|
PRAVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$392.45
|
|
|
Service Code
|
NDC 68382007116
|
| Hospital Charge Code |
11111
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$93.21 |
| Max. Negotiated Rate |
$353.20 |
| Rate for Payer: Aetna Commercial |
$333.58
|
| Rate for Payer: Aetna Medicare |
$102.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.64
|
| Rate for Payer: BCBS Complete |
$156.98
|
| Rate for Payer: BCBS MAPPO |
$98.11
|
| Rate for Payer: BCBS Trust/PPO |
$322.63
|
| Rate for Payer: BCN Commercial |
$305.13
|
| Rate for Payer: BCN Medicare Advantage |
$98.11
|
| Rate for Payer: Cash Price |
$313.96
|
| Rate for Payer: Cofinity Commercial |
$337.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.11
|
| Rate for Payer: Healthscope Commercial |
$353.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.58
|
| Rate for Payer: Nomi Health Commercial |
$321.81
|
| Rate for Payer: PACE Senior Care Partners |
$93.21
|
| Rate for Payer: PACE SWMI |
$98.11
|
| Rate for Payer: PHP Commercial |
$333.58
|
| Rate for Payer: PHP Medicare Advantage |
$98.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$255.09
|
| Rate for Payer: Priority Health HMO/PPO |
$341.43
|
| Rate for Payer: Priority Health Medicare |
$99.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.94
|
| Rate for Payer: Railroad Medicare Medicare |
$98.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$345.36
|
| Rate for Payer: UHC Core |
$327.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.11
|
| Rate for Payer: UHC Exchange |
$98.11
|
| Rate for Payer: UHC Medicare Advantage |
$98.11
|
| Rate for Payer: VA VA |
$98.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.34
|
|
|
PRAVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$3.67
|
|
|
Service Code
|
NDC 51079078201
|
| Hospital Charge Code |
11112
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$3.30 |
| Rate for Payer: Aetna Commercial |
$3.12
|
| Rate for Payer: Aetna Medicare |
$0.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.15
|
| Rate for Payer: BCBS Complete |
$1.47
|
| Rate for Payer: BCBS MAPPO |
$0.92
|
| Rate for Payer: BCBS Trust/PPO |
$3.02
|
| Rate for Payer: BCN Commercial |
$2.85
|
| Rate for Payer: BCN Medicare Advantage |
$0.92
|
| Rate for Payer: Cash Price |
$2.94
|
| Rate for Payer: Cofinity Commercial |
$3.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.92
|
| Rate for Payer: Healthscope Commercial |
$3.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.12
|
| Rate for Payer: Nomi Health Commercial |
$3.01
|
| Rate for Payer: PACE Senior Care Partners |
$0.87
|
| Rate for Payer: PACE SWMI |
$0.92
|
| Rate for Payer: PHP Commercial |
$3.12
|
| Rate for Payer: PHP Medicare Advantage |
$0.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.39
|
| Rate for Payer: Priority Health HMO/PPO |
$3.19
|
| Rate for Payer: Priority Health Medicare |
$0.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.46
|
| Rate for Payer: Railroad Medicare Medicare |
$0.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.23
|
| Rate for Payer: UHC Core |
$3.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.92
|
| Rate for Payer: UHC Exchange |
$0.92
|
| Rate for Payer: UHC Medicare Advantage |
$0.92
|
| Rate for Payer: VA VA |
$0.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.75
|
|
|
PRAVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$366.24
|
|
|
Service Code
|
NDC 51079078220
|
| Hospital Charge Code |
11112
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$238.06 |
| Max. Negotiated Rate |
$329.62 |
| Rate for Payer: Aetna Commercial |
$311.30
|
| Rate for Payer: BCBS Trust/PPO |
$298.96
|
| Rate for Payer: BCN Commercial |
$283.03
|
| Rate for Payer: Cash Price |
$292.99
|
| Rate for Payer: Cofinity Commercial |
$314.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.99
|
| Rate for Payer: Healthscope Commercial |
$329.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.30
|
| Rate for Payer: Nomi Health Commercial |
$300.32
|
| Rate for Payer: PHP Commercial |
$311.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.06
|
| Rate for Payer: Priority Health HMO/PPO |
$318.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$245.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.29
|
| Rate for Payer: UHC Core |
$305.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.68
|
|
|
PRAVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$286.42
|
|
|
Service Code
|
NDC 68382007216
|
| Hospital Charge Code |
11112
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$68.02 |
| Max. Negotiated Rate |
$257.78 |
| Rate for Payer: Aetna Commercial |
$243.46
|
| Rate for Payer: Aetna Medicare |
$74.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.51
|
| Rate for Payer: BCBS Complete |
$114.57
|
| Rate for Payer: BCBS MAPPO |
$71.60
|
| Rate for Payer: BCBS Trust/PPO |
$235.47
|
| Rate for Payer: BCN Commercial |
$222.69
|
| Rate for Payer: BCN Medicare Advantage |
$71.60
|
| Rate for Payer: Cash Price |
$229.14
|
| Rate for Payer: Cofinity Commercial |
$246.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.60
|
| Rate for Payer: Healthscope Commercial |
$257.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.46
|
| Rate for Payer: Nomi Health Commercial |
$234.86
|
| Rate for Payer: PACE Senior Care Partners |
$68.02
|
| Rate for Payer: PACE SWMI |
$71.60
|
| Rate for Payer: PHP Commercial |
$243.46
|
| Rate for Payer: PHP Medicare Advantage |
$71.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.17
|
| Rate for Payer: Priority Health HMO/PPO |
$249.19
|
| Rate for Payer: Priority Health Medicare |
$72.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.90
|
| Rate for Payer: Railroad Medicare Medicare |
$71.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.05
|
| Rate for Payer: UHC Core |
$239.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.60
|
| Rate for Payer: UHC Exchange |
$71.60
|
| Rate for Payer: UHC Medicare Advantage |
$71.60
|
| Rate for Payer: VA VA |
$71.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.82
|
|
|
PRAVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$3.67
|
|
|
Service Code
|
NDC 51079078201
|
| Hospital Charge Code |
11112
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.39 |
| Max. Negotiated Rate |
$3.30 |
| Rate for Payer: Aetna Commercial |
$3.12
|
| Rate for Payer: BCBS Trust/PPO |
$3.00
|
| Rate for Payer: BCN Commercial |
$2.84
|
| Rate for Payer: Cash Price |
$2.94
|
| Rate for Payer: Cofinity Commercial |
$3.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.94
|
| Rate for Payer: Healthscope Commercial |
$3.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.12
|
| Rate for Payer: Nomi Health Commercial |
$3.01
|
| Rate for Payer: PHP Commercial |
$3.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.39
|
| Rate for Payer: Priority Health HMO/PPO |
$3.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.23
|
| Rate for Payer: UHC Core |
$3.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.75
|
|
|
PRAVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$366.24
|
|
|
Service Code
|
NDC 51079078220
|
| Hospital Charge Code |
11112
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$86.98 |
| Max. Negotiated Rate |
$329.62 |
| Rate for Payer: Aetna Commercial |
$311.30
|
| Rate for Payer: Aetna Medicare |
$95.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.45
|
| Rate for Payer: BCBS Complete |
$146.50
|
| Rate for Payer: BCBS MAPPO |
$91.56
|
| Rate for Payer: BCBS Trust/PPO |
$301.09
|
| Rate for Payer: BCN Commercial |
$284.75
|
| Rate for Payer: BCN Medicare Advantage |
$91.56
|
| Rate for Payer: Cash Price |
$292.99
|
| Rate for Payer: Cofinity Commercial |
$314.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.56
|
| Rate for Payer: Healthscope Commercial |
$329.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.30
|
| Rate for Payer: Nomi Health Commercial |
$300.32
|
| Rate for Payer: PACE Senior Care Partners |
$86.98
|
| Rate for Payer: PACE SWMI |
$91.56
|
| Rate for Payer: PHP Commercial |
$311.30
|
| Rate for Payer: PHP Medicare Advantage |
$91.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.06
|
| Rate for Payer: Priority Health HMO/PPO |
$318.63
|
| Rate for Payer: Priority Health Medicare |
$92.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$245.38
|
| Rate for Payer: Railroad Medicare Medicare |
$91.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.29
|
| Rate for Payer: UHC Core |
$305.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.56
|
| Rate for Payer: UHC Exchange |
$91.56
|
| Rate for Payer: UHC Medicare Advantage |
$91.56
|
| Rate for Payer: VA VA |
$91.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.68
|
|
|
PRAVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$300.11
|
|
|
Service Code
|
NDC 68462019790
|
| Hospital Charge Code |
11112
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$71.28 |
| Max. Negotiated Rate |
$270.10 |
| Rate for Payer: Aetna Commercial |
$255.09
|
| Rate for Payer: Aetna Medicare |
$78.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.78
|
| Rate for Payer: BCBS Complete |
$120.04
|
| Rate for Payer: BCBS MAPPO |
$75.03
|
| Rate for Payer: BCBS Trust/PPO |
$246.72
|
| Rate for Payer: BCN Commercial |
$233.34
|
| Rate for Payer: BCN Medicare Advantage |
$75.03
|
| Rate for Payer: Cash Price |
$240.09
|
| Rate for Payer: Cofinity Commercial |
$258.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.03
|
| Rate for Payer: Healthscope Commercial |
$270.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.09
|
| Rate for Payer: Nomi Health Commercial |
$246.09
|
| Rate for Payer: PACE Senior Care Partners |
$71.28
|
| Rate for Payer: PACE SWMI |
$75.03
|
| Rate for Payer: PHP Commercial |
$255.09
|
| Rate for Payer: PHP Medicare Advantage |
$75.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.07
|
| Rate for Payer: Priority Health HMO/PPO |
$261.10
|
| Rate for Payer: Priority Health Medicare |
$75.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.07
|
| Rate for Payer: Railroad Medicare Medicare |
$75.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.10
|
| Rate for Payer: UHC Core |
$250.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.03
|
| Rate for Payer: UHC Exchange |
$75.03
|
| Rate for Payer: UHC Medicare Advantage |
$75.03
|
| Rate for Payer: VA VA |
$75.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.08
|
|
|
PRAVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$284.16
|
|
|
Service Code
|
NDC 00904589361
|
| Hospital Charge Code |
11112
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$184.70 |
| Max. Negotiated Rate |
$255.74 |
| Rate for Payer: Aetna Commercial |
$241.54
|
| Rate for Payer: BCBS Trust/PPO |
$231.96
|
| Rate for Payer: BCN Commercial |
$219.60
|
| Rate for Payer: Cash Price |
$227.33
|
| Rate for Payer: Cofinity Commercial |
$244.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.33
|
| Rate for Payer: Healthscope Commercial |
$255.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.54
|
| Rate for Payer: Nomi Health Commercial |
$233.01
|
| Rate for Payer: PHP Commercial |
$241.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.70
|
| Rate for Payer: Priority Health HMO/PPO |
$247.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$190.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.06
|
| Rate for Payer: UHC Core |
$237.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.12
|
|
|
PRAVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$284.16
|
|
|
Service Code
|
NDC 00904589361
|
| Hospital Charge Code |
11112
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$67.49 |
| Max. Negotiated Rate |
$255.74 |
| Rate for Payer: Aetna Commercial |
$241.54
|
| Rate for Payer: Aetna Medicare |
$73.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.80
|
| Rate for Payer: BCBS Complete |
$113.66
|
| Rate for Payer: BCBS MAPPO |
$71.04
|
| Rate for Payer: BCBS Trust/PPO |
$233.61
|
| Rate for Payer: BCN Commercial |
$220.93
|
| Rate for Payer: BCN Medicare Advantage |
$71.04
|
| Rate for Payer: Cash Price |
$227.33
|
| Rate for Payer: Cofinity Commercial |
$244.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.04
|
| Rate for Payer: Healthscope Commercial |
$255.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.54
|
| Rate for Payer: Nomi Health Commercial |
$233.01
|
| Rate for Payer: PACE Senior Care Partners |
$67.49
|
| Rate for Payer: PACE SWMI |
$71.04
|
| Rate for Payer: PHP Commercial |
$241.54
|
| Rate for Payer: PHP Medicare Advantage |
$71.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.70
|
| Rate for Payer: Priority Health HMO/PPO |
$247.22
|
| Rate for Payer: Priority Health Medicare |
$71.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$190.39
|
| Rate for Payer: Railroad Medicare Medicare |
$71.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.06
|
| Rate for Payer: UHC Core |
$237.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.04
|
| Rate for Payer: UHC Exchange |
$71.04
|
| Rate for Payer: UHC Medicare Advantage |
$71.04
|
| Rate for Payer: VA VA |
$71.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.12
|
|
|
PRAVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$300.11
|
|
|
Service Code
|
NDC 68462019790
|
| Hospital Charge Code |
11112
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$195.07 |
| Max. Negotiated Rate |
$270.10 |
| Rate for Payer: Aetna Commercial |
$255.09
|
| Rate for Payer: BCBS Trust/PPO |
$244.98
|
| Rate for Payer: BCN Commercial |
$231.93
|
| Rate for Payer: Cash Price |
$240.09
|
| Rate for Payer: Cofinity Commercial |
$258.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.09
|
| Rate for Payer: Healthscope Commercial |
$270.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.09
|
| Rate for Payer: Nomi Health Commercial |
$246.09
|
| Rate for Payer: PHP Commercial |
$255.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.07
|
| Rate for Payer: Priority Health HMO/PPO |
$261.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.10
|
| Rate for Payer: UHC Core |
$250.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.08
|
|
|
PRAVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$286.42
|
|
|
Service Code
|
NDC 68382007216
|
| Hospital Charge Code |
11112
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$186.17 |
| Max. Negotiated Rate |
$257.78 |
| Rate for Payer: Aetna Commercial |
$243.46
|
| Rate for Payer: BCBS Trust/PPO |
$233.80
|
| Rate for Payer: BCN Commercial |
$221.35
|
| Rate for Payer: Cash Price |
$229.14
|
| Rate for Payer: Cofinity Commercial |
$246.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.14
|
| Rate for Payer: Healthscope Commercial |
$257.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.46
|
| Rate for Payer: Nomi Health Commercial |
$234.86
|
| Rate for Payer: PHP Commercial |
$243.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.17
|
| Rate for Payer: Priority Health HMO/PPO |
$249.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.05
|
| Rate for Payer: UHC Core |
$239.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.82
|
|
|
PR AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1
|
Professional
|
Both
|
$160.00
|
|
|
Service Code
|
HCPCS 11730
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$135.47 |
| Rate for Payer: Aetna Commercial |
$68.53
|
| Rate for Payer: Aetna Medicare |
$53.19
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: BCBS MAPPO |
$51.14
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$135.47
|
| Rate for Payer: BCN Medicare Advantage |
$51.14
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$73.64
|
| Rate for Payer: Cofinity Commercial |
$68.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.14
|
| Rate for Payer: Mclaren Medicaid |
$34.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.70
|
| Rate for Payer: Meridian Medicaid |
$36.00
|
| Rate for Payer: Nomi Health Commercial |
$61.37
|
| Rate for Payer: PACE SWMI |
$51.14
|
| Rate for Payer: PHP Medicare Advantage |
$51.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.00
|
| Rate for Payer: Priority Health HMO/PPO |
$72.24
|
| Rate for Payer: Priority Health Medicare |
$51.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.14
|
| Rate for Payer: UHC Exchange |
$51.14
|
| Rate for Payer: UHC Medicare Advantage |
$51.14
|
| Rate for Payer: UHCCP Medicaid |
$34.29
|
|
|
PR AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 11732
|
| Min. Negotiated Rate |
$10.65 |
| Max. Negotiated Rate |
$106.97 |
| Rate for Payer: Aetna Commercial |
$21.55
|
| Rate for Payer: Aetna Medicare |
$16.72
|
| Rate for Payer: BCBS Complete |
$11.18
|
| Rate for Payer: BCBS MAPPO |
$16.08
|
| Rate for Payer: BCBS Trust/PPO |
$106.97
|
| Rate for Payer: BCN Commercial |
$39.27
|
| Rate for Payer: BCN Medicare Advantage |
$16.08
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cofinity Commercial |
$23.16
|
| Rate for Payer: Cofinity Commercial |
$21.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.08
|
| Rate for Payer: Mclaren Medicaid |
$10.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.88
|
| Rate for Payer: Meridian Medicaid |
$11.18
|
| Rate for Payer: Nomi Health Commercial |
$19.30
|
| Rate for Payer: PACE SWMI |
$16.08
|
| Rate for Payer: PHP Medicare Advantage |
$16.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.10
|
| Rate for Payer: Priority Health HMO/PPO |
$22.57
|
| Rate for Payer: Priority Health Medicare |
$16.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.08
|
| Rate for Payer: UHC Exchange |
$16.08
|
| Rate for Payer: UHC Medicare Advantage |
$16.08
|
| Rate for Payer: UHCCP Medicaid |
$10.65
|
|
|
PR AXILLARY LYMPHADENECTOMY COMPLETE
|
Facility
|
OP
|
$1,564.00
|
|
|
Service Code
|
CPT 38745
|
| Hospital Charge Code |
38745
|
| Min. Negotiated Rate |
$371.45 |
| Max. Negotiated Rate |
$4,339.88 |
| Rate for Payer: Aetna Commercial |
$1,329.40
|
| Rate for Payer: Aetna Medicare |
$406.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$488.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$488.75
|
| Rate for Payer: BCBS Complete |
$4,339.88
|
| Rate for Payer: BCBS MAPPO |
$391.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,285.76
|
| Rate for Payer: BCN Commercial |
$1,216.01
|
| Rate for Payer: BCN Medicare Advantage |
$391.00
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cofinity Commercial |
$1,345.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,251.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.00
|
| Rate for Payer: Healthscope Commercial |
$1,407.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,173.00
|
| Rate for Payer: Mclaren Medicaid |
$4,132.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$410.55
|
| Rate for Payer: Meridian Medicaid |
$4,339.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$449.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,329.40
|
| Rate for Payer: Nomi Health Commercial |
$1,282.48
|
| Rate for Payer: PACE Senior Care Partners |
$371.45
|
| Rate for Payer: PACE SWMI |
$391.00
|
| Rate for Payer: PHP Commercial |
$1,329.40
|
| Rate for Payer: PHP Medicare Advantage |
$391.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,132.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,016.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,360.68
|
| Rate for Payer: Priority Health Medicare |
$394.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,047.88
|
| Rate for Payer: Railroad Medicare Medicare |
$391.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,376.32
|
| Rate for Payer: UHC Core |
$1,305.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.00
|
| Rate for Payer: UHC Exchange |
$391.00
|
| Rate for Payer: UHC Medicare Advantage |
$391.00
|
| Rate for Payer: UHCCP Medicaid |
$4,132.95
|
| Rate for Payer: VA VA |
$391.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,173.00
|
|
|
PR AXILLARY LYMPHADENECTOMY COMPLETE
|
Professional
|
Both
|
$1,564.00
|
|
|
Service Code
|
HCPCS 38745
|
| Min. Negotiated Rate |
$570.63 |
| Max. Negotiated Rate |
$1,772.22 |
| Rate for Payer: Aetna Commercial |
$1,150.42
|
| Rate for Payer: Aetna Medicare |
$892.86
|
| Rate for Payer: BCBS Complete |
$599.16
|
| Rate for Payer: BCBS MAPPO |
$858.52
|
| Rate for Payer: BCBS Trust/PPO |
$664.07
|
| Rate for Payer: BCN Commercial |
$1,289.62
|
| Rate for Payer: BCN Medicare Advantage |
$858.52
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cofinity Commercial |
$1,236.27
|
| Rate for Payer: Cofinity Commercial |
$1,150.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$858.52
|
| Rate for Payer: Mclaren Medicaid |
$570.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$901.45
|
| Rate for Payer: Meridian Medicaid |
$599.16
|
| Rate for Payer: Nomi Health Commercial |
$1,030.22
|
| Rate for Payer: PACE SWMI |
$858.52
|
| Rate for Payer: PHP Medicare Advantage |
$858.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$570.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,016.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,772.22
|
| Rate for Payer: Priority Health Medicare |
$867.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,772.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$858.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$858.52
|
| Rate for Payer: UHC Exchange |
$858.52
|
| Rate for Payer: UHC Medicare Advantage |
$858.52
|
| Rate for Payer: UHCCP Medicaid |
$570.63
|
|
|
PR AXILLARY LYMPHADENECTOMY COMPLETE
|
Facility
|
IP
|
$1,564.00
|
|
|
Service Code
|
CPT 38745
|
| Hospital Charge Code |
38745
|
| Min. Negotiated Rate |
$1,016.60 |
| Max. Negotiated Rate |
$1,407.60 |
| Rate for Payer: Aetna Commercial |
$1,329.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,276.69
|
| Rate for Payer: BCN Commercial |
$1,208.66
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cofinity Commercial |
$1,345.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,251.20
|
| Rate for Payer: Healthscope Commercial |
$1,407.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,173.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,329.40
|
| Rate for Payer: Nomi Health Commercial |
$1,282.48
|
| Rate for Payer: PHP Commercial |
$1,329.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,016.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,360.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,047.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,376.32
|
| Rate for Payer: UHC Core |
$1,305.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,173.00
|
|
|
PR AXILLARY LYMPHADENECTOMY COMPLETE
|
Professional
|
Both
|
$1,564.00
|
|
|
Service Code
|
HCPCS 38745
|
| Hospital Charge Code |
38745
|
| Min. Negotiated Rate |
$570.63 |
| Max. Negotiated Rate |
$1,772.22 |
| Rate for Payer: Aetna Commercial |
$1,150.42
|
| Rate for Payer: Aetna Medicare |
$892.86
|
| Rate for Payer: BCBS Complete |
$599.16
|
| Rate for Payer: BCBS MAPPO |
$858.52
|
| Rate for Payer: BCBS Trust/PPO |
$664.07
|
| Rate for Payer: BCN Commercial |
$1,289.62
|
| Rate for Payer: BCN Medicare Advantage |
$858.52
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cofinity Commercial |
$1,236.27
|
| Rate for Payer: Cofinity Commercial |
$1,150.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$858.52
|
| Rate for Payer: Mclaren Medicaid |
$570.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$901.45
|
| Rate for Payer: Meridian Medicaid |
$599.16
|
| Rate for Payer: Nomi Health Commercial |
$1,030.22
|
| Rate for Payer: PACE SWMI |
$858.52
|
| Rate for Payer: PHP Medicare Advantage |
$858.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$570.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,016.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,772.22
|
| Rate for Payer: Priority Health Medicare |
$867.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,772.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$858.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$858.52
|
| Rate for Payer: UHC Exchange |
$858.52
|
| Rate for Payer: UHC Medicare Advantage |
$858.52
|
| Rate for Payer: UHCCP Medicaid |
$570.63
|
|
|
PR AXILLARY LYMPHADENECTOMY SUPERFICIAL
|
Professional
|
Both
|
$2,103.00
|
|
|
Service Code
|
HCPCS 38740
|
| Min. Negotiated Rate |
$454.33 |
| Max. Negotiated Rate |
$1,411.40 |
| Rate for Payer: Aetna Commercial |
$913.63
|
| Rate for Payer: Aetna Medicare |
$709.08
|
| Rate for Payer: BCBS Complete |
$477.05
|
| Rate for Payer: BCBS MAPPO |
$681.81
|
| Rate for Payer: BCBS Trust/PPO |
$931.39
|
| Rate for Payer: BCN Commercial |
$1,027.20
|
| Rate for Payer: BCN Medicare Advantage |
$681.81
|
| Rate for Payer: Cash Price |
$1,682.40
|
| Rate for Payer: Cash Price |
$1,682.40
|
| Rate for Payer: Cofinity Commercial |
$981.81
|
| Rate for Payer: Cofinity Commercial |
$913.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$681.81
|
| Rate for Payer: Mclaren Medicaid |
$454.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$715.90
|
| Rate for Payer: Meridian Medicaid |
$477.05
|
| Rate for Payer: Nomi Health Commercial |
$818.17
|
| Rate for Payer: PACE SWMI |
$681.81
|
| Rate for Payer: PHP Medicare Advantage |
$681.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$454.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,366.95
|
| Rate for Payer: Priority Health HMO/PPO |
$1,411.40
|
| Rate for Payer: Priority Health Medicare |
$688.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,411.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$681.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$681.81
|
| Rate for Payer: UHC Exchange |
$681.81
|
| Rate for Payer: UHC Medicare Advantage |
$681.81
|
| Rate for Payer: UHCCP Medicaid |
$454.33
|
|
|
PRAZOSIN 1 MG CAPSULE
|
Facility
|
IP
|
$475.00
|
|
|
Service Code
|
NDC 00378110101
|
| Hospital Charge Code |
6468
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$308.75 |
| Max. Negotiated Rate |
$427.50 |
| Rate for Payer: Aetna Commercial |
$403.75
|
| Rate for Payer: BCBS Trust/PPO |
$387.74
|
| Rate for Payer: BCN Commercial |
$367.08
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cofinity Commercial |
$408.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.00
|
| Rate for Payer: Healthscope Commercial |
$427.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$403.75
|
| Rate for Payer: Nomi Health Commercial |
$389.50
|
| Rate for Payer: PHP Commercial |
$403.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.75
|
| Rate for Payer: Priority Health HMO/PPO |
$413.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$318.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$418.00
|
| Rate for Payer: UHC Core |
$396.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.25
|
|
|
PRAZOSIN 1 MG CAPSULE
|
Facility
|
OP
|
$333.70
|
|
|
Service Code
|
NDC 70954001910
|
| Hospital Charge Code |
6468
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$79.25 |
| Max. Negotiated Rate |
$300.33 |
| Rate for Payer: Aetna Commercial |
$283.64
|
| Rate for Payer: Aetna Medicare |
$86.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.28
|
| Rate for Payer: BCBS Complete |
$133.48
|
| Rate for Payer: BCBS MAPPO |
$83.42
|
| Rate for Payer: BCBS Trust/PPO |
$274.33
|
| Rate for Payer: BCN Commercial |
$259.45
|
| Rate for Payer: BCN Medicare Advantage |
$83.42
|
| Rate for Payer: Cash Price |
$266.96
|
| Rate for Payer: Cofinity Commercial |
$286.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.42
|
| Rate for Payer: Healthscope Commercial |
$300.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.64
|
| Rate for Payer: Nomi Health Commercial |
$273.63
|
| Rate for Payer: PACE Senior Care Partners |
$79.25
|
| Rate for Payer: PACE SWMI |
$83.42
|
| Rate for Payer: PHP Commercial |
$283.64
|
| Rate for Payer: PHP Medicare Advantage |
$83.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.90
|
| Rate for Payer: Priority Health HMO/PPO |
$290.32
|
| Rate for Payer: Priority Health Medicare |
$84.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$223.58
|
| Rate for Payer: Railroad Medicare Medicare |
$83.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.66
|
| Rate for Payer: UHC Core |
$278.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.42
|
| Rate for Payer: UHC Exchange |
$83.42
|
| Rate for Payer: UHC Medicare Advantage |
$83.42
|
| Rate for Payer: VA VA |
$83.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.28
|
|
|
PRAZOSIN 1 MG CAPSULE
|
Facility
|
IP
|
$462.72
|
|
|
Service Code
|
NDC 00904702061
|
| Hospital Charge Code |
6468
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$300.77 |
| Max. Negotiated Rate |
$416.45 |
| Rate for Payer: Aetna Commercial |
$393.31
|
| Rate for Payer: BCBS Trust/PPO |
$377.72
|
| Rate for Payer: BCN Commercial |
$357.59
|
| Rate for Payer: Cash Price |
$370.18
|
| Rate for Payer: Cofinity Commercial |
$397.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.18
|
| Rate for Payer: Healthscope Commercial |
$416.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.31
|
| Rate for Payer: Nomi Health Commercial |
$379.43
|
| Rate for Payer: PHP Commercial |
$393.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.77
|
| Rate for Payer: Priority Health HMO/PPO |
$402.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.19
|
| Rate for Payer: UHC Core |
$386.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.04
|
|
|
PRAZOSIN 1 MG CAPSULE
|
Facility
|
OP
|
$475.00
|
|
|
Service Code
|
NDC 00378110101
|
| Hospital Charge Code |
6468
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$112.81 |
| Max. Negotiated Rate |
$427.50 |
| Rate for Payer: Aetna Commercial |
$403.75
|
| Rate for Payer: Aetna Medicare |
$123.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$148.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$148.44
|
| Rate for Payer: BCBS Complete |
$190.00
|
| Rate for Payer: BCBS MAPPO |
$118.75
|
| Rate for Payer: BCBS Trust/PPO |
$390.50
|
| Rate for Payer: BCN Commercial |
$369.31
|
| Rate for Payer: BCN Medicare Advantage |
$118.75
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cofinity Commercial |
$408.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.75
|
| Rate for Payer: Healthscope Commercial |
$427.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$136.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$403.75
|
| Rate for Payer: Nomi Health Commercial |
$389.50
|
| Rate for Payer: PACE Senior Care Partners |
$112.81
|
| Rate for Payer: PACE SWMI |
$118.75
|
| Rate for Payer: PHP Commercial |
$403.75
|
| Rate for Payer: PHP Medicare Advantage |
$118.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.75
|
| Rate for Payer: Priority Health HMO/PPO |
$413.25
|
| Rate for Payer: Priority Health Medicare |
$119.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$318.25
|
| Rate for Payer: Railroad Medicare Medicare |
$118.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$418.00
|
| Rate for Payer: UHC Core |
$396.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.75
|
| Rate for Payer: UHC Exchange |
$118.75
|
| Rate for Payer: UHC Medicare Advantage |
$118.75
|
| Rate for Payer: VA VA |
$118.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.25
|
|
|
PRAZOSIN 1 MG CAPSULE
|
Facility
|
IP
|
$333.70
|
|
|
Service Code
|
NDC 70954001910
|
| Hospital Charge Code |
6468
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$216.90 |
| Max. Negotiated Rate |
$300.33 |
| Rate for Payer: Aetna Commercial |
$283.64
|
| Rate for Payer: BCBS Trust/PPO |
$272.40
|
| Rate for Payer: BCN Commercial |
$257.88
|
| Rate for Payer: Cash Price |
$266.96
|
| Rate for Payer: Cofinity Commercial |
$286.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.96
|
| Rate for Payer: Healthscope Commercial |
$300.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.64
|
| Rate for Payer: Nomi Health Commercial |
$273.63
|
| Rate for Payer: PHP Commercial |
$283.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.90
|
| Rate for Payer: Priority Health HMO/PPO |
$290.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$223.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.66
|
| Rate for Payer: UHC Core |
$278.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.28
|
|
|
PRAZOSIN 1 MG CAPSULE
|
Facility
|
OP
|
$462.72
|
|
|
Service Code
|
NDC 00904702061
|
| Hospital Charge Code |
6468
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$109.90 |
| Max. Negotiated Rate |
$416.45 |
| Rate for Payer: Aetna Commercial |
$393.31
|
| Rate for Payer: Aetna Medicare |
$120.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$144.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$144.60
|
| Rate for Payer: BCBS Complete |
$185.09
|
| Rate for Payer: BCBS MAPPO |
$115.68
|
| Rate for Payer: BCBS Trust/PPO |
$380.40
|
| Rate for Payer: BCN Commercial |
$359.76
|
| Rate for Payer: BCN Medicare Advantage |
$115.68
|
| Rate for Payer: Cash Price |
$370.18
|
| Rate for Payer: Cofinity Commercial |
$397.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.68
|
| Rate for Payer: Healthscope Commercial |
$416.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$133.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.31
|
| Rate for Payer: Nomi Health Commercial |
$379.43
|
| Rate for Payer: PACE Senior Care Partners |
$109.90
|
| Rate for Payer: PACE SWMI |
$115.68
|
| Rate for Payer: PHP Commercial |
$393.31
|
| Rate for Payer: PHP Medicare Advantage |
$115.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.77
|
| Rate for Payer: Priority Health HMO/PPO |
$402.57
|
| Rate for Payer: Priority Health Medicare |
$116.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.02
|
| Rate for Payer: Railroad Medicare Medicare |
$115.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.19
|
| Rate for Payer: UHC Core |
$386.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.68
|
| Rate for Payer: UHC Exchange |
$115.68
|
| Rate for Payer: UHC Medicare Advantage |
$115.68
|
| Rate for Payer: VA VA |
$115.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.04
|
|
|
PRAZOSIN 5 MG CAPSULE
|
Facility
|
IP
|
$584.64
|
|
|
Service Code
|
NDC 00378320501
|
| Hospital Charge Code |
6470
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$380.02 |
| Max. Negotiated Rate |
$526.18 |
| Rate for Payer: Aetna Commercial |
$496.94
|
| Rate for Payer: BCBS Trust/PPO |
$477.24
|
| Rate for Payer: BCN Commercial |
$451.81
|
| Rate for Payer: Cash Price |
$467.71
|
| Rate for Payer: Cofinity Commercial |
$502.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.71
|
| Rate for Payer: Healthscope Commercial |
$526.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.94
|
| Rate for Payer: Nomi Health Commercial |
$479.40
|
| Rate for Payer: PHP Commercial |
$496.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$380.02
|
| Rate for Payer: Priority Health HMO/PPO |
$508.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$391.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.48
|
| Rate for Payer: UHC Core |
$488.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.48
|
|
