|
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL
|
Facility
|
OP
|
$6.08
|
|
|
Service Code
|
NDC 00904386575
|
| Hospital Charge Code |
29676
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$5.47 |
| Rate for Payer: Aetna Commercial |
$5.17
|
| Rate for Payer: Aetna Medicare |
$1.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.90
|
| Rate for Payer: BCBS Complete |
$1.13
|
| Rate for Payer: BCBS MAPPO |
$1.52
|
| Rate for Payer: BCBS Trust/PPO |
$5.00
|
| Rate for Payer: BCN Commercial |
$5.00
|
| Rate for Payer: BCN Medicare Advantage |
$1.52
|
| Rate for Payer: Cash Price |
$4.86
|
| Rate for Payer: Cofinity Commercial |
$5.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.52
|
| Rate for Payer: Healthscope Commercial |
$5.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.56
|
| Rate for Payer: Mclaren Medicaid |
$1.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.60
|
| Rate for Payer: Meridian Medicaid |
$1.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.17
|
| Rate for Payer: Nomi Health Commercial |
$4.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.56
|
| Rate for Payer: PACE Senior Care Partners |
$1.44
|
| Rate for Payer: PACE SWMI |
$1.52
|
| Rate for Payer: PHP Commercial |
$5.17
|
| Rate for Payer: PHP Medicare Advantage |
$1.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.29
|
| Rate for Payer: Priority Health Medicare |
$1.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.35
|
| Rate for Payer: UHC Core |
$5.08
|
| Rate for Payer: UHC Exchange |
$1.52
|
| Rate for Payer: UHC Medicaid |
$1.07
|
| Rate for Payer: UHC Medicare Advantage |
$1.52
|
| Rate for Payer: UHCCP Medicaid |
$1.07
|
| Rate for Payer: VA VA |
$1.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.56
|
|
|
SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL
|
Facility
|
IP
|
$6.08
|
|
|
Service Code
|
NDC 00904386575
|
| Hospital Charge Code |
29676
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$5.47 |
| Rate for Payer: Aetna Commercial |
$5.17
|
| Rate for Payer: BCBS Trust/PPO |
$5.02
|
| Rate for Payer: BCN Commercial |
$5.02
|
| Rate for Payer: Cash Price |
$4.86
|
| Rate for Payer: Cofinity Commercial |
$5.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.86
|
| Rate for Payer: Healthscope Commercial |
$5.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.17
|
| Rate for Payer: Nomi Health Commercial |
$4.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.56
|
| Rate for Payer: PHP Commercial |
$5.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.35
|
| Rate for Payer: UHC Core |
$5.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.56
|
|
|
SODIUM CHLORIDE 0.9 % CONTINUOUS NEBULIZATION SOLUTION
|
Facility
|
IP
|
$3.46
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
200035
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$3.11 |
| Rate for Payer: Aetna Commercial |
$2.94
|
| Rate for Payer: BCBS Trust/PPO |
$2.86
|
| Rate for Payer: BCN Commercial |
$2.86
|
| Rate for Payer: Cash Price |
$2.77
|
| Rate for Payer: Cofinity Commercial |
$2.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.77
|
| Rate for Payer: Healthscope Commercial |
$3.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.94
|
| Rate for Payer: Nomi Health Commercial |
$2.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.60
|
| Rate for Payer: PHP Commercial |
$2.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.04
|
| Rate for Payer: UHC Core |
$2.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.60
|
|
|
SODIUM CHLORIDE 0.9 % CONTINUOUS NEBULIZATION SOLUTION
|
Facility
|
OP
|
$3.46
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
200035
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.61 |
| Max. Negotiated Rate |
$3.11 |
| Rate for Payer: Aetna Commercial |
$2.94
|
| Rate for Payer: Aetna Medicare |
$0.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.08
|
| Rate for Payer: BCBS Complete |
$0.64
|
| Rate for Payer: BCBS MAPPO |
$0.87
|
| Rate for Payer: BCBS Trust/PPO |
$2.84
|
| Rate for Payer: BCN Commercial |
$2.84
|
| Rate for Payer: BCN Medicare Advantage |
$0.87
|
| Rate for Payer: Cash Price |
$2.77
|
| Rate for Payer: Cofinity Commercial |
$2.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.87
|
| Rate for Payer: Healthscope Commercial |
$3.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.60
|
| Rate for Payer: Mclaren Medicaid |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.91
|
| Rate for Payer: Meridian Medicaid |
$0.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.94
|
| Rate for Payer: Nomi Health Commercial |
$2.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.60
|
| Rate for Payer: PACE Senior Care Partners |
$0.82
|
| Rate for Payer: PACE SWMI |
$0.87
|
| Rate for Payer: PHP Commercial |
$2.94
|
| Rate for Payer: PHP Medicare Advantage |
$0.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.01
|
| Rate for Payer: Priority Health Medicare |
$0.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.41
|
| Rate for Payer: Railroad Medicare Medicare |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.04
|
| Rate for Payer: UHC Core |
$2.89
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Medicaid |
$0.61
|
| Rate for Payer: UHC Medicare Advantage |
$0.87
|
| Rate for Payer: UHCCP Medicaid |
$0.61
|
| Rate for Payer: VA VA |
$0.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.60
|
|
|
SODIUM CHLORIDE 0.9 % FLUSH SOLUTION 100 ML BAG
|
Facility
|
OP
|
$53.75
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
300165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.48 |
| Max. Negotiated Rate |
$48.38 |
| Rate for Payer: Aetna Commercial |
$45.69
|
| Rate for Payer: Aetna Medicare |
$13.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.80
|
| Rate for Payer: BCBS Complete |
$9.95
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCBS Trust/PPO |
$44.19
|
| Rate for Payer: BCN Commercial |
$44.19
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cofinity Commercial |
$46.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.31
|
| Rate for Payer: Mclaren Medicaid |
$9.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.11
|
| Rate for Payer: Meridian Medicaid |
$9.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.69
|
| Rate for Payer: Nomi Health Commercial |
$44.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.31
|
| Rate for Payer: PACE Senior Care Partners |
$12.77
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Commercial |
$45.69
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.76
|
| Rate for Payer: Priority Health Medicare |
$13.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.41
|
| Rate for Payer: Railroad Medicare Medicare |
$13.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.30
|
| Rate for Payer: UHC Core |
$44.88
|
| Rate for Payer: UHC Exchange |
$13.44
|
| Rate for Payer: UHC Medicaid |
$9.48
|
| Rate for Payer: UHC Medicare Advantage |
$13.44
|
| Rate for Payer: UHCCP Medicaid |
$9.48
|
| Rate for Payer: VA VA |
$13.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.31
|
|
|
SODIUM CHLORIDE 0.9 % FLUSH SOLUTION 100 ML BAG
|
Facility
|
IP
|
$53.75
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
300165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$37.41 |
| Max. Negotiated Rate |
$48.38 |
| Rate for Payer: Aetna Commercial |
$45.69
|
| Rate for Payer: BCBS Trust/PPO |
$44.39
|
| Rate for Payer: BCN Commercial |
$44.39
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cofinity Commercial |
$46.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.69
|
| Rate for Payer: Nomi Health Commercial |
$44.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.31
|
| Rate for Payer: PHP Commercial |
$45.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.30
|
| Rate for Payer: UHC Core |
$44.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.31
|
|
|
SODIUM CHLORIDE 0.9 % FOR NEBULIZATION
|
Facility
|
IP
|
$2.19
|
|
|
Service Code
|
NDC 00487930103
|
| Hospital Charge Code |
7325
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.52 |
| Max. Negotiated Rate |
$1.97 |
| Rate for Payer: Aetna Commercial |
$1.86
|
| Rate for Payer: BCBS Trust/PPO |
$1.81
|
| Rate for Payer: BCN Commercial |
$1.81
|
| Rate for Payer: Cash Price |
$1.75
|
| Rate for Payer: Cofinity Commercial |
$1.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.75
|
| Rate for Payer: Healthscope Commercial |
$1.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.86
|
| Rate for Payer: Nomi Health Commercial |
$1.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.64
|
| Rate for Payer: PHP Commercial |
$1.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.93
|
| Rate for Payer: UHC Core |
$1.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.64
|
|
|
SODIUM CHLORIDE 0.9 % FOR NEBULIZATION
|
Facility
|
IP
|
$2.75
|
|
|
Service Code
|
NDC 00487930133
|
| Hospital Charge Code |
7325
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.91 |
| Max. Negotiated Rate |
$2.48 |
| Rate for Payer: Aetna Commercial |
$2.34
|
| Rate for Payer: BCBS Trust/PPO |
$2.27
|
| Rate for Payer: BCN Commercial |
$2.27
|
| Rate for Payer: Cash Price |
$2.20
|
| Rate for Payer: Cofinity Commercial |
$2.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.20
|
| Rate for Payer: Healthscope Commercial |
$2.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.34
|
| Rate for Payer: Nomi Health Commercial |
$2.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.06
|
| Rate for Payer: PHP Commercial |
$2.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.42
|
| Rate for Payer: UHC Core |
$2.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.06
|
|
|
SODIUM CHLORIDE 0.9 % FOR NEBULIZATION
|
Facility
|
OP
|
$2.19
|
|
|
Service Code
|
NDC 00487930103
|
| Hospital Charge Code |
7325
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$1.97 |
| Rate for Payer: Aetna Commercial |
$1.86
|
| Rate for Payer: Aetna Medicare |
$0.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.68
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS MAPPO |
$0.55
|
| Rate for Payer: BCBS Trust/PPO |
$1.80
|
| Rate for Payer: BCN Commercial |
$1.80
|
| Rate for Payer: BCN Medicare Advantage |
$0.55
|
| Rate for Payer: Cash Price |
$1.75
|
| Rate for Payer: Cofinity Commercial |
$1.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.55
|
| Rate for Payer: Healthscope Commercial |
$1.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.64
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.57
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.86
|
| Rate for Payer: Nomi Health Commercial |
$1.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.64
|
| Rate for Payer: PACE Senior Care Partners |
$0.52
|
| Rate for Payer: PACE SWMI |
$0.55
|
| Rate for Payer: PHP Commercial |
$1.86
|
| Rate for Payer: PHP Medicare Advantage |
$0.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.91
|
| Rate for Payer: Priority Health Medicare |
$0.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.52
|
| Rate for Payer: Railroad Medicare Medicare |
$0.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.93
|
| Rate for Payer: UHC Core |
$1.83
|
| Rate for Payer: UHC Exchange |
$0.55
|
| Rate for Payer: UHC Medicaid |
$0.39
|
| Rate for Payer: UHC Medicare Advantage |
$0.55
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: VA VA |
$0.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.64
|
|
|
SODIUM CHLORIDE 0.9 % FOR NEBULIZATION
|
Facility
|
IP
|
$3.14
|
|
|
Service Code
|
NDC 00378698501
|
| Hospital Charge Code |
7325
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.19 |
| Max. Negotiated Rate |
$2.83 |
| Rate for Payer: Aetna Commercial |
$2.67
|
| Rate for Payer: BCBS Trust/PPO |
$2.59
|
| Rate for Payer: BCN Commercial |
$2.59
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Cofinity Commercial |
$2.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.51
|
| Rate for Payer: Healthscope Commercial |
$2.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.67
|
| Rate for Payer: Nomi Health Commercial |
$2.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.35
|
| Rate for Payer: PHP Commercial |
$2.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.76
|
| Rate for Payer: UHC Core |
$2.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.35
|
|
|
SODIUM CHLORIDE 0.9 % FOR NEBULIZATION
|
Facility
|
IP
|
$2.48
|
|
|
Service Code
|
NDC 76204030003
|
| Hospital Charge Code |
7325
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.73 |
| Max. Negotiated Rate |
$2.23 |
| Rate for Payer: Aetna Commercial |
$2.11
|
| Rate for Payer: BCBS Trust/PPO |
$2.05
|
| Rate for Payer: BCN Commercial |
$2.05
|
| Rate for Payer: Cash Price |
$1.98
|
| Rate for Payer: Cofinity Commercial |
$2.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.98
|
| Rate for Payer: Healthscope Commercial |
$2.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.11
|
| Rate for Payer: Nomi Health Commercial |
$2.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.86
|
| Rate for Payer: PHP Commercial |
$2.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.18
|
| Rate for Payer: UHC Core |
$2.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.86
|
|
|
SODIUM CHLORIDE 0.9 % FOR NEBULIZATION
|
Facility
|
OP
|
$2.75
|
|
|
Service Code
|
NDC 00487930133
|
| Hospital Charge Code |
7325
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$2.48 |
| Rate for Payer: Aetna Commercial |
$2.34
|
| Rate for Payer: Aetna Medicare |
$0.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.86
|
| Rate for Payer: BCBS Complete |
$0.51
|
| Rate for Payer: BCBS MAPPO |
$0.69
|
| Rate for Payer: BCBS Trust/PPO |
$2.26
|
| Rate for Payer: BCN Commercial |
$2.26
|
| Rate for Payer: BCN Medicare Advantage |
$0.69
|
| Rate for Payer: Cash Price |
$2.20
|
| Rate for Payer: Cofinity Commercial |
$2.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.69
|
| Rate for Payer: Healthscope Commercial |
$2.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.06
|
| Rate for Payer: Mclaren Medicaid |
$0.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.72
|
| Rate for Payer: Meridian Medicaid |
$0.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.34
|
| Rate for Payer: Nomi Health Commercial |
$2.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.06
|
| Rate for Payer: PACE Senior Care Partners |
$0.65
|
| Rate for Payer: PACE SWMI |
$0.69
|
| Rate for Payer: PHP Commercial |
$2.34
|
| Rate for Payer: PHP Medicare Advantage |
$0.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.39
|
| Rate for Payer: Priority Health Medicare |
$0.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.91
|
| Rate for Payer: Railroad Medicare Medicare |
$0.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.42
|
| Rate for Payer: UHC Core |
$2.30
|
| Rate for Payer: UHC Exchange |
$0.69
|
| Rate for Payer: UHC Medicaid |
$0.48
|
| Rate for Payer: UHC Medicare Advantage |
$0.69
|
| Rate for Payer: UHCCP Medicaid |
$0.48
|
| Rate for Payer: VA VA |
$0.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.06
|
|
|
SODIUM CHLORIDE 0.9 % FOR NEBULIZATION
|
Facility
|
OP
|
$2.48
|
|
|
Service Code
|
NDC 76204030003
|
| Hospital Charge Code |
7325
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$2.23 |
| Rate for Payer: Aetna Commercial |
$2.11
|
| Rate for Payer: Aetna Medicare |
$0.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.78
|
| Rate for Payer: BCBS Complete |
$0.46
|
| Rate for Payer: BCBS MAPPO |
$0.62
|
| Rate for Payer: BCBS Trust/PPO |
$2.04
|
| Rate for Payer: BCN Commercial |
$2.04
|
| Rate for Payer: BCN Medicare Advantage |
$0.62
|
| Rate for Payer: Cash Price |
$1.98
|
| Rate for Payer: Cofinity Commercial |
$2.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.62
|
| Rate for Payer: Healthscope Commercial |
$2.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.86
|
| Rate for Payer: Mclaren Medicaid |
$0.44
|
| 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 |
$2.11
|
| Rate for Payer: Nomi Health Commercial |
$2.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.86
|
| Rate for Payer: PACE Senior Care Partners |
$0.59
|
| Rate for Payer: PACE SWMI |
$0.62
|
| Rate for Payer: PHP Commercial |
$2.11
|
| Rate for Payer: PHP Medicare Advantage |
$0.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.16
|
| Rate for Payer: Priority Health Medicare |
$0.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.18
|
| Rate for Payer: UHC Core |
$2.07
|
| Rate for Payer: UHC Exchange |
$0.62
|
| Rate for Payer: UHC Medicaid |
$0.44
|
| Rate for Payer: UHC Medicare Advantage |
$0.62
|
| Rate for Payer: UHCCP Medicaid |
$0.44
|
| Rate for Payer: VA VA |
$0.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.86
|
|
|
SODIUM CHLORIDE 0.9 % FOR NEBULIZATION
|
Facility
|
OP
|
$3.14
|
|
|
Service Code
|
NDC 00378698501
|
| Hospital Charge Code |
7325
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$2.83 |
| Rate for Payer: Aetna Commercial |
$2.67
|
| Rate for Payer: Aetna Medicare |
$0.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.98
|
| Rate for Payer: BCBS Complete |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.79
|
| Rate for Payer: BCBS Trust/PPO |
$2.58
|
| Rate for Payer: BCN Commercial |
$2.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.79
|
| Rate for Payer: Cash Price |
$2.51
|
| Rate for Payer: Cofinity Commercial |
$2.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.79
|
| Rate for Payer: Healthscope Commercial |
$2.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.35
|
| Rate for Payer: Mclaren Medicaid |
$0.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.82
|
| Rate for Payer: Meridian Medicaid |
$0.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.67
|
| Rate for Payer: Nomi Health Commercial |
$2.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.35
|
| Rate for Payer: PACE Senior Care Partners |
$0.75
|
| Rate for Payer: PACE SWMI |
$0.79
|
| Rate for Payer: PHP Commercial |
$2.67
|
| Rate for Payer: PHP Medicare Advantage |
$0.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.73
|
| Rate for Payer: Priority Health Medicare |
$0.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.19
|
| Rate for Payer: Railroad Medicare Medicare |
$0.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.76
|
| Rate for Payer: UHC Core |
$2.62
|
| Rate for Payer: UHC Exchange |
$0.79
|
| Rate for Payer: UHC Medicaid |
$0.55
|
| Rate for Payer: UHC Medicare Advantage |
$0.79
|
| Rate for Payer: UHCCP Medicaid |
$0.55
|
| Rate for Payer: VA VA |
$0.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.35
|
|
|
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION
|
Facility
|
OP
|
$9.25
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
41463
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.63 |
| Max. Negotiated Rate |
$8.32 |
| Rate for Payer: Aetna Commercial |
$7.86
|
| Rate for Payer: Aetna Commercial |
$18.49
|
| Rate for Payer: Aetna Commercial |
$54.19
|
| Rate for Payer: Aetna Commercial |
$11.69
|
| Rate for Payer: Aetna Commercial |
$47.17
|
| Rate for Payer: Aetna Medicare |
$5.66
|
| Rate for Payer: Aetna Medicare |
$2.40
|
| Rate for Payer: Aetna Medicare |
$14.43
|
| Rate for Payer: Aetna Medicare |
$3.58
|
| Rate for Payer: Aetna Medicare |
$16.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.92
|
| Rate for Payer: BCBS Complete |
$4.03
|
| Rate for Payer: BCBS Complete |
$2.55
|
| Rate for Payer: BCBS Complete |
$10.27
|
| Rate for Payer: BCBS Complete |
$1.71
|
| Rate for Payer: BCBS Complete |
$11.80
|
| Rate for Payer: BCBS MAPPO |
$2.31
|
| Rate for Payer: BCBS MAPPO |
$5.44
|
| Rate for Payer: BCBS MAPPO |
$3.44
|
| Rate for Payer: BCBS MAPPO |
$13.88
|
| Rate for Payer: BCBS MAPPO |
$15.94
|
| Rate for Payer: BCBS Trust/PPO |
$45.63
|
| Rate for Payer: BCBS Trust/PPO |
$11.30
|
| Rate for Payer: BCBS Trust/PPO |
$17.88
|
| Rate for Payer: BCBS Trust/PPO |
$7.60
|
| Rate for Payer: BCBS Trust/PPO |
$52.41
|
| Rate for Payer: BCN Commercial |
$45.63
|
| Rate for Payer: BCN Commercial |
$17.88
|
| Rate for Payer: BCN Commercial |
$11.30
|
| Rate for Payer: BCN Commercial |
$7.60
|
| Rate for Payer: BCN Commercial |
$52.41
|
| Rate for Payer: BCN Medicare Advantage |
$2.31
|
| Rate for Payer: BCN Medicare Advantage |
$15.94
|
| Rate for Payer: BCN Medicare Advantage |
$13.88
|
| Rate for Payer: BCN Medicare Advantage |
$5.44
|
| Rate for Payer: BCN Medicare Advantage |
$3.44
|
| Rate for Payer: Cash Price |
$11.00
|
| Rate for Payer: Cash Price |
$17.40
|
| Rate for Payer: Cash Price |
$7.40
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$44.40
|
| Rate for Payer: Cofinity Commercial |
$54.83
|
| Rate for Payer: Cofinity Commercial |
$47.73
|
| Rate for Payer: Cofinity Commercial |
$7.96
|
| Rate for Payer: Cofinity Commercial |
$11.82
|
| Rate for Payer: Cofinity Commercial |
$18.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.88
|
| Rate for Payer: Healthscope Commercial |
$12.38
|
| Rate for Payer: Healthscope Commercial |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$57.38
|
| Rate for Payer: Healthscope Commercial |
$19.57
|
| Rate for Payer: Healthscope Commercial |
$49.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.62
|
| Rate for Payer: Mclaren Medicaid |
$3.83
|
| Rate for Payer: Mclaren Medicaid |
$11.24
|
| Rate for Payer: Mclaren Medicaid |
$9.78
|
| Rate for Payer: Mclaren Medicaid |
$1.63
|
| Rate for Payer: Mclaren Medicaid |
$2.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.57
|
| Rate for Payer: Meridian Medicaid |
$4.03
|
| Rate for Payer: Meridian Medicaid |
$2.55
|
| Rate for Payer: Meridian Medicaid |
$10.27
|
| Rate for Payer: Meridian Medicaid |
$11.80
|
| Rate for Payer: Meridian Medicaid |
$1.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.86
|
| Rate for Payer: Nomi Health Commercial |
$7.58
|
| Rate for Payer: Nomi Health Commercial |
$45.51
|
| Rate for Payer: Nomi Health Commercial |
$52.27
|
| Rate for Payer: Nomi Health Commercial |
$11.28
|
| Rate for Payer: Nomi Health Commercial |
$17.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.94
|
| Rate for Payer: PACE Senior Care Partners |
$3.27
|
| Rate for Payer: PACE Senior Care Partners |
$5.17
|
| Rate for Payer: PACE Senior Care Partners |
$2.20
|
| Rate for Payer: PACE Senior Care Partners |
$15.14
|
| Rate for Payer: PACE Senior Care Partners |
$13.18
|
| Rate for Payer: PACE SWMI |
$3.44
|
| Rate for Payer: PACE SWMI |
$5.44
|
| Rate for Payer: PACE SWMI |
$13.88
|
| Rate for Payer: PACE SWMI |
$15.94
|
| Rate for Payer: PACE SWMI |
$2.31
|
| Rate for Payer: PHP Commercial |
$54.19
|
| Rate for Payer: PHP Commercial |
$11.69
|
| Rate for Payer: PHP Commercial |
$47.17
|
| Rate for Payer: PHP Commercial |
$18.49
|
| Rate for Payer: PHP Commercial |
$7.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.44
|
| Rate for Payer: PHP Medicare Advantage |
$2.31
|
| Rate for Payer: PHP Medicare Advantage |
$3.44
|
| Rate for Payer: PHP Medicare Advantage |
$15.94
|
| Rate for Payer: PHP Medicare Advantage |
$13.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.92
|
| Rate for Payer: Priority Health Medicare |
$5.49
|
| Rate for Payer: Priority Health Medicare |
$2.34
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Medicare |
$16.10
|
| Rate for Payer: Priority Health Medicare |
$14.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.57
|
| Rate for Payer: Railroad Medicare Medicare |
$2.31
|
| Rate for Payer: Railroad Medicare Medicare |
$15.94
|
| Rate for Payer: Railroad Medicare Medicare |
$13.88
|
| Rate for Payer: Railroad Medicare Medicare |
$3.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.14
|
| Rate for Payer: UHC Core |
$53.23
|
| Rate for Payer: UHC Core |
$11.48
|
| Rate for Payer: UHC Core |
$7.72
|
| Rate for Payer: UHC Core |
$46.34
|
| Rate for Payer: UHC Core |
$18.16
|
| Rate for Payer: UHC Exchange |
$3.44
|
| Rate for Payer: UHC Exchange |
$15.94
|
| Rate for Payer: UHC Exchange |
$5.44
|
| Rate for Payer: UHC Exchange |
$2.31
|
| Rate for Payer: UHC Exchange |
$13.88
|
| Rate for Payer: UHC Medicaid |
$1.63
|
| Rate for Payer: UHC Medicaid |
$11.24
|
| Rate for Payer: UHC Medicaid |
$3.83
|
| Rate for Payer: UHC Medicaid |
$9.78
|
| Rate for Payer: UHC Medicaid |
$2.42
|
| Rate for Payer: UHC Medicare Advantage |
$13.88
|
| Rate for Payer: UHC Medicare Advantage |
$3.44
|
| Rate for Payer: UHC Medicare Advantage |
$2.31
|
| Rate for Payer: UHC Medicare Advantage |
$5.44
|
| Rate for Payer: UHC Medicare Advantage |
$15.94
|
| Rate for Payer: UHCCP Medicaid |
$11.24
|
| Rate for Payer: UHCCP Medicaid |
$1.63
|
| Rate for Payer: UHCCP Medicaid |
$9.78
|
| Rate for Payer: UHCCP Medicaid |
$2.42
|
| Rate for Payer: UHCCP Medicaid |
$3.83
|
| Rate for Payer: VA VA |
$2.31
|
| Rate for Payer: VA VA |
$3.44
|
| Rate for Payer: VA VA |
$15.94
|
| Rate for Payer: VA VA |
$5.44
|
| Rate for Payer: VA VA |
$13.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.31
|
|
|
SODIUM CHLORIDE 0.9 % INJECTION SOLUTION
|
Facility
|
IP
|
$9.25
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
41463
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.44 |
| Max. Negotiated Rate |
$8.32 |
| Rate for Payer: Aetna Commercial |
$7.86
|
| Rate for Payer: Aetna Commercial |
$18.49
|
| Rate for Payer: Aetna Commercial |
$47.17
|
| Rate for Payer: Aetna Commercial |
$54.19
|
| Rate for Payer: Aetna Commercial |
$11.69
|
| Rate for Payer: BCBS Trust/PPO |
$52.65
|
| Rate for Payer: BCBS Trust/PPO |
$7.64
|
| Rate for Payer: BCBS Trust/PPO |
$45.84
|
| Rate for Payer: BCBS Trust/PPO |
$17.96
|
| Rate for Payer: BCBS Trust/PPO |
$11.36
|
| Rate for Payer: BCN Commercial |
$52.65
|
| Rate for Payer: BCN Commercial |
$45.84
|
| Rate for Payer: BCN Commercial |
$11.36
|
| Rate for Payer: BCN Commercial |
$17.96
|
| Rate for Payer: BCN Commercial |
$7.64
|
| Rate for Payer: Cash Price |
$11.00
|
| Rate for Payer: Cash Price |
$7.40
|
| Rate for Payer: Cash Price |
$44.40
|
| Rate for Payer: Cash Price |
$17.40
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cofinity Commercial |
$7.96
|
| Rate for Payer: Cofinity Commercial |
$11.82
|
| Rate for Payer: Cofinity Commercial |
$54.83
|
| Rate for Payer: Cofinity Commercial |
$47.73
|
| Rate for Payer: Cofinity Commercial |
$18.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.40
|
| Rate for Payer: Healthscope Commercial |
$19.57
|
| Rate for Payer: Healthscope Commercial |
$49.95
|
| Rate for Payer: Healthscope Commercial |
$12.38
|
| Rate for Payer: Healthscope Commercial |
$57.38
|
| Rate for Payer: Healthscope Commercial |
$8.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.19
|
| Rate for Payer: Nomi Health Commercial |
$11.28
|
| Rate for Payer: Nomi Health Commercial |
$17.84
|
| Rate for Payer: Nomi Health Commercial |
$45.51
|
| Rate for Payer: Nomi Health Commercial |
$52.27
|
| Rate for Payer: Nomi Health Commercial |
$7.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.94
|
| Rate for Payer: PHP Commercial |
$18.49
|
| Rate for Payer: PHP Commercial |
$47.17
|
| Rate for Payer: PHP Commercial |
$7.86
|
| Rate for Payer: PHP Commercial |
$54.19
|
| Rate for Payer: PHP Commercial |
$11.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.10
|
| Rate for Payer: UHC Core |
$11.48
|
| Rate for Payer: UHC Core |
$18.16
|
| Rate for Payer: UHC Core |
$53.23
|
| Rate for Payer: UHC Core |
$7.72
|
| Rate for Payer: UHC Core |
$46.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.81
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS 1.5 MAINTENANCE SOLUTION
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
180423
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna Medicare |
$18.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.85
|
| Rate for Payer: BCBS Complete |
$12.94
|
| Rate for Payer: BCBS MAPPO |
$17.48
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$57.48
|
| Rate for Payer: BCN Medicare Advantage |
$17.48
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.44
|
| Rate for Payer: Mclaren Medicaid |
$12.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.35
|
| Rate for Payer: Meridian Medicaid |
$12.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: PACE Senior Care Partners |
$16.61
|
| Rate for Payer: PACE SWMI |
$17.48
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: PHP Medicare Advantage |
$17.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.83
|
| Rate for Payer: Priority Health Medicare |
$17.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.66
|
| Rate for Payer: Railroad Medicare Medicare |
$17.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.53
|
| Rate for Payer: UHC Core |
$58.38
|
| Rate for Payer: UHC Exchange |
$17.48
|
| Rate for Payer: UHC Medicaid |
$12.33
|
| Rate for Payer: UHC Medicare Advantage |
$17.48
|
| Rate for Payer: UHCCP Medicaid |
$12.33
|
| Rate for Payer: VA VA |
$17.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.44
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS 1.5 MAINTENANCE SOLUTION
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
180423
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$48.66 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: BCBS Trust/PPO |
$57.75
|
| Rate for Payer: BCN Commercial |
$57.75
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.53
|
| Rate for Payer: UHC Core |
$58.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.44
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS 2X MAINTENANCE SOLUTION
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
300194
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$48.66 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: BCBS Trust/PPO |
$57.75
|
| Rate for Payer: BCN Commercial |
$57.75
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.53
|
| Rate for Payer: UHC Core |
$58.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.44
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS 2X MAINTENANCE SOLUTION
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
300194
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna Medicare |
$18.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.85
|
| Rate for Payer: BCBS Complete |
$12.94
|
| Rate for Payer: BCBS MAPPO |
$17.48
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$57.48
|
| Rate for Payer: BCN Medicare Advantage |
$17.48
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.44
|
| Rate for Payer: Mclaren Medicaid |
$12.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.35
|
| Rate for Payer: Meridian Medicaid |
$12.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: Nomi Health Commercial |
$57.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.44
|
| Rate for Payer: PACE Senior Care Partners |
$16.61
|
| Rate for Payer: PACE SWMI |
$17.48
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: PHP Medicare Advantage |
$17.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.83
|
| Rate for Payer: Priority Health Medicare |
$17.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.66
|
| Rate for Payer: Railroad Medicare Medicare |
$17.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.53
|
| Rate for Payer: UHC Core |
$58.38
|
| Rate for Payer: UHC Exchange |
$17.48
|
| Rate for Payer: UHC Medicaid |
$12.33
|
| Rate for Payer: UHC Medicare Advantage |
$17.48
|
| Rate for Payer: UHCCP Medicaid |
$12.33
|
| Rate for Payer: VA VA |
$17.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.44
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$43.07
|
|
|
Service Code
|
NDC 00338055318
|
| Hospital Charge Code |
116170
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$29.98 |
| Max. Negotiated Rate |
$38.76 |
| Rate for Payer: Aetna Commercial |
$36.61
|
| Rate for Payer: BCBS Trust/PPO |
$35.57
|
| Rate for Payer: BCN Commercial |
$35.57
|
| Rate for Payer: Cash Price |
$34.46
|
| Rate for Payer: Cofinity Commercial |
$37.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.46
|
| Rate for Payer: Healthscope Commercial |
$38.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.61
|
| Rate for Payer: Nomi Health Commercial |
$35.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.30
|
| Rate for Payer: PHP Commercial |
$36.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.90
|
| Rate for Payer: UHC Core |
$35.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.30
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$43.07
|
|
|
Service Code
|
NDC 00338055318
|
| Hospital Charge Code |
116170
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.59 |
| Max. Negotiated Rate |
$38.76 |
| Rate for Payer: Aetna Commercial |
$36.61
|
| Rate for Payer: Aetna Medicare |
$11.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.46
|
| Rate for Payer: BCBS Complete |
$7.97
|
| Rate for Payer: BCBS MAPPO |
$10.77
|
| Rate for Payer: BCBS Trust/PPO |
$35.41
|
| Rate for Payer: BCN Commercial |
$35.41
|
| Rate for Payer: BCN Medicare Advantage |
$10.77
|
| Rate for Payer: Cash Price |
$34.46
|
| Rate for Payer: Cofinity Commercial |
$37.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.77
|
| Rate for Payer: Healthscope Commercial |
$38.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.30
|
| Rate for Payer: Mclaren Medicaid |
$7.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.31
|
| Rate for Payer: Meridian Medicaid |
$7.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.61
|
| Rate for Payer: Nomi Health Commercial |
$35.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.30
|
| Rate for Payer: PACE Senior Care Partners |
$10.23
|
| Rate for Payer: PACE SWMI |
$10.77
|
| Rate for Payer: PHP Commercial |
$36.61
|
| Rate for Payer: PHP Medicare Advantage |
$10.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.47
|
| Rate for Payer: Priority Health Medicare |
$10.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.98
|
| Rate for Payer: Railroad Medicare Medicare |
$10.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.90
|
| Rate for Payer: UHC Core |
$35.96
|
| Rate for Payer: UHC Exchange |
$10.77
|
| Rate for Payer: UHC Medicaid |
$7.59
|
| Rate for Payer: UHC Medicare Advantage |
$10.77
|
| Rate for Payer: UHCCP Medicaid |
$7.59
|
| Rate for Payer: VA VA |
$10.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.30
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK HOSPIRA/PFIZER CUSTOM
|
Facility
|
IP
|
$73.42
|
|
|
Service Code
|
NDC 00409710169
|
| Hospital Charge Code |
301508
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$51.10 |
| Max. Negotiated Rate |
$66.08 |
| Rate for Payer: Aetna Commercial |
$62.41
|
| Rate for Payer: BCBS Trust/PPO |
$60.64
|
| Rate for Payer: BCN Commercial |
$60.64
|
| Rate for Payer: Cash Price |
$58.74
|
| Rate for Payer: Cofinity Commercial |
$63.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.74
|
| Rate for Payer: Healthscope Commercial |
$66.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.41
|
| Rate for Payer: Nomi Health Commercial |
$60.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.06
|
| Rate for Payer: PHP Commercial |
$62.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.61
|
| Rate for Payer: UHC Core |
$61.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.06
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK HOSPIRA/PFIZER CUSTOM
|
Facility
|
OP
|
$73.42
|
|
|
Service Code
|
NDC 00409710167
|
| Hospital Charge Code |
301508
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.94 |
| Max. Negotiated Rate |
$66.08 |
| Rate for Payer: Aetna Commercial |
$62.41
|
| Rate for Payer: Aetna Medicare |
$19.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.94
|
| Rate for Payer: BCBS Complete |
$13.59
|
| Rate for Payer: BCBS MAPPO |
$18.36
|
| Rate for Payer: BCBS Trust/PPO |
$60.36
|
| Rate for Payer: BCN Commercial |
$60.36
|
| Rate for Payer: BCN Medicare Advantage |
$18.36
|
| Rate for Payer: Cash Price |
$58.74
|
| Rate for Payer: Cofinity Commercial |
$63.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.36
|
| Rate for Payer: Healthscope Commercial |
$66.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.06
|
| Rate for Payer: Mclaren Medicaid |
$12.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.27
|
| Rate for Payer: Meridian Medicaid |
$13.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.41
|
| Rate for Payer: Nomi Health Commercial |
$60.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.06
|
| Rate for Payer: PACE Senior Care Partners |
$17.44
|
| Rate for Payer: PACE SWMI |
$18.36
|
| Rate for Payer: PHP Commercial |
$62.41
|
| Rate for Payer: PHP Medicare Advantage |
$18.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.88
|
| Rate for Payer: Priority Health Medicare |
$18.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.10
|
| Rate for Payer: Railroad Medicare Medicare |
$18.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.61
|
| Rate for Payer: UHC Core |
$61.31
|
| Rate for Payer: UHC Exchange |
$18.36
|
| Rate for Payer: UHC Medicaid |
$12.94
|
| Rate for Payer: UHC Medicare Advantage |
$18.36
|
| Rate for Payer: UHCCP Medicaid |
$12.94
|
| Rate for Payer: VA VA |
$18.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.06
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK HOSPIRA/PFIZER CUSTOM
|
Facility
|
IP
|
$73.42
|
|
|
Service Code
|
NDC 00409710167
|
| Hospital Charge Code |
301508
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$51.10 |
| Max. Negotiated Rate |
$66.08 |
| Rate for Payer: Aetna Commercial |
$62.41
|
| Rate for Payer: BCBS Trust/PPO |
$60.64
|
| Rate for Payer: BCN Commercial |
$60.64
|
| Rate for Payer: Cash Price |
$58.74
|
| Rate for Payer: Cofinity Commercial |
$63.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.74
|
| Rate for Payer: Healthscope Commercial |
$66.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.41
|
| Rate for Payer: Nomi Health Commercial |
$60.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.06
|
| Rate for Payer: PHP Commercial |
$62.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.61
|
| Rate for Payer: UHC Core |
$61.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.06
|
|
