|
THYROID DISORDERS
|
Facility
|
IP
|
$4,430.20
|
|
|
Service Code
|
APR-DRG 4272
|
| Min. Negotiated Rate |
$4,219.24 |
| Max. Negotiated Rate |
$4,430.20 |
| Rate for Payer: BCBS Complete |
$4,430.20
|
| Rate for Payer: Mclaren Medicaid |
$4,219.24
|
| Rate for Payer: Meridian Medicaid |
$4,430.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,219.24
|
| Rate for Payer: UHC Medicaid |
$4,219.24
|
| Rate for Payer: UHCCP Medicaid |
$4,219.24
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES
|
Facility
|
IP
|
$23,248.44
|
|
|
Service Code
|
APR-DRG 4044
|
| Min. Negotiated Rate |
$22,141.37 |
| Max. Negotiated Rate |
$23,248.44 |
| Rate for Payer: BCBS Complete |
$23,248.44
|
| Rate for Payer: Mclaren Medicaid |
$22,141.37
|
| Rate for Payer: Meridian Medicaid |
$23,248.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$22,141.37
|
| Rate for Payer: UHC Medicaid |
$22,141.37
|
| Rate for Payer: UHCCP Medicaid |
$22,141.37
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES
|
Facility
|
IP
|
$11,463.84
|
|
|
Service Code
|
APR-DRG 4043
|
| Min. Negotiated Rate |
$10,917.94 |
| Max. Negotiated Rate |
$11,463.84 |
| Rate for Payer: BCBS Complete |
$11,463.84
|
| Rate for Payer: Mclaren Medicaid |
$10,917.94
|
| Rate for Payer: Meridian Medicaid |
$11,463.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,917.94
|
| Rate for Payer: UHC Medicaid |
$10,917.94
|
| Rate for Payer: UHCCP Medicaid |
$10,917.94
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES
|
Facility
|
IP
|
$9,643.38
|
|
|
Service Code
|
APR-DRG 4042
|
| Min. Negotiated Rate |
$9,184.17 |
| Max. Negotiated Rate |
$9,643.38 |
| Rate for Payer: BCBS Complete |
$9,643.38
|
| Rate for Payer: Mclaren Medicaid |
$9,184.17
|
| Rate for Payer: Meridian Medicaid |
$9,643.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,184.17
|
| Rate for Payer: UHC Medicaid |
$9,184.17
|
| Rate for Payer: UHCCP Medicaid |
$9,184.17
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES
|
Facility
|
IP
|
$6,666.60
|
|
|
Service Code
|
APR-DRG 4041
|
| Min. Negotiated Rate |
$6,349.14 |
| Max. Negotiated Rate |
$6,666.60 |
| Rate for Payer: BCBS Complete |
$6,666.60
|
| Rate for Payer: Mclaren Medicaid |
$6,349.14
|
| Rate for Payer: Meridian Medicaid |
$6,666.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,349.14
|
| Rate for Payer: UHC Medicaid |
$6,349.14
|
| Rate for Payer: UHCCP Medicaid |
$6,349.14
|
|
|
THYROID (PORK) 60 MG TABLET
|
Facility
|
OP
|
$354.24
|
|
|
Service Code
|
NDC 62559074201
|
| Hospital Charge Code |
119105
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$62.45 |
| Max. Negotiated Rate |
$318.82 |
| Rate for Payer: Aetna Commercial |
$301.10
|
| Rate for Payer: Aetna Medicare |
$92.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$110.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$110.70
|
| Rate for Payer: BCBS Complete |
$65.57
|
| Rate for Payer: BCBS MAPPO |
$88.56
|
| Rate for Payer: BCBS Trust/PPO |
$291.22
|
| Rate for Payer: BCN Commercial |
$291.22
|
| Rate for Payer: BCN Medicare Advantage |
$88.56
|
| Rate for Payer: Cash Price |
$283.39
|
| Rate for Payer: Cofinity Commercial |
$304.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.56
|
| Rate for Payer: Healthscope Commercial |
$318.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.68
|
| Rate for Payer: Mclaren Medicaid |
$62.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.99
|
| Rate for Payer: Meridian Medicaid |
$65.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$101.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$97.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.10
|
| Rate for Payer: Nomi Health Commercial |
$290.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.68
|
| Rate for Payer: PACE Senior Care Partners |
$84.13
|
| Rate for Payer: PACE SWMI |
$88.56
|
| Rate for Payer: PHP Commercial |
$301.10
|
| Rate for Payer: PHP Medicare Advantage |
$88.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$308.19
|
| Rate for Payer: Priority Health Medicare |
$89.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.55
|
| Rate for Payer: Railroad Medicare Medicare |
$88.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.73
|
| Rate for Payer: UHC Core |
$295.79
|
| Rate for Payer: UHC Exchange |
$88.56
|
| Rate for Payer: UHC Medicaid |
$62.45
|
| Rate for Payer: UHC Medicare Advantage |
$88.56
|
| Rate for Payer: UHCCP Medicaid |
$62.45
|
| Rate for Payer: VA VA |
$88.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.68
|
|
|
THYROID (PORK) 60 MG TABLET
|
Facility
|
IP
|
$340.80
|
|
|
Service Code
|
NDC 42192033001
|
| Hospital Charge Code |
119105
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$237.20 |
| Max. Negotiated Rate |
$306.72 |
| Rate for Payer: Aetna Commercial |
$289.68
|
| Rate for Payer: BCBS Trust/PPO |
$281.47
|
| Rate for Payer: BCN Commercial |
$281.47
|
| Rate for Payer: Cash Price |
$272.64
|
| Rate for Payer: Cofinity Commercial |
$293.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.64
|
| Rate for Payer: Healthscope Commercial |
$306.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.68
|
| Rate for Payer: Nomi Health Commercial |
$279.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.60
|
| Rate for Payer: PHP Commercial |
$289.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$296.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$237.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.90
|
| Rate for Payer: UHC Core |
$284.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.60
|
|
|
THYROID (PORK) 60 MG TABLET
|
Facility
|
IP
|
$354.24
|
|
|
Service Code
|
NDC 62559074201
|
| Hospital Charge Code |
119105
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$246.55 |
| Max. Negotiated Rate |
$318.82 |
| Rate for Payer: Aetna Commercial |
$301.10
|
| Rate for Payer: BCBS Trust/PPO |
$292.57
|
| Rate for Payer: BCN Commercial |
$292.57
|
| Rate for Payer: Cash Price |
$283.39
|
| Rate for Payer: Cofinity Commercial |
$304.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.39
|
| Rate for Payer: Healthscope Commercial |
$318.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.10
|
| Rate for Payer: Nomi Health Commercial |
$290.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.68
|
| Rate for Payer: PHP Commercial |
$301.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$308.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.73
|
| Rate for Payer: UHC Core |
$295.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.68
|
|
|
THYROID (PORK) 60 MG TABLET
|
Facility
|
OP
|
$340.80
|
|
|
Service Code
|
NDC 42192033001
|
| Hospital Charge Code |
119105
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$60.08 |
| Max. Negotiated Rate |
$306.72 |
| Rate for Payer: Aetna Commercial |
$289.68
|
| Rate for Payer: Aetna Medicare |
$88.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.50
|
| Rate for Payer: BCBS Complete |
$63.08
|
| Rate for Payer: BCBS MAPPO |
$85.20
|
| Rate for Payer: BCBS Trust/PPO |
$280.17
|
| Rate for Payer: BCN Commercial |
$280.17
|
| Rate for Payer: BCN Medicare Advantage |
$85.20
|
| Rate for Payer: Cash Price |
$272.64
|
| Rate for Payer: Cofinity Commercial |
$293.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.20
|
| Rate for Payer: Healthscope Commercial |
$306.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.60
|
| Rate for Payer: Mclaren Medicaid |
$60.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.46
|
| Rate for Payer: Meridian Medicaid |
$63.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.68
|
| Rate for Payer: Nomi Health Commercial |
$279.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.60
|
| Rate for Payer: PACE Senior Care Partners |
$80.94
|
| Rate for Payer: PACE SWMI |
$85.20
|
| Rate for Payer: PHP Commercial |
$289.68
|
| Rate for Payer: PHP Medicare Advantage |
$85.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$296.50
|
| Rate for Payer: Priority Health Medicare |
$86.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$237.20
|
| Rate for Payer: Railroad Medicare Medicare |
$85.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.90
|
| Rate for Payer: UHC Core |
$284.57
|
| Rate for Payer: UHC Exchange |
$85.20
|
| Rate for Payer: UHC Medicaid |
$60.08
|
| Rate for Payer: UHC Medicare Advantage |
$85.20
|
| Rate for Payer: UHCCP Medicaid |
$60.08
|
| Rate for Payer: VA VA |
$85.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.60
|
|
|
TICAGRELOR 90 MG TABLET
|
Facility
|
OP
|
$1,668.33
|
|
|
Service Code
|
NDC 00186077760
|
| Hospital Charge Code |
153169
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$294.13 |
| Max. Negotiated Rate |
$1,501.50 |
| Rate for Payer: Aetna Commercial |
$1,418.08
|
| Rate for Payer: Aetna Medicare |
$433.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$521.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$521.35
|
| Rate for Payer: BCBS Complete |
$308.81
|
| Rate for Payer: BCBS MAPPO |
$417.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,371.53
|
| Rate for Payer: BCN Commercial |
$1,371.53
|
| Rate for Payer: BCN Medicare Advantage |
$417.08
|
| Rate for Payer: Cash Price |
$1,334.66
|
| Rate for Payer: Cofinity Commercial |
$1,434.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,334.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$417.08
|
| Rate for Payer: Healthscope Commercial |
$1,501.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,251.25
|
| Rate for Payer: Mclaren Medicaid |
$294.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.94
|
| Rate for Payer: Meridian Medicaid |
$308.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$458.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,418.08
|
| Rate for Payer: Nomi Health Commercial |
$1,368.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,251.25
|
| Rate for Payer: PACE Senior Care Partners |
$396.23
|
| Rate for Payer: PACE SWMI |
$417.08
|
| Rate for Payer: PHP Commercial |
$1,418.08
|
| Rate for Payer: PHP Medicare Advantage |
$417.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$294.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,451.45
|
| Rate for Payer: Priority Health Medicare |
$421.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,161.16
|
| Rate for Payer: Railroad Medicare Medicare |
$417.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,468.13
|
| Rate for Payer: UHC Core |
$1,393.06
|
| Rate for Payer: UHC Exchange |
$417.08
|
| Rate for Payer: UHC Medicaid |
$294.13
|
| Rate for Payer: UHC Medicare Advantage |
$417.08
|
| Rate for Payer: UHCCP Medicaid |
$294.13
|
| Rate for Payer: VA VA |
$417.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,251.25
|
|
|
TICAGRELOR 90 MG TABLET
|
Facility
|
IP
|
$246.24
|
|
|
Service Code
|
NDC 67877049160
|
| Hospital Charge Code |
153169
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$171.38 |
| Max. Negotiated Rate |
$221.62 |
| Rate for Payer: Aetna Commercial |
$209.30
|
| Rate for Payer: BCBS Trust/PPO |
$203.37
|
| Rate for Payer: BCN Commercial |
$203.37
|
| Rate for Payer: Cash Price |
$196.99
|
| Rate for Payer: Cofinity Commercial |
$211.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.99
|
| Rate for Payer: Healthscope Commercial |
$221.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.30
|
| Rate for Payer: Nomi Health Commercial |
$201.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.68
|
| Rate for Payer: PHP Commercial |
$209.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$214.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$171.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.69
|
| Rate for Payer: UHC Core |
$205.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.68
|
|
|
TICAGRELOR 90 MG TABLET
|
Facility
|
OP
|
$246.24
|
|
|
Service Code
|
NDC 67877049160
|
| Hospital Charge Code |
153169
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.41 |
| Max. Negotiated Rate |
$221.62 |
| Rate for Payer: Aetna Commercial |
$209.30
|
| Rate for Payer: Aetna Medicare |
$64.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.95
|
| Rate for Payer: BCBS Complete |
$45.58
|
| Rate for Payer: BCBS MAPPO |
$61.56
|
| Rate for Payer: BCBS Trust/PPO |
$202.43
|
| Rate for Payer: BCN Commercial |
$202.43
|
| Rate for Payer: BCN Medicare Advantage |
$61.56
|
| Rate for Payer: Cash Price |
$196.99
|
| Rate for Payer: Cofinity Commercial |
$211.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.56
|
| Rate for Payer: Healthscope Commercial |
$221.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.68
|
| Rate for Payer: Mclaren Medicaid |
$43.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.64
|
| Rate for Payer: Meridian Medicaid |
$45.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.30
|
| Rate for Payer: Nomi Health Commercial |
$201.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.68
|
| Rate for Payer: PACE Senior Care Partners |
$58.48
|
| Rate for Payer: PACE SWMI |
$61.56
|
| Rate for Payer: PHP Commercial |
$209.30
|
| Rate for Payer: PHP Medicare Advantage |
$61.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$214.23
|
| Rate for Payer: Priority Health Medicare |
$62.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$171.38
|
| Rate for Payer: Railroad Medicare Medicare |
$61.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.69
|
| Rate for Payer: UHC Core |
$205.61
|
| Rate for Payer: UHC Exchange |
$61.56
|
| Rate for Payer: UHC Medicaid |
$43.41
|
| Rate for Payer: UHC Medicare Advantage |
$61.56
|
| Rate for Payer: UHCCP Medicaid |
$43.41
|
| Rate for Payer: VA VA |
$61.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.68
|
|
|
TICAGRELOR 90 MG TABLET
|
Facility
|
IP
|
$1,668.33
|
|
|
Service Code
|
NDC 00186077760
|
| Hospital Charge Code |
153169
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,161.16 |
| Max. Negotiated Rate |
$1,501.50 |
| Rate for Payer: Aetna Commercial |
$1,418.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,377.87
|
| Rate for Payer: BCN Commercial |
$1,377.87
|
| Rate for Payer: Cash Price |
$1,334.66
|
| Rate for Payer: Cofinity Commercial |
$1,434.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,334.66
|
| Rate for Payer: Healthscope Commercial |
$1,501.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,251.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,418.08
|
| Rate for Payer: Nomi Health Commercial |
$1,368.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,251.25
|
| Rate for Payer: PHP Commercial |
$1,418.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,451.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,161.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,468.13
|
| Rate for Payer: UHC Core |
$1,393.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,251.25
|
|
|
TIMOLOL MALEATE 0.5 % EYE DROPS
|
Facility
|
OP
|
$20.61
|
|
|
Service Code
|
NDC 61314022705
|
| Hospital Charge Code |
11562
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$18.55 |
| Rate for Payer: Aetna Commercial |
$17.52
|
| Rate for Payer: Aetna Medicare |
$5.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.44
|
| Rate for Payer: BCBS Complete |
$3.81
|
| Rate for Payer: BCBS MAPPO |
$5.15
|
| Rate for Payer: BCBS Trust/PPO |
$16.94
|
| Rate for Payer: BCN Commercial |
$16.94
|
| Rate for Payer: BCN Medicare Advantage |
$5.15
|
| Rate for Payer: Cash Price |
$16.49
|
| Rate for Payer: Cofinity Commercial |
$17.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.15
|
| Rate for Payer: Healthscope Commercial |
$18.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.46
|
| Rate for Payer: Mclaren Medicaid |
$3.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.41
|
| Rate for Payer: Meridian Medicaid |
$3.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.52
|
| Rate for Payer: Nomi Health Commercial |
$16.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.46
|
| Rate for Payer: PACE Senior Care Partners |
$4.89
|
| Rate for Payer: PACE SWMI |
$5.15
|
| Rate for Payer: PHP Commercial |
$17.52
|
| Rate for Payer: PHP Medicare Advantage |
$5.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$5.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.34
|
| Rate for Payer: Railroad Medicare Medicare |
$5.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.14
|
| Rate for Payer: UHC Core |
$17.21
|
| Rate for Payer: UHC Exchange |
$5.15
|
| Rate for Payer: UHC Medicaid |
$3.63
|
| Rate for Payer: UHC Medicare Advantage |
$5.15
|
| Rate for Payer: UHCCP Medicaid |
$3.63
|
| Rate for Payer: VA VA |
$5.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.46
|
|
|
TIMOLOL MALEATE 0.5 % EYE DROPS
|
Facility
|
IP
|
$22.91
|
|
|
Service Code
|
NDC 60758080105
|
| Hospital Charge Code |
11562
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$15.95 |
| Max. Negotiated Rate |
$20.62 |
| Rate for Payer: Aetna Commercial |
$19.47
|
| Rate for Payer: BCBS Trust/PPO |
$18.92
|
| Rate for Payer: BCN Commercial |
$18.92
|
| Rate for Payer: Cash Price |
$18.33
|
| Rate for Payer: Cofinity Commercial |
$19.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.33
|
| Rate for Payer: Healthscope Commercial |
$20.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.47
|
| Rate for Payer: Nomi Health Commercial |
$18.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.18
|
| Rate for Payer: PHP Commercial |
$19.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.16
|
| Rate for Payer: UHC Core |
$19.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.18
|
|
|
TIMOLOL MALEATE 0.5 % EYE DROPS
|
Facility
|
OP
|
$28.25
|
|
|
Service Code
|
NDC 17478028810
|
| Hospital Charge Code |
11562
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.98 |
| Max. Negotiated Rate |
$25.43 |
| Rate for Payer: Aetna Commercial |
$24.01
|
| Rate for Payer: Aetna Medicare |
$7.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.83
|
| Rate for Payer: BCBS Complete |
$5.23
|
| Rate for Payer: BCBS MAPPO |
$7.06
|
| Rate for Payer: BCBS Trust/PPO |
$23.22
|
| Rate for Payer: BCN Commercial |
$23.22
|
| Rate for Payer: BCN Medicare Advantage |
$7.06
|
| Rate for Payer: Cash Price |
$22.60
|
| Rate for Payer: Cofinity Commercial |
$24.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.06
|
| Rate for Payer: Healthscope Commercial |
$25.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.19
|
| Rate for Payer: Mclaren Medicaid |
$4.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.42
|
| Rate for Payer: Meridian Medicaid |
$5.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.01
|
| Rate for Payer: Nomi Health Commercial |
$23.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.19
|
| Rate for Payer: PACE Senior Care Partners |
$6.71
|
| Rate for Payer: PACE SWMI |
$7.06
|
| Rate for Payer: PHP Commercial |
$24.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.58
|
| Rate for Payer: Priority Health Medicare |
$7.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.66
|
| Rate for Payer: Railroad Medicare Medicare |
$7.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.86
|
| Rate for Payer: UHC Core |
$23.59
|
| Rate for Payer: UHC Exchange |
$7.06
|
| Rate for Payer: UHC Medicaid |
$4.98
|
| Rate for Payer: UHC Medicare Advantage |
$7.06
|
| Rate for Payer: UHCCP Medicaid |
$4.98
|
| Rate for Payer: VA VA |
$7.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.19
|
|
|
TIMOLOL MALEATE 0.5 % EYE DROPS
|
Facility
|
OP
|
$35.81
|
|
|
Service Code
|
NDC 68682081305
|
| Hospital Charge Code |
11562
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.31 |
| Max. Negotiated Rate |
$32.23 |
| Rate for Payer: Aetna Commercial |
$30.44
|
| Rate for Payer: Aetna Medicare |
$9.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.19
|
| Rate for Payer: BCBS Complete |
$6.63
|
| Rate for Payer: BCBS MAPPO |
$8.95
|
| Rate for Payer: BCBS Trust/PPO |
$29.44
|
| Rate for Payer: BCN Commercial |
$29.44
|
| Rate for Payer: BCN Medicare Advantage |
$8.95
|
| Rate for Payer: Cash Price |
$28.65
|
| Rate for Payer: Cofinity Commercial |
$30.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.95
|
| Rate for Payer: Healthscope Commercial |
$32.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.86
|
| Rate for Payer: Mclaren Medicaid |
$6.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.40
|
| Rate for Payer: Meridian Medicaid |
$6.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.44
|
| Rate for Payer: Nomi Health Commercial |
$29.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.86
|
| Rate for Payer: PACE Senior Care Partners |
$8.50
|
| Rate for Payer: PACE SWMI |
$8.95
|
| Rate for Payer: PHP Commercial |
$30.44
|
| Rate for Payer: PHP Medicare Advantage |
$8.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.15
|
| Rate for Payer: Priority Health Medicare |
$9.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.92
|
| Rate for Payer: Railroad Medicare Medicare |
$8.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.51
|
| Rate for Payer: UHC Core |
$29.90
|
| Rate for Payer: UHC Exchange |
$8.95
|
| Rate for Payer: UHC Medicaid |
$6.31
|
| Rate for Payer: UHC Medicare Advantage |
$8.95
|
| Rate for Payer: UHCCP Medicaid |
$6.31
|
| Rate for Payer: VA VA |
$8.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.86
|
|
|
TIMOLOL MALEATE 0.5 % EYE DROPS
|
Facility
|
OP
|
$22.91
|
|
|
Service Code
|
NDC 60758080105
|
| Hospital Charge Code |
11562
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.04 |
| Max. Negotiated Rate |
$20.62 |
| Rate for Payer: Aetna Commercial |
$19.47
|
| Rate for Payer: Aetna Medicare |
$5.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.16
|
| Rate for Payer: BCBS Complete |
$4.24
|
| Rate for Payer: BCBS MAPPO |
$5.73
|
| Rate for Payer: BCBS Trust/PPO |
$18.83
|
| Rate for Payer: BCN Commercial |
$18.83
|
| Rate for Payer: BCN Medicare Advantage |
$5.73
|
| Rate for Payer: Cash Price |
$18.33
|
| Rate for Payer: Cofinity Commercial |
$19.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.73
|
| Rate for Payer: Healthscope Commercial |
$20.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.18
|
| Rate for Payer: Mclaren Medicaid |
$4.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.01
|
| Rate for Payer: Meridian Medicaid |
$4.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.47
|
| Rate for Payer: Nomi Health Commercial |
$18.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.18
|
| Rate for Payer: PACE Senior Care Partners |
$5.44
|
| Rate for Payer: PACE SWMI |
$5.73
|
| Rate for Payer: PHP Commercial |
$19.47
|
| Rate for Payer: PHP Medicare Advantage |
$5.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.93
|
| Rate for Payer: Priority Health Medicare |
$5.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.95
|
| Rate for Payer: Railroad Medicare Medicare |
$5.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.16
|
| Rate for Payer: UHC Core |
$19.13
|
| Rate for Payer: UHC Exchange |
$5.73
|
| Rate for Payer: UHC Medicaid |
$4.04
|
| Rate for Payer: UHC Medicare Advantage |
$5.73
|
| Rate for Payer: UHCCP Medicaid |
$4.04
|
| Rate for Payer: VA VA |
$5.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.18
|
|
|
TIMOLOL MALEATE 0.5 % EYE DROPS
|
Facility
|
IP
|
$31.33
|
|
|
Service Code
|
NDC 61314022710
|
| Hospital Charge Code |
11562
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$21.81 |
| Max. Negotiated Rate |
$28.20 |
| Rate for Payer: Aetna Commercial |
$26.63
|
| Rate for Payer: BCBS Trust/PPO |
$25.88
|
| Rate for Payer: BCN Commercial |
$25.88
|
| Rate for Payer: Cash Price |
$25.06
|
| Rate for Payer: Cofinity Commercial |
$26.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.06
|
| Rate for Payer: Healthscope Commercial |
$28.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.63
|
| Rate for Payer: Nomi Health Commercial |
$25.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.50
|
| Rate for Payer: PHP Commercial |
$26.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.57
|
| Rate for Payer: UHC Core |
$26.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.50
|
|
|
TIMOLOL MALEATE 0.5 % EYE DROPS
|
Facility
|
OP
|
$31.33
|
|
|
Service Code
|
NDC 61314022710
|
| Hospital Charge Code |
11562
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.52 |
| Max. Negotiated Rate |
$28.20 |
| Rate for Payer: Aetna Commercial |
$26.63
|
| Rate for Payer: Aetna Medicare |
$8.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.79
|
| Rate for Payer: BCBS Complete |
$5.80
|
| Rate for Payer: BCBS MAPPO |
$7.83
|
| Rate for Payer: BCBS Trust/PPO |
$25.76
|
| Rate for Payer: BCN Commercial |
$25.76
|
| Rate for Payer: BCN Medicare Advantage |
$7.83
|
| Rate for Payer: Cash Price |
$25.06
|
| Rate for Payer: Cofinity Commercial |
$26.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.83
|
| Rate for Payer: Healthscope Commercial |
$28.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.50
|
| Rate for Payer: Mclaren Medicaid |
$5.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.22
|
| Rate for Payer: Meridian Medicaid |
$5.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.63
|
| Rate for Payer: Nomi Health Commercial |
$25.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.50
|
| Rate for Payer: PACE Senior Care Partners |
$7.44
|
| Rate for Payer: PACE SWMI |
$7.83
|
| Rate for Payer: PHP Commercial |
$26.63
|
| Rate for Payer: PHP Medicare Advantage |
$7.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.26
|
| Rate for Payer: Priority Health Medicare |
$7.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.81
|
| Rate for Payer: Railroad Medicare Medicare |
$7.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.57
|
| Rate for Payer: UHC Core |
$26.16
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$5.52
|
| Rate for Payer: UHC Medicare Advantage |
$7.83
|
| Rate for Payer: UHCCP Medicaid |
$5.52
|
| Rate for Payer: VA VA |
$7.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.50
|
|
|
TIMOLOL MALEATE 0.5 % EYE DROPS
|
Facility
|
IP
|
$35.81
|
|
|
Service Code
|
NDC 68682081305
|
| Hospital Charge Code |
11562
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$24.92 |
| Max. Negotiated Rate |
$32.23 |
| Rate for Payer: Aetna Commercial |
$30.44
|
| Rate for Payer: BCBS Trust/PPO |
$29.58
|
| Rate for Payer: BCN Commercial |
$29.58
|
| Rate for Payer: Cash Price |
$28.65
|
| Rate for Payer: Cofinity Commercial |
$30.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.65
|
| Rate for Payer: Healthscope Commercial |
$32.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.44
|
| Rate for Payer: Nomi Health Commercial |
$29.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.86
|
| Rate for Payer: PHP Commercial |
$30.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.51
|
| Rate for Payer: UHC Core |
$29.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.86
|
|
|
TIMOLOL MALEATE 0.5 % EYE DROPS
|
Facility
|
IP
|
$20.61
|
|
|
Service Code
|
NDC 61314022705
|
| Hospital Charge Code |
11562
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$14.34 |
| Max. Negotiated Rate |
$18.55 |
| Rate for Payer: Aetna Commercial |
$17.52
|
| Rate for Payer: BCBS Trust/PPO |
$17.02
|
| Rate for Payer: BCN Commercial |
$17.02
|
| Rate for Payer: Cash Price |
$16.49
|
| Rate for Payer: Cofinity Commercial |
$17.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.49
|
| Rate for Payer: Healthscope Commercial |
$18.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.52
|
| Rate for Payer: Nomi Health Commercial |
$16.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.46
|
| Rate for Payer: PHP Commercial |
$17.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.14
|
| Rate for Payer: UHC Core |
$17.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.46
|
|
|
TIMOLOL MALEATE 0.5 % EYE DROPS
|
Facility
|
IP
|
$28.25
|
|
|
Service Code
|
NDC 17478028810
|
| Hospital Charge Code |
11562
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$19.66 |
| Max. Negotiated Rate |
$25.43 |
| Rate for Payer: Aetna Commercial |
$24.01
|
| Rate for Payer: BCBS Trust/PPO |
$23.33
|
| Rate for Payer: BCN Commercial |
$23.33
|
| Rate for Payer: Cash Price |
$22.60
|
| Rate for Payer: Cofinity Commercial |
$24.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.60
|
| Rate for Payer: Healthscope Commercial |
$25.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.01
|
| Rate for Payer: Nomi Health Commercial |
$23.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.19
|
| Rate for Payer: PHP Commercial |
$24.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.86
|
| Rate for Payer: UHC Core |
$23.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.19
|
|
|
TIZANIDINE 2 MG TABLET
|
Facility
|
IP
|
$3.20
|
|
|
Service Code
|
NDC 50268075911
|
| Hospital Charge Code |
14792
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.23 |
| Max. Negotiated Rate |
$2.88 |
| Rate for Payer: Aetna Commercial |
$2.72
|
| Rate for Payer: BCBS Trust/PPO |
$2.64
|
| Rate for Payer: BCN Commercial |
$2.64
|
| Rate for Payer: Cash Price |
$2.56
|
| Rate for Payer: Cofinity Commercial |
$2.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.56
|
| Rate for Payer: Healthscope Commercial |
$2.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.72
|
| Rate for Payer: Nomi Health Commercial |
$2.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.40
|
| Rate for Payer: PHP Commercial |
$2.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.82
|
| Rate for Payer: UHC Core |
$2.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.40
|
|
|
TIZANIDINE 2 MG TABLET
|
Facility
|
OP
|
$159.84
|
|
|
Service Code
|
NDC 50268075915
|
| Hospital Charge Code |
14792
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$28.18 |
| Max. Negotiated Rate |
$143.86 |
| Rate for Payer: Aetna Commercial |
$135.86
|
| Rate for Payer: Aetna Medicare |
$41.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.95
|
| Rate for Payer: BCBS Complete |
$29.59
|
| Rate for Payer: BCBS MAPPO |
$39.96
|
| Rate for Payer: BCBS Trust/PPO |
$131.40
|
| Rate for Payer: BCN Commercial |
$131.40
|
| Rate for Payer: BCN Medicare Advantage |
$39.96
|
| Rate for Payer: Cash Price |
$127.87
|
| Rate for Payer: Cofinity Commercial |
$137.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.96
|
| Rate for Payer: Healthscope Commercial |
$143.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.88
|
| Rate for Payer: Mclaren Medicaid |
$28.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.96
|
| Rate for Payer: Meridian Medicaid |
$29.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.86
|
| Rate for Payer: Nomi Health Commercial |
$131.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.88
|
| Rate for Payer: PACE Senior Care Partners |
$37.96
|
| Rate for Payer: PACE SWMI |
$39.96
|
| Rate for Payer: PHP Commercial |
$135.86
|
| Rate for Payer: PHP Medicare Advantage |
$39.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.06
|
| Rate for Payer: Priority Health Medicare |
$40.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.25
|
| Rate for Payer: Railroad Medicare Medicare |
$39.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.66
|
| Rate for Payer: UHC Core |
$133.47
|
| Rate for Payer: UHC Exchange |
$39.96
|
| Rate for Payer: UHC Medicaid |
$28.18
|
| Rate for Payer: UHC Medicare Advantage |
$39.96
|
| Rate for Payer: UHCCP Medicaid |
$28.18
|
| Rate for Payer: VA VA |
$39.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.88
|
|
