|
NEONATE WITH ECMO
|
Facility
|
IP
|
$97,736.30
|
|
|
Service Code
|
APR-DRG 5832
|
| Min. Negotiated Rate |
$93,082.19 |
| Max. Negotiated Rate |
$97,736.30 |
| Rate for Payer: BCBS Complete |
$97,736.30
|
| Rate for Payer: Mclaren Medicaid |
$93,082.19
|
| Rate for Payer: Meridian Medicaid |
$97,736.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$93,082.19
|
| Rate for Payer: UHC Medicaid |
$93,082.19
|
| Rate for Payer: UHCCP Medicaid |
$93,082.19
|
|
|
NEONATE WITH ECMO
|
Facility
|
IP
|
$176,287.33
|
|
|
Service Code
|
APR-DRG 5833
|
| Min. Negotiated Rate |
$167,892.70 |
| Max. Negotiated Rate |
$176,287.33 |
| Rate for Payer: BCBS Complete |
$176,287.33
|
| Rate for Payer: Mclaren Medicaid |
$167,892.70
|
| Rate for Payer: Meridian Medicaid |
$176,287.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$167,892.70
|
| Rate for Payer: UHC Medicaid |
$167,892.70
|
| Rate for Payer: UHCCP Medicaid |
$167,892.70
|
|
|
NEONATE WITH ECMO
|
Facility
|
IP
|
$291,591.95
|
|
|
Service Code
|
APR-DRG 5834
|
| Min. Negotiated Rate |
$277,706.62 |
| Max. Negotiated Rate |
$291,591.95 |
| Rate for Payer: BCBS Complete |
$291,591.95
|
| Rate for Payer: Mclaren Medicaid |
$277,706.62
|
| Rate for Payer: Meridian Medicaid |
$291,591.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$277,706.62
|
| Rate for Payer: UHC Medicaid |
$277,706.62
|
| Rate for Payer: UHCCP Medicaid |
$277,706.62
|
|
|
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$15.47
|
|
|
Service Code
|
HCPCS J2710
|
| Hospital Charge Code |
167219
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$13.92 |
| Rate for Payer: Aetna Commercial |
$13.15
|
| Rate for Payer: Aetna Commercial |
$22.92
|
| Rate for Payer: Aetna Medicare |
$7.01
|
| Rate for Payer: Aetna Medicare |
$4.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.43
|
| Rate for Payer: BCBS Complete |
$2.86
|
| Rate for Payer: BCBS Complete |
$4.99
|
| Rate for Payer: BCBS MAPPO |
$3.87
|
| Rate for Payer: BCBS MAPPO |
$6.74
|
| Rate for Payer: BCBS Trust/PPO |
$12.72
|
| Rate for Payer: BCBS Trust/PPO |
$22.17
|
| Rate for Payer: BCN Commercial |
$22.17
|
| Rate for Payer: BCN Commercial |
$12.72
|
| Rate for Payer: BCN Medicare Advantage |
$6.74
|
| Rate for Payer: BCN Medicare Advantage |
$3.87
|
| Rate for Payer: Cash Price |
$12.38
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cofinity Commercial |
$13.30
|
| Rate for Payer: Cofinity Commercial |
$23.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.87
|
| Rate for Payer: Healthscope Commercial |
$13.92
|
| Rate for Payer: Healthscope Commercial |
$24.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.23
|
| Rate for Payer: Mclaren Medicaid |
$4.75
|
| Rate for Payer: Mclaren Medicaid |
$2.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.06
|
| Rate for Payer: Meridian Medicaid |
$2.86
|
| Rate for Payer: Meridian Medicaid |
$4.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.15
|
| Rate for Payer: Nomi Health Commercial |
$22.12
|
| Rate for Payer: Nomi Health Commercial |
$12.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.23
|
| Rate for Payer: PACE Senior Care Partners |
$6.41
|
| Rate for Payer: PACE Senior Care Partners |
$3.67
|
| Rate for Payer: PACE SWMI |
$6.74
|
| Rate for Payer: PACE SWMI |
$3.87
|
| Rate for Payer: PHP Commercial |
$13.15
|
| Rate for Payer: PHP Commercial |
$22.92
|
| Rate for Payer: PHP Medicare Advantage |
$3.87
|
| Rate for Payer: PHP Medicare Advantage |
$6.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.46
|
| Rate for Payer: Priority Health Medicare |
$6.81
|
| Rate for Payer: Priority Health Medicare |
$3.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.77
|
| Rate for Payer: Railroad Medicare Medicare |
$3.87
|
| Rate for Payer: Railroad Medicare Medicare |
$6.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.73
|
| Rate for Payer: UHC Core |
$22.52
|
| Rate for Payer: UHC Core |
$12.92
|
| Rate for Payer: UHC Exchange |
$6.74
|
| Rate for Payer: UHC Exchange |
$3.87
|
| Rate for Payer: UHC Medicaid |
$4.75
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHC Medicare Advantage |
$3.87
|
| Rate for Payer: UHC Medicare Advantage |
$6.74
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$4.75
|
| Rate for Payer: VA VA |
$3.87
|
| Rate for Payer: VA VA |
$6.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.60
|
|
|
NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$15.47
|
|
|
Service Code
|
HCPCS J2710
|
| Hospital Charge Code |
167219
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.77 |
| Max. Negotiated Rate |
$13.92 |
| Rate for Payer: Aetna Commercial |
$13.15
|
| Rate for Payer: Aetna Commercial |
$22.92
|
| Rate for Payer: BCBS Trust/PPO |
$12.78
|
| Rate for Payer: BCBS Trust/PPO |
$22.27
|
| Rate for Payer: BCN Commercial |
$12.78
|
| Rate for Payer: BCN Commercial |
$22.27
|
| Rate for Payer: Cash Price |
$12.38
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cofinity Commercial |
$23.19
|
| Rate for Payer: Cofinity Commercial |
$13.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.38
|
| Rate for Payer: Healthscope Commercial |
$13.92
|
| Rate for Payer: Healthscope Commercial |
$24.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.92
|
| Rate for Payer: Nomi Health Commercial |
$12.69
|
| Rate for Payer: Nomi Health Commercial |
$22.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.23
|
| Rate for Payer: PHP Commercial |
$22.92
|
| Rate for Payer: PHP Commercial |
$13.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.73
|
| Rate for Payer: UHC Core |
$12.92
|
| Rate for Payer: UHC Core |
$22.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.23
|
|
|
NEPHRITIS AND NEPHROSIS
|
Facility
|
IP
|
$2,992.56
|
|
|
Service Code
|
APR-DRG 4621
|
| Min. Negotiated Rate |
$2,850.05 |
| Max. Negotiated Rate |
$2,992.56 |
| Rate for Payer: BCBS Complete |
$2,992.56
|
| Rate for Payer: Mclaren Medicaid |
$2,850.05
|
| Rate for Payer: Meridian Medicaid |
$2,992.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,850.05
|
| Rate for Payer: UHC Medicaid |
$2,850.05
|
| Rate for Payer: UHCCP Medicaid |
$2,850.05
|
|
|
NEPHRITIS AND NEPHROSIS
|
Facility
|
IP
|
$4,278.76
|
|
|
Service Code
|
APR-DRG 4622
|
| Min. Negotiated Rate |
$4,075.01 |
| Max. Negotiated Rate |
$4,278.76 |
| Rate for Payer: BCBS Complete |
$4,278.76
|
| Rate for Payer: Mclaren Medicaid |
$4,075.01
|
| Rate for Payer: Meridian Medicaid |
$4,278.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,075.01
|
| Rate for Payer: UHC Medicaid |
$4,075.01
|
| Rate for Payer: UHCCP Medicaid |
$4,075.01
|
|
|
NEPHRITIS AND NEPHROSIS
|
Facility
|
IP
|
$7,085.69
|
|
|
Service Code
|
APR-DRG 4623
|
| Min. Negotiated Rate |
$6,748.28 |
| Max. Negotiated Rate |
$7,085.69 |
| Rate for Payer: BCBS Complete |
$7,085.69
|
| Rate for Payer: Mclaren Medicaid |
$6,748.28
|
| Rate for Payer: Meridian Medicaid |
$7,085.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,748.28
|
| Rate for Payer: UHC Medicaid |
$6,748.28
|
| Rate for Payer: UHCCP Medicaid |
$6,748.28
|
|
|
NEPHRITIS AND NEPHROSIS
|
Facility
|
IP
|
$19,923.03
|
|
|
Service Code
|
APR-DRG 4624
|
| Min. Negotiated Rate |
$18,974.31 |
| Max. Negotiated Rate |
$19,923.03 |
| Rate for Payer: BCBS Complete |
$19,923.03
|
| Rate for Payer: Mclaren Medicaid |
$18,974.31
|
| Rate for Payer: Meridian Medicaid |
$19,923.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$18,974.31
|
| Rate for Payer: UHC Medicaid |
$18,974.31
|
| Rate for Payer: UHCCP Medicaid |
$18,974.31
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
|
IP
|
$3,937.49
|
|
|
Service Code
|
APR-DRG 0411
|
| Min. Negotiated Rate |
$3,749.99 |
| Max. Negotiated Rate |
$3,937.49 |
| Rate for Payer: BCBS Complete |
$3,937.49
|
| Rate for Payer: Mclaren Medicaid |
$3,749.99
|
| Rate for Payer: Meridian Medicaid |
$3,937.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,749.99
|
| Rate for Payer: UHC Medicaid |
$3,749.99
|
| Rate for Payer: UHCCP Medicaid |
$3,749.99
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
|
IP
|
$5,123.26
|
|
|
Service Code
|
APR-DRG 0412
|
| Min. Negotiated Rate |
$4,879.29 |
| Max. Negotiated Rate |
$5,123.26 |
| Rate for Payer: BCBS Complete |
$5,123.26
|
| Rate for Payer: Mclaren Medicaid |
$4,879.29
|
| Rate for Payer: Meridian Medicaid |
$5,123.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,879.29
|
| Rate for Payer: UHC Medicaid |
$4,879.29
|
| Rate for Payer: UHCCP Medicaid |
$4,879.29
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
|
IP
|
$7,744.05
|
|
|
Service Code
|
APR-DRG 0413
|
| Min. Negotiated Rate |
$7,375.28 |
| Max. Negotiated Rate |
$7,744.05 |
| Rate for Payer: BCBS Complete |
$7,744.05
|
| Rate for Payer: Mclaren Medicaid |
$7,375.28
|
| Rate for Payer: Meridian Medicaid |
$7,744.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,375.28
|
| Rate for Payer: UHC Medicaid |
$7,375.28
|
| Rate for Payer: UHCCP Medicaid |
$7,375.28
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
|
IP
|
$10,628.80
|
|
|
Service Code
|
APR-DRG 0414
|
| Min. Negotiated Rate |
$10,122.67 |
| Max. Negotiated Rate |
$10,628.80 |
| Rate for Payer: BCBS Complete |
$10,628.80
|
| Rate for Payer: Mclaren Medicaid |
$10,122.67
|
| Rate for Payer: Meridian Medicaid |
$10,628.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,122.67
|
| Rate for Payer: UHC Medicaid |
$10,122.67
|
| Rate for Payer: UHCCP Medicaid |
$10,122.67
|
|
|
NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$238.55
|
|
|
Service Code
|
NDC 65162032109
|
| Hospital Charge Code |
5545
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$42.06 |
| Max. Negotiated Rate |
$214.69 |
| Rate for Payer: Aetna Commercial |
$202.77
|
| Rate for Payer: Aetna Medicare |
$62.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74.55
|
| Rate for Payer: BCBS Complete |
$44.16
|
| Rate for Payer: BCBS MAPPO |
$59.64
|
| Rate for Payer: BCBS Trust/PPO |
$196.11
|
| Rate for Payer: BCN Commercial |
$196.11
|
| Rate for Payer: BCN Medicare Advantage |
$59.64
|
| Rate for Payer: Cash Price |
$190.84
|
| Rate for Payer: Cofinity Commercial |
$205.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.64
|
| Rate for Payer: Healthscope Commercial |
$214.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.91
|
| Rate for Payer: Mclaren Medicaid |
$42.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.62
|
| Rate for Payer: Meridian Medicaid |
$44.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.77
|
| Rate for Payer: Nomi Health Commercial |
$195.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.91
|
| Rate for Payer: PACE Senior Care Partners |
$56.66
|
| Rate for Payer: PACE SWMI |
$59.64
|
| Rate for Payer: PHP Commercial |
$202.77
|
| Rate for Payer: PHP Medicare Advantage |
$59.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$207.54
|
| Rate for Payer: Priority Health Medicare |
$60.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.03
|
| Rate for Payer: Railroad Medicare Medicare |
$59.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.92
|
| Rate for Payer: UHC Core |
$199.19
|
| Rate for Payer: UHC Exchange |
$59.64
|
| Rate for Payer: UHC Medicaid |
$42.06
|
| Rate for Payer: UHC Medicare Advantage |
$59.64
|
| Rate for Payer: UHCCP Medicaid |
$42.06
|
| Rate for Payer: VA VA |
$59.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.91
|
|
|
NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$6.70
|
|
|
Service Code
|
NDC 50268058411
|
| Hospital Charge Code |
5545
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.66 |
| Max. Negotiated Rate |
$6.03 |
| Rate for Payer: Aetna Commercial |
$5.70
|
| Rate for Payer: BCBS Trust/PPO |
$5.53
|
| Rate for Payer: BCN Commercial |
$5.53
|
| Rate for Payer: Cash Price |
$5.36
|
| Rate for Payer: Cofinity Commercial |
$5.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.36
|
| Rate for Payer: Healthscope Commercial |
$6.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.70
|
| Rate for Payer: Nomi Health Commercial |
$5.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.03
|
| Rate for Payer: PHP Commercial |
$5.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.90
|
| Rate for Payer: UHC Core |
$5.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.03
|
|
|
NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$238.55
|
|
|
Service Code
|
NDC 65162032109
|
| Hospital Charge Code |
5545
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$166.03 |
| Max. Negotiated Rate |
$214.69 |
| Rate for Payer: Aetna Commercial |
$202.77
|
| Rate for Payer: BCBS Trust/PPO |
$197.02
|
| Rate for Payer: BCN Commercial |
$197.02
|
| Rate for Payer: Cash Price |
$190.84
|
| Rate for Payer: Cofinity Commercial |
$205.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.84
|
| Rate for Payer: Healthscope Commercial |
$214.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.77
|
| Rate for Payer: Nomi Health Commercial |
$195.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.91
|
| Rate for Payer: PHP Commercial |
$202.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$207.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.92
|
| Rate for Payer: UHC Core |
$199.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.91
|
|
|
NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$6.70
|
|
|
Service Code
|
NDC 50268058411
|
| Hospital Charge Code |
5545
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.18 |
| Max. Negotiated Rate |
$6.03 |
| Rate for Payer: Aetna Commercial |
$5.70
|
| Rate for Payer: Aetna Medicare |
$1.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.09
|
| Rate for Payer: BCBS Complete |
$1.24
|
| Rate for Payer: BCBS MAPPO |
$1.68
|
| Rate for Payer: BCBS Trust/PPO |
$5.51
|
| Rate for Payer: BCN Commercial |
$5.51
|
| Rate for Payer: BCN Medicare Advantage |
$1.68
|
| Rate for Payer: Cash Price |
$5.36
|
| Rate for Payer: Cofinity Commercial |
$5.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.68
|
| Rate for Payer: Healthscope Commercial |
$6.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.03
|
| Rate for Payer: Mclaren Medicaid |
$1.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.76
|
| Rate for Payer: Meridian Medicaid |
$1.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.70
|
| Rate for Payer: Nomi Health Commercial |
$5.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.03
|
| Rate for Payer: PACE Senior Care Partners |
$1.59
|
| Rate for Payer: PACE SWMI |
$1.68
|
| Rate for Payer: PHP Commercial |
$5.70
|
| Rate for Payer: PHP Medicare Advantage |
$1.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.83
|
| Rate for Payer: Priority Health Medicare |
$1.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.66
|
| Rate for Payer: Railroad Medicare Medicare |
$1.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.90
|
| Rate for Payer: UHC Core |
$5.59
|
| Rate for Payer: UHC Exchange |
$1.68
|
| Rate for Payer: UHC Medicaid |
$1.18
|
| Rate for Payer: UHC Medicare Advantage |
$1.68
|
| Rate for Payer: UHCCP Medicaid |
$1.18
|
| Rate for Payer: VA VA |
$1.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.03
|
|
|
NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$200.74
|
|
|
Service Code
|
NDC 50268058413
|
| Hospital Charge Code |
5545
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$139.72 |
| Max. Negotiated Rate |
$180.67 |
| Rate for Payer: Aetna Commercial |
$170.63
|
| Rate for Payer: BCBS Trust/PPO |
$165.79
|
| Rate for Payer: BCN Commercial |
$165.79
|
| Rate for Payer: Cash Price |
$160.59
|
| Rate for Payer: Cofinity Commercial |
$172.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.59
|
| Rate for Payer: Healthscope Commercial |
$180.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.63
|
| Rate for Payer: Nomi Health Commercial |
$164.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.56
|
| Rate for Payer: PHP Commercial |
$170.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$174.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.65
|
| Rate for Payer: UHC Core |
$167.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.56
|
|
|
NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$200.74
|
|
|
Service Code
|
NDC 50268058413
|
| Hospital Charge Code |
5545
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$35.39 |
| Max. Negotiated Rate |
$180.67 |
| Rate for Payer: Aetna Commercial |
$170.63
|
| Rate for Payer: Aetna Medicare |
$52.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.73
|
| Rate for Payer: BCBS Complete |
$37.16
|
| Rate for Payer: BCBS MAPPO |
$50.19
|
| Rate for Payer: BCBS Trust/PPO |
$165.03
|
| Rate for Payer: BCN Commercial |
$165.03
|
| Rate for Payer: BCN Medicare Advantage |
$50.19
|
| Rate for Payer: Cash Price |
$160.59
|
| Rate for Payer: Cofinity Commercial |
$172.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.19
|
| Rate for Payer: Healthscope Commercial |
$180.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.56
|
| Rate for Payer: Mclaren Medicaid |
$35.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.69
|
| Rate for Payer: Meridian Medicaid |
$37.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.63
|
| Rate for Payer: Nomi Health Commercial |
$164.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.56
|
| Rate for Payer: PACE Senior Care Partners |
$47.68
|
| Rate for Payer: PACE SWMI |
$50.19
|
| Rate for Payer: PHP Commercial |
$170.63
|
| Rate for Payer: PHP Medicare Advantage |
$50.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$174.64
|
| Rate for Payer: Priority Health Medicare |
$50.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.72
|
| Rate for Payer: Railroad Medicare Medicare |
$50.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.65
|
| Rate for Payer: UHC Core |
$167.62
|
| Rate for Payer: UHC Exchange |
$50.19
|
| Rate for Payer: UHC Medicaid |
$35.39
|
| Rate for Payer: UHC Medicare Advantage |
$50.19
|
| Rate for Payer: UHCCP Medicaid |
$35.39
|
| Rate for Payer: VA VA |
$50.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.56
|
|
|
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$51.76
|
|
|
Service Code
|
HCPCS J2404
|
| Hospital Charge Code |
12370
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$36.02 |
| Max. Negotiated Rate |
$46.58 |
| Rate for Payer: Aetna Commercial |
$44.00
|
| Rate for Payer: BCBS Trust/PPO |
$42.75
|
| Rate for Payer: BCN Commercial |
$42.75
|
| Rate for Payer: Cash Price |
$41.41
|
| Rate for Payer: Cofinity Commercial |
$44.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.41
|
| Rate for Payer: Healthscope Commercial |
$46.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.00
|
| Rate for Payer: Nomi Health Commercial |
$42.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.82
|
| Rate for Payer: PHP Commercial |
$44.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.55
|
| Rate for Payer: UHC Core |
$43.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.82
|
|
|
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$51.76
|
|
|
Service Code
|
HCPCS J2404
|
| Hospital Charge Code |
12370
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.13 |
| Max. Negotiated Rate |
$46.58 |
| Rate for Payer: Aetna Commercial |
$44.00
|
| Rate for Payer: Aetna Medicare |
$13.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.18
|
| Rate for Payer: BCBS Complete |
$9.58
|
| Rate for Payer: BCBS MAPPO |
$12.94
|
| Rate for Payer: BCBS Trust/PPO |
$42.55
|
| Rate for Payer: BCN Commercial |
$42.55
|
| Rate for Payer: BCN Medicare Advantage |
$12.94
|
| Rate for Payer: Cash Price |
$41.41
|
| Rate for Payer: Cofinity Commercial |
$44.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.94
|
| Rate for Payer: Healthscope Commercial |
$46.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.82
|
| Rate for Payer: Mclaren Medicaid |
$9.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.59
|
| Rate for Payer: Meridian Medicaid |
$9.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.00
|
| Rate for Payer: Nomi Health Commercial |
$42.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.82
|
| Rate for Payer: PACE Senior Care Partners |
$12.29
|
| Rate for Payer: PACE SWMI |
$12.94
|
| Rate for Payer: PHP Commercial |
$44.00
|
| Rate for Payer: PHP Medicare Advantage |
$12.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.03
|
| Rate for Payer: Priority Health Medicare |
$13.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.02
|
| Rate for Payer: Railroad Medicare Medicare |
$12.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.55
|
| Rate for Payer: UHC Core |
$43.22
|
| Rate for Payer: UHC Exchange |
$12.94
|
| Rate for Payer: UHC Medicaid |
$9.13
|
| Rate for Payer: UHC Medicare Advantage |
$12.94
|
| Rate for Payer: UHCCP Medicaid |
$9.13
|
| Rate for Payer: VA VA |
$12.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.82
|
|
|
NICARDIPINE 40 MG/200 ML(0.2 MG/ML) IN SOD CHLOR(ISO) INTRAVENOUS SOLN
|
Facility
|
IP
|
$270.98
|
|
|
Service Code
|
HCPCS J2404
|
| Hospital Charge Code |
94576
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$188.60 |
| Max. Negotiated Rate |
$243.88 |
| Rate for Payer: Aetna Commercial |
$230.33
|
| Rate for Payer: BCBS Trust/PPO |
$223.80
|
| Rate for Payer: BCN Commercial |
$223.80
|
| Rate for Payer: Cash Price |
$216.78
|
| Rate for Payer: Cofinity Commercial |
$233.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.78
|
| Rate for Payer: Healthscope Commercial |
$243.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.33
|
| Rate for Payer: Nomi Health Commercial |
$222.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$203.24
|
| Rate for Payer: PHP Commercial |
$230.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$235.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.46
|
| Rate for Payer: UHC Core |
$226.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.24
|
|
|
NICARDIPINE 40 MG/200 ML(0.2 MG/ML) IN SOD CHLOR(ISO) INTRAVENOUS SOLN
|
Facility
|
OP
|
$270.98
|
|
|
Service Code
|
HCPCS J2404
|
| Hospital Charge Code |
94576
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$47.77 |
| Max. Negotiated Rate |
$243.88 |
| Rate for Payer: Aetna Commercial |
$230.33
|
| Rate for Payer: Aetna Medicare |
$70.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.68
|
| Rate for Payer: BCBS Complete |
$50.16
|
| Rate for Payer: BCBS MAPPO |
$67.75
|
| Rate for Payer: BCBS Trust/PPO |
$222.77
|
| Rate for Payer: BCN Commercial |
$222.77
|
| Rate for Payer: BCN Medicare Advantage |
$67.75
|
| Rate for Payer: Cash Price |
$216.78
|
| Rate for Payer: Cofinity Commercial |
$233.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.75
|
| Rate for Payer: Healthscope Commercial |
$243.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.24
|
| Rate for Payer: Mclaren Medicaid |
$47.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.13
|
| Rate for Payer: Meridian Medicaid |
$50.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.33
|
| Rate for Payer: Nomi Health Commercial |
$222.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$203.24
|
| Rate for Payer: PACE Senior Care Partners |
$64.36
|
| Rate for Payer: PACE SWMI |
$67.75
|
| Rate for Payer: PHP Commercial |
$230.33
|
| Rate for Payer: PHP Medicare Advantage |
$67.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$235.75
|
| Rate for Payer: Priority Health Medicare |
$68.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.60
|
| Rate for Payer: Railroad Medicare Medicare |
$67.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.46
|
| Rate for Payer: UHC Core |
$226.27
|
| Rate for Payer: UHC Exchange |
$67.75
|
| Rate for Payer: UHC Medicaid |
$47.77
|
| Rate for Payer: UHC Medicare Advantage |
$67.75
|
| Rate for Payer: UHCCP Medicaid |
$47.77
|
| Rate for Payer: VA VA |
$67.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.24
|
|
|
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH
|
Facility
|
IP
|
$111.15
|
|
|
Service Code
|
NDC 43598044774
|
| Hospital Charge Code |
27862
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$77.36 |
| Max. Negotiated Rate |
$100.03 |
| Rate for Payer: Aetna Commercial |
$94.48
|
| Rate for Payer: BCBS Trust/PPO |
$91.80
|
| Rate for Payer: BCN Commercial |
$91.80
|
| Rate for Payer: Cash Price |
$88.92
|
| Rate for Payer: Cofinity Commercial |
$95.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.92
|
| Rate for Payer: Healthscope Commercial |
$100.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.48
|
| Rate for Payer: Nomi Health Commercial |
$91.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.36
|
| Rate for Payer: PHP Commercial |
$94.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.81
|
| Rate for Payer: UHC Core |
$92.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.36
|
|
|
NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH
|
Facility
|
OP
|
$8.63
|
|
|
Service Code
|
NDC 60505706200
|
| Hospital Charge Code |
27862
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.52 |
| Max. Negotiated Rate |
$7.77 |
| Rate for Payer: Aetna Commercial |
$7.34
|
| Rate for Payer: Aetna Medicare |
$2.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.70
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: BCBS MAPPO |
$2.16
|
| Rate for Payer: BCBS Trust/PPO |
$7.09
|
| Rate for Payer: BCN Commercial |
$7.09
|
| Rate for Payer: BCN Medicare Advantage |
$2.16
|
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Cofinity Commercial |
$7.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.16
|
| Rate for Payer: Healthscope Commercial |
$7.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.47
|
| Rate for Payer: Mclaren Medicaid |
$1.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.27
|
| Rate for Payer: Meridian Medicaid |
$1.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.34
|
| Rate for Payer: Nomi Health Commercial |
$7.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.47
|
| Rate for Payer: PACE Senior Care Partners |
$2.05
|
| Rate for Payer: PACE SWMI |
$2.16
|
| Rate for Payer: PHP Commercial |
$7.34
|
| Rate for Payer: PHP Medicare Advantage |
$2.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.51
|
| Rate for Payer: Priority Health Medicare |
$2.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.01
|
| Rate for Payer: Railroad Medicare Medicare |
$2.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.59
|
| Rate for Payer: UHC Core |
$7.21
|
| Rate for Payer: UHC Exchange |
$2.16
|
| Rate for Payer: UHC Medicaid |
$1.52
|
| Rate for Payer: UHC Medicare Advantage |
$2.16
|
| Rate for Payer: UHCCP Medicaid |
$1.52
|
| Rate for Payer: VA VA |
$2.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.47
|
|
