Bronson Lakeview Hospital

All Charges

Charge

Type

Setting

Price

EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES

Facility

$4,488.04

Service Code	APR-DRG 1101
Min. Negotiated Rate	$4,274.33
Max. Negotiated Rate	$4,488.04
Rate for Payer: BCBS Complete	$4,488.04
Rate for Payer: Mclaren Medicaid	$4,274.33
Rate for Payer: Meridian Medicaid	$4,488.04
Rate for Payer: Priority Health Choice Medicaid	$4,274.33
Rate for Payer: UHC Medicaid	$4,274.33
Rate for Payer: UHCCP Medicaid	$4,274.33

EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES

Facility

$4,964.46

Service Code	APR-DRG 1102
Min. Negotiated Rate	$4,728.05
Max. Negotiated Rate	$4,964.46
Rate for Payer: BCBS Complete	$4,964.46
Rate for Payer: Mclaren Medicaid	$4,728.05
Rate for Payer: Meridian Medicaid	$4,964.46
Rate for Payer: Priority Health Choice Medicaid	$4,728.05
Rate for Payer: UHC Medicaid	$4,728.05
Rate for Payer: UHCCP Medicaid	$4,728.05

EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES

Facility

$12,781.07

Service Code	APR-DRG 1104
Min. Negotiated Rate	$12,172.44
Max. Negotiated Rate	$12,781.07
Rate for Payer: BCBS Complete	$12,781.07
Rate for Payer: Mclaren Medicaid	$12,172.44
Rate for Payer: Meridian Medicaid	$12,781.07
Rate for Payer: Priority Health Choice Medicaid	$12,172.44
Rate for Payer: UHC Medicaid	$12,172.44
Rate for Payer: UHCCP Medicaid	$12,172.44

EATING DISORDERS

Facility

$20,603.46

Service Code	APR-DRG 7594
Min. Negotiated Rate	$19,622.35
Max. Negotiated Rate	$20,603.46
Rate for Payer: BCBS Complete	$20,603.46
Rate for Payer: Mclaren Medicaid	$19,622.35
Rate for Payer: Meridian Medicaid	$20,603.46
Rate for Payer: Priority Health Choice Medicaid	$19,622.35
Rate for Payer: UHC Medicaid	$19,622.35
Rate for Payer: UHCCP Medicaid	$19,622.35

EATING DISORDERS

Facility

$10,194.99

Service Code	APR-DRG 7593
Min. Negotiated Rate	$9,709.51
Max. Negotiated Rate	$10,194.99
Rate for Payer: BCBS Complete	$10,194.99
Rate for Payer: Mclaren Medicaid	$9,709.51
Rate for Payer: Meridian Medicaid	$10,194.99
Rate for Payer: Priority Health Choice Medicaid	$9,709.51
Rate for Payer: UHC Medicaid	$9,709.51
Rate for Payer: UHCCP Medicaid	$9,709.51

EATING DISORDERS

Facility

$5,244.20

Service Code	APR-DRG 7591
Min. Negotiated Rate	$4,994.48
Max. Negotiated Rate	$5,244.20
Rate for Payer: BCBS Complete	$5,244.20
Rate for Payer: Mclaren Medicaid	$4,994.48
Rate for Payer: Meridian Medicaid	$5,244.20
Rate for Payer: Priority Health Choice Medicaid	$4,994.48
Rate for Payer: UHC Medicaid	$4,994.48
Rate for Payer: UHCCP Medicaid	$4,994.48

EATING DISORDERS

Facility

$6,557.22

Service Code	APR-DRG 7592
Min. Negotiated Rate	$6,244.98
Max. Negotiated Rate	$6,557.22
Rate for Payer: BCBS Complete	$6,557.22
Rate for Payer: Mclaren Medicaid	$6,244.98
Rate for Payer: Meridian Medicaid	$6,557.22
Rate for Payer: Priority Health Choice Medicaid	$6,244.98
Rate for Payer: UHC Medicaid	$6,244.98
Rate for Payer: UHCCP Medicaid	$6,244.98

ELECTIVE HIP JOINT REPLACEMENT

Facility

$13,847.47

Service Code	APR-DRG 3243
Min. Negotiated Rate	$13,188.07
Max. Negotiated Rate	$13,847.47
Rate for Payer: BCBS Complete	$13,847.47
Rate for Payer: Mclaren Medicaid	$13,188.07
Rate for Payer: Meridian Medicaid	$13,847.47
Rate for Payer: Priority Health Choice Medicaid	$13,188.07
Rate for Payer: UHC Medicaid	$13,188.07
Rate for Payer: UHCCP Medicaid	$13,188.07

ELECTIVE HIP JOINT REPLACEMENT

Facility

$9,700.17

Service Code	APR-DRG 3242
Min. Negotiated Rate	$9,238.26
Max. Negotiated Rate	$9,700.17
Rate for Payer: BCBS Complete	$9,700.17
Rate for Payer: Mclaren Medicaid	$9,238.26
Rate for Payer: Meridian Medicaid	$9,700.17
Rate for Payer: Priority Health Choice Medicaid	$9,238.26
Rate for Payer: UHC Medicaid	$9,238.26
Rate for Payer: UHCCP Medicaid	$9,238.26

ELECTIVE HIP JOINT REPLACEMENT

Facility

$21,177.68

Service Code	APR-DRG 3244
Min. Negotiated Rate	$20,169.22
Max. Negotiated Rate	$21,177.68
Rate for Payer: BCBS Complete	$21,177.68
Rate for Payer: Mclaren Medicaid	$20,169.22
Rate for Payer: Meridian Medicaid	$21,177.68
Rate for Payer: Priority Health Choice Medicaid	$20,169.22
Rate for Payer: UHC Medicaid	$20,169.22
Rate for Payer: UHCCP Medicaid	$20,169.22

ELECTIVE HIP JOINT REPLACEMENT

Facility

$7,881.29

Service Code	APR-DRG 3241
Min. Negotiated Rate	$7,505.99
Max. Negotiated Rate	$7,881.29
Rate for Payer: BCBS Complete	$7,881.29
Rate for Payer: Mclaren Medicaid	$7,505.99
Rate for Payer: Meridian Medicaid	$7,881.29
Rate for Payer: Priority Health Choice Medicaid	$7,505.99
Rate for Payer: UHC Medicaid	$7,505.99
Rate for Payer: UHCCP Medicaid	$7,505.99

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$19,415.06

Service Code	APR-DRG 3264
Min. Negotiated Rate	$18,490.54
Max. Negotiated Rate	$19,415.06
Rate for Payer: BCBS Complete	$19,415.06
Rate for Payer: Mclaren Medicaid	$18,490.54
Rate for Payer: Meridian Medicaid	$19,415.06
Rate for Payer: Priority Health Choice Medicaid	$18,490.54
Rate for Payer: UHC Medicaid	$18,490.54
Rate for Payer: UHCCP Medicaid	$18,490.54

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$7,734.05

Service Code	APR-DRG 3261
Min. Negotiated Rate	$7,365.77
Max. Negotiated Rate	$7,734.05
Rate for Payer: BCBS Complete	$7,734.05
Rate for Payer: Mclaren Medicaid	$7,365.77
Rate for Payer: Meridian Medicaid	$7,734.05
Rate for Payer: Priority Health Choice Medicaid	$7,365.77
Rate for Payer: UHC Medicaid	$7,365.77
Rate for Payer: UHCCP Medicaid	$7,365.77

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$8,883.02

Service Code	APR-DRG 3262
Min. Negotiated Rate	$8,460.01
Max. Negotiated Rate	$8,883.02
Rate for Payer: BCBS Complete	$8,883.02
Rate for Payer: Mclaren Medicaid	$8,460.01
Rate for Payer: Meridian Medicaid	$8,883.02
Rate for Payer: Priority Health Choice Medicaid	$8,460.01
Rate for Payer: UHC Medicaid	$8,460.01
Rate for Payer: UHCCP Medicaid	$8,460.01

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$11,716.24

Service Code	APR-DRG 3263
Min. Negotiated Rate	$11,158.32
Max. Negotiated Rate	$11,716.24
Rate for Payer: BCBS Complete	$11,716.24
Rate for Payer: Mclaren Medicaid	$11,158.32
Rate for Payer: Meridian Medicaid	$11,716.24
Rate for Payer: Priority Health Choice Medicaid	$11,158.32
Rate for Payer: UHC Medicaid	$11,158.32
Rate for Payer: UHCCP Medicaid	$11,158.32

EMPAGLIFLOZIN 10 MG TABLET

Facility

$1,083.92

Service Code	NDC 00597015237
Hospital Charge Code	171967
Hospital Revenue Code	637
Min. Negotiated Rate	$754.41
Max. Negotiated Rate	$975.53
Rate for Payer: Aetna Commercial	$921.33
Rate for Payer: BCBS Trust/PPO	$895.21
Rate for Payer: BCN Commercial	$895.21
Rate for Payer: Cash Price	$867.14
Rate for Payer: Cofinity Commercial	$932.17
Rate for Payer: Encore Health Key Benefits Commercial	$867.14
Rate for Payer: Healthscope Commercial	$975.53
Rate for Payer: Lakeland Regional Health Systems Commercial	$812.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$921.33
Rate for Payer: Nomi Health Commercial	$888.81
Rate for Payer: Opus (Opus Packaging Group) HMA	$812.94
Rate for Payer: PHP Commercial	$921.33
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$943.01
Rate for Payer: Priority Health Narrow/Tiered Network	$754.41
Rate for Payer: UHC All Payor (Choice/PPO)	$953.85
Rate for Payer: UHC Core	$905.07
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$812.94

EMPAGLIFLOZIN 10 MG TABLET

Facility

$1,083.92

Service Code	NDC 00597015237
Hospital Charge Code	171967
Hospital Revenue Code	637
Min. Negotiated Rate	$191.10
Max. Negotiated Rate	$975.53
Rate for Payer: Aetna Commercial	$921.33
Rate for Payer: Aetna Medicare	$281.82
Rate for Payer: Allen County Amish Medical Aid Commercial	$338.73
Rate for Payer: Amish Plain Church Group Commercial	$338.73
Rate for Payer: BCBS Complete	$200.63
Rate for Payer: BCBS MAPPO	$270.98
Rate for Payer: BCBS Trust/PPO	$891.09
Rate for Payer: BCN Commercial	$891.09
Rate for Payer: BCN Medicare Advantage	$270.98
Rate for Payer: Cash Price	$867.14
Rate for Payer: Cofinity Commercial	$932.17
Rate for Payer: Encore Health Key Benefits Commercial	$867.14
Rate for Payer: Health Alliance Plan Medicare Advantage	$270.98
Rate for Payer: Healthscope Commercial	$975.53
Rate for Payer: Lakeland Regional Health Systems Commercial	$812.94
Rate for Payer: Mclaren Medicaid	$191.10
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$284.53
Rate for Payer: Meridian Medicaid	$200.63
Rate for Payer: MI Amish Medical Board Commercial	$311.63
Rate for Payer: Molina Medicare/Medicaid	$298.08
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$921.33
Rate for Payer: Nomi Health Commercial	$888.81
Rate for Payer: Opus (Opus Packaging Group) HMA	$812.94
Rate for Payer: PACE Senior Care Partners	$257.43
Rate for Payer: PACE SWMI	$270.98
Rate for Payer: PHP Commercial	$921.33
Rate for Payer: PHP Medicare Advantage	$270.98
Rate for Payer: Priority Health Choice Medicaid	$191.10
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$943.01
Rate for Payer: Priority Health Medicare	$273.69
Rate for Payer: Priority Health Narrow/Tiered Network	$754.41
Rate for Payer: Railroad Medicare Medicare	$270.98
Rate for Payer: UHC All Payor (Choice/PPO)	$953.85
Rate for Payer: UHC Core	$905.07
Rate for Payer: UHC Exchange	$270.98
Rate for Payer: UHC Medicaid	$191.10
Rate for Payer: UHC Medicare Advantage	$270.98
Rate for Payer: UHCCP Medicaid	$191.10
Rate for Payer: VA VA	$270.98
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$812.94

EMPAGLIFLOZIN 25 MG TABLET

Facility

$1,083.92

Service Code	NDC 00597015337
Hospital Charge Code	171966
Hospital Revenue Code	637
Min. Negotiated Rate	$754.41
Max. Negotiated Rate	$975.53
Rate for Payer: Aetna Commercial	$921.33
Rate for Payer: BCBS Trust/PPO	$895.21
Rate for Payer: BCN Commercial	$895.21
Rate for Payer: Cash Price	$867.14
Rate for Payer: Cofinity Commercial	$932.17
Rate for Payer: Encore Health Key Benefits Commercial	$867.14
Rate for Payer: Healthscope Commercial	$975.53
Rate for Payer: Lakeland Regional Health Systems Commercial	$812.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$921.33
Rate for Payer: Nomi Health Commercial	$888.81
Rate for Payer: Opus (Opus Packaging Group) HMA	$812.94
Rate for Payer: PHP Commercial	$921.33
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$943.01
Rate for Payer: Priority Health Narrow/Tiered Network	$754.41
Rate for Payer: UHC All Payor (Choice/PPO)	$953.85
Rate for Payer: UHC Core	$905.07
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$812.94

EMPAGLIFLOZIN 25 MG TABLET

Facility

$1,083.92

Service Code	NDC 00597015337
Hospital Charge Code	171966
Hospital Revenue Code	637
Min. Negotiated Rate	$191.10
Max. Negotiated Rate	$975.53
Rate for Payer: Aetna Commercial	$921.33
Rate for Payer: Aetna Medicare	$281.82
Rate for Payer: Allen County Amish Medical Aid Commercial	$338.73
Rate for Payer: Amish Plain Church Group Commercial	$338.73
Rate for Payer: BCBS Complete	$200.63
Rate for Payer: BCBS MAPPO	$270.98
Rate for Payer: BCBS Trust/PPO	$891.09
Rate for Payer: BCN Commercial	$891.09
Rate for Payer: BCN Medicare Advantage	$270.98
Rate for Payer: Cash Price	$867.14
Rate for Payer: Cofinity Commercial	$932.17
Rate for Payer: Encore Health Key Benefits Commercial	$867.14
Rate for Payer: Health Alliance Plan Medicare Advantage	$270.98
Rate for Payer: Healthscope Commercial	$975.53
Rate for Payer: Lakeland Regional Health Systems Commercial	$812.94
Rate for Payer: Mclaren Medicaid	$191.10
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$284.53
Rate for Payer: Meridian Medicaid	$200.63
Rate for Payer: MI Amish Medical Board Commercial	$311.63
Rate for Payer: Molina Medicare/Medicaid	$298.08
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$921.33
Rate for Payer: Nomi Health Commercial	$888.81
Rate for Payer: Opus (Opus Packaging Group) HMA	$812.94
Rate for Payer: PACE Senior Care Partners	$257.43
Rate for Payer: PACE SWMI	$270.98
Rate for Payer: PHP Commercial	$921.33
Rate for Payer: PHP Medicare Advantage	$270.98
Rate for Payer: Priority Health Choice Medicaid	$191.10
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$943.01
Rate for Payer: Priority Health Medicare	$273.69
Rate for Payer: Priority Health Narrow/Tiered Network	$754.41
Rate for Payer: Railroad Medicare Medicare	$270.98
Rate for Payer: UHC All Payor (Choice/PPO)	$953.85
Rate for Payer: UHC Core	$905.07
Rate for Payer: UHC Exchange	$270.98
Rate for Payer: UHC Medicaid	$191.10
Rate for Payer: UHC Medicare Advantage	$270.98
Rate for Payer: UHCCP Medicaid	$191.10
Rate for Payer: VA VA	$270.98
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$812.94

EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET

Facility

$6,646.02

Service Code	NDC 61958070101
Hospital Charge Code	39255
Hospital Revenue Code	637
Min. Negotiated Rate	$1,171.69
Max. Negotiated Rate	$5,981.42
Rate for Payer: Aetna Commercial	$5,649.12
Rate for Payer: Aetna Medicare	$1,727.97
Rate for Payer: Allen County Amish Medical Aid Commercial	$2,076.88
Rate for Payer: Amish Plain Church Group Commercial	$2,076.88
Rate for Payer: BCBS Complete	$1,230.18
Rate for Payer: BCBS MAPPO	$1,661.51
Rate for Payer: BCBS Trust/PPO	$5,463.69
Rate for Payer: BCN Commercial	$5,463.69
Rate for Payer: BCN Medicare Advantage	$1,661.51
Rate for Payer: Cash Price	$5,316.82
Rate for Payer: Cofinity Commercial	$5,715.58
Rate for Payer: Encore Health Key Benefits Commercial	$5,316.82
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,661.51
Rate for Payer: Healthscope Commercial	$5,981.42
Rate for Payer: Lakeland Regional Health Systems Commercial	$4,984.52
Rate for Payer: Mclaren Medicaid	$1,171.69
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$1,744.58
Rate for Payer: Meridian Medicaid	$1,230.18
Rate for Payer: MI Amish Medical Board Commercial	$1,910.73
Rate for Payer: Molina Medicare/Medicaid	$1,827.66
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$5,649.12
Rate for Payer: Nomi Health Commercial	$5,449.74
Rate for Payer: Opus (Opus Packaging Group) HMA	$4,984.52
Rate for Payer: PACE Senior Care Partners	$1,578.43
Rate for Payer: PACE SWMI	$1,661.51
Rate for Payer: PHP Commercial	$5,649.12
Rate for Payer: PHP Medicare Advantage	$1,661.51
Rate for Payer: Priority Health Choice Medicaid	$1,171.69
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$5,782.04
Rate for Payer: Priority Health Medicare	$1,678.12
Rate for Payer: Priority Health Narrow/Tiered Network	$4,625.63
Rate for Payer: Railroad Medicare Medicare	$1,661.51
Rate for Payer: UHC All Payor (Choice/PPO)	$5,848.50
Rate for Payer: UHC Core	$5,549.43
Rate for Payer: UHC Exchange	$1,661.51
Rate for Payer: UHC Medicaid	$1,171.69
Rate for Payer: UHC Medicare Advantage	$1,661.51
Rate for Payer: UHCCP Medicaid	$1,171.69
Rate for Payer: VA VA	$1,661.51
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$4,984.52

EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET

Facility

$6,646.02

Service Code	NDC 61958070101
Hospital Charge Code	39255
Hospital Revenue Code	637
Min. Negotiated Rate	$4,625.63
Max. Negotiated Rate	$5,981.42
Rate for Payer: Aetna Commercial	$5,649.12
Rate for Payer: BCBS Trust/PPO	$5,488.95
Rate for Payer: BCN Commercial	$5,488.95
Rate for Payer: Cash Price	$5,316.82
Rate for Payer: Cofinity Commercial	$5,715.58
Rate for Payer: Encore Health Key Benefits Commercial	$5,316.82
Rate for Payer: Healthscope Commercial	$5,981.42
Rate for Payer: Lakeland Regional Health Systems Commercial	$4,984.52
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$5,649.12
Rate for Payer: Nomi Health Commercial	$5,449.74
Rate for Payer: Opus (Opus Packaging Group) HMA	$4,984.52
Rate for Payer: PHP Commercial	$5,649.12
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$5,782.04
Rate for Payer: Priority Health Narrow/Tiered Network	$4,625.63
Rate for Payer: UHC All Payor (Choice/PPO)	$5,848.50
Rate for Payer: UHC Core	$5,549.43
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$4,984.52

ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION

Facility

$29.42

Service Code	NDC 43598007811
Hospital Charge Code	9929
Hospital Revenue Code	250
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$26.48
Rate for Payer: Aetna Commercial	$25.01
Rate for Payer: BCBS Trust/PPO	$24.30
Rate for Payer: BCN Commercial	$24.30
Rate for Payer: Cash Price	$23.54
Rate for Payer: Cofinity Commercial	$25.30
Rate for Payer: Encore Health Key Benefits Commercial	$23.54
Rate for Payer: Healthscope Commercial	$26.48
Rate for Payer: Lakeland Regional Health Systems Commercial	$22.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$25.01
Rate for Payer: Nomi Health Commercial	$24.12
Rate for Payer: Opus (Opus Packaging Group) HMA	$22.07
Rate for Payer: PHP Commercial	$25.01
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$25.60
Rate for Payer: Priority Health Narrow/Tiered Network	$20.48
Rate for Payer: UHC All Payor (Choice/PPO)	$25.89
Rate for Payer: UHC Core	$24.57
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$22.07

ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION

Facility

$29.42

Service Code	NDC 43598007858
Hospital Charge Code	9929
Hospital Revenue Code	250
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$26.48
Rate for Payer: Aetna Commercial	$25.01
Rate for Payer: Aetna Medicare	$7.65
Rate for Payer: Allen County Amish Medical Aid Commercial	$9.19
Rate for Payer: Amish Plain Church Group Commercial	$9.19
Rate for Payer: BCBS Complete	$5.45
Rate for Payer: BCBS MAPPO	$7.36
Rate for Payer: BCBS Trust/PPO	$24.19
Rate for Payer: BCN Commercial	$24.19
Rate for Payer: BCN Medicare Advantage	$7.36
Rate for Payer: Cash Price	$23.54
Rate for Payer: Cofinity Commercial	$25.30
Rate for Payer: Encore Health Key Benefits Commercial	$23.54
Rate for Payer: Health Alliance Plan Medicare Advantage	$7.36
Rate for Payer: Healthscope Commercial	$26.48
Rate for Payer: Lakeland Regional Health Systems Commercial	$22.07
Rate for Payer: Mclaren Medicaid	$5.19
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7.72
Rate for Payer: Meridian Medicaid	$5.45
Rate for Payer: MI Amish Medical Board Commercial	$8.46
Rate for Payer: Molina Medicare/Medicaid	$8.09
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$25.01
Rate for Payer: Nomi Health Commercial	$24.12
Rate for Payer: Opus (Opus Packaging Group) HMA	$22.07
Rate for Payer: PACE Senior Care Partners	$6.99
Rate for Payer: PACE SWMI	$7.36
Rate for Payer: PHP Commercial	$25.01
Rate for Payer: PHP Medicare Advantage	$7.36
Rate for Payer: Priority Health Choice Medicaid	$5.19
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$25.60
Rate for Payer: Priority Health Medicare	$7.43
Rate for Payer: Priority Health Narrow/Tiered Network	$20.48
Rate for Payer: Railroad Medicare Medicare	$7.36
Rate for Payer: UHC All Payor (Choice/PPO)	$25.89
Rate for Payer: UHC Core	$24.57
Rate for Payer: UHC Exchange	$7.36
Rate for Payer: UHC Medicaid	$5.19
Rate for Payer: UHC Medicare Advantage	$7.36
Rate for Payer: UHCCP Medicaid	$5.19
Rate for Payer: VA VA	$7.36
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$22.07

ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION

Facility

$19.38

Service Code	NDC 00143978710
Hospital Charge Code	9929
Hospital Revenue Code	250
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$17.44
Rate for Payer: Aetna Commercial	$16.47
Rate for Payer: Aetna Medicare	$5.04
Rate for Payer: Allen County Amish Medical Aid Commercial	$6.06
Rate for Payer: Amish Plain Church Group Commercial	$6.06
Rate for Payer: BCBS Complete	$3.59
Rate for Payer: BCBS MAPPO	$4.84
Rate for Payer: BCBS Trust/PPO	$15.93
Rate for Payer: BCN Commercial	$15.93
Rate for Payer: BCN Medicare Advantage	$4.84
Rate for Payer: Cash Price	$15.50
Rate for Payer: Cofinity Commercial	$16.67
Rate for Payer: Encore Health Key Benefits Commercial	$15.50
Rate for Payer: Health Alliance Plan Medicare Advantage	$4.84
Rate for Payer: Healthscope Commercial	$17.44
Rate for Payer: Lakeland Regional Health Systems Commercial	$14.54
Rate for Payer: Mclaren Medicaid	$3.42
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$5.09
Rate for Payer: Meridian Medicaid	$3.59
Rate for Payer: MI Amish Medical Board Commercial	$5.57
Rate for Payer: Molina Medicare/Medicaid	$5.33
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$16.47
Rate for Payer: Nomi Health Commercial	$15.89
Rate for Payer: Opus (Opus Packaging Group) HMA	$14.54
Rate for Payer: PACE Senior Care Partners	$4.60
Rate for Payer: PACE SWMI	$4.84
Rate for Payer: PHP Commercial	$16.47
Rate for Payer: PHP Medicare Advantage	$4.84
Rate for Payer: Priority Health Choice Medicaid	$3.42
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$16.86
Rate for Payer: Priority Health Medicare	$4.89
Rate for Payer: Priority Health Narrow/Tiered Network	$13.49
Rate for Payer: Railroad Medicare Medicare	$4.84
Rate for Payer: UHC All Payor (Choice/PPO)	$17.05
Rate for Payer: UHC Core	$16.18
Rate for Payer: UHC Exchange	$4.84
Rate for Payer: UHC Medicaid	$3.42
Rate for Payer: UHC Medicare Advantage	$4.84
Rate for Payer: UHCCP Medicaid	$3.42
Rate for Payer: VA VA	$4.84
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$14.54

ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION

Facility

$29.42

Service Code	NDC 43598007858
Hospital Charge Code	9929
Hospital Revenue Code	250
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$26.48
Rate for Payer: Aetna Commercial	$25.01
Rate for Payer: BCBS Trust/PPO	$24.30
Rate for Payer: BCN Commercial	$24.30
Rate for Payer: Cash Price	$23.54
Rate for Payer: Cofinity Commercial	$25.30
Rate for Payer: Encore Health Key Benefits Commercial	$23.54
Rate for Payer: Healthscope Commercial	$26.48
Rate for Payer: Lakeland Regional Health Systems Commercial	$22.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$25.01
Rate for Payer: Nomi Health Commercial	$24.12
Rate for Payer: Opus (Opus Packaging Group) HMA	$22.07
Rate for Payer: PHP Commercial	$25.01
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO	$25.60
Rate for Payer: Priority Health Narrow/Tiered Network	$20.48
Rate for Payer: UHC All Payor (Choice/PPO)	$25.89
Rate for Payer: UHC Core	$24.57
Rate for Payer: Van Buren County Sheriff Dept. Commercial	$22.07

Know your out-of-pocket cost for care.

All Charges