|
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
IP
|
$33.11
|
|
|
Service Code
|
HCPCS J0169
|
| Hospital Charge Code |
152715
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.04 |
| Max. Negotiated Rate |
$29.80 |
| Rate for Payer: Aetna Commercial |
$28.14
|
| Rate for Payer: BCBS Trust/PPO |
$27.35
|
| Rate for Payer: BCN Commercial |
$27.35
|
| Rate for Payer: Cash Price |
$26.49
|
| Rate for Payer: Cofinity Commercial |
$28.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.49
|
| Rate for Payer: Healthscope Commercial |
$29.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Nomi Health Commercial |
$27.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.83
|
| Rate for Payer: PHP Commercial |
$28.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.14
|
| Rate for Payer: UHC Core |
$27.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.83
|
|
|
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
OP
|
$20.73
|
|
|
Service Code
|
HCPCS J0165
|
| Hospital Charge Code |
152715
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$18.66 |
| Rate for Payer: Aetna Commercial |
$17.62
|
| Rate for Payer: Aetna Commercial |
$25.65
|
| Rate for Payer: Aetna Medicare |
$7.85
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.43
|
| Rate for Payer: BCBS Complete |
$3.84
|
| Rate for Payer: BCBS Complete |
$5.59
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS MAPPO |
$7.54
|
| Rate for Payer: BCBS Trust/PPO |
$17.04
|
| Rate for Payer: BCBS Trust/PPO |
$24.81
|
| Rate for Payer: BCN Commercial |
$24.81
|
| Rate for Payer: BCN Commercial |
$17.04
|
| Rate for Payer: BCN Medicare Advantage |
$7.54
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$16.58
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$17.83
|
| Rate for Payer: Cofinity Commercial |
$25.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$18.66
|
| Rate for Payer: Healthscope Commercial |
$27.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.64
|
| Rate for Payer: Mclaren Medicaid |
$5.32
|
| Rate for Payer: Mclaren Medicaid |
$3.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$3.84
|
| Rate for Payer: Meridian Medicaid |
$5.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.62
|
| Rate for Payer: Nomi Health Commercial |
$24.75
|
| Rate for Payer: Nomi Health Commercial |
$17.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.64
|
| Rate for Payer: PACE Senior Care Partners |
$7.17
|
| Rate for Payer: PACE Senior Care Partners |
$4.92
|
| Rate for Payer: PACE SWMI |
$7.54
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$17.62
|
| Rate for Payer: PHP Commercial |
$25.65
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: PHP Medicare Advantage |
$7.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.04
|
| Rate for Payer: Priority Health Medicare |
$7.62
|
| Rate for Payer: Priority Health Medicare |
$5.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.01
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: Railroad Medicare Medicare |
$7.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.56
|
| Rate for Payer: UHC Core |
$25.20
|
| Rate for Payer: UHC Core |
$17.31
|
| Rate for Payer: UHC Exchange |
$7.54
|
| Rate for Payer: UHC Exchange |
$5.18
|
| Rate for Payer: UHC Medicaid |
$5.32
|
| Rate for Payer: UHC Medicaid |
$3.65
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
| Rate for Payer: UHC Medicare Advantage |
$7.54
|
| Rate for Payer: UHCCP Medicaid |
$3.65
|
| Rate for Payer: UHCCP Medicaid |
$5.32
|
| Rate for Payer: VA VA |
$5.18
|
| Rate for Payer: VA VA |
$7.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.55
|
|
|
EPINEPHRINE 1 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$600.98
|
|
|
Service Code
|
HCPCS J0165
|
| Hospital Charge Code |
2850
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$418.28 |
| Max. Negotiated Rate |
$540.88 |
| Rate for Payer: Aetna Commercial |
$510.83
|
| Rate for Payer: BCBS Trust/PPO |
$496.35
|
| Rate for Payer: BCN Commercial |
$496.35
|
| Rate for Payer: Cash Price |
$480.78
|
| Rate for Payer: Cofinity Commercial |
$516.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.78
|
| Rate for Payer: Healthscope Commercial |
$540.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.83
|
| Rate for Payer: Nomi Health Commercial |
$492.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$450.74
|
| Rate for Payer: PHP Commercial |
$510.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$522.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$418.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.86
|
| Rate for Payer: UHC Core |
$501.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.74
|
|
|
EPINEPHRINE 1 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$247.62
|
|
|
Service Code
|
HCPCS J0162
|
| Hospital Charge Code |
2850
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$43.66 |
| Max. Negotiated Rate |
$222.86 |
| Rate for Payer: Aetna Commercial |
$210.48
|
| Rate for Payer: Aetna Medicare |
$64.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.38
|
| Rate for Payer: BCBS Complete |
$45.83
|
| Rate for Payer: BCBS MAPPO |
$61.91
|
| Rate for Payer: BCBS Trust/PPO |
$203.57
|
| Rate for Payer: BCN Commercial |
$203.57
|
| Rate for Payer: BCN Medicare Advantage |
$61.91
|
| Rate for Payer: Cash Price |
$198.10
|
| Rate for Payer: Cofinity Commercial |
$212.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.91
|
| Rate for Payer: Healthscope Commercial |
$222.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.72
|
| Rate for Payer: Mclaren Medicaid |
$43.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.00
|
| Rate for Payer: Meridian Medicaid |
$45.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.48
|
| Rate for Payer: Nomi Health Commercial |
$203.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.72
|
| Rate for Payer: PACE Senior Care Partners |
$58.81
|
| Rate for Payer: PACE SWMI |
$61.91
|
| Rate for Payer: PHP Commercial |
$210.48
|
| Rate for Payer: PHP Medicare Advantage |
$61.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$215.43
|
| Rate for Payer: Priority Health Medicare |
$62.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.34
|
| Rate for Payer: Railroad Medicare Medicare |
$61.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.91
|
| Rate for Payer: UHC Core |
$206.76
|
| Rate for Payer: UHC Exchange |
$61.91
|
| Rate for Payer: UHC Medicaid |
$43.66
|
| Rate for Payer: UHC Medicare Advantage |
$61.91
|
| Rate for Payer: UHCCP Medicaid |
$43.66
|
| Rate for Payer: VA VA |
$61.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.72
|
|
|
EPINEPHRINE 1 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$600.98
|
|
|
Service Code
|
HCPCS J0165
|
| Hospital Charge Code |
2850
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$105.95 |
| Max. Negotiated Rate |
$540.88 |
| Rate for Payer: Aetna Commercial |
$510.83
|
| Rate for Payer: Aetna Medicare |
$156.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$187.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.81
|
| Rate for Payer: BCBS Complete |
$111.24
|
| Rate for Payer: BCBS MAPPO |
$150.25
|
| Rate for Payer: BCBS Trust/PPO |
$494.07
|
| Rate for Payer: BCN Commercial |
$494.07
|
| Rate for Payer: BCN Medicare Advantage |
$150.25
|
| Rate for Payer: Cash Price |
$480.78
|
| Rate for Payer: Cofinity Commercial |
$516.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.25
|
| Rate for Payer: Healthscope Commercial |
$540.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.74
|
| Rate for Payer: Mclaren Medicaid |
$105.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.76
|
| Rate for Payer: Meridian Medicaid |
$111.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$165.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.83
|
| Rate for Payer: Nomi Health Commercial |
$492.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$450.74
|
| Rate for Payer: PACE Senior Care Partners |
$142.73
|
| Rate for Payer: PACE SWMI |
$150.25
|
| Rate for Payer: PHP Commercial |
$510.83
|
| Rate for Payer: PHP Medicare Advantage |
$150.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$522.85
|
| Rate for Payer: Priority Health Medicare |
$151.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$418.28
|
| Rate for Payer: Railroad Medicare Medicare |
$150.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.86
|
| Rate for Payer: UHC Core |
$501.82
|
| Rate for Payer: UHC Exchange |
$150.25
|
| Rate for Payer: UHC Medicaid |
$105.95
|
| Rate for Payer: UHC Medicare Advantage |
$150.25
|
| Rate for Payer: UHCCP Medicaid |
$105.95
|
| Rate for Payer: VA VA |
$150.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.74
|
|
|
EPINEPHRINE 1 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$247.62
|
|
|
Service Code
|
HCPCS J0162
|
| Hospital Charge Code |
2850
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$172.34 |
| Max. Negotiated Rate |
$222.86 |
| Rate for Payer: Aetna Commercial |
$210.48
|
| Rate for Payer: BCBS Trust/PPO |
$204.51
|
| Rate for Payer: BCN Commercial |
$204.51
|
| Rate for Payer: Cash Price |
$198.10
|
| Rate for Payer: Cofinity Commercial |
$212.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.10
|
| Rate for Payer: Healthscope Commercial |
$222.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.48
|
| Rate for Payer: Nomi Health Commercial |
$203.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.72
|
| Rate for Payer: PHP Commercial |
$210.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$215.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.91
|
| Rate for Payer: UHC Core |
$206.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.72
|
|
|
EPINEPHRINE 1 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$310.13
|
|
|
Service Code
|
HCPCS J0169
|
| Hospital Charge Code |
2850
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$54.68 |
| Max. Negotiated Rate |
$279.12 |
| Rate for Payer: Aetna Commercial |
$263.61
|
| Rate for Payer: Aetna Medicare |
$80.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.92
|
| Rate for Payer: BCBS Complete |
$57.41
|
| Rate for Payer: BCBS MAPPO |
$77.53
|
| Rate for Payer: BCBS Trust/PPO |
$254.96
|
| Rate for Payer: BCN Commercial |
$254.96
|
| Rate for Payer: BCN Medicare Advantage |
$77.53
|
| Rate for Payer: Cash Price |
$248.10
|
| Rate for Payer: Cofinity Commercial |
$266.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.53
|
| Rate for Payer: Healthscope Commercial |
$279.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.60
|
| Rate for Payer: Mclaren Medicaid |
$54.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.41
|
| Rate for Payer: Meridian Medicaid |
$57.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.61
|
| Rate for Payer: Nomi Health Commercial |
$254.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$232.60
|
| Rate for Payer: PACE Senior Care Partners |
$73.66
|
| Rate for Payer: PACE SWMI |
$77.53
|
| Rate for Payer: PHP Commercial |
$263.61
|
| Rate for Payer: PHP Medicare Advantage |
$77.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$269.81
|
| Rate for Payer: Priority Health Medicare |
$78.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$215.85
|
| Rate for Payer: Railroad Medicare Medicare |
$77.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.91
|
| Rate for Payer: UHC Core |
$258.96
|
| Rate for Payer: UHC Exchange |
$77.53
|
| Rate for Payer: UHC Medicaid |
$54.68
|
| Rate for Payer: UHC Medicare Advantage |
$77.53
|
| Rate for Payer: UHCCP Medicaid |
$54.68
|
| Rate for Payer: VA VA |
$77.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.60
|
|
|
EPINEPHRINE 1 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$310.13
|
|
|
Service Code
|
HCPCS J0169
|
| Hospital Charge Code |
2850
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$215.85 |
| Max. Negotiated Rate |
$279.12 |
| Rate for Payer: Aetna Commercial |
$263.61
|
| Rate for Payer: BCBS Trust/PPO |
$256.14
|
| Rate for Payer: BCN Commercial |
$256.14
|
| Rate for Payer: Cash Price |
$248.10
|
| Rate for Payer: Cofinity Commercial |
$266.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.10
|
| Rate for Payer: Healthscope Commercial |
$279.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.61
|
| Rate for Payer: Nomi Health Commercial |
$254.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$232.60
|
| Rate for Payer: PHP Commercial |
$263.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$269.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$215.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.91
|
| Rate for Payer: UHC Core |
$258.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.60
|
|
|
EPINEPHRINE ANAPHYLAXIS KIT
|
Facility
|
OP
|
$62.31
|
|
|
Service Code
|
HCPCS J0169
|
| Hospital Charge Code |
181607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.99 |
| Max. Negotiated Rate |
$56.08 |
| Rate for Payer: Aetna Commercial |
$52.96
|
| Rate for Payer: Aetna Medicare |
$16.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.47
|
| Rate for Payer: BCBS Complete |
$11.53
|
| Rate for Payer: BCBS MAPPO |
$15.58
|
| Rate for Payer: BCBS Trust/PPO |
$51.23
|
| Rate for Payer: BCN Commercial |
$51.23
|
| Rate for Payer: BCN Medicare Advantage |
$15.58
|
| Rate for Payer: Cash Price |
$49.85
|
| Rate for Payer: Cofinity Commercial |
$53.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.58
|
| Rate for Payer: Healthscope Commercial |
$56.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.73
|
| Rate for Payer: Mclaren Medicaid |
$10.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.36
|
| Rate for Payer: Meridian Medicaid |
$11.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.96
|
| Rate for Payer: Nomi Health Commercial |
$51.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.73
|
| Rate for Payer: PACE Senior Care Partners |
$14.80
|
| Rate for Payer: PACE SWMI |
$15.58
|
| Rate for Payer: PHP Commercial |
$52.96
|
| Rate for Payer: PHP Medicare Advantage |
$15.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.21
|
| Rate for Payer: Priority Health Medicare |
$15.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.37
|
| Rate for Payer: Railroad Medicare Medicare |
$15.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.83
|
| Rate for Payer: UHC Core |
$52.03
|
| Rate for Payer: UHC Exchange |
$15.58
|
| Rate for Payer: UHC Medicaid |
$10.99
|
| Rate for Payer: UHC Medicare Advantage |
$15.58
|
| Rate for Payer: UHCCP Medicaid |
$10.99
|
| Rate for Payer: VA VA |
$15.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.73
|
|
|
EPINEPHRINE ANAPHYLAXIS KIT
|
Facility
|
IP
|
$62.31
|
|
|
Service Code
|
HCPCS J0169
|
| Hospital Charge Code |
181607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$43.37 |
| Max. Negotiated Rate |
$56.08 |
| Rate for Payer: Aetna Commercial |
$52.96
|
| Rate for Payer: BCBS Trust/PPO |
$51.46
|
| Rate for Payer: BCN Commercial |
$51.46
|
| Rate for Payer: Cash Price |
$49.85
|
| Rate for Payer: Cofinity Commercial |
$53.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.85
|
| Rate for Payer: Healthscope Commercial |
$56.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.96
|
| Rate for Payer: Nomi Health Commercial |
$51.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.73
|
| Rate for Payer: PHP Commercial |
$52.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.83
|
| Rate for Payer: UHC Core |
$52.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.73
|
|
|
EPINEPHRINE HCL 0.1 MG/ML SYRINGE (CODE)
|
Facility
|
OP
|
$35.60
|
|
|
Service Code
|
HCPCS J0167
|
| Hospital Charge Code |
163700
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.28 |
| Max. Negotiated Rate |
$32.04 |
| Rate for Payer: Aetna Commercial |
$30.26
|
| Rate for Payer: Aetna Medicare |
$9.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.12
|
| Rate for Payer: BCBS Complete |
$6.59
|
| Rate for Payer: BCBS MAPPO |
$8.90
|
| Rate for Payer: BCBS Trust/PPO |
$29.27
|
| Rate for Payer: BCN Commercial |
$29.27
|
| Rate for Payer: BCN Medicare Advantage |
$8.90
|
| Rate for Payer: Cash Price |
$28.48
|
| Rate for Payer: Cofinity Commercial |
$30.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.90
|
| Rate for Payer: Healthscope Commercial |
$32.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.70
|
| Rate for Payer: Mclaren Medicaid |
$6.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.35
|
| Rate for Payer: Meridian Medicaid |
$6.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.26
|
| Rate for Payer: Nomi Health Commercial |
$29.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.70
|
| Rate for Payer: PACE Senior Care Partners |
$8.46
|
| Rate for Payer: PACE SWMI |
$8.90
|
| Rate for Payer: PHP Commercial |
$30.26
|
| Rate for Payer: PHP Medicare Advantage |
$8.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$30.97
|
| Rate for Payer: Priority Health Medicare |
$8.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.78
|
| Rate for Payer: Railroad Medicare Medicare |
$8.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.33
|
| Rate for Payer: UHC Core |
$29.73
|
| Rate for Payer: UHC Exchange |
$8.90
|
| Rate for Payer: UHC Medicaid |
$6.28
|
| Rate for Payer: UHC Medicare Advantage |
$8.90
|
| Rate for Payer: UHCCP Medicaid |
$6.28
|
| Rate for Payer: VA VA |
$8.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.70
|
|
|
EPINEPHRINE HCL 0.1 MG/ML SYRINGE (CODE)
|
Facility
|
IP
|
$35.60
|
|
|
Service Code
|
HCPCS J0167
|
| Hospital Charge Code |
163700
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.78 |
| Max. Negotiated Rate |
$32.04 |
| Rate for Payer: Aetna Commercial |
$30.26
|
| Rate for Payer: BCBS Trust/PPO |
$29.40
|
| Rate for Payer: BCN Commercial |
$29.40
|
| Rate for Payer: Cash Price |
$28.48
|
| Rate for Payer: Cofinity Commercial |
$30.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.48
|
| Rate for Payer: Healthscope Commercial |
$32.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.26
|
| Rate for Payer: Nomi Health Commercial |
$29.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.70
|
| Rate for Payer: PHP Commercial |
$30.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$30.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.33
|
| Rate for Payer: UHC Core |
$29.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.70
|
|
|
EPOETIN ALFA-EPBX 3,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$125.33
|
|
|
Service Code
|
HCPCS Q5106
|
| Hospital Charge Code |
186986
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$87.23 |
| Max. Negotiated Rate |
$112.80 |
| Rate for Payer: Aetna Commercial |
$106.53
|
| Rate for Payer: BCBS Trust/PPO |
$103.51
|
| Rate for Payer: BCN Commercial |
$103.51
|
| Rate for Payer: Cash Price |
$100.26
|
| Rate for Payer: Cofinity Commercial |
$107.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.26
|
| Rate for Payer: Healthscope Commercial |
$112.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.53
|
| Rate for Payer: Nomi Health Commercial |
$102.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.00
|
| Rate for Payer: PHP Commercial |
$106.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$109.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.29
|
| Rate for Payer: UHC Core |
$104.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.00
|
|
|
EPOETIN ALFA-EPBX 3,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$125.33
|
|
|
Service Code
|
HCPCS Q5106
|
| Hospital Charge Code |
186986
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.10 |
| Max. Negotiated Rate |
$112.80 |
| Rate for Payer: Aetna Commercial |
$106.53
|
| Rate for Payer: Aetna Medicare |
$32.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.17
|
| Rate for Payer: BCBS Complete |
$23.20
|
| Rate for Payer: BCBS MAPPO |
$31.33
|
| Rate for Payer: BCBS Trust/PPO |
$103.03
|
| Rate for Payer: BCN Commercial |
$103.03
|
| Rate for Payer: BCN Medicare Advantage |
$31.33
|
| Rate for Payer: Cash Price |
$100.26
|
| Rate for Payer: Cofinity Commercial |
$107.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.33
|
| Rate for Payer: Healthscope Commercial |
$112.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.00
|
| Rate for Payer: Mclaren Medicaid |
$22.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.90
|
| Rate for Payer: Meridian Medicaid |
$23.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.53
|
| Rate for Payer: Nomi Health Commercial |
$102.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.00
|
| Rate for Payer: PACE Senior Care Partners |
$29.77
|
| Rate for Payer: PACE SWMI |
$31.33
|
| Rate for Payer: PHP Commercial |
$106.53
|
| Rate for Payer: PHP Medicare Advantage |
$31.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$109.04
|
| Rate for Payer: Priority Health Medicare |
$31.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.23
|
| Rate for Payer: Railroad Medicare Medicare |
$31.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.29
|
| Rate for Payer: UHC Core |
$104.65
|
| Rate for Payer: UHC Exchange |
$31.33
|
| Rate for Payer: UHC Medicaid |
$22.10
|
| Rate for Payer: UHC Medicare Advantage |
$31.33
|
| Rate for Payer: UHCCP Medicaid |
$22.10
|
| Rate for Payer: VA VA |
$31.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.00
|
|
|
EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$204.16
|
|
|
Service Code
|
HCPCS J1327
|
| Hospital Charge Code |
23123
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$142.10 |
| Max. Negotiated Rate |
$183.74 |
| Rate for Payer: Aetna Commercial |
$173.54
|
| Rate for Payer: Aetna Commercial |
$222.84
|
| Rate for Payer: BCBS Trust/PPO |
$168.62
|
| Rate for Payer: BCBS Trust/PPO |
$216.52
|
| Rate for Payer: BCN Commercial |
$168.62
|
| Rate for Payer: BCN Commercial |
$216.52
|
| Rate for Payer: Cash Price |
$163.33
|
| Rate for Payer: Cash Price |
$209.73
|
| Rate for Payer: Cofinity Commercial |
$225.46
|
| Rate for Payer: Cofinity Commercial |
$175.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.33
|
| Rate for Payer: Healthscope Commercial |
$183.74
|
| Rate for Payer: Healthscope Commercial |
$235.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.84
|
| Rate for Payer: Nomi Health Commercial |
$167.41
|
| Rate for Payer: Nomi Health Commercial |
$214.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.62
|
| Rate for Payer: PHP Commercial |
$222.84
|
| Rate for Payer: PHP Commercial |
$173.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$177.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.70
|
| Rate for Payer: UHC Core |
$170.47
|
| Rate for Payer: UHC Core |
$218.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.62
|
|
|
EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$204.16
|
|
|
Service Code
|
HCPCS J1327
|
| Hospital Charge Code |
23123
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$35.99 |
| Max. Negotiated Rate |
$183.74 |
| Rate for Payer: Aetna Commercial |
$173.54
|
| Rate for Payer: Aetna Commercial |
$222.84
|
| Rate for Payer: Aetna Medicare |
$68.16
|
| Rate for Payer: Aetna Medicare |
$53.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.92
|
| Rate for Payer: BCBS Complete |
$37.79
|
| Rate for Payer: BCBS Complete |
$48.53
|
| Rate for Payer: BCBS MAPPO |
$51.04
|
| Rate for Payer: BCBS MAPPO |
$65.54
|
| Rate for Payer: BCBS Trust/PPO |
$167.84
|
| Rate for Payer: BCBS Trust/PPO |
$215.52
|
| Rate for Payer: BCN Commercial |
$215.52
|
| Rate for Payer: BCN Commercial |
$167.84
|
| Rate for Payer: BCN Medicare Advantage |
$65.54
|
| Rate for Payer: BCN Medicare Advantage |
$51.04
|
| Rate for Payer: Cash Price |
$163.33
|
| Rate for Payer: Cash Price |
$209.73
|
| Rate for Payer: Cofinity Commercial |
$175.58
|
| Rate for Payer: Cofinity Commercial |
$225.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.04
|
| Rate for Payer: Healthscope Commercial |
$183.74
|
| Rate for Payer: Healthscope Commercial |
$235.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.62
|
| Rate for Payer: Mclaren Medicaid |
$46.22
|
| Rate for Payer: Mclaren Medicaid |
$35.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.59
|
| Rate for Payer: Meridian Medicaid |
$37.79
|
| Rate for Payer: Meridian Medicaid |
$48.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.54
|
| Rate for Payer: Nomi Health Commercial |
$214.97
|
| Rate for Payer: Nomi Health Commercial |
$167.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.62
|
| Rate for Payer: PACE Senior Care Partners |
$62.26
|
| Rate for Payer: PACE Senior Care Partners |
$48.49
|
| Rate for Payer: PACE SWMI |
$65.54
|
| Rate for Payer: PACE SWMI |
$51.04
|
| Rate for Payer: PHP Commercial |
$173.54
|
| Rate for Payer: PHP Commercial |
$222.84
|
| Rate for Payer: PHP Medicare Advantage |
$51.04
|
| Rate for Payer: PHP Medicare Advantage |
$65.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$177.62
|
| Rate for Payer: Priority Health Medicare |
$66.20
|
| Rate for Payer: Priority Health Medicare |
$51.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.46
|
| Rate for Payer: Railroad Medicare Medicare |
$51.04
|
| Rate for Payer: Railroad Medicare Medicare |
$65.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.70
|
| Rate for Payer: UHC Core |
$218.90
|
| Rate for Payer: UHC Core |
$170.47
|
| Rate for Payer: UHC Exchange |
$65.54
|
| Rate for Payer: UHC Exchange |
$51.04
|
| Rate for Payer: UHC Medicaid |
$46.22
|
| Rate for Payer: UHC Medicaid |
$35.99
|
| Rate for Payer: UHC Medicare Advantage |
$51.04
|
| Rate for Payer: UHC Medicare Advantage |
$65.54
|
| Rate for Payer: UHCCP Medicaid |
$35.99
|
| Rate for Payer: UHCCP Medicaid |
$46.22
|
| Rate for Payer: VA VA |
$51.04
|
| Rate for Payer: VA VA |
$65.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.12
|
|
|
EPTIFIBATIDE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$66.22
|
|
|
Service Code
|
HCPCS J1327
|
| Hospital Charge Code |
23124
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$46.09 |
| Max. Negotiated Rate |
$59.60 |
| Rate for Payer: Aetna Commercial |
$56.29
|
| Rate for Payer: BCBS Trust/PPO |
$54.69
|
| Rate for Payer: BCN Commercial |
$54.69
|
| Rate for Payer: Cash Price |
$52.98
|
| Rate for Payer: Cofinity Commercial |
$56.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.98
|
| Rate for Payer: Healthscope Commercial |
$59.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.29
|
| Rate for Payer: Nomi Health Commercial |
$54.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.66
|
| Rate for Payer: PHP Commercial |
$56.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.27
|
| Rate for Payer: UHC Core |
$55.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.66
|
|
|
EPTIFIBATIDE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$66.22
|
|
|
Service Code
|
HCPCS J1327
|
| Hospital Charge Code |
23124
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$59.60 |
| Rate for Payer: Aetna Commercial |
$56.29
|
| Rate for Payer: Aetna Medicare |
$17.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.69
|
| Rate for Payer: BCBS Complete |
$12.26
|
| Rate for Payer: BCBS MAPPO |
$16.55
|
| Rate for Payer: BCBS Trust/PPO |
$54.44
|
| Rate for Payer: BCN Commercial |
$54.44
|
| Rate for Payer: BCN Medicare Advantage |
$16.55
|
| Rate for Payer: Cash Price |
$52.98
|
| Rate for Payer: Cofinity Commercial |
$56.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.55
|
| Rate for Payer: Healthscope Commercial |
$59.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.66
|
| Rate for Payer: Mclaren Medicaid |
$11.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.38
|
| Rate for Payer: Meridian Medicaid |
$12.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.29
|
| Rate for Payer: Nomi Health Commercial |
$54.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.66
|
| Rate for Payer: PACE Senior Care Partners |
$15.73
|
| Rate for Payer: PACE SWMI |
$16.55
|
| Rate for Payer: PHP Commercial |
$56.29
|
| Rate for Payer: PHP Medicare Advantage |
$16.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.61
|
| Rate for Payer: Priority Health Medicare |
$16.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.09
|
| Rate for Payer: Railroad Medicare Medicare |
$16.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.27
|
| Rate for Payer: UHC Core |
$55.29
|
| Rate for Payer: UHC Exchange |
$16.55
|
| Rate for Payer: UHC Medicaid |
$11.67
|
| Rate for Payer: UHC Medicare Advantage |
$16.55
|
| Rate for Payer: UHCCP Medicaid |
$11.67
|
| Rate for Payer: VA VA |
$16.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.66
|
|
|
ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE
|
Facility
|
IP
|
$310.20
|
|
|
Service Code
|
NDC 64380073706
|
| Hospital Charge Code |
2863
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$215.90 |
| Max. Negotiated Rate |
$279.18 |
| Rate for Payer: Aetna Commercial |
$263.67
|
| Rate for Payer: BCBS Trust/PPO |
$256.19
|
| Rate for Payer: BCN Commercial |
$256.19
|
| Rate for Payer: Cash Price |
$248.16
|
| Rate for Payer: Cofinity Commercial |
$266.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.16
|
| Rate for Payer: Healthscope Commercial |
$279.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.67
|
| Rate for Payer: Nomi Health Commercial |
$254.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$232.65
|
| Rate for Payer: PHP Commercial |
$263.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$269.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$215.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.98
|
| Rate for Payer: UHC Core |
$259.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.65
|
|
|
ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE
|
Facility
|
OP
|
$310.20
|
|
|
Service Code
|
NDC 64380073706
|
| Hospital Charge Code |
2863
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$54.69 |
| Max. Negotiated Rate |
$279.18 |
| Rate for Payer: Aetna Commercial |
$263.67
|
| Rate for Payer: Aetna Medicare |
$80.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.94
|
| Rate for Payer: BCBS Complete |
$57.42
|
| Rate for Payer: BCBS MAPPO |
$77.55
|
| Rate for Payer: BCBS Trust/PPO |
$255.02
|
| Rate for Payer: BCN Commercial |
$255.02
|
| Rate for Payer: BCN Medicare Advantage |
$77.55
|
| Rate for Payer: Cash Price |
$248.16
|
| Rate for Payer: Cofinity Commercial |
$266.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.55
|
| Rate for Payer: Healthscope Commercial |
$279.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.65
|
| Rate for Payer: Mclaren Medicaid |
$54.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.43
|
| Rate for Payer: Meridian Medicaid |
$57.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.67
|
| Rate for Payer: Nomi Health Commercial |
$254.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$232.65
|
| Rate for Payer: PACE Senior Care Partners |
$73.67
|
| Rate for Payer: PACE SWMI |
$77.55
|
| Rate for Payer: PHP Commercial |
$263.67
|
| Rate for Payer: PHP Medicare Advantage |
$77.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$269.87
|
| Rate for Payer: Priority Health Medicare |
$78.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$215.90
|
| Rate for Payer: Railroad Medicare Medicare |
$77.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.98
|
| Rate for Payer: UHC Core |
$259.02
|
| Rate for Payer: UHC Exchange |
$77.55
|
| Rate for Payer: UHC Medicaid |
$54.69
|
| Rate for Payer: UHC Medicare Advantage |
$77.55
|
| Rate for Payer: UHCCP Medicaid |
$54.69
|
| Rate for Payer: VA VA |
$77.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.65
|
|
|
ERTAPENEM 1 GRAM IM SOLR CUSTOM
|
Facility
|
IP
|
$424.00
|
|
|
Service Code
|
HCPCS J1335
|
| Hospital Charge Code |
150756
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$295.10 |
| Max. Negotiated Rate |
$381.60 |
| Rate for Payer: Aetna Commercial |
$360.40
|
| Rate for Payer: BCBS Trust/PPO |
$350.18
|
| Rate for Payer: BCN Commercial |
$350.18
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$364.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.20
|
| Rate for Payer: Healthscope Commercial |
$381.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.40
|
| Rate for Payer: Nomi Health Commercial |
$347.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.00
|
| Rate for Payer: PHP Commercial |
$360.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$368.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$295.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$373.12
|
| Rate for Payer: UHC Core |
$354.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.00
|
|
|
ERTAPENEM 1 GRAM IM SOLR CUSTOM
|
Facility
|
OP
|
$424.00
|
|
|
Service Code
|
HCPCS J1335
|
| Hospital Charge Code |
150756
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$74.75 |
| Max. Negotiated Rate |
$381.60 |
| Rate for Payer: Aetna Commercial |
$360.40
|
| Rate for Payer: Aetna Medicare |
$110.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$132.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$132.50
|
| Rate for Payer: BCBS Complete |
$78.48
|
| Rate for Payer: BCBS MAPPO |
$106.00
|
| Rate for Payer: BCBS Trust/PPO |
$348.57
|
| Rate for Payer: BCN Commercial |
$348.57
|
| Rate for Payer: BCN Medicare Advantage |
$106.00
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$364.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.00
|
| Rate for Payer: Healthscope Commercial |
$381.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.00
|
| Rate for Payer: Mclaren Medicaid |
$74.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.30
|
| Rate for Payer: Meridian Medicaid |
$78.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$116.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.40
|
| Rate for Payer: Nomi Health Commercial |
$347.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.00
|
| Rate for Payer: PACE Senior Care Partners |
$100.70
|
| Rate for Payer: PACE SWMI |
$106.00
|
| Rate for Payer: PHP Commercial |
$360.40
|
| Rate for Payer: PHP Medicare Advantage |
$106.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$368.88
|
| Rate for Payer: Priority Health Medicare |
$107.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$295.10
|
| Rate for Payer: Railroad Medicare Medicare |
$106.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$373.12
|
| Rate for Payer: UHC Core |
$354.04
|
| Rate for Payer: UHC Exchange |
$106.00
|
| Rate for Payer: UHC Medicaid |
$74.75
|
| Rate for Payer: UHC Medicare Advantage |
$106.00
|
| Rate for Payer: UHCCP Medicaid |
$74.75
|
| Rate for Payer: VA VA |
$106.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.00
|
|
|
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION
|
Facility
|
IP
|
$69.41
|
|
|
Service Code
|
HCPCS J1335
|
| Hospital Charge Code |
31922
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$48.31 |
| Max. Negotiated Rate |
$62.47 |
| Rate for Payer: Aetna Commercial |
$59.00
|
| Rate for Payer: Aetna Commercial |
$360.40
|
| Rate for Payer: Aetna Commercial |
$55.96
|
| Rate for Payer: Aetna Commercial |
$56.29
|
| Rate for Payer: Aetna Commercial |
$127.12
|
| Rate for Payer: BCBS Trust/PPO |
$54.69
|
| Rate for Payer: BCBS Trust/PPO |
$57.33
|
| Rate for Payer: BCBS Trust/PPO |
$54.38
|
| Rate for Payer: BCBS Trust/PPO |
$350.18
|
| Rate for Payer: BCBS Trust/PPO |
$123.51
|
| Rate for Payer: BCN Commercial |
$54.69
|
| Rate for Payer: BCN Commercial |
$54.38
|
| Rate for Payer: BCN Commercial |
$123.51
|
| Rate for Payer: BCN Commercial |
$350.18
|
| Rate for Payer: BCN Commercial |
$57.33
|
| Rate for Payer: Cash Price |
$119.64
|
| Rate for Payer: Cash Price |
$55.53
|
| Rate for Payer: Cash Price |
$52.67
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$52.98
|
| Rate for Payer: Cofinity Commercial |
$59.69
|
| Rate for Payer: Cofinity Commercial |
$128.61
|
| Rate for Payer: Cofinity Commercial |
$56.95
|
| Rate for Payer: Cofinity Commercial |
$56.62
|
| Rate for Payer: Cofinity Commercial |
$364.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.53
|
| Rate for Payer: Healthscope Commercial |
$381.60
|
| Rate for Payer: Healthscope Commercial |
$59.26
|
| Rate for Payer: Healthscope Commercial |
$134.59
|
| Rate for Payer: Healthscope Commercial |
$59.60
|
| Rate for Payer: Healthscope Commercial |
$62.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.29
|
| Rate for Payer: Nomi Health Commercial |
$122.63
|
| Rate for Payer: Nomi Health Commercial |
$347.68
|
| Rate for Payer: Nomi Health Commercial |
$53.99
|
| Rate for Payer: Nomi Health Commercial |
$54.30
|
| Rate for Payer: Nomi Health Commercial |
$56.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$112.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.06
|
| Rate for Payer: PHP Commercial |
$360.40
|
| Rate for Payer: PHP Commercial |
$55.96
|
| Rate for Payer: PHP Commercial |
$59.00
|
| Rate for Payer: PHP Commercial |
$56.29
|
| Rate for Payer: PHP Commercial |
$127.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$130.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$368.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$295.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$373.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.27
|
| Rate for Payer: UHC Core |
$124.87
|
| Rate for Payer: UHC Core |
$354.04
|
| Rate for Payer: UHC Core |
$55.29
|
| Rate for Payer: UHC Core |
$57.96
|
| Rate for Payer: UHC Core |
$54.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.66
|
|
|
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION
|
Facility
|
OP
|
$69.41
|
|
|
Service Code
|
HCPCS J1335
|
| Hospital Charge Code |
31922
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.24 |
| Max. Negotiated Rate |
$62.47 |
| Rate for Payer: Aetna Commercial |
$59.00
|
| Rate for Payer: Aetna Commercial |
$360.40
|
| Rate for Payer: Aetna Commercial |
$56.29
|
| Rate for Payer: Aetna Commercial |
$127.12
|
| Rate for Payer: Aetna Commercial |
$55.96
|
| Rate for Payer: Aetna Medicare |
$110.24
|
| Rate for Payer: Aetna Medicare |
$18.05
|
| Rate for Payer: Aetna Medicare |
$17.12
|
| Rate for Payer: Aetna Medicare |
$38.88
|
| Rate for Payer: Aetna Medicare |
$17.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$132.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$132.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.69
|
| Rate for Payer: BCBS Complete |
$78.48
|
| Rate for Payer: BCBS Complete |
$27.68
|
| Rate for Payer: BCBS Complete |
$12.19
|
| Rate for Payer: BCBS Complete |
$12.85
|
| Rate for Payer: BCBS Complete |
$12.26
|
| Rate for Payer: BCBS MAPPO |
$17.35
|
| Rate for Payer: BCBS MAPPO |
$106.00
|
| Rate for Payer: BCBS MAPPO |
$37.39
|
| Rate for Payer: BCBS MAPPO |
$16.46
|
| Rate for Payer: BCBS MAPPO |
$16.55
|
| Rate for Payer: BCBS Trust/PPO |
$54.13
|
| Rate for Payer: BCBS Trust/PPO |
$122.95
|
| Rate for Payer: BCBS Trust/PPO |
$348.57
|
| Rate for Payer: BCBS Trust/PPO |
$57.06
|
| Rate for Payer: BCBS Trust/PPO |
$54.44
|
| Rate for Payer: BCN Commercial |
$54.13
|
| Rate for Payer: BCN Commercial |
$348.57
|
| Rate for Payer: BCN Commercial |
$122.95
|
| Rate for Payer: BCN Commercial |
$57.06
|
| Rate for Payer: BCN Commercial |
$54.44
|
| Rate for Payer: BCN Medicare Advantage |
$17.35
|
| Rate for Payer: BCN Medicare Advantage |
$16.55
|
| Rate for Payer: BCN Medicare Advantage |
$16.46
|
| Rate for Payer: BCN Medicare Advantage |
$106.00
|
| Rate for Payer: BCN Medicare Advantage |
$37.39
|
| Rate for Payer: Cash Price |
$119.64
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$55.53
|
| Rate for Payer: Cash Price |
$52.98
|
| Rate for Payer: Cash Price |
$52.67
|
| Rate for Payer: Cofinity Commercial |
$56.95
|
| Rate for Payer: Cofinity Commercial |
$56.62
|
| Rate for Payer: Cofinity Commercial |
$59.69
|
| Rate for Payer: Cofinity Commercial |
$128.61
|
| Rate for Payer: Cofinity Commercial |
$364.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.46
|
| Rate for Payer: Healthscope Commercial |
$134.59
|
| Rate for Payer: Healthscope Commercial |
$62.47
|
| Rate for Payer: Healthscope Commercial |
$59.60
|
| Rate for Payer: Healthscope Commercial |
$381.60
|
| Rate for Payer: Healthscope Commercial |
$59.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.38
|
| Rate for Payer: Mclaren Medicaid |
$74.75
|
| Rate for Payer: Mclaren Medicaid |
$11.67
|
| Rate for Payer: Mclaren Medicaid |
$11.61
|
| Rate for Payer: Mclaren Medicaid |
$12.24
|
| Rate for Payer: Mclaren Medicaid |
$26.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.28
|
| Rate for Payer: Meridian Medicaid |
$78.48
|
| Rate for Payer: Meridian Medicaid |
$27.68
|
| Rate for Payer: Meridian Medicaid |
$12.19
|
| Rate for Payer: Meridian Medicaid |
$12.26
|
| Rate for Payer: Meridian Medicaid |
$12.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$116.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.00
|
| Rate for Payer: Nomi Health Commercial |
$56.92
|
| Rate for Payer: Nomi Health Commercial |
$53.99
|
| Rate for Payer: Nomi Health Commercial |
$54.30
|
| Rate for Payer: Nomi Health Commercial |
$122.63
|
| Rate for Payer: Nomi Health Commercial |
$347.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$112.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.06
|
| Rate for Payer: PACE Senior Care Partners |
$35.52
|
| Rate for Payer: PACE Senior Care Partners |
$100.70
|
| Rate for Payer: PACE Senior Care Partners |
$16.48
|
| Rate for Payer: PACE Senior Care Partners |
$15.73
|
| Rate for Payer: PACE Senior Care Partners |
$15.64
|
| Rate for Payer: PACE SWMI |
$37.39
|
| Rate for Payer: PACE SWMI |
$106.00
|
| Rate for Payer: PACE SWMI |
$16.46
|
| Rate for Payer: PACE SWMI |
$16.55
|
| Rate for Payer: PACE SWMI |
$17.35
|
| Rate for Payer: PHP Commercial |
$56.29
|
| Rate for Payer: PHP Commercial |
$127.12
|
| Rate for Payer: PHP Commercial |
$55.96
|
| Rate for Payer: PHP Commercial |
$360.40
|
| Rate for Payer: PHP Commercial |
$59.00
|
| Rate for Payer: PHP Medicare Advantage |
$106.00
|
| Rate for Payer: PHP Medicare Advantage |
$17.35
|
| Rate for Payer: PHP Medicare Advantage |
$37.39
|
| Rate for Payer: PHP Medicare Advantage |
$16.55
|
| Rate for Payer: PHP Medicare Advantage |
$16.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$130.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$368.88
|
| Rate for Payer: Priority Health Medicare |
$107.06
|
| Rate for Payer: Priority Health Medicare |
$17.53
|
| Rate for Payer: Priority Health Medicare |
$37.76
|
| Rate for Payer: Priority Health Medicare |
$16.72
|
| Rate for Payer: Priority Health Medicare |
$16.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$295.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.09
|
| Rate for Payer: Railroad Medicare Medicare |
$17.35
|
| Rate for Payer: Railroad Medicare Medicare |
$16.55
|
| Rate for Payer: Railroad Medicare Medicare |
$16.46
|
| Rate for Payer: Railroad Medicare Medicare |
$37.39
|
| Rate for Payer: Railroad Medicare Medicare |
$106.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$373.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.08
|
| Rate for Payer: UHC Core |
$55.29
|
| Rate for Payer: UHC Core |
$124.87
|
| Rate for Payer: UHC Core |
$57.96
|
| Rate for Payer: UHC Core |
$54.98
|
| Rate for Payer: UHC Core |
$354.04
|
| Rate for Payer: UHC Exchange |
$37.39
|
| Rate for Payer: UHC Exchange |
$16.55
|
| Rate for Payer: UHC Exchange |
$106.00
|
| Rate for Payer: UHC Exchange |
$17.35
|
| Rate for Payer: UHC Exchange |
$16.46
|
| Rate for Payer: UHC Medicaid |
$12.24
|
| Rate for Payer: UHC Medicaid |
$11.67
|
| Rate for Payer: UHC Medicaid |
$74.75
|
| Rate for Payer: UHC Medicaid |
$11.61
|
| Rate for Payer: UHC Medicaid |
$26.37
|
| Rate for Payer: UHC Medicare Advantage |
$16.46
|
| Rate for Payer: UHC Medicare Advantage |
$37.39
|
| Rate for Payer: UHC Medicare Advantage |
$17.35
|
| Rate for Payer: UHC Medicare Advantage |
$106.00
|
| Rate for Payer: UHC Medicare Advantage |
$16.55
|
| Rate for Payer: UHCCP Medicaid |
$11.67
|
| Rate for Payer: UHCCP Medicaid |
$12.24
|
| Rate for Payer: UHCCP Medicaid |
$11.61
|
| Rate for Payer: UHCCP Medicaid |
$26.37
|
| Rate for Payer: UHCCP Medicaid |
$74.75
|
| Rate for Payer: VA VA |
$17.35
|
| Rate for Payer: VA VA |
$37.39
|
| Rate for Payer: VA VA |
$16.55
|
| Rate for Payer: VA VA |
$106.00
|
| Rate for Payer: VA VA |
$16.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.16
|
|
|
ERTAPENEM 1 GRAM SOLUTION MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$65.84
|
|
|
Service Code
|
HCPCS J1335
|
| Hospital Charge Code |
301714
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.61 |
| Max. Negotiated Rate |
$59.26 |
| Rate for Payer: Aetna Commercial |
$55.96
|
| Rate for Payer: Aetna Medicare |
$17.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.57
|
| Rate for Payer: BCBS Complete |
$12.19
|
| Rate for Payer: BCBS MAPPO |
$16.46
|
| Rate for Payer: BCBS Trust/PPO |
$54.13
|
| Rate for Payer: BCN Commercial |
$54.13
|
| Rate for Payer: BCN Medicare Advantage |
$16.46
|
| Rate for Payer: Cash Price |
$52.67
|
| Rate for Payer: Cofinity Commercial |
$56.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.46
|
| Rate for Payer: Healthscope Commercial |
$59.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.38
|
| Rate for Payer: Mclaren Medicaid |
$11.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.28
|
| Rate for Payer: Meridian Medicaid |
$12.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.96
|
| Rate for Payer: Nomi Health Commercial |
$53.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.38
|
| Rate for Payer: PACE Senior Care Partners |
$15.64
|
| Rate for Payer: PACE SWMI |
$16.46
|
| Rate for Payer: PHP Commercial |
$55.96
|
| Rate for Payer: PHP Medicare Advantage |
$16.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.28
|
| Rate for Payer: Priority Health Medicare |
$16.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.82
|
| Rate for Payer: Railroad Medicare Medicare |
$16.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.94
|
| Rate for Payer: UHC Core |
$54.98
|
| Rate for Payer: UHC Exchange |
$16.46
|
| Rate for Payer: UHC Medicaid |
$11.61
|
| Rate for Payer: UHC Medicare Advantage |
$16.46
|
| Rate for Payer: UHCCP Medicaid |
$11.61
|
| Rate for Payer: VA VA |
$16.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.38
|
|
