|
RECTAL RESECTION WITH CC
|
Facility
|
IP
|
$52,618.08
|
|
|
Service Code
|
MSDRG 333
|
| Min. Negotiated Rate |
$19,171.08 |
| Max. Negotiated Rate |
$52,618.08 |
| Rate for Payer: Aetna Medicare |
$20,987.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25,225.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25,225.10
|
| Rate for Payer: BCBS MAPPO |
$20,180.08
|
| Rate for Payer: BCBS Trust/PPO |
$52,618.08
|
| Rate for Payer: BCN Commercial |
$52,618.08
|
| Rate for Payer: BCN Medicare Advantage |
$20,180.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,180.08
|
| Rate for Payer: Mclaren Medicare |
$20,180.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21,189.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,207.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$22,198.09
|
| Rate for Payer: Nomi Health Commercial |
$30,214.38
|
| Rate for Payer: PACE Medicare |
$19,171.08
|
| Rate for Payer: PACE SWMI |
$20,180.08
|
| Rate for Payer: PHP Medicare Advantage |
$20,180.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,761.28
|
| Rate for Payer: Priority Health Medicare |
$20,180.08
|
| Rate for Payer: Priority Health Tiered Network |
$30,209.02
|
| Rate for Payer: Railroad Medicare Medicare |
$20,180.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38,177.86
|
| Rate for Payer: UHC Core |
$31,940.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20,180.08
|
| Rate for Payer: UHC Exchange |
$26,085.08
|
| Rate for Payer: VA VA |
$20,180.08
|
|
|
RECTAL RESECTION WITH MCC
|
Facility
|
IP
|
$67,554.17
|
|
|
Service Code
|
MSDRG 332
|
| Min. Negotiated Rate |
$29,328.20 |
| Max. Negotiated Rate |
$67,554.17 |
| Rate for Payer: Aetna Medicare |
$32,106.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38,589.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38,589.74
|
| Rate for Payer: BCBS MAPPO |
$30,871.79
|
| Rate for Payer: BCBS Trust/PPO |
$67,554.17
|
| Rate for Payer: BCN Commercial |
$67,554.17
|
| Rate for Payer: BCN Medicare Advantage |
$30,871.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30,871.79
|
| Rate for Payer: Mclaren Medicare |
$30,871.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,415.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,502.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$33,958.97
|
| Rate for Payer: Nomi Health Commercial |
$46,707.03
|
| Rate for Payer: PACE Medicare |
$29,328.20
|
| Rate for Payer: PACE SWMI |
$30,871.79
|
| Rate for Payer: PHP Medicare Advantage |
$30,871.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$58,373.43
|
| Rate for Payer: Priority Health Medicare |
$30,871.79
|
| Rate for Payer: Priority Health Tiered Network |
$46,698.74
|
| Rate for Payer: Railroad Medicare Medicare |
$30,871.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59,017.41
|
| Rate for Payer: UHC Core |
$49,375.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30,871.79
|
| Rate for Payer: UHC Exchange |
$40,323.74
|
| Rate for Payer: VA VA |
$30,871.79
|
|
|
RECTAL RESECTION WITHOUT CC/MCC
|
Facility
|
IP
|
$41,253.36
|
|
|
Service Code
|
MSDRG 334
|
| Min. Negotiated Rate |
$13,575.71 |
| Max. Negotiated Rate |
$41,253.36 |
| Rate for Payer: Aetna Medicare |
$14,861.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,862.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,862.78
|
| Rate for Payer: BCBS MAPPO |
$14,290.22
|
| Rate for Payer: BCBS Trust/PPO |
$41,253.36
|
| Rate for Payer: BCN Commercial |
$41,253.36
|
| Rate for Payer: BCN Medicare Advantage |
$14,290.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,290.22
|
| Rate for Payer: Mclaren Medicare |
$14,290.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,004.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,433.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,719.24
|
| Rate for Payer: Nomi Health Commercial |
$21,128.91
|
| Rate for Payer: PACE Medicare |
$13,575.71
|
| Rate for Payer: PACE SWMI |
$14,290.22
|
| Rate for Payer: PHP Medicare Advantage |
$14,290.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26,406.45
|
| Rate for Payer: Priority Health Medicare |
$14,290.22
|
| Rate for Payer: Priority Health Tiered Network |
$21,125.16
|
| Rate for Payer: Railroad Medicare Medicare |
$14,290.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,697.77
|
| Rate for Payer: UHC Core |
$22,336.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14,290.22
|
| Rate for Payer: UHC Exchange |
$18,241.29
|
| Rate for Payer: VA VA |
$14,290.22
|
|
|
RED BLOOD CELL DISORDERS WITH MCC
|
Facility
|
IP
|
$27,527.86
|
|
|
Service Code
|
MSDRG 811
|
| Min. Negotiated Rate |
$11,719.86 |
| Max. Negotiated Rate |
$27,527.86 |
| Rate for Payer: Aetna Medicare |
$12,830.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,420.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,420.88
|
| Rate for Payer: BCBS MAPPO |
$12,336.70
|
| Rate for Payer: BCBS Trust/PPO |
$27,527.86
|
| Rate for Payer: BCN Commercial |
$27,527.86
|
| Rate for Payer: BCN Medicare Advantage |
$12,336.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,336.70
|
| Rate for Payer: Mclaren Medicare |
$12,336.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,953.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,187.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,570.37
|
| Rate for Payer: Nomi Health Commercial |
$18,115.47
|
| Rate for Payer: PACE Medicare |
$11,719.86
|
| Rate for Payer: PACE SWMI |
$12,336.70
|
| Rate for Payer: PHP Medicare Advantage |
$12,336.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22,640.32
|
| Rate for Payer: Priority Health Medicare |
$12,336.70
|
| Rate for Payer: Priority Health Tiered Network |
$18,112.25
|
| Rate for Payer: Railroad Medicare Medicare |
$12,336.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22,890.09
|
| Rate for Payer: UHC Core |
$19,150.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,336.70
|
| Rate for Payer: UHC Exchange |
$15,639.69
|
| Rate for Payer: VA VA |
$12,336.70
|
|
|
RED BLOOD CELL DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$18,960.41
|
|
|
Service Code
|
MSDRG 812
|
| Min. Negotiated Rate |
$7,858.02 |
| Max. Negotiated Rate |
$18,960.41 |
| Rate for Payer: Aetna Medicare |
$8,602.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,339.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,339.50
|
| Rate for Payer: BCBS MAPPO |
$8,271.60
|
| Rate for Payer: BCBS Trust/PPO |
$18,960.41
|
| Rate for Payer: BCN Commercial |
$18,960.41
|
| Rate for Payer: BCN Medicare Advantage |
$8,271.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,271.60
|
| Rate for Payer: Mclaren Medicare |
$8,271.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,685.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,512.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,098.76
|
| Rate for Payer: Nomi Health Commercial |
$11,844.78
|
| Rate for Payer: PACE Medicare |
$7,858.02
|
| Rate for Payer: PACE SWMI |
$8,271.60
|
| Rate for Payer: PHP Medicare Advantage |
$8,271.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14,803.35
|
| Rate for Payer: Priority Health Medicare |
$8,271.60
|
| Rate for Payer: Priority Health Tiered Network |
$11,842.68
|
| Rate for Payer: Railroad Medicare Medicare |
$8,271.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,966.66
|
| Rate for Payer: UHC Core |
$12,521.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,271.60
|
| Rate for Payer: UHC Exchange |
$10,225.99
|
| Rate for Payer: VA VA |
$8,271.60
|
|
|
REDUCTION OF TORSION OF TESTIS, SURGICAL, WITH OR WITHOUT FIXATION OF CONTRALATERAL TESTIS
|
Facility
|
OP
|
$11,358.48
|
|
|
Service Code
|
CPT 54600
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,836.94 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$4,365.66
|
| Rate for Payer: BCN Commercial |
$4,365.66
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Mclaren Medicaid |
$3,512.31
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$851.01
|
|
|
Service Code
|
HCPCS J2785
|
| Hospital Charge Code |
91408
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$374.44 |
| Max. Negotiated Rate |
$765.91 |
| Rate for Payer: Aetna American Axle |
$553.16
|
| Rate for Payer: Aetna American Axle |
$24.79
|
| Rate for Payer: Aetna American Axle |
$22.88
|
| Rate for Payer: Aetna American Axle |
$86.23
|
| Rate for Payer: Aetna American Axle |
$20.31
|
| Rate for Payer: Aetna American Axle |
$17.67
|
| Rate for Payer: Aetna Commercial |
$723.36
|
| Rate for Payer: Aetna Commercial |
$26.55
|
| Rate for Payer: Aetna Commercial |
$29.92
|
| Rate for Payer: Aetna Commercial |
$23.11
|
| Rate for Payer: Aetna Commercial |
$32.42
|
| Rate for Payer: Aetna Commercial |
$112.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.23
|
| Rate for Payer: Cash Price |
$680.81
|
| Rate for Payer: Cash Price |
$30.51
|
| Rate for Payer: Cash Price |
$28.16
|
| Rate for Payer: Cash Price |
$106.13
|
| Rate for Payer: Cash Price |
$24.99
|
| Rate for Payer: Cash Price |
$21.75
|
| Rate for Payer: Cofinity Advantage |
$24.64
|
| Rate for Payer: Cofinity Advantage |
$19.03
|
| Rate for Payer: Cofinity Advantage |
$92.86
|
| Rate for Payer: Cofinity Advantage |
$26.70
|
| Rate for Payer: Cofinity Advantage |
$21.87
|
| Rate for Payer: Cofinity Advantage |
$595.71
|
| Rate for Payer: Cofinity Commercial |
$23.38
|
| Rate for Payer: Cofinity Commercial |
$30.27
|
| Rate for Payer: Cofinity Commercial |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$114.09
|
| Rate for Payer: Cofinity Commercial |
$26.87
|
| Rate for Payer: Cofinity Commercial |
$731.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.81
|
| Rate for Payer: Healthscope Commercial |
$34.33
|
| Rate for Payer: Healthscope Commercial |
$119.39
|
| Rate for Payer: Healthscope Commercial |
$31.68
|
| Rate for Payer: Healthscope Commercial |
$24.47
|
| Rate for Payer: Healthscope Commercial |
$28.12
|
| Rate for Payer: Healthscope Commercial |
$765.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$595.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$638.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$723.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$638.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.43
|
| Rate for Payer: PHP Commercial |
$26.55
|
| Rate for Payer: PHP Commercial |
$723.36
|
| Rate for Payer: PHP Commercial |
$32.42
|
| Rate for Payer: PHP Commercial |
$29.92
|
| Rate for Payer: PHP Commercial |
$112.76
|
| Rate for Payer: PHP Commercial |
$23.11
|
| Rate for Payer: Priority Health SBD |
$24.03
|
| Rate for Payer: Priority Health SBD |
$17.13
|
| Rate for Payer: Priority Health SBD |
$83.58
|
| Rate for Payer: Priority Health SBD |
$19.68
|
| Rate for Payer: Priority Health SBD |
$22.18
|
| Rate for Payer: Priority Health SBD |
$536.14
|
| Rate for Payer: UMR Bronson Commercial |
$16.78
|
| Rate for Payer: UMR Bronson Commercial |
$13.75
|
| Rate for Payer: UMR Bronson Commercial |
$15.49
|
| Rate for Payer: UMR Bronson Commercial |
$11.96
|
| Rate for Payer: UMR Bronson Commercial |
$374.44
|
| Rate for Payer: UMR Bronson Commercial |
$58.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$638.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.43
|
|
|
REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$27.19
|
|
|
Service Code
|
HCPCS J2785
|
| Hospital Charge Code |
91408
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.42 |
| Max. Negotiated Rate |
$24.47 |
| Rate for Payer: Aetna American Axle |
$17.67
|
| Rate for Payer: Aetna American Axle |
$22.88
|
| Rate for Payer: Aetna American Axle |
$24.79
|
| Rate for Payer: Aetna American Axle |
$86.23
|
| Rate for Payer: Aetna American Axle |
$553.16
|
| Rate for Payer: Aetna American Axle |
$20.31
|
| Rate for Payer: Aetna Commercial |
$723.36
|
| Rate for Payer: Aetna Commercial |
$32.42
|
| Rate for Payer: Aetna Commercial |
$26.55
|
| Rate for Payer: Aetna Commercial |
$112.76
|
| Rate for Payer: Aetna Commercial |
$29.92
|
| Rate for Payer: Aetna Commercial |
$23.11
|
| Rate for Payer: Aetna Medicare |
$66.33
|
| Rate for Payer: Aetna Medicare |
$13.60
|
| Rate for Payer: Aetna Medicare |
$15.62
|
| Rate for Payer: Aetna Medicare |
$425.50
|
| Rate for Payer: Aetna Medicare |
$19.07
|
| Rate for Payer: Aetna Medicare |
$17.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.88
|
| Rate for Payer: BCBS Complete |
$12.50
|
| Rate for Payer: BCBS Complete |
$10.88
|
| Rate for Payer: BCBS Complete |
$53.06
|
| Rate for Payer: BCBS Complete |
$14.08
|
| Rate for Payer: BCBS Complete |
$15.26
|
| Rate for Payer: BCBS Complete |
$340.40
|
| Rate for Payer: BCBS Trust/PPO |
$8.66
|
| Rate for Payer: BCBS Trust/PPO |
$8.66
|
| Rate for Payer: BCBS Trust/PPO |
$8.66
|
| Rate for Payer: BCBS Trust/PPO |
$8.66
|
| Rate for Payer: BCBS Trust/PPO |
$8.66
|
| Rate for Payer: BCBS Trust/PPO |
$8.66
|
| Rate for Payer: BCN Commercial |
$8.66
|
| Rate for Payer: BCN Commercial |
$8.66
|
| Rate for Payer: BCN Commercial |
$8.66
|
| Rate for Payer: BCN Commercial |
$8.66
|
| Rate for Payer: BCN Commercial |
$8.66
|
| Rate for Payer: BCN Commercial |
$8.66
|
| Rate for Payer: Cash Price |
$680.81
|
| Rate for Payer: Cash Price |
$106.13
|
| Rate for Payer: Cash Price |
$106.13
|
| Rate for Payer: Cash Price |
$24.99
|
| Rate for Payer: Cash Price |
$24.99
|
| Rate for Payer: Cash Price |
$21.75
|
| Rate for Payer: Cash Price |
$21.75
|
| Rate for Payer: Cash Price |
$680.81
|
| Rate for Payer: Cash Price |
$30.51
|
| Rate for Payer: Cash Price |
$28.16
|
| Rate for Payer: Cash Price |
$30.51
|
| Rate for Payer: Cash Price |
$28.16
|
| Rate for Payer: Cofinity Advantage |
$24.64
|
| Rate for Payer: Cofinity Advantage |
$21.87
|
| Rate for Payer: Cofinity Advantage |
$595.71
|
| Rate for Payer: Cofinity Advantage |
$92.86
|
| Rate for Payer: Cofinity Advantage |
$19.03
|
| Rate for Payer: Cofinity Advantage |
$26.70
|
| Rate for Payer: Cofinity Commercial |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$114.09
|
| Rate for Payer: Cofinity Commercial |
$23.38
|
| Rate for Payer: Cofinity Commercial |
$26.87
|
| Rate for Payer: Cofinity Commercial |
$30.27
|
| Rate for Payer: Cofinity Commercial |
$731.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.51
|
| Rate for Payer: Healthscope Commercial |
$119.39
|
| Rate for Payer: Healthscope Commercial |
$34.33
|
| Rate for Payer: Healthscope Commercial |
$28.12
|
| Rate for Payer: Healthscope Commercial |
$31.68
|
| Rate for Payer: Healthscope Commercial |
$765.91
|
| Rate for Payer: Healthscope Commercial |
$24.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$595.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$638.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$680.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$723.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$638.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.43
|
| Rate for Payer: PHP Commercial |
$23.11
|
| Rate for Payer: PHP Commercial |
$26.55
|
| Rate for Payer: PHP Commercial |
$29.92
|
| Rate for Payer: PHP Commercial |
$112.76
|
| Rate for Payer: PHP Commercial |
$32.42
|
| Rate for Payer: PHP Commercial |
$723.36
|
| Rate for Payer: Priority Health SBD |
$22.18
|
| Rate for Payer: Priority Health SBD |
$83.58
|
| Rate for Payer: Priority Health SBD |
$17.13
|
| Rate for Payer: Priority Health SBD |
$536.14
|
| Rate for Payer: Priority Health SBD |
$19.68
|
| Rate for Payer: Priority Health SBD |
$24.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.42
|
| Rate for Payer: UHC Core |
$4.42
|
| Rate for Payer: UHC Core |
$4.42
|
| Rate for Payer: UHC Core |
$4.42
|
| Rate for Payer: UHC Core |
$4.42
|
| Rate for Payer: UHC Core |
$4.42
|
| Rate for Payer: UHC Core |
$4.42
|
| Rate for Payer: UHC Exchange |
$4.42
|
| Rate for Payer: UHC Exchange |
$4.42
|
| Rate for Payer: UHC Exchange |
$4.42
|
| Rate for Payer: UHC Exchange |
$4.42
|
| Rate for Payer: UHC Exchange |
$4.42
|
| Rate for Payer: UHC Exchange |
$4.42
|
| Rate for Payer: UMR Bronson Commercial |
$13.02
|
| Rate for Payer: UMR Bronson Commercial |
$14.11
|
| Rate for Payer: UMR Bronson Commercial |
$10.06
|
| Rate for Payer: UMR Bronson Commercial |
$49.08
|
| Rate for Payer: UMR Bronson Commercial |
$314.87
|
| Rate for Payer: UMR Bronson Commercial |
$11.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$638.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.39
|
|
|
REHABILITATION
|
Facility
|
IP
|
$10,091.37
|
|
|
Service Code
|
APR-DRG 8601
|
| Min. Negotiated Rate |
$9,610.83 |
| Max. Negotiated Rate |
$10,091.37 |
| Rate for Payer: BCBS Complete |
$10,091.37
|
| Rate for Payer: Mclaren Medicaid |
$9,610.83
|
| Rate for Payer: Meridian Medicaid |
$10,091.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,610.83
|
| Rate for Payer: UHC Medicaid |
$9,610.83
|
| Rate for Payer: UHCCP Medicaid |
$9,610.83
|
|
|
REHABILITATION
|
Facility
|
IP
|
$12,803.83
|
|
|
Service Code
|
APR-DRG 8603
|
| Min. Negotiated Rate |
$12,194.13 |
| Max. Negotiated Rate |
$12,803.83 |
| Rate for Payer: BCBS Complete |
$12,803.83
|
| Rate for Payer: Mclaren Medicaid |
$12,194.13
|
| Rate for Payer: Meridian Medicaid |
$12,803.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,194.13
|
| Rate for Payer: UHC Medicaid |
$12,194.13
|
| Rate for Payer: UHCCP Medicaid |
$12,194.13
|
|
|
REHABILITATION
|
Facility
|
IP
|
$15,039.30
|
|
|
Service Code
|
APR-DRG 8604
|
| Min. Negotiated Rate |
$14,323.14 |
| Max. Negotiated Rate |
$15,039.30 |
| Rate for Payer: BCBS Complete |
$15,039.30
|
| Rate for Payer: Mclaren Medicaid |
$14,323.14
|
| Rate for Payer: Meridian Medicaid |
$15,039.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,323.14
|
| Rate for Payer: UHC Medicaid |
$14,323.14
|
| Rate for Payer: UHCCP Medicaid |
$14,323.14
|
|
|
REHABILITATION
|
Facility
|
IP
|
$12,751.17
|
|
|
Service Code
|
APR-DRG 8602
|
| Min. Negotiated Rate |
$12,143.97 |
| Max. Negotiated Rate |
$12,751.17 |
| Rate for Payer: BCBS Complete |
$12,751.17
|
| Rate for Payer: Mclaren Medicaid |
$12,143.97
|
| Rate for Payer: Meridian Medicaid |
$12,751.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,143.97
|
| Rate for Payer: UHC Medicaid |
$12,143.97
|
| Rate for Payer: UHCCP Medicaid |
$12,143.97
|
|
|
REHABILITATION WITH CC/MCC
|
Facility
|
IP
|
$39,309.83
|
|
|
Service Code
|
MSDRG 945
|
| Min. Negotiated Rate |
$12,866.28 |
| Max. Negotiated Rate |
$39,309.83 |
| Rate for Payer: Aetna Medicare |
$14,085.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,929.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,929.31
|
| Rate for Payer: BCBS MAPPO |
$13,543.45
|
| Rate for Payer: BCBS Trust/PPO |
$39,309.83
|
| Rate for Payer: BCN Commercial |
$39,309.83
|
| Rate for Payer: BCN Medicare Advantage |
$13,543.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,543.45
|
| Rate for Payer: Mclaren Medicare |
$13,543.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,220.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,574.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,897.80
|
| Rate for Payer: Nomi Health Commercial |
$19,976.94
|
| Rate for Payer: PACE Medicare |
$12,866.28
|
| Rate for Payer: PACE SWMI |
$13,543.45
|
| Rate for Payer: PHP Medicare Advantage |
$13,543.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24,966.75
|
| Rate for Payer: Priority Health Medicare |
$13,543.45
|
| Rate for Payer: Priority Health Tiered Network |
$19,973.39
|
| Rate for Payer: Railroad Medicare Medicare |
$13,543.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,242.18
|
| Rate for Payer: UHC Core |
$21,118.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,543.45
|
| Rate for Payer: UHC Exchange |
$17,246.76
|
| Rate for Payer: VA VA |
$13,543.45
|
|
|
REHABILITATION WITHOUT CC/MCC
|
Facility
|
IP
|
$22,523.55
|
|
|
Service Code
|
MSDRG 946
|
| Min. Negotiated Rate |
$9,674.14 |
| Max. Negotiated Rate |
$22,523.55 |
| Rate for Payer: Aetna Medicare |
$10,590.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,729.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,729.14
|
| Rate for Payer: BCBS MAPPO |
$10,183.31
|
| Rate for Payer: BCBS Trust/PPO |
$22,523.55
|
| Rate for Payer: BCN Commercial |
$22,523.55
|
| Rate for Payer: BCN Medicare Advantage |
$10,183.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,183.31
|
| Rate for Payer: Mclaren Medicare |
$10,183.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,692.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,710.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$11,201.64
|
| Rate for Payer: Nomi Health Commercial |
$14,793.72
|
| Rate for Payer: PACE Medicare |
$9,674.14
|
| Rate for Payer: PACE SWMI |
$10,183.31
|
| Rate for Payer: PHP Medicare Advantage |
$10,183.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18,488.87
|
| Rate for Payer: Priority Health Medicare |
$10,183.31
|
| Rate for Payer: Priority Health Tiered Network |
$14,791.09
|
| Rate for Payer: Railroad Medicare Medicare |
$10,183.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,692.84
|
| Rate for Payer: UHC Core |
$15,638.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10,183.31
|
| Rate for Payer: UHC Exchange |
$12,771.91
|
| Rate for Payer: VA VA |
$10,183.31
|
|
|
REINSERTION OF RUPTURED BICEPS OR TRICEPS TENDON, DISTAL, WITH OR WITHOUT TENDON GRAFT
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 24342
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$5,639.29
|
| Rate for Payer: BCN Commercial |
$5,639.29
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
REINSERTION OF SPINAL FIXATION DEVICE
|
Facility
|
OP
|
$41,369.85
|
|
|
Service Code
|
CPT 22849
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,762.15 |
| Max. Negotiated Rate |
$41,369.85 |
| Rate for Payer: Aetna Medicare |
$13,304.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,990.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,990.64
|
| Rate for Payer: BCBS Complete |
$7,025.65
|
| Rate for Payer: BCBS MAPPO |
$12,792.51
|
| Rate for Payer: BCBS Trust/PPO |
$5,762.15
|
| Rate for Payer: BCN Commercial |
$5,762.15
|
| Rate for Payer: BCN Medicare Advantage |
$12,792.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,792.51
|
| Rate for Payer: Mclaren Medicaid |
$12,792.51
|
| Rate for Payer: Mclaren Medicare |
$12,792.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,432.14
|
| Rate for Payer: Meridian Medicaid |
$13,432.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,711.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,071.76
|
| Rate for Payer: Nomi Health Commercial |
$38,377.53
|
| Rate for Payer: PACE Medicare |
$12,152.88
|
| Rate for Payer: PACE SWMI |
$12,792.51
|
| Rate for Payer: PHP Medicare Advantage |
$12,792.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,690.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$41,369.85
|
| Rate for Payer: Priority Health Medicare |
$12,792.51
|
| Rate for Payer: Priority Health Tiered Network |
$33,095.88
|
| Rate for Payer: Railroad Medicare Medicare |
$12,792.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,792.51
|
| Rate for Payer: UHC Medicaid |
$6,690.48
|
| Rate for Payer: UHCCP Medicaid |
$6,690.48
|
| Rate for Payer: VA VA |
$12,792.51
|
|
|
RELOCATION OF SKIN POCKET FOR PACEMAKER
|
Facility
|
OP
|
$6,648.46
|
|
|
Service Code
|
CPT 33222
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,075.21 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,693.74
|
| Rate for Payer: BCN Commercial |
$1,693.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$2,158.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,648.46
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health Tiered Network |
$5,318.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: VA VA |
$2,055.86
|
|
|
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION
|
Facility
|
IP
|
$2,267.62
|
|
|
Service Code
|
HCPCS J0248
|
| Hospital Charge Code |
300469
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$997.75 |
| Max. Negotiated Rate |
$2,040.86 |
| Rate for Payer: Aetna American Axle |
$1,473.95
|
| Rate for Payer: Aetna Commercial |
$1,927.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,473.95
|
| Rate for Payer: Cash Price |
$1,814.10
|
| Rate for Payer: Cofinity Advantage |
$1,587.33
|
| Rate for Payer: Cofinity Commercial |
$1,950.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,814.10
|
| Rate for Payer: Healthscope Commercial |
$2,040.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,587.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,700.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,927.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,700.71
|
| Rate for Payer: PHP Commercial |
$1,927.48
|
| Rate for Payer: Priority Health SBD |
$1,428.60
|
| Rate for Payer: UMR Bronson Commercial |
$997.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,700.71
|
|
|
REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION
|
Facility
|
OP
|
$2,267.62
|
|
|
Service Code
|
HCPCS J0248
|
| Hospital Charge Code |
300469
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.61 |
| Max. Negotiated Rate |
$2,040.86 |
| Rate for Payer: Aetna American Axle |
$1,473.95
|
| Rate for Payer: Aetna Commercial |
$1,927.48
|
| Rate for Payer: Aetna Medicare |
$7.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,473.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.62
|
| Rate for Payer: BCBS Complete |
$3.79
|
| Rate for Payer: BCBS MAPPO |
$6.90
|
| Rate for Payer: BCBS Trust/PPO |
$22.34
|
| Rate for Payer: BCN Commercial |
$22.34
|
| Rate for Payer: BCN Medicare Advantage |
$6.90
|
| Rate for Payer: Cash Price |
$1,814.10
|
| Rate for Payer: Cash Price |
$1,814.10
|
| Rate for Payer: Cofinity Advantage |
$1,587.33
|
| Rate for Payer: Cofinity Commercial |
$1,950.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,814.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.90
|
| Rate for Payer: Healthscope Commercial |
$2,040.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,587.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,700.71
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$6.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.25
|
| Rate for Payer: Meridian Medicaid |
$7.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,927.48
|
| Rate for Payer: Nomi Health Commercial |
$20.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,700.71
|
| Rate for Payer: PACE Medicare |
$6.55
|
| Rate for Payer: PACE SWMI |
$6.90
|
| Rate for Payer: PHP Commercial |
$1,927.48
|
| Rate for Payer: PHP Medicare Advantage |
$6.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.22
|
| Rate for Payer: Priority Health Medicare |
$6.90
|
| Rate for Payer: Priority Health SBD |
$1,428.60
|
| Rate for Payer: Priority Health Tiered Network |
$16.98
|
| Rate for Payer: Railroad Medicare Medicare |
$6.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.39
|
| Rate for Payer: UHC Core |
$11.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.90
|
| Rate for Payer: UHC Exchange |
$11.39
|
| Rate for Payer: UHC Medicaid |
$3.61
|
| Rate for Payer: UHCCP Medicaid |
$3.61
|
| Rate for Payer: UMR Bronson Commercial |
$839.02
|
| Rate for Payer: VA VA |
$6.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,700.71
|
|
|
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$238.60
|
|
|
Service Code
|
NDC 63323072303
|
| Hospital Charge Code |
18398
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$88.28 |
| Max. Negotiated Rate |
$214.74 |
| Rate for Payer: Aetna American Axle |
$155.09
|
| Rate for Payer: Aetna Commercial |
$202.81
|
| Rate for Payer: Aetna Medicare |
$119.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.09
|
| Rate for Payer: BCBS Complete |
$95.44
|
| Rate for Payer: Cash Price |
$190.88
|
| Rate for Payer: Cofinity Advantage |
$167.02
|
| Rate for Payer: Cofinity Commercial |
$205.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.88
|
| Rate for Payer: Healthscope Commercial |
$214.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$167.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$190.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.95
|
| Rate for Payer: PHP Commercial |
$202.81
|
| Rate for Payer: Priority Health SBD |
$150.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.09
|
| Rate for Payer: UHC Core |
$124.31
|
| Rate for Payer: UHC Exchange |
$93.77
|
| Rate for Payer: UMR Bronson Commercial |
$88.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.95
|
|
|
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$238.60
|
|
|
Service Code
|
NDC 63323072301
|
| Hospital Charge Code |
18398
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$104.98 |
| Max. Negotiated Rate |
$214.74 |
| Rate for Payer: Aetna American Axle |
$155.09
|
| Rate for Payer: Aetna Commercial |
$202.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.09
|
| Rate for Payer: Cash Price |
$190.88
|
| Rate for Payer: Cofinity Advantage |
$167.02
|
| Rate for Payer: Cofinity Commercial |
$205.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.88
|
| Rate for Payer: Healthscope Commercial |
$214.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$167.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.95
|
| Rate for Payer: PHP Commercial |
$202.81
|
| Rate for Payer: Priority Health SBD |
$150.32
|
| Rate for Payer: UMR Bronson Commercial |
$104.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.95
|
|
|
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$229.46
|
|
|
Service Code
|
NDC 67457019803
|
| Hospital Charge Code |
18398
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$100.96 |
| Max. Negotiated Rate |
$206.51 |
| Rate for Payer: Aetna American Axle |
$149.15
|
| Rate for Payer: Aetna Commercial |
$195.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.15
|
| Rate for Payer: Cash Price |
$183.57
|
| Rate for Payer: Cofinity Advantage |
$160.62
|
| Rate for Payer: Cofinity Commercial |
$197.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.57
|
| Rate for Payer: Healthscope Commercial |
$206.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.09
|
| Rate for Payer: PHP Commercial |
$195.04
|
| Rate for Payer: Priority Health SBD |
$144.56
|
| Rate for Payer: UMR Bronson Commercial |
$100.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.09
|
|
|
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$238.60
|
|
|
Service Code
|
NDC 63323072303
|
| Hospital Charge Code |
18398
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$104.98 |
| Max. Negotiated Rate |
$214.74 |
| Rate for Payer: Aetna American Axle |
$155.09
|
| Rate for Payer: Aetna Commercial |
$202.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.09
|
| Rate for Payer: Cash Price |
$190.88
|
| Rate for Payer: Cofinity Advantage |
$167.02
|
| Rate for Payer: Cofinity Commercial |
$205.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.88
|
| Rate for Payer: Healthscope Commercial |
$214.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$167.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.95
|
| Rate for Payer: PHP Commercial |
$202.81
|
| Rate for Payer: Priority Health SBD |
$150.32
|
| Rate for Payer: UMR Bronson Commercial |
$104.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.95
|
|
|
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$229.46
|
|
|
Service Code
|
NDC 67457019803
|
| Hospital Charge Code |
18398
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$84.90 |
| Max. Negotiated Rate |
$206.51 |
| Rate for Payer: Aetna American Axle |
$149.15
|
| Rate for Payer: Aetna Commercial |
$195.04
|
| Rate for Payer: Aetna Medicare |
$114.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.15
|
| Rate for Payer: BCBS Complete |
$91.78
|
| Rate for Payer: Cash Price |
$183.57
|
| Rate for Payer: Cofinity Advantage |
$160.62
|
| Rate for Payer: Cofinity Commercial |
$197.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.57
|
| Rate for Payer: Healthscope Commercial |
$206.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$183.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.09
|
| Rate for Payer: PHP Commercial |
$195.04
|
| Rate for Payer: Priority Health SBD |
$144.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.15
|
| Rate for Payer: UHC Core |
$119.55
|
| Rate for Payer: UHC Exchange |
$90.18
|
| Rate for Payer: UMR Bronson Commercial |
$84.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.09
|
|
|
REMIFENTANIL 1 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$238.60
|
|
|
Service Code
|
NDC 63323072301
|
| Hospital Charge Code |
18398
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$88.28 |
| Max. Negotiated Rate |
$214.74 |
| Rate for Payer: Aetna American Axle |
$155.09
|
| Rate for Payer: Aetna Commercial |
$202.81
|
| Rate for Payer: Aetna Medicare |
$119.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.09
|
| Rate for Payer: BCBS Complete |
$95.44
|
| Rate for Payer: Cash Price |
$190.88
|
| Rate for Payer: Cofinity Advantage |
$167.02
|
| Rate for Payer: Cofinity Commercial |
$205.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.88
|
| Rate for Payer: Healthscope Commercial |
$214.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$167.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$190.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.95
|
| Rate for Payer: PHP Commercial |
$202.81
|
| Rate for Payer: Priority Health SBD |
$150.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.09
|
| Rate for Payer: UHC Core |
$124.31
|
| Rate for Payer: UHC Exchange |
$93.77
|
| Rate for Payer: UMR Bronson Commercial |
$88.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.95
|
|
