|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$74.45
|
|
|
Service Code
|
NDC 50458059601
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$32.76 |
| Max. Negotiated Rate |
$67.00 |
| Rate for Payer: Aetna American Axle |
$48.39
|
| Rate for Payer: Aetna Commercial |
$63.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.39
|
| Rate for Payer: Cash Price |
$59.56
|
| Rate for Payer: Cofinity Commercial |
$52.12
|
| Rate for Payer: Cofinity Commercial |
$64.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.56
|
| Rate for Payer: Healthscope Commercial |
$67.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.28
|
| Rate for Payer: PHP Commercial |
$63.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.39
|
| Rate for Payer: Priority Health SBD |
$46.90
|
| Rate for Payer: UMR Bronson Commercial |
$32.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$565.22
|
|
|
Service Code
|
NDC 50458030503
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$209.13 |
| Max. Negotiated Rate |
$508.70 |
| Rate for Payer: Aetna American Axle |
$367.39
|
| Rate for Payer: Aetna Commercial |
$480.44
|
| Rate for Payer: Aetna Medicare |
$282.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$367.39
|
| Rate for Payer: BCBS Complete |
$226.09
|
| Rate for Payer: Cash Price |
$452.18
|
| Rate for Payer: Cofinity Commercial |
$395.65
|
| Rate for Payer: Cofinity Commercial |
$486.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$395.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.18
|
| Rate for Payer: Healthscope Commercial |
$508.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$395.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$480.44
|
| Rate for Payer: PHP Commercial |
$480.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.39
|
| Rate for Payer: Priority Health SBD |
$356.09
|
| Rate for Payer: UMR Bronson Commercial |
$209.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.92
|
|
|
RISPERIDONE 1 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$565.22
|
|
|
Service Code
|
NDC 50458030503
|
| Hospital Charge Code |
17377
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$248.70 |
| Max. Negotiated Rate |
$508.70 |
| Rate for Payer: Aetna American Axle |
$367.39
|
| Rate for Payer: Aetna Commercial |
$480.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$367.39
|
| Rate for Payer: Cash Price |
$452.18
|
| Rate for Payer: Cofinity Commercial |
$395.65
|
| Rate for Payer: Cofinity Commercial |
$486.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$395.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.18
|
| Rate for Payer: Healthscope Commercial |
$508.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$395.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$480.44
|
| Rate for Payer: PHP Commercial |
$480.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.39
|
| Rate for Payer: Priority Health SBD |
$356.09
|
| Rate for Payer: UMR Bronson Commercial |
$248.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.92
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
IP
|
$211.50
|
|
|
Service Code
|
NDC 27241000106
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$190.35 |
| Rate for Payer: Aetna American Axle |
$137.47
|
| Rate for Payer: Aetna Commercial |
$179.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.47
|
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cofinity Commercial |
$148.05
|
| Rate for Payer: Cofinity Commercial |
$181.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$148.05
|
| 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 Commercial |
$179.78
|
| Rate for Payer: PHP Commercial |
$179.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.47
|
| Rate for Payer: Priority Health SBD |
$133.25
|
| Rate for Payer: UMR Bronson Commercial |
$93.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.62
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
OP
|
$2.91
|
|
|
Service Code
|
NDC 68084027211
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$2.62 |
| Rate for Payer: Aetna American Axle |
$1.89
|
| Rate for Payer: Aetna Commercial |
$2.47
|
| Rate for Payer: Aetna Medicare |
$1.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.89
|
| Rate for Payer: BCBS Complete |
$1.16
|
| Rate for Payer: Cash Price |
$2.33
|
| Rate for Payer: Cofinity Commercial |
$2.04
|
| Rate for Payer: Cofinity Commercial |
$2.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.33
|
| Rate for Payer: Healthscope Commercial |
$2.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.47
|
| Rate for Payer: PHP Commercial |
$2.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.89
|
| Rate for Payer: Priority Health SBD |
$1.83
|
| Rate for Payer: UMR Bronson Commercial |
$1.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.18
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
OP
|
$290.70
|
|
|
Service Code
|
NDC 68084027201
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$107.56 |
| Max. Negotiated Rate |
$261.63 |
| Rate for Payer: Aetna American Axle |
$188.96
|
| Rate for Payer: Aetna Commercial |
$247.09
|
| Rate for Payer: Aetna Medicare |
$145.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.96
|
| Rate for Payer: BCBS Complete |
$116.28
|
| Rate for Payer: Cash Price |
$232.56
|
| Rate for Payer: Cofinity Commercial |
$203.49
|
| Rate for Payer: Cofinity Commercial |
$250.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$203.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.56
|
| Rate for Payer: Healthscope Commercial |
$261.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$203.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.09
|
| Rate for Payer: PHP Commercial |
$247.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.96
|
| Rate for Payer: Priority Health SBD |
$183.14
|
| Rate for Payer: UMR Bronson Commercial |
$107.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.03
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
IP
|
$290.70
|
|
|
Service Code
|
NDC 68084027201
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$127.91 |
| Max. Negotiated Rate |
$261.63 |
| Rate for Payer: Aetna American Axle |
$188.96
|
| Rate for Payer: Aetna Commercial |
$247.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.96
|
| Rate for Payer: Cash Price |
$232.56
|
| Rate for Payer: Cofinity Commercial |
$203.49
|
| Rate for Payer: Cofinity Commercial |
$250.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$203.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.56
|
| Rate for Payer: Healthscope Commercial |
$261.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$203.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.09
|
| Rate for Payer: PHP Commercial |
$247.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.96
|
| Rate for Payer: Priority Health SBD |
$183.14
|
| Rate for Payer: UMR Bronson Commercial |
$127.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.03
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
IP
|
$39.48
|
|
|
Service Code
|
NDC 68382011414
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$17.37 |
| Max. Negotiated Rate |
$35.53 |
| Rate for Payer: Aetna American Axle |
$25.66
|
| Rate for Payer: Aetna Commercial |
$33.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.66
|
| Rate for Payer: Cash Price |
$31.58
|
| Rate for Payer: Cofinity Commercial |
$27.64
|
| Rate for Payer: Cofinity Commercial |
$33.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.58
|
| Rate for Payer: Healthscope Commercial |
$35.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.56
|
| Rate for Payer: PHP Commercial |
$33.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.66
|
| Rate for Payer: Priority Health SBD |
$24.87
|
| Rate for Payer: UMR Bronson Commercial |
$17.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.61
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
OP
|
$338.40
|
|
|
Service Code
|
NDC 00904635961
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$125.21 |
| Max. Negotiated Rate |
$304.56 |
| Rate for Payer: Aetna American Axle |
$219.96
|
| Rate for Payer: Aetna Commercial |
$287.64
|
| Rate for Payer: Aetna Medicare |
$169.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.96
|
| Rate for Payer: BCBS Complete |
$135.36
|
| Rate for Payer: Cash Price |
$270.72
|
| Rate for Payer: Cofinity Commercial |
$236.88
|
| Rate for Payer: Cofinity Commercial |
$291.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$236.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.72
|
| Rate for Payer: Healthscope Commercial |
$304.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$236.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.64
|
| Rate for Payer: PHP Commercial |
$287.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.96
|
| Rate for Payer: Priority Health SBD |
$213.19
|
| Rate for Payer: UMR Bronson Commercial |
$125.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.80
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
OP
|
$39.48
|
|
|
Service Code
|
NDC 68382011414
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$14.61 |
| Max. Negotiated Rate |
$35.53 |
| Rate for Payer: Aetna American Axle |
$25.66
|
| Rate for Payer: Aetna Commercial |
$33.56
|
| Rate for Payer: Aetna Medicare |
$19.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.66
|
| Rate for Payer: BCBS Complete |
$15.79
|
| Rate for Payer: Cash Price |
$31.58
|
| Rate for Payer: Cofinity Commercial |
$27.64
|
| Rate for Payer: Cofinity Commercial |
$33.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.58
|
| Rate for Payer: Healthscope Commercial |
$35.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.56
|
| Rate for Payer: PHP Commercial |
$33.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.66
|
| Rate for Payer: Priority Health SBD |
$24.87
|
| Rate for Payer: UMR Bronson Commercial |
$14.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.61
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
IP
|
$2.91
|
|
|
Service Code
|
NDC 68084027211
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.28 |
| Max. Negotiated Rate |
$2.62 |
| Rate for Payer: Aetna American Axle |
$1.89
|
| Rate for Payer: Aetna Commercial |
$2.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.89
|
| Rate for Payer: Cash Price |
$2.33
|
| Rate for Payer: Cofinity Commercial |
$2.04
|
| Rate for Payer: Cofinity Commercial |
$2.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.33
|
| Rate for Payer: Healthscope Commercial |
$2.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.47
|
| Rate for Payer: PHP Commercial |
$2.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.89
|
| Rate for Payer: Priority Health SBD |
$1.83
|
| Rate for Payer: UMR Bronson Commercial |
$1.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.18
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
OP
|
$211.50
|
|
|
Service Code
|
NDC 27241000106
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$78.25 |
| Max. Negotiated Rate |
$190.35 |
| Rate for Payer: Aetna American Axle |
$137.47
|
| Rate for Payer: Aetna Commercial |
$179.78
|
| Rate for Payer: Aetna Medicare |
$105.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.47
|
| Rate for Payer: BCBS Complete |
$84.60
|
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cofinity Commercial |
$148.05
|
| Rate for Payer: Cofinity Commercial |
$181.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$148.05
|
| 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 Commercial |
$179.78
|
| Rate for Payer: PHP Commercial |
$179.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.47
|
| Rate for Payer: Priority Health SBD |
$133.25
|
| Rate for Payer: UMR Bronson Commercial |
$78.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.62
|
|
|
RISPERIDONE 1 MG TABLET
|
Facility
|
IP
|
$338.40
|
|
|
Service Code
|
NDC 00904635961
|
| Hospital Charge Code |
18313
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$148.90 |
| Max. Negotiated Rate |
$304.56 |
| Rate for Payer: Aetna American Axle |
$219.96
|
| Rate for Payer: Aetna Commercial |
$287.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.96
|
| Rate for Payer: Cash Price |
$270.72
|
| Rate for Payer: Cofinity Commercial |
$236.88
|
| Rate for Payer: Cofinity Commercial |
$291.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$236.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.72
|
| Rate for Payer: Healthscope Commercial |
$304.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$236.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.64
|
| Rate for Payer: PHP Commercial |
$287.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.96
|
| Rate for Payer: Priority Health SBD |
$213.19
|
| Rate for Payer: UMR Bronson Commercial |
$148.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.80
|
|
|
RISPERIDONE 3 MG DISINTEGRATING TABLET
|
Facility
|
OP
|
$140.59
|
|
|
Service Code
|
NDC 59746004022
|
| Hospital Charge Code |
70257
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.02 |
| Max. Negotiated Rate |
$126.53 |
| Rate for Payer: Aetna American Axle |
$91.38
|
| Rate for Payer: Aetna Commercial |
$119.50
|
| Rate for Payer: Aetna Medicare |
$70.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.38
|
| Rate for Payer: BCBS Complete |
$56.24
|
| Rate for Payer: Cash Price |
$112.47
|
| Rate for Payer: Cofinity Commercial |
$120.91
|
| Rate for Payer: Cofinity Commercial |
$98.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$98.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.47
|
| Rate for Payer: Healthscope Commercial |
$126.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.50
|
| Rate for Payer: PHP Commercial |
$119.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.38
|
| Rate for Payer: Priority Health SBD |
$88.57
|
| Rate for Payer: UMR Bronson Commercial |
$52.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.44
|
|
|
RISPERIDONE 3 MG DISINTEGRATING TABLET
|
Facility
|
IP
|
$140.59
|
|
|
Service Code
|
NDC 59746004022
|
| Hospital Charge Code |
70257
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$61.86 |
| Max. Negotiated Rate |
$126.53 |
| Rate for Payer: Aetna American Axle |
$91.38
|
| Rate for Payer: Aetna Commercial |
$119.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.38
|
| Rate for Payer: Cash Price |
$112.47
|
| Rate for Payer: Cofinity Commercial |
$120.91
|
| Rate for Payer: Cofinity Commercial |
$98.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$98.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.47
|
| Rate for Payer: Healthscope Commercial |
$126.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.50
|
| Rate for Payer: PHP Commercial |
$119.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.38
|
| Rate for Payer: Priority Health SBD |
$88.57
|
| Rate for Payer: UMR Bronson Commercial |
$61.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.44
|
|
|
RISPERIDONE ER 120 MG SUBCUTANEOUS EXTENDED RELEASE SUSPENSION SYRINGE
|
Facility
|
OP
|
$7,009.40
|
|
|
Service Code
|
HCPCS J2798
|
| Hospital Charge Code |
188120
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$6,308.46 |
| Rate for Payer: Aetna American Axle |
$4,556.11
|
| Rate for Payer: Aetna Commercial |
$5,957.99
|
| Rate for Payer: Aetna Medicare |
$12.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,556.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.18
|
| Rate for Payer: BCBS Complete |
$6.83
|
| Rate for Payer: BCBS MAPPO |
$12.14
|
| Rate for Payer: BCN Medicare Advantage |
$12.14
|
| Rate for Payer: Cash Price |
$5,607.52
|
| Rate for Payer: Cash Price |
$5,607.52
|
| Rate for Payer: Cofinity Commercial |
$4,906.58
|
| Rate for Payer: Cofinity Commercial |
$6,028.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,906.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,607.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.14
|
| Rate for Payer: Healthscope Commercial |
$6,308.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,906.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,257.05
|
| Rate for Payer: Mclaren Medicaid |
$6.51
|
| Rate for Payer: Mclaren Medicare |
$12.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.75
|
| Rate for Payer: Meridian Medicaid |
$6.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,957.99
|
| Rate for Payer: PACE Medicare |
$11.53
|
| Rate for Payer: PACE SWMI |
$12.14
|
| Rate for Payer: PHP Commercial |
$5,957.99
|
| Rate for Payer: PHP Medicare Advantage |
$12.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,556.11
|
| Rate for Payer: Priority Health Medicare |
$12.14
|
| Rate for Payer: Priority Health SBD |
$4,415.92
|
| Rate for Payer: Railroad Medicare Medicare |
$12.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.14
|
| Rate for Payer: UHC Exchange |
$23.20
|
| Rate for Payer: UHC Medicare Advantage |
$12.14
|
| Rate for Payer: UHCCP Medicaid |
$6.51
|
| Rate for Payer: UMR Bronson Commercial |
$2,593.48
|
| Rate for Payer: VA VA |
$12.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,257.05
|
|
|
RISPERIDONE MICROSPHERES ER 25 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE
|
Facility
|
OP
|
$1,792.36
|
|
|
Service Code
|
HCPCS J2794
|
| Hospital Charge Code |
37237
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$1,613.12 |
| Rate for Payer: Aetna American Axle |
$1,165.03
|
| Rate for Payer: Aetna Commercial |
$1,523.51
|
| Rate for Payer: Aetna Medicare |
$11.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,165.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.72
|
| Rate for Payer: BCBS Complete |
$6.18
|
| Rate for Payer: BCBS MAPPO |
$10.98
|
| Rate for Payer: BCN Medicare Advantage |
$10.98
|
| Rate for Payer: Cash Price |
$1,433.89
|
| Rate for Payer: Cash Price |
$1,433.89
|
| Rate for Payer: Cofinity Commercial |
$1,541.43
|
| Rate for Payer: Cofinity Commercial |
$1,254.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,254.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,433.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.98
|
| Rate for Payer: Healthscope Commercial |
$1,613.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,254.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,344.27
|
| Rate for Payer: Mclaren Medicaid |
$5.89
|
| Rate for Payer: Mclaren Medicare |
$10.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.53
|
| Rate for Payer: Meridian Medicaid |
$6.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,523.51
|
| Rate for Payer: PACE Medicare |
$10.43
|
| Rate for Payer: PACE SWMI |
$10.98
|
| Rate for Payer: PHP Commercial |
$1,523.51
|
| Rate for Payer: PHP Medicare Advantage |
$10.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,165.03
|
| Rate for Payer: Priority Health Medicare |
$10.98
|
| Rate for Payer: Priority Health SBD |
$1,129.19
|
| Rate for Payer: Railroad Medicare Medicare |
$10.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.98
|
| Rate for Payer: UHC Exchange |
$20.98
|
| Rate for Payer: UHC Medicare Advantage |
$10.98
|
| Rate for Payer: UHCCP Medicaid |
$5.89
|
| Rate for Payer: UMR Bronson Commercial |
$663.17
|
| Rate for Payer: VA VA |
$10.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,344.27
|
|
|
RISPERIDONE MICROSPHERES ER 25 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE
|
Facility
|
IP
|
$1,792.36
|
|
|
Service Code
|
HCPCS J2794
|
| Hospital Charge Code |
37237
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$788.64 |
| Max. Negotiated Rate |
$1,613.12 |
| Rate for Payer: Aetna American Axle |
$1,165.03
|
| Rate for Payer: Aetna Commercial |
$1,523.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,165.03
|
| Rate for Payer: Cash Price |
$1,433.89
|
| Rate for Payer: Cofinity Commercial |
$1,254.65
|
| Rate for Payer: Cofinity Commercial |
$1,541.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,254.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,433.89
|
| Rate for Payer: Healthscope Commercial |
$1,613.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,254.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,344.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,523.51
|
| Rate for Payer: PHP Commercial |
$1,523.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,165.03
|
| Rate for Payer: Priority Health SBD |
$1,129.19
|
| Rate for Payer: UMR Bronson Commercial |
$788.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,344.27
|
|
|
RISPERIDONE MICROSPHERES ER 37.5 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEAS
|
Facility
|
OP
|
$2,688.64
|
|
|
Service Code
|
HCPCS J2794
|
| Hospital Charge Code |
37238
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$2,419.78 |
| Rate for Payer: Aetna American Axle |
$1,747.62
|
| Rate for Payer: Aetna Commercial |
$2,285.34
|
| Rate for Payer: Aetna Medicare |
$11.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,747.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.72
|
| Rate for Payer: BCBS Complete |
$6.18
|
| Rate for Payer: BCBS MAPPO |
$10.98
|
| Rate for Payer: BCN Medicare Advantage |
$10.98
|
| Rate for Payer: Cash Price |
$2,150.91
|
| Rate for Payer: Cash Price |
$2,150.91
|
| Rate for Payer: Cofinity Commercial |
$1,882.05
|
| Rate for Payer: Cofinity Commercial |
$2,312.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,882.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,150.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.98
|
| Rate for Payer: Healthscope Commercial |
$2,419.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,882.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,016.48
|
| Rate for Payer: Mclaren Medicaid |
$5.89
|
| Rate for Payer: Mclaren Medicare |
$10.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.53
|
| Rate for Payer: Meridian Medicaid |
$6.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,285.34
|
| Rate for Payer: PACE Medicare |
$10.43
|
| Rate for Payer: PACE SWMI |
$10.98
|
| Rate for Payer: PHP Commercial |
$2,285.34
|
| Rate for Payer: PHP Medicare Advantage |
$10.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,747.62
|
| Rate for Payer: Priority Health Medicare |
$10.98
|
| Rate for Payer: Priority Health SBD |
$1,693.84
|
| Rate for Payer: Railroad Medicare Medicare |
$10.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.98
|
| Rate for Payer: UHC Exchange |
$20.98
|
| Rate for Payer: UHC Medicare Advantage |
$10.98
|
| Rate for Payer: UHCCP Medicaid |
$5.89
|
| Rate for Payer: UMR Bronson Commercial |
$994.80
|
| Rate for Payer: VA VA |
$10.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,016.48
|
|
|
RISPERIDONE MICROSPHERES ER 50 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE
|
Facility
|
IP
|
$3,585.00
|
|
|
Service Code
|
HCPCS J2794
|
| Hospital Charge Code |
37239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,577.40 |
| Max. Negotiated Rate |
$3,226.50 |
| Rate for Payer: Aetna American Axle |
$2,330.25
|
| Rate for Payer: Aetna Commercial |
$3,047.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,330.25
|
| Rate for Payer: Cash Price |
$2,868.00
|
| Rate for Payer: Cofinity Commercial |
$2,509.50
|
| Rate for Payer: Cofinity Commercial |
$3,083.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,509.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,868.00
|
| Rate for Payer: Healthscope Commercial |
$3,226.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,509.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,688.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,047.25
|
| Rate for Payer: PHP Commercial |
$3,047.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,330.25
|
| Rate for Payer: Priority Health SBD |
$2,258.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,577.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,688.75
|
|
|
RISPERIDONE MICROSPHERES ER 50 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE
|
Facility
|
OP
|
$3,585.00
|
|
|
Service Code
|
HCPCS J2794
|
| Hospital Charge Code |
37239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$3,226.50 |
| Rate for Payer: Aetna American Axle |
$2,330.25
|
| Rate for Payer: Aetna Commercial |
$3,047.25
|
| Rate for Payer: Aetna Medicare |
$11.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,330.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.72
|
| Rate for Payer: BCBS Complete |
$6.18
|
| Rate for Payer: BCBS MAPPO |
$10.98
|
| Rate for Payer: BCN Medicare Advantage |
$10.98
|
| Rate for Payer: Cash Price |
$2,868.00
|
| Rate for Payer: Cash Price |
$2,868.00
|
| Rate for Payer: Cofinity Commercial |
$3,083.10
|
| Rate for Payer: Cofinity Commercial |
$2,509.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,509.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,868.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.98
|
| Rate for Payer: Healthscope Commercial |
$3,226.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,509.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,688.75
|
| Rate for Payer: Mclaren Medicaid |
$5.89
|
| Rate for Payer: Mclaren Medicare |
$10.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.53
|
| Rate for Payer: Meridian Medicaid |
$6.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,047.25
|
| Rate for Payer: PACE Medicare |
$10.43
|
| Rate for Payer: PACE SWMI |
$10.98
|
| Rate for Payer: PHP Commercial |
$3,047.25
|
| Rate for Payer: PHP Medicare Advantage |
$10.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,330.25
|
| Rate for Payer: Priority Health Medicare |
$10.98
|
| Rate for Payer: Priority Health SBD |
$2,258.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.98
|
| Rate for Payer: UHC Exchange |
$20.98
|
| Rate for Payer: UHC Medicare Advantage |
$10.98
|
| Rate for Payer: UHCCP Medicaid |
$5.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,326.45
|
| Rate for Payer: VA VA |
$10.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,688.75
|
|
|
RITONAVIR 100 MG TABLET
|
Facility
|
IP
|
$927.74
|
|
|
Service Code
|
NDC 00074333330
|
| Hospital Charge Code |
100995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$408.21 |
| Max. Negotiated Rate |
$834.97 |
| Rate for Payer: Aetna American Axle |
$603.03
|
| Rate for Payer: Aetna Commercial |
$788.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$603.03
|
| Rate for Payer: Cash Price |
$742.19
|
| Rate for Payer: Cofinity Commercial |
$649.42
|
| Rate for Payer: Cofinity Commercial |
$797.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$649.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$742.19
|
| Rate for Payer: Healthscope Commercial |
$834.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$649.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$695.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$788.58
|
| Rate for Payer: PHP Commercial |
$788.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$603.03
|
| Rate for Payer: Priority Health SBD |
$584.48
|
| Rate for Payer: UMR Bronson Commercial |
$408.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$695.80
|
|
|
RITONAVIR 100 MG TABLET
|
Facility
|
OP
|
$927.74
|
|
|
Service Code
|
NDC 00074333330
|
| Hospital Charge Code |
100995
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$343.26 |
| Max. Negotiated Rate |
$834.97 |
| Rate for Payer: Aetna American Axle |
$603.03
|
| Rate for Payer: Aetna Commercial |
$788.58
|
| Rate for Payer: Aetna Medicare |
$463.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$603.03
|
| Rate for Payer: BCBS Complete |
$371.10
|
| Rate for Payer: Cash Price |
$742.19
|
| Rate for Payer: Cofinity Commercial |
$649.42
|
| Rate for Payer: Cofinity Commercial |
$797.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$649.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$742.19
|
| Rate for Payer: Healthscope Commercial |
$834.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$649.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$695.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$788.58
|
| Rate for Payer: PHP Commercial |
$788.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$603.03
|
| Rate for Payer: Priority Health SBD |
$584.48
|
| Rate for Payer: UMR Bronson Commercial |
$343.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$695.80
|
|
|
RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS
|
Facility
|
IP
|
$21,092.23
|
|
|
Service Code
|
HCPCS J9312
|
| Hospital Charge Code |
22149
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9,280.58 |
| Max. Negotiated Rate |
$18,983.01 |
| Rate for Payer: Aetna American Axle |
$13,709.95
|
| Rate for Payer: Aetna American Axle |
$2,741.99
|
| Rate for Payer: Aetna Commercial |
$17,928.40
|
| Rate for Payer: Aetna Commercial |
$3,585.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,709.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,741.99
|
| Rate for Payer: Cash Price |
$16,873.78
|
| Rate for Payer: Cash Price |
$3,374.76
|
| Rate for Payer: Cofinity Commercial |
$3,627.87
|
| Rate for Payer: Cofinity Commercial |
$2,952.91
|
| Rate for Payer: Cofinity Commercial |
$14,764.56
|
| Rate for Payer: Cofinity Commercial |
$18,139.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$14,764.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,952.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,873.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,374.76
|
| Rate for Payer: Healthscope Commercial |
$18,983.01
|
| Rate for Payer: Healthscope Commercial |
$3,796.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14,764.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,952.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,819.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,163.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,585.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,928.40
|
| Rate for Payer: PHP Commercial |
$3,585.68
|
| Rate for Payer: PHP Commercial |
$17,928.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,709.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,741.99
|
| Rate for Payer: Priority Health SBD |
$13,288.10
|
| Rate for Payer: Priority Health SBD |
$2,657.62
|
| Rate for Payer: UMR Bronson Commercial |
$9,280.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,856.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,819.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,163.84
|
|
|
RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS
|
Facility
|
OP
|
$4,218.45
|
|
|
Service Code
|
HCPCS J9312
|
| Hospital Charge Code |
22149
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.32 |
| Max. Negotiated Rate |
$3,796.61 |
| Rate for Payer: Aetna American Axle |
$2,741.99
|
| Rate for Payer: Aetna American Axle |
$13,709.95
|
| Rate for Payer: Aetna Commercial |
$17,928.40
|
| Rate for Payer: Aetna Commercial |
$3,585.68
|
| Rate for Payer: Aetna Medicare |
$78.23
|
| Rate for Payer: Aetna Medicare |
$78.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,741.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,709.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.03
|
| Rate for Payer: BCBS Complete |
$42.33
|
| Rate for Payer: BCBS Complete |
$42.33
|
| Rate for Payer: BCBS MAPPO |
$75.22
|
| Rate for Payer: BCBS MAPPO |
$75.22
|
| Rate for Payer: BCN Medicare Advantage |
$75.22
|
| Rate for Payer: BCN Medicare Advantage |
$75.22
|
| Rate for Payer: Cash Price |
$16,873.78
|
| Rate for Payer: Cash Price |
$3,374.76
|
| Rate for Payer: Cash Price |
$3,374.76
|
| Rate for Payer: Cash Price |
$16,873.78
|
| Rate for Payer: Cofinity Commercial |
$14,764.56
|
| Rate for Payer: Cofinity Commercial |
$18,139.32
|
| Rate for Payer: Cofinity Commercial |
$2,952.91
|
| Rate for Payer: Cofinity Commercial |
$3,627.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$14,764.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,952.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,374.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,873.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.22
|
| Rate for Payer: Healthscope Commercial |
$3,796.61
|
| Rate for Payer: Healthscope Commercial |
$18,983.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,952.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14,764.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,819.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,163.84
|
| Rate for Payer: Mclaren Medicaid |
$40.32
|
| Rate for Payer: Mclaren Medicaid |
$40.32
|
| Rate for Payer: Mclaren Medicare |
$75.22
|
| Rate for Payer: Mclaren Medicare |
$75.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.98
|
| Rate for Payer: Meridian Medicaid |
$42.33
|
| Rate for Payer: Meridian Medicaid |
$42.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,585.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,928.40
|
| Rate for Payer: PACE Medicare |
$71.46
|
| Rate for Payer: PACE Medicare |
$71.46
|
| Rate for Payer: PACE SWMI |
$75.22
|
| Rate for Payer: PACE SWMI |
$75.22
|
| Rate for Payer: PHP Commercial |
$17,928.40
|
| Rate for Payer: PHP Commercial |
$3,585.68
|
| Rate for Payer: PHP Medicare Advantage |
$75.22
|
| Rate for Payer: PHP Medicare Advantage |
$75.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,709.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,741.99
|
| Rate for Payer: Priority Health Medicare |
$75.22
|
| Rate for Payer: Priority Health Medicare |
$75.22
|
| Rate for Payer: Priority Health SBD |
$13,288.10
|
| Rate for Payer: Priority Health SBD |
$2,657.62
|
| Rate for Payer: Railroad Medicare Medicare |
$75.22
|
| Rate for Payer: Railroad Medicare Medicare |
$75.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.22
|
| Rate for Payer: UHC Exchange |
$143.75
|
| Rate for Payer: UHC Exchange |
$143.75
|
| Rate for Payer: UHC Medicare Advantage |
$75.22
|
| Rate for Payer: UHC Medicare Advantage |
$75.22
|
| Rate for Payer: UHCCP Medicaid |
$40.32
|
| Rate for Payer: UHCCP Medicaid |
$40.32
|
| Rate for Payer: UMR Bronson Commercial |
$7,804.13
|
| Rate for Payer: UMR Bronson Commercial |
$1,560.83
|
| Rate for Payer: VA VA |
$75.22
|
| Rate for Payer: VA VA |
$75.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,163.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,819.17
|
|
