|
PR OCCLUSION FLP TUBE DEV VAG/SUPRAPUBIC APPR
|
Professional
|
Both
|
$462.00
|
|
|
Service Code
|
HCPCS 58615
|
| Min. Negotiated Rate |
$143.99 |
| Max. Negotiated Rate |
$384.31 |
| Rate for Payer: Aetna Commercial |
$302.21
|
| Rate for Payer: Aetna Medicare |
$231.00
|
| Rate for Payer: BCBS Complete |
$151.19
|
| Rate for Payer: BCN Commercial |
$379.46
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Mclaren Medicaid |
$143.99
|
| Rate for Payer: Meridian Medicaid |
$151.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$384.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$384.31
|
| Rate for Payer: UHC Medicaid |
$143.99
|
| Rate for Payer: UHCCP Medicaid |
$143.99
|
|
|
PR OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 97165
|
| Min. Negotiated Rate |
$71.15 |
| Max. Negotiated Rate |
$120.75 |
| Rate for Payer: Aetna Commercial |
$71.15
|
| Rate for Payer: Aetna Medicare |
$80.50
|
| Rate for Payer: BCN Commercial |
$93.18
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.97
|
|
|
PR OCCUPATIONAL THERAPY EVAL MOD COMPLEX 45 MINS
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 97166
|
| Min. Negotiated Rate |
$71.15 |
| Max. Negotiated Rate |
$114.75 |
| Rate for Payer: Aetna Commercial |
$71.15
|
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: BCN Commercial |
$92.83
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.97
|
|
|
PR OCCUPATIONAL THERAPY EVALUATION
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 97003
|
| Min. Negotiated Rate |
$51.60 |
| Max. Negotiated Rate |
$96.75 |
| Rate for Payer: Aetna Medicare |
$64.50
|
| Rate for Payer: BCBS Complete |
$51.60
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
|
|
PR OCCUPATIONAL THERAPY RE-EVALUATION
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 97004
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$56.25 |
| Rate for Payer: Aetna Medicare |
$37.50
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.25
|
|
|
PR OCCUPATIONAL THER RE-EVAL EST PLAN CARE 30 MINS
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 97168
|
| Min. Negotiated Rate |
$47.84 |
| Max. Negotiated Rate |
$79.50 |
| Rate for Payer: Aetna Commercial |
$47.84
|
| Rate for Payer: Aetna Medicare |
$53.00
|
| Rate for Payer: BCN Commercial |
$64.28
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.99
|
|
|
PROCEDURES FOR OBESITY
|
Facility
|
IP
|
$12,514.99
|
|
|
Service Code
|
APR-DRG 4033
|
| Min. Negotiated Rate |
$11,919.04 |
| Max. Negotiated Rate |
$12,514.99 |
| Rate for Payer: BCBS Complete |
$12,514.99
|
| Rate for Payer: Mclaren Medicaid |
$11,919.04
|
| Rate for Payer: Meridian Medicaid |
$12,514.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,919.04
|
| Rate for Payer: UHC Medicaid |
$11,919.04
|
| Rate for Payer: UHCCP Medicaid |
$11,919.04
|
|
|
PROCEDURES FOR OBESITY
|
Facility
|
IP
|
$7,167.20
|
|
|
Service Code
|
APR-DRG 4032
|
| Min. Negotiated Rate |
$6,825.90 |
| Max. Negotiated Rate |
$7,167.20 |
| Rate for Payer: BCBS Complete |
$7,167.20
|
| Rate for Payer: Mclaren Medicaid |
$6,825.90
|
| Rate for Payer: Meridian Medicaid |
$7,167.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,825.90
|
| Rate for Payer: UHC Medicaid |
$6,825.90
|
| Rate for Payer: UHCCP Medicaid |
$6,825.90
|
|
|
PROCEDURES FOR OBESITY
|
Facility
|
IP
|
$23,704.87
|
|
|
Service Code
|
APR-DRG 4034
|
| Min. Negotiated Rate |
$22,576.06 |
| Max. Negotiated Rate |
$23,704.87 |
| Rate for Payer: BCBS Complete |
$23,704.87
|
| Rate for Payer: Mclaren Medicaid |
$22,576.06
|
| Rate for Payer: Meridian Medicaid |
$23,704.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$22,576.06
|
| Rate for Payer: UHC Medicaid |
$22,576.06
|
| Rate for Payer: UHCCP Medicaid |
$22,576.06
|
|
|
PROCEDURES FOR OBESITY
|
Facility
|
IP
|
$5,349.37
|
|
|
Service Code
|
APR-DRG 4031
|
| Min. Negotiated Rate |
$5,094.64 |
| Max. Negotiated Rate |
$5,349.37 |
| Rate for Payer: BCBS Complete |
$5,349.37
|
| Rate for Payer: Mclaren Medicaid |
$5,094.64
|
| Rate for Payer: Meridian Medicaid |
$5,349.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,094.64
|
| Rate for Payer: UHC Medicaid |
$5,094.64
|
| Rate for Payer: UHCCP Medicaid |
$5,094.64
|
|
|
PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SE
|
Facility
|
IP
|
$24,233.86
|
|
|
Service Code
|
APR-DRG 8503
|
| Min. Negotiated Rate |
$23,079.87 |
| Max. Negotiated Rate |
$24,233.86 |
| Rate for Payer: BCBS Complete |
$24,233.86
|
| Rate for Payer: Mclaren Medicaid |
$23,079.87
|
| Rate for Payer: Meridian Medicaid |
$24,233.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$23,079.87
|
| Rate for Payer: UHC Medicaid |
$23,079.87
|
| Rate for Payer: UHCCP Medicaid |
$23,079.87
|
|
|
PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SE
|
Facility
|
IP
|
$55,316.79
|
|
|
Service Code
|
APR-DRG 8504
|
| Min. Negotiated Rate |
$52,682.66 |
| Max. Negotiated Rate |
$55,316.79 |
| Rate for Payer: BCBS Complete |
$55,316.79
|
| Rate for Payer: Mclaren Medicaid |
$52,682.66
|
| Rate for Payer: Meridian Medicaid |
$55,316.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$52,682.66
|
| Rate for Payer: UHC Medicaid |
$52,682.66
|
| Rate for Payer: UHCCP Medicaid |
$52,682.66
|
|
|
PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SE
|
Facility
|
IP
|
$14,637.28
|
|
|
Service Code
|
APR-DRG 8502
|
| Min. Negotiated Rate |
$13,940.27 |
| Max. Negotiated Rate |
$14,637.28 |
| Rate for Payer: BCBS Complete |
$14,637.28
|
| Rate for Payer: Mclaren Medicaid |
$13,940.27
|
| Rate for Payer: Meridian Medicaid |
$14,637.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,940.27
|
| Rate for Payer: UHC Medicaid |
$13,940.27
|
| Rate for Payer: UHCCP Medicaid |
$13,940.27
|
|
|
PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SE
|
Facility
|
IP
|
$7,682.00
|
|
|
Service Code
|
APR-DRG 8501
|
| Min. Negotiated Rate |
$7,316.19 |
| Max. Negotiated Rate |
$7,682.00 |
| Rate for Payer: BCBS Complete |
$7,682.00
|
| Rate for Payer: Mclaren Medicaid |
$7,316.19
|
| Rate for Payer: Meridian Medicaid |
$7,682.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,316.19
|
| Rate for Payer: UHC Medicaid |
$7,316.19
|
| Rate for Payer: UHCCP Medicaid |
$7,316.19
|
|
|
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$29.99
|
|
|
Service Code
|
NDC 00713013506
|
| Hospital Charge Code |
11138
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.29 |
| Max. Negotiated Rate |
$26.99 |
| Rate for Payer: Aetna Commercial |
$25.49
|
| Rate for Payer: Aetna Medicare |
$7.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.37
|
| Rate for Payer: BCBS Complete |
$5.55
|
| Rate for Payer: BCBS MAPPO |
$7.50
|
| Rate for Payer: BCBS Trust/PPO |
$24.65
|
| Rate for Payer: BCN Commercial |
$24.65
|
| Rate for Payer: BCN Medicare Advantage |
$7.50
|
| Rate for Payer: Cash Price |
$23.99
|
| Rate for Payer: Cofinity Commercial |
$25.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.50
|
| Rate for Payer: Healthscope Commercial |
$26.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.49
|
| Rate for Payer: Mclaren Medicaid |
$5.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.87
|
| Rate for Payer: Meridian Medicaid |
$5.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.49
|
| Rate for Payer: Nomi Health Commercial |
$24.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.49
|
| Rate for Payer: PACE Senior Care Partners |
$7.12
|
| Rate for Payer: PACE SWMI |
$7.50
|
| Rate for Payer: PHP Commercial |
$25.49
|
| Rate for Payer: PHP Medicare Advantage |
$7.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.09
|
| Rate for Payer: Priority Health Medicare |
$7.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.87
|
| Rate for Payer: Railroad Medicare Medicare |
$7.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.39
|
| Rate for Payer: UHC Core |
$25.04
|
| Rate for Payer: UHC Exchange |
$7.50
|
| Rate for Payer: UHC Medicaid |
$5.29
|
| Rate for Payer: UHC Medicare Advantage |
$7.50
|
| Rate for Payer: UHCCP Medicaid |
$5.29
|
| Rate for Payer: VA VA |
$7.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.49
|
|
|
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$335.36
|
|
|
Service Code
|
NDC 00574722612
|
| Hospital Charge Code |
11138
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$59.12 |
| Max. Negotiated Rate |
$301.82 |
| Rate for Payer: Aetna Commercial |
$285.06
|
| Rate for Payer: Aetna Medicare |
$87.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.80
|
| Rate for Payer: BCBS Complete |
$62.08
|
| Rate for Payer: BCBS MAPPO |
$83.84
|
| Rate for Payer: BCBS Trust/PPO |
$275.70
|
| Rate for Payer: BCN Commercial |
$275.70
|
| Rate for Payer: BCN Medicare Advantage |
$83.84
|
| Rate for Payer: Cash Price |
$268.29
|
| Rate for Payer: Cofinity Commercial |
$288.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.84
|
| Rate for Payer: Healthscope Commercial |
$301.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$251.52
|
| Rate for Payer: Mclaren Medicaid |
$59.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.03
|
| Rate for Payer: Meridian Medicaid |
$62.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.06
|
| Rate for Payer: Nomi Health Commercial |
$275.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.52
|
| Rate for Payer: PACE Senior Care Partners |
$79.65
|
| Rate for Payer: PACE SWMI |
$83.84
|
| Rate for Payer: PHP Commercial |
$285.06
|
| Rate for Payer: PHP Medicare Advantage |
$83.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$291.76
|
| Rate for Payer: Priority Health Medicare |
$84.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.41
|
| Rate for Payer: Railroad Medicare Medicare |
$83.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.12
|
| Rate for Payer: UHC Core |
$280.03
|
| Rate for Payer: UHC Exchange |
$83.84
|
| Rate for Payer: UHC Medicaid |
$59.12
|
| Rate for Payer: UHC Medicare Advantage |
$83.84
|
| Rate for Payer: UHCCP Medicaid |
$59.12
|
| Rate for Payer: VA VA |
$83.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$251.52
|
|
|
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$29.99
|
|
|
Service Code
|
NDC 00713013506
|
| Hospital Charge Code |
11138
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.87 |
| Max. Negotiated Rate |
$26.99 |
| Rate for Payer: Aetna Commercial |
$25.49
|
| Rate for Payer: BCBS Trust/PPO |
$24.77
|
| Rate for Payer: BCN Commercial |
$24.77
|
| Rate for Payer: Cash Price |
$23.99
|
| Rate for Payer: Cofinity Commercial |
$25.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.99
|
| Rate for Payer: Healthscope Commercial |
$26.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.49
|
| Rate for Payer: Nomi Health Commercial |
$24.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.49
|
| Rate for Payer: PHP Commercial |
$25.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.39
|
| Rate for Payer: UHC Core |
$25.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.49
|
|
|
PROCHLORPERAZINE 25 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$335.36
|
|
|
Service Code
|
NDC 00574722612
|
| Hospital Charge Code |
11138
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$233.41 |
| Max. Negotiated Rate |
$301.82 |
| Rate for Payer: Aetna Commercial |
$285.06
|
| Rate for Payer: BCBS Trust/PPO |
$276.97
|
| Rate for Payer: BCN Commercial |
$276.97
|
| Rate for Payer: Cash Price |
$268.29
|
| Rate for Payer: Cofinity Commercial |
$288.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.29
|
| Rate for Payer: Healthscope Commercial |
$301.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$251.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.06
|
| Rate for Payer: Nomi Health Commercial |
$275.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.52
|
| Rate for Payer: PHP Commercial |
$285.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$291.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.12
|
| Rate for Payer: UHC Core |
$280.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$251.52
|
|
|
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION
|
Facility
|
OP
|
$41.65
|
|
|
Service Code
|
HCPCS J0780
|
| Hospital Charge Code |
155387
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.34 |
| Max. Negotiated Rate |
$37.48 |
| Rate for Payer: Aetna Commercial |
$35.40
|
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Commercial |
$48.05
|
| Rate for Payer: Aetna Commercial |
$47.33
|
| Rate for Payer: Aetna Commercial |
$26.95
|
| Rate for Payer: Aetna Commercial |
$29.50
|
| Rate for Payer: Aetna Commercial |
$65.08
|
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna Commercial |
$19.03
|
| Rate for Payer: Aetna Commercial |
$23.96
|
| Rate for Payer: Aetna Commercial |
$31.02
|
| Rate for Payer: Aetna Commercial |
$33.01
|
| Rate for Payer: Aetna Medicare |
$8.24
|
| Rate for Payer: Aetna Medicare |
$10.10
|
| Rate for Payer: Aetna Medicare |
$10.83
|
| Rate for Payer: Aetna Medicare |
$9.49
|
| Rate for Payer: Aetna Medicare |
$7.33
|
| Rate for Payer: Aetna Medicare |
$14.06
|
| Rate for Payer: Aetna Medicare |
$19.91
|
| Rate for Payer: Aetna Medicare |
$9.02
|
| Rate for Payer: Aetna Medicare |
$14.48
|
| Rate for Payer: Aetna Medicare |
$5.82
|
| Rate for Payer: Aetna Medicare |
$14.70
|
| Rate for Payer: Aetna Medicare |
$8.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.14
|
| Rate for Payer: BCBS Complete |
$6.75
|
| Rate for Payer: BCBS Complete |
$10.46
|
| Rate for Payer: BCBS Complete |
$7.71
|
| Rate for Payer: BCBS Complete |
$7.19
|
| Rate for Payer: BCBS Complete |
$5.22
|
| Rate for Payer: BCBS Complete |
$14.17
|
| Rate for Payer: BCBS Complete |
$5.87
|
| Rate for Payer: BCBS Complete |
$5.89
|
| Rate for Payer: BCBS Complete |
$4.14
|
| Rate for Payer: BCBS Complete |
$6.42
|
| Rate for Payer: BCBS Complete |
$10.31
|
| Rate for Payer: BCBS Complete |
$10.01
|
| Rate for Payer: BCBS MAPPO |
$14.13
|
| Rate for Payer: BCBS MAPPO |
$10.41
|
| Rate for Payer: BCBS MAPPO |
$7.05
|
| Rate for Payer: BCBS MAPPO |
$9.12
|
| Rate for Payer: BCBS MAPPO |
$7.96
|
| Rate for Payer: BCBS MAPPO |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$19.14
|
| Rate for Payer: BCBS MAPPO |
$13.92
|
| Rate for Payer: BCBS MAPPO |
$8.68
|
| Rate for Payer: BCBS MAPPO |
$13.52
|
| Rate for Payer: BCBS MAPPO |
$7.92
|
| Rate for Payer: BCBS MAPPO |
$9.71
|
| Rate for Payer: BCBS Trust/PPO |
$28.54
|
| Rate for Payer: BCBS Trust/PPO |
$46.47
|
| Rate for Payer: BCBS Trust/PPO |
$62.95
|
| Rate for Payer: BCBS Trust/PPO |
$18.41
|
| Rate for Payer: BCBS Trust/PPO |
$26.06
|
| Rate for Payer: BCBS Trust/PPO |
$26.18
|
| Rate for Payer: BCBS Trust/PPO |
$45.77
|
| Rate for Payer: BCBS Trust/PPO |
$34.24
|
| Rate for Payer: BCBS Trust/PPO |
$30.00
|
| Rate for Payer: BCBS Trust/PPO |
$23.17
|
| Rate for Payer: BCBS Trust/PPO |
$31.93
|
| Rate for Payer: BCBS Trust/PPO |
$44.44
|
| Rate for Payer: BCN Commercial |
$44.44
|
| Rate for Payer: BCN Commercial |
$18.41
|
| Rate for Payer: BCN Commercial |
$46.47
|
| Rate for Payer: BCN Commercial |
$26.18
|
| Rate for Payer: BCN Commercial |
$26.06
|
| Rate for Payer: BCN Commercial |
$23.17
|
| Rate for Payer: BCN Commercial |
$62.95
|
| Rate for Payer: BCN Commercial |
$31.93
|
| Rate for Payer: BCN Commercial |
$45.77
|
| Rate for Payer: BCN Commercial |
$28.54
|
| Rate for Payer: BCN Commercial |
$30.00
|
| Rate for Payer: BCN Commercial |
$34.24
|
| Rate for Payer: BCN Medicare Advantage |
$10.41
|
| Rate for Payer: BCN Medicare Advantage |
$7.05
|
| Rate for Payer: BCN Medicare Advantage |
$7.92
|
| Rate for Payer: BCN Medicare Advantage |
$5.60
|
| Rate for Payer: BCN Medicare Advantage |
$13.52
|
| Rate for Payer: BCN Medicare Advantage |
$9.12
|
| Rate for Payer: BCN Medicare Advantage |
$7.96
|
| Rate for Payer: BCN Medicare Advantage |
$14.13
|
| Rate for Payer: BCN Medicare Advantage |
$9.71
|
| Rate for Payer: BCN Medicare Advantage |
$13.92
|
| Rate for Payer: BCN Medicare Advantage |
$19.14
|
| Rate for Payer: BCN Medicare Advantage |
$8.68
|
| Rate for Payer: Cash Price |
$29.19
|
| Rate for Payer: Cash Price |
$17.91
|
| Rate for Payer: Cash Price |
$22.55
|
| Rate for Payer: Cash Price |
$61.26
|
| Rate for Payer: Cash Price |
$45.22
|
| Rate for Payer: Cash Price |
$25.36
|
| Rate for Payer: Cash Price |
$44.54
|
| Rate for Payer: Cash Price |
$25.47
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cash Price |
$27.77
|
| Rate for Payer: Cash Price |
$33.32
|
| Rate for Payer: Cash Price |
$31.07
|
| Rate for Payer: Cofinity Commercial |
$35.82
|
| Rate for Payer: Cofinity Commercial |
$47.88
|
| Rate for Payer: Cofinity Commercial |
$31.38
|
| Rate for Payer: Cofinity Commercial |
$24.24
|
| Rate for Payer: Cofinity Commercial |
$19.26
|
| Rate for Payer: Cofinity Commercial |
$48.62
|
| Rate for Payer: Cofinity Commercial |
$27.26
|
| Rate for Payer: Cofinity Commercial |
$27.38
|
| Rate for Payer: Cofinity Commercial |
$29.85
|
| Rate for Payer: Cofinity Commercial |
$65.85
|
| Rate for Payer: Cofinity Commercial |
$33.40
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.14
|
| Rate for Payer: Healthscope Commercial |
$25.37
|
| Rate for Payer: Healthscope Commercial |
$20.15
|
| Rate for Payer: Healthscope Commercial |
$50.11
|
| Rate for Payer: Healthscope Commercial |
$34.96
|
| Rate for Payer: Healthscope Commercial |
$50.88
|
| Rate for Payer: Healthscope Commercial |
$28.66
|
| Rate for Payer: Healthscope Commercial |
$31.24
|
| Rate for Payer: Healthscope Commercial |
$37.48
|
| Rate for Payer: Healthscope Commercial |
$68.91
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Healthscope Commercial |
$28.53
|
| Rate for Payer: Healthscope Commercial |
$32.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.13
|
| Rate for Payer: Mclaren Medicaid |
$4.97
|
| Rate for Payer: Mclaren Medicaid |
$9.97
|
| Rate for Payer: Mclaren Medicaid |
$9.53
|
| Rate for Payer: Mclaren Medicaid |
$5.59
|
| Rate for Payer: Mclaren Medicaid |
$6.12
|
| Rate for Payer: Mclaren Medicaid |
$9.82
|
| Rate for Payer: Mclaren Medicaid |
$13.50
|
| Rate for Payer: Mclaren Medicaid |
$5.61
|
| Rate for Payer: Mclaren Medicaid |
$3.95
|
| Rate for Payer: Mclaren Medicaid |
$7.34
|
| Rate for Payer: Mclaren Medicaid |
$6.85
|
| Rate for Payer: Mclaren Medicaid |
$6.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.58
|
| Rate for Payer: Meridian Medicaid |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$10.46
|
| Rate for Payer: Meridian Medicaid |
$14.17
|
| Rate for Payer: Meridian Medicaid |
$7.71
|
| Rate for Payer: Meridian Medicaid |
$10.01
|
| Rate for Payer: Meridian Medicaid |
$4.14
|
| Rate for Payer: Meridian Medicaid |
$10.31
|
| Rate for Payer: Meridian Medicaid |
$6.75
|
| Rate for Payer: Meridian Medicaid |
$5.89
|
| Rate for Payer: Meridian Medicaid |
$5.87
|
| Rate for Payer: Meridian Medicaid |
$7.19
|
| Rate for Payer: Meridian Medicaid |
$6.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.08
|
| Rate for Payer: Nomi Health Commercial |
$25.99
|
| Rate for Payer: Nomi Health Commercial |
$46.35
|
| Rate for Payer: Nomi Health Commercial |
$34.15
|
| Rate for Payer: Nomi Health Commercial |
$31.85
|
| Rate for Payer: Nomi Health Commercial |
$26.11
|
| Rate for Payer: Nomi Health Commercial |
$28.46
|
| Rate for Payer: Nomi Health Commercial |
$62.79
|
| Rate for Payer: Nomi Health Commercial |
$23.12
|
| Rate for Payer: Nomi Health Commercial |
$18.36
|
| Rate for Payer: Nomi Health Commercial |
$44.33
|
| Rate for Payer: Nomi Health Commercial |
$45.66
|
| Rate for Payer: Nomi Health Commercial |
$29.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.76
|
| Rate for Payer: PACE Senior Care Partners |
$9.22
|
| Rate for Payer: PACE Senior Care Partners |
$13.22
|
| Rate for Payer: PACE Senior Care Partners |
$8.24
|
| Rate for Payer: PACE Senior Care Partners |
$18.19
|
| Rate for Payer: PACE Senior Care Partners |
$8.67
|
| Rate for Payer: PACE Senior Care Partners |
$6.70
|
| Rate for Payer: PACE Senior Care Partners |
$5.32
|
| Rate for Payer: PACE Senior Care Partners |
$7.56
|
| Rate for Payer: PACE Senior Care Partners |
$13.43
|
| Rate for Payer: PACE Senior Care Partners |
$9.89
|
| Rate for Payer: PACE Senior Care Partners |
$7.53
|
| Rate for Payer: PACE Senior Care Partners |
$12.84
|
| Rate for Payer: PACE SWMI |
$19.14
|
| Rate for Payer: PACE SWMI |
$7.96
|
| Rate for Payer: PACE SWMI |
$9.71
|
| Rate for Payer: PACE SWMI |
$7.05
|
| Rate for Payer: PACE SWMI |
$5.60
|
| Rate for Payer: PACE SWMI |
$9.12
|
| Rate for Payer: PACE SWMI |
$14.13
|
| Rate for Payer: PACE SWMI |
$10.41
|
| Rate for Payer: PACE SWMI |
$13.92
|
| Rate for Payer: PACE SWMI |
$7.92
|
| Rate for Payer: PACE SWMI |
$8.68
|
| Rate for Payer: PACE SWMI |
$13.52
|
| Rate for Payer: PHP Commercial |
$29.50
|
| Rate for Payer: PHP Commercial |
$23.96
|
| Rate for Payer: PHP Commercial |
$48.05
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: PHP Commercial |
$35.40
|
| Rate for Payer: PHP Commercial |
$47.33
|
| Rate for Payer: PHP Commercial |
$31.02
|
| Rate for Payer: PHP Commercial |
$19.03
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: PHP Commercial |
$26.95
|
| Rate for Payer: PHP Commercial |
$33.01
|
| Rate for Payer: PHP Commercial |
$65.08
|
| Rate for Payer: PHP Medicare Advantage |
$13.92
|
| Rate for Payer: PHP Medicare Advantage |
$13.52
|
| Rate for Payer: PHP Medicare Advantage |
$9.12
|
| Rate for Payer: PHP Medicare Advantage |
$5.60
|
| Rate for Payer: PHP Medicare Advantage |
$7.05
|
| Rate for Payer: PHP Medicare Advantage |
$8.68
|
| Rate for Payer: PHP Medicare Advantage |
$7.96
|
| Rate for Payer: PHP Medicare Advantage |
$19.14
|
| Rate for Payer: PHP Medicare Advantage |
$9.71
|
| Rate for Payer: PHP Medicare Advantage |
$7.92
|
| Rate for Payer: PHP Medicare Advantage |
$14.13
|
| Rate for Payer: PHP Medicare Advantage |
$10.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$30.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.62
|
| Rate for Payer: Priority Health Medicare |
$14.06
|
| Rate for Payer: Priority Health Medicare |
$8.00
|
| Rate for Payer: Priority Health Medicare |
$13.65
|
| Rate for Payer: Priority Health Medicare |
$8.04
|
| Rate for Payer: Priority Health Medicare |
$19.33
|
| Rate for Payer: Priority Health Medicare |
$9.21
|
| Rate for Payer: Priority Health Medicare |
$9.81
|
| Rate for Payer: Priority Health Medicare |
$5.65
|
| Rate for Payer: Priority Health Medicare |
$14.27
|
| Rate for Payer: Priority Health Medicare |
$8.76
|
| Rate for Payer: Priority Health Medicare |
$7.12
|
| Rate for Payer: Priority Health Medicare |
$10.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.16
|
| Rate for Payer: Railroad Medicare Medicare |
$8.68
|
| Rate for Payer: Railroad Medicare Medicare |
$7.05
|
| Rate for Payer: Railroad Medicare Medicare |
$9.12
|
| Rate for Payer: Railroad Medicare Medicare |
$7.96
|
| Rate for Payer: Railroad Medicare Medicare |
$9.71
|
| Rate for Payer: Railroad Medicare Medicare |
$5.60
|
| Rate for Payer: Railroad Medicare Medicare |
$7.92
|
| Rate for Payer: Railroad Medicare Medicare |
$10.41
|
| Rate for Payer: Railroad Medicare Medicare |
$19.14
|
| Rate for Payer: Railroad Medicare Medicare |
$14.13
|
| Rate for Payer: Railroad Medicare Medicare |
$13.92
|
| Rate for Payer: Railroad Medicare Medicare |
$13.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.70
|
| Rate for Payer: UHC Core |
$26.59
|
| Rate for Payer: UHC Core |
$34.78
|
| Rate for Payer: UHC Core |
$46.49
|
| Rate for Payer: UHC Core |
$23.54
|
| Rate for Payer: UHC Core |
$28.98
|
| Rate for Payer: UHC Core |
$63.94
|
| Rate for Payer: UHC Core |
$47.20
|
| Rate for Payer: UHC Core |
$18.70
|
| Rate for Payer: UHC Core |
$32.43
|
| Rate for Payer: UHC Core |
$45.14
|
| Rate for Payer: UHC Core |
$30.47
|
| Rate for Payer: UHC Core |
$26.47
|
| Rate for Payer: UHC Exchange |
$8.68
|
| Rate for Payer: UHC Exchange |
$13.92
|
| Rate for Payer: UHC Exchange |
$9.12
|
| Rate for Payer: UHC Exchange |
$19.14
|
| Rate for Payer: UHC Exchange |
$13.52
|
| Rate for Payer: UHC Exchange |
$7.92
|
| Rate for Payer: UHC Exchange |
$9.71
|
| Rate for Payer: UHC Exchange |
$7.96
|
| Rate for Payer: UHC Exchange |
$7.05
|
| Rate for Payer: UHC Exchange |
$10.41
|
| Rate for Payer: UHC Exchange |
$5.60
|
| Rate for Payer: UHC Exchange |
$14.13
|
| Rate for Payer: UHC Medicaid |
$9.97
|
| Rate for Payer: UHC Medicaid |
$9.82
|
| Rate for Payer: UHC Medicaid |
$6.12
|
| Rate for Payer: UHC Medicaid |
$5.61
|
| Rate for Payer: UHC Medicaid |
$3.95
|
| Rate for Payer: UHC Medicaid |
$5.59
|
| Rate for Payer: UHC Medicaid |
$7.34
|
| Rate for Payer: UHC Medicaid |
$9.53
|
| Rate for Payer: UHC Medicaid |
$6.85
|
| Rate for Payer: UHC Medicaid |
$13.50
|
| Rate for Payer: UHC Medicaid |
$6.43
|
| Rate for Payer: UHC Medicaid |
$4.97
|
| Rate for Payer: UHC Medicare Advantage |
$13.52
|
| Rate for Payer: UHC Medicare Advantage |
$8.68
|
| Rate for Payer: UHC Medicare Advantage |
$13.92
|
| Rate for Payer: UHC Medicare Advantage |
$5.60
|
| Rate for Payer: UHC Medicare Advantage |
$9.12
|
| Rate for Payer: UHC Medicare Advantage |
$7.05
|
| Rate for Payer: UHC Medicare Advantage |
$19.14
|
| Rate for Payer: UHC Medicare Advantage |
$14.13
|
| Rate for Payer: UHC Medicare Advantage |
$10.41
|
| Rate for Payer: UHC Medicare Advantage |
$9.71
|
| Rate for Payer: UHC Medicare Advantage |
$7.92
|
| Rate for Payer: UHC Medicare Advantage |
$7.96
|
| Rate for Payer: UHCCP Medicaid |
$9.53
|
| Rate for Payer: UHCCP Medicaid |
$13.50
|
| Rate for Payer: UHCCP Medicaid |
$7.34
|
| Rate for Payer: UHCCP Medicaid |
$9.97
|
| Rate for Payer: UHCCP Medicaid |
$6.43
|
| Rate for Payer: UHCCP Medicaid |
$3.95
|
| Rate for Payer: UHCCP Medicaid |
$9.82
|
| Rate for Payer: UHCCP Medicaid |
$6.12
|
| Rate for Payer: UHCCP Medicaid |
$5.59
|
| Rate for Payer: UHCCP Medicaid |
$5.61
|
| Rate for Payer: UHCCP Medicaid |
$6.85
|
| Rate for Payer: UHCCP Medicaid |
$4.97
|
| Rate for Payer: VA VA |
$9.12
|
| Rate for Payer: VA VA |
$14.13
|
| Rate for Payer: VA VA |
$5.60
|
| Rate for Payer: VA VA |
$7.05
|
| Rate for Payer: VA VA |
$9.71
|
| Rate for Payer: VA VA |
$13.52
|
| Rate for Payer: VA VA |
$10.41
|
| Rate for Payer: VA VA |
$13.92
|
| Rate for Payer: VA VA |
$7.96
|
| Rate for Payer: VA VA |
$7.92
|
| Rate for Payer: VA VA |
$19.14
|
| Rate for Payer: VA VA |
$8.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.13
|
|
|
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION
|
Facility
|
IP
|
$36.49
|
|
|
Service Code
|
HCPCS J0780
|
| Hospital Charge Code |
155387
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$25.40 |
| Max. Negotiated Rate |
$32.84 |
| Rate for Payer: Aetna Commercial |
$31.02
|
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Commercial |
$48.05
|
| Rate for Payer: Aetna Commercial |
$26.95
|
| Rate for Payer: Aetna Commercial |
$23.96
|
| Rate for Payer: Aetna Commercial |
$47.33
|
| Rate for Payer: Aetna Commercial |
$19.03
|
| Rate for Payer: Aetna Commercial |
$65.08
|
| Rate for Payer: Aetna Commercial |
$33.01
|
| Rate for Payer: Aetna Commercial |
$35.40
|
| Rate for Payer: Aetna Commercial |
$29.50
|
| Rate for Payer: BCBS Trust/PPO |
$23.28
|
| Rate for Payer: BCBS Trust/PPO |
$34.40
|
| Rate for Payer: BCBS Trust/PPO |
$46.69
|
| Rate for Payer: BCBS Trust/PPO |
$26.18
|
| Rate for Payer: BCBS Trust/PPO |
$63.24
|
| Rate for Payer: BCBS Trust/PPO |
$26.30
|
| Rate for Payer: BCBS Trust/PPO |
$28.67
|
| Rate for Payer: BCBS Trust/PPO |
$44.65
|
| Rate for Payer: BCBS Trust/PPO |
$18.49
|
| Rate for Payer: BCBS Trust/PPO |
$30.14
|
| Rate for Payer: BCBS Trust/PPO |
$45.99
|
| Rate for Payer: BCBS Trust/PPO |
$32.08
|
| Rate for Payer: BCN Commercial |
$32.08
|
| Rate for Payer: BCN Commercial |
$46.69
|
| Rate for Payer: BCN Commercial |
$45.99
|
| Rate for Payer: BCN Commercial |
$26.18
|
| Rate for Payer: BCN Commercial |
$18.49
|
| Rate for Payer: BCN Commercial |
$26.30
|
| Rate for Payer: BCN Commercial |
$23.28
|
| Rate for Payer: BCN Commercial |
$30.14
|
| Rate for Payer: BCN Commercial |
$34.40
|
| Rate for Payer: BCN Commercial |
$28.67
|
| Rate for Payer: BCN Commercial |
$63.24
|
| Rate for Payer: BCN Commercial |
$44.65
|
| Rate for Payer: Cash Price |
$29.19
|
| Rate for Payer: Cash Price |
$31.07
|
| Rate for Payer: Cash Price |
$17.91
|
| Rate for Payer: Cash Price |
$25.47
|
| Rate for Payer: Cash Price |
$61.26
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cash Price |
$25.36
|
| Rate for Payer: Cash Price |
$22.55
|
| Rate for Payer: Cash Price |
$44.54
|
| Rate for Payer: Cash Price |
$45.22
|
| Rate for Payer: Cash Price |
$27.77
|
| Rate for Payer: Cash Price |
$33.32
|
| Rate for Payer: Cofinity Commercial |
$48.62
|
| Rate for Payer: Cofinity Commercial |
$33.40
|
| Rate for Payer: Cofinity Commercial |
$19.26
|
| Rate for Payer: Cofinity Commercial |
$27.38
|
| Rate for Payer: Cofinity Commercial |
$27.26
|
| Rate for Payer: Cofinity Commercial |
$24.24
|
| Rate for Payer: Cofinity Commercial |
$65.85
|
| Rate for Payer: Cofinity Commercial |
$47.88
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Cofinity Commercial |
$29.85
|
| Rate for Payer: Cofinity Commercial |
$35.82
|
| Rate for Payer: Cofinity Commercial |
$31.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.47
|
| Rate for Payer: Healthscope Commercial |
$34.96
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Healthscope Commercial |
$50.88
|
| Rate for Payer: Healthscope Commercial |
$68.91
|
| Rate for Payer: Healthscope Commercial |
$31.24
|
| Rate for Payer: Healthscope Commercial |
$37.48
|
| Rate for Payer: Healthscope Commercial |
$20.15
|
| Rate for Payer: Healthscope Commercial |
$28.53
|
| Rate for Payer: Healthscope Commercial |
$25.37
|
| Rate for Payer: Healthscope Commercial |
$28.66
|
| Rate for Payer: Healthscope Commercial |
$32.84
|
| Rate for Payer: Healthscope Commercial |
$50.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.08
|
| Rate for Payer: Nomi Health Commercial |
$62.79
|
| Rate for Payer: Nomi Health Commercial |
$18.36
|
| Rate for Payer: Nomi Health Commercial |
$23.12
|
| Rate for Payer: Nomi Health Commercial |
$31.85
|
| Rate for Payer: Nomi Health Commercial |
$44.33
|
| Rate for Payer: Nomi Health Commercial |
$25.99
|
| Rate for Payer: Nomi Health Commercial |
$45.66
|
| Rate for Payer: Nomi Health Commercial |
$46.35
|
| Rate for Payer: Nomi Health Commercial |
$26.11
|
| Rate for Payer: Nomi Health Commercial |
$34.15
|
| Rate for Payer: Nomi Health Commercial |
$28.46
|
| Rate for Payer: Nomi Health Commercial |
$29.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.55
|
| Rate for Payer: PHP Commercial |
$31.02
|
| Rate for Payer: PHP Commercial |
$47.33
|
| Rate for Payer: PHP Commercial |
$19.03
|
| Rate for Payer: PHP Commercial |
$23.96
|
| Rate for Payer: PHP Commercial |
$26.95
|
| Rate for Payer: PHP Commercial |
$48.05
|
| Rate for Payer: PHP Commercial |
$33.01
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: PHP Commercial |
$29.50
|
| Rate for Payer: PHP Commercial |
$65.08
|
| Rate for Payer: PHP Commercial |
$35.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$30.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.90
|
| Rate for Payer: UHC Core |
$46.49
|
| Rate for Payer: UHC Core |
$23.54
|
| Rate for Payer: UHC Core |
$26.47
|
| Rate for Payer: UHC Core |
$45.14
|
| Rate for Payer: UHC Core |
$18.70
|
| Rate for Payer: UHC Core |
$47.20
|
| Rate for Payer: UHC Core |
$26.59
|
| Rate for Payer: UHC Core |
$34.78
|
| Rate for Payer: UHC Core |
$28.98
|
| Rate for Payer: UHC Core |
$32.43
|
| Rate for Payer: UHC Core |
$63.94
|
| Rate for Payer: UHC Core |
$30.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.37
|
|
|
PROCHLORPERAZINE MALEATE 5 MG TABLET
|
Facility
|
IP
|
$307.80
|
|
|
Service Code
|
NDC 59746011306
|
| Hospital Charge Code |
6583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$214.23 |
| Max. Negotiated Rate |
$277.02 |
| Rate for Payer: Aetna Commercial |
$261.63
|
| Rate for Payer: BCBS Trust/PPO |
$254.21
|
| Rate for Payer: BCN Commercial |
$254.21
|
| Rate for Payer: Cash Price |
$246.24
|
| Rate for Payer: Cofinity Commercial |
$264.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$246.24
|
| Rate for Payer: Healthscope Commercial |
$277.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$230.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.63
|
| Rate for Payer: Nomi Health Commercial |
$252.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.85
|
| Rate for Payer: PHP Commercial |
$261.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$267.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.86
|
| Rate for Payer: UHC Core |
$257.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$230.85
|
|
|
PROCHLORPERAZINE MALEATE 5 MG TABLET
|
Facility
|
OP
|
$307.80
|
|
|
Service Code
|
NDC 59746011306
|
| Hospital Charge Code |
6583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$54.27 |
| Max. Negotiated Rate |
$277.02 |
| Rate for Payer: Aetna Commercial |
$261.63
|
| Rate for Payer: Aetna Medicare |
$80.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.19
|
| Rate for Payer: BCBS Complete |
$56.97
|
| Rate for Payer: BCBS MAPPO |
$76.95
|
| Rate for Payer: BCBS Trust/PPO |
$253.04
|
| Rate for Payer: BCN Commercial |
$253.04
|
| Rate for Payer: BCN Medicare Advantage |
$76.95
|
| Rate for Payer: Cash Price |
$246.24
|
| Rate for Payer: Cofinity Commercial |
$264.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$246.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.95
|
| Rate for Payer: Healthscope Commercial |
$277.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$230.85
|
| Rate for Payer: Mclaren Medicaid |
$54.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.80
|
| Rate for Payer: Meridian Medicaid |
$56.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.63
|
| Rate for Payer: Nomi Health Commercial |
$252.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.85
|
| Rate for Payer: PACE Senior Care Partners |
$73.10
|
| Rate for Payer: PACE SWMI |
$76.95
|
| Rate for Payer: PHP Commercial |
$261.63
|
| Rate for Payer: PHP Medicare Advantage |
$76.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$267.79
|
| Rate for Payer: Priority Health Medicare |
$77.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.23
|
| Rate for Payer: Railroad Medicare Medicare |
$76.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.86
|
| Rate for Payer: UHC Core |
$257.01
|
| Rate for Payer: UHC Exchange |
$76.95
|
| Rate for Payer: UHC Medicaid |
$54.27
|
| Rate for Payer: UHC Medicare Advantage |
$76.95
|
| Rate for Payer: UHCCP Medicaid |
$54.27
|
| Rate for Payer: VA VA |
$76.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$230.85
|
|
|
PROCHLORPERAZINE MALEATE 5 MG TABLET
|
Facility
|
IP
|
$258.24
|
|
|
Service Code
|
NDC 50268068415
|
| Hospital Charge Code |
6583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$179.74 |
| Max. Negotiated Rate |
$232.42 |
| Rate for Payer: Aetna Commercial |
$219.50
|
| Rate for Payer: BCBS Trust/PPO |
$213.28
|
| Rate for Payer: BCN Commercial |
$213.28
|
| Rate for Payer: Cash Price |
$206.59
|
| Rate for Payer: Cofinity Commercial |
$222.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.59
|
| Rate for Payer: Healthscope Commercial |
$232.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.50
|
| Rate for Payer: Nomi Health Commercial |
$211.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.68
|
| Rate for Payer: PHP Commercial |
$219.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$224.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.25
|
| Rate for Payer: UHC Core |
$215.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.68
|
|
|
PROCHLORPERAZINE MALEATE 5 MG TABLET
|
Facility
|
IP
|
$234.72
|
|
|
Service Code
|
NDC 00904738106
|
| Hospital Charge Code |
6583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$163.37 |
| Max. Negotiated Rate |
$211.25 |
| Rate for Payer: Aetna Commercial |
$199.51
|
| Rate for Payer: BCBS Trust/PPO |
$193.86
|
| Rate for Payer: BCN Commercial |
$193.86
|
| Rate for Payer: Cash Price |
$187.78
|
| Rate for Payer: Cofinity Commercial |
$201.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.78
|
| Rate for Payer: Healthscope Commercial |
$211.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.51
|
| Rate for Payer: Nomi Health Commercial |
$192.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$176.04
|
| Rate for Payer: PHP Commercial |
$199.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$204.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$163.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.55
|
| Rate for Payer: UHC Core |
$195.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.04
|
|
|
PROCHLORPERAZINE MALEATE 5 MG TABLET
|
Facility
|
OP
|
$234.72
|
|
|
Service Code
|
NDC 00904738106
|
| Hospital Charge Code |
6583
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$41.38 |
| Max. Negotiated Rate |
$211.25 |
| Rate for Payer: Aetna Commercial |
$199.51
|
| Rate for Payer: Aetna Medicare |
$61.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.35
|
| Rate for Payer: BCBS Complete |
$43.45
|
| Rate for Payer: BCBS MAPPO |
$58.68
|
| Rate for Payer: BCBS Trust/PPO |
$192.96
|
| Rate for Payer: BCN Commercial |
$192.96
|
| Rate for Payer: BCN Medicare Advantage |
$58.68
|
| Rate for Payer: Cash Price |
$187.78
|
| Rate for Payer: Cofinity Commercial |
$201.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.68
|
| Rate for Payer: Healthscope Commercial |
$211.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.04
|
| Rate for Payer: Mclaren Medicaid |
$41.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.61
|
| Rate for Payer: Meridian Medicaid |
$43.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.51
|
| Rate for Payer: Nomi Health Commercial |
$192.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$176.04
|
| Rate for Payer: PACE Senior Care Partners |
$55.75
|
| Rate for Payer: PACE SWMI |
$58.68
|
| Rate for Payer: PHP Commercial |
$199.51
|
| Rate for Payer: PHP Medicare Advantage |
$58.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$204.21
|
| Rate for Payer: Priority Health Medicare |
$59.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$163.37
|
| Rate for Payer: Railroad Medicare Medicare |
$58.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.55
|
| Rate for Payer: UHC Core |
$195.99
|
| Rate for Payer: UHC Exchange |
$58.68
|
| Rate for Payer: UHC Medicaid |
$41.38
|
| Rate for Payer: UHC Medicare Advantage |
$58.68
|
| Rate for Payer: UHCCP Medicaid |
$41.38
|
| Rate for Payer: VA VA |
$58.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.04
|
|
