|
DOXEPIN 25 MG CAPSULE
|
Facility
|
IP
|
$319.20
|
|
|
Service Code
|
NDC 51079-437-20
|
| Hospital Charge Code |
2611
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$140.45 |
| Max. Negotiated Rate |
$287.28 |
| Rate for Payer: Aetna American Axle |
$207.48
|
| Rate for Payer: Aetna Commercial |
$271.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.48
|
| Rate for Payer: Cash Price |
$255.36
|
| Rate for Payer: Cofinity Commercial |
$223.44
|
| Rate for Payer: Cofinity Commercial |
$274.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.36
|
| Rate for Payer: Healthscope Commercial |
$287.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$223.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$239.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$271.32
|
| Rate for Payer: PHP Commercial |
$271.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.44
|
| Rate for Payer: Priority Health SBD |
$201.10
|
| Rate for Payer: UMR Bronson Commercial |
$140.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$239.40
|
|
|
DOXEPIN 25 MG CAPSULE
|
Facility
|
IP
|
$297.12
|
|
|
Service Code
|
NDC 0904-6971-61
|
| Hospital Charge Code |
2611
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$130.73 |
| Max. Negotiated Rate |
$267.41 |
| Rate for Payer: Aetna American Axle |
$193.13
|
| Rate for Payer: Aetna Commercial |
$252.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.13
|
| Rate for Payer: Cash Price |
$237.70
|
| Rate for Payer: Cofinity Commercial |
$207.98
|
| Rate for Payer: Cofinity Commercial |
$255.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.70
|
| Rate for Payer: Healthscope Commercial |
$267.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$207.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$252.55
|
| Rate for Payer: PHP Commercial |
$252.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.98
|
| Rate for Payer: Priority Health SBD |
$187.19
|
| Rate for Payer: UMR Bronson Commercial |
$130.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.84
|
|
|
DOXEPIN 25 MG CAPSULE
|
Facility
|
IP
|
$304.32
|
|
|
Service Code
|
NDC 0904-7053-61
|
| Hospital Charge Code |
2611
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$133.90 |
| Max. Negotiated Rate |
$273.89 |
| Rate for Payer: Aetna American Axle |
$197.81
|
| Rate for Payer: Aetna Commercial |
$258.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.81
|
| Rate for Payer: Cash Price |
$243.46
|
| Rate for Payer: Cofinity Commercial |
$213.02
|
| Rate for Payer: Cofinity Commercial |
$261.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.46
|
| Rate for Payer: Healthscope Commercial |
$273.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$258.67
|
| Rate for Payer: PHP Commercial |
$258.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.02
|
| Rate for Payer: Priority Health SBD |
$191.72
|
| Rate for Payer: UMR Bronson Commercial |
$133.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.24
|
|
|
DOXEPIN 25 MG CAPSULE
|
Facility
|
IP
|
$3.20
|
|
|
Service Code
|
NDC 51079-437-01
|
| Hospital Charge Code |
2611
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.41 |
| Max. Negotiated Rate |
$2.88 |
| Rate for Payer: Aetna American Axle |
$2.08
|
| Rate for Payer: Aetna Commercial |
$2.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.08
|
| Rate for Payer: Cash Price |
$2.56
|
| Rate for Payer: Cofinity Commercial |
$2.24
|
| Rate for Payer: Cofinity Commercial |
$2.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.56
|
| Rate for Payer: Healthscope Commercial |
$2.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.72
|
| Rate for Payer: PHP Commercial |
$2.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.24
|
| Rate for Payer: Priority Health SBD |
$2.02
|
| Rate for Payer: UMR Bronson Commercial |
$1.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.40
|
|
|
DOXEPIN 5 % TOPICAL CREAM
|
Facility
|
IP
|
$1,959.30
|
|
|
Service Code
|
NDC 0378-8117-45
|
| Hospital Charge Code |
12666
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$862.09 |
| Max. Negotiated Rate |
$1,763.37 |
| Rate for Payer: Aetna American Axle |
$1,273.54
|
| Rate for Payer: Aetna Commercial |
$1,665.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.54
|
| Rate for Payer: Cash Price |
$1,567.44
|
| Rate for Payer: Cofinity Commercial |
$1,371.51
|
| Rate for Payer: Cofinity Commercial |
$1,685.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,567.44
|
| Rate for Payer: Healthscope Commercial |
$1,763.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,371.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,469.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,665.40
|
| Rate for Payer: PHP Commercial |
$1,665.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,371.51
|
| Rate for Payer: Priority Health SBD |
$1,234.36
|
| Rate for Payer: UMR Bronson Commercial |
$862.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,469.48
|
|
|
DOXEPIN 5 % TOPICAL CREAM
|
Facility
|
IP
|
$1,880.87
|
|
|
Service Code
|
NDC 0093-9609-95
|
| Hospital Charge Code |
12666
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$827.58 |
| Max. Negotiated Rate |
$1,692.78 |
| Rate for Payer: Aetna American Axle |
$1,222.57
|
| Rate for Payer: Aetna Commercial |
$1,598.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,222.57
|
| Rate for Payer: Cash Price |
$1,504.70
|
| Rate for Payer: Cofinity Commercial |
$1,316.61
|
| Rate for Payer: Cofinity Commercial |
$1,617.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,504.70
|
| Rate for Payer: Healthscope Commercial |
$1,692.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,316.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,410.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,598.74
|
| Rate for Payer: PHP Commercial |
$1,598.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,316.61
|
| Rate for Payer: Priority Health SBD |
$1,184.95
|
| Rate for Payer: UMR Bronson Commercial |
$827.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,410.65
|
|
|
DOXERCALCIFEROL 4 MCG/2 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$28.80
|
|
|
Service Code
|
HCPCS J1270
|
| Hospital Charge Code |
28277
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.67 |
| Max. Negotiated Rate |
$25.92 |
| Rate for Payer: Aetna American Axle |
$18.72
|
| Rate for Payer: Aetna Commercial |
$24.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.72
|
| Rate for Payer: Cash Price |
$23.04
|
| Rate for Payer: Cofinity Commercial |
$20.16
|
| Rate for Payer: Cofinity Commercial |
$24.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.04
|
| Rate for Payer: Healthscope Commercial |
$25.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.48
|
| Rate for Payer: PHP Commercial |
$24.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.16
|
| Rate for Payer: Priority Health SBD |
$18.14
|
| Rate for Payer: UMR Bronson Commercial |
$12.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.60
|
|
|
DOXERCALCIFEROL 4 MCG/2 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20.62
|
|
|
Service Code
|
HCPCS J1270
|
| Hospital Charge Code |
28277
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.21 |
| Max. Negotiated Rate |
$18.56 |
| Rate for Payer: Aetna American Axle |
$13.40
|
| Rate for Payer: Aetna American Axle |
$13.42
|
| Rate for Payer: Aetna Commercial |
$17.53
|
| Rate for Payer: Aetna Commercial |
$17.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.40
|
| Rate for Payer: BCBS Complete |
$8.26
|
| Rate for Payer: BCBS Complete |
$8.25
|
| Rate for Payer: BCBS Trust/PPO |
$1.21
|
| Rate for Payer: BCBS Trust/PPO |
$1.21
|
| Rate for Payer: Cash Price |
$16.52
|
| Rate for Payer: Cash Price |
$16.50
|
| Rate for Payer: Cash Price |
$16.52
|
| Rate for Payer: Cash Price |
$16.50
|
| Rate for Payer: Cofinity Commercial |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$14.43
|
| Rate for Payer: Cofinity Commercial |
$17.73
|
| Rate for Payer: Cofinity Commercial |
$14.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.50
|
| Rate for Payer: Healthscope Commercial |
$18.56
|
| Rate for Payer: Healthscope Commercial |
$18.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.55
|
| Rate for Payer: PHP Commercial |
$17.55
|
| Rate for Payer: PHP Commercial |
$17.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.43
|
| Rate for Payer: Priority Health SBD |
$13.01
|
| Rate for Payer: Priority Health SBD |
$12.99
|
| Rate for Payer: UMR Bronson Commercial |
$7.63
|
| Rate for Payer: UMR Bronson Commercial |
$7.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.49
|
|
|
DOXORUBICIN 10 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$169.95
|
|
|
Service Code
|
HCPCS J9000
|
| Hospital Charge Code |
118502
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.59 |
| Max. Negotiated Rate |
$152.96 |
| Rate for Payer: Aetna American Axle |
$110.47
|
| Rate for Payer: Aetna Commercial |
$144.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.47
|
| Rate for Payer: BCBS Complete |
$67.98
|
| Rate for Payer: BCBS Trust/PPO |
$10.59
|
| Rate for Payer: Cash Price |
$135.96
|
| Rate for Payer: Cash Price |
$135.96
|
| Rate for Payer: Cofinity Commercial |
$118.96
|
| Rate for Payer: Cofinity Commercial |
$146.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.96
|
| Rate for Payer: Healthscope Commercial |
$152.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$144.46
|
| Rate for Payer: PHP Commercial |
$144.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.96
|
| Rate for Payer: Priority Health SBD |
$107.07
|
| Rate for Payer: UMR Bronson Commercial |
$62.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.46
|
|
|
DOXORUBICIN 10 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$169.95
|
|
|
Service Code
|
HCPCS J9000
|
| Hospital Charge Code |
118502
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$74.78 |
| Max. Negotiated Rate |
$152.96 |
| Rate for Payer: Aetna American Axle |
$110.47
|
| Rate for Payer: Aetna Commercial |
$144.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.47
|
| Rate for Payer: Cash Price |
$135.96
|
| Rate for Payer: Cofinity Commercial |
$118.96
|
| Rate for Payer: Cofinity Commercial |
$146.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.96
|
| Rate for Payer: Healthscope Commercial |
$152.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$144.46
|
| Rate for Payer: PHP Commercial |
$144.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.96
|
| Rate for Payer: Priority Health SBD |
$107.07
|
| Rate for Payer: UMR Bronson Commercial |
$74.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.46
|
|
|
DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$564.25
|
|
|
Service Code
|
HCPCS J9000
|
| Hospital Charge Code |
2616
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$248.27 |
| Max. Negotiated Rate |
$507.82 |
| Rate for Payer: Aetna American Axle |
$366.76
|
| Rate for Payer: Aetna American Axle |
$168.56
|
| Rate for Payer: Aetna American Axle |
$322.87
|
| Rate for Payer: Aetna American Axle |
$443.46
|
| Rate for Payer: Aetna Commercial |
$422.22
|
| Rate for Payer: Aetna Commercial |
$220.43
|
| Rate for Payer: Aetna Commercial |
$479.61
|
| Rate for Payer: Aetna Commercial |
$579.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.76
|
| Rate for Payer: Cash Price |
$545.80
|
| Rate for Payer: Cash Price |
$397.38
|
| Rate for Payer: Cash Price |
$207.46
|
| Rate for Payer: Cash Price |
$451.40
|
| Rate for Payer: Cofinity Commercial |
$485.26
|
| Rate for Payer: Cofinity Commercial |
$181.53
|
| Rate for Payer: Cofinity Commercial |
$223.02
|
| Rate for Payer: Cofinity Commercial |
$394.98
|
| Rate for Payer: Cofinity Commercial |
$586.74
|
| Rate for Payer: Cofinity Commercial |
$477.58
|
| Rate for Payer: Cofinity Commercial |
$347.71
|
| Rate for Payer: Cofinity Commercial |
$427.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$545.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$397.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$451.40
|
| Rate for Payer: Healthscope Commercial |
$507.82
|
| Rate for Payer: Healthscope Commercial |
$233.40
|
| Rate for Payer: Healthscope Commercial |
$614.02
|
| Rate for Payer: Healthscope Commercial |
$447.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$394.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$477.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$347.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$372.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$511.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$479.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$579.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$220.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$422.22
|
| Rate for Payer: PHP Commercial |
$579.91
|
| Rate for Payer: PHP Commercial |
$422.22
|
| Rate for Payer: PHP Commercial |
$479.61
|
| Rate for Payer: PHP Commercial |
$220.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$394.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.58
|
| Rate for Payer: Priority Health SBD |
$163.38
|
| Rate for Payer: Priority Health SBD |
$429.82
|
| Rate for Payer: Priority Health SBD |
$312.94
|
| Rate for Payer: Priority Health SBD |
$355.48
|
| Rate for Payer: UMR Bronson Commercial |
$218.56
|
| Rate for Payer: UMR Bronson Commercial |
$300.19
|
| Rate for Payer: UMR Bronson Commercial |
$248.27
|
| Rate for Payer: UMR Bronson Commercial |
$114.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$511.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$372.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.50
|
|
|
DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$276.75
|
|
|
Service Code
|
HCPCS J9000
|
| Hospital Charge Code |
2616
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.59 |
| Max. Negotiated Rate |
$249.08 |
| Rate for Payer: Aetna American Axle |
$179.89
|
| Rate for Payer: Aetna American Axle |
$745.55
|
| Rate for Payer: Aetna American Axle |
$366.76
|
| Rate for Payer: Aetna American Axle |
$237.35
|
| Rate for Payer: Aetna Commercial |
$310.39
|
| Rate for Payer: Aetna Commercial |
$479.61
|
| Rate for Payer: Aetna Commercial |
$974.95
|
| Rate for Payer: Aetna Commercial |
$235.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$745.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.76
|
| Rate for Payer: BCBS Complete |
$146.06
|
| Rate for Payer: BCBS Complete |
$225.70
|
| Rate for Payer: BCBS Complete |
$110.70
|
| Rate for Payer: BCBS Complete |
$458.80
|
| Rate for Payer: BCBS Trust/PPO |
$10.59
|
| Rate for Payer: BCBS Trust/PPO |
$10.59
|
| Rate for Payer: BCBS Trust/PPO |
$10.59
|
| Rate for Payer: BCBS Trust/PPO |
$10.59
|
| Rate for Payer: Cash Price |
$451.40
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$292.13
|
| Rate for Payer: Cash Price |
$451.40
|
| Rate for Payer: Cash Price |
$221.40
|
| Rate for Payer: Cash Price |
$221.40
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$292.13
|
| Rate for Payer: Cofinity Commercial |
$802.90
|
| Rate for Payer: Cofinity Commercial |
$394.98
|
| Rate for Payer: Cofinity Commercial |
$485.26
|
| Rate for Payer: Cofinity Commercial |
$314.04
|
| Rate for Payer: Cofinity Commercial |
$255.61
|
| Rate for Payer: Cofinity Commercial |
$986.42
|
| Rate for Payer: Cofinity Commercial |
$193.72
|
| Rate for Payer: Cofinity Commercial |
$238.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$917.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$451.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.13
|
| Rate for Payer: Healthscope Commercial |
$1,032.30
|
| Rate for Payer: Healthscope Commercial |
$249.08
|
| Rate for Payer: Healthscope Commercial |
$328.64
|
| Rate for Payer: Healthscope Commercial |
$507.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$394.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$802.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$860.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$235.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$479.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$310.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$974.95
|
| Rate for Payer: PHP Commercial |
$310.39
|
| Rate for Payer: PHP Commercial |
$235.24
|
| Rate for Payer: PHP Commercial |
$974.95
|
| Rate for Payer: PHP Commercial |
$479.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$394.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$255.61
|
| Rate for Payer: Priority Health SBD |
$174.35
|
| Rate for Payer: Priority Health SBD |
$722.61
|
| Rate for Payer: Priority Health SBD |
$230.05
|
| Rate for Payer: Priority Health SBD |
$355.48
|
| Rate for Payer: UMR Bronson Commercial |
$102.40
|
| Rate for Payer: UMR Bronson Commercial |
$135.11
|
| Rate for Payer: UMR Bronson Commercial |
$208.77
|
| Rate for Payer: UMR Bronson Commercial |
$424.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$860.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.19
|
|
|
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$276.88
|
|
|
Service Code
|
HCPCS J9000
|
| Hospital Charge Code |
118501
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.59 |
| Max. Negotiated Rate |
$249.19 |
| Rate for Payer: Aetna American Axle |
$179.97
|
| Rate for Payer: Aetna American Axle |
$216.87
|
| Rate for Payer: Aetna American Axle |
$166.97
|
| Rate for Payer: Aetna Commercial |
$283.59
|
| Rate for Payer: Aetna Commercial |
$218.35
|
| Rate for Payer: Aetna Commercial |
$235.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.97
|
| Rate for Payer: BCBS Complete |
$102.75
|
| Rate for Payer: BCBS Complete |
$110.75
|
| Rate for Payer: BCBS Complete |
$133.46
|
| Rate for Payer: BCBS Trust/PPO |
$10.59
|
| Rate for Payer: BCBS Trust/PPO |
$10.59
|
| Rate for Payer: BCBS Trust/PPO |
$10.59
|
| Rate for Payer: Cash Price |
$205.50
|
| Rate for Payer: Cash Price |
$266.91
|
| Rate for Payer: Cash Price |
$266.91
|
| Rate for Payer: Cash Price |
$221.50
|
| Rate for Payer: Cash Price |
$205.50
|
| Rate for Payer: Cash Price |
$221.50
|
| Rate for Payer: Cofinity Commercial |
$220.92
|
| Rate for Payer: Cofinity Commercial |
$179.82
|
| Rate for Payer: Cofinity Commercial |
$233.55
|
| Rate for Payer: Cofinity Commercial |
$286.93
|
| Rate for Payer: Cofinity Commercial |
$193.82
|
| Rate for Payer: Cofinity Commercial |
$238.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.91
|
| Rate for Payer: Healthscope Commercial |
$300.28
|
| Rate for Payer: Healthscope Commercial |
$249.19
|
| Rate for Payer: Healthscope Commercial |
$231.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$179.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$235.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$283.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$218.35
|
| Rate for Payer: PHP Commercial |
$283.59
|
| Rate for Payer: PHP Commercial |
$218.35
|
| Rate for Payer: PHP Commercial |
$235.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.55
|
| Rate for Payer: Priority Health SBD |
$210.19
|
| Rate for Payer: Priority Health SBD |
$174.43
|
| Rate for Payer: Priority Health SBD |
$161.83
|
| Rate for Payer: UMR Bronson Commercial |
$123.45
|
| Rate for Payer: UMR Bronson Commercial |
$102.45
|
| Rate for Payer: UMR Bronson Commercial |
$95.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.23
|
|
|
DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$248.05
|
|
|
Service Code
|
HCPCS J9000
|
| Hospital Charge Code |
118501
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$109.14 |
| Max. Negotiated Rate |
$223.24 |
| Rate for Payer: Aetna American Axle |
$161.23
|
| Rate for Payer: Aetna American Axle |
$179.97
|
| Rate for Payer: Aetna Commercial |
$235.35
|
| Rate for Payer: Aetna Commercial |
$210.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.23
|
| Rate for Payer: Cash Price |
$198.44
|
| Rate for Payer: Cash Price |
$221.50
|
| Rate for Payer: Cofinity Commercial |
$238.12
|
| Rate for Payer: Cofinity Commercial |
$213.32
|
| Rate for Payer: Cofinity Commercial |
$173.64
|
| Rate for Payer: Cofinity Commercial |
$193.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.44
|
| Rate for Payer: Healthscope Commercial |
$223.24
|
| Rate for Payer: Healthscope Commercial |
$249.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$235.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$210.84
|
| Rate for Payer: PHP Commercial |
$235.35
|
| Rate for Payer: PHP Commercial |
$210.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.82
|
| Rate for Payer: Priority Health SBD |
$174.43
|
| Rate for Payer: Priority Health SBD |
$156.27
|
| Rate for Payer: UMR Bronson Commercial |
$109.14
|
| Rate for Payer: UMR Bronson Commercial |
$121.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.66
|
|
|
DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION
|
Facility
|
IP
|
$1,971.14
|
|
|
Service Code
|
HCPCS Q2050
|
| Hospital Charge Code |
27431
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$867.30 |
| Max. Negotiated Rate |
$1,774.03 |
| Rate for Payer: Aetna American Axle |
$1,281.24
|
| Rate for Payer: Aetna American Axle |
$618.41
|
| Rate for Payer: Aetna Commercial |
$808.69
|
| Rate for Payer: Aetna Commercial |
$1,675.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$618.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.24
|
| Rate for Payer: Cash Price |
$761.12
|
| Rate for Payer: Cash Price |
$1,576.91
|
| Rate for Payer: Cofinity Commercial |
$818.20
|
| Rate for Payer: Cofinity Commercial |
$665.98
|
| Rate for Payer: Cofinity Commercial |
$1,695.18
|
| Rate for Payer: Cofinity Commercial |
$1,379.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,576.91
|
| Rate for Payer: Healthscope Commercial |
$856.26
|
| Rate for Payer: Healthscope Commercial |
$1,774.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$665.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,379.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,478.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$808.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,675.47
|
| Rate for Payer: PHP Commercial |
$808.69
|
| Rate for Payer: PHP Commercial |
$1,675.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,379.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.98
|
| Rate for Payer: Priority Health SBD |
$599.38
|
| Rate for Payer: Priority Health SBD |
$1,241.82
|
| Rate for Payer: UMR Bronson Commercial |
$867.30
|
| Rate for Payer: UMR Bronson Commercial |
$418.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,478.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.55
|
|
|
DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION
|
Facility
|
OP
|
$3,432.16
|
|
|
Service Code
|
HCPCS Q2050
|
| Hospital Charge Code |
27431
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$46.76 |
| Max. Negotiated Rate |
$3,088.94 |
| Rate for Payer: Aetna American Axle |
$2,230.90
|
| Rate for Payer: Aetna American Axle |
$618.41
|
| Rate for Payer: Aetna American Axle |
$1,281.24
|
| Rate for Payer: Aetna American Axle |
$2,135.03
|
| Rate for Payer: Aetna American Axle |
$1,366.30
|
| Rate for Payer: Aetna American Axle |
$1,841.05
|
| Rate for Payer: Aetna American Axle |
$940.10
|
| Rate for Payer: Aetna Commercial |
$1,786.70
|
| Rate for Payer: Aetna Commercial |
$808.69
|
| Rate for Payer: Aetna Commercial |
$2,917.34
|
| Rate for Payer: Aetna Commercial |
$2,407.53
|
| Rate for Payer: Aetna Commercial |
$1,675.47
|
| Rate for Payer: Aetna Commercial |
$2,791.96
|
| Rate for Payer: Aetna Commercial |
$1,229.36
|
| Rate for Payer: Aetna Medicare |
$88.90
|
| Rate for Payer: Aetna Medicare |
$88.90
|
| Rate for Payer: Aetna Medicare |
$88.90
|
| Rate for Payer: Aetna Medicare |
$88.90
|
| Rate for Payer: Aetna Medicare |
$88.90
|
| Rate for Payer: Aetna Medicare |
$88.90
|
| Rate for Payer: Aetna Medicare |
$88.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$618.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,841.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,366.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$940.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,135.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,230.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.86
|
| Rate for Payer: BCBS Complete |
$49.10
|
| Rate for Payer: BCBS Complete |
$49.10
|
| Rate for Payer: BCBS Complete |
$49.10
|
| Rate for Payer: BCBS Complete |
$49.10
|
| Rate for Payer: BCBS Complete |
$49.10
|
| Rate for Payer: BCBS Complete |
$49.10
|
| Rate for Payer: BCBS Complete |
$49.10
|
| Rate for Payer: BCBS MAPPO |
$85.48
|
| Rate for Payer: BCBS MAPPO |
$85.48
|
| Rate for Payer: BCBS MAPPO |
$85.48
|
| Rate for Payer: BCBS MAPPO |
$85.48
|
| Rate for Payer: BCBS MAPPO |
$85.48
|
| Rate for Payer: BCBS MAPPO |
$85.48
|
| Rate for Payer: BCBS MAPPO |
$85.48
|
| Rate for Payer: BCBS Trust/PPO |
$276.22
|
| Rate for Payer: BCBS Trust/PPO |
$276.22
|
| Rate for Payer: BCBS Trust/PPO |
$276.22
|
| Rate for Payer: BCBS Trust/PPO |
$276.22
|
| Rate for Payer: BCBS Trust/PPO |
$276.22
|
| Rate for Payer: BCBS Trust/PPO |
$276.22
|
| Rate for Payer: BCBS Trust/PPO |
$276.22
|
| Rate for Payer: BCN Medicare Advantage |
$85.48
|
| Rate for Payer: BCN Medicare Advantage |
$85.48
|
| Rate for Payer: BCN Medicare Advantage |
$85.48
|
| Rate for Payer: BCN Medicare Advantage |
$85.48
|
| Rate for Payer: BCN Medicare Advantage |
$85.48
|
| Rate for Payer: BCN Medicare Advantage |
$85.48
|
| Rate for Payer: BCN Medicare Advantage |
$85.48
|
| Rate for Payer: Cash Price |
$1,576.91
|
| Rate for Payer: Cash Price |
$2,745.73
|
| Rate for Payer: Cash Price |
$2,745.73
|
| Rate for Payer: Cash Price |
$2,627.73
|
| Rate for Payer: Cash Price |
$1,576.91
|
| Rate for Payer: Cash Price |
$1,157.04
|
| Rate for Payer: Cash Price |
$2,627.73
|
| Rate for Payer: Cash Price |
$761.12
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Cash Price |
$761.12
|
| Rate for Payer: Cash Price |
$2,265.91
|
| Rate for Payer: Cash Price |
$2,265.91
|
| Rate for Payer: Cash Price |
$1,157.04
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Cofinity Commercial |
$1,379.80
|
| Rate for Payer: Cofinity Commercial |
$2,299.26
|
| Rate for Payer: Cofinity Commercial |
$2,824.81
|
| Rate for Payer: Cofinity Commercial |
$665.98
|
| Rate for Payer: Cofinity Commercial |
$2,435.86
|
| Rate for Payer: Cofinity Commercial |
$1,982.67
|
| Rate for Payer: Cofinity Commercial |
$2,951.66
|
| Rate for Payer: Cofinity Commercial |
$818.20
|
| Rate for Payer: Cofinity Commercial |
$2,402.51
|
| Rate for Payer: Cofinity Commercial |
$1,012.41
|
| Rate for Payer: Cofinity Commercial |
$1,243.82
|
| Rate for Payer: Cofinity Commercial |
$1,471.40
|
| Rate for Payer: Cofinity Commercial |
$1,695.18
|
| Rate for Payer: Cofinity Commercial |
$1,807.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,745.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,576.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,157.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,681.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,627.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,265.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.48
|
| Rate for Payer: Healthscope Commercial |
$1,774.03
|
| Rate for Payer: Healthscope Commercial |
$1,891.80
|
| Rate for Payer: Healthscope Commercial |
$1,301.67
|
| Rate for Payer: Healthscope Commercial |
$3,088.94
|
| Rate for Payer: Healthscope Commercial |
$2,956.19
|
| Rate for Payer: Healthscope Commercial |
$2,549.15
|
| Rate for Payer: Healthscope Commercial |
$856.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,379.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,012.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,471.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,982.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,299.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,402.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$665.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,478.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,576.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,463.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,124.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,574.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,084.72
|
| Rate for Payer: Mclaren Medicaid |
$46.76
|
| Rate for Payer: Mclaren Medicaid |
$46.76
|
| Rate for Payer: Mclaren Medicaid |
$46.76
|
| Rate for Payer: Mclaren Medicaid |
$46.76
|
| Rate for Payer: Mclaren Medicaid |
$46.76
|
| Rate for Payer: Mclaren Medicaid |
$46.76
|
| Rate for Payer: Mclaren Medicaid |
$46.76
|
| Rate for Payer: Mclaren Medicare |
$85.48
|
| Rate for Payer: Mclaren Medicare |
$85.48
|
| Rate for Payer: Mclaren Medicare |
$85.48
|
| Rate for Payer: Mclaren Medicare |
$85.48
|
| Rate for Payer: Mclaren Medicare |
$85.48
|
| Rate for Payer: Mclaren Medicare |
$85.48
|
| Rate for Payer: Mclaren Medicare |
$85.48
|
| Rate for Payer: Meridian Medicaid |
$49.10
|
| Rate for Payer: Meridian Medicaid |
$49.10
|
| Rate for Payer: Meridian Medicaid |
$49.10
|
| Rate for Payer: Meridian Medicaid |
$49.10
|
| Rate for Payer: Meridian Medicaid |
$49.10
|
| Rate for Payer: Meridian Medicaid |
$49.10
|
| Rate for Payer: Meridian Medicaid |
$49.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$89.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$89.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$89.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$89.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$89.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$89.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$89.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$808.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,786.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,675.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,229.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,407.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,917.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,791.96
|
| Rate for Payer: PACE Medicare |
$81.21
|
| Rate for Payer: PACE Medicare |
$81.21
|
| Rate for Payer: PACE Medicare |
$81.21
|
| Rate for Payer: PACE Medicare |
$81.21
|
| Rate for Payer: PACE Medicare |
$81.21
|
| Rate for Payer: PACE Medicare |
$81.21
|
| Rate for Payer: PACE Medicare |
$81.21
|
| Rate for Payer: PACE SWMI |
$85.48
|
| Rate for Payer: PACE SWMI |
$85.48
|
| Rate for Payer: PACE SWMI |
$85.48
|
| Rate for Payer: PACE SWMI |
$85.48
|
| Rate for Payer: PACE SWMI |
$85.48
|
| Rate for Payer: PACE SWMI |
$85.48
|
| Rate for Payer: PACE SWMI |
$85.48
|
| Rate for Payer: PHP Commercial |
$1,786.70
|
| Rate for Payer: PHP Commercial |
$2,407.53
|
| Rate for Payer: PHP Commercial |
$1,675.47
|
| Rate for Payer: PHP Commercial |
$2,791.96
|
| Rate for Payer: PHP Commercial |
$1,229.36
|
| Rate for Payer: PHP Commercial |
$2,917.34
|
| Rate for Payer: PHP Commercial |
$808.69
|
| Rate for Payer: PHP Medicare Advantage |
$85.48
|
| Rate for Payer: PHP Medicare Advantage |
$85.48
|
| Rate for Payer: PHP Medicare Advantage |
$85.48
|
| Rate for Payer: PHP Medicare Advantage |
$85.48
|
| Rate for Payer: PHP Medicare Advantage |
$85.48
|
| Rate for Payer: PHP Medicare Advantage |
$85.48
|
| Rate for Payer: PHP Medicare Advantage |
$85.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,402.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,471.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,299.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,379.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,982.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.39
|
| Rate for Payer: Priority Health Medicare |
$85.48
|
| Rate for Payer: Priority Health Medicare |
$85.48
|
| Rate for Payer: Priority Health Medicare |
$85.48
|
| Rate for Payer: Priority Health Medicare |
$85.48
|
| Rate for Payer: Priority Health Medicare |
$85.48
|
| Rate for Payer: Priority Health Medicare |
$85.48
|
| Rate for Payer: Priority Health Medicare |
$85.48
|
| Rate for Payer: Priority Health Narrow Network |
$340.31
|
| Rate for Payer: Priority Health Narrow Network |
$340.31
|
| Rate for Payer: Priority Health Narrow Network |
$340.31
|
| Rate for Payer: Priority Health Narrow Network |
$340.31
|
| Rate for Payer: Priority Health Narrow Network |
$340.31
|
| Rate for Payer: Priority Health Narrow Network |
$340.31
|
| Rate for Payer: Priority Health Narrow Network |
$340.31
|
| Rate for Payer: Priority Health SBD |
$1,784.41
|
| Rate for Payer: Priority Health SBD |
$2,069.34
|
| Rate for Payer: Priority Health SBD |
$599.38
|
| Rate for Payer: Priority Health SBD |
$1,324.26
|
| Rate for Payer: Priority Health SBD |
$2,162.26
|
| Rate for Payer: Priority Health SBD |
$1,241.82
|
| Rate for Payer: Priority Health SBD |
$911.17
|
| Rate for Payer: Railroad Medicare Medicare |
$85.48
|
| Rate for Payer: Railroad Medicare Medicare |
$85.48
|
| Rate for Payer: Railroad Medicare Medicare |
$85.48
|
| Rate for Payer: Railroad Medicare Medicare |
$85.48
|
| Rate for Payer: Railroad Medicare Medicare |
$85.48
|
| Rate for Payer: Railroad Medicare Medicare |
$85.48
|
| Rate for Payer: Railroad Medicare Medicare |
$85.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.48
|
| Rate for Payer: UHC Medicare Advantage |
$88.05
|
| Rate for Payer: UHC Medicare Advantage |
$88.05
|
| Rate for Payer: UHC Medicare Advantage |
$88.05
|
| Rate for Payer: UHC Medicare Advantage |
$88.05
|
| Rate for Payer: UHC Medicare Advantage |
$88.05
|
| Rate for Payer: UHC Medicare Advantage |
$88.05
|
| Rate for Payer: UHC Medicare Advantage |
$88.05
|
| Rate for Payer: UMR Bronson Commercial |
$535.13
|
| Rate for Payer: UMR Bronson Commercial |
$352.02
|
| Rate for Payer: UMR Bronson Commercial |
$1,269.90
|
| Rate for Payer: UMR Bronson Commercial |
$777.74
|
| Rate for Payer: UMR Bronson Commercial |
$1,047.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,215.32
|
| Rate for Payer: UMR Bronson Commercial |
$729.32
|
| Rate for Payer: VA VA |
$85.48
|
| Rate for Payer: VA VA |
$85.48
|
| Rate for Payer: VA VA |
$85.48
|
| Rate for Payer: VA VA |
$85.48
|
| Rate for Payer: VA VA |
$85.48
|
| Rate for Payer: VA VA |
$85.48
|
| Rate for Payer: VA VA |
$85.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,478.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,576.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,124.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,084.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,463.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,574.12
|
|
|
DOXYCYCLINE 50 MG/5 ML ORAL SYRUP
|
Facility
|
IP
|
$2,288.57
|
|
|
Service Code
|
NDC 0069-0971-95
|
| Hospital Charge Code |
2621
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,006.97 |
| Max. Negotiated Rate |
$2,059.71 |
| Rate for Payer: Aetna American Axle |
$1,487.57
|
| Rate for Payer: Aetna Commercial |
$1,945.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,487.57
|
| Rate for Payer: Cash Price |
$1,830.86
|
| Rate for Payer: Cofinity Commercial |
$1,602.00
|
| Rate for Payer: Cofinity Commercial |
$1,968.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,830.86
|
| Rate for Payer: Healthscope Commercial |
$2,059.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,602.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,716.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,945.28
|
| Rate for Payer: PHP Commercial |
$1,945.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,602.00
|
| Rate for Payer: Priority Health SBD |
$1,441.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,006.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,716.43
|
|
|
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION
|
Facility
|
IP
|
$74.09
|
|
|
Service Code
|
NDC 0143-9381-01
|
| Hospital Charge Code |
2622
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$32.60 |
| Max. Negotiated Rate |
$66.68 |
| Rate for Payer: Aetna American Axle |
$48.16
|
| Rate for Payer: Aetna Commercial |
$62.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.16
|
| Rate for Payer: Cash Price |
$59.27
|
| Rate for Payer: Cofinity Commercial |
$51.86
|
| Rate for Payer: Cofinity Commercial |
$63.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.27
|
| Rate for Payer: Healthscope Commercial |
$66.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.98
|
| Rate for Payer: PHP Commercial |
$62.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.86
|
| Rate for Payer: Priority Health SBD |
$46.68
|
| Rate for Payer: UMR Bronson Commercial |
$32.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.57
|
|
|
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION
|
Facility
|
IP
|
$68.25
|
|
|
Service Code
|
NDC 63323-130-11
|
| Hospital Charge Code |
2622
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$30.03 |
| Max. Negotiated Rate |
$61.42 |
| Rate for Payer: Aetna American Axle |
$44.36
|
| Rate for Payer: Aetna Commercial |
$58.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.36
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cofinity Commercial |
$47.78
|
| Rate for Payer: Cofinity Commercial |
$58.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.60
|
| Rate for Payer: Healthscope Commercial |
$61.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.01
|
| Rate for Payer: PHP Commercial |
$58.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.78
|
| Rate for Payer: Priority Health SBD |
$43.00
|
| Rate for Payer: UMR Bronson Commercial |
$30.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.19
|
|
|
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION
|
Facility
|
IP
|
$68.25
|
|
|
Service Code
|
NDC 63323-130-13
|
| Hospital Charge Code |
2622
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$30.03 |
| Max. Negotiated Rate |
$61.42 |
| Rate for Payer: Aetna American Axle |
$44.36
|
| Rate for Payer: Aetna Commercial |
$58.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.36
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cofinity Commercial |
$47.78
|
| Rate for Payer: Cofinity Commercial |
$58.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.60
|
| Rate for Payer: Healthscope Commercial |
$61.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.01
|
| Rate for Payer: PHP Commercial |
$58.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.78
|
| Rate for Payer: Priority Health SBD |
$43.00
|
| Rate for Payer: UMR Bronson Commercial |
$30.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.19
|
|
|
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION
|
Facility
|
IP
|
$54.76
|
|
|
Service Code
|
NDC 68382-910-10
|
| Hospital Charge Code |
2622
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$24.09 |
| Max. Negotiated Rate |
$49.28 |
| Rate for Payer: Aetna American Axle |
$35.59
|
| Rate for Payer: Aetna Commercial |
$46.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.59
|
| Rate for Payer: Cash Price |
$43.81
|
| Rate for Payer: Cofinity Commercial |
$38.33
|
| Rate for Payer: Cofinity Commercial |
$47.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.81
|
| Rate for Payer: Healthscope Commercial |
$49.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.55
|
| Rate for Payer: PHP Commercial |
$46.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.33
|
| Rate for Payer: Priority Health SBD |
$34.50
|
| Rate for Payer: UMR Bronson Commercial |
$24.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.07
|
|
|
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION
|
Facility
|
IP
|
$54.76
|
|
|
Service Code
|
NDC 68382-910-01
|
| Hospital Charge Code |
2622
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$24.09 |
| Max. Negotiated Rate |
$49.28 |
| Rate for Payer: Aetna American Axle |
$35.59
|
| Rate for Payer: Aetna Commercial |
$46.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.59
|
| Rate for Payer: Cash Price |
$43.81
|
| Rate for Payer: Cofinity Commercial |
$38.33
|
| Rate for Payer: Cofinity Commercial |
$47.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.81
|
| Rate for Payer: Healthscope Commercial |
$49.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.55
|
| Rate for Payer: PHP Commercial |
$46.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.33
|
| Rate for Payer: Priority Health SBD |
$34.50
|
| Rate for Payer: UMR Bronson Commercial |
$24.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.07
|
|
|
DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION
|
Facility
|
IP
|
$74.09
|
|
|
Service Code
|
NDC 0143-9381-10
|
| Hospital Charge Code |
2622
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$32.60 |
| Max. Negotiated Rate |
$66.68 |
| Rate for Payer: Aetna American Axle |
$48.16
|
| Rate for Payer: Aetna Commercial |
$62.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.16
|
| Rate for Payer: Cash Price |
$59.27
|
| Rate for Payer: Cofinity Commercial |
$51.86
|
| Rate for Payer: Cofinity Commercial |
$63.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.27
|
| Rate for Payer: Healthscope Commercial |
$66.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.98
|
| Rate for Payer: PHP Commercial |
$62.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.86
|
| Rate for Payer: Priority Health SBD |
$46.68
|
| Rate for Payer: UMR Bronson Commercial |
$32.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.57
|
|
|
DOXYCYCLINE HYCLATE 100 MG TABLET
|
Facility
|
IP
|
$377.22
|
|
|
Service Code
|
NDC 0378-0167-89
|
| Hospital Charge Code |
2625
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$165.98 |
| Max. Negotiated Rate |
$339.50 |
| Rate for Payer: Aetna American Axle |
$245.19
|
| Rate for Payer: Aetna Commercial |
$320.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.19
|
| Rate for Payer: Cash Price |
$301.78
|
| Rate for Payer: Cofinity Commercial |
$264.05
|
| Rate for Payer: Cofinity Commercial |
$324.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$301.78
|
| Rate for Payer: Healthscope Commercial |
$339.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$264.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$282.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$320.64
|
| Rate for Payer: PHP Commercial |
$320.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$264.05
|
| Rate for Payer: Priority Health SBD |
$237.65
|
| Rate for Payer: UMR Bronson Commercial |
$165.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$282.92
|
|
|
DOXYCYCLINE HYCLATE 100 MG TABLET
|
Facility
|
IP
|
$211.50
|
|
|
Service Code
|
NDC 0143-2112-50
|
| Hospital Charge Code |
2625
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$190.35 |
| Rate for Payer: Aetna American Axle |
$137.48
|
| Rate for Payer: Aetna Commercial |
$179.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.48
|
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cofinity Commercial |
$148.05
|
| Rate for Payer: Cofinity Commercial |
$181.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.20
|
| Rate for Payer: Healthscope Commercial |
$190.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$179.78
|
| Rate for Payer: PHP Commercial |
$179.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.05
|
| Rate for Payer: Priority Health SBD |
$133.24
|
| Rate for Payer: UMR Bronson Commercial |
$93.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.62
|
|
