|
DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$7.87
|
|
|
Service Code
|
NDC 60687060711
|
| Hospital Charge Code |
91073
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$7.08 |
| Rate for Payer: Aetna Commercial |
$6.69
|
| Rate for Payer: Aetna Medicare |
$2.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.46
|
| Rate for Payer: BCBS Complete |
$1.46
|
| Rate for Payer: BCBS MAPPO |
$1.97
|
| Rate for Payer: BCBS Trust/PPO |
$6.47
|
| Rate for Payer: BCN Commercial |
$6.47
|
| Rate for Payer: BCN Medicare Advantage |
$1.97
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cofinity Commercial |
$6.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.97
|
| Rate for Payer: Healthscope Commercial |
$7.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.90
|
| Rate for Payer: Mclaren Medicaid |
$1.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.07
|
| Rate for Payer: Meridian Medicaid |
$1.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.69
|
| Rate for Payer: Nomi Health Commercial |
$6.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.90
|
| Rate for Payer: PACE Senior Care Partners |
$1.87
|
| Rate for Payer: PACE SWMI |
$1.97
|
| Rate for Payer: PHP Commercial |
$6.69
|
| Rate for Payer: PHP Medicare Advantage |
$1.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6.85
|
| Rate for Payer: Priority Health Medicare |
$1.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.93
|
| Rate for Payer: UHC Core |
$6.57
|
| Rate for Payer: UHC Exchange |
$1.97
|
| Rate for Payer: UHC Medicaid |
$1.39
|
| Rate for Payer: UHC Medicare Advantage |
$1.97
|
| Rate for Payer: UHCCP Medicaid |
$1.39
|
| Rate for Payer: VA VA |
$1.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.90
|
|
|
DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$136.37
|
|
|
Service Code
|
NDC 70436001204
|
| Hospital Charge Code |
91073
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$94.91 |
| Max. Negotiated Rate |
$122.73 |
| Rate for Payer: Aetna Commercial |
$115.91
|
| Rate for Payer: BCBS Trust/PPO |
$112.63
|
| Rate for Payer: BCN Commercial |
$112.63
|
| Rate for Payer: Cash Price |
$109.10
|
| Rate for Payer: Cofinity Commercial |
$117.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.10
|
| Rate for Payer: Healthscope Commercial |
$122.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.91
|
| Rate for Payer: Nomi Health Commercial |
$111.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.28
|
| Rate for Payer: PHP Commercial |
$115.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$118.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.01
|
| Rate for Payer: UHC Core |
$113.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.28
|
|
|
DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$235.88
|
|
|
Service Code
|
NDC 60687060721
|
| Hospital Charge Code |
91073
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$164.17 |
| Max. Negotiated Rate |
$212.29 |
| Rate for Payer: Aetna Commercial |
$200.50
|
| Rate for Payer: BCBS Trust/PPO |
$194.81
|
| Rate for Payer: BCN Commercial |
$194.81
|
| Rate for Payer: Cash Price |
$188.70
|
| Rate for Payer: Cofinity Commercial |
$202.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.70
|
| Rate for Payer: Healthscope Commercial |
$212.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.50
|
| Rate for Payer: Nomi Health Commercial |
$193.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$176.91
|
| Rate for Payer: PHP Commercial |
$200.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$205.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.57
|
| Rate for Payer: UHC Core |
$196.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.91
|
|
|
DESVENLAFAXINE SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$1,507.05
|
|
|
Service Code
|
NDC 00008121130
|
| Hospital Charge Code |
91073
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,048.91 |
| Max. Negotiated Rate |
$1,356.35 |
| Rate for Payer: Aetna Commercial |
$1,280.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,244.67
|
| Rate for Payer: BCN Commercial |
$1,244.67
|
| Rate for Payer: Cash Price |
$1,205.64
|
| Rate for Payer: Cofinity Commercial |
$1,296.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,205.64
|
| Rate for Payer: Healthscope Commercial |
$1,356.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,130.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,280.99
|
| Rate for Payer: Nomi Health Commercial |
$1,235.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,130.29
|
| Rate for Payer: PHP Commercial |
$1,280.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,311.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,048.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,326.20
|
| Rate for Payer: UHC Core |
$1,258.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,130.29
|
|
|
DEXAMETHASONE 10 MG/ML PF ORAL SOLUTION (INJECTION FOR ORAL USE CUSTOM)
|
Facility
|
IP
|
$3.74
|
|
|
Service Code
|
NDC 9900000170
|
| Hospital Charge Code |
180638
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.60 |
| Max. Negotiated Rate |
$3.37 |
| Rate for Payer: Aetna Commercial |
$3.18
|
| Rate for Payer: BCBS Trust/PPO |
$3.09
|
| Rate for Payer: BCN Commercial |
$3.09
|
| Rate for Payer: Cash Price |
$2.99
|
| Rate for Payer: Cofinity Commercial |
$3.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.99
|
| Rate for Payer: Healthscope Commercial |
$3.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.18
|
| Rate for Payer: Nomi Health Commercial |
$3.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.81
|
| Rate for Payer: PHP Commercial |
$3.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.29
|
| Rate for Payer: UHC Core |
$3.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.81
|
|
|
DEXAMETHASONE 10 MG/ML PF ORAL SOLUTION (INJECTION FOR ORAL USE CUSTOM)
|
Facility
|
OP
|
$4.64
|
|
|
Service Code
|
NDC 70069002125
|
| Hospital Charge Code |
180638
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$4.18 |
| Rate for Payer: Aetna Commercial |
$3.94
|
| Rate for Payer: Aetna Medicare |
$1.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.45
|
| Rate for Payer: BCBS Complete |
$0.86
|
| Rate for Payer: BCBS MAPPO |
$1.16
|
| Rate for Payer: BCBS Trust/PPO |
$3.81
|
| Rate for Payer: BCN Commercial |
$3.81
|
| Rate for Payer: BCN Medicare Advantage |
$1.16
|
| Rate for Payer: Cash Price |
$3.71
|
| Rate for Payer: Cofinity Commercial |
$3.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.16
|
| Rate for Payer: Healthscope Commercial |
$4.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.48
|
| Rate for Payer: Mclaren Medicaid |
$0.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.22
|
| Rate for Payer: Meridian Medicaid |
$0.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.94
|
| Rate for Payer: Nomi Health Commercial |
$3.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.48
|
| Rate for Payer: PACE Senior Care Partners |
$1.10
|
| Rate for Payer: PACE SWMI |
$1.16
|
| Rate for Payer: PHP Commercial |
$3.94
|
| Rate for Payer: PHP Medicare Advantage |
$1.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.04
|
| Rate for Payer: Priority Health Medicare |
$1.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.08
|
| Rate for Payer: UHC Core |
$3.87
|
| Rate for Payer: UHC Exchange |
$1.16
|
| Rate for Payer: UHC Medicaid |
$0.82
|
| Rate for Payer: UHC Medicare Advantage |
$1.16
|
| Rate for Payer: UHCCP Medicaid |
$0.82
|
| Rate for Payer: VA VA |
$1.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.48
|
|
|
DEXAMETHASONE 10 MG/ML PF ORAL SOLUTION (INJECTION FOR ORAL USE CUSTOM)
|
Facility
|
OP
|
$3.74
|
|
|
Service Code
|
NDC 9900000170
|
| Hospital Charge Code |
180638
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.66 |
| Max. Negotiated Rate |
$3.37 |
| Rate for Payer: Aetna Commercial |
$3.18
|
| Rate for Payer: Aetna Medicare |
$0.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.17
|
| Rate for Payer: BCBS Complete |
$0.69
|
| Rate for Payer: BCBS MAPPO |
$0.94
|
| Rate for Payer: BCBS Trust/PPO |
$3.07
|
| Rate for Payer: BCN Commercial |
$3.07
|
| Rate for Payer: BCN Medicare Advantage |
$0.94
|
| Rate for Payer: Cash Price |
$2.99
|
| Rate for Payer: Cofinity Commercial |
$3.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.94
|
| Rate for Payer: Healthscope Commercial |
$3.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.81
|
| Rate for Payer: Mclaren Medicaid |
$0.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.98
|
| Rate for Payer: Meridian Medicaid |
$0.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.18
|
| Rate for Payer: Nomi Health Commercial |
$3.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.81
|
| Rate for Payer: PACE Senior Care Partners |
$0.89
|
| Rate for Payer: PACE SWMI |
$0.94
|
| Rate for Payer: PHP Commercial |
$3.18
|
| Rate for Payer: PHP Medicare Advantage |
$0.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.25
|
| Rate for Payer: Priority Health Medicare |
$0.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.60
|
| Rate for Payer: Railroad Medicare Medicare |
$0.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.29
|
| Rate for Payer: UHC Core |
$3.12
|
| Rate for Payer: UHC Exchange |
$0.94
|
| Rate for Payer: UHC Medicaid |
$0.66
|
| Rate for Payer: UHC Medicare Advantage |
$0.94
|
| Rate for Payer: UHCCP Medicaid |
$0.66
|
| Rate for Payer: VA VA |
$0.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.81
|
|
|
DEXAMETHASONE 10 MG/ML PF ORAL SOLUTION (INJECTION FOR ORAL USE CUSTOM)
|
Facility
|
IP
|
$4.64
|
|
|
Service Code
|
NDC 70069002125
|
| Hospital Charge Code |
180638
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$4.18 |
| Rate for Payer: Aetna Commercial |
$3.94
|
| Rate for Payer: BCBS Trust/PPO |
$3.83
|
| Rate for Payer: BCN Commercial |
$3.83
|
| Rate for Payer: Cash Price |
$3.71
|
| Rate for Payer: Cofinity Commercial |
$3.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.71
|
| Rate for Payer: Healthscope Commercial |
$4.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.94
|
| Rate for Payer: Nomi Health Commercial |
$3.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.48
|
| Rate for Payer: PHP Commercial |
$3.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.08
|
| Rate for Payer: UHC Core |
$3.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.48
|
|
|
DEXAMETHASONE 10 MG/ML PF ORAL SOLUTION (INJECTION FOR ORAL USE CUSTOM)
|
Facility
|
OP
|
$5.54
|
|
|
Service Code
|
NDC 63323050601
|
| Hospital Charge Code |
180638
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$4.99 |
| Rate for Payer: Aetna Commercial |
$4.71
|
| Rate for Payer: Aetna Medicare |
$1.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.73
|
| Rate for Payer: BCBS Complete |
$1.03
|
| Rate for Payer: BCBS MAPPO |
$1.39
|
| Rate for Payer: BCBS Trust/PPO |
$4.55
|
| Rate for Payer: BCN Commercial |
$4.55
|
| Rate for Payer: BCN Medicare Advantage |
$1.39
|
| Rate for Payer: Cash Price |
$4.43
|
| Rate for Payer: Cofinity Commercial |
$4.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.39
|
| Rate for Payer: Healthscope Commercial |
$4.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.16
|
| Rate for Payer: Mclaren Medicaid |
$0.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.45
|
| Rate for Payer: Meridian Medicaid |
$1.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.71
|
| Rate for Payer: Nomi Health Commercial |
$4.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.16
|
| Rate for Payer: PACE Senior Care Partners |
$1.32
|
| Rate for Payer: PACE SWMI |
$1.39
|
| Rate for Payer: PHP Commercial |
$4.71
|
| Rate for Payer: PHP Medicare Advantage |
$1.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.82
|
| Rate for Payer: Priority Health Medicare |
$1.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.88
|
| Rate for Payer: UHC Core |
$4.63
|
| Rate for Payer: UHC Exchange |
$1.39
|
| Rate for Payer: UHC Medicaid |
$0.98
|
| Rate for Payer: UHC Medicare Advantage |
$1.39
|
| Rate for Payer: UHCCP Medicaid |
$0.98
|
| Rate for Payer: VA VA |
$1.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.16
|
|
|
DEXAMETHASONE 10 MG/ML PF ORAL SOLUTION (INJECTION FOR ORAL USE CUSTOM)
|
Facility
|
IP
|
$5.54
|
|
|
Service Code
|
NDC 63323050601
|
| Hospital Charge Code |
180638
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$4.99 |
| Rate for Payer: Aetna Commercial |
$4.71
|
| Rate for Payer: BCBS Trust/PPO |
$4.58
|
| Rate for Payer: BCN Commercial |
$4.58
|
| Rate for Payer: Cash Price |
$4.43
|
| Rate for Payer: Cofinity Commercial |
$4.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.43
|
| Rate for Payer: Healthscope Commercial |
$4.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.71
|
| Rate for Payer: Nomi Health Commercial |
$4.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.16
|
| Rate for Payer: PHP Commercial |
$4.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.88
|
| Rate for Payer: UHC Core |
$4.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.16
|
|
|
DEXAMETHASONE 4 MG TABLET
|
Facility
|
IP
|
$470.88
|
|
|
Service Code
|
NDC 00054817525
|
| Hospital Charge Code |
2327
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$327.73 |
| Max. Negotiated Rate |
$423.79 |
| Rate for Payer: Aetna Commercial |
$400.25
|
| Rate for Payer: BCBS Trust/PPO |
$388.90
|
| Rate for Payer: BCN Commercial |
$388.90
|
| Rate for Payer: Cash Price |
$376.70
|
| Rate for Payer: Cofinity Commercial |
$404.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.70
|
| Rate for Payer: Healthscope Commercial |
$423.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$353.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$400.25
|
| Rate for Payer: Nomi Health Commercial |
$386.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$353.16
|
| Rate for Payer: PHP Commercial |
$400.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$409.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$327.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$414.37
|
| Rate for Payer: UHC Core |
$393.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$353.16
|
|
|
DEXAMETHASONE 4 MG TABLET
|
Facility
|
OP
|
$470.88
|
|
|
Service Code
|
NDC 00054817525
|
| Hospital Charge Code |
2327
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$83.02 |
| Max. Negotiated Rate |
$423.79 |
| Rate for Payer: Aetna Commercial |
$400.25
|
| Rate for Payer: Aetna Medicare |
$122.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$147.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$147.15
|
| Rate for Payer: BCBS Complete |
$87.16
|
| Rate for Payer: BCBS MAPPO |
$117.72
|
| Rate for Payer: BCBS Trust/PPO |
$387.11
|
| Rate for Payer: BCN Commercial |
$387.11
|
| Rate for Payer: BCN Medicare Advantage |
$117.72
|
| Rate for Payer: Cash Price |
$376.70
|
| Rate for Payer: Cofinity Commercial |
$404.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.72
|
| Rate for Payer: Healthscope Commercial |
$423.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$353.16
|
| Rate for Payer: Mclaren Medicaid |
$83.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.61
|
| Rate for Payer: Meridian Medicaid |
$87.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$129.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$400.25
|
| Rate for Payer: Nomi Health Commercial |
$386.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$353.16
|
| Rate for Payer: PACE Senior Care Partners |
$111.83
|
| Rate for Payer: PACE SWMI |
$117.72
|
| Rate for Payer: PHP Commercial |
$400.25
|
| Rate for Payer: PHP Medicare Advantage |
$117.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$409.67
|
| Rate for Payer: Priority Health Medicare |
$118.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$327.73
|
| Rate for Payer: Railroad Medicare Medicare |
$117.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$414.37
|
| Rate for Payer: UHC Core |
$393.18
|
| Rate for Payer: UHC Exchange |
$117.72
|
| Rate for Payer: UHC Medicaid |
$83.02
|
| Rate for Payer: UHC Medicare Advantage |
$117.72
|
| Rate for Payer: UHCCP Medicaid |
$83.02
|
| Rate for Payer: VA VA |
$117.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$353.16
|
|
|
DEXAMETHASONE 6 MG TABLET
|
Facility
|
IP
|
$813.60
|
|
|
Service Code
|
NDC 00054818325
|
| Hospital Charge Code |
2328
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$566.27 |
| Max. Negotiated Rate |
$732.24 |
| Rate for Payer: Aetna Commercial |
$691.56
|
| Rate for Payer: BCBS Trust/PPO |
$671.95
|
| Rate for Payer: BCN Commercial |
$671.95
|
| Rate for Payer: Cash Price |
$650.88
|
| Rate for Payer: Cofinity Commercial |
$699.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.88
|
| Rate for Payer: Healthscope Commercial |
$732.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.56
|
| Rate for Payer: Nomi Health Commercial |
$667.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$610.20
|
| Rate for Payer: PHP Commercial |
$691.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$707.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$566.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$715.97
|
| Rate for Payer: UHC Core |
$679.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.20
|
|
|
DEXAMETHASONE 6 MG TABLET
|
Facility
|
OP
|
$813.60
|
|
|
Service Code
|
NDC 00054818325
|
| Hospital Charge Code |
2328
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$143.44 |
| Max. Negotiated Rate |
$732.24 |
| Rate for Payer: Aetna Commercial |
$691.56
|
| Rate for Payer: Aetna Medicare |
$211.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$254.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$254.25
|
| Rate for Payer: BCBS Complete |
$150.60
|
| Rate for Payer: BCBS MAPPO |
$203.40
|
| Rate for Payer: BCBS Trust/PPO |
$668.86
|
| Rate for Payer: BCN Commercial |
$668.86
|
| Rate for Payer: BCN Medicare Advantage |
$203.40
|
| Rate for Payer: Cash Price |
$650.88
|
| Rate for Payer: Cofinity Commercial |
$699.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.40
|
| Rate for Payer: Healthscope Commercial |
$732.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.20
|
| Rate for Payer: Mclaren Medicaid |
$143.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.57
|
| Rate for Payer: Meridian Medicaid |
$150.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$233.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$223.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.56
|
| Rate for Payer: Nomi Health Commercial |
$667.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$610.20
|
| Rate for Payer: PACE Senior Care Partners |
$193.23
|
| Rate for Payer: PACE SWMI |
$203.40
|
| Rate for Payer: PHP Commercial |
$691.56
|
| Rate for Payer: PHP Medicare Advantage |
$203.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$707.83
|
| Rate for Payer: Priority Health Medicare |
$205.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$566.27
|
| Rate for Payer: Railroad Medicare Medicare |
$203.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$715.97
|
| Rate for Payer: UHC Core |
$679.36
|
| Rate for Payer: UHC Exchange |
$203.40
|
| Rate for Payer: UHC Medicaid |
$143.44
|
| Rate for Payer: UHC Medicare Advantage |
$203.40
|
| Rate for Payer: UHCCP Medicaid |
$143.44
|
| Rate for Payer: VA VA |
$203.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.20
|
|
|
DEXAMETHASONE 6 MG TABLET
|
Facility
|
OP
|
$675.84
|
|
|
Service Code
|
NDC 00054418625
|
| Hospital Charge Code |
2328
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.15 |
| Max. Negotiated Rate |
$608.26 |
| Rate for Payer: Aetna Commercial |
$574.46
|
| Rate for Payer: Aetna Medicare |
$175.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$211.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$211.20
|
| Rate for Payer: BCBS Complete |
$125.10
|
| Rate for Payer: BCBS MAPPO |
$168.96
|
| Rate for Payer: BCBS Trust/PPO |
$555.61
|
| Rate for Payer: BCN Commercial |
$555.61
|
| Rate for Payer: BCN Medicare Advantage |
$168.96
|
| Rate for Payer: Cash Price |
$540.67
|
| Rate for Payer: Cofinity Commercial |
$581.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.96
|
| Rate for Payer: Healthscope Commercial |
$608.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$506.88
|
| Rate for Payer: Mclaren Medicaid |
$119.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$177.41
|
| Rate for Payer: Meridian Medicaid |
$125.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$194.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$185.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.46
|
| Rate for Payer: Nomi Health Commercial |
$554.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.88
|
| Rate for Payer: PACE Senior Care Partners |
$160.51
|
| Rate for Payer: PACE SWMI |
$168.96
|
| Rate for Payer: PHP Commercial |
$574.46
|
| Rate for Payer: PHP Medicare Advantage |
$168.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$587.98
|
| Rate for Payer: Priority Health Medicare |
$170.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$470.38
|
| Rate for Payer: Railroad Medicare Medicare |
$168.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$594.74
|
| Rate for Payer: UHC Core |
$564.33
|
| Rate for Payer: UHC Exchange |
$168.96
|
| Rate for Payer: UHC Medicaid |
$119.15
|
| Rate for Payer: UHC Medicare Advantage |
$168.96
|
| Rate for Payer: UHCCP Medicaid |
$119.15
|
| Rate for Payer: VA VA |
$168.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$506.88
|
|
|
DEXAMETHASONE 6 MG TABLET
|
Facility
|
IP
|
$675.84
|
|
|
Service Code
|
NDC 00054418625
|
| Hospital Charge Code |
2328
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$470.38 |
| Max. Negotiated Rate |
$608.26 |
| Rate for Payer: Aetna Commercial |
$574.46
|
| Rate for Payer: BCBS Trust/PPO |
$558.18
|
| Rate for Payer: BCN Commercial |
$558.18
|
| Rate for Payer: Cash Price |
$540.67
|
| Rate for Payer: Cofinity Commercial |
$581.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.67
|
| Rate for Payer: Healthscope Commercial |
$608.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$506.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.46
|
| Rate for Payer: Nomi Health Commercial |
$554.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.88
|
| Rate for Payer: PHP Commercial |
$574.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$587.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$470.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$594.74
|
| Rate for Payer: UHC Core |
$564.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$506.88
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML IM INJECTION SOLUTION
|
Facility
|
IP
|
$10.97
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
301171
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.64 |
| Max. Negotiated Rate |
$9.87 |
| Rate for Payer: Aetna Commercial |
$9.32
|
| Rate for Payer: Aetna Commercial |
$15.66
|
| Rate for Payer: Aetna Commercial |
$54.47
|
| Rate for Payer: BCBS Trust/PPO |
$15.21
|
| Rate for Payer: BCBS Trust/PPO |
$9.06
|
| Rate for Payer: BCBS Trust/PPO |
$52.92
|
| Rate for Payer: BCN Commercial |
$15.21
|
| Rate for Payer: BCN Commercial |
$9.06
|
| Rate for Payer: BCN Commercial |
$52.92
|
| Rate for Payer: Cash Price |
$8.78
|
| Rate for Payer: Cash Price |
$51.26
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cofinity Commercial |
$55.11
|
| Rate for Payer: Cofinity Commercial |
$15.84
|
| Rate for Payer: Cofinity Commercial |
$9.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.26
|
| Rate for Payer: Healthscope Commercial |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$9.87
|
| Rate for Payer: Healthscope Commercial |
$57.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.47
|
| Rate for Payer: Nomi Health Commercial |
$9.00
|
| Rate for Payer: Nomi Health Commercial |
$15.10
|
| Rate for Payer: Nomi Health Commercial |
$52.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.06
|
| Rate for Payer: PHP Commercial |
$9.32
|
| Rate for Payer: PHP Commercial |
$54.47
|
| Rate for Payer: PHP Commercial |
$15.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.65
|
| Rate for Payer: UHC Core |
$9.16
|
| Rate for Payer: UHC Core |
$53.51
|
| Rate for Payer: UHC Core |
$15.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.81
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML IM INJECTION SOLUTION
|
Facility
|
OP
|
$10.97
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
301171
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.93 |
| Max. Negotiated Rate |
$9.87 |
| Rate for Payer: Aetna Commercial |
$9.32
|
| Rate for Payer: Aetna Commercial |
$54.47
|
| Rate for Payer: Aetna Commercial |
$15.66
|
| Rate for Payer: Aetna Medicare |
$16.66
|
| Rate for Payer: Aetna Medicare |
$2.85
|
| Rate for Payer: Aetna Medicare |
$4.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.02
|
| Rate for Payer: BCBS Complete |
$3.41
|
| Rate for Payer: BCBS Complete |
$2.03
|
| Rate for Payer: BCBS Complete |
$11.86
|
| Rate for Payer: BCBS MAPPO |
$16.02
|
| Rate for Payer: BCBS MAPPO |
$2.74
|
| Rate for Payer: BCBS MAPPO |
$4.61
|
| Rate for Payer: BCBS Trust/PPO |
$9.02
|
| Rate for Payer: BCBS Trust/PPO |
$15.14
|
| Rate for Payer: BCBS Trust/PPO |
$52.68
|
| Rate for Payer: BCN Commercial |
$15.14
|
| Rate for Payer: BCN Commercial |
$52.68
|
| Rate for Payer: BCN Commercial |
$9.02
|
| Rate for Payer: BCN Medicare Advantage |
$16.02
|
| Rate for Payer: BCN Medicare Advantage |
$4.61
|
| Rate for Payer: BCN Medicare Advantage |
$2.74
|
| Rate for Payer: Cash Price |
$51.26
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cash Price |
$8.78
|
| Rate for Payer: Cofinity Commercial |
$9.43
|
| Rate for Payer: Cofinity Commercial |
$15.84
|
| Rate for Payer: Cofinity Commercial |
$55.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.74
|
| Rate for Payer: Healthscope Commercial |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$9.87
|
| Rate for Payer: Healthscope Commercial |
$57.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.81
|
| Rate for Payer: Mclaren Medicaid |
$1.93
|
| Rate for Payer: Mclaren Medicaid |
$11.30
|
| Rate for Payer: Mclaren Medicaid |
$3.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.82
|
| Rate for Payer: Meridian Medicaid |
$11.86
|
| Rate for Payer: Meridian Medicaid |
$2.03
|
| Rate for Payer: Meridian Medicaid |
$3.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.66
|
| Rate for Payer: Nomi Health Commercial |
$52.55
|
| Rate for Payer: Nomi Health Commercial |
$15.10
|
| Rate for Payer: Nomi Health Commercial |
$9.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.23
|
| Rate for Payer: PACE Senior Care Partners |
$4.37
|
| Rate for Payer: PACE Senior Care Partners |
$2.61
|
| Rate for Payer: PACE Senior Care Partners |
$15.22
|
| Rate for Payer: PACE SWMI |
$16.02
|
| Rate for Payer: PACE SWMI |
$4.61
|
| Rate for Payer: PACE SWMI |
$2.74
|
| Rate for Payer: PHP Commercial |
$9.32
|
| Rate for Payer: PHP Commercial |
$54.47
|
| Rate for Payer: PHP Commercial |
$15.66
|
| Rate for Payer: PHP Medicare Advantage |
$4.61
|
| Rate for Payer: PHP Medicare Advantage |
$2.74
|
| Rate for Payer: PHP Medicare Advantage |
$16.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.75
|
| Rate for Payer: Priority Health Medicare |
$16.18
|
| Rate for Payer: Priority Health Medicare |
$4.65
|
| Rate for Payer: Priority Health Medicare |
$2.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.64
|
| Rate for Payer: Railroad Medicare Medicare |
$4.61
|
| Rate for Payer: Railroad Medicare Medicare |
$16.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.65
|
| Rate for Payer: UHC Core |
$9.16
|
| Rate for Payer: UHC Core |
$53.51
|
| Rate for Payer: UHC Core |
$15.38
|
| Rate for Payer: UHC Exchange |
$16.02
|
| Rate for Payer: UHC Exchange |
$4.61
|
| Rate for Payer: UHC Exchange |
$2.74
|
| Rate for Payer: UHC Medicaid |
$1.93
|
| Rate for Payer: UHC Medicaid |
$11.30
|
| Rate for Payer: UHC Medicaid |
$3.25
|
| Rate for Payer: UHC Medicare Advantage |
$4.61
|
| Rate for Payer: UHC Medicare Advantage |
$2.74
|
| Rate for Payer: UHC Medicare Advantage |
$16.02
|
| Rate for Payer: UHCCP Medicaid |
$3.25
|
| Rate for Payer: UHCCP Medicaid |
$1.93
|
| Rate for Payer: UHCCP Medicaid |
$11.30
|
| Rate for Payer: VA VA |
$2.74
|
| Rate for Payer: VA VA |
$16.02
|
| Rate for Payer: VA VA |
$4.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.06
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML FOR IM INJECTION
|
Facility
|
OP
|
$11.30
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
301229
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.99 |
| Max. Negotiated Rate |
$10.17 |
| Rate for Payer: Aetna Commercial |
$9.61
|
| Rate for Payer: Aetna Medicare |
$2.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.53
|
| Rate for Payer: BCBS Complete |
$2.09
|
| Rate for Payer: BCBS MAPPO |
$2.83
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Medicare Advantage |
$2.83
|
| Rate for Payer: Cash Price |
$9.04
|
| Rate for Payer: Cofinity Commercial |
$9.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.83
|
| Rate for Payer: Healthscope Commercial |
$10.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.47
|
| Rate for Payer: Mclaren Medicaid |
$1.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.97
|
| Rate for Payer: Meridian Medicaid |
$2.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.61
|
| Rate for Payer: Nomi Health Commercial |
$9.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.47
|
| Rate for Payer: PACE Senior Care Partners |
$2.68
|
| Rate for Payer: PACE SWMI |
$2.83
|
| Rate for Payer: PHP Commercial |
$9.61
|
| Rate for Payer: PHP Medicare Advantage |
$2.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.83
|
| Rate for Payer: Priority Health Medicare |
$2.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.94
|
| Rate for Payer: UHC Core |
$9.44
|
| Rate for Payer: UHC Exchange |
$2.83
|
| Rate for Payer: UHC Medicaid |
$1.99
|
| Rate for Payer: UHC Medicare Advantage |
$2.83
|
| Rate for Payer: UHCCP Medicaid |
$1.99
|
| Rate for Payer: VA VA |
$2.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.47
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML FOR IM INJECTION
|
Facility
|
IP
|
$11.30
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
301229
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.86 |
| Max. Negotiated Rate |
$10.17 |
| Rate for Payer: Aetna Commercial |
$9.61
|
| Rate for Payer: BCBS Trust/PPO |
$9.33
|
| Rate for Payer: BCN Commercial |
$9.33
|
| Rate for Payer: Cash Price |
$9.04
|
| Rate for Payer: Cofinity Commercial |
$9.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.04
|
| Rate for Payer: Healthscope Commercial |
$10.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.61
|
| Rate for Payer: Nomi Health Commercial |
$9.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.47
|
| Rate for Payer: PHP Commercial |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.94
|
| Rate for Payer: UHC Core |
$9.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.47
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$11.30
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
2332
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.99 |
| Max. Negotiated Rate |
$10.17 |
| Rate for Payer: Aetna Commercial |
$9.61
|
| Rate for Payer: Aetna Commercial |
$16.80
|
| Rate for Payer: Aetna Commercial |
$388.98
|
| Rate for Payer: Aetna Commercial |
$9.99
|
| Rate for Payer: Aetna Medicare |
$3.06
|
| Rate for Payer: Aetna Medicare |
$2.94
|
| Rate for Payer: Aetna Medicare |
$5.14
|
| Rate for Payer: Aetna Medicare |
$118.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$143.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$143.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.53
|
| Rate for Payer: BCBS Complete |
$84.71
|
| Rate for Payer: BCBS Complete |
$2.17
|
| Rate for Payer: BCBS Complete |
$2.09
|
| Rate for Payer: BCBS Complete |
$3.66
|
| Rate for Payer: BCBS MAPPO |
$2.83
|
| Rate for Payer: BCBS MAPPO |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$114.41
|
| Rate for Payer: BCBS MAPPO |
$4.94
|
| Rate for Payer: BCBS Trust/PPO |
$16.24
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$376.21
|
| Rate for Payer: BCBS Trust/PPO |
$9.66
|
| Rate for Payer: BCN Commercial |
$16.24
|
| Rate for Payer: BCN Commercial |
$376.21
|
| Rate for Payer: BCN Commercial |
$9.66
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Medicare Advantage |
$4.94
|
| Rate for Payer: BCN Medicare Advantage |
$2.94
|
| Rate for Payer: BCN Medicare Advantage |
$114.41
|
| Rate for Payer: BCN Medicare Advantage |
$2.83
|
| Rate for Payer: Cash Price |
$366.10
|
| Rate for Payer: Cash Price |
$15.81
|
| Rate for Payer: Cash Price |
$9.04
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cofinity Commercial |
$10.11
|
| Rate for Payer: Cofinity Commercial |
$9.72
|
| Rate for Payer: Cofinity Commercial |
$16.99
|
| Rate for Payer: Cofinity Commercial |
$393.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$366.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.94
|
| Rate for Payer: Healthscope Commercial |
$10.17
|
| Rate for Payer: Healthscope Commercial |
$411.86
|
| Rate for Payer: Healthscope Commercial |
$17.78
|
| Rate for Payer: Healthscope Commercial |
$10.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$343.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.47
|
| Rate for Payer: Mclaren Medicaid |
$3.48
|
| Rate for Payer: Mclaren Medicaid |
$2.07
|
| Rate for Payer: Mclaren Medicaid |
$1.99
|
| Rate for Payer: Mclaren Medicaid |
$80.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.97
|
| Rate for Payer: Meridian Medicaid |
$2.09
|
| Rate for Payer: Meridian Medicaid |
$3.66
|
| Rate for Payer: Meridian Medicaid |
$84.71
|
| Rate for Payer: Meridian Medicaid |
$2.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$131.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$125.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.98
|
| Rate for Payer: Nomi Health Commercial |
$16.20
|
| Rate for Payer: Nomi Health Commercial |
$9.27
|
| Rate for Payer: Nomi Health Commercial |
$9.63
|
| Rate for Payer: Nomi Health Commercial |
$375.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$343.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.47
|
| Rate for Payer: PACE Senior Care Partners |
$4.69
|
| Rate for Payer: PACE Senior Care Partners |
$108.68
|
| Rate for Payer: PACE Senior Care Partners |
$2.68
|
| Rate for Payer: PACE Senior Care Partners |
$2.79
|
| Rate for Payer: PACE SWMI |
$2.83
|
| Rate for Payer: PACE SWMI |
$114.41
|
| Rate for Payer: PACE SWMI |
$2.94
|
| Rate for Payer: PACE SWMI |
$4.94
|
| Rate for Payer: PHP Commercial |
$9.61
|
| Rate for Payer: PHP Commercial |
$9.99
|
| Rate for Payer: PHP Commercial |
$16.80
|
| Rate for Payer: PHP Commercial |
$388.98
|
| Rate for Payer: PHP Medicare Advantage |
$2.83
|
| Rate for Payer: PHP Medicare Advantage |
$114.41
|
| Rate for Payer: PHP Medicare Advantage |
$2.94
|
| Rate for Payer: PHP Medicare Advantage |
$4.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$398.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.83
|
| Rate for Payer: Priority Health Medicare |
$2.97
|
| Rate for Payer: Priority Health Medicare |
$2.85
|
| Rate for Payer: Priority Health Medicare |
$4.99
|
| Rate for Payer: Priority Health Medicare |
$115.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$318.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.86
|
| Rate for Payer: Railroad Medicare Medicare |
$4.94
|
| Rate for Payer: Railroad Medicare Medicare |
$2.83
|
| Rate for Payer: Railroad Medicare Medicare |
$114.41
|
| Rate for Payer: Railroad Medicare Medicare |
$2.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$402.71
|
| Rate for Payer: UHC Core |
$9.44
|
| Rate for Payer: UHC Core |
$16.50
|
| Rate for Payer: UHC Core |
$9.81
|
| Rate for Payer: UHC Core |
$382.11
|
| Rate for Payer: UHC Exchange |
$4.94
|
| Rate for Payer: UHC Exchange |
$2.94
|
| Rate for Payer: UHC Exchange |
$114.41
|
| Rate for Payer: UHC Exchange |
$2.83
|
| Rate for Payer: UHC Medicaid |
$1.99
|
| Rate for Payer: UHC Medicaid |
$2.07
|
| Rate for Payer: UHC Medicaid |
$3.48
|
| Rate for Payer: UHC Medicaid |
$80.68
|
| Rate for Payer: UHC Medicare Advantage |
$2.94
|
| Rate for Payer: UHC Medicare Advantage |
$2.83
|
| Rate for Payer: UHC Medicare Advantage |
$114.41
|
| Rate for Payer: UHC Medicare Advantage |
$4.94
|
| Rate for Payer: UHCCP Medicaid |
$3.48
|
| Rate for Payer: UHCCP Medicaid |
$80.68
|
| Rate for Payer: UHCCP Medicaid |
$2.07
|
| Rate for Payer: UHCCP Medicaid |
$1.99
|
| Rate for Payer: VA VA |
$2.83
|
| Rate for Payer: VA VA |
$114.41
|
| Rate for Payer: VA VA |
$4.94
|
| Rate for Payer: VA VA |
$2.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$343.21
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$19.76
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
2332
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$17.78 |
| Rate for Payer: Aetna Commercial |
$16.80
|
| Rate for Payer: Aetna Commercial |
$9.99
|
| Rate for Payer: Aetna Commercial |
$9.61
|
| Rate for Payer: Aetna Commercial |
$388.98
|
| Rate for Payer: BCBS Trust/PPO |
$16.32
|
| Rate for Payer: BCBS Trust/PPO |
$377.95
|
| Rate for Payer: BCBS Trust/PPO |
$9.70
|
| Rate for Payer: BCBS Trust/PPO |
$9.33
|
| Rate for Payer: BCN Commercial |
$16.32
|
| Rate for Payer: BCN Commercial |
$9.33
|
| Rate for Payer: BCN Commercial |
$377.95
|
| Rate for Payer: BCN Commercial |
$9.70
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cash Price |
$15.81
|
| Rate for Payer: Cash Price |
$366.10
|
| Rate for Payer: Cash Price |
$9.04
|
| Rate for Payer: Cofinity Commercial |
$9.72
|
| Rate for Payer: Cofinity Commercial |
$393.55
|
| Rate for Payer: Cofinity Commercial |
$16.99
|
| Rate for Payer: Cofinity Commercial |
$10.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$366.10
|
| Rate for Payer: Healthscope Commercial |
$411.86
|
| Rate for Payer: Healthscope Commercial |
$10.57
|
| Rate for Payer: Healthscope Commercial |
$17.78
|
| Rate for Payer: Healthscope Commercial |
$10.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$343.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.98
|
| Rate for Payer: Nomi Health Commercial |
$9.27
|
| Rate for Payer: Nomi Health Commercial |
$9.63
|
| Rate for Payer: Nomi Health Commercial |
$375.25
|
| Rate for Payer: Nomi Health Commercial |
$16.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$343.21
|
| Rate for Payer: PHP Commercial |
$388.98
|
| Rate for Payer: PHP Commercial |
$9.61
|
| Rate for Payer: PHP Commercial |
$9.99
|
| Rate for Payer: PHP Commercial |
$16.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$398.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$318.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$402.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.39
|
| Rate for Payer: UHC Core |
$16.50
|
| Rate for Payer: UHC Core |
$382.11
|
| Rate for Payer: UHC Core |
$9.81
|
| Rate for Payer: UHC Core |
$9.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$343.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.82
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML IM INJECTION SOLUTION
|
Facility
|
OP
|
$14.00
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
301178
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.47 |
| Max. Negotiated Rate |
$12.60 |
| Rate for Payer: Aetna Commercial |
$11.90
|
| Rate for Payer: Aetna Commercial |
$14.21
|
| Rate for Payer: Aetna Medicare |
$4.35
|
| Rate for Payer: Aetna Medicare |
$3.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.22
|
| Rate for Payer: BCBS Complete |
$2.59
|
| Rate for Payer: BCBS Complete |
$3.09
|
| Rate for Payer: BCBS MAPPO |
$3.50
|
| Rate for Payer: BCBS MAPPO |
$4.18
|
| Rate for Payer: BCBS Trust/PPO |
$11.51
|
| Rate for Payer: BCBS Trust/PPO |
$13.75
|
| Rate for Payer: BCN Commercial |
$13.75
|
| Rate for Payer: BCN Commercial |
$11.51
|
| Rate for Payer: BCN Medicare Advantage |
$4.18
|
| Rate for Payer: BCN Medicare Advantage |
$3.50
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$13.38
|
| Rate for Payer: Cofinity Commercial |
$12.04
|
| Rate for Payer: Cofinity Commercial |
$14.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.50
|
| Rate for Payer: Healthscope Commercial |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$15.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.54
|
| Rate for Payer: Mclaren Medicaid |
$2.95
|
| Rate for Payer: Mclaren Medicaid |
$2.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.67
|
| Rate for Payer: Meridian Medicaid |
$2.59
|
| Rate for Payer: Meridian Medicaid |
$3.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: Nomi Health Commercial |
$13.71
|
| Rate for Payer: Nomi Health Commercial |
$11.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.54
|
| Rate for Payer: PACE Senior Care Partners |
$3.97
|
| Rate for Payer: PACE Senior Care Partners |
$3.33
|
| Rate for Payer: PACE SWMI |
$4.18
|
| Rate for Payer: PACE SWMI |
$3.50
|
| Rate for Payer: PHP Commercial |
$11.90
|
| Rate for Payer: PHP Commercial |
$14.21
|
| Rate for Payer: PHP Medicare Advantage |
$3.50
|
| Rate for Payer: PHP Medicare Advantage |
$4.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.18
|
| Rate for Payer: Priority Health Medicare |
$4.22
|
| Rate for Payer: Priority Health Medicare |
$3.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.64
|
| Rate for Payer: Railroad Medicare Medicare |
$3.50
|
| Rate for Payer: Railroad Medicare Medicare |
$4.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.71
|
| Rate for Payer: UHC Core |
$13.96
|
| Rate for Payer: UHC Core |
$11.69
|
| Rate for Payer: UHC Exchange |
$4.18
|
| Rate for Payer: UHC Exchange |
$3.50
|
| Rate for Payer: UHC Medicaid |
$2.95
|
| Rate for Payer: UHC Medicaid |
$2.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.50
|
| Rate for Payer: UHC Medicare Advantage |
$4.18
|
| Rate for Payer: UHCCP Medicaid |
$2.47
|
| Rate for Payer: UHCCP Medicaid |
$2.95
|
| Rate for Payer: VA VA |
$3.50
|
| Rate for Payer: VA VA |
$4.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.50
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML IM INJECTION SOLUTION
|
Facility
|
IP
|
$14.00
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
301178
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.74 |
| Max. Negotiated Rate |
$12.60 |
| Rate for Payer: Aetna Commercial |
$11.90
|
| Rate for Payer: Aetna Commercial |
$14.21
|
| Rate for Payer: BCBS Trust/PPO |
$11.56
|
| Rate for Payer: BCBS Trust/PPO |
$13.81
|
| Rate for Payer: BCN Commercial |
$11.56
|
| Rate for Payer: BCN Commercial |
$13.81
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$13.38
|
| Rate for Payer: Cofinity Commercial |
$14.38
|
| Rate for Payer: Cofinity Commercial |
$12.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Healthscope Commercial |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$15.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.21
|
| Rate for Payer: Nomi Health Commercial |
$11.48
|
| Rate for Payer: Nomi Health Commercial |
$13.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.54
|
| Rate for Payer: PHP Commercial |
$14.21
|
| Rate for Payer: PHP Commercial |
$11.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.71
|
| Rate for Payer: UHC Core |
$11.69
|
| Rate for Payer: UHC Core |
$13.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.54
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$16.72
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
116809
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.64 |
| Max. Negotiated Rate |
$15.05 |
| Rate for Payer: Aetna Commercial |
$14.21
|
| Rate for Payer: Aetna Commercial |
$12.38
|
| Rate for Payer: Aetna Commercial |
$11.90
|
| Rate for Payer: Aetna Commercial |
$14.32
|
| Rate for Payer: BCBS Trust/PPO |
$13.81
|
| Rate for Payer: BCBS Trust/PPO |
$13.92
|
| Rate for Payer: BCBS Trust/PPO |
$12.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.56
|
| Rate for Payer: BCN Commercial |
$13.81
|
| Rate for Payer: BCN Commercial |
$11.56
|
| Rate for Payer: BCN Commercial |
$13.92
|
| Rate for Payer: BCN Commercial |
$12.03
|
| Rate for Payer: Cash Price |
$11.65
|
| Rate for Payer: Cash Price |
$13.38
|
| Rate for Payer: Cash Price |
$13.48
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$12.04
|
| Rate for Payer: Cofinity Commercial |
$14.49
|
| Rate for Payer: Cofinity Commercial |
$14.38
|
| Rate for Payer: Cofinity Commercial |
$12.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.48
|
| Rate for Payer: Healthscope Commercial |
$15.16
|
| Rate for Payer: Healthscope Commercial |
$13.10
|
| Rate for Payer: Healthscope Commercial |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$12.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.32
|
| Rate for Payer: Nomi Health Commercial |
$11.48
|
| Rate for Payer: Nomi Health Commercial |
$11.94
|
| Rate for Payer: Nomi Health Commercial |
$13.82
|
| Rate for Payer: Nomi Health Commercial |
$13.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.64
|
| Rate for Payer: PHP Commercial |
$14.32
|
| Rate for Payer: PHP Commercial |
$11.90
|
| Rate for Payer: PHP Commercial |
$12.38
|
| Rate for Payer: PHP Commercial |
$14.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.71
|
| Rate for Payer: UHC Core |
$13.96
|
| Rate for Payer: UHC Core |
$14.07
|
| Rate for Payer: UHC Core |
$12.16
|
| Rate for Payer: UHC Core |
$11.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.54
|
|
