commercial |
$169.27
|
| Rate for Payer: PHP Commercial |
$49.86
|
| Rate for Payer: PHP Commercial |
$50.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.13
|
| Rate for Payer: Priority Health HMO/PPO |
$51.03
|
| Rate for Payer: Priority Health HMO/PPO |
$51.50
|
| Rate for Payer: Priority Health HMO/PPO |
$173.25
|
| Rate for Payer: Priority Health HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.62
|
| Rate for Payer: UHC Core |
$48.98
|
| Rate for Payer: UHC Core |
$49.42
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Core |
$166.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.99
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$34.49
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10577
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.42 |
| Max. Negotiated Rate |
$31.04 |
| Rate for Payer: Aetna Commercial |
$29.32
|
| Rate for Payer: Aetna Commercial |
$162.01
|
| Rate for Payer: Aetna Commercial |
$120.36
|
| Rate for Payer: Aetna Commercial |
$46.08
|
| Rate for Payer: BCBS Trust/PPO |
$28.15
|
| Rate for Payer: BCBS Trust/PPO |
$44.25
|
| Rate for Payer: BCBS Trust/PPO |
$155.59
|
| Rate for Payer: BCBS Trust/PPO |
$115.59
|
| Rate for Payer: BCN Commercial |
$26.65
|
| Rate for Payer: BCN Commercial |
$109.43
|
| Rate for Payer: BCN Commercial |
$41.89
|
| Rate for Payer: BCN Commercial |
$147.30
|
| Rate for Payer: Cash Price |
$152.48
|
| Rate for Payer: Cash Price |
$27.59
|
| Rate for Payer: Cash Price |
$43.37
|
| Rate for Payer: Cash Price |
$113.28
|
| Rate for Payer: Cofinity Commercial |
$121.78
|
| Rate for Payer: Cofinity Commercial |
$46.62
|
| Rate for Payer: Cofinity Commercial |
$29.66
|
| Rate for Payer: Cofinity Commercial |
$163.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.37
|
| Rate for Payer: Healthscope Commercial |
$48.79
|
| Rate for Payer: Healthscope Commercial |
$171.54
|
| Rate for Payer: Healthscope Commercial |
$31.04
|
| Rate for Payer: Healthscope Commercial |
$127.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.08
|
| Rate for Payer: Nomi Health Commercial |
$116.11
|
| Rate for Payer: Nomi Health Commercial |
$156.29
|
| Rate for Payer: Nomi Health Commercial |
$44.45
|
| Rate for Payer: Nomi Health Commercial |
$28.28
|
| Rate for Payer: PHP Commercial |
$162.01
|
| Rate for Payer: PHP Commercial |
$120.36
|
| Rate for Payer: PHP Commercial |
$29.32
|
| Rate for Payer: PHP Commercial |
$46.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.42
|
| Rate for Payer: Priority Health HMO/PPO |
$30.01
|
| Rate for Payer: Priority Health HMO/PPO |
$47.16
|
| Rate for Payer: Priority Health HMO/PPO |
$123.19
|
| Rate for Payer: Priority Health HMO/PPO |
$165.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.35
|
| Rate for Payer: UHC Core |
$28.80
|
| Rate for Payer: UHC Core |
$45.27
|
| Rate for Payer: UHC Core |
$159.15
|
| Rate for Payer: UHC Core |
$118.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.87
|
|
