|
RIFAMPIN 300 MG CAPSULE
|
Facility
|
OP
|
$190.66
|
|
|
Service Code
|
NDC 68180065907
|
| Hospital Charge Code |
11293
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$70.54 |
| Max. Negotiated Rate |
$171.59 |
| Rate for Payer: Aetna American Axle |
$123.93
|
| Rate for Payer: Aetna Commercial |
$162.06
|
| Rate for Payer: Aetna Medicare |
$95.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.93
|
| Rate for Payer: BCBS Complete |
$76.26
|
| Rate for Payer: Cash Price |
$152.53
|
| Rate for Payer: Cofinity Advantage |
$133.46
|
| Rate for Payer: Cofinity Commercial |
$163.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.53
|
| Rate for Payer: Healthscope Commercial |
$171.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$133.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.00
|
| Rate for Payer: PHP Commercial |
$162.06
|
| Rate for Payer: Priority Health SBD |
$120.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.93
|
| Rate for Payer: UHC Core |
$99.33
|
| Rate for Payer: UHC Exchange |
$74.93
|
| Rate for Payer: UMR Bronson Commercial |
$70.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.00
|
|
|
RIFAMPIN 300 MG CAPSULE
|
Facility
|
OP
|
$108.58
|
|
|
Service Code
|
NDC 68180065906
|
| Hospital Charge Code |
11293
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$40.17 |
| Max. Negotiated Rate |
$97.72 |
| Rate for Payer: Aetna American Axle |
$70.58
|
| Rate for Payer: Aetna Commercial |
$92.29
|
| Rate for Payer: Aetna Medicare |
$54.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.58
|
| Rate for Payer: BCBS Complete |
$43.43
|
| Rate for Payer: Cash Price |
$86.86
|
| Rate for Payer: Cofinity Advantage |
$76.01
|
| Rate for Payer: Cofinity Commercial |
$93.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.86
|
| Rate for Payer: Healthscope Commercial |
$97.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.44
|
| Rate for Payer: PHP Commercial |
$92.29
|
| Rate for Payer: Priority Health SBD |
$68.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.58
|
| Rate for Payer: UHC Core |
$56.57
|
| Rate for Payer: UHC Exchange |
$42.67
|
| Rate for Payer: UMR Bronson Commercial |
$40.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.44
|
|
|
RIFAMPIN 300 MG CAPSULE
|
Facility
|
OP
|
$790.56
|
|
|
Service Code
|
NDC 60687058601
|
| Hospital Charge Code |
11293
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$292.51 |
| Max. Negotiated Rate |
$711.50 |
| Rate for Payer: Aetna American Axle |
$513.86
|
| Rate for Payer: Aetna Commercial |
$671.98
|
| Rate for Payer: Aetna Medicare |
$395.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.86
|
| Rate for Payer: BCBS Complete |
$316.22
|
| Rate for Payer: Cash Price |
$632.45
|
| Rate for Payer: Cofinity Advantage |
$553.39
|
| Rate for Payer: Cofinity Commercial |
$679.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.45
|
| Rate for Payer: Healthscope Commercial |
$711.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$553.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$592.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$632.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$592.92
|
| Rate for Payer: PHP Commercial |
$671.98
|
| Rate for Payer: Priority Health SBD |
$498.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.86
|
| Rate for Payer: UHC Core |
$411.88
|
| Rate for Payer: UHC Exchange |
$310.69
|
| Rate for Payer: UMR Bronson Commercial |
$292.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$592.92
|
|
|
RIFAMPIN 300 MG CAPSULE
|
Facility
|
OP
|
$552.96
|
|
|
Service Code
|
NDC 00904731561
|
| Hospital Charge Code |
11293
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$204.60 |
| Max. Negotiated Rate |
$497.66 |
| Rate for Payer: Aetna American Axle |
$359.42
|
| Rate for Payer: Aetna Commercial |
$470.02
|
| Rate for Payer: Aetna Medicare |
$276.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.42
|
| Rate for Payer: BCBS Complete |
$221.18
|
| Rate for Payer: Cash Price |
$442.37
|
| Rate for Payer: Cofinity Advantage |
$387.07
|
| Rate for Payer: Cofinity Commercial |
$475.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.37
|
| Rate for Payer: Healthscope Commercial |
$497.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$387.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$414.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$442.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$470.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$414.72
|
| Rate for Payer: PHP Commercial |
$470.02
|
| Rate for Payer: Priority Health SBD |
$348.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.42
|
| Rate for Payer: UHC Core |
$288.09
|
| Rate for Payer: UHC Exchange |
$217.31
|
| Rate for Payer: UMR Bronson Commercial |
$204.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$414.72
|
|
|
RIFAMPIN 300 MG CAPSULE
|
Facility
|
IP
|
$7.91
|
|
|
Service Code
|
NDC 60687058611
|
| Hospital Charge Code |
11293
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.48 |
| Max. Negotiated Rate |
$7.12 |
| Rate for Payer: Aetna American Axle |
$5.14
|
| Rate for Payer: Aetna Commercial |
$6.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.14
|
| Rate for Payer: Cash Price |
$6.33
|
| Rate for Payer: Cofinity Advantage |
$5.54
|
| Rate for Payer: Cofinity Commercial |
$6.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.33
|
| Rate for Payer: Healthscope Commercial |
$7.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.93
|
| Rate for Payer: PHP Commercial |
$6.72
|
| Rate for Payer: Priority Health SBD |
$4.98
|
| Rate for Payer: UMR Bronson Commercial |
$3.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.93
|
|
|
RIFAMPIN 300 MG CAPSULE
|
Facility
|
IP
|
$552.96
|
|
|
Service Code
|
NDC 00904731561
|
| Hospital Charge Code |
11293
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$243.30 |
| Max. Negotiated Rate |
$497.66 |
| Rate for Payer: Aetna American Axle |
$359.42
|
| Rate for Payer: Aetna Commercial |
$470.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.42
|
| Rate for Payer: Cash Price |
$442.37
|
| Rate for Payer: Cofinity Advantage |
$387.07
|
| Rate for Payer: Cofinity Commercial |
$475.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.37
|
| Rate for Payer: Healthscope Commercial |
$497.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$387.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$414.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$470.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$414.72
|
| Rate for Payer: PHP Commercial |
$470.02
|
| Rate for Payer: Priority Health SBD |
$348.36
|
| Rate for Payer: UMR Bronson Commercial |
$243.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$414.72
|
|
|
RIFAMPIN 300 MG CAPSULE
|
Facility
|
IP
|
$190.66
|
|
|
Service Code
|
NDC 68180065907
|
| Hospital Charge Code |
11293
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$83.89 |
| Max. Negotiated Rate |
$171.59 |
| Rate for Payer: Aetna American Axle |
$123.93
|
| Rate for Payer: Aetna Commercial |
$162.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.93
|
| Rate for Payer: Cash Price |
$152.53
|
| Rate for Payer: Cofinity Advantage |
$133.46
|
| Rate for Payer: Cofinity Commercial |
$163.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.53
|
| Rate for Payer: Healthscope Commercial |
$171.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$133.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.00
|
| Rate for Payer: PHP Commercial |
$162.06
|
| Rate for Payer: Priority Health SBD |
$120.12
|
| Rate for Payer: UMR Bronson Commercial |
$83.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.00
|
|
|
RIFAMPIN 300 MG CAPSULE
|
Facility
|
IP
|
$790.56
|
|
|
Service Code
|
NDC 60687058601
|
| Hospital Charge Code |
11293
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$347.85 |
| Max. Negotiated Rate |
$711.50 |
| Rate for Payer: Aetna American Axle |
$513.86
|
| Rate for Payer: Aetna Commercial |
$671.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.86
|
| Rate for Payer: Cash Price |
$632.45
|
| Rate for Payer: Cofinity Advantage |
$553.39
|
| Rate for Payer: Cofinity Commercial |
$679.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.45
|
| Rate for Payer: Healthscope Commercial |
$711.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$553.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$592.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$592.92
|
| Rate for Payer: PHP Commercial |
$671.98
|
| Rate for Payer: Priority Health SBD |
$498.05
|
| Rate for Payer: UMR Bronson Commercial |
$347.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$592.92
|
|
|
RIFAMPIN 300 MG CAPSULE
|
Facility
|
OP
|
$7.91
|
|
|
Service Code
|
NDC 60687058611
|
| Hospital Charge Code |
11293
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$7.12 |
| Rate for Payer: Aetna American Axle |
$5.14
|
| Rate for Payer: Aetna Commercial |
$6.72
|
| Rate for Payer: Aetna Medicare |
$3.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.14
|
| Rate for Payer: BCBS Complete |
$3.16
|
| Rate for Payer: Cash Price |
$6.33
|
| Rate for Payer: Cofinity Advantage |
$5.54
|
| Rate for Payer: Cofinity Commercial |
$6.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.33
|
| Rate for Payer: Healthscope Commercial |
$7.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.93
|
| Rate for Payer: PHP Commercial |
$6.72
|
| Rate for Payer: Priority Health SBD |
$4.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.14
|
| Rate for Payer: UHC Core |
$4.12
|
| Rate for Payer: UHC Exchange |
$3.11
|
| Rate for Payer: UMR Bronson Commercial |
$2.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.93
|
|
|
RIFAMPIN 300 MG CAPSULE
|
Facility
|
IP
|
$108.58
|
|
|
Service Code
|
NDC 68180065906
|
| Hospital Charge Code |
11293
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$47.78 |
| Max. Negotiated Rate |
$97.72 |
| Rate for Payer: Aetna American Axle |
$70.58
|
| Rate for Payer: Aetna Commercial |
$92.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.58
|
| Rate for Payer: Cash Price |
$86.86
|
| Rate for Payer: Cofinity Advantage |
$76.01
|
| Rate for Payer: Cofinity Commercial |
$93.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.86
|
| Rate for Payer: Healthscope Commercial |
$97.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.44
|
| Rate for Payer: PHP Commercial |
$92.29
|
| Rate for Payer: Priority Health SBD |
$68.41
|
| Rate for Payer: UMR Bronson Commercial |
$47.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.44
|
|
|
RIFAMPIN 600 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$505.10
|
|
|
Service Code
|
HCPCS J2804
|
| Hospital Charge Code |
11291
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.25 |
| Max. Negotiated Rate |
$454.59 |
| Rate for Payer: Aetna American Axle |
$328.31
|
| Rate for Payer: Aetna American Axle |
$278.28
|
| Rate for Payer: Aetna American Axle |
$383.19
|
| Rate for Payer: Aetna Commercial |
$429.33
|
| Rate for Payer: Aetna Commercial |
$501.09
|
| Rate for Payer: Aetna Commercial |
$363.91
|
| Rate for Payer: Aetna Medicare |
$252.55
|
| Rate for Payer: Aetna Medicare |
$214.06
|
| Rate for Payer: Aetna Medicare |
$294.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$328.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$383.19
|
| Rate for Payer: BCBS Complete |
$171.25
|
| Rate for Payer: BCBS Complete |
$202.04
|
| Rate for Payer: BCBS Complete |
$235.81
|
| Rate for Payer: BCBS Trust/PPO |
$0.48
|
| Rate for Payer: BCBS Trust/PPO |
$0.48
|
| Rate for Payer: BCBS Trust/PPO |
$0.48
|
| Rate for Payer: BCN Commercial |
$0.48
|
| Rate for Payer: BCN Commercial |
$0.48
|
| Rate for Payer: BCN Commercial |
$0.48
|
| Rate for Payer: Cash Price |
$342.50
|
| Rate for Payer: Cash Price |
$342.50
|
| Rate for Payer: Cash Price |
$471.62
|
| Rate for Payer: Cash Price |
$471.62
|
| Rate for Payer: Cash Price |
$404.08
|
| Rate for Payer: Cash Price |
$404.08
|
| Rate for Payer: Cofinity Advantage |
$412.66
|
| Rate for Payer: Cofinity Advantage |
$353.57
|
| Rate for Payer: Cofinity Advantage |
$299.69
|
| Rate for Payer: Cofinity Commercial |
$368.19
|
| Rate for Payer: Cofinity Commercial |
$434.39
|
| Rate for Payer: Cofinity Commercial |
$506.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$471.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.08
|
| Rate for Payer: Healthscope Commercial |
$385.32
|
| Rate for Payer: Healthscope Commercial |
$454.59
|
| Rate for Payer: Healthscope Commercial |
$530.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$299.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$412.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$353.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$442.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$378.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$404.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$471.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$363.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$501.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$321.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$442.14
|
| Rate for Payer: PHP Commercial |
$429.33
|
| Rate for Payer: PHP Commercial |
$363.91
|
| Rate for Payer: PHP Commercial |
$501.09
|
| Rate for Payer: Priority Health SBD |
$269.72
|
| Rate for Payer: Priority Health SBD |
$371.40
|
| Rate for Payer: Priority Health SBD |
$318.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.25
|
| Rate for Payer: UHC Core |
$0.25
|
| Rate for Payer: UHC Core |
$0.25
|
| Rate for Payer: UHC Core |
$0.25
|
| Rate for Payer: UHC Exchange |
$0.25
|
| Rate for Payer: UHC Exchange |
$0.25
|
| Rate for Payer: UHC Exchange |
$0.25
|
| Rate for Payer: UMR Bronson Commercial |
$218.12
|
| Rate for Payer: UMR Bronson Commercial |
$158.41
|
| Rate for Payer: UMR Bronson Commercial |
$186.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$378.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$442.14
|
|
|
RIFAMPIN 600 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$428.13
|
|
|
Service Code
|
HCPCS J2804
|
| Hospital Charge Code |
11291
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$188.38 |
| Max. Negotiated Rate |
$385.32 |
| Rate for Payer: Aetna American Axle |
$278.28
|
| Rate for Payer: Aetna American Axle |
$383.19
|
| Rate for Payer: Aetna American Axle |
$328.31
|
| Rate for Payer: Aetna Commercial |
$429.33
|
| Rate for Payer: Aetna Commercial |
$363.91
|
| Rate for Payer: Aetna Commercial |
$501.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$383.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$328.31
|
| Rate for Payer: Cash Price |
$404.08
|
| Rate for Payer: Cash Price |
$342.50
|
| Rate for Payer: Cash Price |
$471.62
|
| Rate for Payer: Cofinity Advantage |
$412.66
|
| Rate for Payer: Cofinity Advantage |
$299.69
|
| Rate for Payer: Cofinity Advantage |
$353.57
|
| Rate for Payer: Cofinity Commercial |
$506.99
|
| Rate for Payer: Cofinity Commercial |
$368.19
|
| Rate for Payer: Cofinity Commercial |
$434.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$471.62
|
| Rate for Payer: Healthscope Commercial |
$454.59
|
| Rate for Payer: Healthscope Commercial |
$530.57
|
| Rate for Payer: Healthscope Commercial |
$385.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$353.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$299.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$412.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$442.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$378.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$363.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$501.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$321.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$442.14
|
| Rate for Payer: PHP Commercial |
$429.33
|
| Rate for Payer: PHP Commercial |
$363.91
|
| Rate for Payer: PHP Commercial |
$501.09
|
| Rate for Payer: Priority Health SBD |
$269.72
|
| Rate for Payer: Priority Health SBD |
$318.21
|
| Rate for Payer: Priority Health SBD |
$371.40
|
| Rate for Payer: UMR Bronson Commercial |
$188.38
|
| Rate for Payer: UMR Bronson Commercial |
$259.39
|
| Rate for Payer: UMR Bronson Commercial |
$222.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$378.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$442.14
|
|
|
RIFAXIMIN 200 MG TABLET
|
Facility
|
OP
|
$1,158.84
|
|
|
Service Code
|
NDC 65649030103
|
| Hospital Charge Code |
39063
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$428.77 |
| Max. Negotiated Rate |
$1,042.96 |
| Rate for Payer: Aetna American Axle |
$753.25
|
| Rate for Payer: Aetna Commercial |
$985.01
|
| Rate for Payer: Aetna Medicare |
$579.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$753.25
|
| Rate for Payer: BCBS Complete |
$463.54
|
| Rate for Payer: Cash Price |
$927.07
|
| Rate for Payer: Cofinity Advantage |
$811.19
|
| Rate for Payer: Cofinity Commercial |
$996.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$927.07
|
| Rate for Payer: Healthscope Commercial |
$1,042.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$811.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$869.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$927.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$985.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$869.13
|
| Rate for Payer: PHP Commercial |
$985.01
|
| Rate for Payer: Priority Health SBD |
$730.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$753.25
|
| Rate for Payer: UHC Core |
$603.76
|
| Rate for Payer: UHC Exchange |
$455.42
|
| Rate for Payer: UMR Bronson Commercial |
$428.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$869.13
|
|
|
RIFAXIMIN 200 MG TABLET
|
Facility
|
IP
|
$1,158.84
|
|
|
Service Code
|
NDC 65649030103
|
| Hospital Charge Code |
39063
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$509.89 |
| Max. Negotiated Rate |
$1,042.96 |
| Rate for Payer: Aetna American Axle |
$753.25
|
| Rate for Payer: Aetna Commercial |
$985.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$753.25
|
| Rate for Payer: Cash Price |
$927.07
|
| Rate for Payer: Cofinity Advantage |
$811.19
|
| Rate for Payer: Cofinity Commercial |
$996.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$927.07
|
| Rate for Payer: Healthscope Commercial |
$1,042.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$811.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$869.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$985.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$869.13
|
| Rate for Payer: PHP Commercial |
$985.01
|
| Rate for Payer: Priority Health SBD |
$730.07
|
| Rate for Payer: UMR Bronson Commercial |
$509.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$869.13
|
|
|
RIFAXIMIN 550 MG TABLET
|
Facility
|
OP
|
$11,916.96
|
|
|
Service Code
|
NDC 65649030303
|
| Hospital Charge Code |
104604
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4,409.28 |
| Max. Negotiated Rate |
$10,725.26 |
| Rate for Payer: Aetna American Axle |
$7,746.02
|
| Rate for Payer: Aetna Commercial |
$10,129.42
|
| Rate for Payer: Aetna Medicare |
$5,958.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,746.02
|
| Rate for Payer: BCBS Complete |
$4,766.78
|
| Rate for Payer: Cash Price |
$9,533.57
|
| Rate for Payer: Cofinity Advantage |
$8,341.87
|
| Rate for Payer: Cofinity Commercial |
$10,248.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,533.57
|
| Rate for Payer: Healthscope Commercial |
$10,725.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,341.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,937.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,533.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,129.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,937.72
|
| Rate for Payer: PHP Commercial |
$10,129.42
|
| Rate for Payer: Priority Health SBD |
$7,507.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,746.02
|
| Rate for Payer: UHC Core |
$6,208.74
|
| Rate for Payer: UHC Exchange |
$4,683.37
|
| Rate for Payer: UMR Bronson Commercial |
$4,409.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,937.72
|
|
|
RIFAXIMIN 550 MG TABLET
|
Facility
|
OP
|
$11,916.96
|
|
|
Service Code
|
NDC 65649030302
|
| Hospital Charge Code |
104604
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4,409.28 |
| Max. Negotiated Rate |
$10,725.26 |
| Rate for Payer: Aetna American Axle |
$7,746.02
|
| Rate for Payer: Aetna Commercial |
$10,129.42
|
| Rate for Payer: Aetna Medicare |
$5,958.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,746.02
|
| Rate for Payer: BCBS Complete |
$4,766.78
|
| Rate for Payer: Cash Price |
$9,533.57
|
| Rate for Payer: Cofinity Advantage |
$8,341.87
|
| Rate for Payer: Cofinity Commercial |
$10,248.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,533.57
|
| Rate for Payer: Healthscope Commercial |
$10,725.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,341.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,937.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,533.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,129.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,937.72
|
| Rate for Payer: PHP Commercial |
$10,129.42
|
| Rate for Payer: Priority Health SBD |
$7,507.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,746.02
|
| Rate for Payer: UHC Core |
$6,208.74
|
| Rate for Payer: UHC Exchange |
$4,683.37
|
| Rate for Payer: UMR Bronson Commercial |
$4,409.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,937.72
|
|
|
RIFAXIMIN 550 MG TABLET
|
Facility
|
IP
|
$11,916.96
|
|
|
Service Code
|
NDC 65649030303
|
| Hospital Charge Code |
104604
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5,243.46 |
| Max. Negotiated Rate |
$10,725.26 |
| Rate for Payer: Aetna American Axle |
$7,746.02
|
| Rate for Payer: Aetna Commercial |
$10,129.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,746.02
|
| Rate for Payer: Cash Price |
$9,533.57
|
| Rate for Payer: Cofinity Advantage |
$8,341.87
|
| Rate for Payer: Cofinity Commercial |
$10,248.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,533.57
|
| Rate for Payer: Healthscope Commercial |
$10,725.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,341.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,937.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,129.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,937.72
|
| Rate for Payer: PHP Commercial |
$10,129.42
|
| Rate for Payer: Priority Health SBD |
$7,507.68
|
| Rate for Payer: UMR Bronson Commercial |
$5,243.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,937.72
|
|
|
RIFAXIMIN 550 MG TABLET
|
Facility
|
IP
|
$11,916.96
|
|
|
Service Code
|
NDC 65649030302
|
| Hospital Charge Code |
104604
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5,243.46 |
| Max. Negotiated Rate |
$10,725.26 |
| Rate for Payer: Aetna American Axle |
$7,746.02
|
| Rate for Payer: Aetna Commercial |
$10,129.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,746.02
|
| Rate for Payer: Cash Price |
$9,533.57
|
| Rate for Payer: Cofinity Advantage |
$8,341.87
|
| Rate for Payer: Cofinity Commercial |
$10,248.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,533.57
|
| Rate for Payer: Healthscope Commercial |
$10,725.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,341.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,937.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,129.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,937.72
|
| Rate for Payer: PHP Commercial |
$10,129.42
|
| Rate for Payer: Priority Health SBD |
$7,507.68
|
| Rate for Payer: UMR Bronson Commercial |
$5,243.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,937.72
|
|
|
RIMANTADINE 100 MG TABLET
|
Facility
|
IP
|
$827.69
|
|
|
Service Code
|
NDC 00115191101
|
| Hospital Charge Code |
15440
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$364.18 |
| Max. Negotiated Rate |
$744.92 |
| Rate for Payer: Aetna American Axle |
$538.00
|
| Rate for Payer: Aetna Commercial |
$703.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$538.00
|
| Rate for Payer: Cash Price |
$662.15
|
| Rate for Payer: Cofinity Advantage |
$579.38
|
| Rate for Payer: Cofinity Commercial |
$711.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$662.15
|
| Rate for Payer: Healthscope Commercial |
$744.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$579.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$620.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$703.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$620.77
|
| Rate for Payer: PHP Commercial |
$703.54
|
| Rate for Payer: Priority Health SBD |
$521.44
|
| Rate for Payer: UMR Bronson Commercial |
$364.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$620.77
|
|
|
RIMANTADINE 100 MG TABLET
|
Facility
|
OP
|
$827.69
|
|
|
Service Code
|
NDC 00115191101
|
| Hospital Charge Code |
15440
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$306.25 |
| Max. Negotiated Rate |
$744.92 |
| Rate for Payer: Aetna American Axle |
$538.00
|
| Rate for Payer: Aetna Commercial |
$703.54
|
| Rate for Payer: Aetna Medicare |
$413.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$538.00
|
| Rate for Payer: BCBS Complete |
$331.08
|
| Rate for Payer: Cash Price |
$662.15
|
| Rate for Payer: Cofinity Advantage |
$579.38
|
| Rate for Payer: Cofinity Commercial |
$711.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$662.15
|
| Rate for Payer: Healthscope Commercial |
$744.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$579.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$620.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$662.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$703.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$620.77
|
| Rate for Payer: PHP Commercial |
$703.54
|
| Rate for Payer: Priority Health SBD |
$521.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.00
|
| Rate for Payer: UHC Core |
$431.23
|
| Rate for Payer: UHC Exchange |
$325.28
|
| Rate for Payer: UMR Bronson Commercial |
$306.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$620.77
|
|
|
RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$28,334.34
|
|
|
Service Code
|
HCPCS J2327
|
| Hospital Charge Code |
200582
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12,467.11 |
| Max. Negotiated Rate |
$25,500.91 |
| Rate for Payer: Aetna American Axle |
$18,417.32
|
| Rate for Payer: Aetna Commercial |
$24,084.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,417.32
|
| Rate for Payer: Cash Price |
$22,667.47
|
| Rate for Payer: Cofinity Advantage |
$19,834.04
|
| Rate for Payer: Cofinity Commercial |
$24,367.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,667.47
|
| Rate for Payer: Healthscope Commercial |
$25,500.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19,834.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,250.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,084.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,250.76
|
| Rate for Payer: PHP Commercial |
$24,084.19
|
| Rate for Payer: Priority Health SBD |
$17,850.63
|
| Rate for Payer: UMR Bronson Commercial |
$12,467.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,250.76
|
|
|
RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$28,334.34
|
|
|
Service Code
|
HCPCS J2327
|
| Hospital Charge Code |
200582
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.64 |
| Max. Negotiated Rate |
$25,500.91 |
| Rate for Payer: Aetna American Axle |
$18,417.32
|
| Rate for Payer: Aetna Commercial |
$24,084.19
|
| Rate for Payer: Aetna Medicare |
$15.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,417.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.25
|
| Rate for Payer: BCBS Complete |
$8.02
|
| Rate for Payer: BCBS MAPPO |
$14.60
|
| Rate for Payer: BCBS Trust/PPO |
$48.41
|
| Rate for Payer: BCN Commercial |
$48.41
|
| Rate for Payer: BCN Medicare Advantage |
$14.60
|
| Rate for Payer: Cash Price |
$22,667.47
|
| Rate for Payer: Cash Price |
$22,667.47
|
| Rate for Payer: Cofinity Advantage |
$19,834.04
|
| Rate for Payer: Cofinity Commercial |
$24,367.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,667.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.60
|
| Rate for Payer: Healthscope Commercial |
$25,500.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19,834.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,250.76
|
| Rate for Payer: Mclaren Medicaid |
$14.60
|
| Rate for Payer: Mclaren Medicare |
$14.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.33
|
| Rate for Payer: Meridian Medicaid |
$15.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,084.19
|
| Rate for Payer: Nomi Health Commercial |
$43.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,250.76
|
| Rate for Payer: PACE Medicare |
$13.87
|
| Rate for Payer: PACE SWMI |
$14.60
|
| Rate for Payer: PHP Commercial |
$24,084.19
|
| Rate for Payer: PHP Medicare Advantage |
$14.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$47.11
|
| Rate for Payer: Priority Health Medicare |
$14.60
|
| Rate for Payer: Priority Health SBD |
$17,850.63
|
| Rate for Payer: Priority Health Tiered Network |
$37.69
|
| Rate for Payer: Railroad Medicare Medicare |
$14.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.63
|
| Rate for Payer: UHC Core |
$24.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.60
|
| Rate for Payer: UHC Exchange |
$24.63
|
| Rate for Payer: UHC Medicaid |
$7.64
|
| Rate for Payer: UHCCP Medicaid |
$7.64
|
| Rate for Payer: UMR Bronson Commercial |
$10,483.71
|
| Rate for Payer: VA VA |
$14.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,250.76
|
|
|
RISEDRONATE 150 MG TABLET
|
Facility
|
IP
|
$1,270.88
|
|
|
Service Code
|
NDC 00430047801
|
| Hospital Charge Code |
91538
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$559.19 |
| Max. Negotiated Rate |
$1,143.79 |
| Rate for Payer: Aetna American Axle |
$826.07
|
| Rate for Payer: Aetna Commercial |
$1,080.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$826.07
|
| Rate for Payer: Cash Price |
$1,016.70
|
| Rate for Payer: Cofinity Advantage |
$889.62
|
| Rate for Payer: Cofinity Commercial |
$1,092.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,016.70
|
| Rate for Payer: Healthscope Commercial |
$1,143.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$889.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$953.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,080.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$953.16
|
| Rate for Payer: PHP Commercial |
$1,080.25
|
| Rate for Payer: Priority Health SBD |
$800.65
|
| Rate for Payer: UMR Bronson Commercial |
$559.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$953.16
|
|
|
RISEDRONATE 150 MG TABLET
|
Facility
|
OP
|
$1,270.88
|
|
|
Service Code
|
NDC 00430047801
|
| Hospital Charge Code |
91538
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$470.23 |
| Max. Negotiated Rate |
$1,143.79 |
| Rate for Payer: Aetna American Axle |
$826.07
|
| Rate for Payer: Aetna Commercial |
$1,080.25
|
| Rate for Payer: Aetna Medicare |
$635.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$826.07
|
| Rate for Payer: BCBS Complete |
$508.35
|
| Rate for Payer: Cash Price |
$1,016.70
|
| Rate for Payer: Cofinity Advantage |
$889.62
|
| Rate for Payer: Cofinity Commercial |
$1,092.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,016.70
|
| Rate for Payer: Healthscope Commercial |
$1,143.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$889.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$953.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,016.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,080.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$953.16
|
| Rate for Payer: PHP Commercial |
$1,080.25
|
| Rate for Payer: Priority Health SBD |
$800.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$826.07
|
| Rate for Payer: UHC Core |
$662.13
|
| Rate for Payer: UHC Exchange |
$499.46
|
| Rate for Payer: UMR Bronson Commercial |
$470.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$953.16
|
|
|
RISEDRONATE 35 MG TABLET
|
Facility
|
OP
|
$3,526.70
|
|
|
Service Code
|
NDC 00430047207
|
| Hospital Charge Code |
32895
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,304.88 |
| Max. Negotiated Rate |
$3,174.03 |
| Rate for Payer: Aetna American Axle |
$2,292.36
|
| Rate for Payer: Aetna Commercial |
$2,997.70
|
| Rate for Payer: Aetna Medicare |
$1,763.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,292.36
|
| Rate for Payer: BCBS Complete |
$1,410.68
|
| Rate for Payer: Cash Price |
$2,821.36
|
| Rate for Payer: Cofinity Advantage |
$2,468.69
|
| Rate for Payer: Cofinity Commercial |
$3,032.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,821.36
|
| Rate for Payer: Healthscope Commercial |
$3,174.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,468.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,645.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,821.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,997.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,645.03
|
| Rate for Payer: PHP Commercial |
$2,997.70
|
| Rate for Payer: Priority Health SBD |
$2,221.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,292.36
|
| Rate for Payer: UHC Core |
$1,837.41
|
| Rate for Payer: UHC Exchange |
$1,385.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,304.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,645.03
|
|
