|
PR OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP
|
Professional
|
Both
|
$3,537.00
|
|
|
Service Code
|
HCPCS 27822
|
| Min. Negotiated Rate |
$565.30 |
| Max. Negotiated Rate |
$3,847.61 |
| Rate for Payer: Aetna Commercial |
$1,115.30
|
| Rate for Payer: Aetna Medicare |
$865.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,115.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,198.53
|
| Rate for Payer: BCBS Complete |
$593.56
|
| Rate for Payer: BCBS MAPPO |
$832.31
|
| Rate for Payer: BCBS Trust/PPO |
$3,847.61
|
| Rate for Payer: BCN Commercial |
$1,287.17
|
| Rate for Payer: BCN Medicare Advantage |
$832.31
|
| Rate for Payer: Cash Price |
$2,829.60
|
| Rate for Payer: Cash Price |
$2,829.60
|
| Rate for Payer: Cofinity Commercial |
$1,115.30
|
| Rate for Payer: Cofinity Commercial |
$1,198.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$832.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$873.93
|
| Rate for Payer: Meridian Medicaid |
$593.56
|
| Rate for Payer: Nomi Health Commercial |
$998.77
|
| Rate for Payer: PACE SWMI |
$832.31
|
| Rate for Payer: PHP Commercial |
$1,165.23
|
| Rate for Payer: PHP Medicare Advantage |
$832.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$565.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,299.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,347.46
|
| Rate for Payer: Priority Health Medicare |
$832.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,347.46
|
| Rate for Payer: Priority Health SBD |
$1,347.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$832.31
|
| Rate for Payer: UHC Medicare Advantage |
$832.31
|
| Rate for Payer: UHCCP Medicaid |
$565.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,627.02
|
|
|
PR OPH SVCS MEDICAL XM&EVAL COMPRE EST PT 1/>VST
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 92014
|
| Min. Negotiated Rate |
$47.50 |
| Max. Negotiated Rate |
$1,611.32 |
| Rate for Payer: Aetna Commercial |
$93.99
|
| Rate for Payer: Aetna Medicare |
$72.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.99
|
| Rate for Payer: BCBS Complete |
$49.88
|
| Rate for Payer: BCBS MAPPO |
$70.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,611.32
|
| Rate for Payer: BCN Commercial |
$134.35
|
| Rate for Payer: BCN Medicare Advantage |
$70.14
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cofinity Commercial |
$101.00
|
| Rate for Payer: Cofinity Commercial |
$93.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.65
|
| Rate for Payer: Meridian Medicaid |
$49.88
|
| Rate for Payer: Nomi Health Commercial |
$84.17
|
| Rate for Payer: PACE SWMI |
$70.14
|
| Rate for Payer: PHP Commercial |
$98.20
|
| Rate for Payer: PHP Medicare Advantage |
$70.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.60
|
| Rate for Payer: Priority Health Medicare |
$70.14
|
| Rate for Payer: Priority Health Narrow Network |
$92.60
|
| Rate for Payer: Priority Health SBD |
$92.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.14
|
| Rate for Payer: UHC Medicare Advantage |
$70.14
|
| Rate for Payer: UHCCP Medicaid |
$47.50
|
| Rate for Payer: UMR Bronson Commercial |
$78.66
|
|
|
PR OPH SVCS MEDICAL XM&EVAL COMPRE NEW PT 1/> VST
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 92004
|
| Min. Negotiated Rate |
$58.79 |
| Max. Negotiated Rate |
$1,175.47 |
| Rate for Payer: Aetna Commercial |
$116.46
|
| Rate for Payer: Aetna Medicare |
$90.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.15
|
| Rate for Payer: BCBS Complete |
$61.73
|
| Rate for Payer: BCBS MAPPO |
$86.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,175.47
|
| Rate for Payer: BCN Commercial |
$159.06
|
| Rate for Payer: BCN Medicare Advantage |
$86.91
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cofinity Commercial |
$116.46
|
| Rate for Payer: Cofinity Commercial |
$125.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.26
|
| Rate for Payer: Meridian Medicaid |
$61.73
|
| Rate for Payer: Nomi Health Commercial |
$104.29
|
| Rate for Payer: PACE SWMI |
$86.91
|
| Rate for Payer: PHP Commercial |
$121.67
|
| Rate for Payer: PHP Medicare Advantage |
$86.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.02
|
| Rate for Payer: Priority Health Medicare |
$86.91
|
| Rate for Payer: Priority Health Narrow Network |
$115.02
|
| Rate for Payer: Priority Health SBD |
$115.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.91
|
| Rate for Payer: UHC Medicare Advantage |
$86.91
|
| Rate for Payer: UHCCP Medicaid |
$58.79
|
| Rate for Payer: UMR Bronson Commercial |
$96.14
|
|
|
PR OPH SVCS MEDICAL XM&EVAL INTERMEDIATE EST PT
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 92012
|
| Min. Negotiated Rate |
$31.52 |
| Max. Negotiated Rate |
$1,213.51 |
| Rate for Payer: Aetna Commercial |
$62.32
|
| Rate for Payer: Aetna Medicare |
$48.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.97
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS MAPPO |
$46.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,213.51
|
| Rate for Payer: BCN Commercial |
$95.65
|
| Rate for Payer: BCN Medicare Advantage |
$46.51
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Cofinity Commercial |
$66.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.84
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Nomi Health Commercial |
$55.81
|
| Rate for Payer: PACE SWMI |
$46.51
|
| Rate for Payer: PHP Commercial |
$65.11
|
| Rate for Payer: PHP Medicare Advantage |
$46.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.46
|
| Rate for Payer: Priority Health Medicare |
$46.51
|
| Rate for Payer: Priority Health Narrow Network |
$61.46
|
| Rate for Payer: Priority Health SBD |
$61.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.51
|
| Rate for Payer: UHC Medicare Advantage |
$46.51
|
| Rate for Payer: UHCCP Medicaid |
$31.52
|
| Rate for Payer: UMR Bronson Commercial |
$69.00
|
|
|
PR OPH SVCS MEDICAL XM&EVAL INTERMEDIATE NEW PT
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
HCPCS 92002
|
| Min. Negotiated Rate |
$28.54 |
| Max. Negotiated Rate |
$902.86 |
| Rate for Payer: Aetna Commercial |
$56.53
|
| Rate for Payer: Aetna Medicare |
$43.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.75
|
| Rate for Payer: BCBS Complete |
$29.97
|
| Rate for Payer: BCBS MAPPO |
$42.19
|
| Rate for Payer: BCBS Trust/PPO |
$902.86
|
| Rate for Payer: BCN Commercial |
$90.99
|
| Rate for Payer: BCN Medicare Advantage |
$42.19
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cofinity Commercial |
$56.53
|
| Rate for Payer: Cofinity Commercial |
$60.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.30
|
| Rate for Payer: Meridian Medicaid |
$29.97
|
| Rate for Payer: Nomi Health Commercial |
$50.63
|
| Rate for Payer: PACE SWMI |
$42.19
|
| Rate for Payer: PHP Commercial |
$59.07
|
| Rate for Payer: PHP Medicare Advantage |
$42.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.65
|
| Rate for Payer: Priority Health Medicare |
$42.19
|
| Rate for Payer: Priority Health Narrow Network |
$55.65
|
| Rate for Payer: Priority Health SBD |
$55.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.19
|
| Rate for Payer: UHC Medicare Advantage |
$42.19
|
| Rate for Payer: UHCCP Medicaid |
$28.54
|
| Rate for Payer: UMR Bronson Commercial |
$51.06
|
|
|
PR OPN AXILLARY/SUBCLAVIAN ART EXPOS W/CNDT CRTJ
|
Professional
|
Both
|
$787.00
|
|
|
Service Code
|
HCPCS 34716
|
| Min. Negotiated Rate |
$232.60 |
| Max. Negotiated Rate |
$1,773.50 |
| Rate for Payer: Aetna Commercial |
$478.46
|
| Rate for Payer: Aetna Medicare |
$371.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.17
|
| Rate for Payer: BCBS Complete |
$244.23
|
| Rate for Payer: BCBS MAPPO |
$357.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,773.50
|
| Rate for Payer: BCN Commercial |
$530.22
|
| Rate for Payer: BCN Medicare Advantage |
$357.06
|
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Cofinity Commercial |
$478.46
|
| Rate for Payer: Cofinity Commercial |
$514.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.91
|
| Rate for Payer: Meridian Medicaid |
$244.23
|
| Rate for Payer: Nomi Health Commercial |
$428.47
|
| Rate for Payer: PACE SWMI |
$357.06
|
| Rate for Payer: PHP Commercial |
$499.88
|
| Rate for Payer: PHP Medicare Advantage |
$357.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$511.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$578.10
|
| Rate for Payer: Priority Health Medicare |
$357.06
|
| Rate for Payer: Priority Health Narrow Network |
$578.10
|
| Rate for Payer: Priority Health SBD |
$578.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.06
|
| Rate for Payer: UHC Medicare Advantage |
$357.06
|
| Rate for Payer: UHCCP Medicaid |
$232.60
|
| Rate for Payer: UMR Bronson Commercial |
$362.02
|
|
|
PR OPN BRACHIAL ARTERY EXPOS DLVR EVASC PROSTH UNI
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 34834
|
| Min. Negotiated Rate |
$80.30 |
| Max. Negotiated Rate |
$1,323.92 |
| Rate for Payer: Aetna Commercial |
$166.36
|
| Rate for Payer: Aetna Medicare |
$129.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.78
|
| Rate for Payer: BCBS Complete |
$84.32
|
| Rate for Payer: BCBS MAPPO |
$124.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,323.92
|
| Rate for Payer: BCN Commercial |
$184.23
|
| Rate for Payer: BCN Medicare Advantage |
$124.15
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$166.36
|
| Rate for Payer: Cofinity Commercial |
$178.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.36
|
| Rate for Payer: Meridian Medicaid |
$84.32
|
| Rate for Payer: Nomi Health Commercial |
$148.98
|
| Rate for Payer: PACE SWMI |
$124.15
|
| Rate for Payer: PHP Commercial |
$173.81
|
| Rate for Payer: PHP Medicare Advantage |
$124.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.49
|
| Rate for Payer: Priority Health Medicare |
$124.15
|
| Rate for Payer: Priority Health Narrow Network |
$200.49
|
| Rate for Payer: Priority Health SBD |
$200.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.15
|
| Rate for Payer: UHC Medicare Advantage |
$124.15
|
| Rate for Payer: UHCCP Medicaid |
$80.30
|
| Rate for Payer: UMR Bronson Commercial |
$133.40
|
|
|
PR OPN FEM ART EXPOS DLVR EVASC PROSTH UNI
|
Professional
|
Both
|
$1,267.00
|
|
|
Service Code
|
HCPCS 34812
|
| Min. Negotiated Rate |
$128.01 |
| Max. Negotiated Rate |
$823.55 |
| Rate for Payer: Aetna Commercial |
$264.82
|
| Rate for Payer: Aetna Medicare |
$205.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.59
|
| Rate for Payer: BCBS Complete |
$134.41
|
| Rate for Payer: BCBS MAPPO |
$197.63
|
| Rate for Payer: BCBS Trust/PPO |
$498.72
|
| Rate for Payer: BCN Commercial |
$292.72
|
| Rate for Payer: BCN Medicare Advantage |
$197.63
|
| Rate for Payer: Cash Price |
$1,013.60
|
| Rate for Payer: Cash Price |
$1,013.60
|
| Rate for Payer: Cofinity Commercial |
$264.82
|
| Rate for Payer: Cofinity Commercial |
$284.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.51
|
| Rate for Payer: Meridian Medicaid |
$134.41
|
| Rate for Payer: Nomi Health Commercial |
$237.16
|
| Rate for Payer: PACE SWMI |
$197.63
|
| Rate for Payer: PHP Commercial |
$276.68
|
| Rate for Payer: PHP Medicare Advantage |
$197.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$319.63
|
| Rate for Payer: Priority Health Medicare |
$197.63
|
| Rate for Payer: Priority Health Narrow Network |
$319.63
|
| Rate for Payer: Priority Health SBD |
$319.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.63
|
| Rate for Payer: UHC Medicare Advantage |
$197.63
|
| Rate for Payer: UHCCP Medicaid |
$128.01
|
| Rate for Payer: UMR Bronson Commercial |
$582.82
|
|
|
PR OPN FEM ART EXPOS W/CNDT CRTJ DLVR EVASC PROSTH
|
Professional
|
Both
|
$568.00
|
|
|
Service Code
|
HCPCS 34714
|
| Min. Negotiated Rate |
$168.06 |
| Max. Negotiated Rate |
$1,553.20 |
| Rate for Payer: Aetna Commercial |
$346.11
|
| Rate for Payer: Aetna Medicare |
$268.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.94
|
| Rate for Payer: BCBS Complete |
$176.46
|
| Rate for Payer: BCBS MAPPO |
$258.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,553.20
|
| Rate for Payer: BCN Commercial |
$383.62
|
| Rate for Payer: BCN Medicare Advantage |
$258.29
|
| Rate for Payer: Cash Price |
$454.40
|
| Rate for Payer: Cash Price |
$454.40
|
| Rate for Payer: Cofinity Commercial |
$346.11
|
| Rate for Payer: Cofinity Commercial |
$371.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.20
|
| Rate for Payer: Meridian Medicaid |
$176.46
|
| Rate for Payer: Nomi Health Commercial |
$309.95
|
| Rate for Payer: PACE SWMI |
$258.29
|
| Rate for Payer: PHP Commercial |
$361.61
|
| Rate for Payer: PHP Medicare Advantage |
$258.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$369.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.54
|
| Rate for Payer: Priority Health Medicare |
$258.29
|
| Rate for Payer: Priority Health Narrow Network |
$418.54
|
| Rate for Payer: Priority Health SBD |
$418.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$258.29
|
| Rate for Payer: UHC Medicare Advantage |
$258.29
|
| Rate for Payer: UHCCP Medicaid |
$168.06
|
| Rate for Payer: UMR Bronson Commercial |
$261.28
|
|
|
PR OPN ILIAC ART EXPOS CRTJ PROSTH EST CARD BYP
|
Professional
|
Both
|
$2,232.00
|
|
|
Service Code
|
HCPCS 34833
|
| Min. Negotiated Rate |
$244.52 |
| Max. Negotiated Rate |
$1,450.80 |
| Rate for Payer: Aetna Commercial |
$507.50
|
| Rate for Payer: Aetna Medicare |
$393.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$507.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.37
|
| Rate for Payer: BCBS Complete |
$256.75
|
| Rate for Payer: BCBS MAPPO |
$378.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,407.92
|
| Rate for Payer: BCN Commercial |
$557.58
|
| Rate for Payer: BCN Medicare Advantage |
$378.73
|
| Rate for Payer: Cash Price |
$1,785.60
|
| Rate for Payer: Cash Price |
$1,785.60
|
| Rate for Payer: Cofinity Commercial |
$507.50
|
| Rate for Payer: Cofinity Commercial |
$545.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.67
|
| Rate for Payer: Meridian Medicaid |
$256.75
|
| Rate for Payer: Nomi Health Commercial |
$454.48
|
| Rate for Payer: PACE SWMI |
$378.73
|
| Rate for Payer: PHP Commercial |
$530.22
|
| Rate for Payer: PHP Medicare Advantage |
$378.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,450.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$609.46
|
| Rate for Payer: Priority Health Medicare |
$378.73
|
| Rate for Payer: Priority Health Narrow Network |
$609.46
|
| Rate for Payer: Priority Health SBD |
$609.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$378.73
|
| Rate for Payer: UHC Medicare Advantage |
$378.73
|
| Rate for Payer: UHCCP Medicaid |
$244.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,026.72
|
|
|
PR OPN RPR ARYSM RPR ARTL TRAUMA TUBE PROSTH
|
Professional
|
Both
|
$4,812.00
|
|
|
Service Code
|
HCPCS 34830
|
| Min. Negotiated Rate |
$841.05 |
| Max. Negotiated Rate |
$3,127.80 |
| Rate for Payer: Aetna Commercial |
$2,275.83
|
| Rate for Payer: Aetna Medicare |
$1,766.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,275.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,445.67
|
| Rate for Payer: BCBS Complete |
$1,156.27
|
| Rate for Payer: BCBS MAPPO |
$1,698.38
|
| Rate for Payer: BCBS Trust/PPO |
$841.05
|
| Rate for Payer: BCN Commercial |
$2,510.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,698.38
|
| Rate for Payer: Cash Price |
$3,849.60
|
| Rate for Payer: Cash Price |
$3,849.60
|
| Rate for Payer: Cofinity Commercial |
$2,275.83
|
| Rate for Payer: Cofinity Commercial |
$2,445.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,698.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,783.30
|
| Rate for Payer: Meridian Medicaid |
$1,156.27
|
| Rate for Payer: Nomi Health Commercial |
$2,038.06
|
| Rate for Payer: PACE SWMI |
$1,698.38
|
| Rate for Payer: PHP Commercial |
$2,377.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,698.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,101.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,127.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,744.22
|
| Rate for Payer: Priority Health Medicare |
$1,698.38
|
| Rate for Payer: Priority Health Narrow Network |
$2,744.22
|
| Rate for Payer: Priority Health SBD |
$2,744.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,698.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,698.38
|
| Rate for Payer: UHCCP Medicaid |
$1,101.21
|
| Rate for Payer: UMR Bronson Commercial |
$2,213.52
|
|
|
PR OPN RPR ARYSM RPR ARTL TRMA AORTOBIILIAC PROSTH
|
Professional
|
Both
|
$4,077.00
|
|
|
Service Code
|
HCPCS 34831
|
| Min. Negotiated Rate |
$953.05 |
| Max. Negotiated Rate |
$3,001.08 |
| Rate for Payer: Aetna Commercial |
$2,493.00
|
| Rate for Payer: Aetna Medicare |
$1,934.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,493.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,679.05
|
| Rate for Payer: BCBS Complete |
$1,268.77
|
| Rate for Payer: BCBS MAPPO |
$1,860.45
|
| Rate for Payer: BCBS Trust/PPO |
$953.05
|
| Rate for Payer: BCN Commercial |
$2,745.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,860.45
|
| Rate for Payer: Cash Price |
$3,261.60
|
| Rate for Payer: Cash Price |
$3,261.60
|
| Rate for Payer: Cofinity Commercial |
$2,493.00
|
| Rate for Payer: Cofinity Commercial |
$2,679.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,860.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,953.47
|
| Rate for Payer: Meridian Medicaid |
$1,268.77
|
| Rate for Payer: Nomi Health Commercial |
$2,232.54
|
| Rate for Payer: PACE SWMI |
$1,860.45
|
| Rate for Payer: PHP Commercial |
$2,604.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,860.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,208.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,001.08
|
| Rate for Payer: Priority Health Medicare |
$1,860.45
|
| Rate for Payer: Priority Health Narrow Network |
$3,001.08
|
| Rate for Payer: Priority Health SBD |
$3,001.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,860.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,860.45
|
| Rate for Payer: UHCCP Medicaid |
$1,208.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,875.42
|
|
|
PR OPN SUBCLA CRTD ART TRPOS NCK INC ULAT
|
Professional
|
Both
|
$3,200.00
|
|
|
Service Code
|
HCPCS 33889
|
| Min. Negotiated Rate |
$497.14 |
| Max. Negotiated Rate |
$2,852.29 |
| Rate for Payer: Aetna Commercial |
$1,027.43
|
| Rate for Payer: Aetna Medicare |
$797.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,027.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,104.11
|
| Rate for Payer: BCBS Complete |
$522.00
|
| Rate for Payer: BCBS MAPPO |
$766.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,852.29
|
| Rate for Payer: BCN Commercial |
$1,130.80
|
| Rate for Payer: BCN Medicare Advantage |
$766.74
|
| Rate for Payer: Cash Price |
$2,560.00
|
| Rate for Payer: Cash Price |
$2,560.00
|
| Rate for Payer: Cofinity Commercial |
$1,027.43
|
| Rate for Payer: Cofinity Commercial |
$1,104.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$766.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$805.08
|
| Rate for Payer: Meridian Medicaid |
$522.00
|
| Rate for Payer: Nomi Health Commercial |
$920.09
|
| Rate for Payer: PACE SWMI |
$766.74
|
| Rate for Payer: PHP Commercial |
$1,073.44
|
| Rate for Payer: PHP Medicare Advantage |
$766.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$497.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,080.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,234.90
|
| Rate for Payer: Priority Health Medicare |
$766.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,234.90
|
| Rate for Payer: Priority Health SBD |
$1,234.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$766.74
|
| Rate for Payer: UHC Medicare Advantage |
$766.74
|
| Rate for Payer: UHCCP Medicaid |
$497.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,472.00
|
|
|
PROPOFOL 10 MG/ML 100 ML VIAL (BULK CHARGE)
|
Facility
|
OP
|
$65.18
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
180097
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$58.66 |
| Rate for Payer: Aetna American Axle |
$42.37
|
| Rate for Payer: Aetna Commercial |
$55.40
|
| Rate for Payer: Aetna Medicare |
$32.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.37
|
| Rate for Payer: BCBS Complete |
$26.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: Cash Price |
$52.14
|
| Rate for Payer: Cash Price |
$52.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Cofinity Commercial |
$56.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.14
|
| Rate for Payer: Healthscope Commercial |
$58.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.40
|
| Rate for Payer: PHP Commercial |
$55.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.37
|
| Rate for Payer: Priority Health SBD |
$41.06
|
| Rate for Payer: UMR Bronson Commercial |
$24.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.88
|
|
|
PROPOFOL 10 MG/ML 100 ML VIAL (BULK CHARGE)
|
Facility
|
IP
|
$65.18
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
180097
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.68 |
| Max. Negotiated Rate |
$58.66 |
| Rate for Payer: Aetna American Axle |
$42.37
|
| Rate for Payer: Aetna Commercial |
$55.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.37
|
| Rate for Payer: Cash Price |
$52.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Cofinity Commercial |
$56.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.14
|
| Rate for Payer: Healthscope Commercial |
$58.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.40
|
| Rate for Payer: PHP Commercial |
$55.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.37
|
| Rate for Payer: Priority Health SBD |
$41.06
|
| Rate for Payer: UMR Bronson Commercial |
$28.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.88
|
|
|
PROPOFOL 10 MG/ML 20 ML VIAL (BULK CHARGE)
|
Facility
|
OP
|
$63.61
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
180095
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$57.25 |
| Rate for Payer: Aetna American Axle |
$41.35
|
| Rate for Payer: Aetna Commercial |
$54.07
|
| Rate for Payer: Aetna Medicare |
$31.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.35
|
| Rate for Payer: BCBS Complete |
$25.44
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: Cash Price |
$50.89
|
| Rate for Payer: Cash Price |
$50.89
|
| Rate for Payer: Cofinity Commercial |
$44.53
|
| Rate for Payer: Cofinity Commercial |
$54.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.89
|
| Rate for Payer: Healthscope Commercial |
$57.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.07
|
| Rate for Payer: PHP Commercial |
$54.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.35
|
| Rate for Payer: Priority Health SBD |
$40.07
|
| Rate for Payer: UMR Bronson Commercial |
$23.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.71
|
|
|
PROPOFOL 10 MG/ML 20 ML VIAL (BULK CHARGE)
|
Facility
|
IP
|
$63.61
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
180095
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.99 |
| Max. Negotiated Rate |
$57.25 |
| Rate for Payer: Aetna American Axle |
$41.35
|
| Rate for Payer: Aetna Commercial |
$54.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.35
|
| Rate for Payer: Cash Price |
$50.89
|
| Rate for Payer: Cofinity Commercial |
$44.53
|
| Rate for Payer: Cofinity Commercial |
$54.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.89
|
| Rate for Payer: Healthscope Commercial |
$57.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.07
|
| Rate for Payer: PHP Commercial |
$54.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.35
|
| Rate for Payer: Priority Health SBD |
$40.07
|
| Rate for Payer: UMR Bronson Commercial |
$27.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.71
|
|
|
PROPOFOL 10 MG/ML 50 ML VIAL (BULK CHARGE)
|
Facility
|
IP
|
$56.63
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
180096
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.92 |
| Max. Negotiated Rate |
$50.97 |
| Rate for Payer: Aetna American Axle |
$36.81
|
| Rate for Payer: Aetna Commercial |
$48.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.81
|
| Rate for Payer: Cash Price |
$45.30
|
| Rate for Payer: Cofinity Commercial |
$39.64
|
| Rate for Payer: Cofinity Commercial |
$48.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.30
|
| Rate for Payer: Healthscope Commercial |
$50.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.14
|
| Rate for Payer: PHP Commercial |
$48.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.81
|
| Rate for Payer: Priority Health SBD |
$35.68
|
| Rate for Payer: UMR Bronson Commercial |
$24.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.47
|
|
|
PROPOFOL 10 MG/ML 50 ML VIAL (BULK CHARGE)
|
Facility
|
OP
|
$56.63
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
180096
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$50.97 |
| Rate for Payer: Aetna American Axle |
$36.81
|
| Rate for Payer: Aetna Commercial |
$48.14
|
| Rate for Payer: Aetna Medicare |
$28.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.81
|
| Rate for Payer: BCBS Complete |
$22.65
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: Cash Price |
$45.30
|
| Rate for Payer: Cash Price |
$45.30
|
| Rate for Payer: Cofinity Commercial |
$39.64
|
| Rate for Payer: Cofinity Commercial |
$48.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.30
|
| Rate for Payer: Healthscope Commercial |
$50.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.14
|
| Rate for Payer: PHP Commercial |
$48.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.81
|
| Rate for Payer: Priority Health SBD |
$35.68
|
| Rate for Payer: UMR Bronson Commercial |
$20.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.47
|
|
|
PROPOFOL 10 MG/ML CONTINUOUS INFUSION
|
Facility
|
IP
|
$86.30
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
151165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$37.97 |
| Max. Negotiated Rate |
$77.67 |
| Rate for Payer: Aetna American Axle |
$56.10
|
| Rate for Payer: Aetna American Axle |
$66.83
|
| Rate for Payer: Aetna American Axle |
$88.58
|
| Rate for Payer: Aetna American Axle |
$58.06
|
| Rate for Payer: Aetna American Axle |
$36.81
|
| Rate for Payer: Aetna Commercial |
$73.36
|
| Rate for Payer: Aetna Commercial |
$115.84
|
| Rate for Payer: Aetna Commercial |
$87.40
|
| Rate for Payer: Aetna Commercial |
$75.92
|
| Rate for Payer: Aetna Commercial |
$48.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.58
|
| Rate for Payer: Cash Price |
$69.04
|
| Rate for Payer: Cash Price |
$71.46
|
| Rate for Payer: Cash Price |
$109.02
|
| Rate for Payer: Cash Price |
$45.30
|
| Rate for Payer: Cash Price |
$82.26
|
| Rate for Payer: Cofinity Commercial |
$62.52
|
| Rate for Payer: Cofinity Commercial |
$71.97
|
| Rate for Payer: Cofinity Commercial |
$74.22
|
| Rate for Payer: Cofinity Commercial |
$60.41
|
| Rate for Payer: Cofinity Commercial |
$39.64
|
| Rate for Payer: Cofinity Commercial |
$117.20
|
| Rate for Payer: Cofinity Commercial |
$95.40
|
| Rate for Payer: Cofinity Commercial |
$48.70
|
| Rate for Payer: Cofinity Commercial |
$88.43
|
| Rate for Payer: Cofinity Commercial |
$76.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$95.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.30
|
| Rate for Payer: Healthscope Commercial |
$122.65
|
| Rate for Payer: Healthscope Commercial |
$77.67
|
| Rate for Payer: Healthscope Commercial |
$50.97
|
| Rate for Payer: Healthscope Commercial |
$80.39
|
| Rate for Payer: Healthscope Commercial |
$92.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.40
|
| Rate for Payer: PHP Commercial |
$87.40
|
| Rate for Payer: PHP Commercial |
$75.92
|
| Rate for Payer: PHP Commercial |
$48.14
|
| Rate for Payer: PHP Commercial |
$73.36
|
| Rate for Payer: PHP Commercial |
$115.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.83
|
| Rate for Payer: Priority Health SBD |
$56.27
|
| Rate for Payer: Priority Health SBD |
$35.68
|
| Rate for Payer: Priority Health SBD |
$85.86
|
| Rate for Payer: Priority Health SBD |
$64.78
|
| Rate for Payer: Priority Health SBD |
$54.37
|
| Rate for Payer: UMR Bronson Commercial |
$45.24
|
| Rate for Payer: UMR Bronson Commercial |
$59.96
|
| Rate for Payer: UMR Bronson Commercial |
$37.97
|
| Rate for Payer: UMR Bronson Commercial |
$39.30
|
| Rate for Payer: UMR Bronson Commercial |
$24.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.72
|
|
|
PROPOFOL 10 MG/ML CONTINUOUS INFUSION
|
Facility
|
OP
|
$136.28
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
151165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$122.65 |
| Rate for Payer: Aetna American Axle |
$88.58
|
| Rate for Payer: Aetna American Axle |
$56.10
|
| Rate for Payer: Aetna American Axle |
$36.81
|
| Rate for Payer: Aetna American Axle |
$66.83
|
| Rate for Payer: Aetna American Axle |
$58.06
|
| Rate for Payer: Aetna Commercial |
$115.84
|
| Rate for Payer: Aetna Commercial |
$87.40
|
| Rate for Payer: Aetna Commercial |
$75.92
|
| Rate for Payer: Aetna Commercial |
$48.14
|
| Rate for Payer: Aetna Commercial |
$73.36
|
| Rate for Payer: Aetna Medicare |
$28.32
|
| Rate for Payer: Aetna Medicare |
$43.15
|
| Rate for Payer: Aetna Medicare |
$68.14
|
| Rate for Payer: Aetna Medicare |
$51.41
|
| Rate for Payer: Aetna Medicare |
$44.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.81
|
| Rate for Payer: BCBS Complete |
$54.51
|
| Rate for Payer: BCBS Complete |
$41.13
|
| Rate for Payer: BCBS Complete |
$34.52
|
| Rate for Payer: BCBS Complete |
$35.73
|
| Rate for Payer: BCBS Complete |
$22.65
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: Cash Price |
$109.02
|
| Rate for Payer: Cash Price |
$45.30
|
| Rate for Payer: Cash Price |
$82.26
|
| Rate for Payer: Cash Price |
$109.02
|
| Rate for Payer: Cash Price |
$82.26
|
| Rate for Payer: Cash Price |
$45.30
|
| Rate for Payer: Cash Price |
$71.46
|
| Rate for Payer: Cash Price |
$71.46
|
| Rate for Payer: Cash Price |
$69.04
|
| Rate for Payer: Cash Price |
$69.04
|
| Rate for Payer: Cofinity Commercial |
$117.20
|
| Rate for Payer: Cofinity Commercial |
$76.82
|
| Rate for Payer: Cofinity Commercial |
$71.97
|
| Rate for Payer: Cofinity Commercial |
$48.70
|
| Rate for Payer: Cofinity Commercial |
$39.64
|
| Rate for Payer: Cofinity Commercial |
$62.52
|
| Rate for Payer: Cofinity Commercial |
$74.22
|
| Rate for Payer: Cofinity Commercial |
$60.41
|
| Rate for Payer: Cofinity Commercial |
$95.40
|
| Rate for Payer: Cofinity Commercial |
$88.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$95.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.04
|
| Rate for Payer: Healthscope Commercial |
$77.67
|
| Rate for Payer: Healthscope Commercial |
$92.54
|
| Rate for Payer: Healthscope Commercial |
$122.65
|
| Rate for Payer: Healthscope Commercial |
$50.97
|
| Rate for Payer: Healthscope Commercial |
$80.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.40
|
| Rate for Payer: PHP Commercial |
$75.92
|
| Rate for Payer: PHP Commercial |
$73.36
|
| Rate for Payer: PHP Commercial |
$115.84
|
| Rate for Payer: PHP Commercial |
$87.40
|
| Rate for Payer: PHP Commercial |
$48.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.58
|
| Rate for Payer: Priority Health SBD |
$85.86
|
| Rate for Payer: Priority Health SBD |
$56.27
|
| Rate for Payer: Priority Health SBD |
$54.37
|
| Rate for Payer: Priority Health SBD |
$64.78
|
| Rate for Payer: Priority Health SBD |
$35.68
|
| Rate for Payer: UMR Bronson Commercial |
$38.04
|
| Rate for Payer: UMR Bronson Commercial |
$20.95
|
| Rate for Payer: UMR Bronson Commercial |
$50.42
|
| Rate for Payer: UMR Bronson Commercial |
$31.93
|
| Rate for Payer: UMR Bronson Commercial |
$33.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.12
|
|
|
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION
|
Facility
|
OP
|
$72.53
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
11150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$65.28 |
| Rate for Payer: Aetna American Axle |
$47.14
|
| Rate for Payer: Aetna American Axle |
$62.06
|
| Rate for Payer: Aetna American Axle |
$40.45
|
| Rate for Payer: Aetna American Axle |
$42.27
|
| Rate for Payer: Aetna American Axle |
$58.06
|
| Rate for Payer: Aetna American Axle |
$41.47
|
| Rate for Payer: Aetna American Axle |
$51.32
|
| Rate for Payer: Aetna American Axle |
$38.18
|
| Rate for Payer: Aetna American Axle |
$39.99
|
| Rate for Payer: Aetna American Axle |
$44.09
|
| Rate for Payer: Aetna American Axle |
$44.54
|
| Rate for Payer: Aetna Commercial |
$75.92
|
| Rate for Payer: Aetna Commercial |
$57.66
|
| Rate for Payer: Aetna Commercial |
$54.23
|
| Rate for Payer: Aetna Commercial |
$67.11
|
| Rate for Payer: Aetna Commercial |
$49.93
|
| Rate for Payer: Aetna Commercial |
$61.65
|
| Rate for Payer: Aetna Commercial |
$58.25
|
| Rate for Payer: Aetna Commercial |
$81.16
|
| Rate for Payer: Aetna Commercial |
$55.28
|
| Rate for Payer: Aetna Commercial |
$52.30
|
| Rate for Payer: Aetna Commercial |
$52.90
|
| Rate for Payer: Aetna Medicare |
$36.26
|
| Rate for Payer: Aetna Medicare |
$32.52
|
| Rate for Payer: Aetna Medicare |
$30.76
|
| Rate for Payer: Aetna Medicare |
$29.37
|
| Rate for Payer: Aetna Medicare |
$33.92
|
| Rate for Payer: Aetna Medicare |
$34.26
|
| Rate for Payer: Aetna Medicare |
$31.12
|
| Rate for Payer: Aetna Medicare |
$47.74
|
| Rate for Payer: Aetna Medicare |
$44.66
|
| Rate for Payer: Aetna Medicare |
$39.48
|
| Rate for Payer: Aetna Medicare |
$31.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.99
|
| Rate for Payer: BCBS Complete |
$24.89
|
| Rate for Payer: BCBS Complete |
$24.61
|
| Rate for Payer: BCBS Complete |
$38.19
|
| Rate for Payer: BCBS Complete |
$26.01
|
| Rate for Payer: BCBS Complete |
$23.50
|
| Rate for Payer: BCBS Complete |
$29.01
|
| Rate for Payer: BCBS Complete |
$31.58
|
| Rate for Payer: BCBS Complete |
$35.73
|
| Rate for Payer: BCBS Complete |
$25.52
|
| Rate for Payer: BCBS Complete |
$27.41
|
| Rate for Payer: BCBS Complete |
$27.13
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: Cash Price |
$63.16
|
| Rate for Payer: Cash Price |
$54.82
|
| Rate for Payer: Cash Price |
$49.22
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$46.99
|
| Rate for Payer: Cash Price |
$49.22
|
| Rate for Payer: Cash Price |
$46.99
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$76.38
|
| Rate for Payer: Cash Price |
$76.38
|
| Rate for Payer: Cash Price |
$71.46
|
| Rate for Payer: Cash Price |
$71.46
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$63.16
|
| Rate for Payer: Cash Price |
$58.02
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cash Price |
$58.02
|
| Rate for Payer: Cash Price |
$54.82
|
| Rate for Payer: Cash Price |
$54.26
|
| Rate for Payer: Cash Price |
$54.26
|
| Rate for Payer: Cofinity Commercial |
$54.87
|
| Rate for Payer: Cofinity Commercial |
$44.66
|
| Rate for Payer: Cofinity Commercial |
$52.92
|
| Rate for Payer: Cofinity Commercial |
$55.26
|
| Rate for Payer: Cofinity Commercial |
$67.90
|
| Rate for Payer: Cofinity Commercial |
$58.94
|
| Rate for Payer: Cofinity Commercial |
$47.97
|
| Rate for Payer: Cofinity Commercial |
$58.33
|
| Rate for Payer: Cofinity Commercial |
$62.52
|
| Rate for Payer: Cofinity Commercial |
$76.82
|
| Rate for Payer: Cofinity Commercial |
$66.84
|
| Rate for Payer: Cofinity Commercial |
$82.11
|
| Rate for Payer: Cofinity Commercial |
$53.52
|
| Rate for Payer: Cofinity Commercial |
$47.48
|
| Rate for Payer: Cofinity Commercial |
$43.56
|
| Rate for Payer: Cofinity Commercial |
$43.07
|
| Rate for Payer: Cofinity Commercial |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$62.38
|
| Rate for Payer: Cofinity Commercial |
$41.12
|
| Rate for Payer: Cofinity Commercial |
$45.52
|
| Rate for Payer: Cofinity Commercial |
$55.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$50.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$55.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.46
|
| Rate for Payer: Healthscope Commercial |
$61.05
|
| Rate for Payer: Healthscope Commercial |
$57.42
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Healthscope Commercial |
$85.93
|
| Rate for Payer: Healthscope Commercial |
$56.01
|
| Rate for Payer: Healthscope Commercial |
$55.38
|
| Rate for Payer: Healthscope Commercial |
$52.87
|
| Rate for Payer: Healthscope Commercial |
$80.39
|
| Rate for Payer: Healthscope Commercial |
$61.68
|
| Rate for Payer: Healthscope Commercial |
$65.28
|
| Rate for Payer: Healthscope Commercial |
$71.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.66
|
| Rate for Payer: PHP Commercial |
$75.92
|
| Rate for Payer: PHP Commercial |
$55.28
|
| Rate for Payer: PHP Commercial |
$81.16
|
| Rate for Payer: PHP Commercial |
$58.25
|
| Rate for Payer: PHP Commercial |
$54.23
|
| Rate for Payer: PHP Commercial |
$61.65
|
| Rate for Payer: PHP Commercial |
$67.11
|
| Rate for Payer: PHP Commercial |
$52.30
|
| Rate for Payer: PHP Commercial |
$49.93
|
| Rate for Payer: PHP Commercial |
$52.90
|
| Rate for Payer: PHP Commercial |
$57.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.45
|
| Rate for Payer: Priority Health SBD |
$40.97
|
| Rate for Payer: Priority Health SBD |
$45.69
|
| Rate for Payer: Priority Health SBD |
$56.27
|
| Rate for Payer: Priority Health SBD |
$42.73
|
| Rate for Payer: Priority Health SBD |
$49.74
|
| Rate for Payer: Priority Health SBD |
$40.19
|
| Rate for Payer: Priority Health SBD |
$60.15
|
| Rate for Payer: Priority Health SBD |
$43.17
|
| Rate for Payer: Priority Health SBD |
$39.20
|
| Rate for Payer: Priority Health SBD |
$37.01
|
| Rate for Payer: Priority Health SBD |
$38.76
|
| Rate for Payer: UMR Bronson Commercial |
$26.84
|
| Rate for Payer: UMR Bronson Commercial |
$25.10
|
| Rate for Payer: UMR Bronson Commercial |
$23.03
|
| Rate for Payer: UMR Bronson Commercial |
$35.33
|
| Rate for Payer: UMR Bronson Commercial |
$21.73
|
| Rate for Payer: UMR Bronson Commercial |
$22.77
|
| Rate for Payer: UMR Bronson Commercial |
$33.05
|
| Rate for Payer: UMR Bronson Commercial |
$23.61
|
| Rate for Payer: UMR Bronson Commercial |
$25.36
|
| Rate for Payer: UMR Bronson Commercial |
$24.06
|
| Rate for Payer: UMR Bronson Commercial |
$29.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.85
|
|
|
PROPOFOL 10 MG/ML INTRAVENOUS EMULSION
|
Facility
|
IP
|
$61.53
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
11150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.07 |
| Max. Negotiated Rate |
$55.38 |
| Rate for Payer: Aetna American Axle |
$39.99
|
| Rate for Payer: Aetna American Axle |
$41.47
|
| Rate for Payer: Aetna American Axle |
$38.18
|
| Rate for Payer: Aetna American Axle |
$44.09
|
| Rate for Payer: Aetna American Axle |
$44.54
|
| Rate for Payer: Aetna American Axle |
$42.27
|
| Rate for Payer: Aetna American Axle |
$47.14
|
| Rate for Payer: Aetna American Axle |
$51.32
|
| Rate for Payer: Aetna American Axle |
$58.06
|
| Rate for Payer: Aetna American Axle |
$62.06
|
| Rate for Payer: Aetna American Axle |
$40.45
|
| Rate for Payer: Aetna Commercial |
$58.25
|
| Rate for Payer: Aetna Commercial |
$61.65
|
| Rate for Payer: Aetna Commercial |
$52.90
|
| Rate for Payer: Aetna Commercial |
$81.16
|
| Rate for Payer: Aetna Commercial |
$57.66
|
| Rate for Payer: Aetna Commercial |
$54.23
|
| Rate for Payer: Aetna Commercial |
$52.30
|
| Rate for Payer: Aetna Commercial |
$49.93
|
| Rate for Payer: Aetna Commercial |
$75.92
|
| Rate for Payer: Aetna Commercial |
$55.28
|
| Rate for Payer: Aetna Commercial |
$67.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.45
|
| Rate for Payer: Cash Price |
$54.26
|
| Rate for Payer: Cash Price |
$49.22
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$46.99
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$76.38
|
| Rate for Payer: Cash Price |
$71.46
|
| Rate for Payer: Cash Price |
$63.16
|
| Rate for Payer: Cash Price |
$58.02
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cash Price |
$54.82
|
| Rate for Payer: Cofinity Commercial |
$44.66
|
| Rate for Payer: Cofinity Commercial |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$53.52
|
| Rate for Payer: Cofinity Commercial |
$52.92
|
| Rate for Payer: Cofinity Commercial |
$43.07
|
| Rate for Payer: Cofinity Commercial |
$43.56
|
| Rate for Payer: Cofinity Commercial |
$58.33
|
| Rate for Payer: Cofinity Commercial |
$45.52
|
| Rate for Payer: Cofinity Commercial |
$55.93
|
| Rate for Payer: Cofinity Commercial |
$62.52
|
| Rate for Payer: Cofinity Commercial |
$41.12
|
| Rate for Payer: Cofinity Commercial |
$58.94
|
| Rate for Payer: Cofinity Commercial |
$47.97
|
| Rate for Payer: Cofinity Commercial |
$47.48
|
| Rate for Payer: Cofinity Commercial |
$82.11
|
| Rate for Payer: Cofinity Commercial |
$66.84
|
| Rate for Payer: Cofinity Commercial |
$54.87
|
| Rate for Payer: Cofinity Commercial |
$67.90
|
| Rate for Payer: Cofinity Commercial |
$55.26
|
| Rate for Payer: Cofinity Commercial |
$76.82
|
| Rate for Payer: Cofinity Commercial |
$62.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$50.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$55.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.46
|
| Rate for Payer: Healthscope Commercial |
$61.05
|
| Rate for Payer: Healthscope Commercial |
$52.87
|
| Rate for Payer: Healthscope Commercial |
$55.38
|
| Rate for Payer: Healthscope Commercial |
$56.01
|
| Rate for Payer: Healthscope Commercial |
$57.42
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Healthscope Commercial |
$61.68
|
| Rate for Payer: Healthscope Commercial |
$65.28
|
| Rate for Payer: Healthscope Commercial |
$71.06
|
| Rate for Payer: Healthscope Commercial |
$80.39
|
| Rate for Payer: Healthscope Commercial |
$85.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.16
|
| Rate for Payer: PHP Commercial |
$49.93
|
| Rate for Payer: PHP Commercial |
$55.28
|
| Rate for Payer: PHP Commercial |
$67.11
|
| Rate for Payer: PHP Commercial |
$54.23
|
| Rate for Payer: PHP Commercial |
$57.66
|
| Rate for Payer: PHP Commercial |
$75.92
|
| Rate for Payer: PHP Commercial |
$58.25
|
| Rate for Payer: PHP Commercial |
$81.16
|
| Rate for Payer: PHP Commercial |
$52.30
|
| Rate for Payer: PHP Commercial |
$52.90
|
| Rate for Payer: PHP Commercial |
$61.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.09
|
| Rate for Payer: Priority Health SBD |
$38.76
|
| Rate for Payer: Priority Health SBD |
$39.20
|
| Rate for Payer: Priority Health SBD |
$56.27
|
| Rate for Payer: Priority Health SBD |
$60.15
|
| Rate for Payer: Priority Health SBD |
$40.97
|
| Rate for Payer: Priority Health SBD |
$42.73
|
| Rate for Payer: Priority Health SBD |
$43.17
|
| Rate for Payer: Priority Health SBD |
$40.19
|
| Rate for Payer: Priority Health SBD |
$49.74
|
| Rate for Payer: Priority Health SBD |
$37.01
|
| Rate for Payer: Priority Health SBD |
$45.69
|
| Rate for Payer: UMR Bronson Commercial |
$34.74
|
| Rate for Payer: UMR Bronson Commercial |
$27.07
|
| Rate for Payer: UMR Bronson Commercial |
$42.01
|
| Rate for Payer: UMR Bronson Commercial |
$31.91
|
| Rate for Payer: UMR Bronson Commercial |
$27.38
|
| Rate for Payer: UMR Bronson Commercial |
$29.85
|
| Rate for Payer: UMR Bronson Commercial |
$39.30
|
| Rate for Payer: UMR Bronson Commercial |
$25.85
|
| Rate for Payer: UMR Bronson Commercial |
$28.07
|
| Rate for Payer: UMR Bronson Commercial |
$30.15
|
| Rate for Payer: UMR Bronson Commercial |
$28.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.87
|
|
|
PROPOFOL 10 MG/ML IV (CODE)
|
Facility
|
IP
|
$65.03
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
163729
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.61 |
| Max. Negotiated Rate |
$58.53 |
| Rate for Payer: Aetna American Axle |
$42.27
|
| Rate for Payer: Aetna American Axle |
$44.54
|
| Rate for Payer: Aetna Commercial |
$55.28
|
| Rate for Payer: Aetna Commercial |
$58.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.54
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cash Price |
$54.82
|
| Rate for Payer: Cofinity Commercial |
$58.94
|
| Rate for Payer: Cofinity Commercial |
$47.97
|
| Rate for Payer: Cofinity Commercial |
$45.52
|
| Rate for Payer: Cofinity Commercial |
$55.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.82
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Healthscope Commercial |
$61.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.28
|
| Rate for Payer: PHP Commercial |
$58.25
|
| Rate for Payer: PHP Commercial |
$55.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.54
|
| Rate for Payer: Priority Health SBD |
$40.97
|
| Rate for Payer: Priority Health SBD |
$43.17
|
| Rate for Payer: UMR Bronson Commercial |
$28.61
|
| Rate for Payer: UMR Bronson Commercial |
$30.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.40
|
|
|
PROPOFOL 10 MG/ML IV (CODE)
|
Facility
|
OP
|
$65.03
|
|
|
Service Code
|
HCPCS J2704
|
| Hospital Charge Code |
163729
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$58.53 |
| Rate for Payer: Aetna American Axle |
$42.27
|
| Rate for Payer: Aetna American Axle |
$44.54
|
| Rate for Payer: Aetna Commercial |
$58.25
|
| Rate for Payer: Aetna Commercial |
$55.28
|
| Rate for Payer: Aetna Medicare |
$32.52
|
| Rate for Payer: Aetna Medicare |
$34.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.54
|
| Rate for Payer: BCBS Complete |
$27.41
|
| Rate for Payer: BCBS Complete |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: Cash Price |
$54.82
|
| Rate for Payer: Cash Price |
$54.82
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cash Price |
$52.02
|
| Rate for Payer: Cofinity Commercial |
$58.94
|
| Rate for Payer: Cofinity Commercial |
$45.52
|
| Rate for Payer: Cofinity Commercial |
$47.97
|
| Rate for Payer: Cofinity Commercial |
$55.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.02
|
| Rate for Payer: Healthscope Commercial |
$61.68
|
| Rate for Payer: Healthscope Commercial |
$58.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.25
|
| Rate for Payer: PHP Commercial |
$55.28
|
| Rate for Payer: PHP Commercial |
$58.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.54
|
| Rate for Payer: Priority Health SBD |
$43.17
|
| Rate for Payer: Priority Health SBD |
$40.97
|
| Rate for Payer: UMR Bronson Commercial |
$24.06
|
| Rate for Payer: UMR Bronson Commercial |
$25.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.77
|
|
