|
CALCIUM ACETATE 667 MG TABLET
|
Facility
|
IP
|
$559.30
|
|
|
Service Code
|
NDC 71321080320
|
| Hospital Charge Code |
192575
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$363.54 |
| Max. Negotiated Rate |
$503.37 |
| Rate for Payer: Aetna Commercial |
$475.40
|
| Rate for Payer: BCBS Trust/PPO |
$456.56
|
| Rate for Payer: BCN Commercial |
$432.23
|
| Rate for Payer: Cash Price |
$447.44
|
| Rate for Payer: Cofinity Commercial |
$481.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$447.44
|
| Rate for Payer: Healthscope Commercial |
$503.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$419.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$475.40
|
| Rate for Payer: Nomi Health Commercial |
$458.63
|
| Rate for Payer: PHP Commercial |
$475.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.54
|
| Rate for Payer: Priority Health HMO/PPO |
$486.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$374.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$492.18
|
| Rate for Payer: UHC Core |
$467.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$419.48
|
|
|
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE
|
Facility
|
IP
|
$442.70
|
|
|
Service Code
|
NDC 29033002602
|
| Hospital Charge Code |
30961
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$287.76 |
| Max. Negotiated Rate |
$398.43 |
| Rate for Payer: Aetna Commercial |
$376.30
|
| Rate for Payer: BCBS Trust/PPO |
$361.38
|
| Rate for Payer: BCN Commercial |
$342.12
|
| Rate for Payer: Cash Price |
$354.16
|
| Rate for Payer: Cofinity Commercial |
$380.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.16
|
| Rate for Payer: Healthscope Commercial |
$398.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$332.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.30
|
| Rate for Payer: Nomi Health Commercial |
$363.01
|
| Rate for Payer: PHP Commercial |
$376.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.76
|
| Rate for Payer: Priority Health HMO/PPO |
$385.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$296.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$389.58
|
| Rate for Payer: UHC Core |
$369.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$332.02
|
|
|
CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE
|
Facility
|
OP
|
$442.70
|
|
|
Service Code
|
NDC 29033002602
|
| Hospital Charge Code |
30961
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$105.14 |
| Max. Negotiated Rate |
$398.43 |
| Rate for Payer: Aetna Commercial |
$376.30
|
| Rate for Payer: Aetna Medicare |
$115.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$138.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$138.34
|
| Rate for Payer: BCBS Complete |
$177.08
|
| Rate for Payer: BCBS MAPPO |
$110.68
|
| Rate for Payer: BCBS Trust/PPO |
$363.94
|
| Rate for Payer: BCN Commercial |
$344.20
|
| Rate for Payer: BCN Medicare Advantage |
$110.68
|
| Rate for Payer: Cash Price |
$354.16
|
| Rate for Payer: Cofinity Commercial |
$380.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.68
|
| Rate for Payer: Healthscope Commercial |
$398.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$332.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$127.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.30
|
| Rate for Payer: Nomi Health Commercial |
$363.01
|
| Rate for Payer: PACE Senior Care Partners |
$105.14
|
| Rate for Payer: PACE SWMI |
$110.68
|
| Rate for Payer: PHP Commercial |
$376.30
|
| Rate for Payer: PHP Medicare Advantage |
$110.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.76
|
| Rate for Payer: Priority Health HMO/PPO |
$385.15
|
| Rate for Payer: Priority Health Medicare |
$111.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$296.61
|
| Rate for Payer: Railroad Medicare Medicare |
$110.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$389.58
|
| Rate for Payer: UHC Core |
$369.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.68
|
| Rate for Payer: UHC Exchange |
$110.68
|
| Rate for Payer: UHC Medicare Advantage |
$110.68
|
| Rate for Payer: VA VA |
$110.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$332.02
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$70.54
|
|
|
Service Code
|
NDC 00409492834
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$45.85 |
| Max. Negotiated Rate |
$63.49 |
| Rate for Payer: Aetna Commercial |
$59.96
|
| Rate for Payer: BCBS Trust/PPO |
$57.58
|
| Rate for Payer: BCN Commercial |
$54.51
|
| Rate for Payer: Cash Price |
$56.43
|
| Rate for Payer: Cofinity Commercial |
$60.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.43
|
| Rate for Payer: Healthscope Commercial |
$63.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.96
|
| Rate for Payer: Nomi Health Commercial |
$57.84
|
| Rate for Payer: PHP Commercial |
$59.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.85
|
| Rate for Payer: Priority Health HMO/PPO |
$61.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.08
|
| Rate for Payer: UHC Core |
$58.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.90
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$36.23
|
|
|
Service Code
|
NDC 64253090091
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.60 |
| Max. Negotiated Rate |
$32.61 |
| Rate for Payer: Aetna Commercial |
$30.80
|
| Rate for Payer: Aetna Medicare |
$9.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.32
|
| Rate for Payer: BCBS Complete |
$14.49
|
| Rate for Payer: BCBS MAPPO |
$9.06
|
| Rate for Payer: BCBS Trust/PPO |
$29.78
|
| Rate for Payer: BCN Commercial |
$28.17
|
| Rate for Payer: BCN Medicare Advantage |
$9.06
|
| Rate for Payer: Cash Price |
$28.98
|
| Rate for Payer: Cofinity Commercial |
$31.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.06
|
| Rate for Payer: Healthscope Commercial |
$32.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.80
|
| Rate for Payer: Nomi Health Commercial |
$29.71
|
| Rate for Payer: PACE Senior Care Partners |
$8.60
|
| Rate for Payer: PACE SWMI |
$9.06
|
| Rate for Payer: PHP Commercial |
$30.80
|
| Rate for Payer: PHP Medicare Advantage |
$9.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.55
|
| Rate for Payer: Priority Health HMO/PPO |
$31.52
|
| Rate for Payer: Priority Health Medicare |
$9.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.27
|
| Rate for Payer: Railroad Medicare Medicare |
$9.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.88
|
| Rate for Payer: UHC Core |
$30.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.06
|
| Rate for Payer: UHC Exchange |
$9.06
|
| Rate for Payer: UHC Medicare Advantage |
$9.06
|
| Rate for Payer: VA VA |
$9.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.17
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$52.20
|
|
|
Service Code
|
NDC 00409163110
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$33.93 |
| Max. Negotiated Rate |
$46.98 |
| Rate for Payer: Aetna Commercial |
$44.37
|
| Rate for Payer: BCBS Trust/PPO |
$42.61
|
| Rate for Payer: BCN Commercial |
$40.34
|
| Rate for Payer: Cash Price |
$41.76
|
| Rate for Payer: Cofinity Commercial |
$44.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.76
|
| Rate for Payer: Healthscope Commercial |
$46.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.37
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: PHP Commercial |
$44.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.93
|
| Rate for Payer: Priority Health HMO/PPO |
$45.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.94
|
| Rate for Payer: UHC Core |
$43.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.15
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$33.11
|
|
|
Service Code
|
NDC 64253090030
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.86 |
| Max. Negotiated Rate |
$29.80 |
| Rate for Payer: Aetna Commercial |
$28.14
|
| Rate for Payer: Aetna Medicare |
$8.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.35
|
| Rate for Payer: BCBS Complete |
$13.24
|
| Rate for Payer: BCBS MAPPO |
$8.28
|
| Rate for Payer: BCBS Trust/PPO |
$27.22
|
| Rate for Payer: BCN Commercial |
$25.74
|
| Rate for Payer: BCN Medicare Advantage |
$8.28
|
| Rate for Payer: Cash Price |
$26.49
|
| Rate for Payer: Cofinity Commercial |
$28.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.28
|
| Rate for Payer: Healthscope Commercial |
$29.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Nomi Health Commercial |
$27.15
|
| Rate for Payer: PACE Senior Care Partners |
$7.86
|
| Rate for Payer: PACE SWMI |
$8.28
|
| Rate for Payer: PHP Commercial |
$28.14
|
| Rate for Payer: PHP Medicare Advantage |
$8.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.52
|
| Rate for Payer: Priority Health HMO/PPO |
$28.81
|
| Rate for Payer: Priority Health Medicare |
$8.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.18
|
| Rate for Payer: Railroad Medicare Medicare |
$8.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.14
|
| Rate for Payer: UHC Core |
$27.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.28
|
| Rate for Payer: UHC Exchange |
$8.28
|
| Rate for Payer: UHC Medicare Advantage |
$8.28
|
| Rate for Payer: VA VA |
$8.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.83
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$33.11
|
|
|
Service Code
|
NDC 64253090036
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.86 |
| Max. Negotiated Rate |
$29.80 |
| Rate for Payer: Aetna Commercial |
$28.14
|
| Rate for Payer: Aetna Medicare |
$8.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.35
|
| Rate for Payer: BCBS Complete |
$13.24
|
| Rate for Payer: BCBS MAPPO |
$8.28
|
| Rate for Payer: BCBS Trust/PPO |
$27.22
|
| Rate for Payer: BCN Commercial |
$25.74
|
| Rate for Payer: BCN Medicare Advantage |
$8.28
|
| Rate for Payer: Cash Price |
$26.49
|
| Rate for Payer: Cofinity Commercial |
$28.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.28
|
| Rate for Payer: Healthscope Commercial |
$29.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Nomi Health Commercial |
$27.15
|
| Rate for Payer: PACE Senior Care Partners |
$7.86
|
| Rate for Payer: PACE SWMI |
$8.28
|
| Rate for Payer: PHP Commercial |
$28.14
|
| Rate for Payer: PHP Medicare Advantage |
$8.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.52
|
| Rate for Payer: Priority Health HMO/PPO |
$28.81
|
| Rate for Payer: Priority Health Medicare |
$8.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.18
|
| Rate for Payer: Railroad Medicare Medicare |
$8.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.14
|
| Rate for Payer: UHC Core |
$27.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.28
|
| Rate for Payer: UHC Exchange |
$8.28
|
| Rate for Payer: UHC Medicare Advantage |
$8.28
|
| Rate for Payer: VA VA |
$8.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.83
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$70.54
|
|
|
Service Code
|
NDC 00409492811
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$63.49 |
| Rate for Payer: Aetna Commercial |
$59.96
|
| Rate for Payer: Aetna Medicare |
$18.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.04
|
| Rate for Payer: BCBS Complete |
$28.22
|
| Rate for Payer: BCBS MAPPO |
$17.64
|
| Rate for Payer: BCBS Trust/PPO |
$57.99
|
| Rate for Payer: BCN Commercial |
$54.84
|
| Rate for Payer: BCN Medicare Advantage |
$17.64
|
| Rate for Payer: Cash Price |
$56.43
|
| Rate for Payer: Cofinity Commercial |
$60.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.64
|
| Rate for Payer: Healthscope Commercial |
$63.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.96
|
| Rate for Payer: Nomi Health Commercial |
$57.84
|
| Rate for Payer: PACE Senior Care Partners |
$16.75
|
| Rate for Payer: PACE SWMI |
$17.64
|
| Rate for Payer: PHP Commercial |
$59.96
|
| Rate for Payer: PHP Medicare Advantage |
$17.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.85
|
| Rate for Payer: Priority Health HMO/PPO |
$61.37
|
| Rate for Payer: Priority Health Medicare |
$17.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.26
|
| Rate for Payer: Railroad Medicare Medicare |
$17.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.08
|
| Rate for Payer: UHC Core |
$58.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.64
|
| Rate for Payer: UHC Exchange |
$17.64
|
| Rate for Payer: UHC Medicare Advantage |
$17.64
|
| Rate for Payer: VA VA |
$17.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.90
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$70.54
|
|
|
Service Code
|
NDC 00409492811
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$45.85 |
| Max. Negotiated Rate |
$63.49 |
| Rate for Payer: Aetna Commercial |
$59.96
|
| Rate for Payer: BCBS Trust/PPO |
$57.58
|
| Rate for Payer: BCN Commercial |
$54.51
|
| Rate for Payer: Cash Price |
$56.43
|
| Rate for Payer: Cofinity Commercial |
$60.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.43
|
| Rate for Payer: Healthscope Commercial |
$63.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.96
|
| Rate for Payer: Nomi Health Commercial |
$57.84
|
| Rate for Payer: PHP Commercial |
$59.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.85
|
| Rate for Payer: Priority Health HMO/PPO |
$61.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.08
|
| Rate for Payer: UHC Core |
$58.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.90
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$39.34
|
|
|
Service Code
|
NDC 76329330401
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$25.57 |
| Max. Negotiated Rate |
$35.41 |
| Rate for Payer: Aetna Commercial |
$33.44
|
| Rate for Payer: BCBS Trust/PPO |
$32.11
|
| Rate for Payer: BCN Commercial |
$30.40
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Cofinity Commercial |
$33.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.47
|
| Rate for Payer: Healthscope Commercial |
$35.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.44
|
| Rate for Payer: Nomi Health Commercial |
$32.26
|
| Rate for Payer: PHP Commercial |
$33.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.57
|
| Rate for Payer: Priority Health HMO/PPO |
$34.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.62
|
| Rate for Payer: UHC Core |
$32.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.50
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$52.20
|
|
|
Service Code
|
NDC 00409163110
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$46.98 |
| Rate for Payer: Aetna Commercial |
$44.37
|
| Rate for Payer: Aetna Medicare |
$13.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.31
|
| Rate for Payer: BCBS Complete |
$20.88
|
| Rate for Payer: BCBS MAPPO |
$13.05
|
| Rate for Payer: BCBS Trust/PPO |
$42.91
|
| Rate for Payer: BCN Commercial |
$40.59
|
| Rate for Payer: BCN Medicare Advantage |
$13.05
|
| Rate for Payer: Cash Price |
$41.76
|
| Rate for Payer: Cofinity Commercial |
$44.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.05
|
| Rate for Payer: Healthscope Commercial |
$46.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.37
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.40
|
| Rate for Payer: PACE SWMI |
$13.05
|
| Rate for Payer: PHP Commercial |
$44.37
|
| Rate for Payer: PHP Medicare Advantage |
$13.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.93
|
| Rate for Payer: Priority Health HMO/PPO |
$45.41
|
| Rate for Payer: Priority Health Medicare |
$13.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.97
|
| Rate for Payer: Railroad Medicare Medicare |
$13.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.94
|
| Rate for Payer: UHC Core |
$43.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.05
|
| Rate for Payer: UHC Exchange |
$13.05
|
| Rate for Payer: UHC Medicare Advantage |
$13.05
|
| Rate for Payer: VA VA |
$13.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.15
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$70.54
|
|
|
Service Code
|
NDC 00409492834
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$63.49 |
| Rate for Payer: Aetna Commercial |
$59.96
|
| Rate for Payer: Aetna Medicare |
$18.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.04
|
| Rate for Payer: BCBS Complete |
$28.22
|
| Rate for Payer: BCBS MAPPO |
$17.64
|
| Rate for Payer: BCBS Trust/PPO |
$57.99
|
| Rate for Payer: BCN Commercial |
$54.84
|
| Rate for Payer: BCN Medicare Advantage |
$17.64
|
| Rate for Payer: Cash Price |
$56.43
|
| Rate for Payer: Cofinity Commercial |
$60.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.64
|
| Rate for Payer: Healthscope Commercial |
$63.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.96
|
| Rate for Payer: Nomi Health Commercial |
$57.84
|
| Rate for Payer: PACE Senior Care Partners |
$16.75
|
| Rate for Payer: PACE SWMI |
$17.64
|
| Rate for Payer: PHP Commercial |
$59.96
|
| Rate for Payer: PHP Medicare Advantage |
$17.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.85
|
| Rate for Payer: Priority Health HMO/PPO |
$61.37
|
| Rate for Payer: Priority Health Medicare |
$17.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.26
|
| Rate for Payer: Railroad Medicare Medicare |
$17.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.08
|
| Rate for Payer: UHC Core |
$58.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.64
|
| Rate for Payer: UHC Exchange |
$17.64
|
| Rate for Payer: UHC Medicare Advantage |
$17.64
|
| Rate for Payer: VA VA |
$17.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.90
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$33.11
|
|
|
Service Code
|
NDC 64253090036
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.52 |
| Max. Negotiated Rate |
$29.80 |
| Rate for Payer: Aetna Commercial |
$28.14
|
| Rate for Payer: BCBS Trust/PPO |
$27.03
|
| Rate for Payer: BCN Commercial |
$25.59
|
| Rate for Payer: Cash Price |
$26.49
|
| Rate for Payer: Cofinity Commercial |
$28.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.49
|
| Rate for Payer: Healthscope Commercial |
$29.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Nomi Health Commercial |
$27.15
|
| Rate for Payer: PHP Commercial |
$28.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.52
|
| Rate for Payer: Priority Health HMO/PPO |
$28.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.14
|
| Rate for Payer: UHC Core |
$27.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.83
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$36.23
|
|
|
Service Code
|
NDC 64253090091
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$23.55 |
| Max. Negotiated Rate |
$32.61 |
| Rate for Payer: Aetna Commercial |
$30.80
|
| Rate for Payer: BCBS Trust/PPO |
$29.57
|
| Rate for Payer: BCN Commercial |
$28.00
|
| Rate for Payer: Cash Price |
$28.98
|
| Rate for Payer: Cofinity Commercial |
$31.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.98
|
| Rate for Payer: Healthscope Commercial |
$32.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.80
|
| Rate for Payer: Nomi Health Commercial |
$29.71
|
| Rate for Payer: PHP Commercial |
$30.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.55
|
| Rate for Payer: Priority Health HMO/PPO |
$31.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.88
|
| Rate for Payer: UHC Core |
$30.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.17
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$39.34
|
|
|
Service Code
|
NDC 76329330401
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$35.41 |
| Rate for Payer: Aetna Commercial |
$33.44
|
| Rate for Payer: Aetna Medicare |
$10.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.29
|
| Rate for Payer: BCBS Complete |
$15.74
|
| Rate for Payer: BCBS MAPPO |
$9.84
|
| Rate for Payer: BCBS Trust/PPO |
$32.34
|
| Rate for Payer: BCN Commercial |
$30.59
|
| Rate for Payer: BCN Medicare Advantage |
$9.84
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Cofinity Commercial |
$33.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.84
|
| Rate for Payer: Healthscope Commercial |
$35.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.44
|
| Rate for Payer: Nomi Health Commercial |
$32.26
|
| Rate for Payer: PACE Senior Care Partners |
$9.34
|
| Rate for Payer: PACE SWMI |
$9.84
|
| Rate for Payer: PHP Commercial |
$33.44
|
| Rate for Payer: PHP Medicare Advantage |
$9.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.57
|
| Rate for Payer: Priority Health HMO/PPO |
$34.23
|
| Rate for Payer: Priority Health Medicare |
$9.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.36
|
| Rate for Payer: Railroad Medicare Medicare |
$9.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.62
|
| Rate for Payer: UHC Core |
$32.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.84
|
| Rate for Payer: UHC Exchange |
$9.84
|
| Rate for Payer: UHC Medicare Advantage |
$9.84
|
| Rate for Payer: VA VA |
$9.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.50
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$33.11
|
|
|
Service Code
|
NDC 64253090030
|
| Hospital Charge Code |
1306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.52 |
| Max. Negotiated Rate |
$29.80 |
| Rate for Payer: Aetna Commercial |
$28.14
|
| Rate for Payer: BCBS Trust/PPO |
$27.03
|
| Rate for Payer: BCN Commercial |
$25.59
|
| Rate for Payer: Cash Price |
$26.49
|
| Rate for Payer: Cofinity Commercial |
$28.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.49
|
| Rate for Payer: Healthscope Commercial |
$29.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Nomi Health Commercial |
$27.15
|
| Rate for Payer: PHP Commercial |
$28.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.52
|
| Rate for Payer: Priority Health HMO/PPO |
$28.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.14
|
| Rate for Payer: UHC Core |
$27.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.83
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRINGE (CODE)
|
Facility
|
OP
|
$70.54
|
|
|
Service Code
|
NDC 00409492834
|
| Hospital Charge Code |
163711
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$63.49 |
| Rate for Payer: Aetna Commercial |
$59.96
|
| Rate for Payer: Aetna Medicare |
$18.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.04
|
| Rate for Payer: BCBS Complete |
$28.22
|
| Rate for Payer: BCBS MAPPO |
$17.64
|
| Rate for Payer: BCBS Trust/PPO |
$57.99
|
| Rate for Payer: BCN Commercial |
$54.84
|
| Rate for Payer: BCN Medicare Advantage |
$17.64
|
| Rate for Payer: Cash Price |
$56.43
|
| Rate for Payer: Cofinity Commercial |
$60.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.64
|
| Rate for Payer: Healthscope Commercial |
$63.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.96
|
| Rate for Payer: Nomi Health Commercial |
$57.84
|
| Rate for Payer: PACE Senior Care Partners |
$16.75
|
| Rate for Payer: PACE SWMI |
$17.64
|
| Rate for Payer: PHP Commercial |
$59.96
|
| Rate for Payer: PHP Medicare Advantage |
$17.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.85
|
| Rate for Payer: Priority Health HMO/PPO |
$61.37
|
| Rate for Payer: Priority Health Medicare |
$17.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.26
|
| Rate for Payer: Railroad Medicare Medicare |
$17.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.08
|
| Rate for Payer: UHC Core |
$58.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.64
|
| Rate for Payer: UHC Exchange |
$17.64
|
| Rate for Payer: UHC Medicare Advantage |
$17.64
|
| Rate for Payer: VA VA |
$17.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.90
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRINGE (CODE)
|
Facility
|
IP
|
$52.20
|
|
|
Service Code
|
NDC 00409163110
|
| Hospital Charge Code |
163711
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$33.93 |
| Max. Negotiated Rate |
$46.98 |
| Rate for Payer: Aetna Commercial |
$44.37
|
| Rate for Payer: BCBS Trust/PPO |
$42.61
|
| Rate for Payer: BCN Commercial |
$40.34
|
| Rate for Payer: Cash Price |
$41.76
|
| Rate for Payer: Cofinity Commercial |
$44.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.76
|
| Rate for Payer: Healthscope Commercial |
$46.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.37
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: PHP Commercial |
$44.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.93
|
| Rate for Payer: Priority Health HMO/PPO |
$45.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.94
|
| Rate for Payer: UHC Core |
$43.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.15
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRINGE (CODE)
|
Facility
|
IP
|
$70.54
|
|
|
Service Code
|
NDC 00409492834
|
| Hospital Charge Code |
163711
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$45.85 |
| Max. Negotiated Rate |
$63.49 |
| Rate for Payer: Aetna Commercial |
$59.96
|
| Rate for Payer: BCBS Trust/PPO |
$57.58
|
| Rate for Payer: BCN Commercial |
$54.51
|
| Rate for Payer: Cash Price |
$56.43
|
| Rate for Payer: Cofinity Commercial |
$60.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.43
|
| Rate for Payer: Healthscope Commercial |
$63.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.96
|
| Rate for Payer: Nomi Health Commercial |
$57.84
|
| Rate for Payer: PHP Commercial |
$59.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.85
|
| Rate for Payer: Priority Health HMO/PPO |
$61.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.08
|
| Rate for Payer: UHC Core |
$58.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.90
|
|
|
CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRINGE (CODE)
|
Facility
|
OP
|
$52.20
|
|
|
Service Code
|
NDC 00409163110
|
| Hospital Charge Code |
163711
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$46.98 |
| Rate for Payer: Aetna Commercial |
$44.37
|
| Rate for Payer: Aetna Medicare |
$13.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.31
|
| Rate for Payer: BCBS Complete |
$20.88
|
| Rate for Payer: BCBS MAPPO |
$13.05
|
| Rate for Payer: BCBS Trust/PPO |
$42.91
|
| Rate for Payer: BCN Commercial |
$40.59
|
| Rate for Payer: BCN Medicare Advantage |
$13.05
|
| Rate for Payer: Cash Price |
$41.76
|
| Rate for Payer: Cofinity Commercial |
$44.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.05
|
| Rate for Payer: Healthscope Commercial |
$46.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.37
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.40
|
| Rate for Payer: PACE SWMI |
$13.05
|
| Rate for Payer: PHP Commercial |
$44.37
|
| Rate for Payer: PHP Medicare Advantage |
$13.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.93
|
| Rate for Payer: Priority Health HMO/PPO |
$45.41
|
| Rate for Payer: Priority Health Medicare |
$13.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.97
|
| Rate for Payer: Railroad Medicare Medicare |
$13.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.94
|
| Rate for Payer: UHC Core |
$43.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.05
|
| Rate for Payer: UHC Exchange |
$13.05
|
| Rate for Payer: UHC Medicare Advantage |
$13.05
|
| Rate for Payer: VA VA |
$13.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.15
|
|
|
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$33.11
|
|
|
Service Code
|
HCPCS J0612
|
| Hospital Charge Code |
1312
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.52 |
| Max. Negotiated Rate |
$29.80 |
| Rate for Payer: Aetna Commercial |
$28.14
|
| Rate for Payer: BCBS Trust/PPO |
$27.03
|
| Rate for Payer: BCN Commercial |
$25.59
|
| Rate for Payer: Cash Price |
$26.49
|
| Rate for Payer: Cofinity Commercial |
$28.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.49
|
| Rate for Payer: Healthscope Commercial |
$29.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Nomi Health Commercial |
$27.15
|
| Rate for Payer: PHP Commercial |
$28.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.52
|
| Rate for Payer: Priority Health HMO/PPO |
$28.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.14
|
| Rate for Payer: UHC Core |
$27.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.83
|
|
|
CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$33.11
|
|
|
Service Code
|
HCPCS J0612
|
| Hospital Charge Code |
1312
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.86 |
| Max. Negotiated Rate |
$29.80 |
| Rate for Payer: Aetna Commercial |
$28.14
|
| Rate for Payer: Aetna Medicare |
$8.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.35
|
| Rate for Payer: BCBS Complete |
$13.24
|
| Rate for Payer: BCBS MAPPO |
$8.28
|
| Rate for Payer: BCBS Trust/PPO |
$27.22
|
| Rate for Payer: BCN Commercial |
$25.74
|
| Rate for Payer: BCN Medicare Advantage |
$8.28
|
| Rate for Payer: Cash Price |
$26.49
|
| Rate for Payer: Cofinity Commercial |
$28.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.28
|
| Rate for Payer: Healthscope Commercial |
$29.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Nomi Health Commercial |
$27.15
|
| Rate for Payer: PACE Senior Care Partners |
$7.86
|
| Rate for Payer: PACE SWMI |
$8.28
|
| Rate for Payer: PHP Commercial |
$28.14
|
| Rate for Payer: PHP Medicare Advantage |
$8.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.52
|
| Rate for Payer: Priority Health HMO/PPO |
$28.81
|
| Rate for Payer: Priority Health Medicare |
$8.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.18
|
| Rate for Payer: Railroad Medicare Medicare |
$8.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.14
|
| Rate for Payer: UHC Core |
$27.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.28
|
| Rate for Payer: UHC Exchange |
$8.28
|
| Rate for Payer: UHC Medicare Advantage |
$8.28
|
| Rate for Payer: VA VA |
$8.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.83
|
|
|
CALCIUM GLUCONATE 1 GRAM/50 ML IN SODIUM CHLORIDE, ISO-OSM IV SOLUTION
|
Facility
|
OP
|
$35.38
|
|
|
Service Code
|
HCPCS J0612
|
| Hospital Charge Code |
189461
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$31.84 |
| Rate for Payer: Aetna Commercial |
$30.07
|
| Rate for Payer: Aetna Commercial |
$27.99
|
| Rate for Payer: Aetna Medicare |
$9.20
|
| Rate for Payer: Aetna Medicare |
$8.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.29
|
| Rate for Payer: BCBS Complete |
$13.17
|
| Rate for Payer: BCBS Complete |
$14.15
|
| Rate for Payer: BCBS MAPPO |
$8.23
|
| Rate for Payer: BCBS MAPPO |
$8.84
|
| Rate for Payer: BCBS Trust/PPO |
$29.09
|
| Rate for Payer: BCBS Trust/PPO |
$27.07
|
| Rate for Payer: BCN Commercial |
$27.51
|
| Rate for Payer: BCN Commercial |
$25.60
|
| Rate for Payer: BCN Medicare Advantage |
$8.84
|
| Rate for Payer: BCN Medicare Advantage |
$8.23
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cash Price |
$26.34
|
| Rate for Payer: Cofinity Commercial |
$28.32
|
| Rate for Payer: Cofinity Commercial |
$30.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.84
|
| Rate for Payer: Healthscope Commercial |
$29.64
|
| Rate for Payer: Healthscope Commercial |
$31.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.99
|
| Rate for Payer: Nomi Health Commercial |
$29.01
|
| Rate for Payer: Nomi Health Commercial |
$27.00
|
| Rate for Payer: PACE Senior Care Partners |
$8.40
|
| Rate for Payer: PACE Senior Care Partners |
$7.82
|
| Rate for Payer: PACE SWMI |
$8.84
|
| Rate for Payer: PACE SWMI |
$8.23
|
| Rate for Payer: PHP Commercial |
$30.07
|
| Rate for Payer: PHP Commercial |
$27.99
|
| Rate for Payer: PHP Medicare Advantage |
$8.23
|
| Rate for Payer: PHP Medicare Advantage |
$8.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.40
|
| Rate for Payer: Priority Health HMO/PPO |
$28.65
|
| Rate for Payer: Priority Health HMO/PPO |
$30.78
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Medicare |
$8.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.06
|
| Rate for Payer: Railroad Medicare Medicare |
$8.23
|
| Rate for Payer: Railroad Medicare Medicare |
$8.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.13
|
| Rate for Payer: UHC Core |
$29.54
|
| Rate for Payer: UHC Core |
$27.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.23
|
| Rate for Payer: UHC Exchange |
$8.23
|
| Rate for Payer: UHC Exchange |
$8.84
|
| Rate for Payer: UHC Medicare Advantage |
$8.23
|
| Rate for Payer: UHC Medicare Advantage |
$8.84
|
| Rate for Payer: VA VA |
$8.23
|
| Rate for Payer: VA VA |
$8.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.70
|
|
|
CALCIUM GLUCONATE 1 GRAM/50 ML IN SODIUM CHLORIDE, ISO-OSM IV SOLUTION
|
Facility
|
IP
|
$32.93
|
|
|
Service Code
|
HCPCS J0612
|
| Hospital Charge Code |
189461
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.40 |
| Max. Negotiated Rate |
$29.64 |
| Rate for Payer: Aetna Commercial |
$27.99
|
| Rate for Payer: Aetna Commercial |
$30.07
|
| Rate for Payer: BCBS Trust/PPO |
$26.88
|
| Rate for Payer: BCBS Trust/PPO |
$28.88
|
| Rate for Payer: BCN Commercial |
$25.45
|
| Rate for Payer: BCN Commercial |
$27.34
|
| Rate for Payer: Cash Price |
$26.34
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$30.43
|
| Rate for Payer: Cofinity Commercial |
$28.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.34
|
| Rate for Payer: Healthscope Commercial |
$29.64
|
| Rate for Payer: Healthscope Commercial |
$31.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.07
|
| Rate for Payer: Nomi Health Commercial |
$27.00
|
| Rate for Payer: Nomi Health Commercial |
$29.01
|
| Rate for Payer: PHP Commercial |
$27.99
|
| Rate for Payer: PHP Commercial |
$30.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.40
|
| Rate for Payer: Priority Health HMO/PPO |
$30.78
|
| Rate for Payer: Priority Health HMO/PPO |
$28.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.13
|
| Rate for Payer: UHC Core |
$27.50
|
| Rate for Payer: UHC Core |
$29.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.54
|
|
