|
PREDNISONE 2.5 MG TABLET
|
Facility
|
OP
|
$317.25
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6495
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$117.38 |
| Max. Negotiated Rate |
$285.52 |
| Rate for Payer: Aetna American Axle |
$206.21
|
| Rate for Payer: Aetna American Axle |
$120.67
|
| Rate for Payer: Aetna American Axle |
$152.75
|
| Rate for Payer: Aetna Commercial |
$269.66
|
| Rate for Payer: Aetna Commercial |
$199.75
|
| Rate for Payer: Aetna Commercial |
$157.80
|
| Rate for Payer: Aetna Medicare |
$158.62
|
| Rate for Payer: Aetna Medicare |
$117.50
|
| Rate for Payer: Aetna Medicare |
$92.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.67
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCBS Complete |
$94.00
|
| Rate for Payer: BCBS Complete |
$126.90
|
| Rate for Payer: Cash Price |
$253.80
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$148.52
|
| Rate for Payer: Cofinity Commercial |
$202.10
|
| Rate for Payer: Cofinity Commercial |
$129.96
|
| Rate for Payer: Cofinity Commercial |
$159.66
|
| Rate for Payer: Cofinity Commercial |
$272.83
|
| Rate for Payer: Cofinity Commercial |
$222.07
|
| Rate for Payer: Cofinity Commercial |
$164.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$129.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$164.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$222.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$253.80
|
| Rate for Payer: Healthscope Commercial |
$167.09
|
| Rate for Payer: Healthscope Commercial |
$211.50
|
| Rate for Payer: Healthscope Commercial |
$285.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$164.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$222.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.66
|
| Rate for Payer: PHP Commercial |
$157.80
|
| Rate for Payer: PHP Commercial |
$199.75
|
| Rate for Payer: PHP Commercial |
$269.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.67
|
| Rate for Payer: Priority Health SBD |
$148.05
|
| Rate for Payer: Priority Health SBD |
$116.96
|
| Rate for Payer: Priority Health SBD |
$199.87
|
| Rate for Payer: UMR Bronson Commercial |
$117.38
|
| Rate for Payer: UMR Bronson Commercial |
$68.69
|
| Rate for Payer: UMR Bronson Commercial |
$86.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.94
|
|
|
PREDNISONE 50 MG TABLET
|
Facility
|
OP
|
$228.95
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6498
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$84.71 |
| Max. Negotiated Rate |
$206.06 |
| Rate for Payer: Aetna American Axle |
$148.82
|
| Rate for Payer: Aetna American Axle |
$187.10
|
| Rate for Payer: Aetna American Axle |
$192.66
|
| Rate for Payer: Aetna American Axle |
$147.58
|
| Rate for Payer: Aetna American Axle |
$172.90
|
| Rate for Payer: Aetna Commercial |
$192.99
|
| Rate for Payer: Aetna Commercial |
$251.94
|
| Rate for Payer: Aetna Commercial |
$226.10
|
| Rate for Payer: Aetna Commercial |
$244.67
|
| Rate for Payer: Aetna Commercial |
$194.61
|
| Rate for Payer: Aetna Medicare |
$143.93
|
| Rate for Payer: Aetna Medicare |
$114.47
|
| Rate for Payer: Aetna Medicare |
$148.20
|
| Rate for Payer: Aetna Medicare |
$133.00
|
| Rate for Payer: Aetna Medicare |
$113.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.10
|
| Rate for Payer: BCBS Complete |
$118.56
|
| Rate for Payer: BCBS Complete |
$90.82
|
| Rate for Payer: BCBS Complete |
$115.14
|
| Rate for Payer: BCBS Complete |
$106.40
|
| Rate for Payer: BCBS Complete |
$91.58
|
| Rate for Payer: Cash Price |
$237.12
|
| Rate for Payer: Cash Price |
$181.64
|
| Rate for Payer: Cash Price |
$183.16
|
| Rate for Payer: Cash Price |
$230.28
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cofinity Commercial |
$207.48
|
| Rate for Payer: Cofinity Commercial |
$196.90
|
| Rate for Payer: Cofinity Commercial |
$247.55
|
| Rate for Payer: Cofinity Commercial |
$158.94
|
| Rate for Payer: Cofinity Commercial |
$228.76
|
| Rate for Payer: Cofinity Commercial |
$186.20
|
| Rate for Payer: Cofinity Commercial |
$201.50
|
| Rate for Payer: Cofinity Commercial |
$195.26
|
| Rate for Payer: Cofinity Commercial |
$160.26
|
| Rate for Payer: Cofinity Commercial |
$254.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$158.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$201.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$160.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$186.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$207.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$230.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.80
|
| Rate for Payer: Healthscope Commercial |
$204.34
|
| Rate for Payer: Healthscope Commercial |
$239.40
|
| Rate for Payer: Healthscope Commercial |
$266.76
|
| Rate for Payer: Healthscope Commercial |
$259.06
|
| Rate for Payer: Healthscope Commercial |
$206.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$186.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$207.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.94
|
| Rate for Payer: PHP Commercial |
$244.67
|
| Rate for Payer: PHP Commercial |
$226.10
|
| Rate for Payer: PHP Commercial |
$192.99
|
| Rate for Payer: PHP Commercial |
$194.61
|
| Rate for Payer: PHP Commercial |
$251.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.82
|
| Rate for Payer: Priority Health SBD |
$144.24
|
| Rate for Payer: Priority Health SBD |
$143.04
|
| Rate for Payer: Priority Health SBD |
$167.58
|
| Rate for Payer: Priority Health SBD |
$181.35
|
| Rate for Payer: Priority Health SBD |
$186.73
|
| Rate for Payer: UMR Bronson Commercial |
$109.67
|
| Rate for Payer: UMR Bronson Commercial |
$106.50
|
| Rate for Payer: UMR Bronson Commercial |
$84.71
|
| Rate for Payer: UMR Bronson Commercial |
$84.01
|
| Rate for Payer: UMR Bronson Commercial |
$98.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.50
|
|
|
PREDNISONE 50 MG TABLET
|
Facility
|
IP
|
$287.85
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6498
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$126.65 |
| Max. Negotiated Rate |
$259.06 |
| Rate for Payer: Aetna American Axle |
$187.10
|
| Rate for Payer: Aetna American Axle |
$147.58
|
| Rate for Payer: Aetna American Axle |
$148.82
|
| Rate for Payer: Aetna American Axle |
$192.66
|
| Rate for Payer: Aetna American Axle |
$172.90
|
| Rate for Payer: Aetna Commercial |
$244.67
|
| Rate for Payer: Aetna Commercial |
$194.61
|
| Rate for Payer: Aetna Commercial |
$192.99
|
| Rate for Payer: Aetna Commercial |
$251.94
|
| Rate for Payer: Aetna Commercial |
$226.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.82
|
| Rate for Payer: Cash Price |
$230.28
|
| Rate for Payer: Cash Price |
$237.12
|
| Rate for Payer: Cash Price |
$183.16
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$181.64
|
| Rate for Payer: Cofinity Commercial |
$207.48
|
| Rate for Payer: Cofinity Commercial |
$158.94
|
| Rate for Payer: Cofinity Commercial |
$247.55
|
| Rate for Payer: Cofinity Commercial |
$201.50
|
| Rate for Payer: Cofinity Commercial |
$186.20
|
| Rate for Payer: Cofinity Commercial |
$160.26
|
| Rate for Payer: Cofinity Commercial |
$196.90
|
| Rate for Payer: Cofinity Commercial |
$228.76
|
| Rate for Payer: Cofinity Commercial |
$195.26
|
| Rate for Payer: Cofinity Commercial |
$254.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$201.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$158.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$160.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$207.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$186.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$230.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.80
|
| Rate for Payer: Healthscope Commercial |
$206.06
|
| Rate for Payer: Healthscope Commercial |
$259.06
|
| Rate for Payer: Healthscope Commercial |
$239.40
|
| Rate for Payer: Healthscope Commercial |
$266.76
|
| Rate for Payer: Healthscope Commercial |
$204.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$186.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$207.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.99
|
| Rate for Payer: PHP Commercial |
$192.99
|
| Rate for Payer: PHP Commercial |
$251.94
|
| Rate for Payer: PHP Commercial |
$226.10
|
| Rate for Payer: PHP Commercial |
$244.67
|
| Rate for Payer: PHP Commercial |
$194.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.58
|
| Rate for Payer: Priority Health SBD |
$186.73
|
| Rate for Payer: Priority Health SBD |
$167.58
|
| Rate for Payer: Priority Health SBD |
$144.24
|
| Rate for Payer: Priority Health SBD |
$143.04
|
| Rate for Payer: Priority Health SBD |
$181.35
|
| Rate for Payer: UMR Bronson Commercial |
$99.90
|
| Rate for Payer: UMR Bronson Commercial |
$100.74
|
| Rate for Payer: UMR Bronson Commercial |
$126.65
|
| Rate for Payer: UMR Bronson Commercial |
$130.42
|
| Rate for Payer: UMR Bronson Commercial |
$117.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.89
|
|
|
PREDNISONE 5 MG TABLET
|
Facility
|
OP
|
$366.60
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6497
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$135.64 |
| Max. Negotiated Rate |
$329.94 |
| Rate for Payer: Aetna American Axle |
$238.29
|
| Rate for Payer: Aetna American Axle |
$28.26
|
| Rate for Payer: Aetna American Axle |
$229.12
|
| Rate for Payer: Aetna American Axle |
$2.39
|
| Rate for Payer: Aetna Commercial |
$36.96
|
| Rate for Payer: Aetna Commercial |
$311.61
|
| Rate for Payer: Aetna Commercial |
$3.12
|
| Rate for Payer: Aetna Commercial |
$299.62
|
| Rate for Payer: Aetna Medicare |
$1.83
|
| Rate for Payer: Aetna Medicare |
$176.25
|
| Rate for Payer: Aetna Medicare |
$21.74
|
| Rate for Payer: Aetna Medicare |
$183.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.12
|
| Rate for Payer: BCBS Complete |
$141.00
|
| Rate for Payer: BCBS Complete |
$17.39
|
| Rate for Payer: BCBS Complete |
$1.47
|
| Rate for Payer: BCBS Complete |
$146.64
|
| Rate for Payer: Cash Price |
$293.28
|
| Rate for Payer: Cash Price |
$2.94
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cash Price |
$34.78
|
| Rate for Payer: Cofinity Commercial |
$315.28
|
| Rate for Payer: Cofinity Commercial |
$37.39
|
| Rate for Payer: Cofinity Commercial |
$246.75
|
| Rate for Payer: Cofinity Commercial |
$3.16
|
| Rate for Payer: Cofinity Commercial |
$2.57
|
| Rate for Payer: Cofinity Commercial |
$30.44
|
| Rate for Payer: Cofinity Commercial |
$303.15
|
| Rate for Payer: Cofinity Commercial |
$256.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$246.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$256.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.28
|
| Rate for Payer: Healthscope Commercial |
$3.30
|
| Rate for Payer: Healthscope Commercial |
$317.25
|
| Rate for Payer: Healthscope Commercial |
$329.94
|
| Rate for Payer: Healthscope Commercial |
$39.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$256.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.12
|
| Rate for Payer: PHP Commercial |
$3.12
|
| Rate for Payer: PHP Commercial |
$311.61
|
| Rate for Payer: PHP Commercial |
$36.96
|
| Rate for Payer: PHP Commercial |
$299.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.12
|
| Rate for Payer: Priority Health SBD |
$2.31
|
| Rate for Payer: Priority Health SBD |
$27.39
|
| Rate for Payer: Priority Health SBD |
$230.96
|
| Rate for Payer: Priority Health SBD |
$222.07
|
| Rate for Payer: UMR Bronson Commercial |
$1.36
|
| Rate for Payer: UMR Bronson Commercial |
$135.64
|
| Rate for Payer: UMR Bronson Commercial |
$16.09
|
| Rate for Payer: UMR Bronson Commercial |
$130.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.95
|
|
|
PREDNISONE 5 MG TABLET
|
Facility
|
IP
|
$3.67
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6497
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.61 |
| Max. Negotiated Rate |
$3.30 |
| Rate for Payer: Aetna American Axle |
$2.39
|
| Rate for Payer: Aetna American Axle |
$238.29
|
| Rate for Payer: Aetna American Axle |
$229.12
|
| Rate for Payer: Aetna American Axle |
$28.26
|
| Rate for Payer: Aetna Commercial |
$3.12
|
| Rate for Payer: Aetna Commercial |
$36.96
|
| Rate for Payer: Aetna Commercial |
$311.61
|
| Rate for Payer: Aetna Commercial |
$299.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.39
|
| Rate for Payer: Cash Price |
$293.28
|
| Rate for Payer: Cash Price |
$2.94
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cash Price |
$34.78
|
| Rate for Payer: Cofinity Commercial |
$246.75
|
| Rate for Payer: Cofinity Commercial |
$37.39
|
| Rate for Payer: Cofinity Commercial |
$30.44
|
| Rate for Payer: Cofinity Commercial |
$2.57
|
| Rate for Payer: Cofinity Commercial |
$256.62
|
| Rate for Payer: Cofinity Commercial |
$315.28
|
| Rate for Payer: Cofinity Commercial |
$3.16
|
| Rate for Payer: Cofinity Commercial |
$303.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$256.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$246.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.28
|
| Rate for Payer: Healthscope Commercial |
$3.30
|
| Rate for Payer: Healthscope Commercial |
$317.25
|
| Rate for Payer: Healthscope Commercial |
$329.94
|
| Rate for Payer: Healthscope Commercial |
$39.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$256.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.12
|
| Rate for Payer: PHP Commercial |
$3.12
|
| Rate for Payer: PHP Commercial |
$36.96
|
| Rate for Payer: PHP Commercial |
$299.62
|
| Rate for Payer: PHP Commercial |
$311.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.12
|
| Rate for Payer: Priority Health SBD |
$27.39
|
| Rate for Payer: Priority Health SBD |
$222.07
|
| Rate for Payer: Priority Health SBD |
$230.96
|
| Rate for Payer: Priority Health SBD |
$2.31
|
| Rate for Payer: UMR Bronson Commercial |
$1.61
|
| Rate for Payer: UMR Bronson Commercial |
$19.13
|
| Rate for Payer: UMR Bronson Commercial |
$161.30
|
| Rate for Payer: UMR Bronson Commercial |
$155.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.75
|
|
|
PR EDUCATION&TRAINING PT SELF-MGMT NQHP 2-4 PTS
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 98961
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$14.95 |
| Rate for Payer: Aetna Medicare |
$11.50
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.95
|
| Rate for Payer: UMR Bronson Commercial |
$10.58
|
|
|
PR EDUCATION&TRAINING PT SELF-MGMT NQHP 5-8 PTS
|
Professional
|
Both
|
$17.00
|
|
|
Service Code
|
HCPCS 98962
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$11.05 |
| Rate for Payer: Aetna Medicare |
$8.50
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.05
|
| Rate for Payer: UMR Bronson Commercial |
$7.82
|
|
|
PR EDUCATION&TRAINING PT SELF-MGMT NQHP INDIV PT
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 98960
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Medicare |
$24.00
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: UMR Bronson Commercial |
$22.08
|
|
|
PR EEG,ALL NIGHT RECORD
|
Professional
|
Both
|
$1,345.00
|
|
|
Service Code
|
HCPCS 95827
|
| Min. Negotiated Rate |
$538.00 |
| Max. Negotiated Rate |
$874.25 |
| Rate for Payer: Aetna Medicare |
$672.50
|
| Rate for Payer: BCBS Complete |
$538.00
|
| Rate for Payer: Cash Price |
$1,076.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$874.25
|
| Rate for Payer: UMR Bronson Commercial |
$618.70
|
|
|
PR EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/O VIDEO
|
Professional
|
Both
|
$428.00
|
|
|
Service Code
|
HCPCS 95721
|
| Min. Negotiated Rate |
$171.20 |
| Max. Negotiated Rate |
$278.20 |
| Rate for Payer: Aetna Commercial |
$258.26
|
| Rate for Payer: Aetna Medicare |
$200.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.53
|
| Rate for Payer: BCBS Complete |
$171.20
|
| Rate for Payer: BCBS MAPPO |
$192.73
|
| Rate for Payer: BCN Medicare Advantage |
$192.73
|
| Rate for Payer: Cash Price |
$342.40
|
| Rate for Payer: Cash Price |
$342.40
|
| Rate for Payer: Cofinity Commercial |
$277.53
|
| Rate for Payer: Cofinity Commercial |
$258.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$202.37
|
| Rate for Payer: Nomi Health Commercial |
$231.28
|
| Rate for Payer: PACE SWMI |
$192.73
|
| Rate for Payer: PHP Commercial |
$269.82
|
| Rate for Payer: PHP Medicare Advantage |
$192.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.20
|
| Rate for Payer: Priority Health Medicare |
$192.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.73
|
| Rate for Payer: UHC Medicare Advantage |
$192.73
|
| Rate for Payer: UMR Bronson Commercial |
$196.88
|
|
|
PR EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/VEEG
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 95722
|
| Min. Negotiated Rate |
$208.00 |
| Max. Negotiated Rate |
$338.13 |
| Rate for Payer: Aetna Commercial |
$314.65
|
| Rate for Payer: Aetna Medicare |
$244.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$314.65
|
| Rate for Payer: BCBS Complete |
$208.00
|
| Rate for Payer: BCBS MAPPO |
$234.81
|
| Rate for Payer: BCN Medicare Advantage |
$234.81
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$338.13
|
| Rate for Payer: Cofinity Commercial |
$314.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.55
|
| Rate for Payer: Nomi Health Commercial |
$281.77
|
| Rate for Payer: PACE SWMI |
$234.81
|
| Rate for Payer: PHP Commercial |
$328.73
|
| Rate for Payer: PHP Medicare Advantage |
$234.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health Medicare |
$234.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$234.81
|
| Rate for Payer: UHC Medicare Advantage |
$234.81
|
| Rate for Payer: UMR Bronson Commercial |
$239.20
|
|
|
PR EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/O VIDEO
|
Professional
|
Both
|
$531.00
|
|
|
Service Code
|
HCPCS 95723
|
| Min. Negotiated Rate |
$212.40 |
| Max. Negotiated Rate |
$345.15 |
| Rate for Payer: Aetna Commercial |
$317.61
|
| Rate for Payer: Aetna Medicare |
$246.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$317.61
|
| Rate for Payer: BCBS Complete |
$212.40
|
| Rate for Payer: BCBS MAPPO |
$237.02
|
| Rate for Payer: BCN Medicare Advantage |
$237.02
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cofinity Commercial |
$341.31
|
| Rate for Payer: Cofinity Commercial |
$317.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.87
|
| Rate for Payer: Nomi Health Commercial |
$284.42
|
| Rate for Payer: PACE SWMI |
$237.02
|
| Rate for Payer: PHP Commercial |
$331.83
|
| Rate for Payer: PHP Medicare Advantage |
$237.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.15
|
| Rate for Payer: Priority Health Medicare |
$237.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.02
|
| Rate for Payer: UHC Medicare Advantage |
$237.02
|
| Rate for Payer: UMR Bronson Commercial |
$244.26
|
|
|
PR EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/VEEG
|
Professional
|
Both
|
$664.00
|
|
|
Service Code
|
HCPCS 95724
|
| Min. Negotiated Rate |
$265.60 |
| Max. Negotiated Rate |
$431.60 |
| Rate for Payer: Aetna Commercial |
$399.37
|
| Rate for Payer: Aetna Medicare |
$309.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.37
|
| Rate for Payer: BCBS Complete |
$265.60
|
| Rate for Payer: BCBS MAPPO |
$298.04
|
| Rate for Payer: BCN Medicare Advantage |
$298.04
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cofinity Commercial |
$429.18
|
| Rate for Payer: Cofinity Commercial |
$399.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.94
|
| Rate for Payer: Nomi Health Commercial |
$357.65
|
| Rate for Payer: PACE SWMI |
$298.04
|
| Rate for Payer: PHP Commercial |
$417.26
|
| Rate for Payer: PHP Medicare Advantage |
$298.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.60
|
| Rate for Payer: Priority Health Medicare |
$298.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.04
|
| Rate for Payer: UHC Medicare Advantage |
$298.04
|
| Rate for Payer: UMR Bronson Commercial |
$305.44
|
|
|
PR EEG COMPLETE STD PHYS/QHP>84 HR W/O VID
|
Professional
|
Both
|
$607.00
|
|
|
Service Code
|
HCPCS 95725
|
| Min. Negotiated Rate |
$242.80 |
| Max. Negotiated Rate |
$394.55 |
| Rate for Payer: Aetna Commercial |
$363.84
|
| Rate for Payer: Aetna Medicare |
$282.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$363.84
|
| Rate for Payer: BCBS Complete |
$242.80
|
| Rate for Payer: BCBS MAPPO |
$271.52
|
| Rate for Payer: BCN Medicare Advantage |
$271.52
|
| Rate for Payer: Cash Price |
$485.60
|
| Rate for Payer: Cash Price |
$485.60
|
| Rate for Payer: Cofinity Commercial |
$390.99
|
| Rate for Payer: Cofinity Commercial |
$363.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$285.10
|
| Rate for Payer: Nomi Health Commercial |
$325.82
|
| Rate for Payer: PACE SWMI |
$271.52
|
| Rate for Payer: PHP Commercial |
$380.13
|
| Rate for Payer: PHP Medicare Advantage |
$271.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$394.55
|
| Rate for Payer: Priority Health Medicare |
$271.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$271.52
|
| Rate for Payer: UHC Medicare Advantage |
$271.52
|
| Rate for Payer: UMR Bronson Commercial |
$279.22
|
|
|
PR EEG COMPLETE STD PHYS/QHP>84 HR W/VEEG
|
Professional
|
Both
|
$839.00
|
|
|
Service Code
|
HCPCS 95726
|
| Min. Negotiated Rate |
$335.60 |
| Max. Negotiated Rate |
$545.35 |
| Rate for Payer: Aetna Commercial |
$507.14
|
| Rate for Payer: Aetna Medicare |
$393.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$544.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$507.14
|
| Rate for Payer: BCBS Complete |
$335.60
|
| Rate for Payer: BCBS MAPPO |
$378.46
|
| Rate for Payer: BCN Medicare Advantage |
$378.46
|
| Rate for Payer: Cash Price |
$671.20
|
| Rate for Payer: Cash Price |
$671.20
|
| Rate for Payer: Cofinity Commercial |
$544.98
|
| Rate for Payer: Cofinity Commercial |
$507.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.38
|
| Rate for Payer: Nomi Health Commercial |
$454.15
|
| Rate for Payer: PACE SWMI |
$378.46
|
| Rate for Payer: PHP Commercial |
$529.84
|
| Rate for Payer: PHP Medicare Advantage |
$378.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$545.35
|
| Rate for Payer: Priority Health Medicare |
$378.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$378.46
|
| Rate for Payer: UHC Medicare Advantage |
$378.46
|
| Rate for Payer: UMR Bronson Commercial |
$385.94
|
|
|
PR EEG EXTENDED MONITORING 61-119 MINUTES
|
Professional
|
Both
|
$868.00
|
|
|
Service Code
|
HCPCS 95813
|
| Min. Negotiated Rate |
$347.20 |
| Max. Negotiated Rate |
$571.92 |
| Rate for Payer: Aetna Commercial |
$532.21
|
| Rate for Payer: Aetna Medicare |
$413.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$571.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$532.21
|
| Rate for Payer: BCBS Complete |
$347.20
|
| Rate for Payer: BCBS MAPPO |
$397.17
|
| Rate for Payer: BCN Medicare Advantage |
$397.17
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cofinity Commercial |
$571.92
|
| Rate for Payer: Cofinity Commercial |
$532.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.03
|
| Rate for Payer: Nomi Health Commercial |
$476.60
|
| Rate for Payer: PACE SWMI |
$397.17
|
| Rate for Payer: PHP Commercial |
$556.04
|
| Rate for Payer: PHP Medicare Advantage |
$397.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.20
|
| Rate for Payer: Priority Health Medicare |
$397.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$397.17
|
| Rate for Payer: UHC Medicare Advantage |
$397.17
|
| Rate for Payer: UMR Bronson Commercial |
$399.28
|
|
|
PR EEG MONITORING/COMPUTER, EA 24 HOURS, ATTENDED BY TECH/NURSE
|
Professional
|
Both
|
$2,889.00
|
|
|
Service Code
|
HCPCS 95956
|
| Min. Negotiated Rate |
$1,155.60 |
| Max. Negotiated Rate |
$1,877.85 |
| Rate for Payer: Aetna Medicare |
$1,444.50
|
| Rate for Payer: BCBS Complete |
$1,155.60
|
| Rate for Payer: Cash Price |
$2,311.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,877.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,328.94
|
|
|
PR EEG MONITORING/COMPUTER, EA 24 HOURS, UNATTENDED
|
Professional
|
Both
|
$747.00
|
|
|
Service Code
|
HCPCS 95953
|
| Min. Negotiated Rate |
$298.80 |
| Max. Negotiated Rate |
$485.55 |
| Rate for Payer: Aetna Medicare |
$373.50
|
| Rate for Payer: BCBS Complete |
$298.80
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.55
|
| Rate for Payer: UMR Bronson Commercial |
$343.62
|
|
|
PR EEG MONITORING/VIDEORECORD
|
Professional
|
Both
|
$1,556.00
|
|
|
Service Code
|
HCPCS 95951
|
| Min. Negotiated Rate |
$622.40 |
| Max. Negotiated Rate |
$1,011.40 |
| Rate for Payer: Aetna Medicare |
$778.00
|
| Rate for Payer: Aetna Medicare |
$1,551.00
|
| Rate for Payer: BCBS Complete |
$622.40
|
| Rate for Payer: BCBS Complete |
$1,240.80
|
| Rate for Payer: Cash Price |
$2,481.60
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,011.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,016.30
|
| Rate for Payer: UMR Bronson Commercial |
$715.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,426.92
|
|
|
PR EEG PHYS/QHP 2-12 HR WITHOUT VIDEO
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 95717
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$144.33 |
| Rate for Payer: Aetna Commercial |
$134.31
|
| Rate for Payer: Aetna Medicare |
$104.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.33
|
| Rate for Payer: BCBS Complete |
$83.60
|
| Rate for Payer: BCBS MAPPO |
$100.23
|
| Rate for Payer: BCN Medicare Advantage |
$100.23
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cofinity Commercial |
$144.33
|
| Rate for Payer: Cofinity Commercial |
$134.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.24
|
| Rate for Payer: Nomi Health Commercial |
$120.28
|
| Rate for Payer: PACE SWMI |
$100.23
|
| Rate for Payer: PHP Commercial |
$140.32
|
| Rate for Payer: PHP Medicare Advantage |
$100.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.85
|
| Rate for Payer: Priority Health Medicare |
$100.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.23
|
| Rate for Payer: UHC Medicare Advantage |
$100.23
|
| Rate for Payer: UMR Bronson Commercial |
$96.14
|
|
|
PR EEG PHYS/QHP 2-12 HR WITH VEEG
|
Professional
|
Both
|
$274.00
|
|
|
Service Code
|
HCPCS 95718
|
| Min. Negotiated Rate |
$109.60 |
| Max. Negotiated Rate |
$181.38 |
| Rate for Payer: Aetna Commercial |
$168.79
|
| Rate for Payer: Aetna Medicare |
$131.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.79
|
| Rate for Payer: BCBS Complete |
$109.60
|
| Rate for Payer: BCBS MAPPO |
$125.96
|
| Rate for Payer: BCN Medicare Advantage |
$125.96
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cofinity Commercial |
$181.38
|
| Rate for Payer: Cofinity Commercial |
$168.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.26
|
| Rate for Payer: Nomi Health Commercial |
$151.15
|
| Rate for Payer: PACE SWMI |
$125.96
|
| Rate for Payer: PHP Commercial |
$176.34
|
| Rate for Payer: PHP Medicare Advantage |
$125.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.10
|
| Rate for Payer: Priority Health Medicare |
$125.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.96
|
| Rate for Payer: UHC Medicare Advantage |
$125.96
|
| Rate for Payer: UMR Bronson Commercial |
$126.04
|
|
|
PR EEG PHYS/QHP EA INCR>12HR<26HR AFTER 24HR WO VID
|
Professional
|
Both
|
$323.00
|
|
|
Service Code
|
HCPCS 95719
|
| Min. Negotiated Rate |
$129.20 |
| Max. Negotiated Rate |
$216.92 |
| Rate for Payer: Aetna Commercial |
$201.86
|
| Rate for Payer: Aetna Medicare |
$156.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.86
|
| Rate for Payer: BCBS Complete |
$129.20
|
| Rate for Payer: BCBS MAPPO |
$150.64
|
| Rate for Payer: BCN Medicare Advantage |
$150.64
|
| Rate for Payer: Cash Price |
$258.40
|
| Rate for Payer: Cash Price |
$258.40
|
| Rate for Payer: Cofinity Commercial |
$216.92
|
| Rate for Payer: Cofinity Commercial |
$201.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.17
|
| Rate for Payer: Nomi Health Commercial |
$180.77
|
| Rate for Payer: PACE SWMI |
$150.64
|
| Rate for Payer: PHP Commercial |
$210.90
|
| Rate for Payer: PHP Medicare Advantage |
$150.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.95
|
| Rate for Payer: Priority Health Medicare |
$150.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.64
|
| Rate for Payer: UHC Medicare Advantage |
$150.64
|
| Rate for Payer: UMR Bronson Commercial |
$148.58
|
|
|
PR EEG PHYS/QHP EA INCR>12HR<26HR AFTER 24HR W/VEEG
|
Professional
|
Both
|
$425.00
|
|
|
Service Code
|
HCPCS 95720
|
| Min. Negotiated Rate |
$170.00 |
| Max. Negotiated Rate |
$278.51 |
| Rate for Payer: Aetna Commercial |
$259.17
|
| Rate for Payer: Aetna Medicare |
$201.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.17
|
| Rate for Payer: BCBS Complete |
$170.00
|
| Rate for Payer: BCBS MAPPO |
$193.41
|
| Rate for Payer: BCN Medicare Advantage |
$193.41
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cofinity Commercial |
$278.51
|
| Rate for Payer: Cofinity Commercial |
$259.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.08
|
| Rate for Payer: Nomi Health Commercial |
$232.09
|
| Rate for Payer: PACE SWMI |
$193.41
|
| Rate for Payer: PHP Commercial |
$270.77
|
| Rate for Payer: PHP Medicare Advantage |
$193.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.25
|
| Rate for Payer: Priority Health Medicare |
$193.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.41
|
| Rate for Payer: UHC Medicare Advantage |
$193.41
|
| Rate for Payer: UMR Bronson Commercial |
$195.50
|
|
|
PREGABALIN 100 MG CAPSULE
|
Facility
|
OP
|
$154.40
|
|
|
Service Code
|
NDC 69097068105
|
| Hospital Charge Code |
42165
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$57.13 |
| Max. Negotiated Rate |
$138.96 |
| Rate for Payer: Aetna American Axle |
$100.36
|
| Rate for Payer: Aetna Commercial |
$131.24
|
| Rate for Payer: Aetna Medicare |
$77.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.36
|
| Rate for Payer: BCBS Complete |
$61.76
|
| Rate for Payer: Cash Price |
$123.52
|
| Rate for Payer: Cofinity Commercial |
$108.08
|
| Rate for Payer: Cofinity Commercial |
$132.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$108.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.52
|
| Rate for Payer: Healthscope Commercial |
$138.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$108.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.24
|
| Rate for Payer: PHP Commercial |
$131.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.36
|
| Rate for Payer: Priority Health SBD |
$97.27
|
| Rate for Payer: UMR Bronson Commercial |
$57.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.80
|
|
|
PREGABALIN 100 MG CAPSULE
|
Facility
|
OP
|
$272.84
|
|
|
Service Code
|
NDC 00228285909
|
| Hospital Charge Code |
42165
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$100.95 |
| Max. Negotiated Rate |
$245.56 |
| Rate for Payer: Aetna American Axle |
$177.35
|
| Rate for Payer: Aetna Commercial |
$231.91
|
| Rate for Payer: Aetna Medicare |
$136.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.35
|
| Rate for Payer: BCBS Complete |
$109.14
|
| Rate for Payer: Cash Price |
$218.27
|
| Rate for Payer: Cofinity Commercial |
$190.99
|
| Rate for Payer: Cofinity Commercial |
$234.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$190.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.27
|
| Rate for Payer: Healthscope Commercial |
$245.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.91
|
| Rate for Payer: PHP Commercial |
$231.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.35
|
| Rate for Payer: Priority Health SBD |
$171.89
|
| Rate for Payer: UMR Bronson Commercial |
$100.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.63
|
|
