|
METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$141.60
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10577
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$127.44 |
| Rate for Payer: Aetna Commercial |
$120.36
|
| Rate for Payer: Aetna Commercial |
$29.32
|
| Rate for Payer: Aetna Commercial |
$46.08
|
| Rate for Payer: Aetna Commercial |
$162.01
|
| Rate for Payer: Aetna Medicare |
$36.82
|
| Rate for Payer: Aetna Medicare |
$49.56
|
| Rate for Payer: Aetna Medicare |
$8.97
|
| Rate for Payer: Aetna Medicare |
$14.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.94
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: BCBS MAPPO |
$35.40
|
| Rate for Payer: BCBS MAPPO |
$47.65
|
| Rate for Payer: BCBS MAPPO |
$13.55
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$156.69
|
| Rate for Payer: BCBS Trust/PPO |
$44.57
|
| Rate for Payer: BCBS Trust/PPO |
$28.35
|
| Rate for Payer: BCBS Trust/PPO |
$116.41
|
| Rate for Payer: BCN Commercial |
$148.19
|
| Rate for Payer: BCN Commercial |
$26.82
|
| Rate for Payer: BCN Commercial |
$110.09
|
| Rate for Payer: BCN Commercial |
$42.15
|
| Rate for Payer: BCN Medicare Advantage |
$35.40
|
| Rate for Payer: BCN Medicare Advantage |
$47.65
|
| Rate for Payer: BCN Medicare Advantage |
$13.55
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$27.59
|
| Rate for Payer: Cash Price |
$152.48
|
| Rate for Payer: Cash Price |
$113.28
|
| Rate for Payer: Cash Price |
$43.37
|
| Rate for Payer: Cash Price |
$152.48
|
| Rate for Payer: Cash Price |
$113.28
|
| Rate for Payer: Cash Price |
$43.37
|
| Rate for Payer: Cash Price |
$27.59
|
| Rate for Payer: Cofinity Commercial |
$121.78
|
| Rate for Payer: Cofinity Commercial |
$163.92
|
| Rate for Payer: Cofinity Commercial |
$46.62
|
| Rate for Payer: Cofinity Commercial |
$29.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$127.44
|
| Rate for Payer: Healthscope Commercial |
$31.04
|
| Rate for Payer: Healthscope Commercial |
$48.79
|
| Rate for Payer: Healthscope Commercial |
$171.54
|
| 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 |
$106.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.87
|
| Rate for Payer: Mclaren Medicaid |
$0.15
|
| Rate for Payer: Mclaren Medicaid |
$0.15
|
| Rate for Payer: Mclaren Medicaid |
$0.15
|
| Rate for Payer: Mclaren Medicaid |
$0.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.23
|
| Rate for Payer: Meridian Medicaid |
$0.16
|
| Rate for Payer: Meridian Medicaid |
$0.16
|
| Rate for Payer: Meridian Medicaid |
$0.16
|
| Rate for Payer: Meridian Medicaid |
$0.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.08
|
| 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: Nomi Health Commercial |
$116.11
|
| Rate for Payer: PACE Senior Care Partners |
$45.27
|
| Rate for Payer: PACE Senior Care Partners |
$12.87
|
| Rate for Payer: PACE Senior Care Partners |
$8.19
|
| Rate for Payer: PACE Senior Care Partners |
$33.63
|
| Rate for Payer: PACE SWMI |
$13.55
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PACE SWMI |
$35.40
|
| Rate for Payer: PACE SWMI |
$47.65
|
| Rate for Payer: PHP Commercial |
$46.08
|
| 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 Medicare Advantage |
$13.55
|
| Rate for Payer: PHP Medicare Advantage |
$47.65
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: PHP Medicare Advantage |
$35.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.24
|
| 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 Cigna Priority Health |
$92.04
|
| Rate for Payer: Priority Health HMO/PPO |
$47.16
|
| Rate for Payer: Priority Health HMO/PPO |
$165.82
|
| Rate for Payer: Priority Health HMO/PPO |
$30.01
|
| Rate for Payer: Priority Health HMO/PPO |
$123.19
|
| Rate for Payer: Priority Health Medicare |
$13.69
|
| Rate for Payer: Priority Health Medicare |
$48.13
|
| Rate for Payer: Priority Health Medicare |
$8.71
|
| Rate for Payer: Priority Health Medicare |
$35.75
|
| 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: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: Railroad Medicare Medicare |
$47.65
|
| Rate for Payer: Railroad Medicare Medicare |
$35.40
|
| Rate for Payer: Railroad Medicare Medicare |
$13.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.73
|
| Rate for Payer: UHC Core |
$118.24
|
| Rate for Payer: UHC Core |
$45.27
|
| Rate for Payer: UHC Core |
$28.80
|
| Rate for Payer: UHC Core |
$159.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Exchange |
$35.40
|
| Rate for Payer: UHC Exchange |
$47.65
|
| Rate for Payer: UHC Exchange |
$8.62
|
| Rate for Payer: UHC Exchange |
$13.55
|
| Rate for Payer: UHC Medicare Advantage |
$13.55
|
| Rate for Payer: UHC Medicare Advantage |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$35.40
|
| Rate for Payer: UHC Medicare Advantage |
$47.65
|
| Rate for Payer: UHCCP Medicaid |
$0.15
|
| Rate for Payer: UHCCP Medicaid |
$0.15
|
| Rate for Payer: UHCCP Medicaid |
$0.15
|
| Rate for Payer: UHCCP Medicaid |
$0.15
|
| Rate for Payer: VA VA |
$13.55
|
| Rate for Payer: VA VA |
$35.40
|
| Rate for Payer: VA VA |
$47.65
|
| Rate for Payer: VA VA |
$8.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.20
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION
|
Facility
|
IP
|
$48.18
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10578
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$31.32 |
| Max. Negotiated Rate |
$43.36 |
| Rate for Payer: Aetna Commercial |
$40.95
|
| Rate for Payer: BCBS Trust/PPO |
$39.33
|
| Rate for Payer: BCN Commercial |
$37.23
|
| Rate for Payer: Cash Price |
$38.54
|
| Rate for Payer: Cofinity Commercial |
$41.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.54
|
| Rate for Payer: Healthscope Commercial |
$43.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.95
|
| Rate for Payer: Nomi Health Commercial |
$39.51
|
| Rate for Payer: PHP Commercial |
$40.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.32
|
| Rate for Payer: Priority Health HMO/PPO |
$41.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.40
|
| Rate for Payer: UHC Core |
$40.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.13
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION
|
Facility
|
OP
|
$48.18
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10578
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$43.36 |
| Rate for Payer: Aetna Commercial |
$40.95
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: BCBS MAPPO |
$12.04
|
| Rate for Payer: BCBS Trust/PPO |
$39.61
|
| Rate for Payer: BCN Commercial |
$37.46
|
| Rate for Payer: BCN Medicare Advantage |
$12.04
|
| Rate for Payer: Cash Price |
$38.54
|
| Rate for Payer: Cash Price |
$38.54
|
| Rate for Payer: Cofinity Commercial |
$41.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.04
|
| Rate for Payer: Healthscope Commercial |
$43.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.13
|
| Rate for Payer: Mclaren Medicaid |
$0.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$0.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.95
|
| Rate for Payer: Nomi Health Commercial |
$39.51
|
| Rate for Payer: PACE Senior Care Partners |
$11.44
|
| Rate for Payer: PACE SWMI |
$12.04
|
| Rate for Payer: PHP Commercial |
$40.95
|
| Rate for Payer: PHP Medicare Advantage |
$12.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.32
|
| Rate for Payer: Priority Health HMO/PPO |
$41.92
|
| Rate for Payer: Priority Health Medicare |
$12.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.28
|
| Rate for Payer: Railroad Medicare Medicare |
$12.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.40
|
| Rate for Payer: UHC Core |
$40.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.04
|
| Rate for Payer: UHC Exchange |
$12.04
|
| Rate for Payer: UHC Medicare Advantage |
$12.04
|
| Rate for Payer: UHCCP Medicaid |
$0.15
|
| Rate for Payer: VA VA |
$12.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.13
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION
|
Facility
|
OP
|
$16.70
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10580
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$15.03 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare |
$4.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.22
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: BCBS MAPPO |
$4.17
|
| Rate for Payer: BCBS Trust/PPO |
$13.73
|
| Rate for Payer: BCN Commercial |
$12.98
|
| Rate for Payer: BCN Medicare Advantage |
$4.17
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cofinity Commercial |
$14.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.17
|
| Rate for Payer: Healthscope Commercial |
$15.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.53
|
| Rate for Payer: Mclaren Medicaid |
$0.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.38
|
| Rate for Payer: Meridian Medicaid |
$0.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.20
|
| Rate for Payer: Nomi Health Commercial |
$13.69
|
| Rate for Payer: PACE Senior Care Partners |
$3.97
|
| Rate for Payer: PACE SWMI |
$4.17
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: PHP Medicare Advantage |
$4.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.86
|
| Rate for Payer: Priority Health HMO/PPO |
$14.53
|
| Rate for Payer: Priority Health Medicare |
$4.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.19
|
| Rate for Payer: Railroad Medicare Medicare |
$4.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.70
|
| Rate for Payer: UHC Core |
$13.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.17
|
| Rate for Payer: UHC Exchange |
$4.17
|
| Rate for Payer: UHC Medicare Advantage |
$4.17
|
| Rate for Payer: UHCCP Medicaid |
$0.15
|
| Rate for Payer: VA VA |
$4.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.53
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION
|
Facility
|
IP
|
$16.70
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10580
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$15.03 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: BCBS Trust/PPO |
$13.63
|
| Rate for Payer: BCN Commercial |
$12.91
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cofinity Commercial |
$14.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$15.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.20
|
| Rate for Payer: Nomi Health Commercial |
$13.69
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.86
|
| Rate for Payer: Priority Health HMO/PPO |
$14.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.70
|
| Rate for Payer: UHC Core |
$13.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.53
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$105.11
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10581
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$94.60 |
| Rate for Payer: Aetna Commercial |
$89.34
|
| Rate for Payer: Aetna Medicare |
$27.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.85
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: BCBS MAPPO |
$26.28
|
| Rate for Payer: BCBS Trust/PPO |
$86.41
|
| Rate for Payer: BCN Commercial |
$81.72
|
| Rate for Payer: BCN Medicare Advantage |
$26.28
|
| Rate for Payer: Cash Price |
$84.09
|
| Rate for Payer: Cash Price |
$84.09
|
| Rate for Payer: Cofinity Commercial |
$90.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.28
|
| Rate for Payer: Healthscope Commercial |
$94.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.83
|
| Rate for Payer: Mclaren Medicaid |
$0.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.59
|
| Rate for Payer: Meridian Medicaid |
$0.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.34
|
| Rate for Payer: Nomi Health Commercial |
$86.19
|
| Rate for Payer: PACE Senior Care Partners |
$24.96
|
| Rate for Payer: PACE SWMI |
$26.28
|
| Rate for Payer: PHP Commercial |
$89.34
|
| Rate for Payer: PHP Medicare Advantage |
$26.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.32
|
| Rate for Payer: Priority Health HMO/PPO |
$91.45
|
| Rate for Payer: Priority Health Medicare |
$26.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.42
|
| Rate for Payer: Railroad Medicare Medicare |
$26.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.50
|
| Rate for Payer: UHC Core |
$87.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.28
|
| Rate for Payer: UHC Exchange |
$26.28
|
| Rate for Payer: UHC Medicare Advantage |
$26.28
|
| Rate for Payer: UHCCP Medicaid |
$0.15
|
| Rate for Payer: VA VA |
$26.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.83
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$105.11
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10581
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$68.32 |
| Max. Negotiated Rate |
$94.60 |
| Rate for Payer: Aetna Commercial |
$89.34
|
| Rate for Payer: BCBS Trust/PPO |
$85.80
|
| Rate for Payer: BCN Commercial |
$81.23
|
| Rate for Payer: Cash Price |
$84.09
|
| Rate for Payer: Cofinity Commercial |
$90.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.09
|
| Rate for Payer: Healthscope Commercial |
$94.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.34
|
| Rate for Payer: Nomi Health Commercial |
$86.19
|
| Rate for Payer: PHP Commercial |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.32
|
| Rate for Payer: Priority Health HMO/PPO |
$91.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.50
|
| Rate for Payer: UHC Core |
$87.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.83
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOL (CODE)
|
Facility
|
IP
|
$34.95
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
163731
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.72 |
| Max. Negotiated Rate |
$31.45 |
| Rate for Payer: Aetna Commercial |
$29.71
|
| Rate for Payer: BCBS Trust/PPO |
$28.53
|
| Rate for Payer: BCN Commercial |
$27.01
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cofinity Commercial |
$30.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.96
|
| Rate for Payer: Healthscope Commercial |
$31.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.71
|
| Rate for Payer: Nomi Health Commercial |
$28.66
|
| Rate for Payer: PHP Commercial |
$29.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.72
|
| Rate for Payer: Priority Health HMO/PPO |
$30.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.76
|
| Rate for Payer: UHC Core |
$29.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.21
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOL (CODE)
|
Facility
|
OP
|
$34.95
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
163731
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$31.45 |
| Rate for Payer: Aetna Commercial |
$29.71
|
| Rate for Payer: Aetna Medicare |
$9.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.92
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: BCBS MAPPO |
$8.74
|
| Rate for Payer: BCBS Trust/PPO |
$28.73
|
| Rate for Payer: BCN Commercial |
$27.17
|
| Rate for Payer: BCN Medicare Advantage |
$8.74
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cofinity Commercial |
$30.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.74
|
| Rate for Payer: Healthscope Commercial |
$31.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.21
|
| Rate for Payer: Mclaren Medicaid |
$0.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.17
|
| Rate for Payer: Meridian Medicaid |
$0.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.71
|
| Rate for Payer: Nomi Health Commercial |
$28.66
|
| Rate for Payer: PACE Senior Care Partners |
$8.30
|
| Rate for Payer: PACE SWMI |
$8.74
|
| Rate for Payer: PHP Commercial |
$29.71
|
| Rate for Payer: PHP Medicare Advantage |
$8.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.72
|
| Rate for Payer: Priority Health HMO/PPO |
$30.41
|
| Rate for Payer: Priority Health Medicare |
$8.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.42
|
| Rate for Payer: Railroad Medicare Medicare |
$8.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.76
|
| Rate for Payer: UHC Core |
$29.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.74
|
| Rate for Payer: UHC Exchange |
$8.74
|
| Rate for Payer: UHC Medicare Advantage |
$8.74
|
| Rate for Payer: UHCCP Medicaid |
$0.15
|
| Rate for Payer: VA VA |
$8.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.21
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION
|
Facility
|
IP
|
$34.95
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
119451
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.72 |
| Max. Negotiated Rate |
$31.45 |
| Rate for Payer: Aetna Commercial |
$29.71
|
| Rate for Payer: BCBS Trust/PPO |
$28.53
|
| Rate for Payer: BCN Commercial |
$27.01
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cofinity Commercial |
$30.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.96
|
| Rate for Payer: Healthscope Commercial |
$31.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.71
|
| Rate for Payer: Nomi Health Commercial |
$28.66
|
| Rate for Payer: PHP Commercial |
$29.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.72
|
| Rate for Payer: Priority Health HMO/PPO |
$30.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.76
|
| Rate for Payer: UHC Core |
$29.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.21
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION
|
Facility
|
OP
|
$34.95
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
119451
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$31.45 |
| Rate for Payer: Aetna Commercial |
$29.71
|
| Rate for Payer: Aetna Medicare |
$9.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.92
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: BCBS MAPPO |
$8.74
|
| Rate for Payer: BCBS Trust/PPO |
$28.73
|
| Rate for Payer: BCN Commercial |
$27.17
|
| Rate for Payer: BCN Medicare Advantage |
$8.74
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cofinity Commercial |
$30.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.74
|
| Rate for Payer: Healthscope Commercial |
$31.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.21
|
| Rate for Payer: Mclaren Medicaid |
$0.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.17
|
| Rate for Payer: Meridian Medicaid |
$0.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.71
|
| Rate for Payer: Nomi Health Commercial |
$28.66
|
| Rate for Payer: PACE Senior Care Partners |
$8.30
|
| Rate for Payer: PACE SWMI |
$8.74
|
| Rate for Payer: PHP Commercial |
$29.71
|
| Rate for Payer: PHP Medicare Advantage |
$8.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.72
|
| Rate for Payer: Priority Health HMO/PPO |
$30.41
|
| Rate for Payer: Priority Health Medicare |
$8.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.42
|
| Rate for Payer: Railroad Medicare Medicare |
$8.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.76
|
| Rate for Payer: UHC Core |
$29.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.74
|
| Rate for Payer: UHC Exchange |
$8.74
|
| Rate for Payer: UHC Medicare Advantage |
$8.74
|
| Rate for Payer: UHCCP Medicaid |
$0.15
|
| Rate for Payer: VA VA |
$8.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.21
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION
|
Facility
|
OP
|
$21.97
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
119450
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$19.77 |
| Rate for Payer: Aetna Commercial |
$18.67
|
| Rate for Payer: Aetna Medicare |
$5.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.87
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: BCBS MAPPO |
$5.49
|
| Rate for Payer: BCBS Trust/PPO |
$18.06
|
| Rate for Payer: BCN Commercial |
$17.08
|
| Rate for Payer: BCN Medicare Advantage |
$5.49
|
| Rate for Payer: Cash Price |
$17.58
|
| Rate for Payer: Cash Price |
$17.58
|
| Rate for Payer: Cofinity Commercial |
$18.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.49
|
| Rate for Payer: Healthscope Commercial |
$19.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.48
|
| Rate for Payer: Mclaren Medicaid |
$0.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.77
|
| Rate for Payer: Meridian Medicaid |
$0.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.67
|
| Rate for Payer: Nomi Health Commercial |
$18.02
|
| Rate for Payer: PACE Senior Care Partners |
$5.22
|
| Rate for Payer: PACE SWMI |
$5.49
|
| Rate for Payer: PHP Commercial |
$18.67
|
| Rate for Payer: PHP Medicare Advantage |
$5.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO |
$19.11
|
| Rate for Payer: Priority Health Medicare |
$5.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.72
|
| Rate for Payer: Railroad Medicare Medicare |
$5.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.33
|
| Rate for Payer: UHC Core |
$18.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.49
|
| Rate for Payer: UHC Exchange |
$5.49
|
| Rate for Payer: UHC Medicare Advantage |
$5.49
|
| Rate for Payer: UHCCP Medicaid |
$0.15
|
| Rate for Payer: VA VA |
$5.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.48
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION
|
Facility
|
IP
|
$21.97
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
119450
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$19.77 |
| Rate for Payer: Aetna Commercial |
$18.67
|
| Rate for Payer: BCBS Trust/PPO |
$17.93
|
| Rate for Payer: BCN Commercial |
$16.98
|
| Rate for Payer: Cash Price |
$17.58
|
| Rate for Payer: Cofinity Commercial |
$18.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.58
|
| Rate for Payer: Healthscope Commercial |
$19.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.67
|
| Rate for Payer: Nomi Health Commercial |
$18.02
|
| Rate for Payer: PHP Commercial |
$18.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO |
$19.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.33
|
| Rate for Payer: UHC Core |
$18.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.48
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
IP
|
$12.24
|
|
|
Service Code
|
NDC 41167006006
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$9.99
|
| Rate for Payer: BCN Commercial |
$9.46
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Nomi Health Commercial |
$10.04
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| Rate for Payer: Priority Health HMO/PPO |
$10.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.77
|
| Rate for Payer: UHC Core |
$10.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
IP
|
$11.48
|
|
|
Service Code
|
NDC 00536134957
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$10.33 |
| Rate for Payer: Aetna Commercial |
$9.76
|
| Rate for Payer: BCBS Trust/PPO |
$9.37
|
| Rate for Payer: BCN Commercial |
$8.87
|
| Rate for Payer: Cash Price |
$9.18
|
| Rate for Payer: Cofinity Commercial |
$9.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.18
|
| Rate for Payer: Healthscope Commercial |
$10.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.76
|
| Rate for Payer: Nomi Health Commercial |
$9.41
|
| Rate for Payer: PHP Commercial |
$9.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.46
|
| Rate for Payer: Priority Health HMO/PPO |
$9.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.10
|
| Rate for Payer: UHC Core |
$9.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.61
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
OP
|
$11.48
|
|
|
Service Code
|
NDC 00536134957
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$10.33 |
| Rate for Payer: Aetna Commercial |
$9.76
|
| Rate for Payer: Aetna Medicare |
$2.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.59
|
| Rate for Payer: BCBS Complete |
$4.59
|
| Rate for Payer: BCBS MAPPO |
$2.87
|
| Rate for Payer: BCBS Trust/PPO |
$9.44
|
| Rate for Payer: BCN Commercial |
$8.93
|
| Rate for Payer: BCN Medicare Advantage |
$2.87
|
| Rate for Payer: Cash Price |
$9.18
|
| Rate for Payer: Cofinity Commercial |
$9.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.87
|
| Rate for Payer: Healthscope Commercial |
$10.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.76
|
| Rate for Payer: Nomi Health Commercial |
$9.41
|
| Rate for Payer: PACE Senior Care Partners |
$2.73
|
| Rate for Payer: PACE SWMI |
$2.87
|
| Rate for Payer: PHP Commercial |
$9.76
|
| Rate for Payer: PHP Medicare Advantage |
$2.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.46
|
| Rate for Payer: Priority Health HMO/PPO |
$9.99
|
| Rate for Payer: Priority Health Medicare |
$2.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.69
|
| Rate for Payer: Railroad Medicare Medicare |
$2.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.10
|
| Rate for Payer: UHC Core |
$9.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.87
|
| Rate for Payer: UHC Exchange |
$2.87
|
| Rate for Payer: UHC Medicare Advantage |
$2.87
|
| Rate for Payer: VA VA |
$2.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.61
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
IP
|
$12.24
|
|
|
Service Code
|
NDC 41167006003
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$9.99
|
| Rate for Payer: BCN Commercial |
$9.46
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Nomi Health Commercial |
$10.04
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| Rate for Payer: Priority Health HMO/PPO |
$10.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.77
|
| Rate for Payer: UHC Core |
$10.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
IP
|
$12.24
|
|
|
Service Code
|
NDC 45802017453
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$9.99
|
| Rate for Payer: BCN Commercial |
$9.46
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Nomi Health Commercial |
$10.04
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| Rate for Payer: Priority Health HMO/PPO |
$10.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.77
|
| Rate for Payer: UHC Core |
$10.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
OP
|
$12.24
|
|
|
Service Code
|
NDC 41167006006
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: Aetna Medicare |
$3.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.83
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS MAPPO |
$3.06
|
| Rate for Payer: BCBS Trust/PPO |
$10.06
|
| Rate for Payer: BCN Commercial |
$9.52
|
| Rate for Payer: BCN Medicare Advantage |
$3.06
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.06
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Nomi Health Commercial |
$10.04
|
| Rate for Payer: PACE Senior Care Partners |
$2.91
|
| Rate for Payer: PACE SWMI |
$3.06
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: PHP Medicare Advantage |
$3.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| Rate for Payer: Priority Health HMO/PPO |
$10.65
|
| Rate for Payer: Priority Health Medicare |
$3.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.20
|
| Rate for Payer: Railroad Medicare Medicare |
$3.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.77
|
| Rate for Payer: UHC Core |
$10.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.06
|
| Rate for Payer: UHC Exchange |
$3.06
|
| Rate for Payer: UHC Medicare Advantage |
$3.06
|
| Rate for Payer: VA VA |
$3.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
OP
|
$12.24
|
|
|
Service Code
|
NDC 45802017453
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: Aetna Medicare |
$3.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.83
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS MAPPO |
$3.06
|
| Rate for Payer: BCBS Trust/PPO |
$10.06
|
| Rate for Payer: BCN Commercial |
$9.52
|
| Rate for Payer: BCN Medicare Advantage |
$3.06
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.06
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Nomi Health Commercial |
$10.04
|
| Rate for Payer: PACE Senior Care Partners |
$2.91
|
| Rate for Payer: PACE SWMI |
$3.06
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: PHP Medicare Advantage |
$3.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| Rate for Payer: Priority Health HMO/PPO |
$10.65
|
| Rate for Payer: Priority Health Medicare |
$3.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.20
|
| Rate for Payer: Railroad Medicare Medicare |
$3.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.77
|
| Rate for Payer: UHC Core |
$10.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.06
|
| Rate for Payer: UHC Exchange |
$3.06
|
| Rate for Payer: UHC Medicare Advantage |
$3.06
|
| Rate for Payer: VA VA |
$3.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
OP
|
$12.24
|
|
|
Service Code
|
NDC 41167060003
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: Aetna Medicare |
$3.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.83
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS MAPPO |
$3.06
|
| Rate for Payer: BCBS Trust/PPO |
$10.06
|
| Rate for Payer: BCN Commercial |
$9.52
|
| Rate for Payer: BCN Medicare Advantage |
$3.06
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.06
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Nomi Health Commercial |
$10.04
|
| Rate for Payer: PACE Senior Care Partners |
$2.91
|
| Rate for Payer: PACE SWMI |
$3.06
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: PHP Medicare Advantage |
$3.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| Rate for Payer: Priority Health HMO/PPO |
$10.65
|
| Rate for Payer: Priority Health Medicare |
$3.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.20
|
| Rate for Payer: Railroad Medicare Medicare |
$3.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.77
|
| Rate for Payer: UHC Core |
$10.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.06
|
| Rate for Payer: UHC Exchange |
$3.06
|
| Rate for Payer: UHC Medicare Advantage |
$3.06
|
| Rate for Payer: VA VA |
$3.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
OP
|
$12.24
|
|
|
Service Code
|
NDC 41167006003
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: Aetna Medicare |
$3.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.83
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS MAPPO |
$3.06
|
| Rate for Payer: BCBS Trust/PPO |
$10.06
|
| Rate for Payer: BCN Commercial |
$9.52
|
| Rate for Payer: BCN Medicare Advantage |
$3.06
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.06
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Nomi Health Commercial |
$10.04
|
| Rate for Payer: PACE Senior Care Partners |
$2.91
|
| Rate for Payer: PACE SWMI |
$3.06
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: PHP Medicare Advantage |
$3.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| Rate for Payer: Priority Health HMO/PPO |
$10.65
|
| Rate for Payer: Priority Health Medicare |
$3.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.20
|
| Rate for Payer: Railroad Medicare Medicare |
$3.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.77
|
| Rate for Payer: UHC Core |
$10.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.06
|
| Rate for Payer: UHC Exchange |
$3.06
|
| Rate for Payer: UHC Medicare Advantage |
$3.06
|
| Rate for Payer: VA VA |
$3.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
IP
|
$12.24
|
|
|
Service Code
|
NDC 41167060003
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$9.99
|
| Rate for Payer: BCN Commercial |
$9.46
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Nomi Health Commercial |
$10.04
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| Rate for Payer: Priority Health HMO/PPO |
$10.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.77
|
| Rate for Payer: UHC Core |
$10.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 1 % TOPICAL CREAM
|
Facility
|
IP
|
$14.54
|
|
|
Service Code
|
NDC 00536110145
|
| Hospital Charge Code |
168488
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.45 |
| Max. Negotiated Rate |
$13.09 |
| Rate for Payer: Aetna Commercial |
$12.36
|
| Rate for Payer: BCBS Trust/PPO |
$11.87
|
| Rate for Payer: BCN Commercial |
$11.24
|
| Rate for Payer: Cash Price |
$11.63
|
| Rate for Payer: Cofinity Commercial |
$12.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.63
|
| Rate for Payer: Healthscope Commercial |
$13.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.36
|
| Rate for Payer: Nomi Health Commercial |
$11.92
|
| Rate for Payer: PHP Commercial |
$12.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.45
|
| Rate for Payer: Priority Health HMO/PPO |
$12.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.80
|
| Rate for Payer: UHC Core |
$12.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.90
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 1 % TOPICAL CREAM
|
Facility
|
OP
|
$14.54
|
|
|
Service Code
|
NDC 00536110145
|
| Hospital Charge Code |
168488
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.45 |
| Max. Negotiated Rate |
$13.09 |
| Rate for Payer: Aetna Commercial |
$12.36
|
| Rate for Payer: Aetna Medicare |
$3.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.54
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS MAPPO |
$3.63
|
| Rate for Payer: BCBS Trust/PPO |
$11.95
|
| Rate for Payer: BCN Commercial |
$11.30
|
| Rate for Payer: BCN Medicare Advantage |
$3.63
|
| Rate for Payer: Cash Price |
$11.63
|
| Rate for Payer: Cofinity Commercial |
$12.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.63
|
| Rate for Payer: Healthscope Commercial |
$13.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.36
|
| Rate for Payer: Nomi Health Commercial |
$11.92
|
| Rate for Payer: PACE Senior Care Partners |
$3.45
|
| Rate for Payer: PACE SWMI |
$3.63
|
| Rate for Payer: PHP Commercial |
$12.36
|
| Rate for Payer: PHP Medicare Advantage |
$3.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.45
|
| Rate for Payer: Priority Health HMO/PPO |
$12.65
|
| Rate for Payer: Priority Health Medicare |
$3.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.80
|
| Rate for Payer: UHC Core |
$12.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.63
|
| Rate for Payer: UHC Exchange |
$3.63
|
| Rate for Payer: UHC Medicare Advantage |
$3.63
|
| Rate for Payer: VA VA |
$3.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.90
|
|
