|
TRANSURETHRAL PROSTATECTOMY
|
Facility
|
IP
|
$6,457.32
|
|
|
Service Code
|
APR-DRG 4822
|
| Min. Negotiated Rate |
$6,149.82 |
| Max. Negotiated Rate |
$6,457.32 |
| Rate for Payer: BCBS Complete |
$6,457.32
|
| Rate for Payer: Mclaren Medicaid |
$6,149.82
|
| Rate for Payer: Meridian Medicaid |
$6,457.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,149.82
|
| Rate for Payer: UHC Medicaid |
$6,149.82
|
| Rate for Payer: UHCCP Medicaid |
$6,149.82
|
|
|
TRANSURETHRAL PROSTATECTOMY
|
Facility
|
IP
|
$16,329.96
|
|
|
Service Code
|
APR-DRG 4824
|
| Min. Negotiated Rate |
$15,552.34 |
| Max. Negotiated Rate |
$16,329.96 |
| Rate for Payer: BCBS Complete |
$16,329.96
|
| Rate for Payer: Mclaren Medicaid |
$15,552.34
|
| Rate for Payer: Meridian Medicaid |
$16,329.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,552.34
|
| Rate for Payer: UHC Medicaid |
$15,552.34
|
| Rate for Payer: UHCCP Medicaid |
$15,552.34
|
|
|
TRANSURETHRAL PROSTATECTOMY
|
Facility
|
IP
|
$4,780.94
|
|
|
Service Code
|
APR-DRG 4821
|
| Min. Negotiated Rate |
$4,553.27 |
| Max. Negotiated Rate |
$4,780.94 |
| Rate for Payer: BCBS Complete |
$4,780.94
|
| Rate for Payer: Mclaren Medicaid |
$4,553.27
|
| Rate for Payer: Meridian Medicaid |
$4,780.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,553.27
|
| Rate for Payer: UHC Medicaid |
$4,553.27
|
| Rate for Payer: UHCCP Medicaid |
$4,553.27
|
|
|
TRANSURETHRAL PROSTATECTOMY
|
Facility
|
IP
|
$10,552.03
|
|
|
Service Code
|
APR-DRG 4823
|
| Min. Negotiated Rate |
$10,049.55 |
| Max. Negotiated Rate |
$10,552.03 |
| Rate for Payer: BCBS Complete |
$10,552.03
|
| Rate for Payer: Mclaren Medicaid |
$10,049.55
|
| Rate for Payer: Meridian Medicaid |
$10,552.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,049.55
|
| Rate for Payer: UHC Medicaid |
$10,049.55
|
| Rate for Payer: UHCCP Medicaid |
$10,049.55
|
|
|
TRAZODONE 100 MG TABLET
|
Facility
|
OP
|
$390.10
|
|
|
Service Code
|
NDC 00904686961
|
| Hospital Charge Code |
8083
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$68.77 |
| Max. Negotiated Rate |
$351.09 |
| Rate for Payer: Aetna Commercial |
$331.58
|
| Rate for Payer: Aetna Medicare |
$101.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.91
|
| Rate for Payer: BCBS Complete |
$72.21
|
| Rate for Payer: BCBS MAPPO |
$97.53
|
| Rate for Payer: BCBS Trust/PPO |
$320.70
|
| Rate for Payer: BCN Commercial |
$320.70
|
| Rate for Payer: BCN Medicare Advantage |
$97.53
|
| Rate for Payer: Cash Price |
$312.08
|
| Rate for Payer: Cofinity Commercial |
$335.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.53
|
| Rate for Payer: Healthscope Commercial |
$351.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.57
|
| Rate for Payer: Mclaren Medicaid |
$68.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.40
|
| Rate for Payer: Meridian Medicaid |
$72.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.58
|
| Rate for Payer: Nomi Health Commercial |
$319.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.57
|
| Rate for Payer: PACE Senior Care Partners |
$92.65
|
| Rate for Payer: PACE SWMI |
$97.53
|
| Rate for Payer: PHP Commercial |
$331.58
|
| Rate for Payer: PHP Medicare Advantage |
$97.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$339.39
|
| Rate for Payer: Priority Health Medicare |
$98.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.51
|
| Rate for Payer: Railroad Medicare Medicare |
$97.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.29
|
| Rate for Payer: UHC Core |
$325.73
|
| Rate for Payer: UHC Exchange |
$97.53
|
| Rate for Payer: UHC Medicaid |
$68.77
|
| Rate for Payer: UHC Medicare Advantage |
$97.53
|
| Rate for Payer: UHCCP Medicaid |
$68.77
|
| Rate for Payer: VA VA |
$97.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.57
|
|
|
TRAZODONE 100 MG TABLET
|
Facility
|
IP
|
$390.10
|
|
|
Service Code
|
NDC 00904686961
|
| Hospital Charge Code |
8083
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$271.51 |
| Max. Negotiated Rate |
$351.09 |
| Rate for Payer: Aetna Commercial |
$331.58
|
| Rate for Payer: BCBS Trust/PPO |
$322.18
|
| Rate for Payer: BCN Commercial |
$322.18
|
| Rate for Payer: Cash Price |
$312.08
|
| Rate for Payer: Cofinity Commercial |
$335.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.08
|
| Rate for Payer: Healthscope Commercial |
$351.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.58
|
| Rate for Payer: Nomi Health Commercial |
$319.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.57
|
| Rate for Payer: PHP Commercial |
$331.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$339.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.29
|
| Rate for Payer: UHC Core |
$325.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.57
|
|
|
TRAZODONE 25 MG CUSTOM TAB
|
Facility
|
OP
|
$0.92
|
|
|
Service Code
|
NDC 09900000314
|
| Hospital Charge Code |
155125
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$0.83 |
| Rate for Payer: Aetna Commercial |
$0.78
|
| Rate for Payer: Aetna Medicare |
$0.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.29
|
| Rate for Payer: BCBS Complete |
$0.17
|
| Rate for Payer: BCBS MAPPO |
$0.23
|
| Rate for Payer: BCBS Trust/PPO |
$0.76
|
| Rate for Payer: BCN Commercial |
$0.76
|
| Rate for Payer: BCN Medicare Advantage |
$0.23
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cofinity Commercial |
$0.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.23
|
| Rate for Payer: Healthscope Commercial |
$0.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.69
|
| Rate for Payer: Mclaren Medicaid |
$0.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.24
|
| Rate for Payer: Meridian Medicaid |
$0.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.78
|
| Rate for Payer: Nomi Health Commercial |
$0.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.69
|
| Rate for Payer: PACE Senior Care Partners |
$0.22
|
| Rate for Payer: PACE SWMI |
$0.23
|
| Rate for Payer: PHP Commercial |
$0.78
|
| Rate for Payer: PHP Medicare Advantage |
$0.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.80
|
| Rate for Payer: Priority Health Medicare |
$0.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.64
|
| Rate for Payer: Railroad Medicare Medicare |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.81
|
| Rate for Payer: UHC Core |
$0.77
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Medicaid |
$0.16
|
| Rate for Payer: UHC Medicare Advantage |
$0.23
|
| Rate for Payer: UHCCP Medicaid |
$0.16
|
| Rate for Payer: VA VA |
$0.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.69
|
|
|
TRAZODONE 25 MG CUSTOM TAB
|
Facility
|
IP
|
$0.92
|
|
|
Service Code
|
NDC 09900000314
|
| Hospital Charge Code |
155125
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$0.83 |
| Rate for Payer: Aetna Commercial |
$0.78
|
| Rate for Payer: BCBS Trust/PPO |
$0.76
|
| Rate for Payer: BCN Commercial |
$0.76
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cofinity Commercial |
$0.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.74
|
| Rate for Payer: Healthscope Commercial |
$0.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.78
|
| Rate for Payer: Nomi Health Commercial |
$0.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.69
|
| Rate for Payer: PHP Commercial |
$0.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.81
|
| Rate for Payer: UHC Core |
$0.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.69
|
|
|
TRAZODONE 50 MG TABLET
|
Facility
|
IP
|
$145.70
|
|
|
Service Code
|
NDC 60505265301
|
| Hospital Charge Code |
8085
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$101.41 |
| Max. Negotiated Rate |
$131.13 |
| Rate for Payer: Aetna Commercial |
$123.84
|
| Rate for Payer: BCBS Trust/PPO |
$120.33
|
| Rate for Payer: BCN Commercial |
$120.33
|
| Rate for Payer: Cash Price |
$116.56
|
| Rate for Payer: Cofinity Commercial |
$125.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.56
|
| Rate for Payer: Healthscope Commercial |
$131.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Nomi Health Commercial |
$119.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.28
|
| Rate for Payer: PHP Commercial |
$123.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$126.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.22
|
| Rate for Payer: UHC Core |
$121.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.28
|
|
|
TRAZODONE 50 MG TABLET
|
Facility
|
OP
|
$145.70
|
|
|
Service Code
|
NDC 60505265301
|
| Hospital Charge Code |
8085
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$25.69 |
| Max. Negotiated Rate |
$131.13 |
| Rate for Payer: Aetna Commercial |
$123.84
|
| Rate for Payer: Aetna Medicare |
$37.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.53
|
| Rate for Payer: BCBS Complete |
$26.97
|
| Rate for Payer: BCBS MAPPO |
$36.42
|
| Rate for Payer: BCBS Trust/PPO |
$119.78
|
| Rate for Payer: BCN Commercial |
$119.78
|
| Rate for Payer: BCN Medicare Advantage |
$36.42
|
| Rate for Payer: Cash Price |
$116.56
|
| Rate for Payer: Cofinity Commercial |
$125.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.42
|
| Rate for Payer: Healthscope Commercial |
$131.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.28
|
| Rate for Payer: Mclaren Medicaid |
$25.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.25
|
| Rate for Payer: Meridian Medicaid |
$26.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Nomi Health Commercial |
$119.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.28
|
| Rate for Payer: PACE Senior Care Partners |
$34.60
|
| Rate for Payer: PACE SWMI |
$36.42
|
| Rate for Payer: PHP Commercial |
$123.84
|
| Rate for Payer: PHP Medicare Advantage |
$36.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$126.76
|
| Rate for Payer: Priority Health Medicare |
$36.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.41
|
| Rate for Payer: Railroad Medicare Medicare |
$36.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.22
|
| Rate for Payer: UHC Core |
$121.66
|
| Rate for Payer: UHC Exchange |
$36.42
|
| Rate for Payer: UHC Medicaid |
$25.69
|
| Rate for Payer: UHC Medicare Advantage |
$36.42
|
| Rate for Payer: UHCCP Medicaid |
$25.69
|
| Rate for Payer: VA VA |
$36.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.28
|
|
|
TRAZODONE 50 MG TABLET
|
Facility
|
IP
|
$2.68
|
|
|
Service Code
|
NDC 60687044311
|
| Hospital Charge Code |
8085
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$2.41 |
| Rate for Payer: Aetna Commercial |
$2.28
|
| Rate for Payer: BCBS Trust/PPO |
$2.21
|
| Rate for Payer: BCN Commercial |
$2.21
|
| Rate for Payer: Cash Price |
$2.14
|
| Rate for Payer: Cofinity Commercial |
$2.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.14
|
| Rate for Payer: Healthscope Commercial |
$2.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.28
|
| Rate for Payer: Nomi Health Commercial |
$2.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.01
|
| Rate for Payer: PHP Commercial |
$2.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.36
|
| Rate for Payer: UHC Core |
$2.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.01
|
|
|
TRAZODONE 50 MG TABLET
|
Facility
|
OP
|
$244.40
|
|
|
Service Code
|
NDC 00904686861
|
| Hospital Charge Code |
8085
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.09 |
| Max. Negotiated Rate |
$219.96 |
| Rate for Payer: Aetna Commercial |
$207.74
|
| Rate for Payer: Aetna Medicare |
$63.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.38
|
| Rate for Payer: BCBS Complete |
$45.24
|
| Rate for Payer: BCBS MAPPO |
$61.10
|
| Rate for Payer: BCBS Trust/PPO |
$200.92
|
| Rate for Payer: BCN Commercial |
$200.92
|
| Rate for Payer: BCN Medicare Advantage |
$61.10
|
| Rate for Payer: Cash Price |
$195.52
|
| Rate for Payer: Cofinity Commercial |
$210.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.10
|
| Rate for Payer: Healthscope Commercial |
$219.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.30
|
| Rate for Payer: Mclaren Medicaid |
$43.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.16
|
| Rate for Payer: Meridian Medicaid |
$45.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.74
|
| Rate for Payer: Nomi Health Commercial |
$200.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.30
|
| Rate for Payer: PACE Senior Care Partners |
$58.05
|
| Rate for Payer: PACE SWMI |
$61.10
|
| Rate for Payer: PHP Commercial |
$207.74
|
| Rate for Payer: PHP Medicare Advantage |
$61.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$212.63
|
| Rate for Payer: Priority Health Medicare |
$61.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.10
|
| Rate for Payer: Railroad Medicare Medicare |
$61.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.07
|
| Rate for Payer: UHC Core |
$204.07
|
| Rate for Payer: UHC Exchange |
$61.10
|
| Rate for Payer: UHC Medicaid |
$43.09
|
| Rate for Payer: UHC Medicare Advantage |
$61.10
|
| Rate for Payer: UHCCP Medicaid |
$43.09
|
| Rate for Payer: VA VA |
$61.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.30
|
|
|
TRAZODONE 50 MG TABLET
|
Facility
|
OP
|
$267.90
|
|
|
Service Code
|
NDC 60687044301
|
| Hospital Charge Code |
8085
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$47.23 |
| Max. Negotiated Rate |
$241.11 |
| Rate for Payer: Aetna Commercial |
$227.72
|
| Rate for Payer: Aetna Medicare |
$69.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.72
|
| Rate for Payer: BCBS Complete |
$49.59
|
| Rate for Payer: BCBS MAPPO |
$66.97
|
| Rate for Payer: BCBS Trust/PPO |
$220.24
|
| Rate for Payer: BCN Commercial |
$220.24
|
| Rate for Payer: BCN Medicare Advantage |
$66.97
|
| Rate for Payer: Cash Price |
$214.32
|
| Rate for Payer: Cofinity Commercial |
$230.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.97
|
| Rate for Payer: Healthscope Commercial |
$241.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.93
|
| Rate for Payer: Mclaren Medicaid |
$47.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.32
|
| Rate for Payer: Meridian Medicaid |
$49.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.72
|
| Rate for Payer: Nomi Health Commercial |
$219.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.93
|
| Rate for Payer: PACE Senior Care Partners |
$63.63
|
| Rate for Payer: PACE SWMI |
$66.97
|
| Rate for Payer: PHP Commercial |
$227.72
|
| Rate for Payer: PHP Medicare Advantage |
$66.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$233.07
|
| Rate for Payer: Priority Health Medicare |
$67.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.46
|
| Rate for Payer: Railroad Medicare Medicare |
$66.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.75
|
| Rate for Payer: UHC Core |
$223.70
|
| Rate for Payer: UHC Exchange |
$66.97
|
| Rate for Payer: UHC Medicaid |
$47.23
|
| Rate for Payer: UHC Medicare Advantage |
$66.97
|
| Rate for Payer: UHCCP Medicaid |
$47.23
|
| Rate for Payer: VA VA |
$66.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.93
|
|
|
TRAZODONE 50 MG TABLET
|
Facility
|
IP
|
$244.40
|
|
|
Service Code
|
NDC 00904686861
|
| Hospital Charge Code |
8085
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$170.10 |
| Max. Negotiated Rate |
$219.96 |
| Rate for Payer: Aetna Commercial |
$207.74
|
| Rate for Payer: BCBS Trust/PPO |
$201.85
|
| Rate for Payer: BCN Commercial |
$201.85
|
| Rate for Payer: Cash Price |
$195.52
|
| Rate for Payer: Cofinity Commercial |
$210.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.52
|
| Rate for Payer: Healthscope Commercial |
$219.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.74
|
| Rate for Payer: Nomi Health Commercial |
$200.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.30
|
| Rate for Payer: PHP Commercial |
$207.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$212.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.07
|
| Rate for Payer: UHC Core |
$204.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.30
|
|
|
TRAZODONE 50 MG TABLET
|
Facility
|
OP
|
$2.68
|
|
|
Service Code
|
NDC 60687044311
|
| Hospital Charge Code |
8085
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.47 |
| Max. Negotiated Rate |
$2.41 |
| Rate for Payer: Aetna Commercial |
$2.28
|
| Rate for Payer: Aetna Medicare |
$0.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.84
|
| Rate for Payer: BCBS Complete |
$0.50
|
| Rate for Payer: BCBS MAPPO |
$0.67
|
| Rate for Payer: BCBS Trust/PPO |
$2.20
|
| Rate for Payer: BCN Commercial |
$2.20
|
| Rate for Payer: BCN Medicare Advantage |
$0.67
|
| Rate for Payer: Cash Price |
$2.14
|
| Rate for Payer: Cofinity Commercial |
$2.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.67
|
| Rate for Payer: Healthscope Commercial |
$2.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.01
|
| Rate for Payer: Mclaren Medicaid |
$0.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.70
|
| Rate for Payer: Meridian Medicaid |
$0.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.28
|
| Rate for Payer: Nomi Health Commercial |
$2.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.01
|
| Rate for Payer: PACE Senior Care Partners |
$0.64
|
| Rate for Payer: PACE SWMI |
$0.67
|
| Rate for Payer: PHP Commercial |
$2.28
|
| Rate for Payer: PHP Medicare Advantage |
$0.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.33
|
| Rate for Payer: Priority Health Medicare |
$0.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.87
|
| Rate for Payer: Railroad Medicare Medicare |
$0.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.36
|
| Rate for Payer: UHC Core |
$2.24
|
| Rate for Payer: UHC Exchange |
$0.67
|
| Rate for Payer: UHC Medicaid |
$0.47
|
| Rate for Payer: UHC Medicare Advantage |
$0.67
|
| Rate for Payer: UHCCP Medicaid |
$0.47
|
| Rate for Payer: VA VA |
$0.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.01
|
|
|
TRAZODONE 50 MG TABLET
|
Facility
|
IP
|
$267.90
|
|
|
Service Code
|
NDC 60687044301
|
| Hospital Charge Code |
8085
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$186.46 |
| Max. Negotiated Rate |
$241.11 |
| Rate for Payer: Aetna Commercial |
$227.72
|
| Rate for Payer: BCBS Trust/PPO |
$221.26
|
| Rate for Payer: BCN Commercial |
$221.26
|
| Rate for Payer: Cash Price |
$214.32
|
| Rate for Payer: Cofinity Commercial |
$230.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.32
|
| Rate for Payer: Healthscope Commercial |
$241.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.72
|
| Rate for Payer: Nomi Health Commercial |
$219.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.93
|
| Rate for Payer: PHP Commercial |
$227.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$233.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.75
|
| Rate for Payer: UHC Core |
$223.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.93
|
|
|
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM
|
Facility
|
OP
|
$17.76
|
|
|
Service Code
|
NDC 67877025115
|
| Hospital Charge Code |
8113
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.13 |
| Max. Negotiated Rate |
$15.98 |
| Rate for Payer: Aetna Commercial |
$15.10
|
| Rate for Payer: Aetna Medicare |
$4.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.55
|
| Rate for Payer: BCBS Complete |
$3.29
|
| Rate for Payer: BCBS MAPPO |
$4.44
|
| Rate for Payer: BCBS Trust/PPO |
$14.60
|
| Rate for Payer: BCN Commercial |
$14.60
|
| Rate for Payer: BCN Medicare Advantage |
$4.44
|
| Rate for Payer: Cash Price |
$14.21
|
| Rate for Payer: Cofinity Commercial |
$15.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.44
|
| Rate for Payer: Healthscope Commercial |
$15.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.32
|
| Rate for Payer: Mclaren Medicaid |
$3.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.66
|
| Rate for Payer: Meridian Medicaid |
$3.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.10
|
| Rate for Payer: Nomi Health Commercial |
$14.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.32
|
| Rate for Payer: PACE Senior Care Partners |
$4.22
|
| Rate for Payer: PACE SWMI |
$4.44
|
| Rate for Payer: PHP Commercial |
$15.10
|
| Rate for Payer: PHP Medicare Advantage |
$4.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.45
|
| Rate for Payer: Priority Health Medicare |
$4.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.36
|
| Rate for Payer: Railroad Medicare Medicare |
$4.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.63
|
| Rate for Payer: UHC Core |
$14.83
|
| Rate for Payer: UHC Exchange |
$4.44
|
| Rate for Payer: UHC Medicaid |
$3.13
|
| Rate for Payer: UHC Medicare Advantage |
$4.44
|
| Rate for Payer: UHCCP Medicaid |
$3.13
|
| Rate for Payer: VA VA |
$4.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.32
|
|
|
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM
|
Facility
|
IP
|
$10.26
|
|
|
Service Code
|
NDC 21922006204
|
| Hospital Charge Code |
8113
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.14 |
| Max. Negotiated Rate |
$9.23 |
| Rate for Payer: Aetna Commercial |
$8.72
|
| Rate for Payer: BCBS Trust/PPO |
$8.47
|
| Rate for Payer: BCN Commercial |
$8.47
|
| Rate for Payer: Cash Price |
$8.21
|
| Rate for Payer: Cofinity Commercial |
$8.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.21
|
| Rate for Payer: Healthscope Commercial |
$9.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.72
|
| Rate for Payer: Nomi Health Commercial |
$8.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.70
|
| Rate for Payer: PHP Commercial |
$8.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.03
|
| Rate for Payer: UHC Core |
$8.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.70
|
|
|
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM
|
Facility
|
IP
|
$17.76
|
|
|
Service Code
|
NDC 67877025115
|
| Hospital Charge Code |
8113
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$12.36 |
| Max. Negotiated Rate |
$15.98 |
| Rate for Payer: Aetna Commercial |
$15.10
|
| Rate for Payer: BCBS Trust/PPO |
$14.67
|
| Rate for Payer: BCN Commercial |
$14.67
|
| Rate for Payer: Cash Price |
$14.21
|
| Rate for Payer: Cofinity Commercial |
$15.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.21
|
| Rate for Payer: Healthscope Commercial |
$15.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.10
|
| Rate for Payer: Nomi Health Commercial |
$14.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.32
|
| Rate for Payer: PHP Commercial |
$15.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.63
|
| Rate for Payer: UHC Core |
$14.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.32
|
|
|
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM
|
Facility
|
OP
|
$10.26
|
|
|
Service Code
|
NDC 21922006204
|
| Hospital Charge Code |
8113
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$9.23 |
| Rate for Payer: Aetna Commercial |
$8.72
|
| Rate for Payer: Aetna Medicare |
$2.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.21
|
| Rate for Payer: BCBS Complete |
$1.90
|
| Rate for Payer: BCBS MAPPO |
$2.56
|
| Rate for Payer: BCBS Trust/PPO |
$8.43
|
| Rate for Payer: BCN Commercial |
$8.43
|
| Rate for Payer: BCN Medicare Advantage |
$2.56
|
| Rate for Payer: Cash Price |
$8.21
|
| Rate for Payer: Cofinity Commercial |
$8.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.56
|
| Rate for Payer: Healthscope Commercial |
$9.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.70
|
| Rate for Payer: Mclaren Medicaid |
$1.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.69
|
| Rate for Payer: Meridian Medicaid |
$1.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.72
|
| Rate for Payer: Nomi Health Commercial |
$8.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.70
|
| Rate for Payer: PACE Senior Care Partners |
$2.44
|
| Rate for Payer: PACE SWMI |
$2.56
|
| Rate for Payer: PHP Commercial |
$8.72
|
| Rate for Payer: PHP Medicare Advantage |
$2.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8.93
|
| Rate for Payer: Priority Health Medicare |
$2.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.14
|
| Rate for Payer: Railroad Medicare Medicare |
$2.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.03
|
| Rate for Payer: UHC Core |
$8.57
|
| Rate for Payer: UHC Exchange |
$2.56
|
| Rate for Payer: UHC Medicaid |
$1.81
|
| Rate for Payer: UHC Medicare Advantage |
$2.56
|
| Rate for Payer: UHCCP Medicaid |
$1.81
|
| Rate for Payer: VA VA |
$2.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.70
|
|
|
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT
|
Facility
|
IP
|
$11.28
|
|
|
Service Code
|
NDC 00168000615
|
| Hospital Charge Code |
8118
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.85 |
| Max. Negotiated Rate |
$10.15 |
| Rate for Payer: Aetna Commercial |
$9.59
|
| Rate for Payer: BCBS Trust/PPO |
$9.32
|
| Rate for Payer: BCN Commercial |
$9.32
|
| Rate for Payer: Cash Price |
$9.02
|
| Rate for Payer: Cofinity Commercial |
$9.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.02
|
| Rate for Payer: Healthscope Commercial |
$10.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.59
|
| Rate for Payer: Nomi Health Commercial |
$9.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.46
|
| Rate for Payer: PHP Commercial |
$9.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.93
|
| Rate for Payer: UHC Core |
$9.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.46
|
|
|
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT
|
Facility
|
IP
|
$11.07
|
|
|
Service Code
|
NDC 33342033315
|
| Hospital Charge Code |
8118
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.70 |
| Max. Negotiated Rate |
$9.96 |
| Rate for Payer: Aetna Commercial |
$9.41
|
| Rate for Payer: BCBS Trust/PPO |
$9.14
|
| Rate for Payer: BCN Commercial |
$9.14
|
| Rate for Payer: Cash Price |
$8.86
|
| Rate for Payer: Cofinity Commercial |
$9.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.86
|
| Rate for Payer: Healthscope Commercial |
$9.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.41
|
| Rate for Payer: Nomi Health Commercial |
$9.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.30
|
| Rate for Payer: PHP Commercial |
$9.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.74
|
| Rate for Payer: UHC Core |
$9.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.30
|
|
|
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT
|
Facility
|
OP
|
$18.84
|
|
|
Service Code
|
NDC 45802005535
|
| Hospital Charge Code |
8118
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.32 |
| Max. Negotiated Rate |
$16.96 |
| Rate for Payer: Aetna Commercial |
$16.01
|
| Rate for Payer: Aetna Medicare |
$4.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.89
|
| Rate for Payer: BCBS Complete |
$3.49
|
| Rate for Payer: BCBS MAPPO |
$4.71
|
| Rate for Payer: BCBS Trust/PPO |
$15.49
|
| Rate for Payer: BCN Commercial |
$15.49
|
| Rate for Payer: BCN Medicare Advantage |
$4.71
|
| Rate for Payer: Cash Price |
$15.07
|
| Rate for Payer: Cofinity Commercial |
$16.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.71
|
| Rate for Payer: Healthscope Commercial |
$16.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.13
|
| Rate for Payer: Mclaren Medicaid |
$3.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.95
|
| Rate for Payer: Meridian Medicaid |
$3.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.01
|
| Rate for Payer: Nomi Health Commercial |
$15.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.13
|
| Rate for Payer: PACE Senior Care Partners |
$4.47
|
| Rate for Payer: PACE SWMI |
$4.71
|
| Rate for Payer: PHP Commercial |
$16.01
|
| Rate for Payer: PHP Medicare Advantage |
$4.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.39
|
| Rate for Payer: Priority Health Medicare |
$4.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.11
|
| Rate for Payer: Railroad Medicare Medicare |
$4.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.58
|
| Rate for Payer: UHC Core |
$15.73
|
| Rate for Payer: UHC Exchange |
$4.71
|
| Rate for Payer: UHC Medicaid |
$3.32
|
| Rate for Payer: UHC Medicare Advantage |
$4.71
|
| Rate for Payer: UHCCP Medicaid |
$3.32
|
| Rate for Payer: VA VA |
$4.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.13
|
|
|
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT
|
Facility
|
OP
|
$11.07
|
|
|
Service Code
|
NDC 33342033315
|
| Hospital Charge Code |
8118
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$9.96 |
| Rate for Payer: Aetna Commercial |
$9.41
|
| Rate for Payer: Aetna Medicare |
$2.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.46
|
| Rate for Payer: BCBS Complete |
$2.05
|
| Rate for Payer: BCBS MAPPO |
$2.77
|
| Rate for Payer: BCBS Trust/PPO |
$9.10
|
| Rate for Payer: BCN Commercial |
$9.10
|
| Rate for Payer: BCN Medicare Advantage |
$2.77
|
| Rate for Payer: Cash Price |
$8.86
|
| Rate for Payer: Cofinity Commercial |
$9.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.77
|
| Rate for Payer: Healthscope Commercial |
$9.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.30
|
| Rate for Payer: Mclaren Medicaid |
$1.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.91
|
| Rate for Payer: Meridian Medicaid |
$2.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.41
|
| Rate for Payer: Nomi Health Commercial |
$9.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.30
|
| Rate for Payer: PACE Senior Care Partners |
$2.63
|
| Rate for Payer: PACE SWMI |
$2.77
|
| Rate for Payer: PHP Commercial |
$9.41
|
| Rate for Payer: PHP Medicare Advantage |
$2.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.63
|
| Rate for Payer: Priority Health Medicare |
$2.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.70
|
| Rate for Payer: Railroad Medicare Medicare |
$2.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.74
|
| Rate for Payer: UHC Core |
$9.24
|
| Rate for Payer: UHC Exchange |
$2.77
|
| Rate for Payer: UHC Medicaid |
$1.95
|
| Rate for Payer: UHC Medicare Advantage |
$2.77
|
| Rate for Payer: UHCCP Medicaid |
$1.95
|
| Rate for Payer: VA VA |
$2.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.30
|
|
|
TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT
|
Facility
|
IP
|
$18.84
|
|
|
Service Code
|
NDC 45802005535
|
| Hospital Charge Code |
8118
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.11 |
| Max. Negotiated Rate |
$16.96 |
| Rate for Payer: Aetna Commercial |
$16.01
|
| Rate for Payer: BCBS Trust/PPO |
$15.56
|
| Rate for Payer: BCN Commercial |
$15.56
|
| Rate for Payer: Cash Price |
$15.07
|
| Rate for Payer: Cofinity Commercial |
$16.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.07
|
| Rate for Payer: Healthscope Commercial |
$16.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.01
|
| Rate for Payer: Nomi Health Commercial |
$15.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.13
|
| Rate for Payer: PHP Commercial |
$16.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.58
|
| Rate for Payer: UHC Core |
$15.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.13
|
|
