|
PR OPN SUBCLA CRTD ART TRPOS NCK INC ULAT
|
Professional
|
Both
|
$3,296.00
|
|
|
Service Code
|
HCPCS 33889
|
| Min. Negotiated Rate |
$1,063.36 |
| Max. Negotiated Rate |
$2,472.00 |
| Rate for Payer: Aetna Commercial |
$1,063.36
|
| Rate for Payer: Aetna Medicare |
$1,648.00
|
| Rate for Payer: BCBS Complete |
$1,318.40
|
| Rate for Payer: BCN Commercial |
$1,162.29
|
| Rate for Payer: Cash Price |
$2,636.80
|
| Rate for Payer: Cash Price |
$2,636.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,472.00
|
|
|
PROPOFOL 10 MG/ML 20 ML VIAL (BULK CHARGE)
|
Facility
|
IP
|
$63.61
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
180095
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$44.27 |
| Max. Negotiated Rate |
$57.25 |
| Rate for Payer: Aetna Commercial |
$54.07
|
| Rate for Payer: BCBS Trust/PPO |
$52.54
|
| Rate for Payer: BCN Commercial |
$52.54
|
| Rate for Payer: Cash Price |
$50.89
|
| Rate for Payer: Cofinity Commercial |
$54.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.89
|
| Rate for Payer: Healthscope Commercial |
$57.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.07
|
| Rate for Payer: Nomi Health Commercial |
$52.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.71
|
| Rate for Payer: PHP Commercial |
$54.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.98
|
| Rate for Payer: UHC Core |
$53.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.71
|
|
|
PROPOFOL 10 MG/ML 20 ML VIAL (BULK CHARGE)
|
Facility
|
OP
|
$63.61
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
180095
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.21 |
| Max. Negotiated Rate |
$57.25 |
| Rate for Payer: Aetna Commercial |
$54.07
|
| Rate for Payer: Aetna Medicare |
$16.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.88
|
| Rate for Payer: BCBS Complete |
$11.77
|
| Rate for Payer: BCBS MAPPO |
$15.90
|
| Rate for Payer: BCBS Trust/PPO |
$52.29
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: BCN Medicare Advantage |
$15.90
|
| Rate for Payer: Cash Price |
$50.89
|
| Rate for Payer: Cofinity Commercial |
$54.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.90
|
| Rate for Payer: Healthscope Commercial |
$57.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.71
|
| Rate for Payer: Mclaren Medicaid |
$11.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.70
|
| Rate for Payer: Meridian Medicaid |
$11.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.07
|
| Rate for Payer: Nomi Health Commercial |
$52.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.71
|
| Rate for Payer: PACE Senior Care Partners |
$15.11
|
| Rate for Payer: PACE SWMI |
$15.90
|
| Rate for Payer: PHP Commercial |
$54.07
|
| Rate for Payer: PHP Medicare Advantage |
$15.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.34
|
| Rate for Payer: Priority Health Medicare |
$16.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.27
|
| Rate for Payer: Railroad Medicare Medicare |
$15.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.98
|
| Rate for Payer: UHC Core |
$53.11
|
| Rate for Payer: UHC Exchange |
$15.90
|
| Rate for Payer: UHC Medicaid |
$11.21
|
| Rate for Payer: UHC Medicare Advantage |
$15.90
|
| Rate for Payer: UHCCP Medicaid |
$11.21
|
| Rate for Payer: VA VA |
$15.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.71
|
|
|
PROPOFOL 10 MG/ML CONTINUOUS INFUSION
|
Facility
|
OP
|
$77.12
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
151165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$69.41 |
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna Medicare |
$20.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.10
|
| Rate for Payer: BCBS Complete |
$14.27
|
| Rate for Payer: BCBS MAPPO |
$19.28
|
| Rate for Payer: BCBS Trust/PPO |
$63.40
|
| Rate for Payer: BCN Commercial |
$63.40
|
| Rate for Payer: BCN Medicare Advantage |
$19.28
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cofinity Commercial |
$66.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.28
|
| Rate for Payer: Healthscope Commercial |
$69.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.84
|
| Rate for Payer: Mclaren Medicaid |
$13.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.24
|
| Rate for Payer: Meridian Medicaid |
$14.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.55
|
| Rate for Payer: Nomi Health Commercial |
$63.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.84
|
| Rate for Payer: PACE Senior Care Partners |
$18.32
|
| Rate for Payer: PACE SWMI |
$19.28
|
| Rate for Payer: PHP Commercial |
$65.55
|
| Rate for Payer: PHP Medicare Advantage |
$19.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$67.09
|
| Rate for Payer: Priority Health Medicare |
$19.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.68
|
| Rate for Payer: Railroad Medicare Medicare |
$19.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.87
|
| Rate for Payer: UHC Core |
$64.40
|
| Rate for Payer: UHC Exchange |
$19.28
|
| Rate for Payer: UHC Medicaid |
$13.60
|
| Rate for Payer: UHC Medicare Advantage |
$19.28
|
| Rate for Payer: UHCCP Medicaid |
$13.60
|
| Rate for Payer: VA VA |
$19.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.84
|
|
|
PROPOFOL 10 MG/ML CONTINUOUS INFUSION
|
Facility
|
IP
|
$77.12
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
151165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$53.68 |
| Max. Negotiated Rate |
$69.41 |
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: BCBS Trust/PPO |
$63.69
|
| Rate for Payer: BCN Commercial |
$63.69
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cofinity Commercial |
$66.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.70
|
| Rate for Payer: Healthscope Commercial |
$69.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.55
|
| Rate for Payer: Nomi Health Commercial |
$63.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.84
|
| Rate for Payer: PHP Commercial |
$65.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$67.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.87
|
| Rate for Payer: UHC Core |
$64.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.84
|
|
|
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION
|
Facility
|
OP
|
$86.30
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
11150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.21 |
| Max. Negotiated Rate |
$77.67 |
| Rate for Payer: Aetna Commercial |
$73.36
|
| Rate for Payer: Aetna Commercial |
$55.28
|
| Rate for Payer: Aetna Commercial |
$46.36
|
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Commercial |
$115.84
|
| Rate for Payer: Aetna Commercial |
$53.49
|
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna Commercial |
$63.21
|
| Rate for Payer: Aetna Commercial |
$51.12
|
| Rate for Payer: Aetna Commercial |
$57.06
|
| Rate for Payer: Aetna Commercial |
$87.40
|
| Rate for Payer: Aetna Medicare |
$35.43
|
| Rate for Payer: Aetna Medicare |
$26.73
|
| Rate for Payer: Aetna Medicare |
$19.33
|
| Rate for Payer: Aetna Medicare |
$22.44
|
| Rate for Payer: Aetna Medicare |
$21.48
|
| Rate for Payer: Aetna Medicare |
$15.64
|
| Rate for Payer: Aetna Medicare |
$14.18
|
| Rate for Payer: Aetna Medicare |
$20.05
|
| Rate for Payer: Aetna Medicare |
$16.91
|
| Rate for Payer: Aetna Medicare |
$17.45
|
| Rate for Payer: Aetna Medicare |
$16.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.10
|
| Rate for Payer: BCBS Complete |
$14.27
|
| Rate for Payer: BCBS Complete |
$19.03
|
| Rate for Payer: BCBS Complete |
$25.23
|
| Rate for Payer: BCBS Complete |
$11.13
|
| Rate for Payer: BCBS Complete |
$15.29
|
| Rate for Payer: BCBS Complete |
$12.43
|
| Rate for Payer: BCBS Complete |
$11.65
|
| Rate for Payer: BCBS Complete |
$12.04
|
| Rate for Payer: BCBS Complete |
$13.76
|
| Rate for Payer: BCBS Complete |
$10.10
|
| Rate for Payer: BCBS Complete |
$15.97
|
| Rate for Payer: BCBS MAPPO |
$15.73
|
| Rate for Payer: BCBS MAPPO |
$16.78
|
| Rate for Payer: BCBS MAPPO |
$20.66
|
| Rate for Payer: BCBS MAPPO |
$18.59
|
| Rate for Payer: BCBS MAPPO |
$25.70
|
| Rate for Payer: BCBS MAPPO |
$13.63
|
| Rate for Payer: BCBS MAPPO |
$15.04
|
| Rate for Payer: BCBS MAPPO |
$21.57
|
| Rate for Payer: BCBS MAPPO |
$19.28
|
| Rate for Payer: BCBS MAPPO |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$34.07
|
| Rate for Payer: BCBS Trust/PPO |
$84.53
|
| Rate for Payer: BCBS Trust/PPO |
$70.95
|
| Rate for Payer: BCBS Trust/PPO |
$55.19
|
| Rate for Payer: BCBS Trust/PPO |
$67.92
|
| Rate for Payer: BCBS Trust/PPO |
$53.46
|
| Rate for Payer: BCBS Trust/PPO |
$51.73
|
| Rate for Payer: BCBS Trust/PPO |
$49.44
|
| Rate for Payer: BCBS Trust/PPO |
$61.13
|
| Rate for Payer: BCBS Trust/PPO |
$44.84
|
| Rate for Payer: BCBS Trust/PPO |
$112.04
|
| Rate for Payer: BCBS Trust/PPO |
$63.40
|
| Rate for Payer: BCN Commercial |
$70.95
|
| Rate for Payer: BCN Commercial |
$112.04
|
| Rate for Payer: BCN Commercial |
$84.53
|
| Rate for Payer: BCN Commercial |
$55.19
|
| Rate for Payer: BCN Commercial |
$61.13
|
| Rate for Payer: BCN Commercial |
$53.46
|
| Rate for Payer: BCN Commercial |
$63.40
|
| Rate for Payer: BCN Commercial |
$44.84
|
| Rate for Payer: BCN Commercial |
$51.73
|
| Rate for Payer: BCN Commercial |
$67.92
|
| Rate for Payer: BCN Commercial |
$49.44
|
| Rate for Payer: BCN Medicare Advantage |
$15.04
|
| Rate for Payer: BCN Medicare Advantage |
$19.28
|
| Rate for Payer: BCN Medicare Advantage |
$16.26
|
| Rate for Payer: BCN Medicare Advantage |
$15.73
|
| Rate for Payer: BCN Medicare Advantage |
$18.59
|
| Rate for Payer: BCN Medicare Advantage |
$16.78
|
| Rate for Payer: BCN Medicare Advantage |
$20.66
|
| Rate for Payer: BCN Medicare Advantage |
$25.70
|
| Rate for Payer: BCN Medicare Advantage |
$34.07
|
| Rate for Payer: BCN Medicare Advantage |
$21.57
|
| Rate for Payer: BCN Medicare Advantage |
$13.63
|
| Rate for Payer: Cash Price |
$82.26
|
| Rate for Payer: Cash Price |
$43.63
|
| Rate for Payer: Cash Price |
$59.49
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cash Price |
$109.02
|
| Rate for Payer: Cash Price |
$69.04
|
| Rate for Payer: Cash Price |
$53.70
|
| Rate for Payer: Cash Price |
$48.11
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cash Price |
$50.34
|
| Rate for Payer: Cofinity Commercial |
$117.20
|
| Rate for Payer: Cofinity Commercial |
$51.72
|
| Rate for Payer: Cofinity Commercial |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$63.95
|
| Rate for Payer: Cofinity Commercial |
$57.73
|
| Rate for Payer: Cofinity Commercial |
$88.43
|
| Rate for Payer: Cofinity Commercial |
$71.05
|
| Rate for Payer: Cofinity Commercial |
$66.32
|
| Rate for Payer: Cofinity Commercial |
$74.22
|
| Rate for Payer: Cofinity Commercial |
$55.93
|
| Rate for Payer: Cofinity Commercial |
$54.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.78
|
| Rate for Payer: Healthscope Commercial |
$74.36
|
| Rate for Payer: Healthscope Commercial |
$69.41
|
| Rate for Payer: Healthscope Commercial |
$92.54
|
| Rate for Payer: Healthscope Commercial |
$122.65
|
| Rate for Payer: Healthscope Commercial |
$60.42
|
| Rate for Payer: Healthscope Commercial |
$54.13
|
| Rate for Payer: Healthscope Commercial |
$66.92
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Healthscope Commercial |
$77.67
|
| Rate for Payer: Healthscope Commercial |
$49.09
|
| Rate for Payer: Healthscope Commercial |
$56.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.35
|
| Rate for Payer: Mclaren Medicaid |
$15.21
|
| Rate for Payer: Mclaren Medicaid |
$11.46
|
| Rate for Payer: Mclaren Medicaid |
$11.84
|
| Rate for Payer: Mclaren Medicaid |
$13.60
|
| Rate for Payer: Mclaren Medicaid |
$11.09
|
| Rate for Payer: Mclaren Medicaid |
$10.60
|
| Rate for Payer: Mclaren Medicaid |
$24.03
|
| Rate for Payer: Mclaren Medicaid |
$18.13
|
| Rate for Payer: Mclaren Medicaid |
$9.62
|
| Rate for Payer: Mclaren Medicaid |
$13.11
|
| Rate for Payer: Mclaren Medicaid |
$14.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.52
|
| Rate for Payer: Meridian Medicaid |
$25.23
|
| Rate for Payer: Meridian Medicaid |
$11.65
|
| Rate for Payer: Meridian Medicaid |
$11.13
|
| Rate for Payer: Meridian Medicaid |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$10.10
|
| Rate for Payer: Meridian Medicaid |
$12.04
|
| Rate for Payer: Meridian Medicaid |
$12.43
|
| Rate for Payer: Meridian Medicaid |
$15.97
|
| Rate for Payer: Meridian Medicaid |
$14.27
|
| Rate for Payer: Meridian Medicaid |
$15.29
|
| Rate for Payer: Meridian Medicaid |
$19.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.36
|
| Rate for Payer: Nomi Health Commercial |
$67.75
|
| Rate for Payer: Nomi Health Commercial |
$53.32
|
| Rate for Payer: Nomi Health Commercial |
$51.60
|
| Rate for Payer: Nomi Health Commercial |
$70.77
|
| Rate for Payer: Nomi Health Commercial |
$111.75
|
| Rate for Payer: Nomi Health Commercial |
$63.24
|
| Rate for Payer: Nomi Health Commercial |
$44.72
|
| Rate for Payer: Nomi Health Commercial |
$60.98
|
| Rate for Payer: Nomi Health Commercial |
$49.31
|
| Rate for Payer: Nomi Health Commercial |
$84.31
|
| Rate for Payer: Nomi Health Commercial |
$55.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.72
|
| Rate for Payer: PACE Senior Care Partners |
$18.32
|
| Rate for Payer: PACE Senior Care Partners |
$20.50
|
| Rate for Payer: PACE Senior Care Partners |
$19.62
|
| Rate for Payer: PACE Senior Care Partners |
$15.44
|
| Rate for Payer: PACE Senior Care Partners |
$14.28
|
| Rate for Payer: PACE Senior Care Partners |
$12.95
|
| Rate for Payer: PACE Senior Care Partners |
$17.66
|
| Rate for Payer: PACE Senior Care Partners |
$32.37
|
| Rate for Payer: PACE Senior Care Partners |
$24.42
|
| Rate for Payer: PACE Senior Care Partners |
$14.95
|
| Rate for Payer: PACE Senior Care Partners |
$15.94
|
| Rate for Payer: PACE SWMI |
$20.66
|
| Rate for Payer: PACE SWMI |
$34.07
|
| Rate for Payer: PACE SWMI |
$25.70
|
| Rate for Payer: PACE SWMI |
$13.63
|
| Rate for Payer: PACE SWMI |
$15.04
|
| Rate for Payer: PACE SWMI |
$15.73
|
| Rate for Payer: PACE SWMI |
$16.26
|
| Rate for Payer: PACE SWMI |
$16.78
|
| Rate for Payer: PACE SWMI |
$18.59
|
| Rate for Payer: PACE SWMI |
$19.28
|
| Rate for Payer: PACE SWMI |
$21.57
|
| Rate for Payer: PHP Commercial |
$63.21
|
| Rate for Payer: PHP Commercial |
$55.28
|
| Rate for Payer: PHP Commercial |
$46.36
|
| Rate for Payer: PHP Commercial |
$51.12
|
| Rate for Payer: PHP Commercial |
$115.84
|
| Rate for Payer: PHP Commercial |
$57.06
|
| Rate for Payer: PHP Commercial |
$65.55
|
| Rate for Payer: PHP Commercial |
$53.49
|
| Rate for Payer: PHP Commercial |
$70.23
|
| Rate for Payer: PHP Commercial |
$87.40
|
| Rate for Payer: PHP Commercial |
$73.36
|
| Rate for Payer: PHP Medicare Advantage |
$18.59
|
| Rate for Payer: PHP Medicare Advantage |
$19.28
|
| Rate for Payer: PHP Medicare Advantage |
$25.70
|
| Rate for Payer: PHP Medicare Advantage |
$16.26
|
| Rate for Payer: PHP Medicare Advantage |
$13.63
|
| Rate for Payer: PHP Medicare Advantage |
$21.57
|
| Rate for Payer: PHP Medicare Advantage |
$15.04
|
| Rate for Payer: PHP Medicare Advantage |
$34.07
|
| Rate for Payer: PHP Medicare Advantage |
$15.73
|
| Rate for Payer: PHP Medicare Advantage |
$20.66
|
| Rate for Payer: PHP Medicare Advantage |
$16.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$89.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$67.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$118.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.58
|
| Rate for Payer: Priority Health Medicare |
$16.42
|
| Rate for Payer: Priority Health Medicare |
$15.19
|
| Rate for Payer: Priority Health Medicare |
$19.47
|
| Rate for Payer: Priority Health Medicare |
$21.79
|
| Rate for Payer: Priority Health Medicare |
$20.86
|
| Rate for Payer: Priority Health Medicare |
$13.77
|
| Rate for Payer: Priority Health Medicare |
$15.89
|
| Rate for Payer: Priority Health Medicare |
$34.41
|
| Rate for Payer: Priority Health Medicare |
$18.78
|
| Rate for Payer: Priority Health Medicare |
$25.96
|
| Rate for Payer: Priority Health Medicare |
$16.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.96
|
| Rate for Payer: Railroad Medicare Medicare |
$15.73
|
| Rate for Payer: Railroad Medicare Medicare |
$18.59
|
| Rate for Payer: Railroad Medicare Medicare |
$16.26
|
| Rate for Payer: Railroad Medicare Medicare |
$21.57
|
| Rate for Payer: Railroad Medicare Medicare |
$25.70
|
| Rate for Payer: Railroad Medicare Medicare |
$15.04
|
| Rate for Payer: Railroad Medicare Medicare |
$19.28
|
| Rate for Payer: Railroad Medicare Medicare |
$16.78
|
| Rate for Payer: Railroad Medicare Medicare |
$20.66
|
| Rate for Payer: Railroad Medicare Medicare |
$34.07
|
| Rate for Payer: Railroad Medicare Medicare |
$13.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.23
|
| Rate for Payer: UHC Core |
$56.05
|
| Rate for Payer: UHC Core |
$64.40
|
| Rate for Payer: UHC Core |
$68.99
|
| Rate for Payer: UHC Core |
$50.22
|
| Rate for Payer: UHC Core |
$62.09
|
| Rate for Payer: UHC Core |
$52.55
|
| Rate for Payer: UHC Core |
$45.54
|
| Rate for Payer: UHC Core |
$113.79
|
| Rate for Payer: UHC Core |
$54.30
|
| Rate for Payer: UHC Core |
$72.06
|
| Rate for Payer: UHC Core |
$85.85
|
| Rate for Payer: UHC Exchange |
$15.04
|
| Rate for Payer: UHC Exchange |
$19.28
|
| Rate for Payer: UHC Exchange |
$34.07
|
| Rate for Payer: UHC Exchange |
$16.26
|
| Rate for Payer: UHC Exchange |
$18.59
|
| Rate for Payer: UHC Exchange |
$25.70
|
| Rate for Payer: UHC Exchange |
$13.63
|
| Rate for Payer: UHC Exchange |
$20.66
|
| Rate for Payer: UHC Exchange |
$16.78
|
| Rate for Payer: UHC Exchange |
$21.57
|
| Rate for Payer: UHC Exchange |
$15.73
|
| Rate for Payer: UHC Medicaid |
$10.60
|
| Rate for Payer: UHC Medicaid |
$11.46
|
| Rate for Payer: UHC Medicaid |
$13.11
|
| Rate for Payer: UHC Medicaid |
$11.09
|
| Rate for Payer: UHC Medicaid |
$11.84
|
| Rate for Payer: UHC Medicaid |
$13.60
|
| Rate for Payer: UHC Medicaid |
$9.62
|
| Rate for Payer: UHC Medicaid |
$24.03
|
| Rate for Payer: UHC Medicaid |
$14.57
|
| Rate for Payer: UHC Medicaid |
$18.13
|
| Rate for Payer: UHC Medicaid |
$15.21
|
| Rate for Payer: UHC Medicare Advantage |
$15.04
|
| Rate for Payer: UHC Medicare Advantage |
$18.59
|
| Rate for Payer: UHC Medicare Advantage |
$19.28
|
| Rate for Payer: UHC Medicare Advantage |
$25.70
|
| Rate for Payer: UHC Medicare Advantage |
$15.73
|
| Rate for Payer: UHC Medicare Advantage |
$20.66
|
| Rate for Payer: UHC Medicare Advantage |
$16.78
|
| Rate for Payer: UHC Medicare Advantage |
$21.57
|
| Rate for Payer: UHC Medicare Advantage |
$34.07
|
| Rate for Payer: UHC Medicare Advantage |
$16.26
|
| Rate for Payer: UHC Medicare Advantage |
$13.63
|
| Rate for Payer: UHCCP Medicaid |
$14.57
|
| Rate for Payer: UHCCP Medicaid |
$11.46
|
| Rate for Payer: UHCCP Medicaid |
$24.03
|
| Rate for Payer: UHCCP Medicaid |
$13.60
|
| Rate for Payer: UHCCP Medicaid |
$18.13
|
| Rate for Payer: UHCCP Medicaid |
$11.84
|
| Rate for Payer: UHCCP Medicaid |
$10.60
|
| Rate for Payer: UHCCP Medicaid |
$11.09
|
| Rate for Payer: UHCCP Medicaid |
$9.62
|
| Rate for Payer: UHCCP Medicaid |
$13.11
|
| Rate for Payer: UHCCP Medicaid |
$15.21
|
| Rate for Payer: VA VA |
$15.04
|
| Rate for Payer: VA VA |
$16.78
|
| Rate for Payer: VA VA |
$34.07
|
| Rate for Payer: VA VA |
$15.73
|
| Rate for Payer: VA VA |
$16.26
|
| Rate for Payer: VA VA |
$25.70
|
| Rate for Payer: VA VA |
$18.59
|
| Rate for Payer: VA VA |
$20.66
|
| Rate for Payer: VA VA |
$21.57
|
| Rate for Payer: VA VA |
$19.28
|
| Rate for Payer: VA VA |
$13.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.77
|
|
|
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION
|
Facility
|
IP
|
$136.28
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
11150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$94.85 |
| Max. Negotiated Rate |
$122.65 |
| Rate for Payer: Aetna Commercial |
$115.84
|
| Rate for Payer: Aetna Commercial |
$51.12
|
| Rate for Payer: Aetna Commercial |
$87.40
|
| Rate for Payer: Aetna Commercial |
$55.28
|
| Rate for Payer: Aetna Commercial |
$57.06
|
| Rate for Payer: Aetna Commercial |
$53.49
|
| Rate for Payer: Aetna Commercial |
$63.21
|
| Rate for Payer: Aetna Commercial |
$65.55
|
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Commercial |
$73.36
|
| Rate for Payer: Aetna Commercial |
$46.36
|
| Rate for Payer: BCBS Trust/PPO |
$55.44
|
| Rate for Payer: BCBS Trust/PPO |
$61.41
|
| Rate for Payer: BCBS Trust/PPO |
$45.04
|
| Rate for Payer: BCBS Trust/PPO |
$71.28
|
| Rate for Payer: BCBS Trust/PPO |
$53.71
|
| Rate for Payer: BCBS Trust/PPO |
$49.67
|
| Rate for Payer: BCBS Trust/PPO |
$112.55
|
| Rate for Payer: BCBS Trust/PPO |
$84.92
|
| Rate for Payer: BCBS Trust/PPO |
$68.24
|
| Rate for Payer: BCBS Trust/PPO |
$51.97
|
| Rate for Payer: BCBS Trust/PPO |
$63.69
|
| Rate for Payer: BCN Commercial |
$49.67
|
| Rate for Payer: BCN Commercial |
$53.71
|
| Rate for Payer: BCN Commercial |
$55.44
|
| Rate for Payer: BCN Commercial |
$51.97
|
| Rate for Payer: BCN Commercial |
$63.69
|
| Rate for Payer: BCN Commercial |
$68.24
|
| Rate for Payer: BCN Commercial |
$71.28
|
| Rate for Payer: BCN Commercial |
$61.41
|
| Rate for Payer: BCN Commercial |
$45.04
|
| Rate for Payer: BCN Commercial |
$84.92
|
| Rate for Payer: BCN Commercial |
$112.55
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cash Price |
$109.02
|
| Rate for Payer: Cash Price |
$43.63
|
| Rate for Payer: Cash Price |
$48.11
|
| Rate for Payer: Cash Price |
$82.26
|
| Rate for Payer: Cash Price |
$69.04
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cash Price |
$61.70
|
| Rate for Payer: Cash Price |
$59.49
|
| Rate for Payer: Cash Price |
$50.34
|
| Rate for Payer: Cash Price |
$53.70
|
| Rate for Payer: Cofinity Commercial |
$88.43
|
| Rate for Payer: Cofinity Commercial |
$57.73
|
| Rate for Payer: Cofinity Commercial |
$55.93
|
| Rate for Payer: Cofinity Commercial |
$74.22
|
| Rate for Payer: Cofinity Commercial |
$51.72
|
| Rate for Payer: Cofinity Commercial |
$66.32
|
| Rate for Payer: Cofinity Commercial |
$63.95
|
| Rate for Payer: Cofinity Commercial |
$117.20
|
| Rate for Payer: Cofinity Commercial |
$54.12
|
| Rate for Payer: Cofinity Commercial |
$71.05
|
| Rate for Payer: Cofinity Commercial |
$46.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.02
|
| Rate for Payer: Healthscope Commercial |
$69.41
|
| Rate for Payer: Healthscope Commercial |
$74.36
|
| Rate for Payer: Healthscope Commercial |
$92.54
|
| Rate for Payer: Healthscope Commercial |
$49.09
|
| Rate for Payer: Healthscope Commercial |
$122.65
|
| Rate for Payer: Healthscope Commercial |
$60.42
|
| Rate for Payer: Healthscope Commercial |
$66.92
|
| Rate for Payer: Healthscope Commercial |
$77.67
|
| Rate for Payer: Healthscope Commercial |
$56.64
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Healthscope Commercial |
$54.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.36
|
| Rate for Payer: Nomi Health Commercial |
$49.31
|
| Rate for Payer: Nomi Health Commercial |
$63.24
|
| Rate for Payer: Nomi Health Commercial |
$53.32
|
| Rate for Payer: Nomi Health Commercial |
$51.60
|
| Rate for Payer: Nomi Health Commercial |
$60.98
|
| Rate for Payer: Nomi Health Commercial |
$55.05
|
| Rate for Payer: Nomi Health Commercial |
$67.75
|
| Rate for Payer: Nomi Health Commercial |
$70.77
|
| Rate for Payer: Nomi Health Commercial |
$84.31
|
| Rate for Payer: Nomi Health Commercial |
$111.75
|
| Rate for Payer: Nomi Health Commercial |
$44.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.84
|
| Rate for Payer: PHP Commercial |
$87.40
|
| Rate for Payer: PHP Commercial |
$65.55
|
| Rate for Payer: PHP Commercial |
$53.49
|
| Rate for Payer: PHP Commercial |
$57.06
|
| Rate for Payer: PHP Commercial |
$55.28
|
| Rate for Payer: PHP Commercial |
$63.21
|
| Rate for Payer: PHP Commercial |
$70.23
|
| Rate for Payer: PHP Commercial |
$51.12
|
| Rate for Payer: PHP Commercial |
$115.84
|
| Rate for Payer: PHP Commercial |
$46.36
|
| Rate for Payer: PHP Commercial |
$73.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$89.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$67.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$118.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.44
|
| Rate for Payer: UHC Core |
$64.40
|
| Rate for Payer: UHC Core |
$113.79
|
| Rate for Payer: UHC Core |
$72.06
|
| Rate for Payer: UHC Core |
$62.09
|
| Rate for Payer: UHC Core |
$45.54
|
| Rate for Payer: UHC Core |
$54.30
|
| Rate for Payer: UHC Core |
$68.99
|
| Rate for Payer: UHC Core |
$85.85
|
| Rate for Payer: UHC Core |
$50.22
|
| Rate for Payer: UHC Core |
$56.05
|
| Rate for Payer: UHC Core |
$52.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.77
|
|
|
PROPOFOL 10 MG/ML IV (CODE)
|
Facility
|
IP
|
$65.03
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
163729
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$45.26 |
| Max. Negotiated Rate |
$58.53 |
| Rate for Payer: Aetna Commercial |
$55.28
|
| Rate for Payer: BCBS Trust/PPO |
$53.71
|
| Rate for Payer: BCN Commercial |
$53.71
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cofinity Commercial |
$55.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.02
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.28
|
| Rate for Payer: Nomi Health Commercial |
$53.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.77
|
| Rate for Payer: PHP Commercial |
$55.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.23
|
| Rate for Payer: UHC Core |
$54.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.77
|
|
|
PROPOFOL 10 MG/ML IV (CODE)
|
Facility
|
OP
|
$65.03
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
163729
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.46 |
| Max. Negotiated Rate |
$58.53 |
| Rate for Payer: Aetna Commercial |
$55.28
|
| Rate for Payer: Aetna Medicare |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.32
|
| Rate for Payer: BCBS Complete |
$12.04
|
| Rate for Payer: BCBS MAPPO |
$16.26
|
| Rate for Payer: BCBS Trust/PPO |
$53.46
|
| Rate for Payer: BCN Commercial |
$53.46
|
| Rate for Payer: BCN Medicare Advantage |
$16.26
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cofinity Commercial |
$55.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.26
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.77
|
| Rate for Payer: Mclaren Medicaid |
$11.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.07
|
| Rate for Payer: Meridian Medicaid |
$12.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.28
|
| Rate for Payer: Nomi Health Commercial |
$53.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.77
|
| Rate for Payer: PACE Senior Care Partners |
$15.44
|
| Rate for Payer: PACE SWMI |
$16.26
|
| Rate for Payer: PHP Commercial |
$55.28
|
| Rate for Payer: PHP Medicare Advantage |
$16.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.58
|
| Rate for Payer: Priority Health Medicare |
$16.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.26
|
| Rate for Payer: Railroad Medicare Medicare |
$16.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.23
|
| Rate for Payer: UHC Core |
$54.30
|
| Rate for Payer: UHC Exchange |
$16.26
|
| Rate for Payer: UHC Medicaid |
$11.46
|
| Rate for Payer: UHC Medicare Advantage |
$16.26
|
| Rate for Payer: UHCCP Medicaid |
$11.46
|
| Rate for Payer: VA VA |
$16.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.77
|
|
|
PR OPPONENSPLASTY OTHER METHODS
|
Professional
|
Both
|
$3,702.00
|
|
|
Service Code
|
HCPCS 26496
|
| Min. Negotiated Rate |
$561.68 |
| Max. Negotiated Rate |
$2,776.50 |
| Rate for Payer: Aetna Commercial |
$1,203.70
|
| Rate for Payer: Aetna Medicare |
$1,851.00
|
| Rate for Payer: BCBS Complete |
$589.76
|
| Rate for Payer: BCN Commercial |
$1,367.46
|
| Rate for Payer: Cash Price |
$2,961.60
|
| Rate for Payer: Cash Price |
$2,961.60
|
| Rate for Payer: Mclaren Medicaid |
$561.68
|
| Rate for Payer: Meridian Medicaid |
$589.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,776.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$561.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,461.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,461.76
|
| Rate for Payer: UHC Medicaid |
$561.68
|
| Rate for Payer: UHCCP Medicaid |
$561.68
|
|
|
PR OPPONENSPLASTY SUPFCIS TDN TR TYP EA TDN
|
Professional
|
Both
|
$2,451.00
|
|
|
Service Code
|
HCPCS 26490
|
| Min. Negotiated Rate |
$523.77 |
| Max. Negotiated Rate |
$1,838.25 |
| Rate for Payer: Aetna Commercial |
$1,112.25
|
| Rate for Payer: Aetna Medicare |
$1,225.50
|
| Rate for Payer: BCBS Complete |
$549.96
|
| Rate for Payer: BCN Commercial |
$1,267.36
|
| Rate for Payer: Cash Price |
$1,960.80
|
| Rate for Payer: Cash Price |
$1,960.80
|
| Rate for Payer: Mclaren Medicaid |
$523.77
|
| Rate for Payer: Meridian Medicaid |
$549.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,838.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$523.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,354.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,354.78
|
| Rate for Payer: UHC Medicaid |
$523.77
|
| Rate for Payer: UHCCP Medicaid |
$523.77
|
|
|
PR OPPONENSPLASTY TDN TR W/GRF EA TDN
|
Professional
|
Both
|
$1,587.00
|
|
|
Service Code
|
HCPCS 26492
|
| Min. Negotiated Rate |
$575.53 |
| Max. Negotiated Rate |
$1,497.44 |
| Rate for Payer: Aetna Commercial |
$1,229.30
|
| Rate for Payer: Aetna Medicare |
$793.50
|
| Rate for Payer: BCBS Complete |
$604.31
|
| Rate for Payer: BCN Commercial |
$1,400.82
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Mclaren Medicaid |
$575.53
|
| Rate for Payer: Meridian Medicaid |
$604.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,190.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$575.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,497.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,497.44
|
| Rate for Payer: UHC Medicaid |
$575.53
|
| Rate for Payer: UHCCP Medicaid |
$575.53
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
OP
|
$352.50
|
|
|
Service Code
|
NDC 00115165901
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$62.15 |
| Max. Negotiated Rate |
$317.25 |
| Rate for Payer: Aetna Commercial |
$299.62
|
| Rate for Payer: Aetna Medicare |
$91.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$110.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$110.16
|
| Rate for Payer: BCBS Complete |
$65.25
|
| Rate for Payer: BCBS MAPPO |
$88.12
|
| Rate for Payer: BCBS Trust/PPO |
$289.79
|
| Rate for Payer: BCN Commercial |
$289.79
|
| Rate for Payer: BCN Medicare Advantage |
$88.12
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cofinity Commercial |
$303.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.12
|
| Rate for Payer: Healthscope Commercial |
$317.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.38
|
| Rate for Payer: Mclaren Medicaid |
$62.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.53
|
| Rate for Payer: Meridian Medicaid |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$101.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$96.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.62
|
| Rate for Payer: Nomi Health Commercial |
$289.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$264.38
|
| Rate for Payer: PACE Senior Care Partners |
$83.72
|
| Rate for Payer: PACE SWMI |
$88.12
|
| Rate for Payer: PHP Commercial |
$299.62
|
| Rate for Payer: PHP Medicare Advantage |
$88.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$306.68
|
| Rate for Payer: Priority Health Medicare |
$89.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$245.34
|
| Rate for Payer: Railroad Medicare Medicare |
$88.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.20
|
| Rate for Payer: UHC Core |
$294.34
|
| Rate for Payer: UHC Exchange |
$88.12
|
| Rate for Payer: UHC Medicaid |
$62.15
|
| Rate for Payer: UHC Medicare Advantage |
$88.12
|
| Rate for Payer: UHCCP Medicaid |
$62.15
|
| Rate for Payer: VA VA |
$88.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.38
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
OP
|
$357.20
|
|
|
Service Code
|
NDC 00904655061
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$62.97 |
| Max. Negotiated Rate |
$321.48 |
| Rate for Payer: Aetna Commercial |
$303.62
|
| Rate for Payer: Aetna Medicare |
$92.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.62
|
| Rate for Payer: BCBS Complete |
$66.12
|
| Rate for Payer: BCBS MAPPO |
$89.30
|
| Rate for Payer: BCBS Trust/PPO |
$293.65
|
| Rate for Payer: BCN Commercial |
$293.65
|
| Rate for Payer: BCN Medicare Advantage |
$89.30
|
| Rate for Payer: Cash Price |
$285.76
|
| Rate for Payer: Cofinity Commercial |
$307.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.30
|
| Rate for Payer: Healthscope Commercial |
$321.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.90
|
| Rate for Payer: Mclaren Medicaid |
$62.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.77
|
| Rate for Payer: Meridian Medicaid |
$66.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.62
|
| Rate for Payer: Nomi Health Commercial |
$292.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.90
|
| Rate for Payer: PACE Senior Care Partners |
$84.83
|
| Rate for Payer: PACE SWMI |
$89.30
|
| Rate for Payer: PHP Commercial |
$303.62
|
| Rate for Payer: PHP Medicare Advantage |
$89.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$310.76
|
| Rate for Payer: Priority Health Medicare |
$90.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$248.61
|
| Rate for Payer: Railroad Medicare Medicare |
$89.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.34
|
| Rate for Payer: UHC Core |
$298.26
|
| Rate for Payer: UHC Exchange |
$89.30
|
| Rate for Payer: UHC Medicaid |
$62.97
|
| Rate for Payer: UHC Medicare Advantage |
$89.30
|
| Rate for Payer: UHCCP Medicaid |
$62.97
|
| Rate for Payer: VA VA |
$89.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.90
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
IP
|
$245.10
|
|
|
Service Code
|
NDC 60687058701
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$170.59 |
| Max. Negotiated Rate |
$220.59 |
| Rate for Payer: Aetna Commercial |
$208.34
|
| Rate for Payer: BCBS Trust/PPO |
$202.43
|
| Rate for Payer: BCN Commercial |
$202.43
|
| Rate for Payer: Cash Price |
$196.08
|
| Rate for Payer: Cofinity Commercial |
$210.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.08
|
| Rate for Payer: Healthscope Commercial |
$220.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.34
|
| Rate for Payer: Nomi Health Commercial |
$200.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.82
|
| Rate for Payer: PHP Commercial |
$208.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$213.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.69
|
| Rate for Payer: UHC Core |
$204.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.82
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
IP
|
$2.46
|
|
|
Service Code
|
NDC 60687058711
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.71 |
| Max. Negotiated Rate |
$2.21 |
| Rate for Payer: Aetna Commercial |
$2.09
|
| Rate for Payer: BCBS Trust/PPO |
$2.03
|
| Rate for Payer: BCN Commercial |
$2.03
|
| Rate for Payer: Cash Price |
$1.97
|
| Rate for Payer: Cofinity Commercial |
$2.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.97
|
| Rate for Payer: Healthscope Commercial |
$2.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.09
|
| Rate for Payer: Nomi Health Commercial |
$2.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.84
|
| Rate for Payer: PHP Commercial |
$2.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.16
|
| Rate for Payer: UHC Core |
$2.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.84
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
IP
|
$357.20
|
|
|
Service Code
|
NDC 00904655061
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$248.61 |
| Max. Negotiated Rate |
$321.48 |
| Rate for Payer: Aetna Commercial |
$303.62
|
| Rate for Payer: BCBS Trust/PPO |
$295.01
|
| Rate for Payer: BCN Commercial |
$295.01
|
| Rate for Payer: Cash Price |
$285.76
|
| Rate for Payer: Cofinity Commercial |
$307.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.76
|
| Rate for Payer: Healthscope Commercial |
$321.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.62
|
| Rate for Payer: Nomi Health Commercial |
$292.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.90
|
| Rate for Payer: PHP Commercial |
$303.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$310.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$248.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.34
|
| Rate for Payer: UHC Core |
$298.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.90
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
OP
|
$2.46
|
|
|
Service Code
|
NDC 60687058711
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$2.21 |
| Rate for Payer: Aetna Commercial |
$2.09
|
| Rate for Payer: Aetna Medicare |
$0.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.77
|
| Rate for Payer: BCBS Complete |
$0.46
|
| Rate for Payer: BCBS MAPPO |
$0.62
|
| Rate for Payer: BCBS Trust/PPO |
$2.02
|
| Rate for Payer: BCN Commercial |
$2.02
|
| Rate for Payer: BCN Medicare Advantage |
$0.62
|
| Rate for Payer: Cash Price |
$1.97
|
| Rate for Payer: Cofinity Commercial |
$2.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.62
|
| Rate for Payer: Healthscope Commercial |
$2.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.84
|
| Rate for Payer: Mclaren Medicaid |
$0.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.65
|
| Rate for Payer: Meridian Medicaid |
$0.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.09
|
| Rate for Payer: Nomi Health Commercial |
$2.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.84
|
| Rate for Payer: PACE Senior Care Partners |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.62
|
| Rate for Payer: PHP Commercial |
$2.09
|
| Rate for Payer: PHP Medicare Advantage |
$0.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.14
|
| Rate for Payer: Priority Health Medicare |
$0.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.71
|
| Rate for Payer: Railroad Medicare Medicare |
$0.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.16
|
| Rate for Payer: UHC Core |
$2.05
|
| Rate for Payer: UHC Exchange |
$0.62
|
| Rate for Payer: UHC Medicaid |
$0.43
|
| Rate for Payer: UHC Medicare Advantage |
$0.62
|
| Rate for Payer: UHCCP Medicaid |
$0.43
|
| Rate for Payer: VA VA |
$0.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.84
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
IP
|
$352.50
|
|
|
Service Code
|
NDC 00115165901
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$245.34 |
| Max. Negotiated Rate |
$317.25 |
| Rate for Payer: Aetna Commercial |
$299.62
|
| Rate for Payer: BCBS Trust/PPO |
$291.13
|
| Rate for Payer: BCN Commercial |
$291.13
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cofinity Commercial |
$303.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.00
|
| Rate for Payer: Healthscope Commercial |
$317.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.62
|
| Rate for Payer: Nomi Health Commercial |
$289.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$264.38
|
| Rate for Payer: PHP Commercial |
$299.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$306.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$245.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.20
|
| Rate for Payer: UHC Core |
$294.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.38
|
|
|
PROPRANOLOL 10 MG TABLET
|
Facility
|
OP
|
$245.10
|
|
|
Service Code
|
NDC 60687058701
|
| Hospital Charge Code |
6656
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.21 |
| Max. Negotiated Rate |
$220.59 |
| Rate for Payer: Aetna Commercial |
$208.34
|
| Rate for Payer: Aetna Medicare |
$63.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.59
|
| Rate for Payer: BCBS Complete |
$45.37
|
| Rate for Payer: BCBS MAPPO |
$61.27
|
| Rate for Payer: BCBS Trust/PPO |
$201.50
|
| Rate for Payer: BCN Commercial |
$201.50
|
| Rate for Payer: BCN Medicare Advantage |
$61.27
|
| Rate for Payer: Cash Price |
$196.08
|
| Rate for Payer: Cofinity Commercial |
$210.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.27
|
| Rate for Payer: Healthscope Commercial |
$220.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.82
|
| Rate for Payer: Mclaren Medicaid |
$43.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.34
|
| Rate for Payer: Meridian Medicaid |
$45.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.34
|
| Rate for Payer: Nomi Health Commercial |
$200.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.82
|
| Rate for Payer: PACE Senior Care Partners |
$58.21
|
| Rate for Payer: PACE SWMI |
$61.27
|
| Rate for Payer: PHP Commercial |
$208.34
|
| Rate for Payer: PHP Medicare Advantage |
$61.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$213.24
|
| Rate for Payer: Priority Health Medicare |
$61.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.59
|
| Rate for Payer: Railroad Medicare Medicare |
$61.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.69
|
| Rate for Payer: UHC Core |
$204.66
|
| Rate for Payer: UHC Exchange |
$61.27
|
| Rate for Payer: UHC Medicaid |
$43.21
|
| Rate for Payer: UHC Medicare Advantage |
$61.27
|
| Rate for Payer: UHCCP Medicaid |
$43.21
|
| Rate for Payer: VA VA |
$61.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.82
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
OP
|
$422.75
|
|
|
Service Code
|
NDC 60687059801
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$74.53 |
| Max. Negotiated Rate |
$380.48 |
| Rate for Payer: Aetna Commercial |
$359.34
|
| Rate for Payer: Aetna Medicare |
$109.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$132.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$132.11
|
| Rate for Payer: BCBS Complete |
$78.25
|
| Rate for Payer: BCBS MAPPO |
$105.69
|
| Rate for Payer: BCBS Trust/PPO |
$347.54
|
| Rate for Payer: BCN Commercial |
$347.54
|
| Rate for Payer: BCN Medicare Advantage |
$105.69
|
| Rate for Payer: Cash Price |
$338.20
|
| Rate for Payer: Cofinity Commercial |
$363.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.69
|
| Rate for Payer: Healthscope Commercial |
$380.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.06
|
| Rate for Payer: Mclaren Medicaid |
$74.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.97
|
| Rate for Payer: Meridian Medicaid |
$78.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$116.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.34
|
| Rate for Payer: Nomi Health Commercial |
$346.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$317.06
|
| Rate for Payer: PACE Senior Care Partners |
$100.40
|
| Rate for Payer: PACE SWMI |
$105.69
|
| Rate for Payer: PHP Commercial |
$359.34
|
| Rate for Payer: PHP Medicare Advantage |
$105.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$367.79
|
| Rate for Payer: Priority Health Medicare |
$106.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.23
|
| Rate for Payer: Railroad Medicare Medicare |
$105.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.02
|
| Rate for Payer: UHC Core |
$353.00
|
| Rate for Payer: UHC Exchange |
$105.69
|
| Rate for Payer: UHC Medicaid |
$74.53
|
| Rate for Payer: UHC Medicare Advantage |
$105.69
|
| Rate for Payer: UHCCP Medicaid |
$74.53
|
| Rate for Payer: VA VA |
$105.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.06
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
OP
|
$279.30
|
|
|
Service Code
|
NDC 00904670561
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.24 |
| Max. Negotiated Rate |
$251.37 |
| Rate for Payer: Aetna Commercial |
$237.41
|
| Rate for Payer: Aetna Medicare |
$72.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.28
|
| Rate for Payer: BCBS Complete |
$51.70
|
| Rate for Payer: BCBS MAPPO |
$69.83
|
| Rate for Payer: BCBS Trust/PPO |
$229.61
|
| Rate for Payer: BCN Commercial |
$229.61
|
| Rate for Payer: BCN Medicare Advantage |
$69.83
|
| Rate for Payer: Cash Price |
$223.44
|
| Rate for Payer: Cofinity Commercial |
$240.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.83
|
| Rate for Payer: Healthscope Commercial |
$251.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.47
|
| Rate for Payer: Mclaren Medicaid |
$49.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.32
|
| Rate for Payer: Meridian Medicaid |
$51.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.41
|
| Rate for Payer: Nomi Health Commercial |
$229.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$209.47
|
| Rate for Payer: PACE Senior Care Partners |
$66.33
|
| Rate for Payer: PACE SWMI |
$69.83
|
| Rate for Payer: PHP Commercial |
$237.41
|
| Rate for Payer: PHP Medicare Advantage |
$69.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$242.99
|
| Rate for Payer: Priority Health Medicare |
$70.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$194.39
|
| Rate for Payer: Railroad Medicare Medicare |
$69.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.78
|
| Rate for Payer: UHC Core |
$233.22
|
| Rate for Payer: UHC Exchange |
$69.83
|
| Rate for Payer: UHC Medicaid |
$49.24
|
| Rate for Payer: UHC Medicare Advantage |
$69.83
|
| Rate for Payer: UHCCP Medicaid |
$49.24
|
| Rate for Payer: VA VA |
$69.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.47
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
OP
|
$315.40
|
|
|
Service Code
|
NDC 00378018301
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$55.61 |
| Max. Negotiated Rate |
$283.86 |
| Rate for Payer: Aetna Commercial |
$268.09
|
| Rate for Payer: Aetna Medicare |
$82.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.56
|
| Rate for Payer: BCBS Complete |
$58.38
|
| Rate for Payer: BCBS MAPPO |
$78.85
|
| Rate for Payer: BCBS Trust/PPO |
$259.29
|
| Rate for Payer: BCN Commercial |
$259.29
|
| Rate for Payer: BCN Medicare Advantage |
$78.85
|
| Rate for Payer: Cash Price |
$252.32
|
| Rate for Payer: Cofinity Commercial |
$271.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.85
|
| Rate for Payer: Healthscope Commercial |
$283.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.55
|
| Rate for Payer: Mclaren Medicaid |
$55.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.79
|
| Rate for Payer: Meridian Medicaid |
$58.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.09
|
| Rate for Payer: Nomi Health Commercial |
$258.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.55
|
| Rate for Payer: PACE Senior Care Partners |
$74.91
|
| Rate for Payer: PACE SWMI |
$78.85
|
| Rate for Payer: PHP Commercial |
$268.09
|
| Rate for Payer: PHP Medicare Advantage |
$78.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.40
|
| Rate for Payer: Priority Health Medicare |
$79.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.52
|
| Rate for Payer: Railroad Medicare Medicare |
$78.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.55
|
| Rate for Payer: UHC Core |
$263.36
|
| Rate for Payer: UHC Exchange |
$78.85
|
| Rate for Payer: UHC Medicaid |
$55.61
|
| Rate for Payer: UHC Medicare Advantage |
$78.85
|
| Rate for Payer: UHCCP Medicaid |
$55.61
|
| Rate for Payer: VA VA |
$78.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.55
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
IP
|
$422.75
|
|
|
Service Code
|
NDC 60687059801
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$294.23 |
| Max. Negotiated Rate |
$380.48 |
| Rate for Payer: Aetna Commercial |
$359.34
|
| Rate for Payer: BCBS Trust/PPO |
$349.15
|
| Rate for Payer: BCN Commercial |
$349.15
|
| Rate for Payer: Cash Price |
$338.20
|
| Rate for Payer: Cofinity Commercial |
$363.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.20
|
| Rate for Payer: Healthscope Commercial |
$380.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.34
|
| Rate for Payer: Nomi Health Commercial |
$346.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$317.06
|
| Rate for Payer: PHP Commercial |
$359.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$367.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.02
|
| Rate for Payer: UHC Core |
$353.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.06
|
|
|
PROPRANOLOL 20 MG TABLET
|
Facility
|
IP
|
$315.40
|
|
|
Service Code
|
NDC 00378018301
|
| Hospital Charge Code |
6657
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$219.52 |
| Max. Negotiated Rate |
$283.86 |
| Rate for Payer: Aetna Commercial |
$268.09
|
| Rate for Payer: BCBS Trust/PPO |
$260.49
|
| Rate for Payer: BCN Commercial |
$260.49
|
| Rate for Payer: Cash Price |
$252.32
|
| Rate for Payer: Cofinity Commercial |
$271.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.32
|
| Rate for Payer: Healthscope Commercial |
$283.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.09
|
| Rate for Payer: Nomi Health Commercial |
$258.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.55
|
| Rate for Payer: PHP Commercial |
$268.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.55
|
| Rate for Payer: UHC Core |
$263.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.55
|
|
