|
SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE
|
Facility
|
OP
|
$895.16
|
|
|
Service Code
|
CPT 45338
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$852.47 |
| Max. Negotiated Rate |
$895.16 |
| Rate for Payer: BCBS Complete |
$895.16
|
| Rate for Payer: Mclaren Medicaid |
$852.47
|
| Rate for Payer: Meridian Medicaid |
$895.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$852.47
|
| Rate for Payer: UHCCP Medicaid |
$852.47
|
|
|
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK
|
Facility
|
OP
|
$81.90
|
|
|
Service Code
|
NDC 12165010003
|
| Hospital Charge Code |
11359
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$19.45 |
| Max. Negotiated Rate |
$73.71 |
| Rate for Payer: Aetna Commercial |
$69.61
|
| Rate for Payer: Aetna Medicare |
$21.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.59
|
| Rate for Payer: BCBS Complete |
$32.76
|
| Rate for Payer: BCBS MAPPO |
$20.48
|
| Rate for Payer: BCBS Trust/PPO |
$67.33
|
| Rate for Payer: BCN Commercial |
$63.68
|
| Rate for Payer: BCN Medicare Advantage |
$20.48
|
| Rate for Payer: Cash Price |
$65.52
|
| Rate for Payer: Cofinity Commercial |
$70.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.48
|
| Rate for Payer: Healthscope Commercial |
$73.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.61
|
| Rate for Payer: Nomi Health Commercial |
$67.16
|
| Rate for Payer: PACE Senior Care Partners |
$19.45
|
| Rate for Payer: PACE SWMI |
$20.48
|
| Rate for Payer: PHP Commercial |
$69.61
|
| Rate for Payer: PHP Medicare Advantage |
$20.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.23
|
| Rate for Payer: Priority Health HMO/PPO |
$71.25
|
| Rate for Payer: Priority Health Medicare |
$20.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.87
|
| Rate for Payer: Railroad Medicare Medicare |
$20.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.07
|
| Rate for Payer: UHC Core |
$68.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.48
|
| Rate for Payer: UHC Exchange |
$20.48
|
| Rate for Payer: UHC Medicare Advantage |
$20.48
|
| Rate for Payer: VA VA |
$20.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.42
|
|
|
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK
|
Facility
|
IP
|
$81.90
|
|
|
Service Code
|
NDC 12165010003
|
| Hospital Charge Code |
11359
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$53.23 |
| Max. Negotiated Rate |
$73.71 |
| Rate for Payer: Aetna Commercial |
$69.61
|
| Rate for Payer: BCBS Trust/PPO |
$66.85
|
| Rate for Payer: BCN Commercial |
$63.29
|
| Rate for Payer: Cash Price |
$65.52
|
| Rate for Payer: Cofinity Commercial |
$70.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.52
|
| Rate for Payer: Healthscope Commercial |
$73.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.61
|
| Rate for Payer: Nomi Health Commercial |
$67.16
|
| Rate for Payer: PHP Commercial |
$69.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.23
|
| Rate for Payer: Priority Health HMO/PPO |
$71.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.07
|
| Rate for Payer: UHC Core |
$68.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.42
|
|
|
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK
|
Facility
|
OP
|
$5.16
|
|
|
Service Code
|
NDC 09900000976
|
| Hospital Charge Code |
11359
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.23 |
| Max. Negotiated Rate |
$4.64 |
| Rate for Payer: Aetna Commercial |
$4.39
|
| Rate for Payer: Aetna Medicare |
$1.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.61
|
| Rate for Payer: BCBS Complete |
$2.06
|
| Rate for Payer: BCBS MAPPO |
$1.29
|
| Rate for Payer: BCBS Trust/PPO |
$4.24
|
| Rate for Payer: BCN Commercial |
$4.01
|
| Rate for Payer: BCN Medicare Advantage |
$1.29
|
| Rate for Payer: Cash Price |
$4.13
|
| Rate for Payer: Cofinity Commercial |
$4.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.29
|
| Rate for Payer: Healthscope Commercial |
$4.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.39
|
| Rate for Payer: Nomi Health Commercial |
$4.23
|
| Rate for Payer: PACE Senior Care Partners |
$1.23
|
| Rate for Payer: PACE SWMI |
$1.29
|
| Rate for Payer: PHP Commercial |
$4.39
|
| Rate for Payer: PHP Medicare Advantage |
$1.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.35
|
| Rate for Payer: Priority Health HMO/PPO |
$4.49
|
| Rate for Payer: Priority Health Medicare |
$1.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.46
|
| Rate for Payer: Railroad Medicare Medicare |
$1.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.54
|
| Rate for Payer: UHC Core |
$4.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.29
|
| Rate for Payer: UHC Exchange |
$1.29
|
| Rate for Payer: UHC Medicare Advantage |
$1.29
|
| Rate for Payer: VA VA |
$1.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.87
|
|
|
SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK
|
Facility
|
IP
|
$5.16
|
|
|
Service Code
|
NDC 09900000976
|
| Hospital Charge Code |
11359
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.35 |
| Max. Negotiated Rate |
$4.64 |
| Rate for Payer: Aetna Commercial |
$4.39
|
| Rate for Payer: BCBS Trust/PPO |
$4.21
|
| Rate for Payer: BCN Commercial |
$3.99
|
| Rate for Payer: Cash Price |
$4.13
|
| Rate for Payer: Cofinity Commercial |
$4.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.13
|
| Rate for Payer: Healthscope Commercial |
$4.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.39
|
| Rate for Payer: Nomi Health Commercial |
$4.23
|
| Rate for Payer: PHP Commercial |
$4.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.35
|
| Rate for Payer: Priority Health HMO/PPO |
$4.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.54
|
| Rate for Payer: UHC Core |
$4.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.87
|
|
|
SILVER SULFADIAZINE 1 % TOPICAL CREAM
|
Facility
|
OP
|
$18.90
|
|
|
Service Code
|
NDC 67877012450
|
| Hospital Charge Code |
7224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.49 |
| Max. Negotiated Rate |
$17.01 |
| Rate for Payer: Aetna Commercial |
$16.07
|
| Rate for Payer: Aetna Medicare |
$4.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.91
|
| Rate for Payer: BCBS Complete |
$7.56
|
| Rate for Payer: BCBS MAPPO |
$4.72
|
| Rate for Payer: BCBS Trust/PPO |
$15.54
|
| Rate for Payer: BCN Commercial |
$14.69
|
| Rate for Payer: BCN Medicare Advantage |
$4.72
|
| Rate for Payer: Cash Price |
$15.12
|
| Rate for Payer: Cofinity Commercial |
$16.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.72
|
| Rate for Payer: Healthscope Commercial |
$17.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.07
|
| Rate for Payer: Nomi Health Commercial |
$15.50
|
| Rate for Payer: PACE Senior Care Partners |
$4.49
|
| Rate for Payer: PACE SWMI |
$4.72
|
| Rate for Payer: PHP Commercial |
$16.07
|
| Rate for Payer: PHP Medicare Advantage |
$4.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.29
|
| Rate for Payer: Priority Health HMO/PPO |
$16.44
|
| Rate for Payer: Priority Health Medicare |
$4.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.66
|
| Rate for Payer: Railroad Medicare Medicare |
$4.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.63
|
| Rate for Payer: UHC Core |
$15.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.72
|
| Rate for Payer: UHC Exchange |
$4.72
|
| Rate for Payer: UHC Medicare Advantage |
$4.72
|
| Rate for Payer: VA VA |
$4.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.18
|
|
|
SILVER SULFADIAZINE 1 % TOPICAL CREAM
|
Facility
|
IP
|
$18.90
|
|
|
Service Code
|
NDC 67877012450
|
| Hospital Charge Code |
7224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$12.29 |
| Max. Negotiated Rate |
$17.01 |
| Rate for Payer: Aetna Commercial |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$15.43
|
| Rate for Payer: BCN Commercial |
$14.61
|
| Rate for Payer: Cash Price |
$15.12
|
| Rate for Payer: Cofinity Commercial |
$16.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.12
|
| Rate for Payer: Healthscope Commercial |
$17.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.07
|
| Rate for Payer: Nomi Health Commercial |
$15.50
|
| Rate for Payer: PHP Commercial |
$16.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.29
|
| Rate for Payer: Priority Health HMO/PPO |
$16.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.63
|
| Rate for Payer: UHC Core |
$15.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.18
|
|
|
SILVER SULFADIAZINE 1 % TOPICAL CREAM
|
Facility
|
IP
|
$18.90
|
|
|
Service Code
|
NDC 67877012405
|
| Hospital Charge Code |
7224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$12.29 |
| Max. Negotiated Rate |
$17.01 |
| Rate for Payer: Aetna Commercial |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$15.43
|
| Rate for Payer: BCN Commercial |
$14.61
|
| Rate for Payer: Cash Price |
$15.12
|
| Rate for Payer: Cofinity Commercial |
$16.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.12
|
| Rate for Payer: Healthscope Commercial |
$17.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.07
|
| Rate for Payer: Nomi Health Commercial |
$15.50
|
| Rate for Payer: PHP Commercial |
$16.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.29
|
| Rate for Payer: Priority Health HMO/PPO |
$16.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.63
|
| Rate for Payer: UHC Core |
$15.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.18
|
|
|
SILVER SULFADIAZINE 1 % TOPICAL CREAM
|
Facility
|
OP
|
$18.90
|
|
|
Service Code
|
NDC 67877012405
|
| Hospital Charge Code |
7224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.49 |
| Max. Negotiated Rate |
$17.01 |
| Rate for Payer: Aetna Commercial |
$16.07
|
| Rate for Payer: Aetna Medicare |
$4.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.91
|
| Rate for Payer: BCBS Complete |
$7.56
|
| Rate for Payer: BCBS MAPPO |
$4.72
|
| Rate for Payer: BCBS Trust/PPO |
$15.54
|
| Rate for Payer: BCN Commercial |
$14.69
|
| Rate for Payer: BCN Medicare Advantage |
$4.72
|
| Rate for Payer: Cash Price |
$15.12
|
| Rate for Payer: Cofinity Commercial |
$16.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.72
|
| Rate for Payer: Healthscope Commercial |
$17.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.07
|
| Rate for Payer: Nomi Health Commercial |
$15.50
|
| Rate for Payer: PACE Senior Care Partners |
$4.49
|
| Rate for Payer: PACE SWMI |
$4.72
|
| Rate for Payer: PHP Commercial |
$16.07
|
| Rate for Payer: PHP Medicare Advantage |
$4.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.29
|
| Rate for Payer: Priority Health HMO/PPO |
$16.44
|
| Rate for Payer: Priority Health Medicare |
$4.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.66
|
| Rate for Payer: Railroad Medicare Medicare |
$4.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.63
|
| Rate for Payer: UHC Core |
$15.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.72
|
| Rate for Payer: UHC Exchange |
$4.72
|
| Rate for Payer: UHC Medicare Advantage |
$4.72
|
| Rate for Payer: VA VA |
$4.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.18
|
|
|
SILVER SULFADIAZINE 1 % TOPICAL CREAM
|
Facility
|
IP
|
$88.20
|
|
|
Service Code
|
NDC 67877012440
|
| Hospital Charge Code |
7224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$57.33 |
| Max. Negotiated Rate |
$79.38 |
| Rate for Payer: Aetna Commercial |
$74.97
|
| Rate for Payer: BCBS Trust/PPO |
$72.00
|
| Rate for Payer: BCN Commercial |
$68.16
|
| Rate for Payer: Cash Price |
$70.56
|
| Rate for Payer: Cofinity Commercial |
$75.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.56
|
| Rate for Payer: Healthscope Commercial |
$79.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.97
|
| Rate for Payer: Nomi Health Commercial |
$72.32
|
| Rate for Payer: PHP Commercial |
$74.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.33
|
| Rate for Payer: Priority Health HMO/PPO |
$76.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.62
|
| Rate for Payer: UHC Core |
$73.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.15
|
|
|
SILVER SULFADIAZINE 1 % TOPICAL CREAM
|
Facility
|
OP
|
$88.20
|
|
|
Service Code
|
NDC 67877012440
|
| Hospital Charge Code |
7224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.95 |
| Max. Negotiated Rate |
$79.38 |
| Rate for Payer: Aetna Commercial |
$74.97
|
| Rate for Payer: Aetna Medicare |
$22.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.56
|
| Rate for Payer: BCBS Complete |
$35.28
|
| Rate for Payer: BCBS MAPPO |
$22.05
|
| Rate for Payer: BCBS Trust/PPO |
$72.51
|
| Rate for Payer: BCN Commercial |
$68.58
|
| Rate for Payer: BCN Medicare Advantage |
$22.05
|
| Rate for Payer: Cash Price |
$70.56
|
| Rate for Payer: Cofinity Commercial |
$75.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.05
|
| Rate for Payer: Healthscope Commercial |
$79.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.97
|
| Rate for Payer: Nomi Health Commercial |
$72.32
|
| Rate for Payer: PACE Senior Care Partners |
$20.95
|
| Rate for Payer: PACE SWMI |
$22.05
|
| Rate for Payer: PHP Commercial |
$74.97
|
| Rate for Payer: PHP Medicare Advantage |
$22.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.33
|
| Rate for Payer: Priority Health HMO/PPO |
$76.73
|
| Rate for Payer: Priority Health Medicare |
$22.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.09
|
| Rate for Payer: Railroad Medicare Medicare |
$22.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.62
|
| Rate for Payer: UHC Core |
$73.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.05
|
| Rate for Payer: UHC Exchange |
$22.05
|
| Rate for Payer: UHC Medicare Advantage |
$22.05
|
| Rate for Payer: VA VA |
$22.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.15
|
|
|
SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION
|
Facility
|
IP
|
$1.78
|
|
|
Service Code
|
NDC 09900000351
|
| Hospital Charge Code |
7228
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.16 |
| Max. Negotiated Rate |
$1.60 |
| Rate for Payer: Aetna Commercial |
$1.51
|
| Rate for Payer: BCBS Trust/PPO |
$1.45
|
| Rate for Payer: BCN Commercial |
$1.38
|
| Rate for Payer: Cash Price |
$1.42
|
| Rate for Payer: Cofinity Commercial |
$1.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.42
|
| Rate for Payer: Healthscope Commercial |
$1.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.51
|
| Rate for Payer: Nomi Health Commercial |
$1.46
|
| Rate for Payer: PHP Commercial |
$1.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.57
|
| Rate for Payer: UHC Core |
$1.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.33
|
|
|
SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION
|
Facility
|
IP
|
$0.97
|
|
|
Service Code
|
NDC 09900000926
|
| Hospital Charge Code |
7228
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$0.87 |
| Rate for Payer: Aetna Commercial |
$0.82
|
| Rate for Payer: BCBS Trust/PPO |
$0.79
|
| Rate for Payer: BCN Commercial |
$0.75
|
| Rate for Payer: Cash Price |
$0.78
|
| Rate for Payer: Cofinity Commercial |
$0.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.78
|
| Rate for Payer: Healthscope Commercial |
$0.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.82
|
| Rate for Payer: Nomi Health Commercial |
$0.80
|
| Rate for Payer: PHP Commercial |
$0.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.63
|
| Rate for Payer: Priority Health HMO/PPO |
$0.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.85
|
| Rate for Payer: UHC Core |
$0.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.73
|
|
|
SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION
|
Facility
|
OP
|
$0.97
|
|
|
Service Code
|
NDC 09900000926
|
| Hospital Charge Code |
7228
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$0.87 |
| Rate for Payer: Aetna Commercial |
$0.82
|
| Rate for Payer: Aetna Medicare |
$0.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.30
|
| Rate for Payer: BCBS Complete |
$0.39
|
| Rate for Payer: BCBS MAPPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.80
|
| Rate for Payer: BCN Commercial |
$0.75
|
| Rate for Payer: BCN Medicare Advantage |
$0.24
|
| Rate for Payer: Cash Price |
$0.78
|
| Rate for Payer: Cofinity Commercial |
$0.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.24
|
| Rate for Payer: Healthscope Commercial |
$0.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.82
|
| Rate for Payer: Nomi Health Commercial |
$0.80
|
| Rate for Payer: PACE Senior Care Partners |
$0.23
|
| Rate for Payer: PACE SWMI |
$0.24
|
| Rate for Payer: PHP Commercial |
$0.82
|
| Rate for Payer: PHP Medicare Advantage |
$0.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.63
|
| Rate for Payer: Priority Health HMO/PPO |
$0.84
|
| Rate for Payer: Priority Health Medicare |
$0.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.65
|
| Rate for Payer: Railroad Medicare Medicare |
$0.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.85
|
| Rate for Payer: UHC Core |
$0.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.24
|
| Rate for Payer: UHC Exchange |
$0.24
|
| Rate for Payer: UHC Medicare Advantage |
$0.24
|
| Rate for Payer: VA VA |
$0.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.73
|
|
|
SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION
|
Facility
|
IP
|
$24.64
|
|
|
Service Code
|
NDC 19903001023
|
| Hospital Charge Code |
7228
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$16.02 |
| Max. Negotiated Rate |
$22.18 |
| Rate for Payer: Aetna Commercial |
$20.94
|
| Rate for Payer: BCBS Trust/PPO |
$20.11
|
| Rate for Payer: BCN Commercial |
$19.04
|
| Rate for Payer: Cash Price |
$19.71
|
| Rate for Payer: Cofinity Commercial |
$21.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.71
|
| Rate for Payer: Healthscope Commercial |
$22.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.94
|
| Rate for Payer: Nomi Health Commercial |
$20.20
|
| Rate for Payer: PHP Commercial |
$20.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.02
|
| Rate for Payer: Priority Health HMO/PPO |
$21.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.68
|
| Rate for Payer: UHC Core |
$20.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.48
|
|
|
SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION
|
Facility
|
OP
|
$24.64
|
|
|
Service Code
|
NDC 19903001023
|
| Hospital Charge Code |
7228
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.85 |
| Max. Negotiated Rate |
$22.18 |
| Rate for Payer: Aetna Commercial |
$20.94
|
| Rate for Payer: Aetna Medicare |
$6.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.70
|
| Rate for Payer: BCBS Complete |
$9.86
|
| Rate for Payer: BCBS MAPPO |
$6.16
|
| Rate for Payer: BCBS Trust/PPO |
$20.26
|
| Rate for Payer: BCN Commercial |
$19.16
|
| Rate for Payer: BCN Medicare Advantage |
$6.16
|
| Rate for Payer: Cash Price |
$19.71
|
| Rate for Payer: Cofinity Commercial |
$21.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.16
|
| Rate for Payer: Healthscope Commercial |
$22.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.94
|
| Rate for Payer: Nomi Health Commercial |
$20.20
|
| Rate for Payer: PACE Senior Care Partners |
$5.85
|
| Rate for Payer: PACE SWMI |
$6.16
|
| Rate for Payer: PHP Commercial |
$20.94
|
| Rate for Payer: PHP Medicare Advantage |
$6.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.02
|
| Rate for Payer: Priority Health HMO/PPO |
$21.44
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.51
|
| Rate for Payer: Railroad Medicare Medicare |
$6.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.68
|
| Rate for Payer: UHC Core |
$20.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.16
|
| Rate for Payer: UHC Exchange |
$6.16
|
| Rate for Payer: UHC Medicare Advantage |
$6.16
|
| Rate for Payer: VA VA |
$6.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.48
|
|
|
SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION
|
Facility
|
OP
|
$1.78
|
|
|
Service Code
|
NDC 09900000351
|
| Hospital Charge Code |
7228
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.42 |
| Max. Negotiated Rate |
$1.60 |
| Rate for Payer: Aetna Commercial |
$1.51
|
| Rate for Payer: Aetna Medicare |
$0.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.56
|
| Rate for Payer: BCBS Complete |
$0.71
|
| Rate for Payer: BCBS MAPPO |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$1.46
|
| Rate for Payer: BCN Commercial |
$1.38
|
| Rate for Payer: BCN Medicare Advantage |
$0.45
|
| Rate for Payer: Cash Price |
$1.42
|
| Rate for Payer: Cofinity Commercial |
$1.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.45
|
| Rate for Payer: Healthscope Commercial |
$1.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.51
|
| Rate for Payer: Nomi Health Commercial |
$1.46
|
| Rate for Payer: PACE Senior Care Partners |
$0.42
|
| Rate for Payer: PACE SWMI |
$0.45
|
| Rate for Payer: PHP Commercial |
$1.51
|
| Rate for Payer: PHP Medicare Advantage |
$0.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1.55
|
| Rate for Payer: Priority Health Medicare |
$0.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.19
|
| Rate for Payer: Railroad Medicare Medicare |
$0.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.57
|
| Rate for Payer: UHC Core |
$1.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.45
|
| Rate for Payer: UHC Exchange |
$0.45
|
| Rate for Payer: UHC Medicare Advantage |
$0.45
|
| Rate for Payer: VA VA |
$0.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.33
|
|
|
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 2.5 CM OR LESS
|
Facility
|
OP
|
$150.85
|
|
|
Service Code
|
CPT 12011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$143.66 |
| Max. Negotiated Rate |
$150.85 |
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
|
|
SINCALIDE 5 MCG SOLUTION FOR INJECTION
|
Facility
|
IP
|
$439.34
|
|
|
Service Code
|
HCPCS J2805
|
| Hospital Charge Code |
11368
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$285.57 |
| Max. Negotiated Rate |
$395.41 |
| Rate for Payer: Aetna Commercial |
$373.44
|
| Rate for Payer: BCBS Trust/PPO |
$358.63
|
| Rate for Payer: BCN Commercial |
$339.52
|
| Rate for Payer: Cash Price |
$351.47
|
| Rate for Payer: Cofinity Commercial |
$377.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.47
|
| Rate for Payer: Healthscope Commercial |
$395.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.44
|
| Rate for Payer: Nomi Health Commercial |
$360.26
|
| Rate for Payer: PHP Commercial |
$373.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.57
|
| Rate for Payer: Priority Health HMO/PPO |
$382.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.62
|
| Rate for Payer: UHC Core |
$366.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.50
|
|
|
SINCALIDE 5 MCG SOLUTION FOR INJECTION
|
Facility
|
OP
|
$439.34
|
|
|
Service Code
|
HCPCS J2805
|
| Hospital Charge Code |
11368
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$104.34 |
| Max. Negotiated Rate |
$395.41 |
| Rate for Payer: Aetna Commercial |
$373.44
|
| Rate for Payer: Aetna Medicare |
$114.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.29
|
| Rate for Payer: BCBS Complete |
$175.74
|
| Rate for Payer: BCBS MAPPO |
$109.83
|
| Rate for Payer: BCBS Trust/PPO |
$361.18
|
| Rate for Payer: BCN Commercial |
$341.59
|
| Rate for Payer: BCN Medicare Advantage |
$109.83
|
| Rate for Payer: Cash Price |
$351.47
|
| Rate for Payer: Cofinity Commercial |
$377.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.83
|
| Rate for Payer: Healthscope Commercial |
$395.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.44
|
| Rate for Payer: Nomi Health Commercial |
$360.26
|
| Rate for Payer: PACE Senior Care Partners |
$104.34
|
| Rate for Payer: PACE SWMI |
$109.83
|
| Rate for Payer: PHP Commercial |
$373.44
|
| Rate for Payer: PHP Medicare Advantage |
$109.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.57
|
| Rate for Payer: Priority Health HMO/PPO |
$382.23
|
| Rate for Payer: Priority Health Medicare |
$110.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.36
|
| Rate for Payer: Railroad Medicare Medicare |
$109.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.62
|
| Rate for Payer: UHC Core |
$366.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.83
|
| Rate for Payer: UHC Exchange |
$109.83
|
| Rate for Payer: UHC Medicare Advantage |
$109.83
|
| Rate for Payer: VA VA |
$109.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.50
|
|
|
SITAGLIPTIN PHOSPHATE 100 MG TABLET
|
Facility
|
OP
|
$1,135.31
|
|
|
Service Code
|
NDC 00006027731
|
| Hospital Charge Code |
77617
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$269.64 |
| Max. Negotiated Rate |
$1,021.78 |
| Rate for Payer: Aetna Commercial |
$965.01
|
| Rate for Payer: Aetna Medicare |
$295.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$354.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$354.78
|
| Rate for Payer: BCBS Complete |
$454.12
|
| Rate for Payer: BCBS MAPPO |
$283.83
|
| Rate for Payer: BCBS Trust/PPO |
$933.34
|
| Rate for Payer: BCN Commercial |
$882.70
|
| Rate for Payer: BCN Medicare Advantage |
$283.83
|
| Rate for Payer: Cash Price |
$908.25
|
| Rate for Payer: Cofinity Commercial |
$976.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$283.83
|
| Rate for Payer: Healthscope Commercial |
$1,021.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$851.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$298.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$326.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$965.01
|
| Rate for Payer: Nomi Health Commercial |
$930.95
|
| Rate for Payer: PACE Senior Care Partners |
$269.64
|
| Rate for Payer: PACE SWMI |
$283.83
|
| Rate for Payer: PHP Commercial |
$965.01
|
| Rate for Payer: PHP Medicare Advantage |
$283.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.95
|
| Rate for Payer: Priority Health HMO/PPO |
$987.72
|
| Rate for Payer: Priority Health Medicare |
$286.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$760.66
|
| Rate for Payer: Railroad Medicare Medicare |
$283.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$999.07
|
| Rate for Payer: UHC Core |
$947.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$283.83
|
| Rate for Payer: UHC Exchange |
$283.83
|
| Rate for Payer: UHC Medicare Advantage |
$283.83
|
| Rate for Payer: VA VA |
$283.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$851.48
|
|
|
SITAGLIPTIN PHOSPHATE 100 MG TABLET
|
Facility
|
IP
|
$1,135.31
|
|
|
Service Code
|
NDC 00006027731
|
| Hospital Charge Code |
77617
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$737.95 |
| Max. Negotiated Rate |
$1,021.78 |
| Rate for Payer: Aetna Commercial |
$965.01
|
| Rate for Payer: BCBS Trust/PPO |
$926.75
|
| Rate for Payer: BCN Commercial |
$877.37
|
| Rate for Payer: Cash Price |
$908.25
|
| Rate for Payer: Cofinity Commercial |
$976.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.25
|
| Rate for Payer: Healthscope Commercial |
$1,021.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$851.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$965.01
|
| Rate for Payer: Nomi Health Commercial |
$930.95
|
| Rate for Payer: PHP Commercial |
$965.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.95
|
| Rate for Payer: Priority Health HMO/PPO |
$987.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$760.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$999.07
|
| Rate for Payer: UHC Core |
$947.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$851.48
|
|
|
SKIN CARE CONSULT
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS 00177
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$16.90 |
| Rate for Payer: Aetna Medicare |
$13.00
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.90
|
|
|
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$26.26
|
|
|
Service Code
|
NDC 00409329906
|
| Hospital Charge Code |
7301
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.07 |
| Max. Negotiated Rate |
$23.63 |
| Rate for Payer: Aetna Commercial |
$22.32
|
| Rate for Payer: BCBS Trust/PPO |
$21.44
|
| Rate for Payer: BCN Commercial |
$20.29
|
| Rate for Payer: Cash Price |
$21.01
|
| Rate for Payer: Cofinity Commercial |
$22.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.01
|
| Rate for Payer: Healthscope Commercial |
$23.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.32
|
| Rate for Payer: Nomi Health Commercial |
$21.53
|
| Rate for Payer: PHP Commercial |
$22.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.07
|
| Rate for Payer: Priority Health HMO/PPO |
$22.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.11
|
| Rate for Payer: UHC Core |
$21.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.70
|
|
|
SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$26.26
|
|
|
Service Code
|
NDC 00409329906
|
| Hospital Charge Code |
7301
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.24 |
| Max. Negotiated Rate |
$23.63 |
| Rate for Payer: Aetna Commercial |
$22.32
|
| Rate for Payer: Aetna Medicare |
$6.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.21
|
| Rate for Payer: BCBS Complete |
$10.50
|
| Rate for Payer: BCBS MAPPO |
$6.57
|
| Rate for Payer: BCBS Trust/PPO |
$21.59
|
| Rate for Payer: BCN Commercial |
$20.42
|
| Rate for Payer: BCN Medicare Advantage |
$6.57
|
| Rate for Payer: Cash Price |
$21.01
|
| Rate for Payer: Cofinity Commercial |
$22.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.57
|
| Rate for Payer: Healthscope Commercial |
$23.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.32
|
| Rate for Payer: Nomi Health Commercial |
$21.53
|
| Rate for Payer: PACE Senior Care Partners |
$6.24
|
| Rate for Payer: PACE SWMI |
$6.57
|
| Rate for Payer: PHP Commercial |
$22.32
|
| Rate for Payer: PHP Medicare Advantage |
$6.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.07
|
| Rate for Payer: Priority Health HMO/PPO |
$22.85
|
| Rate for Payer: Priority Health Medicare |
$6.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.59
|
| Rate for Payer: Railroad Medicare Medicare |
$6.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.11
|
| Rate for Payer: UHC Core |
$21.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.57
|
| Rate for Payer: UHC Exchange |
$6.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.70
|
|
