|
CHG X-RAY THOR-LUMB SP SCOLIOSIS
|
Professional
|
Both
|
$137.00
|
|
|
Service Code
|
HCPCS 72090
|
| Min. Negotiated Rate |
$54.80 |
| Max. Negotiated Rate |
$102.75 |
| Rate for Payer: Aetna Medicare |
$68.50
|
| Rate for Payer: Aetna Medicare |
$51.50
|
| Rate for Payer: Aetna Medicare |
$36.50
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS Complete |
$41.20
|
| Rate for Payer: BCBS Complete |
$54.80
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.75
|
|
|
CHG X-RAY TRUNK SPINE SCOLIOSIS
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 72069
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: Aetna Medicare |
$31.00
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.50
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$117,373.80
|
|
|
Service Code
|
APR-DRG 0112
|
| Min. Negotiated Rate |
$111,784.57 |
| Max. Negotiated Rate |
$117,373.80 |
| Rate for Payer: BCBS Complete |
$117,373.80
|
| Rate for Payer: Mclaren Medicaid |
$111,784.57
|
| Rate for Payer: Meridian Medicaid |
$117,373.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$111,784.57
|
| Rate for Payer: UHC Medicaid |
$111,784.57
|
| Rate for Payer: UHCCP Medicaid |
$111,784.57
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$138,326.94
|
|
|
Service Code
|
APR-DRG 0113
|
| Min. Negotiated Rate |
$131,739.95 |
| Max. Negotiated Rate |
$138,326.94 |
| Rate for Payer: BCBS Complete |
$138,326.94
|
| Rate for Payer: Mclaren Medicaid |
$131,739.95
|
| Rate for Payer: Meridian Medicaid |
$138,326.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$131,739.95
|
| Rate for Payer: UHC Medicaid |
$131,739.95
|
| Rate for Payer: UHCCP Medicaid |
$131,739.95
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$179,528.61
|
|
|
Service Code
|
APR-DRG 0114
|
| Min. Negotiated Rate |
$170,979.63 |
| Max. Negotiated Rate |
$179,528.61 |
| Rate for Payer: BCBS Complete |
$179,528.61
|
| Rate for Payer: Mclaren Medicaid |
$170,979.63
|
| Rate for Payer: Meridian Medicaid |
$179,528.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$170,979.63
|
| Rate for Payer: UHC Medicaid |
$170,979.63
|
| Rate for Payer: UHCCP Medicaid |
$170,979.63
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$54,160.47
|
|
|
Service Code
|
APR-DRG 0111
|
| Min. Negotiated Rate |
$51,581.40 |
| Max. Negotiated Rate |
$54,160.47 |
| Rate for Payer: BCBS Complete |
$54,160.47
|
| Rate for Payer: Mclaren Medicaid |
$51,581.40
|
| Rate for Payer: Meridian Medicaid |
$54,160.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$51,581.40
|
| Rate for Payer: UHC Medicaid |
$51,581.40
|
| Rate for Payer: UHCCP Medicaid |
$51,581.40
|
|
|
CHLORDIAZEPOXIDE 10 MG CAPSULE
|
Facility
|
IP
|
$321.95
|
|
|
Service Code
|
NDC 00555003302
|
| Hospital Charge Code |
1622
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$224.08 |
| Max. Negotiated Rate |
$289.75 |
| Rate for Payer: Aetna Commercial |
$273.66
|
| Rate for Payer: BCBS Trust/PPO |
$265.90
|
| Rate for Payer: BCN Commercial |
$265.90
|
| Rate for Payer: Cash Price |
$257.56
|
| Rate for Payer: Cofinity Commercial |
$276.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.56
|
| Rate for Payer: Healthscope Commercial |
$289.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.66
|
| Rate for Payer: Nomi Health Commercial |
$264.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$241.46
|
| Rate for Payer: PHP Commercial |
$273.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$280.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.32
|
| Rate for Payer: UHC Core |
$268.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.46
|
|
|
CHLORDIAZEPOXIDE 10 MG CAPSULE
|
Facility
|
IP
|
$4.36
|
|
|
Service Code
|
NDC 51079037501
|
| Hospital Charge Code |
1622
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$3.92 |
| Rate for Payer: Aetna Commercial |
$3.71
|
| Rate for Payer: BCBS Trust/PPO |
$3.60
|
| Rate for Payer: BCN Commercial |
$3.60
|
| Rate for Payer: Cash Price |
$3.49
|
| Rate for Payer: Cofinity Commercial |
$3.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.49
|
| Rate for Payer: Healthscope Commercial |
$3.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.71
|
| Rate for Payer: Nomi Health Commercial |
$3.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.27
|
| Rate for Payer: PHP Commercial |
$3.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.84
|
| Rate for Payer: UHC Core |
$3.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.27
|
|
|
CHLORDIAZEPOXIDE 10 MG CAPSULE
|
Facility
|
OP
|
$4.36
|
|
|
Service Code
|
NDC 51079037501
|
| Hospital Charge Code |
1622
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.92 |
| Rate for Payer: Aetna Commercial |
$3.71
|
| Rate for Payer: Aetna Medicare |
$1.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.36
|
| Rate for Payer: BCBS Complete |
$0.81
|
| Rate for Payer: BCBS MAPPO |
$1.09
|
| Rate for Payer: BCBS Trust/PPO |
$3.58
|
| Rate for Payer: BCN Commercial |
$3.58
|
| Rate for Payer: BCN Medicare Advantage |
$1.09
|
| Rate for Payer: Cash Price |
$3.49
|
| Rate for Payer: Cofinity Commercial |
$3.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.09
|
| Rate for Payer: Healthscope Commercial |
$3.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.27
|
| Rate for Payer: Mclaren Medicaid |
$0.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.14
|
| Rate for Payer: Meridian Medicaid |
$0.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.71
|
| Rate for Payer: Nomi Health Commercial |
$3.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.27
|
| Rate for Payer: PACE Senior Care Partners |
$1.04
|
| Rate for Payer: PACE SWMI |
$1.09
|
| Rate for Payer: PHP Commercial |
$3.71
|
| Rate for Payer: PHP Medicare Advantage |
$1.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.79
|
| Rate for Payer: Priority Health Medicare |
$1.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.84
|
| Rate for Payer: UHC Core |
$3.64
|
| Rate for Payer: UHC Exchange |
$1.09
|
| Rate for Payer: UHC Medicaid |
$0.77
|
| Rate for Payer: UHC Medicare Advantage |
$1.09
|
| Rate for Payer: UHCCP Medicaid |
$0.77
|
| Rate for Payer: VA VA |
$1.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.27
|
|
|
CHLORDIAZEPOXIDE 10 MG CAPSULE
|
Facility
|
OP
|
$321.95
|
|
|
Service Code
|
NDC 00555003302
|
| Hospital Charge Code |
1622
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$56.76 |
| Max. Negotiated Rate |
$289.75 |
| Rate for Payer: Aetna Commercial |
$273.66
|
| Rate for Payer: Aetna Medicare |
$83.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.61
|
| Rate for Payer: BCBS Complete |
$59.59
|
| Rate for Payer: BCBS MAPPO |
$80.49
|
| Rate for Payer: BCBS Trust/PPO |
$264.68
|
| Rate for Payer: BCN Commercial |
$264.68
|
| Rate for Payer: BCN Medicare Advantage |
$80.49
|
| Rate for Payer: Cash Price |
$257.56
|
| Rate for Payer: Cofinity Commercial |
$276.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.49
|
| Rate for Payer: Healthscope Commercial |
$289.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.46
|
| Rate for Payer: Mclaren Medicaid |
$56.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.51
|
| Rate for Payer: Meridian Medicaid |
$59.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.66
|
| Rate for Payer: Nomi Health Commercial |
$264.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$241.46
|
| Rate for Payer: PACE Senior Care Partners |
$76.46
|
| Rate for Payer: PACE SWMI |
$80.49
|
| Rate for Payer: PHP Commercial |
$273.66
|
| Rate for Payer: PHP Medicare Advantage |
$80.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$280.10
|
| Rate for Payer: Priority Health Medicare |
$81.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.08
|
| Rate for Payer: Railroad Medicare Medicare |
$80.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.32
|
| Rate for Payer: UHC Core |
$268.83
|
| Rate for Payer: UHC Exchange |
$80.49
|
| Rate for Payer: UHC Medicaid |
$56.76
|
| Rate for Payer: UHC Medicare Advantage |
$80.49
|
| Rate for Payer: UHCCP Medicaid |
$56.76
|
| Rate for Payer: VA VA |
$80.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.46
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE
|
Facility
|
IP
|
$326.88
|
|
|
Service Code
|
NDC 60687080701
|
| Hospital Charge Code |
1623
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$227.51 |
| Max. Negotiated Rate |
$294.19 |
| Rate for Payer: Aetna Commercial |
$277.85
|
| Rate for Payer: BCBS Trust/PPO |
$269.97
|
| Rate for Payer: BCN Commercial |
$269.97
|
| Rate for Payer: Cash Price |
$261.50
|
| Rate for Payer: Cofinity Commercial |
$281.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.50
|
| Rate for Payer: Healthscope Commercial |
$294.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$245.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.85
|
| Rate for Payer: Nomi Health Commercial |
$268.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.16
|
| Rate for Payer: PHP Commercial |
$277.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$284.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.65
|
| Rate for Payer: UHC Core |
$272.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$245.16
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE
|
Facility
|
OP
|
$326.88
|
|
|
Service Code
|
NDC 60687080701
|
| Hospital Charge Code |
1623
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$57.63 |
| Max. Negotiated Rate |
$294.19 |
| Rate for Payer: Aetna Commercial |
$277.85
|
| Rate for Payer: Aetna Medicare |
$84.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.15
|
| Rate for Payer: BCBS Complete |
$60.51
|
| Rate for Payer: BCBS MAPPO |
$81.72
|
| Rate for Payer: BCBS Trust/PPO |
$268.73
|
| Rate for Payer: BCN Commercial |
$268.73
|
| Rate for Payer: BCN Medicare Advantage |
$81.72
|
| Rate for Payer: Cash Price |
$261.50
|
| Rate for Payer: Cofinity Commercial |
$281.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.72
|
| Rate for Payer: Healthscope Commercial |
$294.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$245.16
|
| Rate for Payer: Mclaren Medicaid |
$57.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.81
|
| Rate for Payer: Meridian Medicaid |
$60.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$89.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.85
|
| Rate for Payer: Nomi Health Commercial |
$268.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.16
|
| Rate for Payer: PACE Senior Care Partners |
$77.63
|
| Rate for Payer: PACE SWMI |
$81.72
|
| Rate for Payer: PHP Commercial |
$277.85
|
| Rate for Payer: PHP Medicare Advantage |
$81.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$284.39
|
| Rate for Payer: Priority Health Medicare |
$82.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.51
|
| Rate for Payer: Railroad Medicare Medicare |
$81.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.65
|
| Rate for Payer: UHC Core |
$272.94
|
| Rate for Payer: UHC Exchange |
$81.72
|
| Rate for Payer: UHC Medicaid |
$57.63
|
| Rate for Payer: UHC Medicare Advantage |
$81.72
|
| Rate for Payer: UHCCP Medicaid |
$57.63
|
| Rate for Payer: VA VA |
$81.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$245.16
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE
|
Facility
|
IP
|
$3.27
|
|
|
Service Code
|
NDC 60687080711
|
| Hospital Charge Code |
1623
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$2.94 |
| Rate for Payer: Aetna Commercial |
$2.78
|
| Rate for Payer: BCBS Trust/PPO |
$2.70
|
| Rate for Payer: BCN Commercial |
$2.70
|
| Rate for Payer: Cash Price |
$2.62
|
| Rate for Payer: Cofinity Commercial |
$2.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.62
|
| Rate for Payer: Healthscope Commercial |
$2.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.78
|
| Rate for Payer: Nomi Health Commercial |
$2.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.45
|
| Rate for Payer: PHP Commercial |
$2.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.88
|
| Rate for Payer: UHC Core |
$2.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.45
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE
|
Facility
|
OP
|
$469.30
|
|
|
Service Code
|
NDC 51079014120
|
| Hospital Charge Code |
1623
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.74 |
| Max. Negotiated Rate |
$422.37 |
| Rate for Payer: Aetna Commercial |
$398.90
|
| Rate for Payer: Aetna Medicare |
$122.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.66
|
| Rate for Payer: BCBS Complete |
$86.87
|
| Rate for Payer: BCBS MAPPO |
$117.33
|
| Rate for Payer: BCBS Trust/PPO |
$385.81
|
| Rate for Payer: BCN Commercial |
$385.81
|
| Rate for Payer: BCN Medicare Advantage |
$117.33
|
| Rate for Payer: Cash Price |
$375.44
|
| Rate for Payer: Cofinity Commercial |
$403.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.33
|
| Rate for Payer: Healthscope Commercial |
$422.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.98
|
| Rate for Payer: Mclaren Medicaid |
$82.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.19
|
| Rate for Payer: Meridian Medicaid |
$86.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$134.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$129.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.90
|
| Rate for Payer: Nomi Health Commercial |
$384.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.98
|
| Rate for Payer: PACE Senior Care Partners |
$111.46
|
| Rate for Payer: PACE SWMI |
$117.33
|
| Rate for Payer: PHP Commercial |
$398.90
|
| Rate for Payer: PHP Medicare Advantage |
$117.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$408.29
|
| Rate for Payer: Priority Health Medicare |
$118.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$326.63
|
| Rate for Payer: Railroad Medicare Medicare |
$117.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.98
|
| Rate for Payer: UHC Core |
$391.87
|
| Rate for Payer: UHC Exchange |
$117.33
|
| Rate for Payer: UHC Medicaid |
$82.74
|
| Rate for Payer: UHC Medicare Advantage |
$117.33
|
| Rate for Payer: UHCCP Medicaid |
$82.74
|
| Rate for Payer: VA VA |
$117.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.98
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE
|
Facility
|
IP
|
$1,880.00
|
|
|
Service Code
|
NDC 00555015904
|
| Hospital Charge Code |
1623
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,308.48 |
| Max. Negotiated Rate |
$1,692.00 |
| Rate for Payer: Aetna Commercial |
$1,598.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,552.69
|
| Rate for Payer: BCN Commercial |
$1,552.69
|
| Rate for Payer: Cash Price |
$1,504.00
|
| Rate for Payer: Cofinity Commercial |
$1,616.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,504.00
|
| Rate for Payer: Healthscope Commercial |
$1,692.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,410.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,598.00
|
| Rate for Payer: Nomi Health Commercial |
$1,541.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,410.00
|
| Rate for Payer: PHP Commercial |
$1,598.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,635.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,308.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,654.40
|
| Rate for Payer: UHC Core |
$1,569.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,410.00
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE
|
Facility
|
OP
|
$385.40
|
|
|
Service Code
|
NDC 00555015902
|
| Hospital Charge Code |
1623
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$346.86 |
| Rate for Payer: Aetna Commercial |
$327.59
|
| Rate for Payer: Aetna Medicare |
$100.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$120.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$120.44
|
| Rate for Payer: BCBS Complete |
$71.34
|
| Rate for Payer: BCBS MAPPO |
$96.35
|
| Rate for Payer: BCBS Trust/PPO |
$316.84
|
| Rate for Payer: BCN Commercial |
$316.84
|
| Rate for Payer: BCN Medicare Advantage |
$96.35
|
| Rate for Payer: Cash Price |
$308.32
|
| Rate for Payer: Cofinity Commercial |
$331.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.35
|
| Rate for Payer: Healthscope Commercial |
$346.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.05
|
| Rate for Payer: Mclaren Medicaid |
$67.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.17
|
| Rate for Payer: Meridian Medicaid |
$71.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.59
|
| Rate for Payer: Nomi Health Commercial |
$316.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.05
|
| Rate for Payer: PACE Senior Care Partners |
$91.53
|
| Rate for Payer: PACE SWMI |
$96.35
|
| Rate for Payer: PHP Commercial |
$327.59
|
| Rate for Payer: PHP Medicare Advantage |
$96.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$335.30
|
| Rate for Payer: Priority Health Medicare |
$97.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.24
|
| Rate for Payer: Railroad Medicare Medicare |
$96.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.15
|
| Rate for Payer: UHC Core |
$321.81
|
| Rate for Payer: UHC Exchange |
$96.35
|
| Rate for Payer: UHC Medicaid |
$67.95
|
| Rate for Payer: UHC Medicare Advantage |
$96.35
|
| Rate for Payer: UHCCP Medicaid |
$67.95
|
| Rate for Payer: VA VA |
$96.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.05
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE
|
Facility
|
IP
|
$385.40
|
|
|
Service Code
|
NDC 00555015902
|
| Hospital Charge Code |
1623
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$268.24 |
| Max. Negotiated Rate |
$346.86 |
| Rate for Payer: Aetna Commercial |
$327.59
|
| Rate for Payer: BCBS Trust/PPO |
$318.30
|
| Rate for Payer: BCN Commercial |
$318.30
|
| Rate for Payer: Cash Price |
$308.32
|
| Rate for Payer: Cofinity Commercial |
$331.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.32
|
| Rate for Payer: Healthscope Commercial |
$346.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.59
|
| Rate for Payer: Nomi Health Commercial |
$316.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.05
|
| Rate for Payer: PHP Commercial |
$327.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$335.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.15
|
| Rate for Payer: UHC Core |
$321.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.05
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE
|
Facility
|
IP
|
$4.70
|
|
|
Service Code
|
NDC 51079014101
|
| Hospital Charge Code |
1623
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$4.23 |
| Rate for Payer: Aetna Commercial |
$4.00
|
| Rate for Payer: BCBS Trust/PPO |
$3.88
|
| Rate for Payer: BCN Commercial |
$3.88
|
| Rate for Payer: Cash Price |
$3.76
|
| Rate for Payer: Cofinity Commercial |
$4.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.76
|
| Rate for Payer: Healthscope Commercial |
$4.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.00
|
| Rate for Payer: Nomi Health Commercial |
$3.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.52
|
| Rate for Payer: PHP Commercial |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.14
|
| Rate for Payer: UHC Core |
$3.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.52
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE
|
Facility
|
IP
|
$469.30
|
|
|
Service Code
|
NDC 51079014120
|
| Hospital Charge Code |
1623
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$326.63 |
| Max. Negotiated Rate |
$422.37 |
| Rate for Payer: Aetna Commercial |
$398.90
|
| Rate for Payer: BCBS Trust/PPO |
$387.59
|
| Rate for Payer: BCN Commercial |
$387.59
|
| Rate for Payer: Cash Price |
$375.44
|
| Rate for Payer: Cofinity Commercial |
$403.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.44
|
| Rate for Payer: Healthscope Commercial |
$422.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.90
|
| Rate for Payer: Nomi Health Commercial |
$384.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.98
|
| Rate for Payer: PHP Commercial |
$398.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$408.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$326.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.98
|
| Rate for Payer: UHC Core |
$391.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.98
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE
|
Facility
|
OP
|
$3.27
|
|
|
Service Code
|
NDC 60687080711
|
| Hospital Charge Code |
1623
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$2.94 |
| Rate for Payer: Aetna Commercial |
$2.78
|
| Rate for Payer: Aetna Medicare |
$0.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.02
|
| Rate for Payer: BCBS Complete |
$0.61
|
| Rate for Payer: BCBS MAPPO |
$0.82
|
| Rate for Payer: BCBS Trust/PPO |
$2.69
|
| Rate for Payer: BCN Commercial |
$2.69
|
| Rate for Payer: BCN Medicare Advantage |
$0.82
|
| Rate for Payer: Cash Price |
$2.62
|
| Rate for Payer: Cofinity Commercial |
$2.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.82
|
| Rate for Payer: Healthscope Commercial |
$2.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.45
|
| Rate for Payer: Mclaren Medicaid |
$0.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.86
|
| Rate for Payer: Meridian Medicaid |
$0.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.78
|
| Rate for Payer: Nomi Health Commercial |
$2.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.45
|
| Rate for Payer: PACE Senior Care Partners |
$0.78
|
| Rate for Payer: PACE SWMI |
$0.82
|
| Rate for Payer: PHP Commercial |
$2.78
|
| Rate for Payer: PHP Medicare Advantage |
$0.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.84
|
| Rate for Payer: Priority Health Medicare |
$0.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.28
|
| Rate for Payer: Railroad Medicare Medicare |
$0.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.88
|
| Rate for Payer: UHC Core |
$2.73
|
| Rate for Payer: UHC Exchange |
$0.82
|
| Rate for Payer: UHC Medicaid |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.82
|
| Rate for Payer: UHCCP Medicaid |
$0.58
|
| Rate for Payer: VA VA |
$0.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.45
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE
|
Facility
|
OP
|
$4.70
|
|
|
Service Code
|
NDC 51079014101
|
| Hospital Charge Code |
1623
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.83 |
| Max. Negotiated Rate |
$4.23 |
| Rate for Payer: Aetna Commercial |
$4.00
|
| Rate for Payer: Aetna Medicare |
$1.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.47
|
| Rate for Payer: BCBS Complete |
$0.87
|
| Rate for Payer: BCBS MAPPO |
$1.18
|
| Rate for Payer: BCBS Trust/PPO |
$3.86
|
| Rate for Payer: BCN Commercial |
$3.86
|
| Rate for Payer: BCN Medicare Advantage |
$1.18
|
| Rate for Payer: Cash Price |
$3.76
|
| Rate for Payer: Cofinity Commercial |
$4.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.18
|
| Rate for Payer: Healthscope Commercial |
$4.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.52
|
| Rate for Payer: Mclaren Medicaid |
$0.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.23
|
| Rate for Payer: Meridian Medicaid |
$0.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.00
|
| Rate for Payer: Nomi Health Commercial |
$3.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.52
|
| Rate for Payer: PACE Senior Care Partners |
$1.12
|
| Rate for Payer: PACE SWMI |
$1.18
|
| Rate for Payer: PHP Commercial |
$4.00
|
| Rate for Payer: PHP Medicare Advantage |
$1.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.09
|
| Rate for Payer: Priority Health Medicare |
$1.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.14
|
| Rate for Payer: UHC Core |
$3.92
|
| Rate for Payer: UHC Exchange |
$1.18
|
| Rate for Payer: UHC Medicaid |
$0.83
|
| Rate for Payer: UHC Medicare Advantage |
$1.18
|
| Rate for Payer: UHCCP Medicaid |
$0.83
|
| Rate for Payer: VA VA |
$1.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.52
|
|
|
CHLORDIAZEPOXIDE 25 MG CAPSULE
|
Facility
|
OP
|
$1,880.00
|
|
|
Service Code
|
NDC 00555015904
|
| Hospital Charge Code |
1623
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$331.44 |
| Max. Negotiated Rate |
$1,692.00 |
| Rate for Payer: Aetna Commercial |
$1,598.00
|
| Rate for Payer: Aetna Medicare |
$488.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$587.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$587.50
|
| Rate for Payer: BCBS Complete |
$347.99
|
| Rate for Payer: BCBS MAPPO |
$470.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,545.55
|
| Rate for Payer: BCN Commercial |
$1,545.55
|
| Rate for Payer: BCN Medicare Advantage |
$470.00
|
| Rate for Payer: Cash Price |
$1,504.00
|
| Rate for Payer: Cofinity Commercial |
$1,616.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,504.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$470.00
|
| Rate for Payer: Healthscope Commercial |
$1,692.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,410.00
|
| Rate for Payer: Mclaren Medicaid |
$331.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$493.50
|
| Rate for Payer: Meridian Medicaid |
$347.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$540.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$517.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,598.00
|
| Rate for Payer: Nomi Health Commercial |
$1,541.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,410.00
|
| Rate for Payer: PACE Senior Care Partners |
$446.50
|
| Rate for Payer: PACE SWMI |
$470.00
|
| Rate for Payer: PHP Commercial |
$1,598.00
|
| Rate for Payer: PHP Medicare Advantage |
$470.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$331.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,635.60
|
| Rate for Payer: Priority Health Medicare |
$474.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,308.48
|
| Rate for Payer: Railroad Medicare Medicare |
$470.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,654.40
|
| Rate for Payer: UHC Core |
$1,569.80
|
| Rate for Payer: UHC Exchange |
$470.00
|
| Rate for Payer: UHC Medicaid |
$331.44
|
| Rate for Payer: UHC Medicare Advantage |
$470.00
|
| Rate for Payer: UHCCP Medicaid |
$331.44
|
| Rate for Payer: VA VA |
$470.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,410.00
|
|
|
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH
|
Facility
|
IP
|
$19.39
|
|
|
Service Code
|
NDC 00904703587
|
| Hospital Charge Code |
9516
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$17.45 |
| Rate for Payer: Aetna Commercial |
$16.48
|
| Rate for Payer: BCBS Trust/PPO |
$16.01
|
| Rate for Payer: BCN Commercial |
$16.01
|
| Rate for Payer: Cash Price |
$15.51
|
| Rate for Payer: Cofinity Commercial |
$16.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.51
|
| Rate for Payer: Healthscope Commercial |
$17.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.48
|
| Rate for Payer: Nomi Health Commercial |
$15.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.54
|
| Rate for Payer: PHP Commercial |
$16.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.06
|
| Rate for Payer: UHC Core |
$16.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.54
|
|
|
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH
|
Facility
|
IP
|
$25.03
|
|
|
Service Code
|
NDC 00904703588
|
| Hospital Charge Code |
9516
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$22.53 |
| Rate for Payer: Aetna Commercial |
$21.28
|
| Rate for Payer: BCBS Trust/PPO |
$20.67
|
| Rate for Payer: BCN Commercial |
$20.67
|
| Rate for Payer: Cash Price |
$20.02
|
| Rate for Payer: Cofinity Commercial |
$21.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.02
|
| Rate for Payer: Healthscope Commercial |
$22.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.28
|
| Rate for Payer: Nomi Health Commercial |
$20.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.77
|
| Rate for Payer: PHP Commercial |
$21.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.03
|
| Rate for Payer: UHC Core |
$20.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.77
|
|
|
CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH
|
Facility
|
OP
|
$25.03
|
|
|
Service Code
|
NDC 00904703588
|
| Hospital Charge Code |
9516
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.41 |
| Max. Negotiated Rate |
$22.53 |
| Rate for Payer: Aetna Commercial |
$21.28
|
| Rate for Payer: Aetna Medicare |
$6.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.82
|
| Rate for Payer: BCBS Complete |
$4.63
|
| Rate for Payer: BCBS MAPPO |
$6.26
|
| Rate for Payer: BCBS Trust/PPO |
$20.58
|
| Rate for Payer: BCN Commercial |
$20.58
|
| Rate for Payer: BCN Medicare Advantage |
$6.26
|
| Rate for Payer: Cash Price |
$20.02
|
| Rate for Payer: Cofinity Commercial |
$21.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.26
|
| Rate for Payer: Healthscope Commercial |
$22.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.77
|
| Rate for Payer: Mclaren Medicaid |
$4.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.57
|
| Rate for Payer: Meridian Medicaid |
$4.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.28
|
| Rate for Payer: Nomi Health Commercial |
$20.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.77
|
| Rate for Payer: PACE Senior Care Partners |
$5.94
|
| Rate for Payer: PACE SWMI |
$6.26
|
| Rate for Payer: PHP Commercial |
$21.28
|
| Rate for Payer: PHP Medicare Advantage |
$6.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.78
|
| Rate for Payer: Priority Health Medicare |
$6.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.42
|
| Rate for Payer: Railroad Medicare Medicare |
$6.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.03
|
| Rate for Payer: UHC Core |
$20.90
|
| Rate for Payer: UHC Exchange |
$6.26
|
| Rate for Payer: UHC Medicaid |
$4.41
|
| Rate for Payer: UHC Medicare Advantage |
$6.26
|
| Rate for Payer: UHCCP Medicaid |
$4.41
|
| Rate for Payer: VA VA |
$6.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.77
|
|
