|
BUDESONIDE 0.5 MG/2 ML ORAL SUSPENSION
|
Facility
|
OP
|
$7.89
|
|
|
Service Code
|
NDC 00093681673
|
| Hospital Charge Code |
180108
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.92 |
| Max. Negotiated Rate |
$7.10 |
| Rate for Payer: Aetna American Axle |
$5.13
|
| Rate for Payer: Aetna Commercial |
$6.71
|
| Rate for Payer: Aetna Medicare |
$3.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.13
|
| Rate for Payer: BCBS Complete |
$3.16
|
| Rate for Payer: Cash Price |
$6.31
|
| Rate for Payer: Cofinity Commercial |
$5.52
|
| Rate for Payer: Cofinity Commercial |
$6.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.31
|
| Rate for Payer: Healthscope Commercial |
$7.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.71
|
| Rate for Payer: PHP Commercial |
$6.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.13
|
| Rate for Payer: Priority Health SBD |
$4.97
|
| Rate for Payer: UMR Bronson Commercial |
$2.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.92
|
|
|
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION
|
Facility
|
OP
|
$8.64
|
|
|
Service Code
|
HCPCS J7626
|
| Hospital Charge Code |
28775
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$7.78 |
| Rate for Payer: Cofinity Medicare Advantage |
$6.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.89
|
| Rate for Payer: Priority Health SBD |
$4.97
|
| Rate for Payer: UMR Bronson Commercial |
$2.92
|
| Rate for Payer: UMR Bronson Commercial |
$3.80
|
| Rate for Payer: UMR Bronson Commercial |
$6.37
|
| Rate for Payer: UMR Bronson Commercial |
$3.80
|
| Rate for Payer: UMR Bronson Commercial |
$11.88
|
| Rate for Payer: UMR Bronson Commercial |
$3.20
|
| Rate for Payer: UMR Bronson Commercial |
$11.83
|
| Rate for Payer: UMR Bronson Commercial |
$13.68
|
| Rate for Payer: Aetna American Axle |
$5.62
|
| Rate for Payer: Aetna American Axle |
$5.13
|
| Rate for Payer: Aetna American Axle |
$20.88
|
| Rate for Payer: Aetna American Axle |
$20.78
|
| Rate for Payer: Aetna American Axle |
$24.04
|
| Rate for Payer: Aetna American Axle |
$6.68
|
| Rate for Payer: Aetna American Axle |
$11.19
|
| Rate for Payer: Aetna American Axle |
$6.68
|
| Rate for Payer: Aetna Commercial |
$8.74
|
| Rate for Payer: Aetna Commercial |
$14.63
|
| Rate for Payer: Aetna Commercial |
$8.73
|
| Rate for Payer: Aetna Commercial |
$27.30
|
| Rate for Payer: Aetna Commercial |
$27.17
|
| Rate for Payer: Aetna Commercial |
$31.43
|
| Rate for Payer: Aetna Commercial |
$6.71
|
| Rate for Payer: Aetna Commercial |
$7.34
|
| Rate for Payer: Aetna Medicare |
$15.98
|
| Rate for Payer: Aetna Medicare |
$8.60
|
| Rate for Payer: Aetna Medicare |
$3.94
|
| Rate for Payer: Aetna Medicare |
$5.14
|
| Rate for Payer: Aetna Medicare |
$4.32
|
| Rate for Payer: Aetna Medicare |
$16.06
|
| Rate for Payer: Aetna Medicare |
$5.14
|
| Rate for Payer: Aetna Medicare |
$18.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.88
|
| Rate for Payer: BCBS Complete |
$3.46
|
| Rate for Payer: BCBS Complete |
$14.79
|
| Rate for Payer: BCBS Complete |
$12.79
|
| Rate for Payer: BCBS Complete |
$4.11
|
| Rate for Payer: BCBS Complete |
$4.11
|
| Rate for Payer: BCBS Complete |
$6.88
|
| Rate for Payer: BCBS Complete |
$3.16
|
| Rate for Payer: BCBS Complete |
$12.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.31
|
| Rate for Payer: BCBS Trust/PPO |
$3.31
|
| Rate for Payer: BCBS Trust/PPO |
$3.31
|
| Rate for Payer: BCBS Trust/PPO |
$3.31
|
| Rate for Payer: BCBS Trust/PPO |
$3.31
|
| Rate for Payer: BCBS Trust/PPO |
$3.31
|
| Rate for Payer: BCBS Trust/PPO |
$3.31
|
| Rate for Payer: BCBS Trust/PPO |
$3.31
|
| Rate for Payer: BCN Commercial |
$3.31
|
| Rate for Payer: BCN Commercial |
$3.31
|
| Rate for Payer: BCN Commercial |
$3.31
|
| Rate for Payer: BCN Commercial |
$3.31
|
| Rate for Payer: BCN Commercial |
$3.31
|
| Rate for Payer: BCN Commercial |
$3.31
|
| Rate for Payer: BCN Commercial |
$3.31
|
| Rate for Payer: BCN Commercial |
$3.31
|
| Rate for Payer: Cash Price |
$8.22
|
| Rate for Payer: Cash Price |
$13.77
|
| Rate for Payer: Cash Price |
$8.22
|
| Rate for Payer: Cash Price |
$13.77
|
| Rate for Payer: Cash Price |
$8.22
|
| Rate for Payer: Cash Price |
$8.22
|
| Rate for Payer: Cash Price |
$25.58
|
| Rate for Payer: Cash Price |
$25.58
|
| Rate for Payer: Cash Price |
$25.70
|
| Rate for Payer: Cash Price |
$25.70
|
| Rate for Payer: Cash Price |
$29.58
|
| Rate for Payer: Cash Price |
$29.58
|
| Rate for Payer: Cash Price |
$6.31
|
| Rate for Payer: Cash Price |
$6.31
|
| Rate for Payer: Cash Price |
$6.91
|
| Rate for Payer: Cash Price |
$6.91
|
| Rate for Payer: Cofinity Commercial |
$12.05
|
| Rate for Payer: Cofinity Commercial |
$22.38
|
| Rate for Payer: Cofinity Commercial |
$27.49
|
| Rate for Payer: Cofinity Commercial |
$22.48
|
| Rate for Payer: Cofinity Commercial |
$5.52
|
| Rate for Payer: Cofinity Commercial |
$27.62
|
| Rate for Payer: Cofinity Commercial |
$14.80
|
| Rate for Payer: Cofinity Commercial |
$7.20
|
| Rate for Payer: Cofinity Commercial |
$8.83
|
| Rate for Payer: Cofinity Commercial |
$31.80
|
| Rate for Payer: Cofinity Commercial |
$25.89
|
| Rate for Payer: Cofinity Commercial |
$6.79
|
| Rate for Payer: Cofinity Commercial |
$7.43
|
| Rate for Payer: Cofinity Commercial |
$6.05
|
| Rate for Payer: Cofinity Commercial |
$8.84
|
| Rate for Payer: Cofinity Commercial |
$7.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.70
|
| Rate for Payer: Healthscope Commercial |
$15.49
|
| Rate for Payer: Healthscope Commercial |
$9.25
|
| Rate for Payer: Healthscope Commercial |
$7.78
|
| Rate for Payer: Healthscope Commercial |
$28.77
|
| Rate for Payer: Healthscope Commercial |
$28.91
|
| Rate for Payer: Healthscope Commercial |
$7.10
|
| Rate for Payer: Healthscope Commercial |
$9.24
|
| Rate for Payer: Healthscope Commercial |
$33.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.17
|
| Rate for Payer: PHP Commercial |
$6.71
|
| Rate for Payer: PHP Commercial |
$7.34
|
| Rate for Payer: PHP Commercial |
$31.43
|
| Rate for Payer: PHP Commercial |
$27.30
|
| Rate for Payer: PHP Commercial |
$8.73
|
| Rate for Payer: PHP Commercial |
$14.63
|
| Rate for Payer: PHP Commercial |
$27.17
|
| Rate for Payer: PHP Commercial |
$8.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.41
|
| Rate for Payer: Priority Health Narrow Network |
$1.13
|
| Rate for Payer: Priority Health Narrow Network |
$1.13
|
| Rate for Payer: Priority Health Narrow Network |
$1.13
|
| Rate for Payer: Priority Health Narrow Network |
$1.13
|
| Rate for Payer: Priority Health Narrow Network |
$1.13
|
| Rate for Payer: Priority Health Narrow Network |
$1.13
|
| Rate for Payer: Priority Health Narrow Network |
$1.13
|
| Rate for Payer: Priority Health Narrow Network |
$1.13
|
| Rate for Payer: Priority Health SBD |
$20.24
|
| Rate for Payer: Priority Health SBD |
$20.14
|
| Rate for Payer: Priority Health SBD |
$23.30
|
| Rate for Payer: Priority Health SBD |
$6.47
|
| Rate for Payer: Priority Health SBD |
$10.84
|
| Rate for Payer: Priority Health SBD |
$6.48
|
| Rate for Payer: Priority Health SBD |
$5.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.70
|
|
|
BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION
|
Facility
|
IP
|
$7.89
|
|
|
Service Code
|
HCPCS J7626
|
| Hospital Charge Code |
28775
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$7.10 |
| Rate for Payer: Cofinity Commercial |
$25.89
|
| Rate for Payer: Cofinity Commercial |
$31.80
|
| Rate for Payer: Cofinity Commercial |
$5.52
|
| Rate for Payer: Cofinity Commercial |
$6.79
|
| Rate for Payer: Cofinity Commercial |
$6.05
|
| Rate for Payer: Cofinity Commercial |
$7.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.89
|
| Rate for Payer: Aetna American Axle |
$5.13
|
| Rate for Payer: Aetna American Axle |
$24.04
|
| Rate for Payer: Aetna American Axle |
$20.88
|
| Rate for Payer: Aetna American Axle |
$11.19
|
| Rate for Payer: Aetna American Axle |
$6.68
|
| Rate for Payer: Aetna American Axle |
$6.68
|
| Rate for Payer: Aetna American Axle |
$20.78
|
| Rate for Payer: Aetna American Axle |
$5.62
|
| Rate for Payer: Aetna Commercial |
$7.34
|
| Rate for Payer: Aetna Commercial |
$6.71
|
| Rate for Payer: Aetna Commercial |
$14.63
|
| Rate for Payer: Aetna Commercial |
$27.17
|
| Rate for Payer: Aetna Commercial |
$8.74
|
| Rate for Payer: Aetna Commercial |
$8.73
|
| Rate for Payer: Aetna Commercial |
$31.43
|
| Rate for Payer: Aetna Commercial |
$27.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.88
|
| Rate for Payer: Cash Price |
$25.58
|
| Rate for Payer: Cash Price |
$6.31
|
| Rate for Payer: Cash Price |
$25.70
|
| Rate for Payer: Cash Price |
$6.91
|
| Rate for Payer: Cash Price |
$8.22
|
| Rate for Payer: Cash Price |
$13.77
|
| Rate for Payer: Cash Price |
$8.22
|
| Rate for Payer: Cash Price |
$29.58
|
| Rate for Payer: Cofinity Commercial |
$27.49
|
| Rate for Payer: Cofinity Commercial |
$7.19
|
| Rate for Payer: Cofinity Commercial |
$22.38
|
| Rate for Payer: Cofinity Commercial |
$12.05
|
| Rate for Payer: Cofinity Commercial |
$7.20
|
| Rate for Payer: Cofinity Commercial |
$8.84
|
| Rate for Payer: Cofinity Commercial |
$14.80
|
| Rate for Payer: Cofinity Commercial |
$8.83
|
| Rate for Payer: Cofinity Commercial |
$22.48
|
| Rate for Payer: Cofinity Commercial |
$27.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.77
|
| Rate for Payer: Healthscope Commercial |
$9.24
|
| Rate for Payer: Healthscope Commercial |
$7.78
|
| Rate for Payer: Healthscope Commercial |
$7.10
|
| Rate for Payer: Healthscope Commercial |
$28.91
|
| Rate for Payer: Healthscope Commercial |
$33.28
|
| Rate for Payer: Healthscope Commercial |
$28.77
|
| Rate for Payer: Healthscope Commercial |
$15.49
|
| Rate for Payer: Healthscope Commercial |
$9.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.63
|
| Rate for Payer: PHP Commercial |
$6.71
|
| Rate for Payer: PHP Commercial |
$14.63
|
| Rate for Payer: PHP Commercial |
$31.43
|
| Rate for Payer: PHP Commercial |
$27.17
|
| Rate for Payer: PHP Commercial |
$7.34
|
| Rate for Payer: PHP Commercial |
$8.73
|
| Rate for Payer: PHP Commercial |
$27.30
|
| Rate for Payer: PHP Commercial |
$8.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.19
|
| Rate for Payer: Priority Health SBD |
$10.84
|
| Rate for Payer: Priority Health SBD |
$6.48
|
| Rate for Payer: Priority Health SBD |
$6.47
|
| Rate for Payer: Priority Health SBD |
$20.14
|
| Rate for Payer: Priority Health SBD |
$23.30
|
| Rate for Payer: Priority Health SBD |
$20.24
|
| Rate for Payer: Priority Health SBD |
$5.44
|
| Rate for Payer: Priority Health SBD |
$4.97
|
| Rate for Payer: UMR Bronson Commercial |
$7.57
|
| Rate for Payer: UMR Bronson Commercial |
$14.07
|
| Rate for Payer: UMR Bronson Commercial |
$16.27
|
| Rate for Payer: UMR Bronson Commercial |
$3.47
|
| Rate for Payer: UMR Bronson Commercial |
$4.52
|
| Rate for Payer: UMR Bronson Commercial |
$3.80
|
| Rate for Payer: UMR Bronson Commercial |
$14.13
|
| Rate for Payer: UMR Bronson Commercial |
$4.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.09
|
|
|
BUDESONIDE 180 MCG/ACTUATION BREATH ACTIVATED POWDER INHALER
|
Facility
|
IP
|
$861.28
|
|
|
Service Code
|
NDC 00186091612
|
| Hospital Charge Code |
96977
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$378.96 |
| Max. Negotiated Rate |
$775.15 |
| Rate for Payer: Aetna American Axle |
$559.83
|
| Rate for Payer: Aetna Commercial |
$732.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.83
|
| Rate for Payer: Cash Price |
$689.02
|
| Rate for Payer: Cofinity Commercial |
$602.90
|
| Rate for Payer: Cofinity Commercial |
$740.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$602.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$689.02
|
| Rate for Payer: Healthscope Commercial |
$775.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$602.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$645.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$732.09
|
| Rate for Payer: PHP Commercial |
$732.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$559.83
|
| Rate for Payer: Priority Health SBD |
$542.61
|
| Rate for Payer: UMR Bronson Commercial |
$378.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$645.96
|
|
|
BUDESONIDE 180 MCG/ACTUATION BREATH ACTIVATED POWDER INHALER
|
Facility
|
OP
|
$861.28
|
|
|
Service Code
|
NDC 00186091612
|
| Hospital Charge Code |
96977
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$318.67 |
| Max. Negotiated Rate |
$775.15 |
| Rate for Payer: Aetna American Axle |
$559.83
|
| Rate for Payer: Aetna Commercial |
$732.09
|
| Rate for Payer: Aetna Medicare |
$430.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.83
|
| Rate for Payer: BCBS Complete |
$344.51
|
| Rate for Payer: Cash Price |
$689.02
|
| Rate for Payer: Cofinity Commercial |
$602.90
|
| Rate for Payer: Cofinity Commercial |
$740.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$602.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$689.02
|
| Rate for Payer: Healthscope Commercial |
$775.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$602.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$645.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$732.09
|
| Rate for Payer: PHP Commercial |
$732.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$559.83
|
| Rate for Payer: Priority Health SBD |
$542.61
|
| Rate for Payer: UMR Bronson Commercial |
$318.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$645.96
|
|
|
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION
|
Facility
|
IP
|
$10.28
|
|
|
Service Code
|
HCPCS J7626
|
| Hospital Charge Code |
88223
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.52 |
| Max. Negotiated Rate |
$9.25 |
| Rate for Payer: Aetna American Axle |
$6.68
|
| Rate for Payer: Aetna American Axle |
$20.56
|
| Rate for Payer: Aetna American Axle |
$48.09
|
| Rate for Payer: Aetna Commercial |
$26.89
|
| Rate for Payer: Aetna Commercial |
$8.74
|
| Rate for Payer: Aetna Commercial |
$62.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.56
|
| Rate for Payer: Cash Price |
$59.18
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cash Price |
$8.22
|
| Rate for Payer: Cofinity Commercial |
$8.84
|
| Rate for Payer: Cofinity Commercial |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$22.14
|
| Rate for Payer: Cofinity Commercial |
$63.62
|
| Rate for Payer: Cofinity Commercial |
$51.79
|
| Rate for Payer: Cofinity Commercial |
$7.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$28.47
|
| Rate for Payer: Healthscope Commercial |
$9.25
|
| Rate for Payer: Healthscope Commercial |
$66.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.89
|
| Rate for Payer: PHP Commercial |
$62.88
|
| Rate for Payer: PHP Commercial |
$26.89
|
| Rate for Payer: PHP Commercial |
$8.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.68
|
| Rate for Payer: Priority Health SBD |
$46.61
|
| Rate for Payer: Priority Health SBD |
$19.93
|
| Rate for Payer: Priority Health SBD |
$6.48
|
| Rate for Payer: UMR Bronson Commercial |
$4.52
|
| Rate for Payer: UMR Bronson Commercial |
$32.55
|
| Rate for Payer: UMR Bronson Commercial |
$13.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.72
|
|
|
BUDESONIDE 1 MG/2 ML SUSPENSION FOR NEBULIZATION
|
Facility
|
OP
|
$10.28
|
|
|
Service Code
|
HCPCS J7626
|
| Hospital Charge Code |
88223
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$9.25 |
| Rate for Payer: Aetna American Axle |
$6.68
|
| Rate for Payer: Aetna American Axle |
$20.56
|
| Rate for Payer: Aetna American Axle |
$48.09
|
| Rate for Payer: Aetna Commercial |
$26.89
|
| Rate for Payer: Aetna Commercial |
$62.88
|
| Rate for Payer: Aetna Commercial |
$8.74
|
| Rate for Payer: Aetna Medicare |
$36.99
|
| Rate for Payer: Aetna Medicare |
$15.82
|
| Rate for Payer: Aetna Medicare |
$5.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.56
|
| Rate for Payer: BCBS Complete |
$4.11
|
| Rate for Payer: BCBS Complete |
$29.59
|
| Rate for Payer: BCBS Complete |
$12.65
|
| Rate for Payer: BCBS Trust/PPO |
$3.31
|
| Rate for Payer: BCBS Trust/PPO |
$3.31
|
| Rate for Payer: BCBS Trust/PPO |
$3.31
|
| Rate for Payer: BCN Commercial |
$3.31
|
| Rate for Payer: BCN Commercial |
$3.31
|
| Rate for Payer: BCN Commercial |
$3.31
|
| Rate for Payer: Cash Price |
$59.18
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cash Price |
$59.18
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cash Price |
$8.22
|
| Rate for Payer: Cash Price |
$8.22
|
| Rate for Payer: Cofinity Commercial |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$7.20
|
| Rate for Payer: Cofinity Commercial |
$63.62
|
| Rate for Payer: Cofinity Commercial |
$22.14
|
| Rate for Payer: Cofinity Commercial |
$51.79
|
| Rate for Payer: Cofinity Commercial |
$8.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$9.25
|
| Rate for Payer: Healthscope Commercial |
$66.58
|
| Rate for Payer: Healthscope Commercial |
$28.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.74
|
| Rate for Payer: PHP Commercial |
$62.88
|
| Rate for Payer: PHP Commercial |
$26.89
|
| Rate for Payer: PHP Commercial |
$8.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.41
|
| Rate for Payer: Priority Health Narrow Network |
$1.13
|
| Rate for Payer: Priority Health Narrow Network |
$1.13
|
| Rate for Payer: Priority Health Narrow Network |
$1.13
|
| Rate for Payer: Priority Health SBD |
$6.48
|
| Rate for Payer: Priority Health SBD |
$19.93
|
| Rate for Payer: Priority Health SBD |
$46.61
|
| Rate for Payer: UMR Bronson Commercial |
$3.80
|
| Rate for Payer: UMR Bronson Commercial |
$11.70
|
| Rate for Payer: UMR Bronson Commercial |
$27.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.72
|
|
|
BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE
|
Facility
|
OP
|
$317.76
|
|
|
Service Code
|
NDC 65162077810
|
| Hospital Charge Code |
31576
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$117.57 |
| Max. Negotiated Rate |
$285.98 |
| Rate for Payer: Aetna American Axle |
$206.54
|
| Rate for Payer: Aetna Commercial |
$270.10
|
| Rate for Payer: Aetna Medicare |
$158.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.54
|
| Rate for Payer: BCBS Complete |
$127.10
|
| Rate for Payer: Cash Price |
$254.21
|
| Rate for Payer: Cofinity Commercial |
$222.43
|
| Rate for Payer: Cofinity Commercial |
$273.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$222.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.21
|
| Rate for Payer: Healthscope Commercial |
$285.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$222.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$238.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$270.10
|
| Rate for Payer: PHP Commercial |
$270.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.54
|
| Rate for Payer: Priority Health SBD |
$200.19
|
| Rate for Payer: UMR Bronson Commercial |
$117.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$238.32
|
|
|
BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE
|
Facility
|
IP
|
$1,529.58
|
|
|
Service Code
|
NDC 00378715501
|
| Hospital Charge Code |
31576
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$673.02 |
| Max. Negotiated Rate |
$1,376.62 |
| Rate for Payer: Aetna American Axle |
$994.23
|
| Rate for Payer: Aetna Commercial |
$1,300.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.23
|
| Rate for Payer: Cash Price |
$1,223.66
|
| Rate for Payer: Cofinity Commercial |
$1,070.71
|
| Rate for Payer: Cofinity Commercial |
$1,315.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,070.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,223.66
|
| Rate for Payer: Healthscope Commercial |
$1,376.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,070.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.14
|
| Rate for Payer: PHP Commercial |
$1,300.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.23
|
| Rate for Payer: Priority Health SBD |
$963.64
|
| Rate for Payer: UMR Bronson Commercial |
$673.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.18
|
|
|
BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE
|
Facility
|
IP
|
$317.76
|
|
|
Service Code
|
NDC 65162077810
|
| Hospital Charge Code |
31576
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$139.81 |
| Max. Negotiated Rate |
$285.98 |
| Rate for Payer: Aetna American Axle |
$206.54
|
| Rate for Payer: Aetna Commercial |
$270.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.54
|
| Rate for Payer: Cash Price |
$254.21
|
| Rate for Payer: Cofinity Commercial |
$222.43
|
| Rate for Payer: Cofinity Commercial |
$273.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$222.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.21
|
| Rate for Payer: Healthscope Commercial |
$285.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$222.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$238.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$270.10
|
| Rate for Payer: PHP Commercial |
$270.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.54
|
| Rate for Payer: Priority Health SBD |
$200.19
|
| Rate for Payer: UMR Bronson Commercial |
$139.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$238.32
|
|
|
BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE
|
Facility
|
IP
|
$440.64
|
|
|
Service Code
|
NDC 00574985510
|
| Hospital Charge Code |
31576
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$193.88 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna American Axle |
$286.42
|
| Rate for Payer: Aetna Commercial |
$374.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.42
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$378.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$308.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$308.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: PHP Commercial |
$374.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health SBD |
$277.60
|
| Rate for Payer: UMR Bronson Commercial |
$193.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.48
|
|
|
BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE
|
Facility
|
OP
|
$1,529.58
|
|
|
Service Code
|
NDC 00378715501
|
| Hospital Charge Code |
31576
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$565.94 |
| Max. Negotiated Rate |
$1,376.62 |
| Rate for Payer: Aetna American Axle |
$994.23
|
| Rate for Payer: Aetna Commercial |
$1,300.14
|
| Rate for Payer: Aetna Medicare |
$764.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.23
|
| Rate for Payer: BCBS Complete |
$611.83
|
| Rate for Payer: Cash Price |
$1,223.66
|
| Rate for Payer: Cofinity Commercial |
$1,070.71
|
| Rate for Payer: Cofinity Commercial |
$1,315.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,070.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,223.66
|
| Rate for Payer: Healthscope Commercial |
$1,376.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,070.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.14
|
| Rate for Payer: PHP Commercial |
$1,300.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.23
|
| Rate for Payer: Priority Health SBD |
$963.64
|
| Rate for Payer: UMR Bronson Commercial |
$565.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.18
|
|
|
BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE
|
Facility
|
OP
|
$440.64
|
|
|
Service Code
|
NDC 00574985510
|
| Hospital Charge Code |
31576
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$163.04 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna American Axle |
$286.42
|
| Rate for Payer: Aetna Commercial |
$374.54
|
| Rate for Payer: Aetna Medicare |
$220.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.42
|
| Rate for Payer: BCBS Complete |
$176.26
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$378.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$308.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$308.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: PHP Commercial |
$374.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health SBD |
$277.60
|
| Rate for Payer: UMR Bronson Commercial |
$163.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.48
|
|
|
BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$185.64
|
|
|
Service Code
|
NDC 00186037028
|
| Hospital Charge Code |
81454
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.68 |
| Max. Negotiated Rate |
$167.08 |
| Rate for Payer: Aetna American Axle |
$120.67
|
| Rate for Payer: Aetna Commercial |
$157.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.67
|
| Rate for Payer: Cash Price |
$148.51
|
| Rate for Payer: Cofinity Commercial |
$129.95
|
| Rate for Payer: Cofinity Commercial |
$159.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$129.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.51
|
| Rate for Payer: Healthscope Commercial |
$167.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.79
|
| Rate for Payer: PHP Commercial |
$157.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.67
|
| Rate for Payer: Priority Health SBD |
$116.95
|
| Rate for Payer: UMR Bronson Commercial |
$81.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.23
|
|
|
BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$185.64
|
|
|
Service Code
|
NDC 00186037028
|
| Hospital Charge Code |
81454
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$68.69 |
| Max. Negotiated Rate |
$167.08 |
| Rate for Payer: Aetna American Axle |
$120.67
|
| Rate for Payer: Aetna Commercial |
$157.79
|
| Rate for Payer: Aetna Medicare |
$92.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.67
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: Cash Price |
$148.51
|
| Rate for Payer: Cofinity Commercial |
$129.95
|
| Rate for Payer: Cofinity Commercial |
$159.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$129.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.51
|
| Rate for Payer: Healthscope Commercial |
$167.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.79
|
| Rate for Payer: PHP Commercial |
$157.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.67
|
| Rate for Payer: Priority Health SBD |
$116.95
|
| Rate for Payer: UMR Bronson Commercial |
$68.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.23
|
|
|
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
OP
|
$185.64
|
|
|
Service Code
|
NDC 00186037228
|
| Hospital Charge Code |
81453
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$68.69 |
| Max. Negotiated Rate |
$167.08 |
| Rate for Payer: Aetna American Axle |
$120.67
|
| Rate for Payer: Aetna Commercial |
$157.79
|
| Rate for Payer: Aetna Medicare |
$92.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.67
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: Cash Price |
$148.51
|
| Rate for Payer: Cofinity Commercial |
$129.95
|
| Rate for Payer: Cofinity Commercial |
$159.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$129.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.51
|
| Rate for Payer: Healthscope Commercial |
$167.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.79
|
| Rate for Payer: PHP Commercial |
$157.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.67
|
| Rate for Payer: Priority Health SBD |
$116.95
|
| Rate for Payer: UMR Bronson Commercial |
$68.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.23
|
|
|
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER
|
Facility
|
IP
|
$185.64
|
|
|
Service Code
|
NDC 00186037228
|
| Hospital Charge Code |
81453
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.68 |
| Max. Negotiated Rate |
$167.08 |
| Rate for Payer: Aetna American Axle |
$120.67
|
| Rate for Payer: Aetna Commercial |
$157.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.67
|
| Rate for Payer: Cash Price |
$148.51
|
| Rate for Payer: Cofinity Commercial |
$129.95
|
| Rate for Payer: Cofinity Commercial |
$159.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$129.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.51
|
| Rate for Payer: Healthscope Commercial |
$167.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.79
|
| Rate for Payer: PHP Commercial |
$157.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.67
|
| Rate for Payer: Priority Health SBD |
$116.95
|
| Rate for Payer: UMR Bronson Commercial |
$81.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.23
|
|
|
BUFFERED LIDOCAINE 1% SOLUTION CUSTOM
|
Facility
|
OP
|
$4.92
|
|
|
Service Code
|
NDC 00990000106
|
| Hospital Charge Code |
500546
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$4.43 |
| Rate for Payer: Aetna American Axle |
$3.20
|
| Rate for Payer: Aetna Commercial |
$4.18
|
| Rate for Payer: Aetna Medicare |
$2.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.20
|
| Rate for Payer: BCBS Complete |
$1.97
|
| Rate for Payer: Cash Price |
$3.94
|
| Rate for Payer: Cofinity Commercial |
$3.44
|
| Rate for Payer: Cofinity Commercial |
$4.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.94
|
| Rate for Payer: Healthscope Commercial |
$4.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.18
|
| Rate for Payer: PHP Commercial |
$4.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.20
|
| Rate for Payer: Priority Health SBD |
$3.10
|
| Rate for Payer: UMR Bronson Commercial |
$1.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.69
|
|
|
BUFFERED LIDOCAINE 1% SOLUTION CUSTOM
|
Facility
|
IP
|
$4.92
|
|
|
Service Code
|
NDC 00990000106
|
| Hospital Charge Code |
500546
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$4.43 |
| Rate for Payer: Aetna American Axle |
$3.20
|
| Rate for Payer: Aetna Commercial |
$4.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.20
|
| Rate for Payer: Cash Price |
$3.94
|
| Rate for Payer: Cofinity Commercial |
$3.44
|
| Rate for Payer: Cofinity Commercial |
$4.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.94
|
| Rate for Payer: Healthscope Commercial |
$4.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.18
|
| Rate for Payer: PHP Commercial |
$4.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.20
|
| Rate for Payer: Priority Health SBD |
$3.10
|
| Rate for Payer: UMR Bronson Commercial |
$2.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.69
|
|
|
BUFFERED LIDOCAINE 1% WITH EPI
|
Facility
|
OP
|
$16.56
|
|
|
Service Code
|
NDC 09900000149
|
| Hospital Charge Code |
500548
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.13 |
| Max. Negotiated Rate |
$14.90 |
| Rate for Payer: Aetna American Axle |
$10.76
|
| Rate for Payer: Aetna Commercial |
$14.08
|
| Rate for Payer: Aetna Medicare |
$8.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.76
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: Cash Price |
$13.25
|
| Rate for Payer: Cofinity Commercial |
$11.59
|
| Rate for Payer: Cofinity Commercial |
$14.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$14.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.08
|
| Rate for Payer: PHP Commercial |
$14.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.76
|
| Rate for Payer: Priority Health SBD |
$10.43
|
| Rate for Payer: UMR Bronson Commercial |
$6.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.42
|
|
|
BUFFERED LIDOCAINE 1% WITH EPI
|
Facility
|
IP
|
$16.56
|
|
|
Service Code
|
NDC 09900000149
|
| Hospital Charge Code |
500548
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.29 |
| Max. Negotiated Rate |
$14.90 |
| Rate for Payer: Aetna American Axle |
$10.76
|
| Rate for Payer: Aetna Commercial |
$14.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.76
|
| Rate for Payer: Cash Price |
$13.25
|
| Rate for Payer: Cofinity Commercial |
$11.59
|
| Rate for Payer: Cofinity Commercial |
$14.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$14.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.08
|
| Rate for Payer: PHP Commercial |
$14.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.76
|
| Rate for Payer: Priority Health SBD |
$10.43
|
| Rate for Payer: UMR Bronson Commercial |
$7.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.42
|
|
|
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$23.74
|
|
|
Service Code
|
HCPCS J1939
|
| Hospital Charge Code |
9308
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$21.37 |
| Rate for Payer: Aetna American Axle |
$15.43
|
| Rate for Payer: Aetna American Axle |
$14.53
|
| Rate for Payer: Aetna American Axle |
$14.96
|
| Rate for Payer: Aetna American Axle |
$15.80
|
| Rate for Payer: Aetna American Axle |
$16.96
|
| Rate for Payer: Aetna American Axle |
$18.70
|
| Rate for Payer: Aetna American Axle |
$16.59
|
| Rate for Payer: Aetna American Axle |
$15.68
|
| Rate for Payer: Aetna American Axle |
$18.95
|
| Rate for Payer: Aetna American Axle |
$9.67
|
| Rate for Payer: Aetna Commercial |
$20.18
|
| Rate for Payer: Aetna Commercial |
$20.66
|
| Rate for Payer: Aetna Commercial |
$20.51
|
| Rate for Payer: Aetna Commercial |
$19.57
|
| Rate for Payer: Aetna Commercial |
$19.00
|
| Rate for Payer: Aetna Commercial |
$12.65
|
| Rate for Payer: Aetna Commercial |
$24.79
|
| Rate for Payer: Aetna Commercial |
$24.45
|
| Rate for Payer: Aetna Commercial |
$22.18
|
| Rate for Payer: Aetna Commercial |
$21.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.43
|
| Rate for Payer: Cash Price |
$17.88
|
| Rate for Payer: Cash Price |
$19.45
|
| Rate for Payer: Cash Price |
$20.88
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cash Price |
$23.33
|
| Rate for Payer: Cash Price |
$18.42
|
| Rate for Payer: Cash Price |
$20.42
|
| Rate for Payer: Cash Price |
$11.90
|
| Rate for Payer: Cash Price |
$23.02
|
| Rate for Payer: Cash Price |
$18.99
|
| Rate for Payer: Cofinity Commercial |
$19.22
|
| Rate for Payer: Cofinity Commercial |
$10.42
|
| Rate for Payer: Cofinity Commercial |
$20.42
|
| Rate for Payer: Cofinity Commercial |
$16.62
|
| Rate for Payer: Cofinity Commercial |
$16.11
|
| Rate for Payer: Cofinity Commercial |
$15.64
|
| Rate for Payer: Cofinity Commercial |
$19.80
|
| Rate for Payer: Cofinity Commercial |
$12.80
|
| Rate for Payer: Cofinity Commercial |
$16.89
|
| Rate for Payer: Cofinity Commercial |
$20.75
|
| Rate for Payer: Cofinity Commercial |
$17.02
|
| Rate for Payer: Cofinity Commercial |
$20.91
|
| Rate for Payer: Cofinity Commercial |
$17.86
|
| Rate for Payer: Cofinity Commercial |
$21.95
|
| Rate for Payer: Cofinity Commercial |
$18.27
|
| Rate for Payer: Cofinity Commercial |
$22.45
|
| Rate for Payer: Cofinity Commercial |
$20.14
|
| Rate for Payer: Cofinity Commercial |
$24.74
|
| Rate for Payer: Cofinity Commercial |
$20.41
|
| Rate for Payer: Cofinity Commercial |
$25.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.45
|
| Rate for Payer: Healthscope Commercial |
$13.39
|
| Rate for Payer: Healthscope Commercial |
$20.12
|
| Rate for Payer: Healthscope Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$21.37
|
| Rate for Payer: Healthscope Commercial |
$22.97
|
| Rate for Payer: Healthscope Commercial |
$26.24
|
| Rate for Payer: Healthscope Commercial |
$25.89
|
| Rate for Payer: Healthscope Commercial |
$21.72
|
| Rate for Payer: Healthscope Commercial |
$21.88
|
| Rate for Payer: Healthscope Commercial |
$23.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.45
|
| Rate for Payer: PHP Commercial |
$24.45
|
| Rate for Payer: PHP Commercial |
$20.18
|
| Rate for Payer: PHP Commercial |
$20.51
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Commercial |
$24.79
|
| Rate for Payer: PHP Commercial |
$22.18
|
| Rate for Payer: PHP Commercial |
$12.65
|
| Rate for Payer: PHP Commercial |
$19.57
|
| Rate for Payer: PHP Commercial |
$21.69
|
| Rate for Payer: PHP Commercial |
$20.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.67
|
| Rate for Payer: Priority Health SBD |
$16.08
|
| Rate for Payer: Priority Health SBD |
$9.37
|
| Rate for Payer: Priority Health SBD |
$14.08
|
| Rate for Payer: Priority Health SBD |
$15.20
|
| Rate for Payer: Priority Health SBD |
$14.50
|
| Rate for Payer: Priority Health SBD |
$16.44
|
| Rate for Payer: Priority Health SBD |
$18.37
|
| Rate for Payer: Priority Health SBD |
$14.96
|
| Rate for Payer: Priority Health SBD |
$18.13
|
| Rate for Payer: Priority Health SBD |
$15.32
|
| Rate for Payer: UMR Bronson Commercial |
$10.45
|
| Rate for Payer: UMR Bronson Commercial |
$12.66
|
| Rate for Payer: UMR Bronson Commercial |
$6.55
|
| Rate for Payer: UMR Bronson Commercial |
$12.83
|
| Rate for Payer: UMR Bronson Commercial |
$11.48
|
| Rate for Payer: UMR Bronson Commercial |
$10.62
|
| Rate for Payer: UMR Bronson Commercial |
$11.23
|
| Rate for Payer: UMR Bronson Commercial |
$10.70
|
| Rate for Payer: UMR Bronson Commercial |
$10.13
|
| Rate for Payer: UMR Bronson Commercial |
$9.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.58
|
|
|
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$23.02
|
|
|
Service Code
|
HCPCS J1939
|
| Hospital Charge Code |
9308
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$20.72 |
| Rate for Payer: Aetna American Axle |
$14.96
|
| Rate for Payer: Aetna American Axle |
$18.70
|
| Rate for Payer: Aetna American Axle |
$15.68
|
| Rate for Payer: Aetna American Axle |
$18.95
|
| Rate for Payer: Aetna American Axle |
$16.59
|
| Rate for Payer: Aetna American Axle |
$14.53
|
| Rate for Payer: Aetna American Axle |
$16.96
|
| Rate for Payer: Aetna American Axle |
$15.43
|
| Rate for Payer: Aetna American Axle |
$15.80
|
| Rate for Payer: Aetna American Axle |
$9.67
|
| Rate for Payer: Aetna Commercial |
$20.18
|
| Rate for Payer: Aetna Commercial |
$21.69
|
| Rate for Payer: Aetna Commercial |
$12.65
|
| Rate for Payer: Aetna Commercial |
$20.51
|
| Rate for Payer: Aetna Commercial |
$24.45
|
| Rate for Payer: Aetna Commercial |
$19.57
|
| Rate for Payer: Aetna Commercial |
$20.66
|
| Rate for Payer: Aetna Commercial |
$19.00
|
| Rate for Payer: Aetna Commercial |
$22.18
|
| Rate for Payer: Aetna Commercial |
$24.79
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS Trust/PPO |
$1.67
|
| Rate for Payer: BCBS Trust/PPO |
$1.67
|
| Rate for Payer: BCBS Trust/PPO |
$1.67
|
| Rate for Payer: BCBS Trust/PPO |
$1.67
|
| Rate for Payer: BCBS Trust/PPO |
$1.67
|
| Rate for Payer: BCBS Trust/PPO |
$1.67
|
| Rate for Payer: BCBS Trust/PPO |
$1.67
|
| Rate for Payer: BCBS Trust/PPO |
$1.67
|
| Rate for Payer: BCBS Trust/PPO |
$1.67
|
| Rate for Payer: BCBS Trust/PPO |
$1.67
|
| Rate for Payer: BCN Commercial |
$1.67
|
| Rate for Payer: BCN Commercial |
$1.67
|
| Rate for Payer: BCN Commercial |
$1.67
|
| Rate for Payer: BCN Commercial |
$1.67
|
| Rate for Payer: BCN Commercial |
$1.67
|
| Rate for Payer: BCN Commercial |
$1.67
|
| Rate for Payer: BCN Commercial |
$1.67
|
| Rate for Payer: BCN Commercial |
$1.67
|
| Rate for Payer: BCN Commercial |
$1.67
|
| Rate for Payer: BCN Commercial |
$1.67
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cash Price |
$23.02
|
| Rate for Payer: Cash Price |
$23.33
|
| Rate for Payer: Cash Price |
$20.42
|
| Rate for Payer: Cash Price |
$17.88
|
| Rate for Payer: Cash Price |
$20.88
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cash Price |
$18.42
|
| Rate for Payer: Cash Price |
$19.45
|
| Rate for Payer: Cash Price |
$19.45
|
| Rate for Payer: Cash Price |
$18.42
|
| Rate for Payer: Cash Price |
$11.90
|
| Rate for Payer: Cash Price |
$11.90
|
| Rate for Payer: Cash Price |
$17.88
|
| Rate for Payer: Cash Price |
$23.33
|
| Rate for Payer: Cash Price |
$18.99
|
| Rate for Payer: Cash Price |
$23.02
|
| Rate for Payer: Cash Price |
$18.99
|
| Rate for Payer: Cash Price |
$20.42
|
| Rate for Payer: Cash Price |
$20.88
|
| Rate for Payer: Cofinity Commercial |
$19.22
|
| Rate for Payer: Cofinity Commercial |
$16.89
|
| Rate for Payer: Cofinity Commercial |
$20.75
|
| Rate for Payer: Cofinity Commercial |
$22.45
|
| Rate for Payer: Cofinity Commercial |
$19.80
|
| Rate for Payer: Cofinity Commercial |
$20.41
|
| Rate for Payer: Cofinity Commercial |
$12.80
|
| Rate for Payer: Cofinity Commercial |
$10.42
|
| Rate for Payer: Cofinity Commercial |
$25.08
|
| Rate for Payer: Cofinity Commercial |
$20.42
|
| Rate for Payer: Cofinity Commercial |
$16.62
|
| Rate for Payer: Cofinity Commercial |
$17.02
|
| Rate for Payer: Cofinity Commercial |
$20.91
|
| Rate for Payer: Cofinity Commercial |
$16.11
|
| Rate for Payer: Cofinity Commercial |
$24.74
|
| Rate for Payer: Cofinity Commercial |
$21.95
|
| Rate for Payer: Cofinity Commercial |
$15.64
|
| Rate for Payer: Cofinity Commercial |
$20.14
|
| Rate for Payer: Cofinity Commercial |
$18.27
|
| Rate for Payer: Cofinity Commercial |
$17.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Healthscope Commercial |
$25.89
|
| Rate for Payer: Healthscope Commercial |
$26.24
|
| Rate for Payer: Healthscope Commercial |
$21.88
|
| Rate for Payer: Healthscope Commercial |
$23.49
|
| Rate for Payer: Healthscope Commercial |
$22.97
|
| Rate for Payer: Healthscope Commercial |
$21.72
|
| Rate for Payer: Healthscope Commercial |
$20.12
|
| Rate for Payer: Healthscope Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$13.39
|
| Rate for Payer: Healthscope Commercial |
$21.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.58
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.65
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PHP Commercial |
$19.57
|
| Rate for Payer: PHP Commercial |
$20.18
|
| Rate for Payer: PHP Commercial |
$24.45
|
| Rate for Payer: PHP Commercial |
$20.66
|
| Rate for Payer: PHP Commercial |
$24.79
|
| Rate for Payer: PHP Commercial |
$21.69
|
| Rate for Payer: PHP Commercial |
$12.65
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Commercial |
$22.18
|
| Rate for Payer: PHP Commercial |
$20.51
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.80
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Narrow Network |
$1.44
|
| Rate for Payer: Priority Health Narrow Network |
$1.44
|
| Rate for Payer: Priority Health Narrow Network |
$1.44
|
| Rate for Payer: Priority Health Narrow Network |
$1.44
|
| Rate for Payer: Priority Health Narrow Network |
$1.44
|
| Rate for Payer: Priority Health Narrow Network |
$1.44
|
| Rate for Payer: Priority Health Narrow Network |
$1.44
|
| Rate for Payer: Priority Health Narrow Network |
$1.44
|
| Rate for Payer: Priority Health Narrow Network |
$1.44
|
| Rate for Payer: Priority Health Narrow Network |
$1.44
|
| Rate for Payer: Priority Health SBD |
$9.37
|
| Rate for Payer: Priority Health SBD |
$16.44
|
| Rate for Payer: Priority Health SBD |
$14.96
|
| Rate for Payer: Priority Health SBD |
$18.13
|
| Rate for Payer: Priority Health SBD |
$16.08
|
| Rate for Payer: Priority Health SBD |
$18.37
|
| Rate for Payer: Priority Health SBD |
$15.20
|
| Rate for Payer: Priority Health SBD |
$14.08
|
| Rate for Payer: Priority Health SBD |
$14.50
|
| Rate for Payer: Priority Health SBD |
$15.32
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UMR Bronson Commercial |
$10.79
|
| Rate for Payer: UMR Bronson Commercial |
$8.99
|
| Rate for Payer: UMR Bronson Commercial |
$5.51
|
| Rate for Payer: UMR Bronson Commercial |
$9.44
|
| Rate for Payer: UMR Bronson Commercial |
$8.27
|
| Rate for Payer: UMR Bronson Commercial |
$8.93
|
| Rate for Payer: UMR Bronson Commercial |
$10.64
|
| Rate for Payer: UMR Bronson Commercial |
$9.66
|
| Rate for Payer: UMR Bronson Commercial |
$8.78
|
| Rate for Payer: UMR Bronson Commercial |
$8.52
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.16
|
|
|
BUMETANIDE 0.5 MG TABLET
|
Facility
|
IP
|
$215.76
|
|
|
Service Code
|
NDC 50268013015
|
| Hospital Charge Code |
9309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$94.93 |
| Max. Negotiated Rate |
$194.18 |
| Rate for Payer: Aetna American Axle |
$140.24
|
| Rate for Payer: Aetna Commercial |
$183.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.24
|
| Rate for Payer: Cash Price |
$172.61
|
| Rate for Payer: Cofinity Commercial |
$151.03
|
| Rate for Payer: Cofinity Commercial |
$185.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$151.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.61
|
| Rate for Payer: Healthscope Commercial |
$194.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$151.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.40
|
| Rate for Payer: PHP Commercial |
$183.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.24
|
| Rate for Payer: Priority Health SBD |
$135.93
|
| Rate for Payer: UMR Bronson Commercial |
$94.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.82
|
|
|
BUMETANIDE 0.5 MG TABLET
|
Facility
|
IP
|
$300.20
|
|
|
Service Code
|
NDC 69238148901
|
| Hospital Charge Code |
9309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$132.09 |
| Max. Negotiated Rate |
$270.18 |
| Rate for Payer: Aetna American Axle |
$195.13
|
| Rate for Payer: Aetna Commercial |
$255.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.13
|
| Rate for Payer: Cash Price |
$240.16
|
| Rate for Payer: Cofinity Commercial |
$210.14
|
| Rate for Payer: Cofinity Commercial |
$258.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$210.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.16
|
| Rate for Payer: Healthscope Commercial |
$270.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$210.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.17
|
| Rate for Payer: PHP Commercial |
$255.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.13
|
| Rate for Payer: Priority Health SBD |
$189.13
|
| Rate for Payer: UMR Bronson Commercial |
$132.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.15
|
|
