|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$41.47
|
|
|
Service Code
|
NDC 0338-0553-18
|
| Hospital Charge Code |
116170
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.25 |
| Max. Negotiated Rate |
$37.32 |
| Rate for Payer: Aetna American Axle |
$26.96
|
| Rate for Payer: Aetna Commercial |
$35.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.96
|
| Rate for Payer: Cash Price |
$33.18
|
| Rate for Payer: Cofinity Commercial |
$35.66
|
| Rate for Payer: Cofinity Commercial |
$29.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.18
|
| Rate for Payer: Healthscope Commercial |
$37.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.25
|
| Rate for Payer: PHP Commercial |
$35.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.03
|
| Rate for Payer: Priority Health SBD |
$26.13
|
| Rate for Payer: UMR Bronson Commercial |
$18.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.10
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$41.47
|
|
|
Service Code
|
NDC 0338-0553-11
|
| Hospital Charge Code |
116170
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.34 |
| Max. Negotiated Rate |
$37.32 |
| Rate for Payer: Aetna American Axle |
$26.96
|
| Rate for Payer: Aetna Commercial |
$35.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.96
|
| Rate for Payer: BCBS Complete |
$16.59
|
| Rate for Payer: Cash Price |
$33.18
|
| Rate for Payer: Cofinity Commercial |
$29.03
|
| Rate for Payer: Cofinity Commercial |
$35.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.18
|
| Rate for Payer: Healthscope Commercial |
$37.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.25
|
| Rate for Payer: PHP Commercial |
$35.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.03
|
| Rate for Payer: Priority Health SBD |
$26.13
|
| Rate for Payer: UMR Bronson Commercial |
$15.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.10
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$41.47
|
|
|
Service Code
|
NDC 0338-0553-18
|
| Hospital Charge Code |
116170
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.34 |
| Max. Negotiated Rate |
$37.32 |
| Rate for Payer: Aetna American Axle |
$26.96
|
| Rate for Payer: Aetna Commercial |
$35.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.96
|
| Rate for Payer: BCBS Complete |
$16.59
|
| Rate for Payer: Cash Price |
$33.18
|
| Rate for Payer: Cofinity Commercial |
$29.03
|
| Rate for Payer: Cofinity Commercial |
$35.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.18
|
| Rate for Payer: Healthscope Commercial |
$37.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.25
|
| Rate for Payer: PHP Commercial |
$35.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.03
|
| Rate for Payer: Priority Health SBD |
$26.13
|
| Rate for Payer: UMR Bronson Commercial |
$15.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.10
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$55.99
|
|
|
Service Code
|
HCPCS J7050
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$50.39 |
| Rate for Payer: Aetna American Axle |
$36.39
|
| Rate for Payer: Aetna Commercial |
$47.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.39
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Trust/PPO |
$2.16
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cofinity Commercial |
$39.19
|
| Rate for Payer: Cofinity Commercial |
$48.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.79
|
| Rate for Payer: Healthscope Commercial |
$50.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.59
|
| Rate for Payer: PHP Commercial |
$47.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.19
|
| Rate for Payer: Priority Health SBD |
$35.27
|
| Rate for Payer: UMR Bronson Commercial |
$20.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.99
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$62.71
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.59 |
| Max. Negotiated Rate |
$56.44 |
| Rate for Payer: Aetna American Axle |
$40.76
|
| Rate for Payer: Aetna American Axle |
$29.03
|
| Rate for Payer: Aetna American Axle |
$34.94
|
| Rate for Payer: Aetna American Axle |
$39.31
|
| Rate for Payer: Aetna American Axle |
$33.48
|
| Rate for Payer: Aetna Commercial |
$43.78
|
| Rate for Payer: Aetna Commercial |
$53.30
|
| Rate for Payer: Aetna Commercial |
$37.96
|
| Rate for Payer: Aetna Commercial |
$51.40
|
| Rate for Payer: Aetna Commercial |
$45.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.76
|
| Rate for Payer: Cash Price |
$41.21
|
| Rate for Payer: Cash Price |
$50.17
|
| Rate for Payer: Cash Price |
$35.73
|
| Rate for Payer: Cash Price |
$48.38
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cofinity Commercial |
$31.26
|
| Rate for Payer: Cofinity Commercial |
$38.41
|
| Rate for Payer: Cofinity Commercial |
$36.06
|
| Rate for Payer: Cofinity Commercial |
$44.30
|
| Rate for Payer: Cofinity Commercial |
$37.62
|
| Rate for Payer: Cofinity Commercial |
$46.22
|
| Rate for Payer: Cofinity Commercial |
$42.33
|
| Rate for Payer: Cofinity Commercial |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$43.90
|
| Rate for Payer: Cofinity Commercial |
$53.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.17
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Healthscope Commercial |
$54.42
|
| Rate for Payer: Healthscope Commercial |
$56.44
|
| Rate for Payer: Healthscope Commercial |
$40.19
|
| Rate for Payer: Healthscope Commercial |
$46.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.69
|
| Rate for Payer: PHP Commercial |
$37.96
|
| Rate for Payer: PHP Commercial |
$43.78
|
| Rate for Payer: PHP Commercial |
$51.40
|
| Rate for Payer: PHP Commercial |
$45.69
|
| Rate for Payer: PHP Commercial |
$53.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.90
|
| Rate for Payer: Priority Health SBD |
$39.51
|
| Rate for Payer: Priority Health SBD |
$33.86
|
| Rate for Payer: Priority Health SBD |
$28.14
|
| Rate for Payer: Priority Health SBD |
$38.10
|
| Rate for Payer: Priority Health SBD |
$32.45
|
| Rate for Payer: UMR Bronson Commercial |
$19.65
|
| Rate for Payer: UMR Bronson Commercial |
$23.65
|
| Rate for Payer: UMR Bronson Commercial |
$22.66
|
| Rate for Payer: UMR Bronson Commercial |
$27.59
|
| Rate for Payer: UMR Bronson Commercial |
$26.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.50
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$55.99
|
|
|
Service Code
|
HCPCS J7050
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.64 |
| Max. Negotiated Rate |
$50.39 |
| Rate for Payer: Aetna American Axle |
$36.39
|
| Rate for Payer: Aetna Commercial |
$47.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.39
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cofinity Commercial |
$39.19
|
| Rate for Payer: Cofinity Commercial |
$48.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.79
|
| Rate for Payer: Healthscope Commercial |
$50.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.59
|
| Rate for Payer: PHP Commercial |
$47.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.19
|
| Rate for Payer: Priority Health SBD |
$35.27
|
| Rate for Payer: UMR Bronson Commercial |
$24.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.99
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$58.23
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$52.41 |
| Rate for Payer: Aetna American Axle |
$37.85
|
| Rate for Payer: Aetna American Axle |
$39.31
|
| Rate for Payer: Aetna American Axle |
$52.88
|
| Rate for Payer: Aetna American Axle |
$33.48
|
| Rate for Payer: Aetna American Axle |
$34.94
|
| Rate for Payer: Aetna American Axle |
$40.90
|
| Rate for Payer: Aetna American Axle |
$40.76
|
| Rate for Payer: Aetna Commercial |
$53.30
|
| Rate for Payer: Aetna Commercial |
$51.40
|
| Rate for Payer: Aetna Commercial |
$45.69
|
| Rate for Payer: Aetna Commercial |
$43.78
|
| Rate for Payer: Aetna Commercial |
$69.15
|
| Rate for Payer: Aetna Commercial |
$53.49
|
| Rate for Payer: Aetna Commercial |
$49.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.88
|
| Rate for Payer: BCBS Complete |
$21.50
|
| Rate for Payer: BCBS Complete |
$24.19
|
| Rate for Payer: BCBS Complete |
$32.54
|
| Rate for Payer: BCBS Complete |
$25.08
|
| Rate for Payer: BCBS Complete |
$20.60
|
| Rate for Payer: BCBS Complete |
$23.29
|
| Rate for Payer: BCBS Complete |
$25.17
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: Cash Price |
$65.08
|
| Rate for Payer: Cash Price |
$41.21
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$48.38
|
| Rate for Payer: Cash Price |
$41.21
|
| Rate for Payer: Cash Price |
$65.08
|
| Rate for Payer: Cash Price |
$50.34
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$50.17
|
| Rate for Payer: Cash Price |
$50.34
|
| Rate for Payer: Cash Price |
$48.38
|
| Rate for Payer: Cash Price |
$50.17
|
| Rate for Payer: Cash Price |
$46.58
|
| Rate for Payer: Cofinity Commercial |
$36.06
|
| Rate for Payer: Cofinity Commercial |
$54.12
|
| Rate for Payer: Cofinity Commercial |
$44.05
|
| Rate for Payer: Cofinity Commercial |
$37.62
|
| Rate for Payer: Cofinity Commercial |
$46.22
|
| Rate for Payer: Cofinity Commercial |
$40.76
|
| Rate for Payer: Cofinity Commercial |
$50.08
|
| Rate for Payer: Cofinity Commercial |
$69.96
|
| Rate for Payer: Cofinity Commercial |
$56.94
|
| Rate for Payer: Cofinity Commercial |
$42.33
|
| Rate for Payer: Cofinity Commercial |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$44.30
|
| Rate for Payer: Cofinity Commercial |
$43.90
|
| Rate for Payer: Cofinity Commercial |
$53.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Healthscope Commercial |
$56.44
|
| Rate for Payer: Healthscope Commercial |
$54.42
|
| Rate for Payer: Healthscope Commercial |
$56.64
|
| Rate for Payer: Healthscope Commercial |
$52.41
|
| Rate for Payer: Healthscope Commercial |
$73.22
|
| Rate for Payer: Healthscope Commercial |
$46.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$53.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$69.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.50
|
| Rate for Payer: PHP Commercial |
$43.78
|
| Rate for Payer: PHP Commercial |
$45.69
|
| Rate for Payer: PHP Commercial |
$49.50
|
| Rate for Payer: PHP Commercial |
$51.40
|
| Rate for Payer: PHP Commercial |
$53.30
|
| Rate for Payer: PHP Commercial |
$53.49
|
| Rate for Payer: PHP Commercial |
$69.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.62
|
| Rate for Payer: Priority Health SBD |
$33.86
|
| Rate for Payer: Priority Health SBD |
$32.45
|
| Rate for Payer: Priority Health SBD |
$36.68
|
| Rate for Payer: Priority Health SBD |
$39.65
|
| Rate for Payer: Priority Health SBD |
$39.51
|
| Rate for Payer: Priority Health SBD |
$38.10
|
| Rate for Payer: Priority Health SBD |
$51.25
|
| Rate for Payer: UMR Bronson Commercial |
$23.20
|
| Rate for Payer: UMR Bronson Commercial |
$23.28
|
| Rate for Payer: UMR Bronson Commercial |
$22.37
|
| Rate for Payer: UMR Bronson Commercial |
$19.06
|
| Rate for Payer: UMR Bronson Commercial |
$21.55
|
| Rate for Payer: UMR Bronson Commercial |
$19.89
|
| Rate for Payer: UMR Bronson Commercial |
$30.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.01
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.69 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna American Axle |
$45.45
|
| Rate for Payer: Aetna American Axle |
$43.67
|
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna Commercial |
$57.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: BCBS Complete |
$26.88
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$8.69
|
| Rate for Payer: BCBS Trust/PPO |
$8.69
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$57.78
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Cofinity Commercial |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$47.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Healthscope Commercial |
$60.47
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.11
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.94
|
| Rate for Payer: Priority Health SBD |
$42.33
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: UMR Bronson Commercial |
$25.87
|
| Rate for Payer: UMR Bronson Commercial |
$24.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.39
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$67.19
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
27838
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.56 |
| Max. Negotiated Rate |
$60.47 |
| Rate for Payer: Aetna American Axle |
$43.67
|
| Rate for Payer: Aetna American Axle |
$45.45
|
| Rate for Payer: Aetna Commercial |
$57.11
|
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.67
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$47.03
|
| Rate for Payer: Cofinity Commercial |
$57.78
|
| Rate for Payer: Cofinity Commercial |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Healthscope Commercial |
$60.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.43
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.94
|
| Rate for Payer: Priority Health SBD |
$42.33
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: UMR Bronson Commercial |
$30.76
|
| Rate for Payer: UMR Bronson Commercial |
$29.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.44
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (DOSE, ADMIN OVER AND INDICATION REQUIRED)
|
Facility
|
OP
|
$55.99
|
|
|
Service Code
|
HCPCS J7050
|
| Hospital Charge Code |
301089
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$50.39 |
| Rate for Payer: Aetna American Axle |
$36.39
|
| Rate for Payer: Aetna Commercial |
$47.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.39
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Trust/PPO |
$2.16
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cofinity Commercial |
$39.19
|
| Rate for Payer: Cofinity Commercial |
$48.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.79
|
| Rate for Payer: Healthscope Commercial |
$50.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.59
|
| Rate for Payer: PHP Commercial |
$47.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.19
|
| Rate for Payer: Priority Health SBD |
$35.27
|
| Rate for Payer: UMR Bronson Commercial |
$20.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.99
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (DOSE, ADMIN OVER AND INDICATION REQUIRED)
|
Facility
|
OP
|
$53.75
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
301089
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$48.38 |
| Rate for Payer: Aetna American Axle |
$34.94
|
| Rate for Payer: Aetna American Axle |
$33.48
|
| Rate for Payer: Aetna American Axle |
$39.31
|
| Rate for Payer: Aetna American Axle |
$40.76
|
| Rate for Payer: Aetna Commercial |
$53.30
|
| Rate for Payer: Aetna Commercial |
$51.40
|
| Rate for Payer: Aetna Commercial |
$45.69
|
| Rate for Payer: Aetna Commercial |
$43.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.31
|
| Rate for Payer: BCBS Complete |
$24.19
|
| Rate for Payer: BCBS Complete |
$21.50
|
| Rate for Payer: BCBS Complete |
$20.60
|
| Rate for Payer: BCBS Complete |
$25.08
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: Cash Price |
$48.38
|
| Rate for Payer: Cash Price |
$50.17
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$41.21
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$50.17
|
| Rate for Payer: Cash Price |
$48.38
|
| Rate for Payer: Cash Price |
$41.21
|
| Rate for Payer: Cofinity Commercial |
$46.22
|
| Rate for Payer: Cofinity Commercial |
$42.33
|
| Rate for Payer: Cofinity Commercial |
$53.93
|
| Rate for Payer: Cofinity Commercial |
$43.90
|
| Rate for Payer: Cofinity Commercial |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$36.06
|
| Rate for Payer: Cofinity Commercial |
$44.30
|
| Rate for Payer: Cofinity Commercial |
$37.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Healthscope Commercial |
$56.44
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Healthscope Commercial |
$46.36
|
| Rate for Payer: Healthscope Commercial |
$54.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.40
|
| Rate for Payer: PHP Commercial |
$53.30
|
| Rate for Payer: PHP Commercial |
$43.78
|
| Rate for Payer: PHP Commercial |
$45.69
|
| Rate for Payer: PHP Commercial |
$51.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.06
|
| Rate for Payer: Priority Health SBD |
$33.86
|
| Rate for Payer: Priority Health SBD |
$38.10
|
| Rate for Payer: Priority Health SBD |
$32.45
|
| Rate for Payer: Priority Health SBD |
$39.51
|
| Rate for Payer: UMR Bronson Commercial |
$22.37
|
| Rate for Payer: UMR Bronson Commercial |
$19.89
|
| Rate for Payer: UMR Bronson Commercial |
$19.06
|
| Rate for Payer: UMR Bronson Commercial |
$23.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.63
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (DOSE, ADMIN OVER AND INDICATION REQUIRED)
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
301089
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.69 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna American Axle |
$45.45
|
| Rate for Payer: Aetna American Axle |
$43.67
|
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna Commercial |
$57.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.67
|
| Rate for Payer: BCBS Complete |
$26.88
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$8.69
|
| Rate for Payer: BCBS Trust/PPO |
$8.69
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$57.78
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Cofinity Commercial |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$47.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Healthscope Commercial |
$60.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.43
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.03
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: Priority Health SBD |
$42.33
|
| Rate for Payer: UMR Bronson Commercial |
$24.86
|
| Rate for Payer: UMR Bronson Commercial |
$25.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.44
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (DOSE AND RATE REQUIRED)
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
301024
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.69 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna American Axle |
$45.45
|
| Rate for Payer: Aetna American Axle |
$43.67
|
| Rate for Payer: Aetna Commercial |
$57.11
|
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.67
|
| Rate for Payer: BCBS Complete |
$26.88
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$8.69
|
| Rate for Payer: BCBS Trust/PPO |
$8.69
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cofinity Commercial |
$57.78
|
| Rate for Payer: Cofinity Commercial |
$47.03
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Cofinity Commercial |
$48.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Healthscope Commercial |
$60.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.43
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.03
|
| Rate for Payer: Priority Health SBD |
$42.33
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: UMR Bronson Commercial |
$24.86
|
| Rate for Payer: UMR Bronson Commercial |
$25.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.39
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (DOSE AND RATE REQUIRED)
|
Facility
|
OP
|
$55.99
|
|
|
Service Code
|
HCPCS J7050
|
| Hospital Charge Code |
301024
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$50.39 |
| Rate for Payer: Aetna American Axle |
$36.39
|
| Rate for Payer: Aetna Commercial |
$47.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.39
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Trust/PPO |
$2.16
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cofinity Commercial |
$39.19
|
| Rate for Payer: Cofinity Commercial |
$48.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.79
|
| Rate for Payer: Healthscope Commercial |
$50.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.59
|
| Rate for Payer: PHP Commercial |
$47.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.19
|
| Rate for Payer: Priority Health SBD |
$35.27
|
| Rate for Payer: UMR Bronson Commercial |
$20.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.99
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (DOSE AND RATE REQUIRED)
|
Facility
|
OP
|
$62.71
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
301024
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$56.44 |
| Rate for Payer: Aetna American Axle |
$40.76
|
| Rate for Payer: Aetna American Axle |
$39.31
|
| Rate for Payer: Aetna American Axle |
$33.48
|
| Rate for Payer: Aetna American Axle |
$34.94
|
| Rate for Payer: Aetna Commercial |
$51.40
|
| Rate for Payer: Aetna Commercial |
$43.78
|
| Rate for Payer: Aetna Commercial |
$45.69
|
| Rate for Payer: Aetna Commercial |
$53.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.48
|
| Rate for Payer: BCBS Complete |
$20.60
|
| Rate for Payer: BCBS Complete |
$24.19
|
| Rate for Payer: BCBS Complete |
$21.50
|
| Rate for Payer: BCBS Complete |
$25.08
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: Cash Price |
$48.38
|
| Rate for Payer: Cash Price |
$41.21
|
| Rate for Payer: Cash Price |
$41.21
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$48.38
|
| Rate for Payer: Cash Price |
$50.17
|
| Rate for Payer: Cash Price |
$50.17
|
| Rate for Payer: Cofinity Commercial |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$42.33
|
| Rate for Payer: Cofinity Commercial |
$53.93
|
| Rate for Payer: Cofinity Commercial |
$43.90
|
| Rate for Payer: Cofinity Commercial |
$36.06
|
| Rate for Payer: Cofinity Commercial |
$44.30
|
| Rate for Payer: Cofinity Commercial |
$46.22
|
| Rate for Payer: Cofinity Commercial |
$37.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.38
|
| Rate for Payer: Healthscope Commercial |
$56.44
|
| Rate for Payer: Healthscope Commercial |
$54.42
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Healthscope Commercial |
$46.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$53.30
|
| Rate for Payer: PHP Commercial |
$45.69
|
| Rate for Payer: PHP Commercial |
$43.78
|
| Rate for Payer: PHP Commercial |
$51.40
|
| Rate for Payer: PHP Commercial |
$53.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.90
|
| Rate for Payer: Priority Health SBD |
$33.86
|
| Rate for Payer: Priority Health SBD |
$39.51
|
| Rate for Payer: Priority Health SBD |
$38.10
|
| Rate for Payer: Priority Health SBD |
$32.45
|
| Rate for Payer: UMR Bronson Commercial |
$19.89
|
| Rate for Payer: UMR Bronson Commercial |
$19.06
|
| Rate for Payer: UMR Bronson Commercial |
$22.37
|
| Rate for Payer: UMR Bronson Commercial |
$23.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.63
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (DOSE REQUIRED)
|
Facility
|
OP
|
$62.71
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
301459
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$56.44 |
| Rate for Payer: Aetna American Axle |
$40.76
|
| Rate for Payer: Aetna American Axle |
$34.94
|
| Rate for Payer: Aetna American Axle |
$33.48
|
| Rate for Payer: Aetna American Axle |
$39.31
|
| Rate for Payer: Aetna Commercial |
$51.40
|
| Rate for Payer: Aetna Commercial |
$43.78
|
| Rate for Payer: Aetna Commercial |
$45.69
|
| Rate for Payer: Aetna Commercial |
$53.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.94
|
| Rate for Payer: BCBS Complete |
$24.19
|
| Rate for Payer: BCBS Complete |
$25.08
|
| Rate for Payer: BCBS Complete |
$20.60
|
| Rate for Payer: BCBS Complete |
$21.50
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: Cash Price |
$50.17
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$41.21
|
| Rate for Payer: Cash Price |
$48.38
|
| Rate for Payer: Cash Price |
$50.17
|
| Rate for Payer: Cash Price |
$41.21
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$48.38
|
| Rate for Payer: Cofinity Commercial |
$36.06
|
| Rate for Payer: Cofinity Commercial |
$53.93
|
| Rate for Payer: Cofinity Commercial |
$37.62
|
| Rate for Payer: Cofinity Commercial |
$46.22
|
| Rate for Payer: Cofinity Commercial |
$43.90
|
| Rate for Payer: Cofinity Commercial |
$42.33
|
| Rate for Payer: Cofinity Commercial |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$44.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Healthscope Commercial |
$56.44
|
| Rate for Payer: Healthscope Commercial |
$46.36
|
| Rate for Payer: Healthscope Commercial |
$54.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$53.30
|
| Rate for Payer: PHP Commercial |
$45.69
|
| Rate for Payer: PHP Commercial |
$51.40
|
| Rate for Payer: PHP Commercial |
$53.30
|
| Rate for Payer: PHP Commercial |
$43.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.62
|
| Rate for Payer: Priority Health SBD |
$38.10
|
| Rate for Payer: Priority Health SBD |
$33.86
|
| Rate for Payer: Priority Health SBD |
$32.45
|
| Rate for Payer: Priority Health SBD |
$39.51
|
| Rate for Payer: UMR Bronson Commercial |
$22.37
|
| Rate for Payer: UMR Bronson Commercial |
$19.06
|
| Rate for Payer: UMR Bronson Commercial |
$23.20
|
| Rate for Payer: UMR Bronson Commercial |
$19.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.63
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (DOSE REQUIRED)
|
Facility
|
IP
|
$47.85
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
301459
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.05 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna American Axle |
$31.10
|
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.10
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Commercial |
$33.50
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.67
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.50
|
| Rate for Payer: Priority Health SBD |
$30.15
|
| Rate for Payer: UMR Bronson Commercial |
$21.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.89
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (DOSE REQUIRED)
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
301459
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.69 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna American Axle |
$45.45
|
| Rate for Payer: Aetna American Axle |
$43.67
|
| Rate for Payer: Aetna Commercial |
$57.11
|
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.67
|
| Rate for Payer: BCBS Complete |
$26.88
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$8.69
|
| Rate for Payer: BCBS Trust/PPO |
$8.69
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cofinity Commercial |
$47.03
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Cofinity Commercial |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$57.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$60.47
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.43
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.94
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: Priority Health SBD |
$42.33
|
| Rate for Payer: UMR Bronson Commercial |
$24.86
|
| Rate for Payer: UMR Bronson Commercial |
$25.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.44
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (DOSE REQUIRED)
|
Facility
|
OP
|
$55.99
|
|
|
Service Code
|
HCPCS J7050
|
| Hospital Charge Code |
301459
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$50.39 |
| Rate for Payer: Aetna American Axle |
$36.39
|
| Rate for Payer: Aetna Commercial |
$47.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.39
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Trust/PPO |
$2.16
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cofinity Commercial |
$39.19
|
| Rate for Payer: Cofinity Commercial |
$48.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.79
|
| Rate for Payer: Healthscope Commercial |
$50.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.59
|
| Rate for Payer: PHP Commercial |
$47.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.19
|
| Rate for Payer: Priority Health SBD |
$35.27
|
| Rate for Payer: UMR Bronson Commercial |
$20.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.99
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION EKOS COOLANT LUMEN
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
300184
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$30.76 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna American Axle |
$45.45
|
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.43
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.94
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: UMR Bronson Commercial |
$30.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.44
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION EKOS SHEATH MAINTENANCE
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
300183
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$30.76 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna American Axle |
$45.45
|
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.43
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.94
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: UMR Bronson Commercial |
$30.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.44
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION ML/M2/HR
|
Facility
|
IP
|
$55.99
|
|
|
Service Code
|
HCPCS J7050
|
| Hospital Charge Code |
300708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.64 |
| Max. Negotiated Rate |
$50.39 |
| Rate for Payer: Aetna American Axle |
$36.39
|
| Rate for Payer: Aetna Commercial |
$47.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.39
|
| Rate for Payer: Cash Price |
$44.79
|
| Rate for Payer: Cofinity Commercial |
$39.19
|
| Rate for Payer: Cofinity Commercial |
$48.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.79
|
| Rate for Payer: Healthscope Commercial |
$50.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.59
|
| Rate for Payer: PHP Commercial |
$47.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.19
|
| Rate for Payer: Priority Health SBD |
$35.27
|
| Rate for Payer: UMR Bronson Commercial |
$24.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.99
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION ML/M2/HR
|
Facility
|
IP
|
$51.51
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
300708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.66 |
| Max. Negotiated Rate |
$46.36 |
| Rate for Payer: Aetna American Axle |
$33.48
|
| Rate for Payer: Aetna American Axle |
$34.94
|
| Rate for Payer: Aetna American Axle |
$39.31
|
| Rate for Payer: Aetna American Axle |
$40.76
|
| Rate for Payer: Aetna Commercial |
$53.30
|
| Rate for Payer: Aetna Commercial |
$51.40
|
| Rate for Payer: Aetna Commercial |
$43.78
|
| Rate for Payer: Aetna Commercial |
$45.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.48
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cash Price |
$50.17
|
| Rate for Payer: Cash Price |
$48.38
|
| Rate for Payer: Cash Price |
$41.21
|
| Rate for Payer: Cofinity Commercial |
$36.06
|
| Rate for Payer: Cofinity Commercial |
$44.30
|
| Rate for Payer: Cofinity Commercial |
$53.93
|
| Rate for Payer: Cofinity Commercial |
$37.62
|
| Rate for Payer: Cofinity Commercial |
$46.22
|
| Rate for Payer: Cofinity Commercial |
$42.33
|
| Rate for Payer: Cofinity Commercial |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$43.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.17
|
| Rate for Payer: Healthscope Commercial |
$46.36
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Healthscope Commercial |
$56.44
|
| Rate for Payer: Healthscope Commercial |
$54.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.78
|
| Rate for Payer: PHP Commercial |
$51.40
|
| Rate for Payer: PHP Commercial |
$43.78
|
| Rate for Payer: PHP Commercial |
$45.69
|
| Rate for Payer: PHP Commercial |
$53.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.90
|
| Rate for Payer: Priority Health SBD |
$38.10
|
| Rate for Payer: Priority Health SBD |
$33.86
|
| Rate for Payer: Priority Health SBD |
$32.45
|
| Rate for Payer: Priority Health SBD |
$39.51
|
| Rate for Payer: UMR Bronson Commercial |
$22.66
|
| Rate for Payer: UMR Bronson Commercial |
$23.65
|
| Rate for Payer: UMR Bronson Commercial |
$26.61
|
| Rate for Payer: UMR Bronson Commercial |
$27.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.35
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION ML/M2/HR
|
Facility
|
IP
|
$67.19
|
|
|
Service Code
|
HCPCS J7030
|
| Hospital Charge Code |
300708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.56 |
| Max. Negotiated Rate |
$60.47 |
| Rate for Payer: Aetna American Axle |
$43.67
|
| Rate for Payer: Aetna American Axle |
$45.45
|
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna Commercial |
$57.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: Cash Price |
$53.75
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$47.03
|
| Rate for Payer: Cofinity Commercial |
$57.78
|
| Rate for Payer: Cofinity Commercial |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Healthscope Commercial |
$60.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.43
|
| Rate for Payer: PHP Commercial |
$57.11
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.03
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: Priority Health SBD |
$42.33
|
| Rate for Payer: UMR Bronson Commercial |
$30.76
|
| Rate for Payer: UMR Bronson Commercial |
$29.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.44
|
|
|
SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION (SD)
|
Facility
|
IP
|
$62.71
|
|
|
Service Code
|
HCPCS J7040
|
| Hospital Charge Code |
180607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.59 |
| Max. Negotiated Rate |
$56.44 |
| Rate for Payer: Aetna American Axle |
$40.76
|
| Rate for Payer: Aetna American Axle |
$34.94
|
| Rate for Payer: Aetna Commercial |
$53.30
|
| Rate for Payer: Aetna Commercial |
$45.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.76
|
| Rate for Payer: Cash Price |
$50.17
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cofinity Commercial |
$46.22
|
| Rate for Payer: Cofinity Commercial |
$53.93
|
| Rate for Payer: Cofinity Commercial |
$43.90
|
| Rate for Payer: Cofinity Commercial |
$37.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Healthscope Commercial |
$56.44
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.69
|
| Rate for Payer: PHP Commercial |
$53.30
|
| Rate for Payer: PHP Commercial |
$45.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.62
|
| Rate for Payer: Priority Health SBD |
$33.86
|
| Rate for Payer: Priority Health SBD |
$39.51
|
| Rate for Payer: UMR Bronson Commercial |
$23.65
|
| Rate for Payer: UMR Bronson Commercial |
$27.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.31
|
|
