|
SPIRONOLACTONE 25 MG TABLET
|
Facility
|
IP
|
$336.05
|
|
|
Service Code
|
NDC 00904692761
|
| Hospital Charge Code |
7437
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$233.89 |
| Max. Negotiated Rate |
$302.44 |
| Rate for Payer: Aetna Commercial |
$285.64
|
| Rate for Payer: BCBS Trust/PPO |
$277.54
|
| Rate for Payer: BCN Commercial |
$277.54
|
| Rate for Payer: Cash Price |
$268.84
|
| Rate for Payer: Cofinity Commercial |
$289.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.84
|
| Rate for Payer: Healthscope Commercial |
$302.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$252.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.64
|
| Rate for Payer: Nomi Health Commercial |
$275.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.04
|
| Rate for Payer: PHP Commercial |
$285.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$292.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.72
|
| Rate for Payer: UHC Core |
$280.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$252.04
|
|
|
SPIRONOLACTONE 25 MG TABLET
|
Facility
|
OP
|
$274.95
|
|
|
Service Code
|
NDC 53746051101
|
| Hospital Charge Code |
7437
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.47 |
| Max. Negotiated Rate |
$247.46 |
| Rate for Payer: Aetna Commercial |
$233.71
|
| Rate for Payer: Aetna Medicare |
$71.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.92
|
| Rate for Payer: BCBS Complete |
$50.89
|
| Rate for Payer: BCBS MAPPO |
$68.74
|
| Rate for Payer: BCBS Trust/PPO |
$226.04
|
| Rate for Payer: BCN Commercial |
$226.04
|
| Rate for Payer: BCN Medicare Advantage |
$68.74
|
| Rate for Payer: Cash Price |
$219.96
|
| Rate for Payer: Cofinity Commercial |
$236.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.74
|
| Rate for Payer: Healthscope Commercial |
$247.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.21
|
| Rate for Payer: Mclaren Medicaid |
$48.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.17
|
| Rate for Payer: Meridian Medicaid |
$50.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$75.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.71
|
| Rate for Payer: Nomi Health Commercial |
$225.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.21
|
| Rate for Payer: PACE Senior Care Partners |
$65.30
|
| Rate for Payer: PACE SWMI |
$68.74
|
| Rate for Payer: PHP Commercial |
$233.71
|
| Rate for Payer: PHP Medicare Advantage |
$68.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$239.21
|
| Rate for Payer: Priority Health Medicare |
$69.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.37
|
| Rate for Payer: Railroad Medicare Medicare |
$68.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.96
|
| Rate for Payer: UHC Core |
$229.58
|
| Rate for Payer: UHC Exchange |
$68.74
|
| Rate for Payer: UHC Medicaid |
$48.47
|
| Rate for Payer: UHC Medicare Advantage |
$68.74
|
| Rate for Payer: UHCCP Medicaid |
$48.47
|
| Rate for Payer: VA VA |
$68.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.21
|
|
|
SPIRONOLACTONE 25 MG TABLET
|
Facility
|
IP
|
$282.00
|
|
|
Service Code
|
NDC 63739054410
|
| Hospital Charge Code |
7437
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$196.27 |
| Max. Negotiated Rate |
$253.80 |
| Rate for Payer: Aetna Commercial |
$239.70
|
| Rate for Payer: BCBS Trust/PPO |
$232.90
|
| Rate for Payer: BCN Commercial |
$232.90
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$242.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.60
|
| Rate for Payer: Healthscope Commercial |
$253.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.70
|
| Rate for Payer: Nomi Health Commercial |
$231.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.50
|
| Rate for Payer: PHP Commercial |
$239.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$245.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.16
|
| Rate for Payer: UHC Core |
$235.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.50
|
|
|
SPIRONOLACTONE 25 MG TABLET
|
Facility
|
IP
|
$274.95
|
|
|
Service Code
|
NDC 53746051101
|
| Hospital Charge Code |
7437
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$191.37 |
| Max. Negotiated Rate |
$247.46 |
| Rate for Payer: Aetna Commercial |
$233.71
|
| Rate for Payer: BCBS Trust/PPO |
$227.08
|
| Rate for Payer: BCN Commercial |
$227.08
|
| Rate for Payer: Cash Price |
$219.96
|
| Rate for Payer: Cofinity Commercial |
$236.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.96
|
| Rate for Payer: Healthscope Commercial |
$247.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.71
|
| Rate for Payer: Nomi Health Commercial |
$225.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.21
|
| Rate for Payer: PHP Commercial |
$233.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$239.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.96
|
| Rate for Payer: UHC Core |
$229.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.21
|
|
|
SPIRONOLACTONE 25 MG TABLET
|
Facility
|
OP
|
$3.69
|
|
|
Service Code
|
NDC 51079010301
|
| Hospital Charge Code |
7437
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.65 |
| Max. Negotiated Rate |
$3.32 |
| Rate for Payer: Aetna Commercial |
$3.14
|
| Rate for Payer: Aetna Medicare |
$0.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.15
|
| Rate for Payer: BCBS Complete |
$0.68
|
| Rate for Payer: BCBS MAPPO |
$0.92
|
| Rate for Payer: BCBS Trust/PPO |
$3.03
|
| Rate for Payer: BCN Commercial |
$3.03
|
| Rate for Payer: BCN Medicare Advantage |
$0.92
|
| Rate for Payer: Cash Price |
$2.95
|
| Rate for Payer: Cofinity Commercial |
$3.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.92
|
| Rate for Payer: Healthscope Commercial |
$3.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.77
|
| Rate for Payer: Mclaren Medicaid |
$0.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.97
|
| Rate for Payer: Meridian Medicaid |
$0.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.14
|
| Rate for Payer: Nomi Health Commercial |
$3.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.77
|
| Rate for Payer: PACE Senior Care Partners |
$0.88
|
| Rate for Payer: PACE SWMI |
$0.92
|
| Rate for Payer: PHP Commercial |
$3.14
|
| Rate for Payer: PHP Medicare Advantage |
$0.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.21
|
| Rate for Payer: Priority Health Medicare |
$0.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.57
|
| Rate for Payer: Railroad Medicare Medicare |
$0.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.25
|
| Rate for Payer: UHC Core |
$3.08
|
| Rate for Payer: UHC Exchange |
$0.92
|
| Rate for Payer: UHC Medicaid |
$0.65
|
| Rate for Payer: UHC Medicare Advantage |
$0.92
|
| Rate for Payer: UHCCP Medicaid |
$0.65
|
| Rate for Payer: VA VA |
$0.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.77
|
|
|
SPIRONOLACTONE 25 MG TABLET
|
Facility
|
IP
|
$3.69
|
|
|
Service Code
|
NDC 51079010301
|
| Hospital Charge Code |
7437
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$3.32 |
| Rate for Payer: Aetna Commercial |
$3.14
|
| Rate for Payer: BCBS Trust/PPO |
$3.05
|
| Rate for Payer: BCN Commercial |
$3.05
|
| Rate for Payer: Cash Price |
$2.95
|
| Rate for Payer: Cofinity Commercial |
$3.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.95
|
| Rate for Payer: Healthscope Commercial |
$3.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.14
|
| Rate for Payer: Nomi Health Commercial |
$3.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.77
|
| Rate for Payer: PHP Commercial |
$3.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.25
|
| Rate for Payer: UHC Core |
$3.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.77
|
|
|
SPIRONOLACTONE 25 MG TABLET
|
Facility
|
OP
|
$336.05
|
|
|
Service Code
|
NDC 00904692761
|
| Hospital Charge Code |
7437
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$59.25 |
| Max. Negotiated Rate |
$302.44 |
| Rate for Payer: Aetna Commercial |
$285.64
|
| Rate for Payer: Aetna Medicare |
$87.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$105.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$105.02
|
| Rate for Payer: BCBS Complete |
$62.20
|
| Rate for Payer: BCBS MAPPO |
$84.01
|
| Rate for Payer: BCBS Trust/PPO |
$276.27
|
| Rate for Payer: BCN Commercial |
$276.27
|
| Rate for Payer: BCN Medicare Advantage |
$84.01
|
| Rate for Payer: Cash Price |
$268.84
|
| Rate for Payer: Cofinity Commercial |
$289.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.01
|
| Rate for Payer: Healthscope Commercial |
$302.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$252.04
|
| Rate for Payer: Mclaren Medicaid |
$59.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.21
|
| Rate for Payer: Meridian Medicaid |
$62.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.64
|
| Rate for Payer: Nomi Health Commercial |
$275.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.04
|
| Rate for Payer: PACE Senior Care Partners |
$79.81
|
| Rate for Payer: PACE SWMI |
$84.01
|
| Rate for Payer: PHP Commercial |
$285.64
|
| Rate for Payer: PHP Medicare Advantage |
$84.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$292.36
|
| Rate for Payer: Priority Health Medicare |
$84.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.89
|
| Rate for Payer: Railroad Medicare Medicare |
$84.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.72
|
| Rate for Payer: UHC Core |
$280.60
|
| Rate for Payer: UHC Exchange |
$84.01
|
| Rate for Payer: UHC Medicaid |
$59.25
|
| Rate for Payer: UHC Medicare Advantage |
$84.01
|
| Rate for Payer: UHCCP Medicaid |
$59.25
|
| Rate for Payer: VA VA |
$84.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$252.04
|
|
|
SPIRONOLACTONE 25 MG TABLET
|
Facility
|
OP
|
$282.00
|
|
|
Service Code
|
NDC 63739054410
|
| Hospital Charge Code |
7437
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.72 |
| Max. Negotiated Rate |
$253.80 |
| Rate for Payer: Aetna Commercial |
$239.70
|
| Rate for Payer: Aetna Medicare |
$73.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.12
|
| Rate for Payer: BCBS Complete |
$52.20
|
| Rate for Payer: BCBS MAPPO |
$70.50
|
| Rate for Payer: BCBS Trust/PPO |
$231.83
|
| Rate for Payer: BCN Commercial |
$231.83
|
| Rate for Payer: BCN Medicare Advantage |
$70.50
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$242.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.50
|
| Rate for Payer: Healthscope Commercial |
$253.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.50
|
| Rate for Payer: Mclaren Medicaid |
$49.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.03
|
| Rate for Payer: Meridian Medicaid |
$52.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.70
|
| Rate for Payer: Nomi Health Commercial |
$231.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.50
|
| Rate for Payer: PACE Senior Care Partners |
$66.97
|
| Rate for Payer: PACE SWMI |
$70.50
|
| Rate for Payer: PHP Commercial |
$239.70
|
| Rate for Payer: PHP Medicare Advantage |
$70.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$245.34
|
| Rate for Payer: Priority Health Medicare |
$71.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.27
|
| Rate for Payer: Railroad Medicare Medicare |
$70.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.16
|
| Rate for Payer: UHC Core |
$235.47
|
| Rate for Payer: UHC Exchange |
$70.50
|
| Rate for Payer: UHC Medicaid |
$49.72
|
| Rate for Payer: UHC Medicare Advantage |
$70.50
|
| Rate for Payer: UHCCP Medicaid |
$49.72
|
| Rate for Payer: VA VA |
$70.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.50
|
|
|
SPLENIC PROCEDURES
|
Facility
|
IP
|
$21,408.00
|
|
|
Service Code
|
APR-DRG 6504
|
| Min. Negotiated Rate |
$20,388.57 |
| Max. Negotiated Rate |
$21,408.00 |
| Rate for Payer: BCBS Complete |
$21,408.00
|
| Rate for Payer: Mclaren Medicaid |
$20,388.57
|
| Rate for Payer: Meridian Medicaid |
$21,408.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$20,388.57
|
| Rate for Payer: UHC Medicaid |
$20,388.57
|
| Rate for Payer: UHCCP Medicaid |
$20,388.57
|
|
|
SPLENIC PROCEDURES
|
Facility
|
IP
|
$15,218.34
|
|
|
Service Code
|
APR-DRG 6503
|
| Min. Negotiated Rate |
$14,493.65 |
| Max. Negotiated Rate |
$15,218.34 |
| Rate for Payer: BCBS Complete |
$15,218.34
|
| Rate for Payer: Mclaren Medicaid |
$14,493.65
|
| Rate for Payer: Meridian Medicaid |
$15,218.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,493.65
|
| Rate for Payer: UHC Medicaid |
$14,493.65
|
| Rate for Payer: UHCCP Medicaid |
$14,493.65
|
|
|
SPLENIC PROCEDURES
|
Facility
|
IP
|
$8,871.45
|
|
|
Service Code
|
APR-DRG 6501
|
| Min. Negotiated Rate |
$8,449.00 |
| Max. Negotiated Rate |
$8,871.45 |
| Rate for Payer: BCBS Complete |
$8,871.45
|
| Rate for Payer: Mclaren Medicaid |
$8,449.00
|
| Rate for Payer: Meridian Medicaid |
$8,871.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,449.00
|
| Rate for Payer: UHC Medicaid |
$8,449.00
|
| Rate for Payer: UHCCP Medicaid |
$8,449.00
|
|
|
SPLENIC PROCEDURES
|
Facility
|
IP
|
$12,123.24
|
|
|
Service Code
|
APR-DRG 6502
|
| Min. Negotiated Rate |
$11,545.94 |
| Max. Negotiated Rate |
$12,123.24 |
| Rate for Payer: BCBS Complete |
$12,123.24
|
| Rate for Payer: Mclaren Medicaid |
$11,545.94
|
| Rate for Payer: Meridian Medicaid |
$12,123.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,545.94
|
| Rate for Payer: UHC Medicaid |
$11,545.94
|
| Rate for Payer: UHCCP Medicaid |
$11,545.94
|
|
|
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION (CODE)
|
Facility
|
OP
|
$23.68
|
|
|
Service Code
|
HCPCS J0330
|
| Hospital Charge Code |
163722
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.17 |
| Max. Negotiated Rate |
$21.31 |
| Rate for Payer: Aetna Commercial |
$20.13
|
| Rate for Payer: Aetna Medicare |
$6.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.40
|
| Rate for Payer: BCBS Complete |
$4.38
|
| Rate for Payer: BCBS MAPPO |
$5.92
|
| Rate for Payer: BCBS Trust/PPO |
$19.47
|
| Rate for Payer: BCN Commercial |
$19.47
|
| Rate for Payer: BCN Medicare Advantage |
$5.92
|
| Rate for Payer: Cash Price |
$18.94
|
| Rate for Payer: Cofinity Commercial |
$20.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.92
|
| Rate for Payer: Healthscope Commercial |
$21.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.76
|
| Rate for Payer: Mclaren Medicaid |
$4.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.22
|
| Rate for Payer: Meridian Medicaid |
$4.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.13
|
| Rate for Payer: Nomi Health Commercial |
$19.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.76
|
| Rate for Payer: PACE Senior Care Partners |
$5.62
|
| Rate for Payer: PACE SWMI |
$5.92
|
| Rate for Payer: PHP Commercial |
$20.13
|
| Rate for Payer: PHP Medicare Advantage |
$5.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.60
|
| Rate for Payer: Priority Health Medicare |
$5.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.48
|
| Rate for Payer: Railroad Medicare Medicare |
$5.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.84
|
| Rate for Payer: UHC Core |
$19.77
|
| Rate for Payer: UHC Exchange |
$5.92
|
| Rate for Payer: UHC Medicaid |
$4.17
|
| Rate for Payer: UHC Medicare Advantage |
$5.92
|
| Rate for Payer: UHCCP Medicaid |
$4.17
|
| Rate for Payer: VA VA |
$5.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.76
|
|
|
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION (CODE)
|
Facility
|
IP
|
$23.68
|
|
|
Service Code
|
HCPCS J0330
|
| Hospital Charge Code |
163722
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.48 |
| Max. Negotiated Rate |
$21.31 |
| Rate for Payer: Aetna Commercial |
$20.13
|
| Rate for Payer: BCBS Trust/PPO |
$19.56
|
| Rate for Payer: BCN Commercial |
$19.56
|
| Rate for Payer: Cash Price |
$18.94
|
| Rate for Payer: Cofinity Commercial |
$20.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.94
|
| Rate for Payer: Healthscope Commercial |
$21.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.13
|
| Rate for Payer: Nomi Health Commercial |
$19.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.76
|
| Rate for Payer: PHP Commercial |
$20.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.84
|
| Rate for Payer: UHC Core |
$19.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.76
|
|
|
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$26.97
|
|
|
Service Code
|
HCPCS J0330
|
| Hospital Charge Code |
7536
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.75 |
| Max. Negotiated Rate |
$24.27 |
| Rate for Payer: Aetna Commercial |
$22.92
|
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: Aetna Commercial |
$14.03
|
| Rate for Payer: Aetna Commercial |
$20.13
|
| Rate for Payer: Aetna Commercial |
$18.50
|
| Rate for Payer: Aetna Commercial |
$18.37
|
| Rate for Payer: Aetna Medicare |
$5.68
|
| Rate for Payer: Aetna Medicare |
$5.62
|
| Rate for Payer: Aetna Medicare |
$4.29
|
| Rate for Payer: Aetna Medicare |
$7.01
|
| Rate for Payer: Aetna Medicare |
$5.66
|
| Rate for Payer: Aetna Medicare |
$6.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.82
|
| Rate for Payer: BCBS Complete |
$4.03
|
| Rate for Payer: BCBS Complete |
$4.38
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS Complete |
$3.06
|
| Rate for Payer: BCBS Complete |
$4.99
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$5.46
|
| Rate for Payer: BCBS MAPPO |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$5.92
|
| Rate for Payer: BCBS MAPPO |
$5.40
|
| Rate for Payer: BCBS MAPPO |
$4.13
|
| Rate for Payer: BCBS MAPPO |
$5.44
|
| Rate for Payer: BCBS Trust/PPO |
$13.57
|
| Rate for Payer: BCBS Trust/PPO |
$19.47
|
| Rate for Payer: BCBS Trust/PPO |
$17.77
|
| Rate for Payer: BCBS Trust/PPO |
$17.89
|
| Rate for Payer: BCBS Trust/PPO |
$17.95
|
| Rate for Payer: BCBS Trust/PPO |
$22.17
|
| Rate for Payer: BCN Commercial |
$17.89
|
| Rate for Payer: BCN Commercial |
$17.95
|
| Rate for Payer: BCN Commercial |
$13.57
|
| Rate for Payer: BCN Commercial |
$17.77
|
| Rate for Payer: BCN Commercial |
$19.47
|
| Rate for Payer: BCN Commercial |
$22.17
|
| Rate for Payer: BCN Medicare Advantage |
$5.92
|
| Rate for Payer: BCN Medicare Advantage |
$6.74
|
| Rate for Payer: BCN Medicare Advantage |
$5.44
|
| Rate for Payer: BCN Medicare Advantage |
$4.13
|
| Rate for Payer: BCN Medicare Advantage |
$5.46
|
| Rate for Payer: BCN Medicare Advantage |
$5.40
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cash Price |
$13.21
|
| Rate for Payer: Cash Price |
$17.29
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cash Price |
$18.94
|
| Rate for Payer: Cash Price |
$17.41
|
| Rate for Payer: Cofinity Commercial |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$18.71
|
| Rate for Payer: Cofinity Commercial |
$14.20
|
| Rate for Payer: Cofinity Commercial |
$18.58
|
| Rate for Payer: Cofinity Commercial |
$23.19
|
| Rate for Payer: Cofinity Commercial |
$20.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.40
|
| Rate for Payer: Healthscope Commercial |
$19.65
|
| Rate for Payer: Healthscope Commercial |
$24.27
|
| Rate for Payer: Healthscope Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$19.45
|
| Rate for Payer: Healthscope Commercial |
$14.86
|
| Rate for Payer: Healthscope Commercial |
$21.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.32
|
| Rate for Payer: Mclaren Medicaid |
$3.81
|
| Rate for Payer: Mclaren Medicaid |
$2.91
|
| Rate for Payer: Mclaren Medicaid |
$3.84
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Mclaren Medicaid |
$4.17
|
| Rate for Payer: Mclaren Medicaid |
$4.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.71
|
| Rate for Payer: Meridian Medicaid |
$4.38
|
| Rate for Payer: Meridian Medicaid |
$4.99
|
| Rate for Payer: Meridian Medicaid |
$4.00
|
| Rate for Payer: Meridian Medicaid |
$3.06
|
| Rate for Payer: Meridian Medicaid |
$4.03
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.92
|
| Rate for Payer: Nomi Health Commercial |
$17.84
|
| Rate for Payer: Nomi Health Commercial |
$17.90
|
| Rate for Payer: Nomi Health Commercial |
$13.54
|
| Rate for Payer: Nomi Health Commercial |
$19.42
|
| Rate for Payer: Nomi Health Commercial |
$22.12
|
| Rate for Payer: Nomi Health Commercial |
$17.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.21
|
| Rate for Payer: PACE Senior Care Partners |
$5.17
|
| Rate for Payer: PACE Senior Care Partners |
$5.13
|
| Rate for Payer: PACE Senior Care Partners |
$5.18
|
| Rate for Payer: PACE Senior Care Partners |
$5.62
|
| Rate for Payer: PACE Senior Care Partners |
$3.92
|
| Rate for Payer: PACE Senior Care Partners |
$6.41
|
| Rate for Payer: PACE SWMI |
$5.40
|
| Rate for Payer: PACE SWMI |
$5.46
|
| Rate for Payer: PACE SWMI |
$6.74
|
| Rate for Payer: PACE SWMI |
$4.13
|
| Rate for Payer: PACE SWMI |
$5.92
|
| Rate for Payer: PACE SWMI |
$5.44
|
| Rate for Payer: PHP Commercial |
$18.50
|
| Rate for Payer: PHP Commercial |
$18.37
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Commercial |
$20.13
|
| Rate for Payer: PHP Commercial |
$22.92
|
| Rate for Payer: PHP Commercial |
$14.03
|
| Rate for Payer: PHP Medicare Advantage |
$6.74
|
| Rate for Payer: PHP Medicare Advantage |
$5.40
|
| Rate for Payer: PHP Medicare Advantage |
$5.92
|
| Rate for Payer: PHP Medicare Advantage |
$4.13
|
| Rate for Payer: PHP Medicare Advantage |
$5.46
|
| Rate for Payer: PHP Medicare Advantage |
$5.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.46
|
| Rate for Payer: Priority Health Medicare |
$4.17
|
| Rate for Payer: Priority Health Medicare |
$6.81
|
| Rate for Payer: Priority Health Medicare |
$5.46
|
| Rate for Payer: Priority Health Medicare |
$5.51
|
| Rate for Payer: Priority Health Medicare |
$5.49
|
| Rate for Payer: Priority Health Medicare |
$5.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.19
|
| Rate for Payer: Railroad Medicare Medicare |
$4.13
|
| Rate for Payer: Railroad Medicare Medicare |
$5.92
|
| Rate for Payer: Railroad Medicare Medicare |
$5.46
|
| Rate for Payer: Railroad Medicare Medicare |
$5.40
|
| Rate for Payer: Railroad Medicare Medicare |
$5.44
|
| Rate for Payer: Railroad Medicare Medicare |
$6.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.53
|
| Rate for Payer: UHC Core |
$18.17
|
| Rate for Payer: UHC Core |
$19.77
|
| Rate for Payer: UHC Core |
$18.23
|
| Rate for Payer: UHC Core |
$22.52
|
| Rate for Payer: UHC Core |
$13.79
|
| Rate for Payer: UHC Core |
$18.04
|
| Rate for Payer: UHC Exchange |
$5.40
|
| Rate for Payer: UHC Exchange |
$4.13
|
| Rate for Payer: UHC Exchange |
$5.46
|
| Rate for Payer: UHC Exchange |
$5.44
|
| Rate for Payer: UHC Exchange |
$5.92
|
| Rate for Payer: UHC Exchange |
$6.74
|
| Rate for Payer: UHC Medicaid |
$4.17
|
| Rate for Payer: UHC Medicaid |
$3.85
|
| Rate for Payer: UHC Medicaid |
$3.81
|
| Rate for Payer: UHC Medicaid |
$3.84
|
| Rate for Payer: UHC Medicaid |
$2.91
|
| Rate for Payer: UHC Medicaid |
$4.75
|
| Rate for Payer: UHC Medicare Advantage |
$5.40
|
| Rate for Payer: UHC Medicare Advantage |
$5.92
|
| Rate for Payer: UHC Medicare Advantage |
$5.46
|
| Rate for Payer: UHC Medicare Advantage |
$5.44
|
| Rate for Payer: UHC Medicare Advantage |
$4.13
|
| Rate for Payer: UHC Medicare Advantage |
$6.74
|
| Rate for Payer: UHCCP Medicaid |
$4.17
|
| Rate for Payer: UHCCP Medicaid |
$3.85
|
| Rate for Payer: UHCCP Medicaid |
$3.84
|
| Rate for Payer: UHCCP Medicaid |
$3.81
|
| Rate for Payer: UHCCP Medicaid |
$2.91
|
| Rate for Payer: UHCCP Medicaid |
$4.75
|
| Rate for Payer: VA VA |
$5.44
|
| Rate for Payer: VA VA |
$5.40
|
| Rate for Payer: VA VA |
$5.92
|
| Rate for Payer: VA VA |
$5.46
|
| Rate for Payer: VA VA |
$4.13
|
| Rate for Payer: VA VA |
$6.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.32
|
|
|
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$26.97
|
|
|
Service Code
|
HCPCS J0330
|
| Hospital Charge Code |
7536
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.77 |
| Max. Negotiated Rate |
$24.27 |
| Rate for Payer: Aetna Commercial |
$22.92
|
| Rate for Payer: Aetna Commercial |
$14.03
|
| Rate for Payer: Aetna Commercial |
$18.50
|
| Rate for Payer: Aetna Commercial |
$18.37
|
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: Aetna Commercial |
$20.13
|
| Rate for Payer: BCBS Trust/PPO |
$22.27
|
| Rate for Payer: BCBS Trust/PPO |
$18.03
|
| Rate for Payer: BCBS Trust/PPO |
$19.56
|
| Rate for Payer: BCBS Trust/PPO |
$17.85
|
| Rate for Payer: BCBS Trust/PPO |
$13.64
|
| Rate for Payer: BCBS Trust/PPO |
$17.97
|
| Rate for Payer: BCN Commercial |
$19.56
|
| Rate for Payer: BCN Commercial |
$18.03
|
| Rate for Payer: BCN Commercial |
$13.64
|
| Rate for Payer: BCN Commercial |
$17.97
|
| Rate for Payer: BCN Commercial |
$22.27
|
| Rate for Payer: BCN Commercial |
$17.85
|
| Rate for Payer: Cash Price |
$21.58
|
| Rate for Payer: Cash Price |
$17.29
|
| Rate for Payer: Cash Price |
$17.41
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cash Price |
$13.21
|
| Rate for Payer: Cash Price |
$18.94
|
| Rate for Payer: Cofinity Commercial |
$20.36
|
| Rate for Payer: Cofinity Commercial |
$18.58
|
| Rate for Payer: Cofinity Commercial |
$18.71
|
| Rate for Payer: Cofinity Commercial |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$14.20
|
| Rate for Payer: Cofinity Commercial |
$23.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.58
|
| Rate for Payer: Healthscope Commercial |
$14.86
|
| Rate for Payer: Healthscope Commercial |
$19.45
|
| Rate for Payer: Healthscope Commercial |
$21.31
|
| Rate for Payer: Healthscope Commercial |
$24.27
|
| Rate for Payer: Healthscope Commercial |
$19.65
|
| Rate for Payer: Healthscope Commercial |
$19.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.50
|
| Rate for Payer: Nomi Health Commercial |
$19.42
|
| Rate for Payer: Nomi Health Commercial |
$13.54
|
| Rate for Payer: Nomi Health Commercial |
$17.72
|
| Rate for Payer: Nomi Health Commercial |
$17.90
|
| Rate for Payer: Nomi Health Commercial |
$17.84
|
| Rate for Payer: Nomi Health Commercial |
$22.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.37
|
| Rate for Payer: PHP Commercial |
$20.13
|
| Rate for Payer: PHP Commercial |
$22.92
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Commercial |
$14.03
|
| Rate for Payer: PHP Commercial |
$18.37
|
| Rate for Payer: PHP Commercial |
$18.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.73
|
| Rate for Payer: UHC Core |
$22.52
|
| Rate for Payer: UHC Core |
$18.04
|
| Rate for Payer: UHC Core |
$18.17
|
| Rate for Payer: UHC Core |
$19.77
|
| Rate for Payer: UHC Core |
$18.23
|
| Rate for Payer: UHC Core |
$13.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.38
|
|
|
SUCRALFATE 100 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$33.17
|
|
|
Service Code
|
NDC 60687073842
|
| Hospital Charge Code |
11441
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.85 |
| Max. Negotiated Rate |
$29.85 |
| Rate for Payer: Aetna Commercial |
$28.19
|
| Rate for Payer: Aetna Medicare |
$8.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.37
|
| Rate for Payer: BCBS Complete |
$6.14
|
| Rate for Payer: BCBS MAPPO |
$8.29
|
| Rate for Payer: BCBS Trust/PPO |
$27.27
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: BCN Medicare Advantage |
$8.29
|
| Rate for Payer: Cash Price |
$26.54
|
| Rate for Payer: Cofinity Commercial |
$28.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.29
|
| Rate for Payer: Healthscope Commercial |
$29.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.88
|
| Rate for Payer: Mclaren Medicaid |
$5.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.71
|
| Rate for Payer: Meridian Medicaid |
$6.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.19
|
| Rate for Payer: Nomi Health Commercial |
$27.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.88
|
| Rate for Payer: PACE Senior Care Partners |
$7.88
|
| Rate for Payer: PACE SWMI |
$8.29
|
| Rate for Payer: PHP Commercial |
$28.19
|
| Rate for Payer: PHP Medicare Advantage |
$8.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.86
|
| Rate for Payer: Priority Health Medicare |
$8.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.09
|
| Rate for Payer: Railroad Medicare Medicare |
$8.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.19
|
| Rate for Payer: UHC Core |
$27.70
|
| Rate for Payer: UHC Exchange |
$8.29
|
| Rate for Payer: UHC Medicaid |
$5.85
|
| Rate for Payer: UHC Medicare Advantage |
$8.29
|
| Rate for Payer: UHCCP Medicaid |
$5.85
|
| Rate for Payer: VA VA |
$8.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.88
|
|
|
SUCRALFATE 100 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$42.29
|
|
|
Service Code
|
NDC 68094004361
|
| Hospital Charge Code |
11441
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$38.06 |
| Rate for Payer: Aetna Commercial |
$35.95
|
| Rate for Payer: Aetna Medicare |
$11.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.22
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS MAPPO |
$10.57
|
| Rate for Payer: BCBS Trust/PPO |
$34.77
|
| Rate for Payer: BCN Commercial |
$34.77
|
| Rate for Payer: BCN Medicare Advantage |
$10.57
|
| Rate for Payer: Cash Price |
$33.83
|
| Rate for Payer: Cofinity Commercial |
$36.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.57
|
| Rate for Payer: Healthscope Commercial |
$38.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.72
|
| Rate for Payer: Mclaren Medicaid |
$7.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.10
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.95
|
| Rate for Payer: Nomi Health Commercial |
$34.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.72
|
| Rate for Payer: PACE Senior Care Partners |
$10.04
|
| Rate for Payer: PACE SWMI |
$10.57
|
| Rate for Payer: PHP Commercial |
$35.95
|
| Rate for Payer: PHP Medicare Advantage |
$10.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.79
|
| Rate for Payer: Priority Health Medicare |
$10.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.43
|
| Rate for Payer: Railroad Medicare Medicare |
$10.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.22
|
| Rate for Payer: UHC Core |
$35.31
|
| Rate for Payer: UHC Exchange |
$10.57
|
| Rate for Payer: UHC Medicaid |
$7.46
|
| Rate for Payer: UHC Medicare Advantage |
$10.57
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
| Rate for Payer: VA VA |
$10.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.72
|
|
|
SUCRALFATE 100 MG/ML ORAL SUSPENSION
|
Facility
|
IP
|
$45.51
|
|
|
Service Code
|
NDC 00904747072
|
| Hospital Charge Code |
11441
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.67 |
| Max. Negotiated Rate |
$40.96 |
| Rate for Payer: Aetna Commercial |
$38.68
|
| Rate for Payer: BCBS Trust/PPO |
$37.59
|
| Rate for Payer: BCN Commercial |
$37.59
|
| Rate for Payer: Cash Price |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$39.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.41
|
| Rate for Payer: Healthscope Commercial |
$40.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.68
|
| Rate for Payer: Nomi Health Commercial |
$37.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.13
|
| Rate for Payer: PHP Commercial |
$38.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.05
|
| Rate for Payer: UHC Core |
$38.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.13
|
|
|
SUCRALFATE 100 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$25.25
|
|
|
Service Code
|
NDC 60687073823
|
| Hospital Charge Code |
11441
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.45 |
| Max. Negotiated Rate |
$22.73 |
| Rate for Payer: Aetna Commercial |
$21.46
|
| Rate for Payer: Aetna Medicare |
$6.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.89
|
| Rate for Payer: BCBS Complete |
$4.67
|
| Rate for Payer: BCBS MAPPO |
$6.31
|
| Rate for Payer: BCBS Trust/PPO |
$20.76
|
| Rate for Payer: BCN Commercial |
$20.76
|
| Rate for Payer: BCN Medicare Advantage |
$6.31
|
| Rate for Payer: Cash Price |
$20.20
|
| Rate for Payer: Cofinity Commercial |
$21.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.31
|
| Rate for Payer: Healthscope Commercial |
$22.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.94
|
| Rate for Payer: Mclaren Medicaid |
$4.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.63
|
| Rate for Payer: Meridian Medicaid |
$4.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.46
|
| Rate for Payer: Nomi Health Commercial |
$20.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.94
|
| Rate for Payer: PACE Senior Care Partners |
$6.00
|
| Rate for Payer: PACE SWMI |
$6.31
|
| Rate for Payer: PHP Commercial |
$21.46
|
| Rate for Payer: PHP Medicare Advantage |
$6.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.97
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.57
|
| Rate for Payer: Railroad Medicare Medicare |
$6.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.22
|
| Rate for Payer: UHC Core |
$21.08
|
| Rate for Payer: UHC Exchange |
$6.31
|
| Rate for Payer: UHC Medicaid |
$4.45
|
| Rate for Payer: UHC Medicare Advantage |
$6.31
|
| Rate for Payer: UHCCP Medicaid |
$4.45
|
| Rate for Payer: VA VA |
$6.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.94
|
|
|
SUCRALFATE 100 MG/ML ORAL SUSPENSION
|
Facility
|
IP
|
$30.15
|
|
|
Service Code
|
NDC 00904747066
|
| Hospital Charge Code |
11441
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.98 |
| Max. Negotiated Rate |
$27.14 |
| Rate for Payer: Aetna Commercial |
$25.63
|
| Rate for Payer: BCBS Trust/PPO |
$24.90
|
| Rate for Payer: BCN Commercial |
$24.90
|
| Rate for Payer: Cash Price |
$24.12
|
| Rate for Payer: Cofinity Commercial |
$25.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.12
|
| Rate for Payer: Healthscope Commercial |
$27.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.63
|
| Rate for Payer: Nomi Health Commercial |
$24.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.61
|
| Rate for Payer: PHP Commercial |
$25.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.53
|
| Rate for Payer: UHC Core |
$25.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.61
|
|
|
SUCRALFATE 100 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$42.29
|
|
|
Service Code
|
NDC 68094004359
|
| Hospital Charge Code |
11441
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$38.06 |
| Rate for Payer: Aetna Commercial |
$35.95
|
| Rate for Payer: Aetna Medicare |
$11.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.22
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS MAPPO |
$10.57
|
| Rate for Payer: BCBS Trust/PPO |
$34.77
|
| Rate for Payer: BCN Commercial |
$34.77
|
| Rate for Payer: BCN Medicare Advantage |
$10.57
|
| Rate for Payer: Cash Price |
$33.83
|
| Rate for Payer: Cofinity Commercial |
$36.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.57
|
| Rate for Payer: Healthscope Commercial |
$38.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.72
|
| Rate for Payer: Mclaren Medicaid |
$7.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.10
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.95
|
| Rate for Payer: Nomi Health Commercial |
$34.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.72
|
| Rate for Payer: PACE Senior Care Partners |
$10.04
|
| Rate for Payer: PACE SWMI |
$10.57
|
| Rate for Payer: PHP Commercial |
$35.95
|
| Rate for Payer: PHP Medicare Advantage |
$10.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.79
|
| Rate for Payer: Priority Health Medicare |
$10.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.43
|
| Rate for Payer: Railroad Medicare Medicare |
$10.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.22
|
| Rate for Payer: UHC Core |
$35.31
|
| Rate for Payer: UHC Exchange |
$10.57
|
| Rate for Payer: UHC Medicaid |
$7.46
|
| Rate for Payer: UHC Medicare Advantage |
$10.57
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
| Rate for Payer: VA VA |
$10.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.72
|
|
|
SUCRALFATE 100 MG/ML ORAL SUSPENSION
|
Facility
|
IP
|
$33.17
|
|
|
Service Code
|
NDC 60687073842
|
| Hospital Charge Code |
11441
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$23.09 |
| Max. Negotiated Rate |
$29.85 |
| Rate for Payer: Aetna Commercial |
$28.19
|
| Rate for Payer: BCBS Trust/PPO |
$27.40
|
| Rate for Payer: BCN Commercial |
$27.40
|
| Rate for Payer: Cash Price |
$26.54
|
| Rate for Payer: Cofinity Commercial |
$28.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.54
|
| Rate for Payer: Healthscope Commercial |
$29.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.19
|
| Rate for Payer: Nomi Health Commercial |
$27.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.88
|
| Rate for Payer: PHP Commercial |
$28.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.19
|
| Rate for Payer: UHC Core |
$27.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.88
|
|
|
SUCRALFATE 100 MG/ML ORAL SUSPENSION
|
Facility
|
OP
|
$25.40
|
|
|
Service Code
|
NDC 00121097410
|
| Hospital Charge Code |
11441
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.48 |
| Max. Negotiated Rate |
$22.86 |
| Rate for Payer: Aetna Commercial |
$21.59
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.94
|
| Rate for Payer: BCBS Complete |
$4.70
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.88
|
| Rate for Payer: BCN Commercial |
$20.88
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.32
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.05
|
| Rate for Payer: Mclaren Medicaid |
$4.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.67
|
| Rate for Payer: Meridian Medicaid |
$4.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.59
|
| Rate for Payer: Nomi Health Commercial |
$20.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.05
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.59
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.10
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.68
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.35
|
| Rate for Payer: UHC Core |
$21.21
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicaid |
$4.48
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$4.48
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.05
|
|
|
SUCRALFATE 100 MG/ML ORAL SUSPENSION
|
Facility
|
IP
|
$25.25
|
|
|
Service Code
|
NDC 60687073823
|
| Hospital Charge Code |
11441
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$17.57 |
| Max. Negotiated Rate |
$22.73 |
| Rate for Payer: Aetna Commercial |
$21.46
|
| Rate for Payer: BCBS Trust/PPO |
$20.85
|
| Rate for Payer: BCN Commercial |
$20.85
|
| Rate for Payer: Cash Price |
$20.20
|
| Rate for Payer: Cofinity Commercial |
$21.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.20
|
| Rate for Payer: Healthscope Commercial |
$22.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.46
|
| Rate for Payer: Nomi Health Commercial |
$20.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.94
|
| Rate for Payer: PHP Commercial |
$21.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.22
|
| Rate for Payer: UHC Core |
$21.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.94
|
|
