|
MUPIROCIN 2 % TOPICAL OINTMENT
|
Facility
|
OP
|
$20.79
|
|
|
Service Code
|
NDC 51672131200
|
| Hospital Charge Code |
10674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$18.71 |
| Rate for Payer: Aetna Commercial |
$17.67
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$8.32
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$17.09
|
| Rate for Payer: BCN Commercial |
$16.16
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.63
|
| Rate for Payer: Cofinity Commercial |
$17.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.67
|
| Rate for Payer: Nomi Health Commercial |
$17.05
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.67
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.51
|
| Rate for Payer: Priority Health HMO/PPO |
$18.09
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.93
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.30
|
| Rate for Payer: UHC Core |
$17.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Exchange |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.20
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.59
|
|
|
MUPIROCIN 2 % TOPICAL OINTMENT
|
Facility
|
OP
|
$29.96
|
|
|
Service Code
|
NDC 45802011222
|
| Hospital Charge Code |
10674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.12 |
| Max. Negotiated Rate |
$26.96 |
| Rate for Payer: Aetna Commercial |
$25.47
|
| Rate for Payer: Aetna Medicare |
$7.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.36
|
| Rate for Payer: BCBS Complete |
$11.98
|
| Rate for Payer: BCBS MAPPO |
$7.49
|
| Rate for Payer: BCBS Trust/PPO |
$24.63
|
| Rate for Payer: BCN Commercial |
$23.29
|
| Rate for Payer: BCN Medicare Advantage |
$7.49
|
| Rate for Payer: Cash Price |
$23.97
|
| Rate for Payer: Cofinity Commercial |
$25.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.49
|
| Rate for Payer: Healthscope Commercial |
$26.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.47
|
| Rate for Payer: Nomi Health Commercial |
$24.57
|
| Rate for Payer: PACE Senior Care Partners |
$7.12
|
| Rate for Payer: PACE SWMI |
$7.49
|
| Rate for Payer: PHP Commercial |
$25.47
|
| Rate for Payer: PHP Medicare Advantage |
$7.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.47
|
| Rate for Payer: Priority Health HMO/PPO |
$26.07
|
| Rate for Payer: Priority Health Medicare |
$7.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.07
|
| Rate for Payer: Railroad Medicare Medicare |
$7.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.36
|
| Rate for Payer: UHC Core |
$25.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.49
|
| Rate for Payer: UHC Exchange |
$7.49
|
| Rate for Payer: UHC Medicare Advantage |
$7.49
|
| Rate for Payer: VA VA |
$7.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.47
|
|
|
MUPIROCIN 2 % TOPICAL OINTMENT
|
Facility
|
IP
|
$29.96
|
|
|
Service Code
|
NDC 45802011222
|
| Hospital Charge Code |
10674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$26.96 |
| Rate for Payer: Aetna Commercial |
$25.47
|
| Rate for Payer: BCBS Trust/PPO |
$24.46
|
| Rate for Payer: BCN Commercial |
$23.15
|
| Rate for Payer: Cash Price |
$23.97
|
| Rate for Payer: Cofinity Commercial |
$25.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.97
|
| Rate for Payer: Healthscope Commercial |
$26.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.47
|
| Rate for Payer: Nomi Health Commercial |
$24.57
|
| Rate for Payer: PHP Commercial |
$25.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.47
|
| Rate for Payer: Priority Health HMO/PPO |
$26.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.36
|
| Rate for Payer: UHC Core |
$25.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.47
|
|
|
MUPIROCIN 2 % TOPICAL OINTMENT
|
Facility
|
IP
|
$20.79
|
|
|
Service Code
|
NDC 51672131200
|
| Hospital Charge Code |
10674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.51 |
| Max. Negotiated Rate |
$18.71 |
| Rate for Payer: Aetna Commercial |
$17.67
|
| Rate for Payer: BCBS Trust/PPO |
$16.97
|
| Rate for Payer: BCN Commercial |
$16.07
|
| Rate for Payer: Cash Price |
$16.63
|
| Rate for Payer: Cofinity Commercial |
$17.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.63
|
| Rate for Payer: Healthscope Commercial |
$18.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.67
|
| Rate for Payer: Nomi Health Commercial |
$17.05
|
| Rate for Payer: PHP Commercial |
$17.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.51
|
| Rate for Payer: Priority Health HMO/PPO |
$18.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.30
|
| Rate for Payer: UHC Core |
$17.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.59
|
|
|
MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$47.17
|
|
|
Service Code
|
NDC 54643564901
|
| Hospital Charge Code |
161578
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$30.66 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$40.09
|
| Rate for Payer: BCBS Trust/PPO |
$38.50
|
| Rate for Payer: BCN Commercial |
$36.45
|
| Rate for Payer: Cash Price |
$37.74
|
| Rate for Payer: Cofinity Commercial |
$40.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.74
|
| Rate for Payer: Healthscope Commercial |
$42.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.09
|
| Rate for Payer: Nomi Health Commercial |
$38.68
|
| Rate for Payer: PHP Commercial |
$40.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.66
|
| Rate for Payer: Priority Health HMO/PPO |
$41.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.51
|
| Rate for Payer: UHC Core |
$39.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.38
|
|
|
MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$47.17
|
|
|
Service Code
|
NDC 54643564901
|
| Hospital Charge Code |
161578
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$40.09
|
| Rate for Payer: Aetna Medicare |
$12.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.74
|
| Rate for Payer: BCBS Complete |
$18.87
|
| Rate for Payer: BCBS MAPPO |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$38.78
|
| Rate for Payer: BCN Commercial |
$36.67
|
| Rate for Payer: BCN Medicare Advantage |
$11.79
|
| Rate for Payer: Cash Price |
$37.74
|
| Rate for Payer: Cofinity Commercial |
$40.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.79
|
| Rate for Payer: Healthscope Commercial |
$42.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.09
|
| Rate for Payer: Nomi Health Commercial |
$38.68
|
| Rate for Payer: PACE Senior Care Partners |
$11.20
|
| Rate for Payer: PACE SWMI |
$11.79
|
| Rate for Payer: PHP Commercial |
$40.09
|
| Rate for Payer: PHP Medicare Advantage |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.66
|
| Rate for Payer: Priority Health HMO/PPO |
$41.04
|
| Rate for Payer: Priority Health Medicare |
$11.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.60
|
| Rate for Payer: Railroad Medicare Medicare |
$11.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.51
|
| Rate for Payer: UHC Core |
$39.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.79
|
| Rate for Payer: UHC Exchange |
$11.79
|
| Rate for Payer: UHC Medicare Advantage |
$11.79
|
| Rate for Payer: VA VA |
$11.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.38
|
|
|
MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$319.15
|
|
|
Service Code
|
NDC 54643565002
|
| Hospital Charge Code |
161578
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$75.80 |
| Max. Negotiated Rate |
$287.24 |
| Rate for Payer: Aetna Commercial |
$271.28
|
| Rate for Payer: Aetna Medicare |
$82.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$99.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$99.73
|
| Rate for Payer: BCBS Complete |
$127.66
|
| Rate for Payer: BCBS MAPPO |
$79.79
|
| Rate for Payer: BCBS Trust/PPO |
$262.37
|
| Rate for Payer: BCN Commercial |
$248.14
|
| Rate for Payer: BCN Medicare Advantage |
$79.79
|
| Rate for Payer: Cash Price |
$255.32
|
| Rate for Payer: Cofinity Commercial |
$274.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.79
|
| Rate for Payer: Healthscope Commercial |
$287.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$239.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.28
|
| Rate for Payer: Nomi Health Commercial |
$261.70
|
| Rate for Payer: PACE Senior Care Partners |
$75.80
|
| Rate for Payer: PACE SWMI |
$79.79
|
| Rate for Payer: PHP Commercial |
$271.28
|
| Rate for Payer: PHP Medicare Advantage |
$79.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.45
|
| Rate for Payer: Priority Health HMO/PPO |
$277.66
|
| Rate for Payer: Priority Health Medicare |
$80.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.83
|
| Rate for Payer: Railroad Medicare Medicare |
$79.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$280.85
|
| Rate for Payer: UHC Core |
$266.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.79
|
| Rate for Payer: UHC Exchange |
$79.79
|
| Rate for Payer: UHC Medicare Advantage |
$79.79
|
| Rate for Payer: VA VA |
$79.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$239.36
|
|
|
MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$319.15
|
|
|
Service Code
|
NDC 54643565002
|
| Hospital Charge Code |
161578
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$207.45 |
| Max. Negotiated Rate |
$287.24 |
| Rate for Payer: Aetna Commercial |
$271.28
|
| Rate for Payer: BCBS Trust/PPO |
$260.52
|
| Rate for Payer: BCN Commercial |
$246.64
|
| Rate for Payer: Cash Price |
$255.32
|
| Rate for Payer: Cofinity Commercial |
$274.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.32
|
| Rate for Payer: Healthscope Commercial |
$287.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$239.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.28
|
| Rate for Payer: Nomi Health Commercial |
$261.70
|
| Rate for Payer: PHP Commercial |
$271.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.45
|
| Rate for Payer: Priority Health HMO/PPO |
$277.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$280.85
|
| Rate for Payer: UHC Core |
$266.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$239.36
|
|
|
MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$63.68
|
|
|
Service Code
|
NDC 54643900701
|
| Hospital Charge Code |
161578
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$41.39 |
| Max. Negotiated Rate |
$57.31 |
| Rate for Payer: Aetna Commercial |
$54.13
|
| Rate for Payer: BCBS Trust/PPO |
$51.98
|
| Rate for Payer: BCN Commercial |
$49.21
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.13
|
| Rate for Payer: Nomi Health Commercial |
$52.22
|
| Rate for Payer: PHP Commercial |
$54.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.39
|
| Rate for Payer: Priority Health HMO/PPO |
$55.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.04
|
| Rate for Payer: UHC Core |
$53.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.76
|
|
|
MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$63.68
|
|
|
Service Code
|
NDC 54643900701
|
| Hospital Charge Code |
161578
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.12 |
| Max. Negotiated Rate |
$57.31 |
| Rate for Payer: Aetna Commercial |
$54.13
|
| Rate for Payer: Aetna Medicare |
$16.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.90
|
| Rate for Payer: BCBS Complete |
$25.47
|
| Rate for Payer: BCBS MAPPO |
$15.92
|
| Rate for Payer: BCBS Trust/PPO |
$52.35
|
| Rate for Payer: BCN Commercial |
$49.51
|
| Rate for Payer: BCN Medicare Advantage |
$15.92
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.92
|
| Rate for Payer: Healthscope Commercial |
$57.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.13
|
| Rate for Payer: Nomi Health Commercial |
$52.22
|
| Rate for Payer: PACE Senior Care Partners |
$15.12
|
| Rate for Payer: PACE SWMI |
$15.92
|
| Rate for Payer: PHP Commercial |
$54.13
|
| Rate for Payer: PHP Medicare Advantage |
$15.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.39
|
| Rate for Payer: Priority Health HMO/PPO |
$55.40
|
| Rate for Payer: Priority Health Medicare |
$16.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.67
|
| Rate for Payer: Railroad Medicare Medicare |
$15.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.04
|
| Rate for Payer: UHC Core |
$53.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.92
|
| Rate for Payer: UHC Exchange |
$15.92
|
| Rate for Payer: UHC Medicare Advantage |
$15.92
|
| Rate for Payer: VA VA |
$15.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.76
|
|
|
MYCOPHENOLATE MOFETIL 250 MG CAPSULE
|
Facility
|
IP
|
$370.50
|
|
|
Service Code
|
HCPCS J7517
|
| Hospital Charge Code |
15113
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$240.82 |
| Max. Negotiated Rate |
$333.45 |
| Rate for Payer: Aetna Commercial |
$314.93
|
| Rate for Payer: Aetna Commercial |
$343.57
|
| Rate for Payer: BCBS Trust/PPO |
$302.44
|
| Rate for Payer: BCBS Trust/PPO |
$329.95
|
| Rate for Payer: BCN Commercial |
$286.32
|
| Rate for Payer: BCN Commercial |
$312.37
|
| Rate for Payer: Cash Price |
$296.40
|
| Rate for Payer: Cash Price |
$323.36
|
| Rate for Payer: Cofinity Commercial |
$347.61
|
| Rate for Payer: Cofinity Commercial |
$318.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.40
|
| Rate for Payer: Healthscope Commercial |
$333.45
|
| Rate for Payer: Healthscope Commercial |
$363.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.57
|
| Rate for Payer: Nomi Health Commercial |
$303.81
|
| Rate for Payer: Nomi Health Commercial |
$331.44
|
| Rate for Payer: PHP Commercial |
$314.93
|
| Rate for Payer: PHP Commercial |
$343.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.82
|
| Rate for Payer: Priority Health HMO/PPO |
$351.65
|
| Rate for Payer: Priority Health HMO/PPO |
$322.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$248.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$270.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.70
|
| Rate for Payer: UHC Core |
$309.37
|
| Rate for Payer: UHC Core |
$337.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.15
|
|
|
MYCOPHENOLATE MOFETIL 250 MG CAPSULE
|
Facility
|
OP
|
$404.20
|
|
|
Service Code
|
HCPCS J7517
|
| Hospital Charge Code |
15113
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$96.00 |
| Max. Negotiated Rate |
$363.78 |
| Rate for Payer: Aetna Commercial |
$343.57
|
| Rate for Payer: Aetna Commercial |
$314.93
|
| Rate for Payer: Aetna Medicare |
$105.09
|
| Rate for Payer: Aetna Medicare |
$96.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.78
|
| Rate for Payer: BCBS Complete |
$148.20
|
| Rate for Payer: BCBS Complete |
$161.68
|
| Rate for Payer: BCBS MAPPO |
$92.62
|
| Rate for Payer: BCBS MAPPO |
$101.05
|
| Rate for Payer: BCBS Trust/PPO |
$332.29
|
| Rate for Payer: BCBS Trust/PPO |
$304.59
|
| Rate for Payer: BCN Commercial |
$314.27
|
| Rate for Payer: BCN Commercial |
$288.06
|
| Rate for Payer: BCN Medicare Advantage |
$101.05
|
| Rate for Payer: BCN Medicare Advantage |
$92.62
|
| Rate for Payer: Cash Price |
$323.36
|
| Rate for Payer: Cash Price |
$296.40
|
| Rate for Payer: Cofinity Commercial |
$318.63
|
| Rate for Payer: Cofinity Commercial |
$347.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.05
|
| Rate for Payer: Healthscope Commercial |
$333.45
|
| Rate for Payer: Healthscope Commercial |
$363.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.93
|
| Rate for Payer: Nomi Health Commercial |
$331.44
|
| Rate for Payer: Nomi Health Commercial |
$303.81
|
| Rate for Payer: PACE Senior Care Partners |
$96.00
|
| Rate for Payer: PACE Senior Care Partners |
$87.99
|
| Rate for Payer: PACE SWMI |
$101.05
|
| Rate for Payer: PACE SWMI |
$92.62
|
| Rate for Payer: PHP Commercial |
$343.57
|
| Rate for Payer: PHP Commercial |
$314.93
|
| Rate for Payer: PHP Medicare Advantage |
$92.62
|
| Rate for Payer: PHP Medicare Advantage |
$101.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.82
|
| Rate for Payer: Priority Health HMO/PPO |
$322.33
|
| Rate for Payer: Priority Health HMO/PPO |
$351.65
|
| Rate for Payer: Priority Health Medicare |
$102.06
|
| Rate for Payer: Priority Health Medicare |
$93.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$270.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$248.24
|
| Rate for Payer: Railroad Medicare Medicare |
$92.62
|
| Rate for Payer: Railroad Medicare Medicare |
$101.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.70
|
| Rate for Payer: UHC Core |
$337.51
|
| Rate for Payer: UHC Core |
$309.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.62
|
| Rate for Payer: UHC Exchange |
$92.62
|
| Rate for Payer: UHC Exchange |
$101.05
|
| Rate for Payer: UHC Medicare Advantage |
$92.62
|
| Rate for Payer: UHC Medicare Advantage |
$101.05
|
| Rate for Payer: VA VA |
$92.62
|
| Rate for Payer: VA VA |
$101.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.88
|
|
|
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION
|
Facility
|
OP
|
$20.99
|
|
|
Service Code
|
HCPCS J2290
|
| Hospital Charge Code |
5335
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.99 |
| Max. Negotiated Rate |
$18.89 |
| Rate for Payer: Aetna Commercial |
$17.84
|
| Rate for Payer: Aetna Commercial |
$20.48
|
| Rate for Payer: Aetna Commercial |
$23.56
|
| Rate for Payer: Aetna Commercial |
$17.40
|
| Rate for Payer: Aetna Commercial |
$79.15
|
| Rate for Payer: Aetna Medicare |
$6.26
|
| Rate for Payer: Aetna Medicare |
$5.32
|
| Rate for Payer: Aetna Medicare |
$5.46
|
| Rate for Payer: Aetna Medicare |
$7.21
|
| Rate for Payer: Aetna Medicare |
$24.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.66
|
| Rate for Payer: BCBS Complete |
$11.09
|
| Rate for Payer: BCBS Complete |
$8.19
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS Complete |
$9.64
|
| Rate for Payer: BCBS Complete |
$37.25
|
| Rate for Payer: BCBS MAPPO |
$6.02
|
| Rate for Payer: BCBS MAPPO |
$5.12
|
| Rate for Payer: BCBS MAPPO |
$5.25
|
| Rate for Payer: BCBS MAPPO |
$6.93
|
| Rate for Payer: BCBS MAPPO |
$23.28
|
| Rate for Payer: BCBS Trust/PPO |
$16.83
|
| Rate for Payer: BCBS Trust/PPO |
$17.26
|
| Rate for Payer: BCBS Trust/PPO |
$19.80
|
| Rate for Payer: BCBS Trust/PPO |
$76.55
|
| Rate for Payer: BCBS Trust/PPO |
$22.79
|
| Rate for Payer: BCN Commercial |
$72.40
|
| Rate for Payer: BCN Commercial |
$15.92
|
| Rate for Payer: BCN Commercial |
$16.32
|
| Rate for Payer: BCN Commercial |
$18.73
|
| Rate for Payer: BCN Commercial |
$21.55
|
| Rate for Payer: BCN Medicare Advantage |
$23.28
|
| Rate for Payer: BCN Medicare Advantage |
$6.93
|
| Rate for Payer: BCN Medicare Advantage |
$5.12
|
| Rate for Payer: BCN Medicare Advantage |
$5.25
|
| Rate for Payer: BCN Medicare Advantage |
$6.02
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Cash Price |
$22.18
|
| Rate for Payer: Cash Price |
$74.50
|
| Rate for Payer: Cash Price |
$19.27
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Cofinity Commercial |
$80.08
|
| Rate for Payer: Cofinity Commercial |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$18.05
|
| Rate for Payer: Cofinity Commercial |
$23.84
|
| Rate for Payer: Cofinity Commercial |
$20.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.02
|
| Rate for Payer: Healthscope Commercial |
$18.89
|
| Rate for Payer: Healthscope Commercial |
$18.42
|
| Rate for Payer: Healthscope Commercial |
$24.95
|
| Rate for Payer: Healthscope Commercial |
$21.68
|
| Rate for Payer: Healthscope Commercial |
$83.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.15
|
| Rate for Payer: Nomi Health Commercial |
$17.21
|
| Rate for Payer: Nomi Health Commercial |
$22.73
|
| Rate for Payer: Nomi Health Commercial |
$19.75
|
| Rate for Payer: Nomi Health Commercial |
$76.36
|
| Rate for Payer: Nomi Health Commercial |
$16.79
|
| Rate for Payer: PACE Senior Care Partners |
$4.86
|
| Rate for Payer: PACE Senior Care Partners |
$6.58
|
| Rate for Payer: PACE Senior Care Partners |
$4.99
|
| Rate for Payer: PACE Senior Care Partners |
$5.72
|
| Rate for Payer: PACE Senior Care Partners |
$22.12
|
| Rate for Payer: PACE SWMI |
$5.12
|
| Rate for Payer: PACE SWMI |
$6.93
|
| Rate for Payer: PACE SWMI |
$6.02
|
| Rate for Payer: PACE SWMI |
$5.25
|
| Rate for Payer: PACE SWMI |
$23.28
|
| Rate for Payer: PHP Commercial |
$79.15
|
| Rate for Payer: PHP Commercial |
$20.48
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Commercial |
$17.84
|
| Rate for Payer: PHP Commercial |
$17.40
|
| Rate for Payer: PHP Medicare Advantage |
$6.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.93
|
| Rate for Payer: PHP Medicare Advantage |
$23.28
|
| Rate for Payer: PHP Medicare Advantage |
$5.12
|
| Rate for Payer: PHP Medicare Advantage |
$5.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.31
|
| Rate for Payer: Priority Health HMO/PPO |
$17.81
|
| Rate for Payer: Priority Health HMO/PPO |
$20.96
|
| Rate for Payer: Priority Health HMO/PPO |
$81.01
|
| Rate for Payer: Priority Health HMO/PPO |
$24.12
|
| Rate for Payer: Priority Health HMO/PPO |
$18.26
|
| Rate for Payer: Priority Health Medicare |
$23.51
|
| Rate for Payer: Priority Health Medicare |
$6.08
|
| Rate for Payer: Priority Health Medicare |
$5.30
|
| Rate for Payer: Priority Health Medicare |
$7.00
|
| Rate for Payer: Priority Health Medicare |
$5.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.39
|
| Rate for Payer: Railroad Medicare Medicare |
$6.93
|
| Rate for Payer: Railroad Medicare Medicare |
$6.02
|
| Rate for Payer: Railroad Medicare Medicare |
$5.12
|
| Rate for Payer: Railroad Medicare Medicare |
$5.25
|
| Rate for Payer: Railroad Medicare Medicare |
$23.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.20
|
| Rate for Payer: UHC Core |
$17.53
|
| Rate for Payer: UHC Core |
$77.76
|
| Rate for Payer: UHC Core |
$20.12
|
| Rate for Payer: UHC Core |
$23.15
|
| Rate for Payer: UHC Core |
$17.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.02
|
| Rate for Payer: UHC Exchange |
$6.02
|
| Rate for Payer: UHC Exchange |
$23.28
|
| Rate for Payer: UHC Exchange |
$5.12
|
| Rate for Payer: UHC Exchange |
$6.93
|
| Rate for Payer: UHC Exchange |
$5.25
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: UHC Medicare Advantage |
$23.28
|
| Rate for Payer: UHC Medicare Advantage |
$6.02
|
| Rate for Payer: UHC Medicare Advantage |
$5.12
|
| Rate for Payer: UHC Medicare Advantage |
$6.93
|
| Rate for Payer: VA VA |
$5.12
|
| Rate for Payer: VA VA |
$6.93
|
| Rate for Payer: VA VA |
$5.25
|
| Rate for Payer: VA VA |
$23.28
|
| Rate for Payer: VA VA |
$6.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.07
|
|
|
NAFCILLIN 2 GRAM SOLUTION FOR INJECTION
|
Facility
|
IP
|
$93.12
|
|
|
Service Code
|
HCPCS J2290
|
| Hospital Charge Code |
5335
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$60.53 |
| Max. Negotiated Rate |
$83.81 |
| Rate for Payer: Aetna Commercial |
$79.15
|
| Rate for Payer: Aetna Commercial |
$17.84
|
| Rate for Payer: Aetna Commercial |
$20.48
|
| Rate for Payer: Aetna Commercial |
$23.56
|
| Rate for Payer: Aetna Commercial |
$17.40
|
| Rate for Payer: BCBS Trust/PPO |
$22.63
|
| Rate for Payer: BCBS Trust/PPO |
$76.01
|
| Rate for Payer: BCBS Trust/PPO |
$19.66
|
| Rate for Payer: BCBS Trust/PPO |
$17.13
|
| Rate for Payer: BCBS Trust/PPO |
$16.71
|
| Rate for Payer: BCN Commercial |
$21.42
|
| Rate for Payer: BCN Commercial |
$18.62
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: BCN Commercial |
$16.22
|
| Rate for Payer: BCN Commercial |
$71.96
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Cash Price |
$74.50
|
| Rate for Payer: Cash Price |
$19.27
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Cash Price |
$22.18
|
| Rate for Payer: Cofinity Commercial |
$80.08
|
| Rate for Payer: Cofinity Commercial |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$23.84
|
| Rate for Payer: Cofinity Commercial |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$18.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.50
|
| Rate for Payer: Healthscope Commercial |
$18.89
|
| Rate for Payer: Healthscope Commercial |
$21.68
|
| Rate for Payer: Healthscope Commercial |
$18.42
|
| Rate for Payer: Healthscope Commercial |
$24.95
|
| Rate for Payer: Healthscope Commercial |
$83.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.56
|
| Rate for Payer: Nomi Health Commercial |
$16.79
|
| Rate for Payer: Nomi Health Commercial |
$17.21
|
| Rate for Payer: Nomi Health Commercial |
$19.75
|
| Rate for Payer: Nomi Health Commercial |
$22.73
|
| Rate for Payer: Nomi Health Commercial |
$76.36
|
| Rate for Payer: PHP Commercial |
$20.48
|
| Rate for Payer: PHP Commercial |
$17.84
|
| Rate for Payer: PHP Commercial |
$17.40
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Commercial |
$79.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.31
|
| Rate for Payer: Priority Health HMO/PPO |
$17.81
|
| Rate for Payer: Priority Health HMO/PPO |
$81.01
|
| Rate for Payer: Priority Health HMO/PPO |
$20.96
|
| Rate for Payer: Priority Health HMO/PPO |
$24.12
|
| Rate for Payer: Priority Health HMO/PPO |
$18.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.39
|
| Rate for Payer: UHC Core |
$17.09
|
| Rate for Payer: UHC Core |
$17.53
|
| Rate for Payer: UHC Core |
$23.15
|
| Rate for Payer: UHC Core |
$77.76
|
| Rate for Payer: UHC Core |
$20.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.79
|
|
|
NAFCILLIN 2 GRAM SOLUTION MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$24.09
|
|
|
Service Code
|
HCPCS J2290
|
| Hospital Charge Code |
301716
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.66 |
| Max. Negotiated Rate |
$21.68 |
| Rate for Payer: Aetna Commercial |
$20.48
|
| Rate for Payer: BCBS Trust/PPO |
$19.66
|
| Rate for Payer: BCN Commercial |
$18.62
|
| Rate for Payer: Cash Price |
$19.27
|
| Rate for Payer: Cofinity Commercial |
$20.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.27
|
| Rate for Payer: Healthscope Commercial |
$21.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.48
|
| Rate for Payer: Nomi Health Commercial |
$19.75
|
| Rate for Payer: PHP Commercial |
$20.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.66
|
| Rate for Payer: Priority Health HMO/PPO |
$20.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.20
|
| Rate for Payer: UHC Core |
$20.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.07
|
|
|
NAFCILLIN 2 GRAM SOLUTION MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$24.09
|
|
|
Service Code
|
HCPCS J2290
|
| Hospital Charge Code |
301716
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.72 |
| Max. Negotiated Rate |
$21.68 |
| Rate for Payer: Aetna Commercial |
$20.48
|
| Rate for Payer: Aetna Medicare |
$6.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.53
|
| Rate for Payer: BCBS Complete |
$9.64
|
| Rate for Payer: BCBS MAPPO |
$6.02
|
| Rate for Payer: BCBS Trust/PPO |
$19.80
|
| Rate for Payer: BCN Commercial |
$18.73
|
| Rate for Payer: BCN Medicare Advantage |
$6.02
|
| Rate for Payer: Cash Price |
$19.27
|
| Rate for Payer: Cofinity Commercial |
$20.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.02
|
| Rate for Payer: Healthscope Commercial |
$21.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.48
|
| Rate for Payer: Nomi Health Commercial |
$19.75
|
| Rate for Payer: PACE Senior Care Partners |
$5.72
|
| Rate for Payer: PACE SWMI |
$6.02
|
| Rate for Payer: PHP Commercial |
$20.48
|
| Rate for Payer: PHP Medicare Advantage |
$6.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.66
|
| Rate for Payer: Priority Health HMO/PPO |
$20.96
|
| Rate for Payer: Priority Health Medicare |
$6.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.14
|
| Rate for Payer: Railroad Medicare Medicare |
$6.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.20
|
| Rate for Payer: UHC Core |
$20.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.02
|
| Rate for Payer: UHC Exchange |
$6.02
|
| Rate for Payer: UHC Medicare Advantage |
$6.02
|
| Rate for Payer: VA VA |
$6.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.07
|
|
|
NALOXEGOL 12.5 MG TABLET
|
Facility
|
IP
|
$1,501.61
|
|
|
Service Code
|
NDC 82625880101
|
| Hospital Charge Code |
173967
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$976.05 |
| Max. Negotiated Rate |
$1,351.45 |
| Rate for Payer: Aetna Commercial |
$1,276.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,225.76
|
| Rate for Payer: BCN Commercial |
$1,160.44
|
| Rate for Payer: Cash Price |
$1,201.29
|
| Rate for Payer: Cofinity Commercial |
$1,291.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,201.29
|
| Rate for Payer: Healthscope Commercial |
$1,351.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,126.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,276.37
|
| Rate for Payer: Nomi Health Commercial |
$1,231.32
|
| Rate for Payer: PHP Commercial |
$1,276.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$976.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,306.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,006.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,321.42
|
| Rate for Payer: UHC Core |
$1,253.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,126.21
|
|
|
NALOXEGOL 12.5 MG TABLET
|
Facility
|
OP
|
$1,501.61
|
|
|
Service Code
|
NDC 82625880101
|
| Hospital Charge Code |
173967
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$356.63 |
| Max. Negotiated Rate |
$1,351.45 |
| Rate for Payer: Aetna Commercial |
$1,276.37
|
| Rate for Payer: Aetna Medicare |
$390.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$469.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$469.25
|
| Rate for Payer: BCBS Complete |
$600.64
|
| Rate for Payer: BCBS MAPPO |
$375.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,234.47
|
| Rate for Payer: BCN Commercial |
$1,167.50
|
| Rate for Payer: BCN Medicare Advantage |
$375.40
|
| Rate for Payer: Cash Price |
$1,201.29
|
| Rate for Payer: Cofinity Commercial |
$1,291.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,201.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$375.40
|
| Rate for Payer: Healthscope Commercial |
$1,351.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,126.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$394.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$431.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,276.37
|
| Rate for Payer: Nomi Health Commercial |
$1,231.32
|
| Rate for Payer: PACE Senior Care Partners |
$356.63
|
| Rate for Payer: PACE SWMI |
$375.40
|
| Rate for Payer: PHP Commercial |
$1,276.37
|
| Rate for Payer: PHP Medicare Advantage |
$375.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$976.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,306.40
|
| Rate for Payer: Priority Health Medicare |
$379.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,006.08
|
| Rate for Payer: Railroad Medicare Medicare |
$375.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,321.42
|
| Rate for Payer: UHC Core |
$1,253.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$375.40
|
| Rate for Payer: UHC Exchange |
$375.40
|
| Rate for Payer: UHC Medicare Advantage |
$375.40
|
| Rate for Payer: VA VA |
$375.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,126.21
|
|
|
NALOXONE 0.4 MG/ML INJECTION (CODE)
|
Facility
|
IP
|
$63.57
|
|
|
Service Code
|
HCPCS J2310
|
| Hospital Charge Code |
163714
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.32 |
| Max. Negotiated Rate |
$57.21 |
| Rate for Payer: Aetna Commercial |
$54.03
|
| Rate for Payer: BCBS Trust/PPO |
$51.89
|
| Rate for Payer: BCN Commercial |
$49.13
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cofinity Commercial |
$54.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.86
|
| Rate for Payer: Healthscope Commercial |
$57.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.03
|
| Rate for Payer: Nomi Health Commercial |
$52.13
|
| Rate for Payer: PHP Commercial |
$54.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.32
|
| Rate for Payer: Priority Health HMO/PPO |
$55.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.94
|
| Rate for Payer: UHC Core |
$53.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.68
|
|
|
NALOXONE 0.4 MG/ML INJECTION (CODE)
|
Facility
|
OP
|
$63.57
|
|
|
Service Code
|
HCPCS J2310
|
| Hospital Charge Code |
163714
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.10 |
| Max. Negotiated Rate |
$57.21 |
| Rate for Payer: Aetna Commercial |
$54.03
|
| Rate for Payer: Aetna Medicare |
$16.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.87
|
| Rate for Payer: BCBS Complete |
$25.43
|
| Rate for Payer: BCBS MAPPO |
$15.89
|
| Rate for Payer: BCBS Trust/PPO |
$52.26
|
| Rate for Payer: BCN Commercial |
$49.43
|
| Rate for Payer: BCN Medicare Advantage |
$15.89
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cofinity Commercial |
$54.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.89
|
| Rate for Payer: Healthscope Commercial |
$57.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.03
|
| Rate for Payer: Nomi Health Commercial |
$52.13
|
| Rate for Payer: PACE Senior Care Partners |
$15.10
|
| Rate for Payer: PACE SWMI |
$15.89
|
| Rate for Payer: PHP Commercial |
$54.03
|
| Rate for Payer: PHP Medicare Advantage |
$15.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.32
|
| Rate for Payer: Priority Health HMO/PPO |
$55.31
|
| Rate for Payer: Priority Health Medicare |
$16.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.59
|
| Rate for Payer: Railroad Medicare Medicare |
$15.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.94
|
| Rate for Payer: UHC Core |
$53.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.89
|
| Rate for Payer: UHC Exchange |
$15.89
|
| Rate for Payer: UHC Medicare Advantage |
$15.89
|
| Rate for Payer: VA VA |
$15.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.68
|
|
|
NALOXONE 0.4 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$27.88
|
|
|
Service Code
|
HCPCS J2310
|
| Hospital Charge Code |
5373
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.12 |
| Max. Negotiated Rate |
$25.09 |
| Rate for Payer: Aetna Commercial |
$23.70
|
| Rate for Payer: Aetna Commercial |
$16.63
|
| Rate for Payer: Aetna Commercial |
$15.69
|
| Rate for Payer: Aetna Commercial |
$54.03
|
| Rate for Payer: BCBS Trust/PPO |
$22.76
|
| Rate for Payer: BCBS Trust/PPO |
$51.89
|
| Rate for Payer: BCBS Trust/PPO |
$15.97
|
| Rate for Payer: BCBS Trust/PPO |
$15.07
|
| Rate for Payer: BCN Commercial |
$21.55
|
| Rate for Payer: BCN Commercial |
$14.27
|
| Rate for Payer: BCN Commercial |
$49.13
|
| Rate for Payer: BCN Commercial |
$15.12
|
| Rate for Payer: Cash Price |
$15.65
|
| Rate for Payer: Cash Price |
$22.30
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cash Price |
$14.77
|
| Rate for Payer: Cofinity Commercial |
$15.88
|
| Rate for Payer: Cofinity Commercial |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$23.98
|
| Rate for Payer: Cofinity Commercial |
$16.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.86
|
| Rate for Payer: Healthscope Commercial |
$57.21
|
| Rate for Payer: Healthscope Commercial |
$17.60
|
| Rate for Payer: Healthscope Commercial |
$25.09
|
| Rate for Payer: Healthscope Commercial |
$16.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.03
|
| Rate for Payer: Nomi Health Commercial |
$15.14
|
| Rate for Payer: Nomi Health Commercial |
$16.04
|
| Rate for Payer: Nomi Health Commercial |
$52.13
|
| Rate for Payer: Nomi Health Commercial |
$22.86
|
| Rate for Payer: PHP Commercial |
$16.63
|
| Rate for Payer: PHP Commercial |
$15.69
|
| Rate for Payer: PHP Commercial |
$23.70
|
| Rate for Payer: PHP Commercial |
$54.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.12
|
| Rate for Payer: Priority Health HMO/PPO |
$24.26
|
| Rate for Payer: Priority Health HMO/PPO |
$55.31
|
| Rate for Payer: Priority Health HMO/PPO |
$16.06
|
| Rate for Payer: Priority Health HMO/PPO |
$17.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.53
|
| Rate for Payer: UHC Core |
$23.28
|
| Rate for Payer: UHC Core |
$53.08
|
| Rate for Payer: UHC Core |
$16.33
|
| Rate for Payer: UHC Core |
$15.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.91
|
|
|
NALOXONE 0.4 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$18.46
|
|
|
Service Code
|
HCPCS J2310
|
| Hospital Charge Code |
5373
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.38 |
| Max. Negotiated Rate |
$16.61 |
| Rate for Payer: Aetna Commercial |
$15.69
|
| Rate for Payer: Aetna Commercial |
$54.03
|
| Rate for Payer: Aetna Commercial |
$23.70
|
| Rate for Payer: Aetna Commercial |
$16.63
|
| Rate for Payer: Aetna Medicare |
$5.09
|
| Rate for Payer: Aetna Medicare |
$4.80
|
| Rate for Payer: Aetna Medicare |
$7.25
|
| Rate for Payer: Aetna Medicare |
$16.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.77
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS Complete |
$7.82
|
| Rate for Payer: BCBS Complete |
$25.43
|
| Rate for Payer: BCBS Complete |
$11.15
|
| Rate for Payer: BCBS MAPPO |
$4.62
|
| Rate for Payer: BCBS MAPPO |
$4.89
|
| Rate for Payer: BCBS MAPPO |
$15.89
|
| Rate for Payer: BCBS MAPPO |
$6.97
|
| Rate for Payer: BCBS Trust/PPO |
$15.18
|
| Rate for Payer: BCBS Trust/PPO |
$52.26
|
| Rate for Payer: BCBS Trust/PPO |
$16.08
|
| Rate for Payer: BCBS Trust/PPO |
$22.92
|
| Rate for Payer: BCN Commercial |
$14.35
|
| Rate for Payer: BCN Commercial |
$21.68
|
| Rate for Payer: BCN Commercial |
$15.21
|
| Rate for Payer: BCN Commercial |
$49.43
|
| Rate for Payer: BCN Medicare Advantage |
$4.89
|
| Rate for Payer: BCN Medicare Advantage |
$15.89
|
| Rate for Payer: BCN Medicare Advantage |
$4.62
|
| Rate for Payer: BCN Medicare Advantage |
$6.97
|
| Rate for Payer: Cash Price |
$14.77
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cash Price |
$22.30
|
| Rate for Payer: Cash Price |
$15.65
|
| Rate for Payer: Cofinity Commercial |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$16.82
|
| Rate for Payer: Cofinity Commercial |
$15.88
|
| Rate for Payer: Cofinity Commercial |
$23.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.97
|
| Rate for Payer: Healthscope Commercial |
$16.61
|
| Rate for Payer: Healthscope Commercial |
$57.21
|
| Rate for Payer: Healthscope Commercial |
$25.09
|
| Rate for Payer: Healthscope Commercial |
$17.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.70
|
| Rate for Payer: Nomi Health Commercial |
$22.86
|
| Rate for Payer: Nomi Health Commercial |
$52.13
|
| Rate for Payer: Nomi Health Commercial |
$15.14
|
| Rate for Payer: Nomi Health Commercial |
$16.04
|
| Rate for Payer: PACE Senior Care Partners |
$4.38
|
| Rate for Payer: PACE Senior Care Partners |
$6.62
|
| Rate for Payer: PACE Senior Care Partners |
$15.10
|
| Rate for Payer: PACE Senior Care Partners |
$4.65
|
| Rate for Payer: PACE SWMI |
$4.89
|
| Rate for Payer: PACE SWMI |
$4.62
|
| Rate for Payer: PACE SWMI |
$6.97
|
| Rate for Payer: PACE SWMI |
$15.89
|
| Rate for Payer: PHP Commercial |
$23.70
|
| Rate for Payer: PHP Commercial |
$54.03
|
| Rate for Payer: PHP Commercial |
$16.63
|
| Rate for Payer: PHP Commercial |
$15.69
|
| Rate for Payer: PHP Medicare Advantage |
$4.89
|
| Rate for Payer: PHP Medicare Advantage |
$4.62
|
| Rate for Payer: PHP Medicare Advantage |
$15.89
|
| Rate for Payer: PHP Medicare Advantage |
$6.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.00
|
| Rate for Payer: Priority Health HMO/PPO |
$17.02
|
| Rate for Payer: Priority Health HMO/PPO |
$55.31
|
| Rate for Payer: Priority Health HMO/PPO |
$24.26
|
| Rate for Payer: Priority Health HMO/PPO |
$16.06
|
| Rate for Payer: Priority Health Medicare |
$7.04
|
| Rate for Payer: Priority Health Medicare |
$4.66
|
| Rate for Payer: Priority Health Medicare |
$4.94
|
| Rate for Payer: Priority Health Medicare |
$16.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.37
|
| Rate for Payer: Railroad Medicare Medicare |
$4.89
|
| Rate for Payer: Railroad Medicare Medicare |
$6.97
|
| Rate for Payer: Railroad Medicare Medicare |
$4.62
|
| Rate for Payer: Railroad Medicare Medicare |
$15.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.21
|
| Rate for Payer: UHC Core |
$15.41
|
| Rate for Payer: UHC Core |
$53.08
|
| Rate for Payer: UHC Core |
$16.33
|
| Rate for Payer: UHC Core |
$23.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.89
|
| Rate for Payer: UHC Exchange |
$15.89
|
| Rate for Payer: UHC Exchange |
$4.89
|
| Rate for Payer: UHC Exchange |
$4.62
|
| Rate for Payer: UHC Exchange |
$6.97
|
| Rate for Payer: UHC Medicare Advantage |
$15.89
|
| Rate for Payer: UHC Medicare Advantage |
$4.62
|
| Rate for Payer: UHC Medicare Advantage |
$6.97
|
| Rate for Payer: UHC Medicare Advantage |
$4.89
|
| Rate for Payer: VA VA |
$4.89
|
| Rate for Payer: VA VA |
$15.89
|
| Rate for Payer: VA VA |
$6.97
|
| Rate for Payer: VA VA |
$4.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.91
|
|
|
NALOXONE 1 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$53.92
|
|
|
Service Code
|
HCPCS J2310
|
| Hospital Charge Code |
5374
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$35.05 |
| Max. Negotiated Rate |
$48.53 |
| Rate for Payer: Aetna Commercial |
$45.83
|
| Rate for Payer: Aetna Commercial |
$40.21
|
| Rate for Payer: Aetna Commercial |
$39.25
|
| Rate for Payer: Aetna Commercial |
$73.70
|
| Rate for Payer: BCBS Trust/PPO |
$44.01
|
| Rate for Payer: BCBS Trust/PPO |
$70.78
|
| Rate for Payer: BCBS Trust/PPO |
$38.62
|
| Rate for Payer: BCBS Trust/PPO |
$37.70
|
| Rate for Payer: BCN Commercial |
$41.67
|
| Rate for Payer: BCN Commercial |
$35.69
|
| Rate for Payer: BCN Commercial |
$67.01
|
| Rate for Payer: BCN Commercial |
$36.56
|
| Rate for Payer: Cash Price |
$37.85
|
| Rate for Payer: Cash Price |
$43.14
|
| Rate for Payer: Cash Price |
$69.37
|
| Rate for Payer: Cash Price |
$36.94
|
| Rate for Payer: Cofinity Commercial |
$39.71
|
| Rate for Payer: Cofinity Commercial |
$74.57
|
| Rate for Payer: Cofinity Commercial |
$46.37
|
| Rate for Payer: Cofinity Commercial |
$40.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.37
|
| Rate for Payer: Healthscope Commercial |
$78.04
|
| Rate for Payer: Healthscope Commercial |
$42.58
|
| Rate for Payer: Healthscope Commercial |
$48.53
|
| Rate for Payer: Healthscope Commercial |
$41.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.70
|
| Rate for Payer: Nomi Health Commercial |
$37.87
|
| Rate for Payer: Nomi Health Commercial |
$38.79
|
| Rate for Payer: Nomi Health Commercial |
$71.10
|
| Rate for Payer: Nomi Health Commercial |
$44.21
|
| Rate for Payer: PHP Commercial |
$40.21
|
| Rate for Payer: PHP Commercial |
$39.25
|
| Rate for Payer: PHP Commercial |
$45.83
|
| Rate for Payer: PHP Commercial |
$73.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.05
|
| Rate for Payer: Priority Health HMO/PPO |
$46.91
|
| Rate for Payer: Priority Health HMO/PPO |
$75.44
|
| Rate for Payer: Priority Health HMO/PPO |
$40.18
|
| Rate for Payer: Priority Health HMO/PPO |
$41.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.45
|
| Rate for Payer: UHC Core |
$45.02
|
| Rate for Payer: UHC Core |
$72.40
|
| Rate for Payer: UHC Core |
$39.50
|
| Rate for Payer: UHC Core |
$38.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.44
|
|
|
NALOXONE 1 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$46.18
|
|
|
Service Code
|
HCPCS J2310
|
| Hospital Charge Code |
5374
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$41.56 |
| Rate for Payer: Aetna Commercial |
$39.25
|
| Rate for Payer: Aetna Commercial |
$73.70
|
| Rate for Payer: Aetna Commercial |
$45.83
|
| Rate for Payer: Aetna Commercial |
$40.21
|
| Rate for Payer: Aetna Medicare |
$12.30
|
| Rate for Payer: Aetna Medicare |
$12.01
|
| Rate for Payer: Aetna Medicare |
$14.02
|
| Rate for Payer: Aetna Medicare |
$22.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.43
|
| Rate for Payer: BCBS Complete |
$18.47
|
| Rate for Payer: BCBS Complete |
$18.92
|
| Rate for Payer: BCBS Complete |
$34.68
|
| Rate for Payer: BCBS Complete |
$21.57
|
| Rate for Payer: BCBS MAPPO |
$11.54
|
| Rate for Payer: BCBS MAPPO |
$11.83
|
| Rate for Payer: BCBS MAPPO |
$21.68
|
| Rate for Payer: BCBS MAPPO |
$13.48
|
| Rate for Payer: BCBS Trust/PPO |
$37.96
|
| Rate for Payer: BCBS Trust/PPO |
$71.28
|
| Rate for Payer: BCBS Trust/PPO |
$38.89
|
| Rate for Payer: BCBS Trust/PPO |
$44.33
|
| Rate for Payer: BCN Commercial |
$35.90
|
| Rate for Payer: BCN Commercial |
$41.92
|
| Rate for Payer: BCN Commercial |
$36.78
|
| Rate for Payer: BCN Commercial |
$67.42
|
| Rate for Payer: BCN Medicare Advantage |
$11.83
|
| Rate for Payer: BCN Medicare Advantage |
$21.68
|
| Rate for Payer: BCN Medicare Advantage |
$11.54
|
| Rate for Payer: BCN Medicare Advantage |
$13.48
|
| Rate for Payer: Cash Price |
$36.94
|
| Rate for Payer: Cash Price |
$69.37
|
| Rate for Payer: Cash Price |
$43.14
|
| Rate for Payer: Cash Price |
$37.85
|
| Rate for Payer: Cofinity Commercial |
$74.57
|
| Rate for Payer: Cofinity Commercial |
$40.69
|
| Rate for Payer: Cofinity Commercial |
$39.71
|
| Rate for Payer: Cofinity Commercial |
$46.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.48
|
| Rate for Payer: Healthscope Commercial |
$41.56
|
| Rate for Payer: Healthscope Commercial |
$78.04
|
| Rate for Payer: Healthscope Commercial |
$48.53
|
| Rate for Payer: Healthscope Commercial |
$42.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.83
|
| Rate for Payer: Nomi Health Commercial |
$44.21
|
| Rate for Payer: Nomi Health Commercial |
$71.10
|
| Rate for Payer: Nomi Health Commercial |
$37.87
|
| Rate for Payer: Nomi Health Commercial |
$38.79
|
| Rate for Payer: PACE Senior Care Partners |
$10.97
|
| Rate for Payer: PACE Senior Care Partners |
$12.81
|
| Rate for Payer: PACE Senior Care Partners |
$20.59
|
| Rate for Payer: PACE Senior Care Partners |
$11.24
|
| Rate for Payer: PACE SWMI |
$11.83
|
| Rate for Payer: PACE SWMI |
$11.54
|
| Rate for Payer: PACE SWMI |
$13.48
|
| Rate for Payer: PACE SWMI |
$21.68
|
| Rate for Payer: PHP Commercial |
$45.83
|
| Rate for Payer: PHP Commercial |
$73.70
|
| Rate for Payer: PHP Commercial |
$40.21
|
| Rate for Payer: PHP Commercial |
$39.25
|
| Rate for Payer: PHP Medicare Advantage |
$11.83
|
| Rate for Payer: PHP Medicare Advantage |
$11.54
|
| Rate for Payer: PHP Medicare Advantage |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$13.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.02
|
| Rate for Payer: Priority Health HMO/PPO |
$41.16
|
| Rate for Payer: Priority Health HMO/PPO |
$75.44
|
| Rate for Payer: Priority Health HMO/PPO |
$46.91
|
| Rate for Payer: Priority Health HMO/PPO |
$40.18
|
| Rate for Payer: Priority Health Medicare |
$13.61
|
| Rate for Payer: Priority Health Medicare |
$11.66
|
| Rate for Payer: Priority Health Medicare |
$11.95
|
| Rate for Payer: Priority Health Medicare |
$21.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.94
|
| Rate for Payer: Railroad Medicare Medicare |
$11.83
|
| Rate for Payer: Railroad Medicare Medicare |
$13.48
|
| Rate for Payer: Railroad Medicare Medicare |
$11.54
|
| Rate for Payer: Railroad Medicare Medicare |
$21.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.63
|
| Rate for Payer: UHC Core |
$38.56
|
| Rate for Payer: UHC Core |
$72.40
|
| Rate for Payer: UHC Core |
$39.50
|
| Rate for Payer: UHC Core |
$45.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.83
|
| Rate for Payer: UHC Exchange |
$21.68
|
| Rate for Payer: UHC Exchange |
$11.83
|
| Rate for Payer: UHC Exchange |
$11.54
|
| Rate for Payer: UHC Exchange |
$13.48
|
| Rate for Payer: UHC Medicare Advantage |
$21.68
|
| Rate for Payer: UHC Medicare Advantage |
$11.54
|
| Rate for Payer: UHC Medicare Advantage |
$13.48
|
| Rate for Payer: UHC Medicare Advantage |
$11.83
|
| Rate for Payer: VA VA |
$11.83
|
| Rate for Payer: VA VA |
$21.68
|
| Rate for Payer: VA VA |
$13.48
|
| Rate for Payer: VA VA |
$11.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.44
|
|
|
NALTREXONE ER 380 MG INTRAMUSCULAR SUSPENSION,EXTENDED RELEASE
|
Facility
|
OP
|
$5,030.47
|
|
|
Service Code
|
HCPCS J2315
|
| Hospital Charge Code |
76527
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$4,527.42 |
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,572.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,572.02
|
| Rate for Payer: BCBS Complete |
$3.22
|
| Rate for Payer: BCBS MAPPO |
$1,257.62
|
| Rate for Payer: BCBS Trust/PPO |
$4,135.55
|
| Rate for Payer: BCN Commercial |
$3,911.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,257.62
|
| Rate for Payer: Cash Price |
$4,024.38
|
| Rate for Payer: Cash Price |
$4,024.38
|
| Rate for Payer: Cofinity Commercial |
$4,326.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,024.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,257.62
|
| Rate for Payer: Healthscope Commercial |
$4,527.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,772.85
|
| Rate for Payer: Mclaren Medicaid |
$3.07
|
| Rate for Payer: Aetna Commercial |
$4,275.90
|
| Rate for Payer: Aetna Medicare |
$1,307.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,320.50
|
| Rate for Payer: Meridian Medicaid |
$3.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,446.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,275.90
|
| Rate for Payer: Nomi Health Commercial |
$4,124.99
|
| Rate for Payer: PACE Senior Care Partners |
$1,194.74
|
| Rate for Payer: PACE SWMI |
$1,257.62
|
| Rate for Payer: PHP Commercial |
$4,275.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,257.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,269.81
|
| Rate for Payer: Priority Health HMO/PPO |
$4,376.51
|
| Rate for Payer: Priority Health Medicare |
$1,270.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,370.41
|
| Rate for Payer: Railroad Medicare Medicare |
$1,257.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,426.81
|
| Rate for Payer: UHC Core |
$4,200.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,257.62
|
| Rate for Payer: UHC Exchange |
$1,257.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,257.62
|
| Rate for Payer: UHCCP Medicaid |
$3.07
|
| Rate for Payer: VA VA |
$1,257.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,772.85
|
|
