|
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
|
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% 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% 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
|
|
|
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
|
|
|
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 |
$20.11
|
| 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 |
$19.57
|
| 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 |
$17.27
|
| 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 |
$17.27
|
| 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 |
$19.57
|
|
|
BUMETANIDE 0.25 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$22.35
|
|
|
Service Code
|
HCPCS J1939
|
| Hospital Charge Code |
9308
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$20.11 |
| Rate for Payer: Aetna American Axle |
$14.53
|
| Rate for Payer: Aetna American Axle |
$15.80
|
| Rate for Payer: Aetna American Axle |
$9.67
|
| Rate for Payer: Aetna American Axle |
$16.59
|
| Rate for Payer: Aetna American Axle |
$15.43
|
| Rate for Payer: Aetna American Axle |
$14.96
|
| Rate for Payer: Aetna American Axle |
$15.68
|
| Rate for Payer: Aetna American Axle |
$18.70
|
| Rate for Payer: Aetna American Axle |
$18.95
|
| Rate for Payer: Aetna American Axle |
$16.96
|
| Rate for Payer: Aetna Commercial |
$22.18
|
| Rate for Payer: Aetna Commercial |
$24.45
|
| Rate for Payer: Aetna Commercial |
$19.00
|
| Rate for Payer: Aetna Commercial |
$24.79
|
| Rate for Payer: Aetna Commercial |
$12.65
|
| Rate for Payer: Aetna Commercial |
$21.69
|
| 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 Medicare |
$0.38
|
| Rate for Payer: Aetna Medicare |
$0.38
|
| Rate for Payer: Aetna Medicare |
$0.38
|
| Rate for Payer: Aetna Medicare |
$0.38
|
| Rate for Payer: Aetna Medicare |
$0.38
|
| Rate for Payer: Aetna Medicare |
$0.38
|
| Rate for Payer: Aetna Medicare |
$0.38
|
| Rate for Payer: Aetna Medicare |
$0.38
|
| Rate for Payer: Aetna Medicare |
$0.38
|
| Rate for Payer: Aetna Medicare |
$0.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.46
|
| Rate for Payer: BCBS Complete |
$0.21
|
| Rate for Payer: BCBS Complete |
$0.21
|
| Rate for Payer: BCBS Complete |
$0.21
|
| Rate for Payer: BCBS Complete |
$0.21
|
| Rate for Payer: BCBS Complete |
$0.21
|
| Rate for Payer: BCBS Complete |
$0.21
|
| Rate for Payer: BCBS Complete |
$0.21
|
| Rate for Payer: BCBS Complete |
$0.21
|
| Rate for Payer: BCBS Complete |
$0.21
|
| Rate for Payer: BCBS Complete |
$0.21
|
| Rate for Payer: BCBS MAPPO |
$0.37
|
| Rate for Payer: BCBS MAPPO |
$0.37
|
| Rate for Payer: BCBS MAPPO |
$0.37
|
| Rate for Payer: BCBS MAPPO |
$0.37
|
| Rate for Payer: BCBS MAPPO |
$0.37
|
| Rate for Payer: BCBS MAPPO |
$0.37
|
| Rate for Payer: BCBS MAPPO |
$0.37
|
| Rate for Payer: BCBS MAPPO |
$0.37
|
| Rate for Payer: BCBS MAPPO |
$0.37
|
| Rate for Payer: BCBS MAPPO |
$0.37
|
| Rate for Payer: BCN Medicare Advantage |
$0.37
|
| Rate for Payer: BCN Medicare Advantage |
$0.37
|
| Rate for Payer: BCN Medicare Advantage |
$0.37
|
| Rate for Payer: BCN Medicare Advantage |
$0.37
|
| Rate for Payer: BCN Medicare Advantage |
$0.37
|
| Rate for Payer: BCN Medicare Advantage |
$0.37
|
| Rate for Payer: BCN Medicare Advantage |
$0.37
|
| Rate for Payer: BCN Medicare Advantage |
$0.37
|
| Rate for Payer: BCN Medicare Advantage |
$0.37
|
| Rate for Payer: BCN Medicare Advantage |
$0.37
|
| Rate for Payer: Cash Price |
$19.45
|
| Rate for Payer: Cash Price |
$17.88
|
| 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 |
$19.30
|
| Rate for Payer: Cash Price |
$20.88
|
| Rate for Payer: Cash Price |
$23.02
|
| Rate for Payer: Cash Price |
$20.88
|
| Rate for Payer: Cash Price |
$19.45
|
| Rate for Payer: Cash Price |
$18.42
|
| Rate for Payer: Cash Price |
$23.02
|
| Rate for Payer: Cash Price |
$20.42
|
| 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 |
$18.99
|
| Rate for Payer: Cash Price |
$18.99
|
| Rate for Payer: Cash Price |
$23.33
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cofinity Commercial |
$15.64
|
| Rate for Payer: Cofinity Commercial |
$24.74
|
| Rate for Payer: Cofinity Commercial |
$20.42
|
| Rate for Payer: Cofinity Commercial |
$17.86
|
| Rate for Payer: Cofinity Commercial |
$20.91
|
| Rate for Payer: Cofinity Commercial |
$21.95
|
| Rate for Payer: Cofinity Commercial |
$20.75
|
| Rate for Payer: Cofinity Commercial |
$20.41
|
| Rate for Payer: Cofinity Commercial |
$18.27
|
| Rate for Payer: Cofinity Commercial |
$22.45
|
| Rate for Payer: Cofinity Commercial |
$17.02
|
| Rate for Payer: Cofinity Commercial |
$25.08
|
| Rate for Payer: Cofinity Commercial |
$16.11
|
| Rate for Payer: Cofinity Commercial |
$19.80
|
| Rate for Payer: Cofinity Commercial |
$20.14
|
| Rate for Payer: Cofinity Commercial |
$19.22
|
| Rate for Payer: Cofinity Commercial |
$12.80
|
| Rate for Payer: Cofinity Commercial |
$10.42
|
| Rate for Payer: Cofinity Commercial |
$16.89
|
| Rate for Payer: Cofinity Commercial |
$16.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.42
|
| 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 |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.37
|
| Rate for Payer: Healthscope Commercial |
$26.24
|
| Rate for Payer: Healthscope Commercial |
$20.11
|
| Rate for Payer: Healthscope Commercial |
$23.49
|
| Rate for Payer: Healthscope Commercial |
$13.39
|
| Rate for Payer: Healthscope Commercial |
$22.97
|
| Rate for Payer: Healthscope Commercial |
$21.37
|
| Rate for Payer: Healthscope Commercial |
$21.88
|
| Rate for Payer: Healthscope Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.89
|
| Rate for Payer: Healthscope Commercial |
$21.72
|
| 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 |
$20.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.86
|
| 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 |
$17.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.27
|
| 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 |
$19.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.16
|
| Rate for Payer: Mclaren Medicaid |
$0.20
|
| Rate for Payer: Mclaren Medicaid |
$0.20
|
| Rate for Payer: Mclaren Medicaid |
$0.20
|
| Rate for Payer: Mclaren Medicaid |
$0.20
|
| Rate for Payer: Mclaren Medicaid |
$0.20
|
| Rate for Payer: Mclaren Medicaid |
$0.20
|
| Rate for Payer: Mclaren Medicaid |
$0.20
|
| Rate for Payer: Mclaren Medicaid |
$0.20
|
| Rate for Payer: Mclaren Medicaid |
$0.20
|
| Rate for Payer: Mclaren Medicaid |
$0.20
|
| Rate for Payer: Mclaren Medicare |
$0.37
|
| Rate for Payer: Mclaren Medicare |
$0.37
|
| Rate for Payer: Mclaren Medicare |
$0.37
|
| Rate for Payer: Mclaren Medicare |
$0.37
|
| Rate for Payer: Mclaren Medicare |
$0.37
|
| Rate for Payer: Mclaren Medicare |
$0.37
|
| Rate for Payer: Mclaren Medicare |
$0.37
|
| Rate for Payer: Mclaren Medicare |
$0.37
|
| Rate for Payer: Mclaren Medicare |
$0.37
|
| Rate for Payer: Mclaren Medicare |
$0.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.39
|
| Rate for Payer: Meridian Medicaid |
$0.21
|
| Rate for Payer: Meridian Medicaid |
$0.21
|
| Rate for Payer: Meridian Medicaid |
$0.21
|
| Rate for Payer: Meridian Medicaid |
$0.21
|
| Rate for Payer: Meridian Medicaid |
$0.21
|
| Rate for Payer: Meridian Medicaid |
$0.21
|
| Rate for Payer: Meridian Medicaid |
$0.21
|
| Rate for Payer: Meridian Medicaid |
$0.21
|
| Rate for Payer: Meridian Medicaid |
$0.21
|
| Rate for Payer: Meridian Medicaid |
$0.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.65
|
| 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 |
$19.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.69
|
| Rate for Payer: PACE Medicare |
$0.35
|
| Rate for Payer: PACE Medicare |
$0.35
|
| Rate for Payer: PACE Medicare |
$0.35
|
| Rate for Payer: PACE Medicare |
$0.35
|
| Rate for Payer: PACE Medicare |
$0.35
|
| Rate for Payer: PACE Medicare |
$0.35
|
| Rate for Payer: PACE Medicare |
$0.35
|
| Rate for Payer: PACE Medicare |
$0.35
|
| Rate for Payer: PACE Medicare |
$0.35
|
| Rate for Payer: PACE Medicare |
$0.35
|
| Rate for Payer: PACE SWMI |
$0.37
|
| Rate for Payer: PACE SWMI |
$0.37
|
| Rate for Payer: PACE SWMI |
$0.37
|
| Rate for Payer: PACE SWMI |
$0.37
|
| Rate for Payer: PACE SWMI |
$0.37
|
| Rate for Payer: PACE SWMI |
$0.37
|
| Rate for Payer: PACE SWMI |
$0.37
|
| Rate for Payer: PACE SWMI |
$0.37
|
| Rate for Payer: PACE SWMI |
$0.37
|
| Rate for Payer: PACE SWMI |
$0.37
|
| Rate for Payer: PHP Commercial |
$21.69
|
| Rate for Payer: PHP Commercial |
$22.18
|
| Rate for Payer: PHP Commercial |
$20.66
|
| Rate for Payer: PHP Commercial |
$20.51
|
| Rate for Payer: PHP Commercial |
$24.45
|
| Rate for Payer: PHP Commercial |
$12.65
|
| Rate for Payer: PHP Commercial |
$24.79
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Commercial |
$19.57
|
| Rate for Payer: PHP Commercial |
$20.18
|
| Rate for Payer: PHP Medicare Advantage |
$0.37
|
| Rate for Payer: PHP Medicare Advantage |
$0.37
|
| Rate for Payer: PHP Medicare Advantage |
$0.37
|
| Rate for Payer: PHP Medicare Advantage |
$0.37
|
| Rate for Payer: PHP Medicare Advantage |
$0.37
|
| Rate for Payer: PHP Medicare Advantage |
$0.37
|
| Rate for Payer: PHP Medicare Advantage |
$0.37
|
| Rate for Payer: PHP Medicare Advantage |
$0.37
|
| Rate for Payer: PHP Medicare Advantage |
$0.37
|
| Rate for Payer: PHP Medicare Advantage |
$0.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.20
|
| 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 |
$14.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.70
|
| 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 |
$16.59
|
| Rate for Payer: Priority Health Medicare |
$0.37
|
| Rate for Payer: Priority Health Medicare |
$0.37
|
| Rate for Payer: Priority Health Medicare |
$0.37
|
| Rate for Payer: Priority Health Medicare |
$0.37
|
| Rate for Payer: Priority Health Medicare |
$0.37
|
| Rate for Payer: Priority Health Medicare |
$0.37
|
| Rate for Payer: Priority Health Medicare |
$0.37
|
| Rate for Payer: Priority Health Medicare |
$0.37
|
| Rate for Payer: Priority Health Medicare |
$0.37
|
| Rate for Payer: Priority Health Medicare |
$0.37
|
| Rate for Payer: Priority Health SBD |
$16.44
|
| Rate for Payer: Priority Health SBD |
$18.37
|
| Rate for Payer: Priority Health SBD |
$9.37
|
| Rate for Payer: Priority Health SBD |
$15.20
|
| Rate for Payer: Priority Health SBD |
$14.96
|
| Rate for Payer: Priority Health SBD |
$16.08
|
| Rate for Payer: Priority Health SBD |
$15.32
|
| Rate for Payer: Priority Health SBD |
$14.08
|
| Rate for Payer: Priority Health SBD |
$14.50
|
| Rate for Payer: Priority Health SBD |
$18.13
|
| Rate for Payer: Railroad Medicare Medicare |
$0.37
|
| Rate for Payer: Railroad Medicare Medicare |
$0.37
|
| Rate for Payer: Railroad Medicare Medicare |
$0.37
|
| Rate for Payer: Railroad Medicare Medicare |
$0.37
|
| Rate for Payer: Railroad Medicare Medicare |
$0.37
|
| Rate for Payer: Railroad Medicare Medicare |
$0.37
|
| Rate for Payer: Railroad Medicare Medicare |
$0.37
|
| Rate for Payer: Railroad Medicare Medicare |
$0.37
|
| Rate for Payer: Railroad Medicare Medicare |
$0.37
|
| Rate for Payer: Railroad Medicare Medicare |
$0.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.37
|
| Rate for Payer: UHC Exchange |
$0.71
|
| Rate for Payer: UHC Exchange |
$0.71
|
| Rate for Payer: UHC Exchange |
$0.71
|
| Rate for Payer: UHC Exchange |
$0.71
|
| Rate for Payer: UHC Exchange |
$0.71
|
| Rate for Payer: UHC Exchange |
$0.71
|
| Rate for Payer: UHC Exchange |
$0.71
|
| Rate for Payer: UHC Exchange |
$0.71
|
| Rate for Payer: UHC Exchange |
$0.71
|
| Rate for Payer: UHC Exchange |
$0.71
|
| Rate for Payer: UHC Medicare Advantage |
$0.37
|
| Rate for Payer: UHC Medicare Advantage |
$0.37
|
| Rate for Payer: UHC Medicare Advantage |
$0.37
|
| Rate for Payer: UHC Medicare Advantage |
$0.37
|
| Rate for Payer: UHC Medicare Advantage |
$0.37
|
| Rate for Payer: UHC Medicare Advantage |
$0.37
|
| Rate for Payer: UHC Medicare Advantage |
$0.37
|
| Rate for Payer: UHC Medicare Advantage |
$0.37
|
| Rate for Payer: UHC Medicare Advantage |
$0.37
|
| Rate for Payer: UHC Medicare Advantage |
$0.37
|
| Rate for Payer: UHCCP Medicaid |
$0.20
|
| Rate for Payer: UHCCP Medicaid |
$0.20
|
| Rate for Payer: UHCCP Medicaid |
$0.20
|
| Rate for Payer: UHCCP Medicaid |
$0.20
|
| Rate for Payer: UHCCP Medicaid |
$0.20
|
| Rate for Payer: UHCCP Medicaid |
$0.20
|
| Rate for Payer: UHCCP Medicaid |
$0.20
|
| Rate for Payer: UHCCP Medicaid |
$0.20
|
| Rate for Payer: UHCCP Medicaid |
$0.20
|
| Rate for Payer: UHCCP Medicaid |
$0.20
|
| Rate for Payer: UMR Bronson Commercial |
$8.78
|
| Rate for Payer: UMR Bronson Commercial |
$9.44
|
| Rate for Payer: UMR Bronson Commercial |
$10.79
|
| Rate for Payer: UMR Bronson Commercial |
$8.99
|
| Rate for Payer: UMR Bronson Commercial |
$8.93
|
| Rate for Payer: UMR Bronson Commercial |
$10.64
|
| Rate for Payer: UMR Bronson Commercial |
$8.52
|
| Rate for Payer: UMR Bronson Commercial |
$8.27
|
| Rate for Payer: UMR Bronson Commercial |
$5.51
|
| Rate for Payer: UMR Bronson Commercial |
$9.66
|
| Rate for Payer: VA VA |
$0.37
|
| Rate for Payer: VA VA |
$0.37
|
| Rate for Payer: VA VA |
$0.37
|
| Rate for Payer: VA VA |
$0.37
|
| Rate for Payer: VA VA |
$0.37
|
| Rate for Payer: VA VA |
$0.37
|
| Rate for Payer: VA VA |
$0.37
|
| Rate for Payer: VA VA |
$0.37
|
| Rate for Payer: VA VA |
$0.37
|
| Rate for Payer: VA VA |
$0.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.76
|
|
|
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
|
|
|
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
|
OP
|
$398.05
|
|
|
Service Code
|
NDC 00185012801
|
| Hospital Charge Code |
9309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$147.28 |
| Max. Negotiated Rate |
$358.25 |
| Rate for Payer: Aetna American Axle |
$258.73
|
| Rate for Payer: Aetna Commercial |
$338.34
|
| Rate for Payer: Aetna Medicare |
$199.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.73
|
| Rate for Payer: BCBS Complete |
$159.22
|
| Rate for Payer: Cash Price |
$318.44
|
| Rate for Payer: Cofinity Commercial |
$278.63
|
| Rate for Payer: Cofinity Commercial |
$342.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$278.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.44
|
| Rate for Payer: Healthscope Commercial |
$358.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$278.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.34
|
| Rate for Payer: PHP Commercial |
$338.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.73
|
| Rate for Payer: Priority Health SBD |
$250.77
|
| Rate for Payer: UMR Bronson Commercial |
$147.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.54
|
|
|
BUMETANIDE 0.5 MG TABLET
|
Facility
|
OP
|
$300.20
|
|
|
Service Code
|
NDC 69238148901
|
| Hospital Charge Code |
9309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$111.07 |
| Max. Negotiated Rate |
$270.18 |
| Rate for Payer: Aetna American Axle |
$195.13
|
| Rate for Payer: Aetna Commercial |
$255.17
|
| Rate for Payer: Aetna Medicare |
$150.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.13
|
| Rate for Payer: BCBS Complete |
$120.08
|
| 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 |
$111.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.15
|
|
|
BUMETANIDE 0.5 MG TABLET
|
Facility
|
OP
|
$4.32
|
|
|
Service Code
|
NDC 50268013011
|
| Hospital Charge Code |
9309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$3.89 |
| Rate for Payer: Aetna American Axle |
$2.81
|
| Rate for Payer: Aetna Commercial |
$3.67
|
| Rate for Payer: Aetna Medicare |
$2.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.81
|
| Rate for Payer: BCBS Complete |
$1.73
|
| Rate for Payer: Cash Price |
$3.46
|
| Rate for Payer: Cofinity Commercial |
$3.02
|
| Rate for Payer: Cofinity Commercial |
$3.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.46
|
| Rate for Payer: Healthscope Commercial |
$3.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.67
|
| Rate for Payer: PHP Commercial |
$3.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.81
|
| Rate for Payer: Priority Health SBD |
$2.72
|
| Rate for Payer: UMR Bronson Commercial |
$1.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.24
|
|
|
BUMETANIDE 0.5 MG TABLET
|
Facility
|
OP
|
$215.76
|
|
|
Service Code
|
NDC 50268013015
|
| Hospital Charge Code |
9309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$79.83 |
| Max. Negotiated Rate |
$194.18 |
| Rate for Payer: Aetna American Axle |
$140.24
|
| Rate for Payer: Aetna Commercial |
$183.40
|
| Rate for Payer: Aetna Medicare |
$107.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.24
|
| Rate for Payer: BCBS Complete |
$86.30
|
| 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 |
$79.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.82
|
|
|
BUMETANIDE 0.5 MG TABLET
|
Facility
|
IP
|
$4.32
|
|
|
Service Code
|
NDC 50268013011
|
| Hospital Charge Code |
9309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.90 |
| Max. Negotiated Rate |
$3.89 |
| Rate for Payer: Aetna American Axle |
$2.81
|
| Rate for Payer: Aetna Commercial |
$3.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.81
|
| Rate for Payer: Cash Price |
$3.46
|
| Rate for Payer: Cofinity Commercial |
$3.02
|
| Rate for Payer: Cofinity Commercial |
$3.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.46
|
| Rate for Payer: Healthscope Commercial |
$3.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.67
|
| Rate for Payer: PHP Commercial |
$3.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.81
|
| Rate for Payer: Priority Health SBD |
$2.72
|
| Rate for Payer: UMR Bronson Commercial |
$1.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.24
|
|
|
BUMETANIDE 0.5 MG TABLET
|
Facility
|
IP
|
$398.05
|
|
|
Service Code
|
NDC 00185012801
|
| Hospital Charge Code |
9309
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$175.14 |
| Max. Negotiated Rate |
$358.25 |
| Rate for Payer: Aetna American Axle |
$258.73
|
| Rate for Payer: Aetna Commercial |
$338.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.73
|
| Rate for Payer: Cash Price |
$318.44
|
| Rate for Payer: Cofinity Commercial |
$278.63
|
| Rate for Payer: Cofinity Commercial |
$342.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$278.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.44
|
| Rate for Payer: Healthscope Commercial |
$358.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$278.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.34
|
| Rate for Payer: PHP Commercial |
$338.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.73
|
| Rate for Payer: Priority Health SBD |
$250.77
|
| Rate for Payer: UMR Bronson Commercial |
$175.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.54
|
|
|
BUMETANIDE 1 MG TABLET
|
Facility
|
OP
|
$300.20
|
|
|
Service Code
|
NDC 42799012001
|
| Hospital Charge Code |
9310
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$111.07 |
| Max. Negotiated Rate |
$270.18 |
| Rate for Payer: Aetna American Axle |
$195.13
|
| Rate for Payer: Aetna Commercial |
$255.17
|
| Rate for Payer: Aetna Medicare |
$150.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.13
|
| Rate for Payer: BCBS Complete |
$120.08
|
| 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 |
$111.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.15
|
|
|
BUMETANIDE 1 MG TABLET
|
Facility
|
OP
|
$258.40
|
|
|
Service Code
|
NDC 69238149001
|
| Hospital Charge Code |
9310
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$95.61 |
| Max. Negotiated Rate |
$232.56 |
| Rate for Payer: Aetna American Axle |
$167.96
|
| Rate for Payer: Aetna Commercial |
$219.64
|
| Rate for Payer: Aetna Medicare |
$129.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.96
|
| Rate for Payer: BCBS Complete |
$103.36
|
| Rate for Payer: Cash Price |
$206.72
|
| Rate for Payer: Cofinity Commercial |
$180.88
|
| Rate for Payer: Cofinity Commercial |
$222.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$180.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.72
|
| Rate for Payer: Healthscope Commercial |
$232.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.64
|
| Rate for Payer: PHP Commercial |
$219.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.96
|
| Rate for Payer: Priority Health SBD |
$162.79
|
| Rate for Payer: UMR Bronson Commercial |
$95.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.80
|
|
|
BUMETANIDE 1 MG TABLET
|
Facility
|
IP
|
$300.20
|
|
|
Service Code
|
NDC 42799012001
|
| Hospital Charge Code |
9310
|
|
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
|
|
|
BUMETANIDE 1 MG TABLET
|
Facility
|
OP
|
$394.56
|
|
|
Service Code
|
NDC 00904701661
|
| Hospital Charge Code |
9310
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$145.99 |
| Max. Negotiated Rate |
$355.10 |
| Rate for Payer: Aetna American Axle |
$256.46
|
| Rate for Payer: Aetna Commercial |
$335.38
|
| Rate for Payer: Aetna Medicare |
$197.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.46
|
| Rate for Payer: BCBS Complete |
$157.82
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Cofinity Commercial |
$276.19
|
| Rate for Payer: Cofinity Commercial |
$339.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$276.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.65
|
| Rate for Payer: Healthscope Commercial |
$355.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$276.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.38
|
| Rate for Payer: PHP Commercial |
$335.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.46
|
| Rate for Payer: Priority Health SBD |
$248.57
|
| Rate for Payer: UMR Bronson Commercial |
$145.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.92
|
|
|
BUMETANIDE 1 MG TABLET
|
Facility
|
IP
|
$394.56
|
|
|
Service Code
|
NDC 00904701661
|
| Hospital Charge Code |
9310
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$173.61 |
| Max. Negotiated Rate |
$355.10 |
| Rate for Payer: Aetna American Axle |
$256.46
|
| Rate for Payer: Aetna Commercial |
$335.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.46
|
| Rate for Payer: Cash Price |
$315.65
|
| Rate for Payer: Cofinity Commercial |
$276.19
|
| Rate for Payer: Cofinity Commercial |
$339.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$276.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.65
|
| Rate for Payer: Healthscope Commercial |
$355.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$276.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.38
|
| Rate for Payer: PHP Commercial |
$335.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.46
|
| Rate for Payer: Priority Health SBD |
$248.57
|
| Rate for Payer: UMR Bronson Commercial |
$173.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.92
|
|
|
BUMETANIDE 1 MG TABLET
|
Facility
|
IP
|
$400.90
|
|
|
Service Code
|
NDC 00185012901
|
| Hospital Charge Code |
9310
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$360.81 |
| Rate for Payer: Aetna American Axle |
$260.58
|
| Rate for Payer: Aetna Commercial |
$340.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.58
|
| Rate for Payer: Cash Price |
$320.72
|
| Rate for Payer: Cofinity Commercial |
$280.63
|
| Rate for Payer: Cofinity Commercial |
$344.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$280.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.72
|
| Rate for Payer: Healthscope Commercial |
$360.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$280.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.76
|
| Rate for Payer: PHP Commercial |
$340.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.58
|
| Rate for Payer: Priority Health SBD |
$252.57
|
| Rate for Payer: UMR Bronson Commercial |
$176.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.68
|
|
|
BUMETANIDE 1 MG TABLET
|
Facility
|
IP
|
$258.40
|
|
|
Service Code
|
NDC 69238149001
|
| Hospital Charge Code |
9310
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$113.70 |
| Max. Negotiated Rate |
$232.56 |
| Rate for Payer: Aetna American Axle |
$167.96
|
| Rate for Payer: Aetna Commercial |
$219.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.96
|
| Rate for Payer: Cash Price |
$206.72
|
| Rate for Payer: Cofinity Commercial |
$180.88
|
| Rate for Payer: Cofinity Commercial |
$222.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$180.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.72
|
| Rate for Payer: Healthscope Commercial |
$232.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.64
|
| Rate for Payer: PHP Commercial |
$219.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.96
|
| Rate for Payer: Priority Health SBD |
$162.79
|
| Rate for Payer: UMR Bronson Commercial |
$113.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.80
|
|
