|
PILOCARPINE 4 % EYE DROPS
|
Facility
|
OP
|
$152.99
|
|
|
Service Code
|
NDC 61314020615
|
| Hospital Charge Code |
6282
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$36.34 |
| Max. Negotiated Rate |
$137.69 |
| Rate for Payer: Aetna Commercial |
$130.04
|
| Rate for Payer: Aetna Medicare |
$39.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.81
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCBS MAPPO |
$38.25
|
| Rate for Payer: BCBS Trust/PPO |
$125.77
|
| Rate for Payer: BCN Commercial |
$118.95
|
| Rate for Payer: BCN Medicare Advantage |
$38.25
|
| Rate for Payer: Cash Price |
$122.39
|
| Rate for Payer: Cofinity Commercial |
$131.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.25
|
| Rate for Payer: Healthscope Commercial |
$137.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.04
|
| Rate for Payer: Nomi Health Commercial |
$125.45
|
| Rate for Payer: PACE Senior Care Partners |
$36.34
|
| Rate for Payer: PACE SWMI |
$38.25
|
| Rate for Payer: PHP Commercial |
$130.04
|
| Rate for Payer: PHP Medicare Advantage |
$38.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.44
|
| Rate for Payer: Priority Health HMO/PPO |
$133.10
|
| Rate for Payer: Priority Health Medicare |
$38.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.50
|
| Rate for Payer: Railroad Medicare Medicare |
$38.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.63
|
| Rate for Payer: UHC Core |
$127.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.25
|
| Rate for Payer: UHC Exchange |
$38.25
|
| Rate for Payer: UHC Medicare Advantage |
$38.25
|
| Rate for Payer: VA VA |
$38.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.74
|
|
|
PILOCARPINE 5 MG TABLET
|
Facility
|
IP
|
$361.00
|
|
|
Service Code
|
NDC 00527131301
|
| Hospital Charge Code |
12803
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$234.65 |
| Max. Negotiated Rate |
$324.90 |
| Rate for Payer: Aetna Commercial |
$306.85
|
| Rate for Payer: BCBS Trust/PPO |
$294.68
|
| Rate for Payer: BCN Commercial |
$278.98
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cofinity Commercial |
$310.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.80
|
| Rate for Payer: Healthscope Commercial |
$324.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.85
|
| Rate for Payer: Nomi Health Commercial |
$296.02
|
| Rate for Payer: PHP Commercial |
$306.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.65
|
| Rate for Payer: Priority Health HMO/PPO |
$314.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$317.68
|
| Rate for Payer: UHC Core |
$301.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.75
|
|
|
PILOCARPINE 5 MG TABLET
|
Facility
|
OP
|
$361.00
|
|
|
Service Code
|
NDC 00527131301
|
| Hospital Charge Code |
12803
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$85.74 |
| Max. Negotiated Rate |
$324.90 |
| Rate for Payer: Aetna Commercial |
$306.85
|
| Rate for Payer: Aetna Medicare |
$93.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.81
|
| Rate for Payer: BCBS Complete |
$144.40
|
| Rate for Payer: BCBS MAPPO |
$90.25
|
| Rate for Payer: BCBS Trust/PPO |
$296.78
|
| Rate for Payer: BCN Commercial |
$280.68
|
| Rate for Payer: BCN Medicare Advantage |
$90.25
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cofinity Commercial |
$310.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.25
|
| Rate for Payer: Healthscope Commercial |
$324.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.85
|
| Rate for Payer: Nomi Health Commercial |
$296.02
|
| Rate for Payer: PACE Senior Care Partners |
$85.74
|
| Rate for Payer: PACE SWMI |
$90.25
|
| Rate for Payer: PHP Commercial |
$306.85
|
| Rate for Payer: PHP Medicare Advantage |
$90.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.65
|
| Rate for Payer: Priority Health HMO/PPO |
$314.07
|
| Rate for Payer: Priority Health Medicare |
$91.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.87
|
| Rate for Payer: Railroad Medicare Medicare |
$90.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$317.68
|
| Rate for Payer: UHC Core |
$301.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.25
|
| Rate for Payer: UHC Exchange |
$90.25
|
| Rate for Payer: UHC Medicare Advantage |
$90.25
|
| Rate for Payer: VA VA |
$90.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.75
|
|
|
PIOGLITAZONE 15 MG TABLET
|
Facility
|
IP
|
$1,337.11
|
|
|
Service Code
|
NDC 64764015104
|
| Hospital Charge Code |
25528
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$869.12 |
| Max. Negotiated Rate |
$1,203.40 |
| Rate for Payer: Aetna Commercial |
$1,136.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,091.48
|
| Rate for Payer: BCN Commercial |
$1,033.32
|
| Rate for Payer: Cash Price |
$1,069.69
|
| Rate for Payer: Cofinity Commercial |
$1,149.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,069.69
|
| Rate for Payer: Healthscope Commercial |
$1,203.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,002.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,136.54
|
| Rate for Payer: Nomi Health Commercial |
$1,096.43
|
| Rate for Payer: PHP Commercial |
$1,136.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.12
|
| Rate for Payer: Priority Health HMO/PPO |
$1,163.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$895.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,176.66
|
| Rate for Payer: UHC Core |
$1,116.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,002.83
|
|
|
PIOGLITAZONE 15 MG TABLET
|
Facility
|
OP
|
$58.52
|
|
|
Service Code
|
NDC 16729002010
|
| Hospital Charge Code |
25528
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.90 |
| Max. Negotiated Rate |
$52.67 |
| Rate for Payer: Aetna Commercial |
$49.74
|
| Rate for Payer: Aetna Medicare |
$15.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.29
|
| Rate for Payer: BCBS Complete |
$23.41
|
| Rate for Payer: BCBS MAPPO |
$14.63
|
| Rate for Payer: BCBS Trust/PPO |
$48.11
|
| Rate for Payer: BCN Commercial |
$45.50
|
| Rate for Payer: BCN Medicare Advantage |
$14.63
|
| Rate for Payer: Cash Price |
$46.82
|
| Rate for Payer: Cofinity Commercial |
$50.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.63
|
| Rate for Payer: Healthscope Commercial |
$52.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.74
|
| Rate for Payer: Nomi Health Commercial |
$47.99
|
| Rate for Payer: PACE Senior Care Partners |
$13.90
|
| Rate for Payer: PACE SWMI |
$14.63
|
| Rate for Payer: PHP Commercial |
$49.74
|
| Rate for Payer: PHP Medicare Advantage |
$14.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.04
|
| Rate for Payer: Priority Health HMO/PPO |
$50.91
|
| Rate for Payer: Priority Health Medicare |
$14.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.21
|
| Rate for Payer: Railroad Medicare Medicare |
$14.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.50
|
| Rate for Payer: UHC Core |
$48.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.63
|
| Rate for Payer: UHC Exchange |
$14.63
|
| Rate for Payer: UHC Medicare Advantage |
$14.63
|
| Rate for Payer: VA VA |
$14.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.89
|
|
|
PIOGLITAZONE 15 MG TABLET
|
Facility
|
IP
|
$58.52
|
|
|
Service Code
|
NDC 16729002010
|
| Hospital Charge Code |
25528
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$38.04 |
| Max. Negotiated Rate |
$52.67 |
| Rate for Payer: Aetna Commercial |
$49.74
|
| Rate for Payer: BCBS Trust/PPO |
$47.77
|
| Rate for Payer: BCN Commercial |
$45.22
|
| Rate for Payer: Cash Price |
$46.82
|
| Rate for Payer: Cofinity Commercial |
$50.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.82
|
| Rate for Payer: Healthscope Commercial |
$52.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.74
|
| Rate for Payer: Nomi Health Commercial |
$47.99
|
| Rate for Payer: PHP Commercial |
$49.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.04
|
| Rate for Payer: Priority Health HMO/PPO |
$50.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.50
|
| Rate for Payer: UHC Core |
$48.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.89
|
|
|
PIOGLITAZONE 15 MG TABLET
|
Facility
|
OP
|
$445.92
|
|
|
Service Code
|
NDC 00904709061
|
| Hospital Charge Code |
25528
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$105.91 |
| Max. Negotiated Rate |
$401.33 |
| Rate for Payer: Aetna Commercial |
$379.03
|
| Rate for Payer: Aetna Medicare |
$115.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$139.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$139.35
|
| Rate for Payer: BCBS Complete |
$178.37
|
| Rate for Payer: BCBS MAPPO |
$111.48
|
| Rate for Payer: BCBS Trust/PPO |
$366.59
|
| Rate for Payer: BCN Commercial |
$346.70
|
| Rate for Payer: BCN Medicare Advantage |
$111.48
|
| Rate for Payer: Cash Price |
$356.74
|
| Rate for Payer: Cofinity Commercial |
$383.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.48
|
| Rate for Payer: Healthscope Commercial |
$401.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.03
|
| Rate for Payer: Nomi Health Commercial |
$365.65
|
| Rate for Payer: PACE Senior Care Partners |
$105.91
|
| Rate for Payer: PACE SWMI |
$111.48
|
| Rate for Payer: PHP Commercial |
$379.03
|
| Rate for Payer: PHP Medicare Advantage |
$111.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.85
|
| Rate for Payer: Priority Health HMO/PPO |
$387.95
|
| Rate for Payer: Priority Health Medicare |
$112.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$298.77
|
| Rate for Payer: Railroad Medicare Medicare |
$111.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.41
|
| Rate for Payer: UHC Core |
$372.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$111.48
|
| Rate for Payer: UHC Exchange |
$111.48
|
| Rate for Payer: UHC Medicare Advantage |
$111.48
|
| Rate for Payer: VA VA |
$111.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.44
|
|
|
PIOGLITAZONE 15 MG TABLET
|
Facility
|
IP
|
$445.92
|
|
|
Service Code
|
NDC 00904709061
|
| Hospital Charge Code |
25528
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$289.85 |
| Max. Negotiated Rate |
$401.33 |
| Rate for Payer: Aetna Commercial |
$379.03
|
| Rate for Payer: BCBS Trust/PPO |
$364.00
|
| Rate for Payer: BCN Commercial |
$344.61
|
| Rate for Payer: Cash Price |
$356.74
|
| Rate for Payer: Cofinity Commercial |
$383.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.74
|
| Rate for Payer: Healthscope Commercial |
$401.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.03
|
| Rate for Payer: Nomi Health Commercial |
$365.65
|
| Rate for Payer: PHP Commercial |
$379.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.85
|
| Rate for Payer: Priority Health HMO/PPO |
$387.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$298.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.41
|
| Rate for Payer: UHC Core |
$372.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.44
|
|
|
PIOGLITAZONE 15 MG TABLET
|
Facility
|
IP
|
$83.90
|
|
|
Service Code
|
NDC 57237021930
|
| Hospital Charge Code |
25528
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$54.54 |
| Max. Negotiated Rate |
$75.51 |
| Rate for Payer: Aetna Commercial |
$71.32
|
| Rate for Payer: BCBS Trust/PPO |
$68.49
|
| Rate for Payer: BCN Commercial |
$64.84
|
| Rate for Payer: Cash Price |
$67.12
|
| Rate for Payer: Cofinity Commercial |
$72.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.12
|
| Rate for Payer: Healthscope Commercial |
$75.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.32
|
| Rate for Payer: Nomi Health Commercial |
$68.80
|
| Rate for Payer: PHP Commercial |
$71.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.54
|
| Rate for Payer: Priority Health HMO/PPO |
$72.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.83
|
| Rate for Payer: UHC Core |
$70.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.92
|
|
|
PIOGLITAZONE 15 MG TABLET
|
Facility
|
OP
|
$83.90
|
|
|
Service Code
|
NDC 57237021930
|
| Hospital Charge Code |
25528
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$19.93 |
| Max. Negotiated Rate |
$75.51 |
| Rate for Payer: Aetna Commercial |
$71.32
|
| Rate for Payer: Aetna Medicare |
$21.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.22
|
| Rate for Payer: BCBS Complete |
$33.56
|
| Rate for Payer: BCBS MAPPO |
$20.98
|
| Rate for Payer: BCBS Trust/PPO |
$68.97
|
| Rate for Payer: BCN Commercial |
$65.23
|
| Rate for Payer: BCN Medicare Advantage |
$20.98
|
| Rate for Payer: Cash Price |
$67.12
|
| Rate for Payer: Cofinity Commercial |
$72.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.98
|
| Rate for Payer: Healthscope Commercial |
$75.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.32
|
| Rate for Payer: Nomi Health Commercial |
$68.80
|
| Rate for Payer: PACE Senior Care Partners |
$19.93
|
| Rate for Payer: PACE SWMI |
$20.98
|
| Rate for Payer: PHP Commercial |
$71.32
|
| Rate for Payer: PHP Medicare Advantage |
$20.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.54
|
| Rate for Payer: Priority Health HMO/PPO |
$72.99
|
| Rate for Payer: Priority Health Medicare |
$21.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.21
|
| Rate for Payer: Railroad Medicare Medicare |
$20.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.83
|
| Rate for Payer: UHC Core |
$70.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.98
|
| Rate for Payer: UHC Exchange |
$20.98
|
| Rate for Payer: UHC Medicare Advantage |
$20.98
|
| Rate for Payer: VA VA |
$20.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.92
|
|
|
PIOGLITAZONE 15 MG TABLET
|
Facility
|
OP
|
$1,337.11
|
|
|
Service Code
|
NDC 64764015104
|
| Hospital Charge Code |
25528
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$317.56 |
| Max. Negotiated Rate |
$1,203.40 |
| Rate for Payer: Aetna Commercial |
$1,136.54
|
| Rate for Payer: Aetna Medicare |
$347.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$417.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$417.85
|
| Rate for Payer: BCBS Complete |
$534.84
|
| Rate for Payer: BCBS MAPPO |
$334.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.24
|
| Rate for Payer: BCN Commercial |
$1,039.60
|
| Rate for Payer: BCN Medicare Advantage |
$334.28
|
| Rate for Payer: Cash Price |
$1,069.69
|
| Rate for Payer: Cofinity Commercial |
$1,149.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,069.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.28
|
| Rate for Payer: Healthscope Commercial |
$1,203.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,002.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$384.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,136.54
|
| Rate for Payer: Nomi Health Commercial |
$1,096.43
|
| Rate for Payer: PACE Senior Care Partners |
$317.56
|
| Rate for Payer: PACE SWMI |
$334.28
|
| Rate for Payer: PHP Commercial |
$1,136.54
|
| Rate for Payer: PHP Medicare Advantage |
$334.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.12
|
| Rate for Payer: Priority Health HMO/PPO |
$1,163.29
|
| Rate for Payer: Priority Health Medicare |
$337.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$895.86
|
| Rate for Payer: Railroad Medicare Medicare |
$334.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,176.66
|
| Rate for Payer: UHC Core |
$1,116.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$334.28
|
| Rate for Payer: UHC Exchange |
$334.28
|
| Rate for Payer: UHC Medicare Advantage |
$334.28
|
| Rate for Payer: VA VA |
$334.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,002.83
|
|
|
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$20.23
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
301719
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$18.21 |
| Rate for Payer: Aetna Commercial |
$17.20
|
| Rate for Payer: Aetna Medicare |
$5.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.32
|
| Rate for Payer: BCBS Complete |
$8.09
|
| Rate for Payer: BCBS MAPPO |
$5.06
|
| Rate for Payer: BCBS Trust/PPO |
$16.63
|
| Rate for Payer: BCN Commercial |
$15.73
|
| Rate for Payer: BCN Medicare Advantage |
$5.06
|
| Rate for Payer: Cash Price |
$16.18
|
| Rate for Payer: Cofinity Commercial |
$17.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.06
|
| Rate for Payer: Healthscope Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.20
|
| Rate for Payer: Nomi Health Commercial |
$16.59
|
| Rate for Payer: PACE Senior Care Partners |
$4.80
|
| Rate for Payer: PACE SWMI |
$5.06
|
| Rate for Payer: PHP Commercial |
$17.20
|
| Rate for Payer: PHP Medicare Advantage |
$5.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.15
|
| Rate for Payer: Priority Health HMO/PPO |
$17.60
|
| Rate for Payer: Priority Health Medicare |
$5.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.55
|
| Rate for Payer: Railroad Medicare Medicare |
$5.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.80
|
| Rate for Payer: UHC Core |
$16.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.06
|
| Rate for Payer: UHC Exchange |
$5.06
|
| Rate for Payer: UHC Medicare Advantage |
$5.06
|
| Rate for Payer: VA VA |
$5.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.17
|
|
|
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$20.23
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
301719
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.15 |
| Max. Negotiated Rate |
$18.21 |
| Rate for Payer: Aetna Commercial |
$17.20
|
| Rate for Payer: BCBS Trust/PPO |
$16.51
|
| Rate for Payer: BCN Commercial |
$15.63
|
| Rate for Payer: Cash Price |
$16.18
|
| Rate for Payer: Cofinity Commercial |
$17.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.18
|
| Rate for Payer: Healthscope Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.20
|
| Rate for Payer: Nomi Health Commercial |
$16.59
|
| Rate for Payer: PHP Commercial |
$17.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.15
|
| Rate for Payer: Priority Health HMO/PPO |
$17.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.80
|
| Rate for Payer: UHC Core |
$16.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.17
|
|
|
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$28.77
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
18304
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.70 |
| Max. Negotiated Rate |
$25.89 |
| Rate for Payer: Aetna Commercial |
$24.45
|
| Rate for Payer: Aetna Commercial |
$18.13
|
| Rate for Payer: Aetna Commercial |
$18.85
|
| Rate for Payer: Aetna Commercial |
$23.61
|
| Rate for Payer: Aetna Commercial |
$17.20
|
| Rate for Payer: BCBS Trust/PPO |
$22.68
|
| Rate for Payer: BCBS Trust/PPO |
$23.48
|
| Rate for Payer: BCBS Trust/PPO |
$18.11
|
| Rate for Payer: BCBS Trust/PPO |
$17.41
|
| Rate for Payer: BCBS Trust/PPO |
$16.51
|
| Rate for Payer: BCN Commercial |
$21.47
|
| Rate for Payer: BCN Commercial |
$17.14
|
| Rate for Payer: BCN Commercial |
$15.63
|
| Rate for Payer: BCN Commercial |
$16.48
|
| Rate for Payer: BCN Commercial |
$22.23
|
| Rate for Payer: Cash Price |
$16.18
|
| Rate for Payer: Cash Price |
$23.02
|
| Rate for Payer: Cash Price |
$17.74
|
| Rate for Payer: Cash Price |
$17.06
|
| Rate for Payer: Cash Price |
$22.22
|
| Rate for Payer: Cofinity Commercial |
$24.74
|
| Rate for Payer: Cofinity Commercial |
$17.40
|
| Rate for Payer: Cofinity Commercial |
$23.89
|
| Rate for Payer: Cofinity Commercial |
$19.07
|
| Rate for Payer: Cofinity Commercial |
$18.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.02
|
| Rate for Payer: Healthscope Commercial |
$19.20
|
| Rate for Payer: Healthscope Commercial |
$19.96
|
| Rate for Payer: Healthscope Commercial |
$18.21
|
| Rate for Payer: Healthscope Commercial |
$25.00
|
| Rate for Payer: Healthscope Commercial |
$25.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.61
|
| Rate for Payer: Nomi Health Commercial |
$16.59
|
| Rate for Payer: Nomi Health Commercial |
$17.49
|
| Rate for Payer: Nomi Health Commercial |
$18.19
|
| Rate for Payer: Nomi Health Commercial |
$22.78
|
| Rate for Payer: Nomi Health Commercial |
$23.59
|
| Rate for Payer: PHP Commercial |
$18.85
|
| Rate for Payer: PHP Commercial |
$18.13
|
| Rate for Payer: PHP Commercial |
$17.20
|
| Rate for Payer: PHP Commercial |
$23.61
|
| Rate for Payer: PHP Commercial |
$24.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.15
|
| Rate for Payer: Priority Health HMO/PPO |
$17.60
|
| Rate for Payer: Priority Health HMO/PPO |
$25.03
|
| Rate for Payer: Priority Health HMO/PPO |
$19.30
|
| Rate for Payer: Priority Health HMO/PPO |
$24.17
|
| Rate for Payer: Priority Health HMO/PPO |
$18.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.45
|
| Rate for Payer: UHC Core |
$16.89
|
| Rate for Payer: UHC Core |
$17.81
|
| Rate for Payer: UHC Core |
$23.20
|
| Rate for Payer: UHC Core |
$24.02
|
| Rate for Payer: UHC Core |
$18.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.84
|
|
|
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$21.33
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
18304
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$19.20 |
| Rate for Payer: Aetna Commercial |
$18.13
|
| Rate for Payer: Aetna Commercial |
$18.85
|
| Rate for Payer: Aetna Commercial |
$23.61
|
| Rate for Payer: Aetna Commercial |
$17.20
|
| Rate for Payer: Aetna Commercial |
$24.45
|
| Rate for Payer: Aetna Medicare |
$5.77
|
| Rate for Payer: Aetna Medicare |
$5.26
|
| Rate for Payer: Aetna Medicare |
$5.55
|
| Rate for Payer: Aetna Medicare |
$7.22
|
| Rate for Payer: Aetna Medicare |
$7.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.68
|
| Rate for Payer: BCBS Complete |
$11.11
|
| Rate for Payer: BCBS Complete |
$8.09
|
| Rate for Payer: BCBS Complete |
$8.53
|
| Rate for Payer: BCBS Complete |
$8.87
|
| Rate for Payer: BCBS Complete |
$11.51
|
| Rate for Payer: BCBS MAPPO |
$5.54
|
| Rate for Payer: BCBS MAPPO |
$5.06
|
| Rate for Payer: BCBS MAPPO |
$5.33
|
| Rate for Payer: BCBS MAPPO |
$6.94
|
| Rate for Payer: BCBS MAPPO |
$7.19
|
| Rate for Payer: BCBS Trust/PPO |
$16.63
|
| Rate for Payer: BCBS Trust/PPO |
$17.54
|
| Rate for Payer: BCBS Trust/PPO |
$18.23
|
| Rate for Payer: BCBS Trust/PPO |
$23.65
|
| Rate for Payer: BCBS Trust/PPO |
$22.84
|
| Rate for Payer: BCN Commercial |
$22.37
|
| Rate for Payer: BCN Commercial |
$15.73
|
| Rate for Payer: BCN Commercial |
$16.58
|
| Rate for Payer: BCN Commercial |
$17.24
|
| Rate for Payer: BCN Commercial |
$21.60
|
| Rate for Payer: BCN Medicare Advantage |
$7.19
|
| Rate for Payer: BCN Medicare Advantage |
$6.94
|
| Rate for Payer: BCN Medicare Advantage |
$5.06
|
| Rate for Payer: BCN Medicare Advantage |
$5.33
|
| Rate for Payer: BCN Medicare Advantage |
$5.54
|
| Rate for Payer: Cash Price |
$16.18
|
| Rate for Payer: Cash Price |
$22.22
|
| Rate for Payer: Cash Price |
$23.02
|
| Rate for Payer: Cash Price |
$17.74
|
| Rate for Payer: Cash Price |
$17.06
|
| Rate for Payer: Cofinity Commercial |
$24.74
|
| Rate for Payer: Cofinity Commercial |
$17.40
|
| Rate for Payer: Cofinity Commercial |
$18.34
|
| Rate for Payer: Cofinity Commercial |
$23.89
|
| Rate for Payer: Cofinity Commercial |
$19.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.54
|
| Rate for Payer: Healthscope Commercial |
$19.20
|
| Rate for Payer: Healthscope Commercial |
$18.21
|
| Rate for Payer: Healthscope Commercial |
$25.00
|
| Rate for Payer: Healthscope Commercial |
$19.96
|
| Rate for Payer: Healthscope Commercial |
$25.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.45
|
| Rate for Payer: Nomi Health Commercial |
$17.49
|
| Rate for Payer: Nomi Health Commercial |
$22.78
|
| Rate for Payer: Nomi Health Commercial |
$18.19
|
| Rate for Payer: Nomi Health Commercial |
$23.59
|
| Rate for Payer: Nomi Health Commercial |
$16.59
|
| Rate for Payer: PACE Senior Care Partners |
$4.80
|
| Rate for Payer: PACE Senior Care Partners |
$6.60
|
| Rate for Payer: PACE Senior Care Partners |
$5.07
|
| Rate for Payer: PACE Senior Care Partners |
$5.27
|
| Rate for Payer: PACE Senior Care Partners |
$6.83
|
| Rate for Payer: PACE SWMI |
$5.06
|
| Rate for Payer: PACE SWMI |
$6.94
|
| Rate for Payer: PACE SWMI |
$5.54
|
| Rate for Payer: PACE SWMI |
$5.33
|
| Rate for Payer: PACE SWMI |
$7.19
|
| Rate for Payer: PHP Commercial |
$24.45
|
| Rate for Payer: PHP Commercial |
$18.85
|
| Rate for Payer: PHP Commercial |
$23.61
|
| Rate for Payer: PHP Commercial |
$18.13
|
| Rate for Payer: PHP Commercial |
$17.20
|
| Rate for Payer: PHP Medicare Advantage |
$5.54
|
| Rate for Payer: PHP Medicare Advantage |
$6.94
|
| Rate for Payer: PHP Medicare Advantage |
$7.19
|
| Rate for Payer: PHP Medicare Advantage |
$5.06
|
| Rate for Payer: PHP Medicare Advantage |
$5.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.15
|
| Rate for Payer: Priority Health HMO/PPO |
$17.60
|
| Rate for Payer: Priority Health HMO/PPO |
$19.30
|
| Rate for Payer: Priority Health HMO/PPO |
$25.03
|
| Rate for Payer: Priority Health HMO/PPO |
$24.17
|
| Rate for Payer: Priority Health HMO/PPO |
$18.56
|
| Rate for Payer: Priority Health Medicare |
$7.26
|
| Rate for Payer: Priority Health Medicare |
$5.60
|
| Rate for Payer: Priority Health Medicare |
$5.39
|
| Rate for Payer: Priority Health Medicare |
$7.01
|
| Rate for Payer: Priority Health Medicare |
$5.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.28
|
| Rate for Payer: Railroad Medicare Medicare |
$6.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.54
|
| Rate for Payer: Railroad Medicare Medicare |
$5.06
|
| Rate for Payer: Railroad Medicare Medicare |
$5.33
|
| Rate for Payer: Railroad Medicare Medicare |
$7.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.52
|
| Rate for Payer: UHC Core |
$17.81
|
| Rate for Payer: UHC Core |
$24.02
|
| Rate for Payer: UHC Core |
$18.52
|
| Rate for Payer: UHC Core |
$23.20
|
| Rate for Payer: UHC Core |
$16.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.54
|
| Rate for Payer: UHC Exchange |
$5.54
|
| Rate for Payer: UHC Exchange |
$7.19
|
| Rate for Payer: UHC Exchange |
$5.06
|
| Rate for Payer: UHC Exchange |
$6.94
|
| Rate for Payer: UHC Exchange |
$5.33
|
| Rate for Payer: UHC Medicare Advantage |
$5.33
|
| Rate for Payer: UHC Medicare Advantage |
$7.19
|
| Rate for Payer: UHC Medicare Advantage |
$5.54
|
| Rate for Payer: UHC Medicare Advantage |
$5.06
|
| Rate for Payer: UHC Medicare Advantage |
$6.94
|
| Rate for Payer: VA VA |
$5.06
|
| Rate for Payer: VA VA |
$6.94
|
| Rate for Payer: VA VA |
$5.33
|
| Rate for Payer: VA VA |
$7.19
|
| Rate for Payer: VA VA |
$5.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.64
|
|
|
PIPERACILLIN-TAZOBACTAM 3.375GM IVPB (IV PREMIX)
|
Facility
|
IP
|
$26.26
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
180352
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.07 |
| Max. Negotiated Rate |
$23.63 |
| Rate for Payer: Aetna Commercial |
$22.32
|
| Rate for Payer: BCBS Trust/PPO |
$21.44
|
| Rate for Payer: BCN Commercial |
$20.29
|
| Rate for Payer: Cash Price |
$21.01
|
| Rate for Payer: Cofinity Commercial |
$22.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.01
|
| Rate for Payer: Healthscope Commercial |
$23.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.32
|
| Rate for Payer: Nomi Health Commercial |
$21.53
|
| Rate for Payer: PHP Commercial |
$22.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.07
|
| Rate for Payer: Priority Health HMO/PPO |
$22.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.11
|
| Rate for Payer: UHC Core |
$21.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.70
|
|
|
PIPERACILLIN-TAZOBACTAM 3.375GM IVPB (IV PREMIX)
|
Facility
|
OP
|
$26.26
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
180352
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.24 |
| Max. Negotiated Rate |
$23.63 |
| Rate for Payer: Aetna Commercial |
$22.32
|
| Rate for Payer: Aetna Medicare |
$6.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.21
|
| Rate for Payer: BCBS Complete |
$10.50
|
| Rate for Payer: BCBS MAPPO |
$6.56
|
| Rate for Payer: BCBS Trust/PPO |
$21.59
|
| Rate for Payer: BCN Commercial |
$20.42
|
| Rate for Payer: BCN Medicare Advantage |
$6.56
|
| Rate for Payer: Cash Price |
$21.01
|
| Rate for Payer: Cofinity Commercial |
$22.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.56
|
| Rate for Payer: Healthscope Commercial |
$23.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.32
|
| Rate for Payer: Nomi Health Commercial |
$21.53
|
| Rate for Payer: PACE Senior Care Partners |
$6.24
|
| Rate for Payer: PACE SWMI |
$6.56
|
| Rate for Payer: PHP Commercial |
$22.32
|
| Rate for Payer: PHP Medicare Advantage |
$6.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.07
|
| Rate for Payer: Priority Health HMO/PPO |
$22.85
|
| Rate for Payer: Priority Health Medicare |
$6.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.59
|
| Rate for Payer: Railroad Medicare Medicare |
$6.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.11
|
| Rate for Payer: UHC Core |
$21.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.56
|
| Rate for Payer: UHC Exchange |
$6.56
|
| Rate for Payer: UHC Medicare Advantage |
$6.56
|
| Rate for Payer: VA VA |
$6.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.70
|
|
|
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$17.35
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
301717
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$15.62 |
| Rate for Payer: Aetna Commercial |
$14.75
|
| Rate for Payer: Aetna Medicare |
$4.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.42
|
| Rate for Payer: BCBS Complete |
$6.94
|
| Rate for Payer: BCBS MAPPO |
$4.34
|
| Rate for Payer: BCBS Trust/PPO |
$14.26
|
| Rate for Payer: BCN Commercial |
$13.49
|
| Rate for Payer: BCN Medicare Advantage |
$4.34
|
| Rate for Payer: Cash Price |
$13.88
|
| Rate for Payer: Cofinity Commercial |
$14.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.34
|
| Rate for Payer: Healthscope Commercial |
$15.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.75
|
| Rate for Payer: Nomi Health Commercial |
$14.23
|
| Rate for Payer: PACE Senior Care Partners |
$4.12
|
| Rate for Payer: PACE SWMI |
$4.34
|
| Rate for Payer: PHP Commercial |
$14.75
|
| Rate for Payer: PHP Medicare Advantage |
$4.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.28
|
| Rate for Payer: Priority Health HMO/PPO |
$15.09
|
| Rate for Payer: Priority Health Medicare |
$4.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.62
|
| Rate for Payer: Railroad Medicare Medicare |
$4.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.27
|
| Rate for Payer: UHC Core |
$14.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.34
|
| Rate for Payer: UHC Exchange |
$4.34
|
| Rate for Payer: UHC Medicare Advantage |
$4.34
|
| Rate for Payer: VA VA |
$4.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.01
|
|
|
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$17.35
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
301717
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.28 |
| Max. Negotiated Rate |
$15.62 |
| Rate for Payer: Aetna Commercial |
$14.75
|
| Rate for Payer: BCBS Trust/PPO |
$14.16
|
| Rate for Payer: BCN Commercial |
$13.41
|
| Rate for Payer: Cash Price |
$13.88
|
| Rate for Payer: Cofinity Commercial |
$14.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.88
|
| Rate for Payer: Healthscope Commercial |
$15.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.75
|
| Rate for Payer: Nomi Health Commercial |
$14.23
|
| Rate for Payer: PHP Commercial |
$14.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.28
|
| Rate for Payer: Priority Health HMO/PPO |
$15.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.27
|
| Rate for Payer: UHC Core |
$14.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.01
|
|
|
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$27.30
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
18303
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.74 |
| Max. Negotiated Rate |
$24.57 |
| Rate for Payer: Aetna Commercial |
$23.20
|
| Rate for Payer: Aetna Commercial |
$14.94
|
| Rate for Payer: Aetna Commercial |
$18.01
|
| Rate for Payer: Aetna Commercial |
$21.90
|
| Rate for Payer: Aetna Commercial |
$19.30
|
| Rate for Payer: Aetna Commercial |
$14.75
|
| Rate for Payer: Aetna Commercial |
$22.84
|
| Rate for Payer: BCBS Trust/PPO |
$22.28
|
| Rate for Payer: BCBS Trust/PPO |
$14.35
|
| Rate for Payer: BCBS Trust/PPO |
$21.93
|
| Rate for Payer: BCBS Trust/PPO |
$14.16
|
| Rate for Payer: BCBS Trust/PPO |
$21.03
|
| Rate for Payer: BCBS Trust/PPO |
$17.30
|
| Rate for Payer: BCBS Trust/PPO |
$18.53
|
| Rate for Payer: BCN Commercial |
$16.38
|
| Rate for Payer: BCN Commercial |
$20.77
|
| Rate for Payer: BCN Commercial |
$21.10
|
| Rate for Payer: BCN Commercial |
$19.91
|
| Rate for Payer: BCN Commercial |
$13.59
|
| Rate for Payer: BCN Commercial |
$17.54
|
| Rate for Payer: BCN Commercial |
$13.41
|
| Rate for Payer: Cash Price |
$16.95
|
| Rate for Payer: Cash Price |
$13.88
|
| Rate for Payer: Cash Price |
$20.61
|
| Rate for Payer: Cash Price |
$21.84
|
| Rate for Payer: Cash Price |
$21.50
|
| Rate for Payer: Cash Price |
$14.06
|
| Rate for Payer: Cash Price |
$18.16
|
| Rate for Payer: Cofinity Commercial |
$19.52
|
| Rate for Payer: Cofinity Commercial |
$14.92
|
| Rate for Payer: Cofinity Commercial |
$22.15
|
| Rate for Payer: Cofinity Commercial |
$18.22
|
| Rate for Payer: Cofinity Commercial |
$15.12
|
| Rate for Payer: Cofinity Commercial |
$23.48
|
| Rate for Payer: Cofinity Commercial |
$23.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.84
|
| Rate for Payer: Healthscope Commercial |
$15.82
|
| Rate for Payer: Healthscope Commercial |
$19.07
|
| Rate for Payer: Healthscope Commercial |
$24.18
|
| Rate for Payer: Healthscope Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$15.62
|
| Rate for Payer: Healthscope Commercial |
$24.57
|
| Rate for Payer: Healthscope Commercial |
$20.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.01
|
| Rate for Payer: Nomi Health Commercial |
$18.61
|
| Rate for Payer: Nomi Health Commercial |
$14.23
|
| Rate for Payer: Nomi Health Commercial |
$22.39
|
| Rate for Payer: Nomi Health Commercial |
$22.03
|
| Rate for Payer: Nomi Health Commercial |
$21.12
|
| Rate for Payer: Nomi Health Commercial |
$17.38
|
| Rate for Payer: Nomi Health Commercial |
$14.42
|
| Rate for Payer: PHP Commercial |
$14.75
|
| Rate for Payer: PHP Commercial |
$19.30
|
| Rate for Payer: PHP Commercial |
$21.90
|
| Rate for Payer: PHP Commercial |
$22.84
|
| Rate for Payer: PHP Commercial |
$23.20
|
| Rate for Payer: PHP Commercial |
$14.94
|
| Rate for Payer: PHP Commercial |
$18.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.76
|
| Rate for Payer: Priority Health HMO/PPO |
$15.29
|
| Rate for Payer: Priority Health HMO/PPO |
$22.41
|
| Rate for Payer: Priority Health HMO/PPO |
$23.75
|
| Rate for Payer: Priority Health HMO/PPO |
$18.44
|
| Rate for Payer: Priority Health HMO/PPO |
$19.75
|
| Rate for Payer: Priority Health HMO/PPO |
$15.09
|
| Rate for Payer: Priority Health HMO/PPO |
$23.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.65
|
| Rate for Payer: UHC Core |
$14.49
|
| Rate for Payer: UHC Core |
$22.44
|
| Rate for Payer: UHC Core |
$14.68
|
| Rate for Payer: UHC Core |
$17.69
|
| Rate for Payer: UHC Core |
$21.51
|
| Rate for Payer: UHC Core |
$22.80
|
| Rate for Payer: UHC Core |
$18.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.15
|
|
|
PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$25.76
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
18303
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.12 |
| Max. Negotiated Rate |
$23.18 |
| Rate for Payer: Aetna Commercial |
$21.90
|
| Rate for Payer: Aetna Commercial |
$23.20
|
| Rate for Payer: Aetna Commercial |
$14.94
|
| Rate for Payer: Aetna Commercial |
$22.84
|
| Rate for Payer: Aetna Commercial |
$18.01
|
| Rate for Payer: Aetna Commercial |
$14.75
|
| Rate for Payer: Aetna Commercial |
$19.30
|
| Rate for Payer: Aetna Medicare |
$4.57
|
| Rate for Payer: Aetna Medicare |
$4.51
|
| Rate for Payer: Aetna Medicare |
$6.70
|
| Rate for Payer: Aetna Medicare |
$7.10
|
| Rate for Payer: Aetna Medicare |
$5.90
|
| Rate for Payer: Aetna Medicare |
$6.99
|
| Rate for Payer: Aetna Medicare |
$5.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.05
|
| Rate for Payer: BCBS Complete |
$10.75
|
| Rate for Payer: BCBS Complete |
$6.94
|
| Rate for Payer: BCBS Complete |
$7.03
|
| Rate for Payer: BCBS Complete |
$9.08
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS Complete |
$8.48
|
| Rate for Payer: BCBS Complete |
$10.92
|
| Rate for Payer: BCBS MAPPO |
$6.44
|
| Rate for Payer: BCBS MAPPO |
$6.82
|
| Rate for Payer: BCBS MAPPO |
$6.72
|
| Rate for Payer: BCBS MAPPO |
$5.68
|
| Rate for Payer: BCBS MAPPO |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$4.34
|
| Rate for Payer: BCBS MAPPO |
$5.30
|
| Rate for Payer: BCBS Trust/PPO |
$14.26
|
| Rate for Payer: BCBS Trust/PPO |
$14.45
|
| Rate for Payer: BCBS Trust/PPO |
$22.44
|
| Rate for Payer: BCBS Trust/PPO |
$22.09
|
| Rate for Payer: BCBS Trust/PPO |
$17.42
|
| Rate for Payer: BCBS Trust/PPO |
$21.18
|
| Rate for Payer: BCBS Trust/PPO |
$18.66
|
| Rate for Payer: BCN Commercial |
$17.65
|
| Rate for Payer: BCN Commercial |
$13.49
|
| Rate for Payer: BCN Commercial |
$16.48
|
| Rate for Payer: BCN Commercial |
$13.67
|
| Rate for Payer: BCN Commercial |
$20.89
|
| Rate for Payer: BCN Commercial |
$20.03
|
| Rate for Payer: BCN Commercial |
$21.23
|
| Rate for Payer: BCN Medicare Advantage |
$6.82
|
| Rate for Payer: BCN Medicare Advantage |
$6.44
|
| Rate for Payer: BCN Medicare Advantage |
$6.72
|
| Rate for Payer: BCN Medicare Advantage |
$5.30
|
| Rate for Payer: BCN Medicare Advantage |
$4.34
|
| Rate for Payer: BCN Medicare Advantage |
$4.40
|
| Rate for Payer: BCN Medicare Advantage |
$5.68
|
| Rate for Payer: Cash Price |
$13.88
|
| Rate for Payer: Cash Price |
$21.84
|
| Rate for Payer: Cash Price |
$20.61
|
| Rate for Payer: Cash Price |
$18.16
|
| Rate for Payer: Cash Price |
$21.50
|
| Rate for Payer: Cash Price |
$16.95
|
| Rate for Payer: Cash Price |
$14.06
|
| Rate for Payer: Cofinity Commercial |
$18.22
|
| Rate for Payer: Cofinity Commercial |
$19.52
|
| Rate for Payer: Cofinity Commercial |
$23.48
|
| Rate for Payer: Cofinity Commercial |
$14.92
|
| Rate for Payer: Cofinity Commercial |
$15.12
|
| Rate for Payer: Cofinity Commercial |
$22.15
|
| Rate for Payer: Cofinity Commercial |
$23.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.68
|
| Rate for Payer: Healthscope Commercial |
$20.43
|
| Rate for Payer: Healthscope Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$24.18
|
| Rate for Payer: Healthscope Commercial |
$15.82
|
| Rate for Payer: Healthscope Commercial |
$24.57
|
| Rate for Payer: Healthscope Commercial |
$15.62
|
| Rate for Payer: Healthscope Commercial |
$19.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.94
|
| Rate for Payer: Nomi Health Commercial |
$22.03
|
| Rate for Payer: Nomi Health Commercial |
$14.23
|
| Rate for Payer: Nomi Health Commercial |
$14.42
|
| Rate for Payer: Nomi Health Commercial |
$22.39
|
| Rate for Payer: Nomi Health Commercial |
$18.61
|
| Rate for Payer: Nomi Health Commercial |
$17.38
|
| Rate for Payer: Nomi Health Commercial |
$21.12
|
| Rate for Payer: PACE Senior Care Partners |
$6.12
|
| Rate for Payer: PACE Senior Care Partners |
$6.48
|
| Rate for Payer: PACE Senior Care Partners |
$5.39
|
| Rate for Payer: PACE Senior Care Partners |
$4.18
|
| Rate for Payer: PACE Senior Care Partners |
$4.12
|
| Rate for Payer: PACE Senior Care Partners |
$5.03
|
| Rate for Payer: PACE Senior Care Partners |
$6.38
|
| Rate for Payer: PACE SWMI |
$6.72
|
| Rate for Payer: PACE SWMI |
$5.30
|
| Rate for Payer: PACE SWMI |
$6.44
|
| Rate for Payer: PACE SWMI |
$4.34
|
| Rate for Payer: PACE SWMI |
$5.68
|
| Rate for Payer: PACE SWMI |
$4.40
|
| Rate for Payer: PACE SWMI |
$6.82
|
| Rate for Payer: PHP Commercial |
$21.90
|
| Rate for Payer: PHP Commercial |
$18.01
|
| Rate for Payer: PHP Commercial |
$22.84
|
| Rate for Payer: PHP Commercial |
$23.20
|
| Rate for Payer: PHP Commercial |
$14.75
|
| Rate for Payer: PHP Commercial |
$14.94
|
| Rate for Payer: PHP Commercial |
$19.30
|
| Rate for Payer: PHP Medicare Advantage |
$4.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.68
|
| Rate for Payer: PHP Medicare Advantage |
$5.30
|
| Rate for Payer: PHP Medicare Advantage |
$6.44
|
| Rate for Payer: PHP Medicare Advantage |
$6.72
|
| Rate for Payer: PHP Medicare Advantage |
$4.40
|
| Rate for Payer: PHP Medicare Advantage |
$6.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.28
|
| Rate for Payer: Priority Health HMO/PPO |
$15.29
|
| Rate for Payer: Priority Health HMO/PPO |
$19.75
|
| Rate for Payer: Priority Health HMO/PPO |
$22.41
|
| Rate for Payer: Priority Health HMO/PPO |
$23.38
|
| Rate for Payer: Priority Health HMO/PPO |
$18.44
|
| Rate for Payer: Priority Health HMO/PPO |
$23.75
|
| Rate for Payer: Priority Health HMO/PPO |
$15.09
|
| Rate for Payer: Priority Health Medicare |
$4.44
|
| Rate for Payer: Priority Health Medicare |
$5.73
|
| Rate for Payer: Priority Health Medicare |
$5.35
|
| Rate for Payer: Priority Health Medicare |
$4.38
|
| Rate for Payer: Priority Health Medicare |
$6.50
|
| Rate for Payer: Priority Health Medicare |
$6.78
|
| Rate for Payer: Priority Health Medicare |
$6.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.21
|
| Rate for Payer: Railroad Medicare Medicare |
$6.82
|
| Rate for Payer: Railroad Medicare Medicare |
$4.34
|
| Rate for Payer: Railroad Medicare Medicare |
$6.72
|
| Rate for Payer: Railroad Medicare Medicare |
$5.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.30
|
| Rate for Payer: Railroad Medicare Medicare |
$4.40
|
| Rate for Payer: Railroad Medicare Medicare |
$6.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.27
|
| Rate for Payer: UHC Core |
$14.68
|
| Rate for Payer: UHC Core |
$22.44
|
| Rate for Payer: UHC Core |
$14.49
|
| Rate for Payer: UHC Core |
$18.95
|
| Rate for Payer: UHC Core |
$17.69
|
| Rate for Payer: UHC Core |
$21.51
|
| Rate for Payer: UHC Core |
$22.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.82
|
| Rate for Payer: UHC Exchange |
$5.68
|
| Rate for Payer: UHC Exchange |
$6.72
|
| Rate for Payer: UHC Exchange |
$6.82
|
| Rate for Payer: UHC Exchange |
$4.40
|
| Rate for Payer: UHC Exchange |
$5.30
|
| Rate for Payer: UHC Exchange |
$4.34
|
| Rate for Payer: UHC Exchange |
$6.44
|
| Rate for Payer: UHC Medicare Advantage |
$6.82
|
| Rate for Payer: UHC Medicare Advantage |
$4.34
|
| Rate for Payer: UHC Medicare Advantage |
$5.30
|
| Rate for Payer: UHC Medicare Advantage |
$5.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.44
|
| Rate for Payer: UHC Medicare Advantage |
$6.72
|
| Rate for Payer: UHC Medicare Advantage |
$4.40
|
| Rate for Payer: VA VA |
$5.30
|
| Rate for Payer: VA VA |
$5.68
|
| Rate for Payer: VA VA |
$4.40
|
| Rate for Payer: VA VA |
$6.82
|
| Rate for Payer: VA VA |
$4.34
|
| Rate for Payer: VA VA |
$6.44
|
| Rate for Payer: VA VA |
$6.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.32
|
|
|
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$17.12
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
18302
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.07 |
| Max. Negotiated Rate |
$15.41 |
| Rate for Payer: Aetna Commercial |
$14.55
|
| Rate for Payer: Aetna Commercial |
$33.86
|
| Rate for Payer: Aetna Commercial |
$24.15
|
| Rate for Payer: Aetna Commercial |
$16.18
|
| Rate for Payer: Aetna Medicare |
$4.95
|
| Rate for Payer: Aetna Medicare |
$4.45
|
| Rate for Payer: Aetna Medicare |
$7.39
|
| Rate for Payer: Aetna Medicare |
$10.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.35
|
| Rate for Payer: BCBS Complete |
$6.85
|
| Rate for Payer: BCBS Complete |
$7.62
|
| Rate for Payer: BCBS Complete |
$15.94
|
| Rate for Payer: BCBS Complete |
$11.36
|
| Rate for Payer: BCBS MAPPO |
$4.28
|
| Rate for Payer: BCBS MAPPO |
$4.76
|
| Rate for Payer: BCBS MAPPO |
$9.96
|
| Rate for Payer: BCBS MAPPO |
$7.10
|
| Rate for Payer: BCBS Trust/PPO |
$14.07
|
| Rate for Payer: BCBS Trust/PPO |
$32.75
|
| Rate for Payer: BCBS Trust/PPO |
$15.65
|
| Rate for Payer: BCBS Trust/PPO |
$23.36
|
| Rate for Payer: BCN Commercial |
$13.31
|
| Rate for Payer: BCN Commercial |
$22.09
|
| Rate for Payer: BCN Commercial |
$14.80
|
| Rate for Payer: BCN Commercial |
$30.98
|
| Rate for Payer: BCN Medicare Advantage |
$4.76
|
| Rate for Payer: BCN Medicare Advantage |
$9.96
|
| Rate for Payer: BCN Medicare Advantage |
$4.28
|
| Rate for Payer: BCN Medicare Advantage |
$7.10
|
| Rate for Payer: Cash Price |
$13.70
|
| Rate for Payer: Cash Price |
$31.87
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cash Price |
$15.23
|
| Rate for Payer: Cofinity Commercial |
$34.26
|
| Rate for Payer: Cofinity Commercial |
$16.37
|
| Rate for Payer: Cofinity Commercial |
$14.72
|
| Rate for Payer: Cofinity Commercial |
$24.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.10
|
| Rate for Payer: Healthscope Commercial |
$15.41
|
| Rate for Payer: Healthscope Commercial |
$35.86
|
| Rate for Payer: Healthscope Commercial |
$25.57
|
| Rate for Payer: Healthscope Commercial |
$17.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: Nomi Health Commercial |
$32.67
|
| Rate for Payer: Nomi Health Commercial |
$14.04
|
| Rate for Payer: Nomi Health Commercial |
$15.61
|
| Rate for Payer: PACE Senior Care Partners |
$4.07
|
| Rate for Payer: PACE Senior Care Partners |
$6.75
|
| Rate for Payer: PACE Senior Care Partners |
$9.46
|
| Rate for Payer: PACE Senior Care Partners |
$4.52
|
| Rate for Payer: PACE SWMI |
$4.76
|
| Rate for Payer: PACE SWMI |
$4.28
|
| Rate for Payer: PACE SWMI |
$7.10
|
| Rate for Payer: PACE SWMI |
$9.96
|
| Rate for Payer: PHP Commercial |
$24.15
|
| Rate for Payer: PHP Commercial |
$33.86
|
| Rate for Payer: PHP Commercial |
$16.18
|
| Rate for Payer: PHP Commercial |
$14.55
|
| Rate for Payer: PHP Medicare Advantage |
$4.76
|
| Rate for Payer: PHP Medicare Advantage |
$4.28
|
| Rate for Payer: PHP Medicare Advantage |
$9.96
|
| Rate for Payer: PHP Medicare Advantage |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.13
|
| Rate for Payer: Priority Health HMO/PPO |
$16.56
|
| Rate for Payer: Priority Health HMO/PPO |
$34.66
|
| Rate for Payer: Priority Health HMO/PPO |
$24.72
|
| Rate for Payer: Priority Health HMO/PPO |
$14.89
|
| Rate for Payer: Priority Health Medicare |
$7.17
|
| Rate for Payer: Priority Health Medicare |
$4.32
|
| Rate for Payer: Priority Health Medicare |
$4.81
|
| Rate for Payer: Priority Health Medicare |
$10.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.47
|
| Rate for Payer: Railroad Medicare Medicare |
$4.76
|
| Rate for Payer: Railroad Medicare Medicare |
$7.10
|
| Rate for Payer: Railroad Medicare Medicare |
$4.28
|
| Rate for Payer: Railroad Medicare Medicare |
$9.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.76
|
| Rate for Payer: UHC Core |
$14.30
|
| Rate for Payer: UHC Core |
$33.27
|
| Rate for Payer: UHC Core |
$15.90
|
| Rate for Payer: UHC Core |
$23.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.76
|
| Rate for Payer: UHC Exchange |
$9.96
|
| Rate for Payer: UHC Exchange |
$4.76
|
| Rate for Payer: UHC Exchange |
$4.28
|
| Rate for Payer: UHC Exchange |
$7.10
|
| Rate for Payer: UHC Medicare Advantage |
$9.96
|
| Rate for Payer: UHC Medicare Advantage |
$4.28
|
| Rate for Payer: UHC Medicare Advantage |
$7.10
|
| Rate for Payer: UHC Medicare Advantage |
$4.76
|
| Rate for Payer: VA VA |
$4.76
|
| Rate for Payer: VA VA |
$9.96
|
| Rate for Payer: VA VA |
$7.10
|
| Rate for Payer: VA VA |
$4.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.31
|
|
|
PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$28.41
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
18302
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.47 |
| Max. Negotiated Rate |
$25.57 |
| Rate for Payer: Aetna Commercial |
$24.15
|
| Rate for Payer: Aetna Commercial |
$16.18
|
| Rate for Payer: Aetna Commercial |
$14.55
|
| Rate for Payer: Aetna Commercial |
$33.86
|
| Rate for Payer: BCBS Trust/PPO |
$23.19
|
| Rate for Payer: BCBS Trust/PPO |
$32.52
|
| Rate for Payer: BCBS Trust/PPO |
$15.54
|
| Rate for Payer: BCBS Trust/PPO |
$13.98
|
| Rate for Payer: BCN Commercial |
$21.96
|
| Rate for Payer: BCN Commercial |
$13.23
|
| Rate for Payer: BCN Commercial |
$30.79
|
| Rate for Payer: BCN Commercial |
$14.71
|
| Rate for Payer: Cash Price |
$15.23
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cash Price |
$31.87
|
| Rate for Payer: Cash Price |
$13.70
|
| Rate for Payer: Cofinity Commercial |
$14.72
|
| Rate for Payer: Cofinity Commercial |
$34.26
|
| Rate for Payer: Cofinity Commercial |
$24.43
|
| Rate for Payer: Cofinity Commercial |
$16.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.87
|
| Rate for Payer: Healthscope Commercial |
$35.86
|
| Rate for Payer: Healthscope Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$25.57
|
| Rate for Payer: Healthscope Commercial |
$15.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.86
|
| Rate for Payer: Nomi Health Commercial |
$14.04
|
| Rate for Payer: Nomi Health Commercial |
$15.61
|
| Rate for Payer: Nomi Health Commercial |
$32.67
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: PHP Commercial |
$16.18
|
| Rate for Payer: PHP Commercial |
$14.55
|
| Rate for Payer: PHP Commercial |
$24.15
|
| Rate for Payer: PHP Commercial |
$33.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.47
|
| Rate for Payer: Priority Health HMO/PPO |
$24.72
|
| Rate for Payer: Priority Health HMO/PPO |
$34.66
|
| Rate for Payer: Priority Health HMO/PPO |
$14.89
|
| Rate for Payer: Priority Health HMO/PPO |
$16.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.00
|
| Rate for Payer: UHC Core |
$23.72
|
| Rate for Payer: UHC Core |
$33.27
|
| Rate for Payer: UHC Core |
$15.90
|
| Rate for Payer: UHC Core |
$14.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.31
|
|
|
PIPERACILLIN-TAZOBACTAM 4.5 GRAM MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$39.84
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
301718
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.46 |
| Max. Negotiated Rate |
$35.86 |
| Rate for Payer: Aetna Commercial |
$33.86
|
| Rate for Payer: Aetna Medicare |
$10.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.45
|
| Rate for Payer: BCBS Complete |
$15.94
|
| Rate for Payer: BCBS MAPPO |
$9.96
|
| Rate for Payer: BCBS Trust/PPO |
$32.75
|
| Rate for Payer: BCN Commercial |
$30.98
|
| Rate for Payer: BCN Medicare Advantage |
$9.96
|
| Rate for Payer: Cash Price |
$31.87
|
| Rate for Payer: Cofinity Commercial |
$34.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.96
|
| Rate for Payer: Healthscope Commercial |
$35.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.86
|
| Rate for Payer: Nomi Health Commercial |
$32.67
|
| Rate for Payer: PACE Senior Care Partners |
$9.46
|
| Rate for Payer: PACE SWMI |
$9.96
|
| Rate for Payer: PHP Commercial |
$33.86
|
| Rate for Payer: PHP Medicare Advantage |
$9.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.90
|
| Rate for Payer: Priority Health HMO/PPO |
$34.66
|
| Rate for Payer: Priority Health Medicare |
$10.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.69
|
| Rate for Payer: Railroad Medicare Medicare |
$9.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.06
|
| Rate for Payer: UHC Core |
$33.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.96
|
| Rate for Payer: UHC Exchange |
$9.96
|
| Rate for Payer: UHC Medicare Advantage |
$9.96
|
| Rate for Payer: VA VA |
$9.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.88
|
|
|
PIPERACILLIN-TAZOBACTAM 4.5 GRAM MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$39.84
|
|
|
Service Code
|
HCPCS J2543
|
| Hospital Charge Code |
301718
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$25.90 |
| Max. Negotiated Rate |
$35.86 |
| Rate for Payer: Aetna Commercial |
$33.86
|
| Rate for Payer: BCBS Trust/PPO |
$32.52
|
| Rate for Payer: BCN Commercial |
$30.79
|
| Rate for Payer: Cash Price |
$31.87
|
| Rate for Payer: Cofinity Commercial |
$34.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.87
|
| Rate for Payer: Healthscope Commercial |
$35.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.86
|
| Rate for Payer: Nomi Health Commercial |
$32.67
|
| Rate for Payer: PHP Commercial |
$33.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.90
|
| Rate for Payer: Priority Health HMO/PPO |
$34.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.06
|
| Rate for Payer: UHC Core |
$33.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.88
|
|
