|
RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$25,495.40
|
|
|
Service Code
|
HCPCS J2327
|
| Hospital Charge Code |
200582
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$22,945.86 |
| Rate for Payer: Aetna American Axle |
$16,572.01
|
| Rate for Payer: Aetna Commercial |
$21,671.09
|
| Rate for Payer: Aetna Medicare |
$15.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16,572.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.20
|
| Rate for Payer: BCBS Complete |
$8.82
|
| Rate for Payer: BCBS MAPPO |
$15.36
|
| Rate for Payer: BCBS Trust/PPO |
$49.64
|
| Rate for Payer: BCN Medicare Advantage |
$15.36
|
| Rate for Payer: Cash Price |
$20,396.32
|
| Rate for Payer: Cash Price |
$20,396.32
|
| Rate for Payer: Cofinity Commercial |
$21,926.04
|
| Rate for Payer: Cofinity Commercial |
$17,846.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,396.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.36
|
| Rate for Payer: Healthscope Commercial |
$22,945.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,846.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19,121.55
|
| Rate for Payer: Mclaren Medicaid |
$8.40
|
| Rate for Payer: Mclaren Medicare |
$15.36
|
| Rate for Payer: Meridian Medicaid |
$8.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21,671.09
|
| Rate for Payer: PACE Medicare |
$14.59
|
| Rate for Payer: PACE SWMI |
$15.36
|
| Rate for Payer: PHP Commercial |
$21,671.09
|
| Rate for Payer: PHP Medicare Advantage |
$15.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,846.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.04
|
| Rate for Payer: Priority Health Medicare |
$15.36
|
| Rate for Payer: Priority Health Narrow Network |
$36.03
|
| Rate for Payer: Priority Health SBD |
$16,062.10
|
| Rate for Payer: Railroad Medicare Medicare |
$15.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.36
|
| Rate for Payer: UHC Medicare Advantage |
$15.82
|
| Rate for Payer: UMR Bronson Commercial |
$9,433.30
|
| Rate for Payer: VA VA |
$15.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19,121.55
|
|
|
RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$25,495.40
|
|
|
Service Code
|
HCPCS J2327
|
| Hospital Charge Code |
200582
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11,217.98 |
| Max. Negotiated Rate |
$22,945.86 |
| Rate for Payer: Aetna American Axle |
$16,572.01
|
| Rate for Payer: Aetna Commercial |
$21,671.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16,572.01
|
| Rate for Payer: Cash Price |
$20,396.32
|
| Rate for Payer: Cofinity Commercial |
$17,846.78
|
| Rate for Payer: Cofinity Commercial |
$21,926.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,396.32
|
| Rate for Payer: Healthscope Commercial |
$22,945.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,846.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19,121.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21,671.09
|
| Rate for Payer: PHP Commercial |
$21,671.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,846.78
|
| Rate for Payer: Priority Health SBD |
$16,062.10
|
| Rate for Payer: UMR Bronson Commercial |
$11,217.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19,121.55
|
|
|
RISEDRONATE 150 MG TABLET
|
Facility
|
IP
|
$1,270.88
|
|
|
Service Code
|
NDC 0430-0478-01
|
| Hospital Charge Code |
91538
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$559.19 |
| Max. Negotiated Rate |
$1,143.79 |
| Rate for Payer: Aetna American Axle |
$826.07
|
| Rate for Payer: Aetna Commercial |
$1,080.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$826.07
|
| Rate for Payer: Cash Price |
$1,016.70
|
| Rate for Payer: Cofinity Commercial |
$1,092.96
|
| Rate for Payer: Cofinity Commercial |
$889.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,016.70
|
| Rate for Payer: Healthscope Commercial |
$1,143.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$889.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$953.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,080.25
|
| Rate for Payer: PHP Commercial |
$1,080.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$889.62
|
| Rate for Payer: Priority Health SBD |
$800.65
|
| Rate for Payer: UMR Bronson Commercial |
$559.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$953.16
|
|
|
RISEDRONATE 35 MG TABLET
|
Facility
|
IP
|
$3,519.90
|
|
|
Service Code
|
NDC 0430-0472-07
|
| Hospital Charge Code |
32895
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,548.76 |
| Max. Negotiated Rate |
$3,167.91 |
| Rate for Payer: Aetna American Axle |
$2,287.94
|
| Rate for Payer: Aetna Commercial |
$2,991.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,287.94
|
| Rate for Payer: Cash Price |
$2,815.92
|
| Rate for Payer: Cofinity Commercial |
$2,463.93
|
| Rate for Payer: Cofinity Commercial |
$3,027.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,815.92
|
| Rate for Payer: Healthscope Commercial |
$3,167.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,463.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,639.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,991.92
|
| Rate for Payer: PHP Commercial |
$2,991.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,463.93
|
| Rate for Payer: Priority Health SBD |
$2,217.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,548.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,639.92
|
|
|
RISEDRONATE 5 MG TABLET
|
Facility
|
IP
|
$258.08
|
|
|
Service Code
|
NDC 33342-107-07
|
| Hospital Charge Code |
27112
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$113.56 |
| Max. Negotiated Rate |
$232.27 |
| Rate for Payer: Aetna American Axle |
$167.75
|
| Rate for Payer: Aetna Commercial |
$219.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.75
|
| Rate for Payer: Cash Price |
$206.46
|
| Rate for Payer: Cofinity Commercial |
$180.66
|
| Rate for Payer: Cofinity Commercial |
$221.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.46
|
| Rate for Payer: Healthscope Commercial |
$232.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$219.37
|
| Rate for Payer: PHP Commercial |
$219.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.66
|
| Rate for Payer: Priority Health SBD |
$162.59
|
| Rate for Payer: UMR Bronson Commercial |
$113.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.56
|
|
|
RISPERIDONE 0.25 MG TABLET
|
Facility
|
IP
|
$310.20
|
|
|
Service Code
|
NDC 0904-6357-61
|
| Hospital Charge Code |
25519
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$136.49 |
| Max. Negotiated Rate |
$279.18 |
| Rate for Payer: Aetna American Axle |
$201.63
|
| Rate for Payer: Aetna Commercial |
$263.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.63
|
| Rate for Payer: Cash Price |
$248.16
|
| Rate for Payer: Cofinity Commercial |
$217.14
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$217.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$263.67
|
| Rate for Payer: PHP Commercial |
$263.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.14
|
| Rate for Payer: Priority Health SBD |
$195.43
|
| Rate for Payer: UMR Bronson Commercial |
$136.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.65
|
|
|
RISPERIDONE 0.25 MG TABLET
|
Facility
|
IP
|
$399.50
|
|
|
Service Code
|
NDC 68084-270-11
|
| Hospital Charge Code |
25519
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$175.78 |
| Max. Negotiated Rate |
$359.55 |
| Rate for Payer: Aetna American Axle |
$259.68
|
| Rate for Payer: Aetna Commercial |
$339.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.68
|
| Rate for Payer: Cash Price |
$319.60
|
| Rate for Payer: Cofinity Commercial |
$279.65
|
| Rate for Payer: Cofinity Commercial |
$343.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$319.60
|
| Rate for Payer: Healthscope Commercial |
$359.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$279.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$299.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$339.58
|
| Rate for Payer: PHP Commercial |
$339.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.65
|
| Rate for Payer: Priority Health SBD |
$251.68
|
| Rate for Payer: UMR Bronson Commercial |
$175.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$299.62
|
|
|
RISPERIDONE 0.25 MG TABLET
|
Facility
|
IP
|
$26.79
|
|
|
Service Code
|
NDC 68382-112-14
|
| Hospital Charge Code |
25519
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.79 |
| Max. Negotiated Rate |
$24.11 |
| Rate for Payer: Aetna American Axle |
$17.41
|
| Rate for Payer: Aetna Commercial |
$22.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.41
|
| Rate for Payer: Cash Price |
$21.43
|
| Rate for Payer: Cofinity Commercial |
$18.75
|
| Rate for Payer: Cofinity Commercial |
$23.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.43
|
| Rate for Payer: Healthscope Commercial |
$24.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.77
|
| Rate for Payer: PHP Commercial |
$22.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.75
|
| Rate for Payer: Priority Health SBD |
$16.88
|
| Rate for Payer: UMR Bronson Commercial |
$11.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.09
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$92.63
|
|
|
Service Code
|
NDC 65162-673-84
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$40.76 |
| Max. Negotiated Rate |
$83.37 |
| Rate for Payer: Aetna American Axle |
$60.21
|
| Rate for Payer: Aetna Commercial |
$78.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.21
|
| Rate for Payer: Cash Price |
$74.10
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Cofinity Commercial |
$79.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.10
|
| Rate for Payer: Healthscope Commercial |
$83.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.74
|
| Rate for Payer: PHP Commercial |
$78.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.84
|
| Rate for Payer: Priority Health SBD |
$58.36
|
| Rate for Payer: UMR Bronson Commercial |
$40.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.47
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$419.03
|
|
|
Service Code
|
NDC 50458-596-01
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$184.37 |
| Max. Negotiated Rate |
$377.13 |
| Rate for Payer: Aetna American Axle |
$272.37
|
| Rate for Payer: Aetna Commercial |
$356.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.37
|
| Rate for Payer: Cash Price |
$335.22
|
| Rate for Payer: Cofinity Commercial |
$293.32
|
| Rate for Payer: Cofinity Commercial |
$360.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.22
|
| Rate for Payer: Healthscope Commercial |
$377.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$293.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$356.18
|
| Rate for Payer: PHP Commercial |
$356.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.32
|
| Rate for Payer: Priority Health SBD |
$263.99
|
| Rate for Payer: UMR Bronson Commercial |
$184.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.27
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$565.22
|
|
|
Service Code
|
NDC 50458-305-03
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$248.70 |
| Max. Negotiated Rate |
$508.70 |
| Rate for Payer: Aetna American Axle |
$367.39
|
| Rate for Payer: Aetna Commercial |
$480.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$367.39
|
| Rate for Payer: Cash Price |
$452.18
|
| Rate for Payer: Cofinity Commercial |
$395.65
|
| Rate for Payer: Cofinity Commercial |
$486.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.18
|
| Rate for Payer: Healthscope Commercial |
$508.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$395.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$480.44
|
| Rate for Payer: PHP Commercial |
$480.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$395.65
|
| Rate for Payer: Priority Health SBD |
$356.09
|
| Rate for Payer: UMR Bronson Commercial |
$248.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.92
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
IP
|
$197.40
|
|
|
Service Code
|
NDC 27241-001-06
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$86.86 |
| Max. Negotiated Rate |
$177.66 |
| Rate for Payer: Aetna American Axle |
$128.31
|
| Rate for Payer: Aetna Commercial |
$167.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.31
|
| Rate for Payer: Cash Price |
$157.92
|
| Rate for Payer: Cofinity Commercial |
$138.18
|
| Rate for Payer: Cofinity Commercial |
$169.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.92
|
| Rate for Payer: Healthscope Commercial |
$177.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$167.79
|
| Rate for Payer: PHP Commercial |
$167.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.18
|
| Rate for Payer: Priority Health SBD |
$124.36
|
| Rate for Payer: UMR Bronson Commercial |
$86.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.05
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
IP
|
$244.15
|
|
|
Service Code
|
NDC 68084-272-11
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$107.43 |
| Max. Negotiated Rate |
$219.74 |
| Rate for Payer: Aetna American Axle |
$158.70
|
| Rate for Payer: Aetna Commercial |
$207.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.70
|
| Rate for Payer: Cash Price |
$195.32
|
| Rate for Payer: Cofinity Commercial |
$209.97
|
| Rate for Payer: Cofinity Commercial |
$170.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.32
|
| Rate for Payer: Healthscope Commercial |
$219.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.53
|
| Rate for Payer: PHP Commercial |
$207.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.90
|
| Rate for Payer: Priority Health SBD |
$153.81
|
| Rate for Payer: UMR Bronson Commercial |
$107.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.11
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
IP
|
$38.07
|
|
|
Service Code
|
NDC 68382-114-14
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$34.26 |
| Rate for Payer: Aetna American Axle |
$24.75
|
| Rate for Payer: Aetna Commercial |
$32.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.75
|
| Rate for Payer: Cash Price |
$30.46
|
| Rate for Payer: Cofinity Commercial |
$26.65
|
| Rate for Payer: Cofinity Commercial |
$32.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.46
|
| Rate for Payer: Healthscope Commercial |
$34.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.36
|
| Rate for Payer: PHP Commercial |
$32.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
| Rate for Payer: Priority Health SBD |
$23.98
|
| Rate for Payer: UMR Bronson Commercial |
$16.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.55
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
IP
|
$338.40
|
|
|
Service Code
|
NDC 0904-6359-61
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$148.90 |
| Max. Negotiated Rate |
$304.56 |
| Rate for Payer: Aetna American Axle |
$219.96
|
| Rate for Payer: Aetna Commercial |
$287.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.96
|
| Rate for Payer: Cash Price |
$270.72
|
| Rate for Payer: Cofinity Commercial |
$236.88
|
| Rate for Payer: Cofinity Commercial |
$291.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.72
|
| Rate for Payer: Healthscope Commercial |
$304.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$236.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$287.64
|
| Rate for Payer: PHP Commercial |
$287.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$236.88
|
| Rate for Payer: Priority Health SBD |
$213.19
|
| Rate for Payer: UMR Bronson Commercial |
$148.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.80
|
|
|
RISPERIDONE 3 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$137.90
|
|
|
Service Code
|
NDC 59746-040-22
|
| Hospital Charge Code |
70257
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$60.68 |
| Max. Negotiated Rate |
$124.11 |
| Rate for Payer: Aetna American Axle |
$89.64
|
| Rate for Payer: Aetna Commercial |
$117.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.64
|
| Rate for Payer: Cash Price |
$110.32
|
| Rate for Payer: Cofinity Commercial |
$118.59
|
| Rate for Payer: Cofinity Commercial |
$96.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.32
|
| Rate for Payer: Healthscope Commercial |
$124.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$117.22
|
| Rate for Payer: PHP Commercial |
$117.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.53
|
| Rate for Payer: Priority Health SBD |
$86.88
|
| Rate for Payer: UMR Bronson Commercial |
$60.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.42
|
|
|
RISPERIDONE MICROSPHERES ER 25 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE
|
Facility
|
OP
|
$1,792.36
|
|
|
Service Code
|
HCPCS J2794
|
| Hospital Charge Code |
37237
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.65 |
| Max. Negotiated Rate |
$1,613.12 |
| Rate for Payer: Aetna American Axle |
$1,165.03
|
| Rate for Payer: Aetna Commercial |
$1,523.51
|
| Rate for Payer: Aetna Medicare |
$12.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,165.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.19
|
| Rate for Payer: BCBS Complete |
$6.98
|
| Rate for Payer: BCBS MAPPO |
$12.15
|
| Rate for Payer: BCBS Trust/PPO |
$39.27
|
| Rate for Payer: BCN Medicare Advantage |
$12.15
|
| Rate for Payer: Cash Price |
$1,433.89
|
| Rate for Payer: Cash Price |
$1,433.89
|
| Rate for Payer: Cofinity Commercial |
$1,541.43
|
| Rate for Payer: Cofinity Commercial |
$1,254.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,433.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.15
|
| Rate for Payer: Healthscope Commercial |
$1,613.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,254.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,344.27
|
| Rate for Payer: Mclaren Medicaid |
$6.65
|
| Rate for Payer: Mclaren Medicare |
$12.15
|
| Rate for Payer: Meridian Medicaid |
$6.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,523.51
|
| Rate for Payer: PACE Medicare |
$11.54
|
| Rate for Payer: PACE SWMI |
$12.15
|
| Rate for Payer: PHP Commercial |
$1,523.51
|
| Rate for Payer: PHP Medicare Advantage |
$12.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,254.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.67
|
| Rate for Payer: Priority Health Medicare |
$12.15
|
| Rate for Payer: Priority Health Narrow Network |
$28.54
|
| Rate for Payer: Priority Health SBD |
$1,129.19
|
| Rate for Payer: Railroad Medicare Medicare |
$12.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.15
|
| Rate for Payer: UHC Medicare Advantage |
$12.52
|
| Rate for Payer: UMR Bronson Commercial |
$663.17
|
| Rate for Payer: VA VA |
$12.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,344.27
|
|
|
RISPERIDONE MICROSPHERES ER 25 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE
|
Facility
|
IP
|
$1,792.36
|
|
|
Service Code
|
HCPCS J2794
|
| Hospital Charge Code |
37237
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$788.64 |
| Max. Negotiated Rate |
$1,613.12 |
| Rate for Payer: Aetna American Axle |
$1,165.03
|
| Rate for Payer: Aetna Commercial |
$1,523.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,165.03
|
| Rate for Payer: Cash Price |
$1,433.89
|
| Rate for Payer: Cofinity Commercial |
$1,254.65
|
| Rate for Payer: Cofinity Commercial |
$1,541.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,433.89
|
| Rate for Payer: Healthscope Commercial |
$1,613.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,254.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,344.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,523.51
|
| Rate for Payer: PHP Commercial |
$1,523.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,254.65
|
| Rate for Payer: Priority Health SBD |
$1,129.19
|
| Rate for Payer: UMR Bronson Commercial |
$788.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,344.27
|
|
|
RISPERIDONE MICROSPHERES ER 37.5 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEAS
|
Facility
|
OP
|
$2,688.64
|
|
|
Service Code
|
HCPCS J2794
|
| Hospital Charge Code |
37238
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.65 |
| Max. Negotiated Rate |
$2,419.78 |
| Rate for Payer: Aetna American Axle |
$1,747.62
|
| Rate for Payer: Aetna Commercial |
$2,285.34
|
| Rate for Payer: Aetna Medicare |
$12.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,747.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.19
|
| Rate for Payer: BCBS Complete |
$6.98
|
| Rate for Payer: BCBS MAPPO |
$12.15
|
| Rate for Payer: BCBS Trust/PPO |
$39.27
|
| Rate for Payer: BCN Medicare Advantage |
$12.15
|
| Rate for Payer: Cash Price |
$2,150.91
|
| Rate for Payer: Cash Price |
$2,150.91
|
| Rate for Payer: Cofinity Commercial |
$1,882.05
|
| Rate for Payer: Cofinity Commercial |
$2,312.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,150.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.15
|
| Rate for Payer: Healthscope Commercial |
$2,419.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,882.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,016.48
|
| Rate for Payer: Mclaren Medicaid |
$6.65
|
| Rate for Payer: Mclaren Medicare |
$12.15
|
| Rate for Payer: Meridian Medicaid |
$6.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,285.34
|
| Rate for Payer: PACE Medicare |
$11.54
|
| Rate for Payer: PACE SWMI |
$12.15
|
| Rate for Payer: PHP Commercial |
$2,285.34
|
| Rate for Payer: PHP Medicare Advantage |
$12.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,882.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.67
|
| Rate for Payer: Priority Health Medicare |
$12.15
|
| Rate for Payer: Priority Health Narrow Network |
$28.54
|
| Rate for Payer: Priority Health SBD |
$1,693.84
|
| Rate for Payer: Railroad Medicare Medicare |
$12.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.15
|
| Rate for Payer: UHC Medicare Advantage |
$12.52
|
| Rate for Payer: UMR Bronson Commercial |
$994.80
|
| Rate for Payer: VA VA |
$12.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,016.48
|
|
|
RISPERIDONE MICROSPHERES ER 50 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE
|
Facility
|
IP
|
$3,585.00
|
|
|
Service Code
|
HCPCS J2794
|
| Hospital Charge Code |
37239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,577.40 |
| Max. Negotiated Rate |
$3,226.50 |
| Rate for Payer: Aetna American Axle |
$2,330.25
|
| Rate for Payer: Aetna Commercial |
$3,047.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,330.25
|
| Rate for Payer: Cash Price |
$2,868.00
|
| Rate for Payer: Cofinity Commercial |
$2,509.50
|
| Rate for Payer: Cofinity Commercial |
$3,083.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,868.00
|
| Rate for Payer: Healthscope Commercial |
$3,226.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,509.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,688.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,047.25
|
| Rate for Payer: PHP Commercial |
$3,047.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,509.50
|
| Rate for Payer: Priority Health SBD |
$2,258.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,577.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,688.75
|
|
|
RITONAVIR 100 MG TABLET
|
Facility
|
IP
|
$927.74
|
|
|
Service Code
|
NDC 0074-3333-30
|
| Hospital Charge Code |
100995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$408.21 |
| Max. Negotiated Rate |
$834.97 |
| Rate for Payer: Aetna American Axle |
$603.03
|
| Rate for Payer: Aetna Commercial |
$788.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$603.03
|
| Rate for Payer: Cash Price |
$742.19
|
| Rate for Payer: Cofinity Commercial |
$649.42
|
| Rate for Payer: Cofinity Commercial |
$797.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$742.19
|
| Rate for Payer: Healthscope Commercial |
$834.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$649.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$695.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$788.58
|
| Rate for Payer: PHP Commercial |
$788.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$649.42
|
| Rate for Payer: Priority Health SBD |
$584.48
|
| Rate for Payer: UMR Bronson Commercial |
$408.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$695.80
|
|
|
RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS
|
Facility
|
IP
|
$17,928.35
|
|
|
Service Code
|
HCPCS J9312
|
| Hospital Charge Code |
22149
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7,888.47 |
| Max. Negotiated Rate |
$16,135.52 |
| Rate for Payer: Aetna American Axle |
$11,653.43
|
| Rate for Payer: Aetna American Axle |
$2,330.69
|
| Rate for Payer: Aetna Commercial |
$15,239.10
|
| Rate for Payer: Aetna Commercial |
$3,047.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,330.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,653.43
|
| Rate for Payer: Cash Price |
$2,868.54
|
| Rate for Payer: Cash Price |
$14,342.68
|
| Rate for Payer: Cofinity Commercial |
$3,083.68
|
| Rate for Payer: Cofinity Commercial |
$15,418.38
|
| Rate for Payer: Cofinity Commercial |
$12,549.84
|
| Rate for Payer: Cofinity Commercial |
$2,509.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,342.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,868.54
|
| Rate for Payer: Healthscope Commercial |
$3,227.10
|
| Rate for Payer: Healthscope Commercial |
$16,135.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,509.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,549.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,689.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,446.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,047.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,239.10
|
| Rate for Payer: PHP Commercial |
$3,047.82
|
| Rate for Payer: PHP Commercial |
$15,239.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,509.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,549.84
|
| Rate for Payer: Priority Health SBD |
$2,258.97
|
| Rate for Payer: Priority Health SBD |
$11,294.86
|
| Rate for Payer: UMR Bronson Commercial |
$7,888.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,577.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,689.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,446.26
|
|
|
RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS
|
Facility
|
OP
|
$17,928.35
|
|
|
Service Code
|
HCPCS J9312
|
| Hospital Charge Code |
22149
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$43.32 |
| Max. Negotiated Rate |
$16,135.52 |
| Rate for Payer: Aetna American Axle |
$11,653.43
|
| Rate for Payer: Aetna American Axle |
$2,330.69
|
| Rate for Payer: Aetna Commercial |
$15,239.10
|
| Rate for Payer: Aetna Commercial |
$3,047.82
|
| Rate for Payer: Aetna Medicare |
$82.37
|
| Rate for Payer: Aetna Medicare |
$82.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,653.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,330.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$99.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$99.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$99.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$99.00
|
| Rate for Payer: BCBS Complete |
$45.49
|
| Rate for Payer: BCBS Complete |
$45.49
|
| Rate for Payer: BCBS MAPPO |
$79.20
|
| Rate for Payer: BCBS MAPPO |
$79.20
|
| Rate for Payer: BCBS Trust/PPO |
$255.92
|
| Rate for Payer: BCBS Trust/PPO |
$255.92
|
| Rate for Payer: BCN Medicare Advantage |
$79.20
|
| Rate for Payer: BCN Medicare Advantage |
$79.20
|
| Rate for Payer: Cash Price |
$2,868.54
|
| Rate for Payer: Cash Price |
$14,342.68
|
| Rate for Payer: Cash Price |
$2,868.54
|
| Rate for Payer: Cash Price |
$14,342.68
|
| Rate for Payer: Cofinity Commercial |
$2,509.97
|
| Rate for Payer: Cofinity Commercial |
$12,549.84
|
| Rate for Payer: Cofinity Commercial |
$15,418.38
|
| Rate for Payer: Cofinity Commercial |
$3,083.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,342.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,868.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.20
|
| Rate for Payer: Healthscope Commercial |
$16,135.52
|
| Rate for Payer: Healthscope Commercial |
$3,227.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,509.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,549.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,689.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,446.26
|
| Rate for Payer: Mclaren Medicaid |
$43.32
|
| Rate for Payer: Mclaren Medicaid |
$43.32
|
| Rate for Payer: Mclaren Medicare |
$79.20
|
| Rate for Payer: Mclaren Medicare |
$79.20
|
| Rate for Payer: Meridian Medicaid |
$45.49
|
| Rate for Payer: Meridian Medicaid |
$45.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$83.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$83.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,239.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,047.82
|
| Rate for Payer: PACE Medicare |
$75.24
|
| Rate for Payer: PACE Medicare |
$75.24
|
| Rate for Payer: PACE SWMI |
$79.20
|
| Rate for Payer: PACE SWMI |
$79.20
|
| Rate for Payer: PHP Commercial |
$3,047.82
|
| Rate for Payer: PHP Commercial |
$15,239.10
|
| Rate for Payer: PHP Medicare Advantage |
$79.20
|
| Rate for Payer: PHP Medicare Advantage |
$79.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,549.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,509.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.51
|
| Rate for Payer: Priority Health Medicare |
$79.20
|
| Rate for Payer: Priority Health Medicare |
$79.20
|
| Rate for Payer: Priority Health Narrow Network |
$188.41
|
| Rate for Payer: Priority Health Narrow Network |
$188.41
|
| Rate for Payer: Priority Health SBD |
$2,258.97
|
| Rate for Payer: Priority Health SBD |
$11,294.86
|
| Rate for Payer: Railroad Medicare Medicare |
$79.20
|
| Rate for Payer: Railroad Medicare Medicare |
$79.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.20
|
| Rate for Payer: UHC Medicare Advantage |
$81.57
|
| Rate for Payer: UHC Medicare Advantage |
$81.57
|
| Rate for Payer: UMR Bronson Commercial |
$6,633.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,326.70
|
| Rate for Payer: VA VA |
$79.20
|
| Rate for Payer: VA VA |
$79.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,446.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,689.25
|
|
|
RITUXIMAB 1,400 MG/11.7 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN
|
Facility
|
OP
|
$14,534.22
|
|
|
Service Code
|
HCPCS J9311
|
| Hospital Charge Code |
183548
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$13,080.80 |
| Rate for Payer: Aetna American Axle |
$9,447.24
|
| Rate for Payer: Aetna Commercial |
$12,354.09
|
| Rate for Payer: Aetna Medicare |
$38.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,447.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.76
|
| Rate for Payer: BCBS Complete |
$21.49
|
| Rate for Payer: BCBS MAPPO |
$37.40
|
| Rate for Payer: BCBS Trust/PPO |
$120.87
|
| Rate for Payer: BCN Medicare Advantage |
$37.40
|
| Rate for Payer: Cash Price |
$11,627.38
|
| Rate for Payer: Cash Price |
$11,627.38
|
| Rate for Payer: Cofinity Commercial |
$12,499.43
|
| Rate for Payer: Cofinity Commercial |
$10,173.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,627.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.40
|
| Rate for Payer: Healthscope Commercial |
$13,080.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,173.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,900.66
|
| Rate for Payer: Mclaren Medicaid |
$20.46
|
| Rate for Payer: Mclaren Medicare |
$37.40
|
| Rate for Payer: Meridian Medicaid |
$21.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,354.09
|
| Rate for Payer: PACE Medicare |
$35.53
|
| Rate for Payer: PACE SWMI |
$37.40
|
| Rate for Payer: PHP Commercial |
$12,354.09
|
| Rate for Payer: PHP Medicare Advantage |
$37.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,173.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.07
|
| Rate for Payer: Priority Health Medicare |
$37.40
|
| Rate for Payer: Priority Health Narrow Network |
$87.26
|
| Rate for Payer: Priority Health SBD |
$9,156.56
|
| Rate for Payer: Railroad Medicare Medicare |
$37.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.40
|
| Rate for Payer: UHC Medicare Advantage |
$38.53
|
| Rate for Payer: UMR Bronson Commercial |
$5,377.66
|
| Rate for Payer: VA VA |
$37.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,900.66
|
|
|
RITUXIMAB 1,600 MG/13.4 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN
|
Facility
|
OP
|
$16,610.57
|
|
|
Service Code
|
HCPCS J9311
|
| Hospital Charge Code |
183627
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$14,949.51 |
| Rate for Payer: Aetna American Axle |
$10,796.87
|
| Rate for Payer: Aetna Commercial |
$14,118.98
|
| Rate for Payer: Aetna Medicare |
$38.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,796.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.76
|
| Rate for Payer: BCBS Complete |
$21.49
|
| Rate for Payer: BCBS MAPPO |
$37.40
|
| Rate for Payer: BCBS Trust/PPO |
$120.87
|
| Rate for Payer: BCN Medicare Advantage |
$37.40
|
| Rate for Payer: Cash Price |
$13,288.46
|
| Rate for Payer: Cash Price |
$13,288.46
|
| Rate for Payer: Cofinity Commercial |
$11,627.40
|
| Rate for Payer: Cofinity Commercial |
$14,285.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,288.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.40
|
| Rate for Payer: Healthscope Commercial |
$14,949.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,627.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,457.93
|
| Rate for Payer: Mclaren Medicaid |
$20.46
|
| Rate for Payer: Mclaren Medicare |
$37.40
|
| Rate for Payer: Meridian Medicaid |
$21.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,118.98
|
| Rate for Payer: PACE Medicare |
$35.53
|
| Rate for Payer: PACE SWMI |
$37.40
|
| Rate for Payer: PHP Commercial |
$14,118.98
|
| Rate for Payer: PHP Medicare Advantage |
$37.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,627.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.07
|
| Rate for Payer: Priority Health Medicare |
$37.40
|
| Rate for Payer: Priority Health Narrow Network |
$87.26
|
| Rate for Payer: Priority Health SBD |
$10,464.66
|
| Rate for Payer: Railroad Medicare Medicare |
$37.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.40
|
| Rate for Payer: UHC Medicare Advantage |
$38.53
|
| Rate for Payer: UMR Bronson Commercial |
$6,145.91
|
| Rate for Payer: VA VA |
$37.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,457.93
|
|
