|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$46.66
|
|
|
Service Code
|
NDC 68094076362
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$41.99 |
| Rate for Payer: Aetna Commercial |
$39.66
|
| Rate for Payer: Aetna Medicare |
$12.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.58
|
| Rate for Payer: BCBS Complete |
$18.66
|
| Rate for Payer: BCBS MAPPO |
$11.66
|
| Rate for Payer: BCBS Trust/PPO |
$38.36
|
| Rate for Payer: BCN Commercial |
$36.28
|
| Rate for Payer: BCN Medicare Advantage |
$11.66
|
| Rate for Payer: Cash Price |
$37.33
|
| Rate for Payer: Cofinity Commercial |
$40.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.66
|
| Rate for Payer: Healthscope Commercial |
$41.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.66
|
| Rate for Payer: Nomi Health Commercial |
$38.26
|
| Rate for Payer: PACE Senior Care Partners |
$11.08
|
| Rate for Payer: PACE SWMI |
$11.66
|
| Rate for Payer: PHP Commercial |
$39.66
|
| Rate for Payer: PHP Medicare Advantage |
$11.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.33
|
| Rate for Payer: Priority Health HMO/PPO |
$40.59
|
| Rate for Payer: Priority Health Medicare |
$11.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.26
|
| Rate for Payer: Railroad Medicare Medicare |
$11.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.06
|
| Rate for Payer: UHC Core |
$38.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.66
|
| Rate for Payer: UHC Exchange |
$11.66
|
| Rate for Payer: UHC Medicare Advantage |
$11.66
|
| Rate for Payer: VA VA |
$11.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.99
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$46.66
|
|
|
Service Code
|
NDC 68094076362
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$30.33 |
| Max. Negotiated Rate |
$41.99 |
| Rate for Payer: Aetna Commercial |
$39.66
|
| Rate for Payer: BCBS Trust/PPO |
$38.09
|
| Rate for Payer: BCN Commercial |
$36.06
|
| Rate for Payer: Cash Price |
$37.33
|
| Rate for Payer: Cofinity Commercial |
$40.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.33
|
| Rate for Payer: Healthscope Commercial |
$41.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.66
|
| Rate for Payer: Nomi Health Commercial |
$38.26
|
| Rate for Payer: PHP Commercial |
$39.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.33
|
| Rate for Payer: Priority Health HMO/PPO |
$40.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.06
|
| Rate for Payer: UHC Core |
$38.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.99
|
|
|
ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$46.66
|
|
|
Service Code
|
NDC 68094076359
|
| Hospital Charge Code |
18877
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$41.99 |
| Rate for Payer: Aetna Commercial |
$39.66
|
| Rate for Payer: Aetna Medicare |
$12.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.58
|
| Rate for Payer: BCBS Complete |
$18.66
|
| Rate for Payer: BCBS MAPPO |
$11.66
|
| Rate for Payer: BCBS Trust/PPO |
$38.36
|
| Rate for Payer: BCN Commercial |
$36.28
|
| Rate for Payer: BCN Medicare Advantage |
$11.66
|
| Rate for Payer: Cash Price |
$37.33
|
| Rate for Payer: Cofinity Commercial |
$40.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.66
|
| Rate for Payer: Healthscope Commercial |
$41.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.66
|
| Rate for Payer: Nomi Health Commercial |
$38.26
|
| Rate for Payer: PACE Senior Care Partners |
$11.08
|
| Rate for Payer: PACE SWMI |
$11.66
|
| Rate for Payer: PHP Commercial |
$39.66
|
| Rate for Payer: PHP Medicare Advantage |
$11.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.33
|
| Rate for Payer: Priority Health HMO/PPO |
$40.59
|
| Rate for Payer: Priority Health Medicare |
$11.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.26
|
| Rate for Payer: Railroad Medicare Medicare |
$11.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.06
|
| Rate for Payer: UHC Core |
$38.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.66
|
| Rate for Payer: UHC Exchange |
$11.66
|
| Rate for Payer: UHC Medicare Advantage |
$11.66
|
| Rate for Payer: VA VA |
$11.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.99
|
|
|
ONDANSETRON HCL 4 MG TABLET
|
Facility
|
IP
|
$195.23
|
|
|
Service Code
|
NDC 50268062115
|
| Hospital Charge Code |
10778
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$126.90 |
| Max. Negotiated Rate |
$175.71 |
| Rate for Payer: Aetna Commercial |
$165.95
|
| Rate for Payer: BCBS Trust/PPO |
$159.37
|
| Rate for Payer: BCN Commercial |
$150.87
|
| Rate for Payer: Cash Price |
$156.18
|
| Rate for Payer: Cofinity Commercial |
$167.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.18
|
| Rate for Payer: Healthscope Commercial |
$175.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.95
|
| Rate for Payer: Nomi Health Commercial |
$160.09
|
| Rate for Payer: PHP Commercial |
$165.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.90
|
| Rate for Payer: Priority Health HMO/PPO |
$169.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.80
|
| Rate for Payer: UHC Core |
$163.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.42
|
|
|
ONDANSETRON HCL 4 MG TABLET
|
Facility
|
IP
|
$3.91
|
|
|
Service Code
|
NDC 50268062111
|
| Hospital Charge Code |
10778
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$3.52 |
| Rate for Payer: Aetna Commercial |
$3.32
|
| Rate for Payer: BCBS Trust/PPO |
$3.19
|
| Rate for Payer: BCN Commercial |
$3.02
|
| Rate for Payer: Cash Price |
$3.13
|
| Rate for Payer: Cofinity Commercial |
$3.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.13
|
| Rate for Payer: Healthscope Commercial |
$3.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.32
|
| Rate for Payer: Nomi Health Commercial |
$3.21
|
| Rate for Payer: PHP Commercial |
$3.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.54
|
| Rate for Payer: Priority Health HMO/PPO |
$3.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.44
|
| Rate for Payer: UHC Core |
$3.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.93
|
|
|
ONDANSETRON HCL 4 MG TABLET
|
Facility
|
OP
|
$195.23
|
|
|
Service Code
|
NDC 50268062115
|
| Hospital Charge Code |
10778
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$46.37 |
| Max. Negotiated Rate |
$175.71 |
| Rate for Payer: Aetna Commercial |
$165.95
|
| Rate for Payer: Aetna Medicare |
$50.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.01
|
| Rate for Payer: BCBS Complete |
$78.09
|
| Rate for Payer: BCBS MAPPO |
$48.81
|
| Rate for Payer: BCBS Trust/PPO |
$160.50
|
| Rate for Payer: BCN Commercial |
$151.79
|
| Rate for Payer: BCN Medicare Advantage |
$48.81
|
| Rate for Payer: Cash Price |
$156.18
|
| Rate for Payer: Cofinity Commercial |
$167.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.81
|
| Rate for Payer: Healthscope Commercial |
$175.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.95
|
| Rate for Payer: Nomi Health Commercial |
$160.09
|
| Rate for Payer: PACE Senior Care Partners |
$46.37
|
| Rate for Payer: PACE SWMI |
$48.81
|
| Rate for Payer: PHP Commercial |
$165.95
|
| Rate for Payer: PHP Medicare Advantage |
$48.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.90
|
| Rate for Payer: Priority Health HMO/PPO |
$169.85
|
| Rate for Payer: Priority Health Medicare |
$49.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.80
|
| Rate for Payer: Railroad Medicare Medicare |
$48.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.80
|
| Rate for Payer: UHC Core |
$163.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.81
|
| Rate for Payer: UHC Exchange |
$48.81
|
| Rate for Payer: UHC Medicare Advantage |
$48.81
|
| Rate for Payer: VA VA |
$48.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.42
|
|
|
ONDANSETRON HCL 4 MG TABLET
|
Facility
|
OP
|
$3.91
|
|
|
Service Code
|
NDC 50268062111
|
| Hospital Charge Code |
10778
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$3.52 |
| Rate for Payer: Aetna Commercial |
$3.32
|
| Rate for Payer: Aetna Medicare |
$1.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.22
|
| Rate for Payer: BCBS Complete |
$1.56
|
| Rate for Payer: BCBS MAPPO |
$0.98
|
| Rate for Payer: BCBS Trust/PPO |
$3.21
|
| Rate for Payer: BCN Commercial |
$3.04
|
| Rate for Payer: BCN Medicare Advantage |
$0.98
|
| Rate for Payer: Cash Price |
$3.13
|
| Rate for Payer: Cofinity Commercial |
$3.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.98
|
| Rate for Payer: Healthscope Commercial |
$3.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.32
|
| Rate for Payer: Nomi Health Commercial |
$3.21
|
| Rate for Payer: PACE Senior Care Partners |
$0.93
|
| Rate for Payer: PACE SWMI |
$0.98
|
| Rate for Payer: PHP Commercial |
$3.32
|
| Rate for Payer: PHP Medicare Advantage |
$0.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.54
|
| Rate for Payer: Priority Health HMO/PPO |
$3.40
|
| Rate for Payer: Priority Health Medicare |
$0.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.62
|
| Rate for Payer: Railroad Medicare Medicare |
$0.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.44
|
| Rate for Payer: UHC Core |
$3.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.98
|
| Rate for Payer: UHC Exchange |
$0.98
|
| Rate for Payer: UHC Medicare Advantage |
$0.98
|
| Rate for Payer: VA VA |
$0.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.93
|
|
|
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION (CODE)
|
Facility
|
IP
|
$12.15
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
163708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.90 |
| Max. Negotiated Rate |
$10.94 |
| Rate for Payer: Aetna Commercial |
$10.33
|
| Rate for Payer: Aetna Commercial |
$14.70
|
| Rate for Payer: Aetna Commercial |
$7.74
|
| Rate for Payer: BCBS Trust/PPO |
$14.11
|
| Rate for Payer: BCBS Trust/PPO |
$9.92
|
| Rate for Payer: BCBS Trust/PPO |
$7.43
|
| Rate for Payer: BCN Commercial |
$13.36
|
| Rate for Payer: BCN Commercial |
$9.39
|
| Rate for Payer: BCN Commercial |
$7.03
|
| Rate for Payer: Cash Price |
$9.72
|
| Rate for Payer: Cash Price |
$7.28
|
| Rate for Payer: Cash Price |
$13.83
|
| Rate for Payer: Cofinity Commercial |
$7.83
|
| Rate for Payer: Cofinity Commercial |
$14.87
|
| Rate for Payer: Cofinity Commercial |
$10.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.28
|
| Rate for Payer: Healthscope Commercial |
$15.56
|
| Rate for Payer: Healthscope Commercial |
$10.94
|
| Rate for Payer: Healthscope Commercial |
$8.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.74
|
| Rate for Payer: Nomi Health Commercial |
$9.96
|
| Rate for Payer: Nomi Health Commercial |
$14.18
|
| Rate for Payer: Nomi Health Commercial |
$7.46
|
| Rate for Payer: PHP Commercial |
$14.70
|
| Rate for Payer: PHP Commercial |
$10.33
|
| Rate for Payer: PHP Commercial |
$7.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.24
|
| Rate for Payer: Priority Health HMO/PPO |
$7.92
|
| Rate for Payer: Priority Health HMO/PPO |
$15.04
|
| Rate for Payer: Priority Health HMO/PPO |
$10.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.69
|
| Rate for Payer: UHC Core |
$10.15
|
| Rate for Payer: UHC Core |
$7.60
|
| Rate for Payer: UHC Core |
$14.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.97
|
|
|
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION (CODE)
|
Facility
|
OP
|
$12.15
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
163708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.89 |
| Max. Negotiated Rate |
$10.94 |
| Rate for Payer: Aetna Commercial |
$10.33
|
| Rate for Payer: Aetna Commercial |
$7.74
|
| Rate for Payer: Aetna Commercial |
$14.70
|
| Rate for Payer: Aetna Medicare |
$2.37
|
| Rate for Payer: Aetna Medicare |
$3.16
|
| Rate for Payer: Aetna Medicare |
$4.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.84
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS Complete |
$4.86
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$2.27
|
| Rate for Payer: BCBS MAPPO |
$3.04
|
| Rate for Payer: BCBS MAPPO |
$4.32
|
| Rate for Payer: BCBS Trust/PPO |
$14.21
|
| Rate for Payer: BCBS Trust/PPO |
$9.99
|
| Rate for Payer: BCBS Trust/PPO |
$7.48
|
| Rate for Payer: BCN Commercial |
$13.44
|
| Rate for Payer: BCN Commercial |
$7.08
|
| Rate for Payer: BCN Commercial |
$9.45
|
| Rate for Payer: BCN Medicare Advantage |
$3.04
|
| Rate for Payer: BCN Medicare Advantage |
$4.32
|
| Rate for Payer: BCN Medicare Advantage |
$2.27
|
| Rate for Payer: Cash Price |
$13.83
|
| Rate for Payer: Cash Price |
$7.28
|
| Rate for Payer: Cash Price |
$9.72
|
| Rate for Payer: Cofinity Commercial |
$7.83
|
| Rate for Payer: Cofinity Commercial |
$10.45
|
| Rate for Payer: Cofinity Commercial |
$14.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.04
|
| Rate for Payer: Healthscope Commercial |
$15.56
|
| Rate for Payer: Healthscope Commercial |
$10.94
|
| Rate for Payer: Healthscope Commercial |
$8.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.33
|
| Rate for Payer: Nomi Health Commercial |
$7.46
|
| Rate for Payer: Nomi Health Commercial |
$9.96
|
| Rate for Payer: Nomi Health Commercial |
$14.18
|
| Rate for Payer: PACE Senior Care Partners |
$2.16
|
| Rate for Payer: PACE Senior Care Partners |
$2.89
|
| Rate for Payer: PACE Senior Care Partners |
$4.11
|
| Rate for Payer: PACE SWMI |
$4.32
|
| Rate for Payer: PACE SWMI |
$3.04
|
| Rate for Payer: PACE SWMI |
$2.27
|
| Rate for Payer: PHP Commercial |
$7.74
|
| Rate for Payer: PHP Commercial |
$14.70
|
| Rate for Payer: PHP Commercial |
$10.33
|
| Rate for Payer: PHP Medicare Advantage |
$4.32
|
| Rate for Payer: PHP Medicare Advantage |
$2.27
|
| Rate for Payer: PHP Medicare Advantage |
$3.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.24
|
| Rate for Payer: Priority Health HMO/PPO |
$7.92
|
| Rate for Payer: Priority Health HMO/PPO |
$10.57
|
| Rate for Payer: Priority Health HMO/PPO |
$15.04
|
| Rate for Payer: Priority Health Medicare |
$3.07
|
| Rate for Payer: Priority Health Medicare |
$2.30
|
| Rate for Payer: Priority Health Medicare |
$4.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.14
|
| Rate for Payer: Railroad Medicare Medicare |
$4.32
|
| Rate for Payer: Railroad Medicare Medicare |
$2.27
|
| Rate for Payer: Railroad Medicare Medicare |
$3.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.69
|
| Rate for Payer: UHC Core |
$7.60
|
| Rate for Payer: UHC Core |
$14.44
|
| Rate for Payer: UHC Core |
$10.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.32
|
| Rate for Payer: UHC Exchange |
$4.32
|
| Rate for Payer: UHC Exchange |
$3.04
|
| Rate for Payer: UHC Exchange |
$2.27
|
| Rate for Payer: UHC Medicare Advantage |
$3.04
|
| Rate for Payer: UHC Medicare Advantage |
$4.32
|
| Rate for Payer: UHC Medicare Advantage |
$2.27
|
| Rate for Payer: VA VA |
$4.32
|
| Rate for Payer: VA VA |
$2.27
|
| Rate for Payer: VA VA |
$3.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.97
|
|
|
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION
|
Facility
|
IP
|
$17.29
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
105614
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.24 |
| Max. Negotiated Rate |
$15.56 |
| Rate for Payer: Aetna Commercial |
$14.70
|
| Rate for Payer: Aetna Commercial |
$13.12
|
| Rate for Payer: Aetna Commercial |
$9.86
|
| Rate for Payer: Aetna Commercial |
$8.88
|
| Rate for Payer: Aetna Commercial |
$9.10
|
| Rate for Payer: Aetna Commercial |
$10.33
|
| Rate for Payer: Aetna Commercial |
$7.91
|
| Rate for Payer: Aetna Commercial |
$7.74
|
| Rate for Payer: BCBS Trust/PPO |
$7.43
|
| Rate for Payer: BCBS Trust/PPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$14.11
|
| Rate for Payer: BCBS Trust/PPO |
$8.53
|
| Rate for Payer: BCBS Trust/PPO |
$7.59
|
| Rate for Payer: BCBS Trust/PPO |
$8.73
|
| Rate for Payer: BCBS Trust/PPO |
$9.92
|
| Rate for Payer: BCBS Trust/PPO |
$9.47
|
| Rate for Payer: BCN Commercial |
$8.96
|
| Rate for Payer: BCN Commercial |
$8.08
|
| Rate for Payer: BCN Commercial |
$9.39
|
| Rate for Payer: BCN Commercial |
$8.27
|
| Rate for Payer: BCN Commercial |
$13.36
|
| Rate for Payer: BCN Commercial |
$7.19
|
| Rate for Payer: BCN Commercial |
$11.92
|
| Rate for Payer: BCN Commercial |
$7.03
|
| Rate for Payer: Cash Price |
$7.28
|
| Rate for Payer: Cash Price |
$9.28
|
| Rate for Payer: Cash Price |
$12.34
|
| Rate for Payer: Cash Price |
$8.56
|
| Rate for Payer: Cash Price |
$8.36
|
| Rate for Payer: Cash Price |
$9.72
|
| Rate for Payer: Cash Price |
$7.44
|
| Rate for Payer: Cash Price |
$13.83
|
| Rate for Payer: Cofinity Commercial |
$10.45
|
| Rate for Payer: Cofinity Commercial |
$8.99
|
| Rate for Payer: Cofinity Commercial |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$9.20
|
| Rate for Payer: Cofinity Commercial |
$13.27
|
| Rate for Payer: Cofinity Commercial |
$14.87
|
| Rate for Payer: Cofinity Commercial |
$7.83
|
| Rate for Payer: Cofinity Commercial |
$8.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.56
|
| Rate for Payer: Healthscope Commercial |
$9.40
|
| Rate for Payer: Healthscope Commercial |
$8.37
|
| Rate for Payer: Healthscope Commercial |
$8.19
|
| Rate for Payer: Healthscope Commercial |
$10.94
|
| Rate for Payer: Healthscope Commercial |
$9.63
|
| Rate for Payer: Healthscope Commercial |
$10.44
|
| Rate for Payer: Healthscope Commercial |
$15.56
|
| Rate for Payer: Healthscope Commercial |
$13.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.74
|
| Rate for Payer: Nomi Health Commercial |
$7.46
|
| Rate for Payer: Nomi Health Commercial |
$12.65
|
| Rate for Payer: Nomi Health Commercial |
$14.18
|
| Rate for Payer: Nomi Health Commercial |
$7.63
|
| Rate for Payer: Nomi Health Commercial |
$8.57
|
| Rate for Payer: Nomi Health Commercial |
$8.77
|
| Rate for Payer: Nomi Health Commercial |
$9.96
|
| Rate for Payer: Nomi Health Commercial |
$9.51
|
| Rate for Payer: PHP Commercial |
$7.91
|
| Rate for Payer: PHP Commercial |
$8.88
|
| Rate for Payer: PHP Commercial |
$9.86
|
| Rate for Payer: PHP Commercial |
$10.33
|
| Rate for Payer: PHP Commercial |
$7.74
|
| Rate for Payer: PHP Commercial |
$9.10
|
| Rate for Payer: PHP Commercial |
$13.12
|
| Rate for Payer: PHP Commercial |
$14.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.04
|
| Rate for Payer: Priority Health HMO/PPO |
$13.42
|
| Rate for Payer: Priority Health HMO/PPO |
$15.04
|
| Rate for Payer: Priority Health HMO/PPO |
$9.31
|
| Rate for Payer: Priority Health HMO/PPO |
$9.09
|
| Rate for Payer: Priority Health HMO/PPO |
$10.57
|
| Rate for Payer: Priority Health HMO/PPO |
$7.92
|
| Rate for Payer: Priority Health HMO/PPO |
$10.09
|
| Rate for Payer: Priority Health HMO/PPO |
$8.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.42
|
| Rate for Payer: UHC Core |
$10.15
|
| Rate for Payer: UHC Core |
$8.73
|
| Rate for Payer: UHC Core |
$14.44
|
| Rate for Payer: UHC Core |
$8.93
|
| Rate for Payer: UHC Core |
$12.88
|
| Rate for Payer: UHC Core |
$7.77
|
| Rate for Payer: UHC Core |
$7.60
|
| Rate for Payer: UHC Core |
$9.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.57
|
|
|
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION
|
Facility
|
OP
|
$10.45
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
105614
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$9.40 |
| Rate for Payer: Aetna Commercial |
$8.88
|
| Rate for Payer: Aetna Commercial |
$9.10
|
| Rate for Payer: Aetna Commercial |
$9.86
|
| Rate for Payer: Aetna Commercial |
$10.33
|
| Rate for Payer: Aetna Commercial |
$13.12
|
| Rate for Payer: Aetna Commercial |
$14.70
|
| Rate for Payer: Aetna Commercial |
$7.74
|
| Rate for Payer: Aetna Commercial |
$7.91
|
| Rate for Payer: Aetna Medicare |
$4.50
|
| Rate for Payer: Aetna Medicare |
$4.01
|
| Rate for Payer: Aetna Medicare |
$2.42
|
| Rate for Payer: Aetna Medicare |
$2.37
|
| Rate for Payer: Aetna Medicare |
$3.02
|
| Rate for Payer: Aetna Medicare |
$3.16
|
| Rate for Payer: Aetna Medicare |
$2.72
|
| Rate for Payer: Aetna Medicare |
$2.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.62
|
| Rate for Payer: BCBS Complete |
$6.17
|
| Rate for Payer: BCBS Complete |
$4.28
|
| Rate for Payer: BCBS Complete |
$4.64
|
| Rate for Payer: BCBS Complete |
$4.86
|
| Rate for Payer: BCBS Complete |
$4.18
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS MAPPO |
$2.67
|
| Rate for Payer: BCBS MAPPO |
$3.86
|
| Rate for Payer: BCBS MAPPO |
$4.32
|
| Rate for Payer: BCBS MAPPO |
$2.90
|
| Rate for Payer: BCBS MAPPO |
$2.27
|
| Rate for Payer: BCBS MAPPO |
$3.04
|
| Rate for Payer: BCBS MAPPO |
$2.61
|
| Rate for Payer: BCBS MAPPO |
$2.33
|
| Rate for Payer: BCBS Trust/PPO |
$9.54
|
| Rate for Payer: BCBS Trust/PPO |
$9.99
|
| Rate for Payer: BCBS Trust/PPO |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$14.21
|
| Rate for Payer: BCBS Trust/PPO |
$12.69
|
| Rate for Payer: BCBS Trust/PPO |
$8.59
|
| Rate for Payer: BCBS Trust/PPO |
$8.80
|
| Rate for Payer: BCBS Trust/PPO |
$7.48
|
| Rate for Payer: BCN Commercial |
$7.23
|
| Rate for Payer: BCN Commercial |
$9.45
|
| Rate for Payer: BCN Commercial |
$8.32
|
| Rate for Payer: BCN Commercial |
$13.44
|
| Rate for Payer: BCN Commercial |
$12.00
|
| Rate for Payer: BCN Commercial |
$7.08
|
| Rate for Payer: BCN Commercial |
$8.12
|
| Rate for Payer: BCN Commercial |
$9.02
|
| Rate for Payer: BCN Medicare Advantage |
$3.86
|
| Rate for Payer: BCN Medicare Advantage |
$2.27
|
| Rate for Payer: BCN Medicare Advantage |
$2.90
|
| Rate for Payer: BCN Medicare Advantage |
$2.61
|
| Rate for Payer: BCN Medicare Advantage |
$2.33
|
| Rate for Payer: BCN Medicare Advantage |
$4.32
|
| Rate for Payer: BCN Medicare Advantage |
$3.04
|
| Rate for Payer: BCN Medicare Advantage |
$2.67
|
| Rate for Payer: Cash Price |
$13.83
|
| Rate for Payer: Cash Price |
$8.56
|
| Rate for Payer: Cash Price |
$12.34
|
| Rate for Payer: Cash Price |
$7.28
|
| Rate for Payer: Cash Price |
$9.28
|
| Rate for Payer: Cash Price |
$9.72
|
| Rate for Payer: Cash Price |
$7.44
|
| Rate for Payer: Cash Price |
$8.36
|
| Rate for Payer: Cofinity Commercial |
$9.20
|
| Rate for Payer: Cofinity Commercial |
$14.87
|
| Rate for Payer: Cofinity Commercial |
$13.27
|
| Rate for Payer: Cofinity Commercial |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$7.83
|
| Rate for Payer: Cofinity Commercial |
$8.99
|
| Rate for Payer: Cofinity Commercial |
$10.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.33
|
| Rate for Payer: Healthscope Commercial |
$10.44
|
| Rate for Payer: Healthscope Commercial |
$8.19
|
| Rate for Payer: Healthscope Commercial |
$9.40
|
| Rate for Payer: Healthscope Commercial |
$13.89
|
| Rate for Payer: Healthscope Commercial |
$8.37
|
| Rate for Payer: Healthscope Commercial |
$10.94
|
| Rate for Payer: Healthscope Commercial |
$9.63
|
| Rate for Payer: Healthscope Commercial |
$15.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.88
|
| Rate for Payer: Nomi Health Commercial |
$8.77
|
| Rate for Payer: Nomi Health Commercial |
$14.18
|
| Rate for Payer: Nomi Health Commercial |
$9.96
|
| Rate for Payer: Nomi Health Commercial |
$9.51
|
| Rate for Payer: Nomi Health Commercial |
$7.46
|
| Rate for Payer: Nomi Health Commercial |
$7.63
|
| Rate for Payer: Nomi Health Commercial |
$8.57
|
| Rate for Payer: Nomi Health Commercial |
$12.65
|
| Rate for Payer: PACE Senior Care Partners |
$2.21
|
| Rate for Payer: PACE Senior Care Partners |
$2.48
|
| Rate for Payer: PACE Senior Care Partners |
$2.89
|
| Rate for Payer: PACE Senior Care Partners |
$4.11
|
| Rate for Payer: PACE Senior Care Partners |
$3.66
|
| Rate for Payer: PACE Senior Care Partners |
$2.16
|
| Rate for Payer: PACE Senior Care Partners |
$2.75
|
| Rate for Payer: PACE Senior Care Partners |
$2.54
|
| Rate for Payer: PACE SWMI |
$3.86
|
| Rate for Payer: PACE SWMI |
$2.61
|
| Rate for Payer: PACE SWMI |
$2.90
|
| Rate for Payer: PACE SWMI |
$3.04
|
| Rate for Payer: PACE SWMI |
$2.67
|
| Rate for Payer: PACE SWMI |
$4.32
|
| Rate for Payer: PACE SWMI |
$2.27
|
| Rate for Payer: PACE SWMI |
$2.33
|
| Rate for Payer: PHP Commercial |
$9.86
|
| Rate for Payer: PHP Commercial |
$7.91
|
| Rate for Payer: PHP Commercial |
$8.88
|
| Rate for Payer: PHP Commercial |
$13.12
|
| Rate for Payer: PHP Commercial |
$10.33
|
| Rate for Payer: PHP Commercial |
$7.74
|
| Rate for Payer: PHP Commercial |
$14.70
|
| Rate for Payer: PHP Commercial |
$9.10
|
| Rate for Payer: PHP Medicare Advantage |
$2.27
|
| Rate for Payer: PHP Medicare Advantage |
$3.04
|
| Rate for Payer: PHP Medicare Advantage |
$2.67
|
| Rate for Payer: PHP Medicare Advantage |
$3.86
|
| Rate for Payer: PHP Medicare Advantage |
$2.90
|
| Rate for Payer: PHP Medicare Advantage |
$2.33
|
| Rate for Payer: PHP Medicare Advantage |
$4.32
|
| Rate for Payer: PHP Medicare Advantage |
$2.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.04
|
| Rate for Payer: Priority Health HMO/PPO |
$8.09
|
| Rate for Payer: Priority Health HMO/PPO |
$13.42
|
| Rate for Payer: Priority Health HMO/PPO |
$10.57
|
| Rate for Payer: Priority Health HMO/PPO |
$15.04
|
| Rate for Payer: Priority Health HMO/PPO |
$9.09
|
| Rate for Payer: Priority Health HMO/PPO |
$9.31
|
| Rate for Payer: Priority Health HMO/PPO |
$7.92
|
| Rate for Payer: Priority Health HMO/PPO |
$10.09
|
| Rate for Payer: Priority Health Medicare |
$2.35
|
| Rate for Payer: Priority Health Medicare |
$3.90
|
| Rate for Payer: Priority Health Medicare |
$3.07
|
| Rate for Payer: Priority Health Medicare |
$2.70
|
| Rate for Payer: Priority Health Medicare |
$2.64
|
| Rate for Payer: Priority Health Medicare |
$4.37
|
| Rate for Payer: Priority Health Medicare |
$2.30
|
| Rate for Payer: Priority Health Medicare |
$2.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.10
|
| Rate for Payer: Railroad Medicare Medicare |
$2.90
|
| Rate for Payer: Railroad Medicare Medicare |
$4.32
|
| Rate for Payer: Railroad Medicare Medicare |
$2.67
|
| Rate for Payer: Railroad Medicare Medicare |
$2.61
|
| Rate for Payer: Railroad Medicare Medicare |
$2.27
|
| Rate for Payer: Railroad Medicare Medicare |
$2.33
|
| Rate for Payer: Railroad Medicare Medicare |
$3.04
|
| Rate for Payer: Railroad Medicare Medicare |
$3.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.18
|
| Rate for Payer: UHC Core |
$12.88
|
| Rate for Payer: UHC Core |
$8.93
|
| Rate for Payer: UHC Core |
$14.44
|
| Rate for Payer: UHC Core |
$8.73
|
| Rate for Payer: UHC Core |
$9.69
|
| Rate for Payer: UHC Core |
$10.15
|
| Rate for Payer: UHC Core |
$7.77
|
| Rate for Payer: UHC Core |
$7.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.86
|
| Rate for Payer: UHC Exchange |
$4.32
|
| Rate for Payer: UHC Exchange |
$2.90
|
| Rate for Payer: UHC Exchange |
$2.27
|
| Rate for Payer: UHC Exchange |
$2.67
|
| Rate for Payer: UHC Exchange |
$2.61
|
| Rate for Payer: UHC Exchange |
$3.86
|
| Rate for Payer: UHC Exchange |
$3.04
|
| Rate for Payer: UHC Exchange |
$2.33
|
| Rate for Payer: UHC Medicare Advantage |
$2.67
|
| Rate for Payer: UHC Medicare Advantage |
$4.32
|
| Rate for Payer: UHC Medicare Advantage |
$2.27
|
| Rate for Payer: UHC Medicare Advantage |
$3.86
|
| Rate for Payer: UHC Medicare Advantage |
$3.04
|
| Rate for Payer: UHC Medicare Advantage |
$2.90
|
| Rate for Payer: UHC Medicare Advantage |
$2.33
|
| Rate for Payer: UHC Medicare Advantage |
$2.61
|
| Rate for Payer: VA VA |
$2.27
|
| Rate for Payer: VA VA |
$3.86
|
| Rate for Payer: VA VA |
$2.67
|
| Rate for Payer: VA VA |
$3.04
|
| Rate for Payer: VA VA |
$2.61
|
| Rate for Payer: VA VA |
$2.33
|
| Rate for Payer: VA VA |
$4.32
|
| Rate for Payer: VA VA |
$2.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.84
|
|
|
OPEN TREATMENT OF CLAVICULAR FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED
|
Facility
|
OP
|
$5,423.52
|
|
|
Service Code
|
CPT 23515
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,164.92 |
| Max. Negotiated Rate |
$5,423.52 |
| Rate for Payer: BCBS Complete |
$5,423.52
|
| Rate for Payer: Mclaren Medicaid |
$5,164.92
|
| Rate for Payer: Meridian Medicaid |
$5,423.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,164.92
|
| Rate for Payer: UHCCP Medicaid |
$5,164.92
|
|
|
OPEN TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS), INCLUDES INTERNAL FIXATION, WHEN PERFORMED
|
Facility
|
OP
|
$5,423.52
|
|
|
Service Code
|
CPT 27792
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,164.92 |
| Max. Negotiated Rate |
$5,423.52 |
| Rate for Payer: BCBS Complete |
$5,423.52
|
| Rate for Payer: Mclaren Medicaid |
$5,164.92
|
| Rate for Payer: Meridian Medicaid |
$5,423.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,164.92
|
| Rate for Payer: UHCCP Medicaid |
$5,164.92
|
|
|
OPEN TREATMENT OF DISTAL RADIAL EXTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION, WITH INTERNAL FIXATION
|
Facility
|
OP
|
$5,423.52
|
|
|
Service Code
|
CPT 25607
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,164.92 |
| Max. Negotiated Rate |
$5,423.52 |
| Rate for Payer: BCBS Complete |
$5,423.52
|
| Rate for Payer: Mclaren Medicaid |
$5,164.92
|
| Rate for Payer: Meridian Medicaid |
$5,423.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,164.92
|
| Rate for Payer: UHCCP Medicaid |
$5,164.92
|
|
|
OPEN TREATMENT OF DISTAL TIBIOFIBULAR JOINT (SYNDESMOSIS) DISRUPTION, INCLUDES INTERNAL FIXATION, WHEN PERFORMED
|
Facility
|
OP
|
$5,423.52
|
|
|
Service Code
|
CPT 27829
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,164.92 |
| Max. Negotiated Rate |
$5,423.52 |
| Rate for Payer: BCBS Complete |
$5,423.52
|
| Rate for Payer: Mclaren Medicaid |
$5,164.92
|
| Rate for Payer: Meridian Medicaid |
$5,423.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,164.92
|
| Rate for Payer: UHCCP Medicaid |
$5,164.92
|
|
|
OPEN TREATMENT OF FRACTURE, GREAT TOE, PHALANX OR PHALANGES, INCLUDES INTERNAL FIXATION, WHEN PERFORMED
|
Facility
|
OP
|
$2,463.31
|
|
|
Service Code
|
CPT 28505
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,345.85 |
| Max. Negotiated Rate |
$2,463.31 |
| Rate for Payer: BCBS Complete |
$2,463.31
|
| Rate for Payer: Mclaren Medicaid |
$2,345.85
|
| Rate for Payer: Meridian Medicaid |
$2,463.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,345.85
|
| Rate for Payer: UHCCP Medicaid |
$2,345.85
|
|
|
ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$43.19
|
|
|
Service Code
|
HCPCS J2360
|
| Hospital Charge Code |
5886
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.26 |
| Max. Negotiated Rate |
$38.87 |
| Rate for Payer: Aetna Commercial |
$36.71
|
| Rate for Payer: Aetna Commercial |
$51.31
|
| Rate for Payer: Aetna Commercial |
$51.02
|
| Rate for Payer: Aetna Commercial |
$37.54
|
| Rate for Payer: Aetna Medicare |
$11.48
|
| Rate for Payer: Aetna Medicare |
$11.23
|
| Rate for Payer: Aetna Medicare |
$15.61
|
| Rate for Payer: Aetna Medicare |
$15.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.50
|
| Rate for Payer: BCBS Complete |
$17.28
|
| Rate for Payer: BCBS Complete |
$17.67
|
| Rate for Payer: BCBS Complete |
$24.14
|
| Rate for Payer: BCBS Complete |
$24.01
|
| Rate for Payer: BCBS MAPPO |
$10.80
|
| Rate for Payer: BCBS MAPPO |
$11.04
|
| Rate for Payer: BCBS MAPPO |
$15.09
|
| Rate for Payer: BCBS MAPPO |
$15.01
|
| Rate for Payer: BCBS Trust/PPO |
$35.51
|
| Rate for Payer: BCBS Trust/PPO |
$49.62
|
| Rate for Payer: BCBS Trust/PPO |
$36.31
|
| Rate for Payer: BCBS Trust/PPO |
$49.34
|
| Rate for Payer: BCN Commercial |
$33.58
|
| Rate for Payer: BCN Commercial |
$46.67
|
| Rate for Payer: BCN Commercial |
$34.34
|
| Rate for Payer: BCN Commercial |
$46.93
|
| Rate for Payer: BCN Medicare Advantage |
$11.04
|
| Rate for Payer: BCN Medicare Advantage |
$15.09
|
| Rate for Payer: BCN Medicare Advantage |
$10.80
|
| Rate for Payer: BCN Medicare Advantage |
$15.01
|
| Rate for Payer: Cash Price |
$34.55
|
| Rate for Payer: Cash Price |
$48.29
|
| Rate for Payer: Cash Price |
$48.02
|
| Rate for Payer: Cash Price |
$35.34
|
| Rate for Payer: Cofinity Commercial |
$51.91
|
| Rate for Payer: Cofinity Commercial |
$37.99
|
| Rate for Payer: Cofinity Commercial |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$51.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.01
|
| Rate for Payer: Healthscope Commercial |
$38.87
|
| Rate for Payer: Healthscope Commercial |
$54.32
|
| Rate for Payer: Healthscope Commercial |
$54.02
|
| Rate for Payer: Healthscope Commercial |
$39.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.02
|
| Rate for Payer: Nomi Health Commercial |
$49.22
|
| Rate for Payer: Nomi Health Commercial |
$49.50
|
| Rate for Payer: Nomi Health Commercial |
$35.42
|
| Rate for Payer: Nomi Health Commercial |
$36.22
|
| Rate for Payer: PACE Senior Care Partners |
$10.26
|
| Rate for Payer: PACE Senior Care Partners |
$14.25
|
| Rate for Payer: PACE Senior Care Partners |
$14.34
|
| Rate for Payer: PACE Senior Care Partners |
$10.49
|
| Rate for Payer: PACE SWMI |
$11.04
|
| Rate for Payer: PACE SWMI |
$10.80
|
| Rate for Payer: PACE SWMI |
$15.01
|
| Rate for Payer: PACE SWMI |
$15.09
|
| Rate for Payer: PHP Commercial |
$51.02
|
| Rate for Payer: PHP Commercial |
$51.31
|
| Rate for Payer: PHP Commercial |
$37.54
|
| Rate for Payer: PHP Commercial |
$36.71
|
| Rate for Payer: PHP Medicare Advantage |
$11.04
|
| Rate for Payer: PHP Medicare Advantage |
$10.80
|
| Rate for Payer: PHP Medicare Advantage |
$15.09
|
| Rate for Payer: PHP Medicare Advantage |
$15.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.07
|
| Rate for Payer: Priority Health HMO/PPO |
$38.43
|
| Rate for Payer: Priority Health HMO/PPO |
$52.51
|
| Rate for Payer: Priority Health HMO/PPO |
$52.22
|
| Rate for Payer: Priority Health HMO/PPO |
$37.58
|
| Rate for Payer: Priority Health Medicare |
$15.16
|
| Rate for Payer: Priority Health Medicare |
$10.91
|
| Rate for Payer: Priority Health Medicare |
$11.15
|
| Rate for Payer: Priority Health Medicare |
$15.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.94
|
| Rate for Payer: Railroad Medicare Medicare |
$11.04
|
| Rate for Payer: Railroad Medicare Medicare |
$15.01
|
| Rate for Payer: Railroad Medicare Medicare |
$10.80
|
| Rate for Payer: Railroad Medicare Medicare |
$15.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.87
|
| Rate for Payer: UHC Core |
$36.06
|
| Rate for Payer: UHC Core |
$50.40
|
| Rate for Payer: UHC Core |
$36.88
|
| Rate for Payer: UHC Core |
$50.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.04
|
| Rate for Payer: UHC Exchange |
$15.09
|
| Rate for Payer: UHC Exchange |
$11.04
|
| Rate for Payer: UHC Exchange |
$10.80
|
| Rate for Payer: UHC Exchange |
$15.01
|
| Rate for Payer: UHC Medicare Advantage |
$15.09
|
| Rate for Payer: UHC Medicare Advantage |
$10.80
|
| Rate for Payer: UHC Medicare Advantage |
$15.01
|
| Rate for Payer: UHC Medicare Advantage |
$11.04
|
| Rate for Payer: VA VA |
$11.04
|
| Rate for Payer: VA VA |
$15.09
|
| Rate for Payer: VA VA |
$15.01
|
| Rate for Payer: VA VA |
$10.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.02
|
|
|
ORPHENADRINE CITRATE 30 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$60.02
|
|
|
Service Code
|
HCPCS J2360
|
| Hospital Charge Code |
5886
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$39.01 |
| Max. Negotiated Rate |
$54.02 |
| Rate for Payer: Aetna Commercial |
$51.02
|
| Rate for Payer: Aetna Commercial |
$37.54
|
| Rate for Payer: Aetna Commercial |
$36.71
|
| Rate for Payer: Aetna Commercial |
$51.31
|
| Rate for Payer: BCBS Trust/PPO |
$48.99
|
| Rate for Payer: BCBS Trust/PPO |
$49.27
|
| Rate for Payer: BCBS Trust/PPO |
$36.06
|
| Rate for Payer: BCBS Trust/PPO |
$35.26
|
| Rate for Payer: BCN Commercial |
$46.38
|
| Rate for Payer: BCN Commercial |
$33.38
|
| Rate for Payer: BCN Commercial |
$46.65
|
| Rate for Payer: BCN Commercial |
$34.13
|
| Rate for Payer: Cash Price |
$35.34
|
| Rate for Payer: Cash Price |
$48.02
|
| Rate for Payer: Cash Price |
$48.29
|
| Rate for Payer: Cash Price |
$34.55
|
| Rate for Payer: Cofinity Commercial |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$51.91
|
| Rate for Payer: Cofinity Commercial |
$51.62
|
| Rate for Payer: Cofinity Commercial |
$37.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.29
|
| Rate for Payer: Healthscope Commercial |
$54.32
|
| Rate for Payer: Healthscope Commercial |
$39.75
|
| Rate for Payer: Healthscope Commercial |
$54.02
|
| Rate for Payer: Healthscope Commercial |
$38.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.31
|
| Rate for Payer: Nomi Health Commercial |
$35.42
|
| Rate for Payer: Nomi Health Commercial |
$36.22
|
| Rate for Payer: Nomi Health Commercial |
$49.50
|
| Rate for Payer: Nomi Health Commercial |
$49.22
|
| Rate for Payer: PHP Commercial |
$37.54
|
| Rate for Payer: PHP Commercial |
$36.71
|
| Rate for Payer: PHP Commercial |
$51.02
|
| Rate for Payer: PHP Commercial |
$51.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.01
|
| Rate for Payer: Priority Health HMO/PPO |
$52.22
|
| Rate for Payer: Priority Health HMO/PPO |
$52.51
|
| Rate for Payer: Priority Health HMO/PPO |
$37.58
|
| Rate for Payer: Priority Health HMO/PPO |
$38.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.82
|
| Rate for Payer: UHC Core |
$50.12
|
| Rate for Payer: UHC Core |
$50.40
|
| Rate for Payer: UHC Core |
$36.88
|
| Rate for Payer: UHC Core |
$36.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.02
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
IP
|
$39.17
|
|
|
Service Code
|
NDC 68180067511
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$25.46 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Aetna Commercial |
$33.29
|
| Rate for Payer: BCBS Trust/PPO |
$31.97
|
| Rate for Payer: BCN Commercial |
$30.27
|
| Rate for Payer: Cash Price |
$31.34
|
| Rate for Payer: Cofinity Commercial |
$33.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.34
|
| Rate for Payer: Healthscope Commercial |
$35.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.29
|
| Rate for Payer: Nomi Health Commercial |
$32.12
|
| Rate for Payer: PHP Commercial |
$33.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.46
|
| Rate for Payer: Priority Health HMO/PPO |
$34.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.47
|
| Rate for Payer: UHC Core |
$32.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.38
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
IP
|
$479.49
|
|
|
Service Code
|
NDC 00004080285
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$311.67 |
| Max. Negotiated Rate |
$431.54 |
| Rate for Payer: Aetna Commercial |
$407.57
|
| Rate for Payer: BCBS Trust/PPO |
$391.41
|
| Rate for Payer: BCN Commercial |
$370.55
|
| Rate for Payer: Cash Price |
$383.59
|
| Rate for Payer: Cofinity Commercial |
$412.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.59
|
| Rate for Payer: Healthscope Commercial |
$431.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.57
|
| Rate for Payer: Nomi Health Commercial |
$393.18
|
| Rate for Payer: PHP Commercial |
$407.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.67
|
| Rate for Payer: Priority Health HMO/PPO |
$417.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$321.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.95
|
| Rate for Payer: UHC Core |
$400.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.62
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
OP
|
$479.49
|
|
|
Service Code
|
NDC 00004080285
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$113.88 |
| Max. Negotiated Rate |
$431.54 |
| Rate for Payer: Aetna Commercial |
$407.57
|
| Rate for Payer: Aetna Medicare |
$124.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$149.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$149.84
|
| Rate for Payer: BCBS Complete |
$191.80
|
| Rate for Payer: BCBS MAPPO |
$119.87
|
| Rate for Payer: BCBS Trust/PPO |
$394.19
|
| Rate for Payer: BCN Commercial |
$372.80
|
| Rate for Payer: BCN Medicare Advantage |
$119.87
|
| Rate for Payer: Cash Price |
$383.59
|
| Rate for Payer: Cofinity Commercial |
$412.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.87
|
| Rate for Payer: Healthscope Commercial |
$431.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$137.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.57
|
| Rate for Payer: Nomi Health Commercial |
$393.18
|
| Rate for Payer: PACE Senior Care Partners |
$113.88
|
| Rate for Payer: PACE SWMI |
$119.87
|
| Rate for Payer: PHP Commercial |
$407.57
|
| Rate for Payer: PHP Medicare Advantage |
$119.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.67
|
| Rate for Payer: Priority Health HMO/PPO |
$417.16
|
| Rate for Payer: Priority Health Medicare |
$121.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$321.26
|
| Rate for Payer: Railroad Medicare Medicare |
$119.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.95
|
| Rate for Payer: UHC Core |
$400.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.87
|
| Rate for Payer: UHC Exchange |
$119.87
|
| Rate for Payer: UHC Medicare Advantage |
$119.87
|
| Rate for Payer: VA VA |
$119.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.62
|
|
|
OSELTAMIVIR 30 MG CAPSULE
|
Facility
|
OP
|
$39.17
|
|
|
Service Code
|
NDC 68180067511
|
| Hospital Charge Code |
88704
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.30 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Aetna Commercial |
$33.29
|
| Rate for Payer: Aetna Medicare |
$10.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.24
|
| Rate for Payer: BCBS Complete |
$15.67
|
| Rate for Payer: BCBS MAPPO |
$9.79
|
| Rate for Payer: BCBS Trust/PPO |
$32.20
|
| Rate for Payer: BCN Commercial |
$30.45
|
| Rate for Payer: BCN Medicare Advantage |
$9.79
|
| Rate for Payer: Cash Price |
$31.34
|
| Rate for Payer: Cofinity Commercial |
$33.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$35.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.29
|
| Rate for Payer: Nomi Health Commercial |
$32.12
|
| Rate for Payer: PACE Senior Care Partners |
$9.30
|
| Rate for Payer: PACE SWMI |
$9.79
|
| Rate for Payer: PHP Commercial |
$33.29
|
| Rate for Payer: PHP Medicare Advantage |
$9.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.46
|
| Rate for Payer: Priority Health HMO/PPO |
$34.08
|
| Rate for Payer: Priority Health Medicare |
$9.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.24
|
| Rate for Payer: Railroad Medicare Medicare |
$9.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.47
|
| Rate for Payer: UHC Core |
$32.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.79
|
| Rate for Payer: UHC Exchange |
$9.79
|
| Rate for Payer: UHC Medicare Advantage |
$9.79
|
| Rate for Payer: VA VA |
$9.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.38
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$27.75
|
|
|
Service Code
|
NDC 09900000790
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$24.98 |
| Rate for Payer: Aetna Commercial |
$23.59
|
| Rate for Payer: Aetna Medicare |
$7.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.67
|
| Rate for Payer: BCBS Complete |
$11.10
|
| Rate for Payer: BCBS MAPPO |
$6.94
|
| Rate for Payer: BCBS Trust/PPO |
$22.81
|
| Rate for Payer: BCN Commercial |
$21.58
|
| Rate for Payer: BCN Medicare Advantage |
$6.94
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cofinity Commercial |
$23.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.94
|
| Rate for Payer: Healthscope Commercial |
$24.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.59
|
| Rate for Payer: Nomi Health Commercial |
$22.75
|
| Rate for Payer: PACE Senior Care Partners |
$6.59
|
| Rate for Payer: PACE SWMI |
$6.94
|
| Rate for Payer: PHP Commercial |
$23.59
|
| Rate for Payer: PHP Medicare Advantage |
$6.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.04
|
| Rate for Payer: Priority Health HMO/PPO |
$24.14
|
| Rate for Payer: Priority Health Medicare |
$7.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.59
|
| Rate for Payer: Railroad Medicare Medicare |
$6.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.42
|
| Rate for Payer: UHC Core |
$23.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.94
|
| Rate for Payer: UHC Exchange |
$6.94
|
| Rate for Payer: UHC Medicare Advantage |
$6.94
|
| Rate for Payer: VA VA |
$6.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.81
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$522.59
|
|
|
Service Code
|
NDC 00004082205
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$124.12 |
| Max. Negotiated Rate |
$470.33 |
| Rate for Payer: Aetna Commercial |
$444.20
|
| Rate for Payer: Aetna Medicare |
$135.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$163.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$163.31
|
| Rate for Payer: BCBS Complete |
$209.04
|
| Rate for Payer: BCBS MAPPO |
$130.65
|
| Rate for Payer: BCBS Trust/PPO |
$429.62
|
| Rate for Payer: BCN Commercial |
$406.31
|
| Rate for Payer: BCN Medicare Advantage |
$130.65
|
| Rate for Payer: Cash Price |
$418.07
|
| Rate for Payer: Cofinity Commercial |
$449.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$418.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.65
|
| Rate for Payer: Healthscope Commercial |
$470.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$391.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$150.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.20
|
| Rate for Payer: Nomi Health Commercial |
$428.52
|
| Rate for Payer: PACE Senior Care Partners |
$124.12
|
| Rate for Payer: PACE SWMI |
$130.65
|
| Rate for Payer: PHP Commercial |
$444.20
|
| Rate for Payer: PHP Medicare Advantage |
$130.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.68
|
| Rate for Payer: Priority Health HMO/PPO |
$454.65
|
| Rate for Payer: Priority Health Medicare |
$131.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$350.14
|
| Rate for Payer: Railroad Medicare Medicare |
$130.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$459.88
|
| Rate for Payer: UHC Core |
$436.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.65
|
| Rate for Payer: UHC Exchange |
$130.65
|
| Rate for Payer: UHC Medicare Advantage |
$130.65
|
| Rate for Payer: VA VA |
$130.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$391.94
|
|
|
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION
|
Facility
|
IP
|
$27.75
|
|
|
Service Code
|
NDC 09900000790
|
| Hospital Charge Code |
153071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$18.04 |
| Max. Negotiated Rate |
$24.98 |
| Rate for Payer: Aetna Commercial |
$23.59
|
| Rate for Payer: BCBS Trust/PPO |
$22.65
|
| Rate for Payer: BCN Commercial |
$21.45
|
| Rate for Payer: Cash Price |
$22.20
|
| Rate for Payer: Cofinity Commercial |
$23.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.20
|
| Rate for Payer: Healthscope Commercial |
$24.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.59
|
| Rate for Payer: Nomi Health Commercial |
$22.75
|
| Rate for Payer: PHP Commercial |
$23.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.04
|
| Rate for Payer: Priority Health HMO/PPO |
$24.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.42
|
| Rate for Payer: UHC Core |
$23.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.81
|
|
