|
ROPINIROLE 0.25 MG TABLET
|
Facility
|
OP
|
$138.65
|
|
|
Service Code
|
NDC 43547026810
|
| Hospital Charge Code |
21688
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$51.30 |
| Max. Negotiated Rate |
$124.78 |
| Rate for Payer: Aetna American Axle |
$90.12
|
| Rate for Payer: Aetna Commercial |
$117.85
|
| Rate for Payer: Aetna Medicare |
$69.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.12
|
| Rate for Payer: BCBS Complete |
$55.46
|
| Rate for Payer: Cash Price |
$110.92
|
| Rate for Payer: Cofinity Commercial |
$119.24
|
| Rate for Payer: Cofinity Commercial |
$97.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$97.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.92
|
| Rate for Payer: Healthscope Commercial |
$124.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$97.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.85
|
| Rate for Payer: PHP Commercial |
$117.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.12
|
| Rate for Payer: Priority Health SBD |
$87.35
|
| Rate for Payer: UMR Bronson Commercial |
$51.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.99
|
|
|
ROPINIROLE 0.25 MG TABLET
|
Facility
|
OP
|
$355.30
|
|
|
Service Code
|
NDC 60687057701
|
| Hospital Charge Code |
21688
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$131.46 |
| Max. Negotiated Rate |
$319.77 |
| Rate for Payer: Aetna American Axle |
$230.94
|
| Rate for Payer: Aetna Commercial |
$302.00
|
| Rate for Payer: Aetna Medicare |
$177.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.94
|
| Rate for Payer: BCBS Complete |
$142.12
|
| Rate for Payer: Cash Price |
$284.24
|
| Rate for Payer: Cofinity Commercial |
$248.71
|
| Rate for Payer: Cofinity Commercial |
$305.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$248.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.24
|
| Rate for Payer: Healthscope Commercial |
$319.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$248.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.00
|
| Rate for Payer: PHP Commercial |
$302.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.94
|
| Rate for Payer: Priority Health SBD |
$223.84
|
| Rate for Payer: UMR Bronson Commercial |
$131.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.48
|
|
|
ROPINIROLE 0.25 MG TABLET
|
Facility
|
IP
|
$3.56
|
|
|
Service Code
|
NDC 60687057711
|
| Hospital Charge Code |
21688
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.57 |
| Max. Negotiated Rate |
$3.20 |
| Rate for Payer: Aetna American Axle |
$2.31
|
| Rate for Payer: Aetna Commercial |
$3.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.31
|
| Rate for Payer: Cash Price |
$2.85
|
| Rate for Payer: Cofinity Commercial |
$2.49
|
| Rate for Payer: Cofinity Commercial |
$3.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.85
|
| Rate for Payer: Healthscope Commercial |
$3.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.03
|
| Rate for Payer: PHP Commercial |
$3.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.31
|
| Rate for Payer: Priority Health SBD |
$2.24
|
| Rate for Payer: UMR Bronson Commercial |
$1.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.67
|
|
|
ROPINIROLE 1 MG TABLET
|
Facility
|
OP
|
$342.00
|
|
|
Service Code
|
NDC 00904599601
|
| Hospital Charge Code |
21689
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$126.54 |
| Max. Negotiated Rate |
$307.80 |
| Rate for Payer: Aetna American Axle |
$222.30
|
| Rate for Payer: Aetna Commercial |
$290.70
|
| Rate for Payer: Aetna Medicare |
$171.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.30
|
| Rate for Payer: BCBS Complete |
$136.80
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cofinity Commercial |
$239.40
|
| Rate for Payer: Cofinity Commercial |
$294.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$239.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$273.60
|
| Rate for Payer: Healthscope Commercial |
$307.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$239.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$256.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$290.70
|
| Rate for Payer: PHP Commercial |
$290.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.30
|
| Rate for Payer: Priority Health SBD |
$215.46
|
| Rate for Payer: UMR Bronson Commercial |
$126.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$256.50
|
|
|
ROPINIROLE 1 MG TABLET
|
Facility
|
IP
|
$190.35
|
|
|
Service Code
|
NDC 43547027010
|
| Hospital Charge Code |
21689
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$83.75 |
| Max. Negotiated Rate |
$171.32 |
| Rate for Payer: Aetna American Axle |
$123.73
|
| Rate for Payer: Aetna Commercial |
$161.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.73
|
| Rate for Payer: Cash Price |
$152.28
|
| Rate for Payer: Cofinity Commercial |
$133.24
|
| Rate for Payer: Cofinity Commercial |
$163.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$133.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.28
|
| Rate for Payer: Healthscope Commercial |
$171.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$133.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.80
|
| Rate for Payer: PHP Commercial |
$161.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.73
|
| Rate for Payer: Priority Health SBD |
$119.92
|
| Rate for Payer: UMR Bronson Commercial |
$83.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.76
|
|
|
ROPINIROLE 1 MG TABLET
|
Facility
|
OP
|
$263.20
|
|
|
Service Code
|
NDC 62332003231
|
| Hospital Charge Code |
21689
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$97.38 |
| Max. Negotiated Rate |
$236.88 |
| Rate for Payer: Aetna American Axle |
$171.08
|
| Rate for Payer: Aetna Commercial |
$223.72
|
| Rate for Payer: Aetna Medicare |
$131.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.08
|
| Rate for Payer: BCBS Complete |
$105.28
|
| Rate for Payer: Cash Price |
$210.56
|
| Rate for Payer: Cofinity Commercial |
$184.24
|
| Rate for Payer: Cofinity Commercial |
$226.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$184.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.56
|
| Rate for Payer: Healthscope Commercial |
$236.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.72
|
| Rate for Payer: PHP Commercial |
$223.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.08
|
| Rate for Payer: Priority Health SBD |
$165.82
|
| Rate for Payer: UMR Bronson Commercial |
$97.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.40
|
|
|
ROPINIROLE 1 MG TABLET
|
Facility
|
IP
|
$263.20
|
|
|
Service Code
|
NDC 62332003231
|
| Hospital Charge Code |
21689
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$115.81 |
| Max. Negotiated Rate |
$236.88 |
| Rate for Payer: Aetna American Axle |
$171.08
|
| Rate for Payer: Aetna Commercial |
$223.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.08
|
| Rate for Payer: Cash Price |
$210.56
|
| Rate for Payer: Cofinity Commercial |
$184.24
|
| Rate for Payer: Cofinity Commercial |
$226.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$184.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.56
|
| Rate for Payer: Healthscope Commercial |
$236.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.72
|
| Rate for Payer: PHP Commercial |
$223.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.08
|
| Rate for Payer: Priority Health SBD |
$165.82
|
| Rate for Payer: UMR Bronson Commercial |
$115.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.40
|
|
|
ROPINIROLE 1 MG TABLET
|
Facility
|
IP
|
$305.50
|
|
|
Service Code
|
NDC 16729023401
|
| Hospital Charge Code |
21689
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$134.42 |
| Max. Negotiated Rate |
$274.95 |
| Rate for Payer: Aetna American Axle |
$198.58
|
| Rate for Payer: Aetna Commercial |
$259.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.58
|
| Rate for Payer: Cash Price |
$244.40
|
| Rate for Payer: Cofinity Commercial |
$213.85
|
| Rate for Payer: Cofinity Commercial |
$262.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$213.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.40
|
| Rate for Payer: Healthscope Commercial |
$274.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.68
|
| Rate for Payer: PHP Commercial |
$259.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.58
|
| Rate for Payer: Priority Health SBD |
$192.46
|
| Rate for Payer: UMR Bronson Commercial |
$134.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.12
|
|
|
ROPINIROLE 1 MG TABLET
|
Facility
|
OP
|
$190.35
|
|
|
Service Code
|
NDC 43547027010
|
| Hospital Charge Code |
21689
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$70.43 |
| Max. Negotiated Rate |
$171.32 |
| Rate for Payer: Aetna American Axle |
$123.73
|
| Rate for Payer: Aetna Commercial |
$161.80
|
| Rate for Payer: Aetna Medicare |
$95.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.73
|
| Rate for Payer: BCBS Complete |
$76.14
|
| Rate for Payer: Cash Price |
$152.28
|
| Rate for Payer: Cofinity Commercial |
$133.24
|
| Rate for Payer: Cofinity Commercial |
$163.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$133.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.28
|
| Rate for Payer: Healthscope Commercial |
$171.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$133.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.80
|
| Rate for Payer: PHP Commercial |
$161.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.73
|
| Rate for Payer: Priority Health SBD |
$119.92
|
| Rate for Payer: UMR Bronson Commercial |
$70.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.76
|
|
|
ROPINIROLE 1 MG TABLET
|
Facility
|
IP
|
$342.00
|
|
|
Service Code
|
NDC 00904599601
|
| Hospital Charge Code |
21689
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$150.48 |
| Max. Negotiated Rate |
$307.80 |
| Rate for Payer: Aetna American Axle |
$222.30
|
| Rate for Payer: Aetna Commercial |
$290.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.30
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cofinity Commercial |
$239.40
|
| Rate for Payer: Cofinity Commercial |
$294.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$239.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$273.60
|
| Rate for Payer: Healthscope Commercial |
$307.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$239.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$256.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$290.70
|
| Rate for Payer: PHP Commercial |
$290.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.30
|
| Rate for Payer: Priority Health SBD |
$215.46
|
| Rate for Payer: UMR Bronson Commercial |
$150.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$256.50
|
|
|
ROPINIROLE 1 MG TABLET
|
Facility
|
OP
|
$305.50
|
|
|
Service Code
|
NDC 16729023401
|
| Hospital Charge Code |
21689
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$113.04 |
| Max. Negotiated Rate |
$274.95 |
| Rate for Payer: Aetna American Axle |
$198.58
|
| Rate for Payer: Aetna Commercial |
$259.68
|
| Rate for Payer: Aetna Medicare |
$152.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.58
|
| Rate for Payer: BCBS Complete |
$122.20
|
| Rate for Payer: Cash Price |
$244.40
|
| Rate for Payer: Cofinity Commercial |
$213.85
|
| Rate for Payer: Cofinity Commercial |
$262.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$213.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.40
|
| Rate for Payer: Healthscope Commercial |
$274.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.68
|
| Rate for Payer: PHP Commercial |
$259.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.58
|
| Rate for Payer: Priority Health SBD |
$192.46
|
| Rate for Payer: UMR Bronson Commercial |
$113.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.12
|
|
|
ROPIVACAINE 0.2 % FOR NERVE BLOCK INJECTION
|
Facility
|
IP
|
$122.04
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
161560
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$53.70 |
| Max. Negotiated Rate |
$109.84 |
| Rate for Payer: Aetna American Axle |
$79.33
|
| Rate for Payer: Aetna Commercial |
$103.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.33
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cofinity Commercial |
$104.95
|
| Rate for Payer: Cofinity Commercial |
$85.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$85.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.63
|
| Rate for Payer: Healthscope Commercial |
$109.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.73
|
| Rate for Payer: PHP Commercial |
$103.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.33
|
| Rate for Payer: Priority Health SBD |
$76.89
|
| Rate for Payer: UMR Bronson Commercial |
$53.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.53
|
|
|
ROPIVACAINE 0.2 % FOR NERVE BLOCK INJECTION
|
Facility
|
OP
|
$122.04
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
161560
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$109.84 |
| Rate for Payer: Aetna American Axle |
$79.33
|
| Rate for Payer: Aetna Commercial |
$103.73
|
| Rate for Payer: Aetna Medicare |
$61.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.33
|
| Rate for Payer: BCBS Complete |
$48.82
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cofinity Commercial |
$104.95
|
| Rate for Payer: Cofinity Commercial |
$85.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$85.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.63
|
| Rate for Payer: Healthscope Commercial |
$109.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.73
|
| Rate for Payer: PHP Commercial |
$103.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.33
|
| Rate for Payer: Priority Health SBD |
$76.89
|
| Rate for Payer: UMR Bronson Commercial |
$45.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.53
|
|
|
ROPIVACAINE 0.5 % 50ML IN SODIUM CHLORIDE 0.9% ML INFILTRATION 100 ML (TOTAL KNEE)
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
301830
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$48.40 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna American Axle |
$71.50
|
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$77.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health SBD |
$69.30
|
| Rate for Payer: UMR Bronson Commercial |
$48.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
|
ROPIVACAINE 0.5 % 50ML IN SODIUM CHLORIDE 0.9% ML INFILTRATION 100 ML (TOTAL KNEE)
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
301830
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna American Axle |
$71.50
|
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Cofinity Commercial |
$77.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health SBD |
$69.30
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UMR Bronson Commercial |
$40.70
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
|
ROPIVACAINE 0.5 % 60 ML IN SODIUM CHLORIDE 0.9% ML INFILTRATION 100 ML (TOTAL HIP)
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
301829
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$48.40 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna American Axle |
$71.50
|
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$77.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health SBD |
$69.30
|
| Rate for Payer: UMR Bronson Commercial |
$48.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
|
ROPIVACAINE 0.5 % 60 ML IN SODIUM CHLORIDE 0.9% ML INFILTRATION 100 ML (TOTAL HIP)
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
301829
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna American Axle |
$71.50
|
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Cofinity Commercial |
$77.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health SBD |
$69.30
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UMR Bronson Commercial |
$40.70
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
|
ROPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION
|
Facility
|
OP
|
$144.01
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
18194
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$129.61 |
| Rate for Payer: Aetna American Axle |
$93.61
|
| Rate for Payer: Aetna American Axle |
$26.44
|
| Rate for Payer: Aetna American Axle |
$52.67
|
| Rate for Payer: Aetna American Axle |
$64.69
|
| Rate for Payer: Aetna American Axle |
$47.69
|
| Rate for Payer: Aetna American Axle |
$48.82
|
| Rate for Payer: Aetna American Axle |
$48.10
|
| Rate for Payer: Aetna Commercial |
$62.90
|
| Rate for Payer: Aetna Commercial |
$84.60
|
| Rate for Payer: Aetna Commercial |
$63.84
|
| Rate for Payer: Aetna Commercial |
$68.88
|
| Rate for Payer: Aetna Commercial |
$62.36
|
| Rate for Payer: Aetna Commercial |
$122.41
|
| Rate for Payer: Aetna Commercial |
$34.58
|
| Rate for Payer: Aetna Medicare |
$37.00
|
| Rate for Payer: Aetna Medicare |
$37.55
|
| Rate for Payer: Aetna Medicare |
$20.34
|
| Rate for Payer: Aetna Medicare |
$40.52
|
| Rate for Payer: Aetna Medicare |
$36.68
|
| Rate for Payer: Aetna Medicare |
$72.00
|
| Rate for Payer: Aetna Medicare |
$49.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.67
|
| Rate for Payer: BCBS Complete |
$30.04
|
| Rate for Payer: BCBS Complete |
$16.27
|
| Rate for Payer: BCBS Complete |
$29.35
|
| Rate for Payer: BCBS Complete |
$57.60
|
| Rate for Payer: BCBS Complete |
$39.81
|
| Rate for Payer: BCBS Complete |
$32.41
|
| Rate for Payer: BCBS Complete |
$29.60
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: Cash Price |
$79.62
|
| Rate for Payer: Cash Price |
$32.54
|
| Rate for Payer: Cash Price |
$58.70
|
| Rate for Payer: Cash Price |
$115.21
|
| Rate for Payer: Cash Price |
$32.54
|
| Rate for Payer: Cash Price |
$115.21
|
| Rate for Payer: Cash Price |
$58.70
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$60.08
|
| Rate for Payer: Cash Price |
$60.08
|
| Rate for Payer: Cash Price |
$64.82
|
| Rate for Payer: Cash Price |
$64.82
|
| Rate for Payer: Cash Price |
$79.62
|
| Rate for Payer: Cofinity Commercial |
$28.48
|
| Rate for Payer: Cofinity Commercial |
$85.60
|
| Rate for Payer: Cofinity Commercial |
$52.57
|
| Rate for Payer: Cofinity Commercial |
$123.85
|
| Rate for Payer: Cofinity Commercial |
$63.10
|
| Rate for Payer: Cofinity Commercial |
$69.67
|
| Rate for Payer: Cofinity Commercial |
$100.81
|
| Rate for Payer: Cofinity Commercial |
$64.59
|
| Rate for Payer: Cofinity Commercial |
$51.36
|
| Rate for Payer: Cofinity Commercial |
$69.69
|
| Rate for Payer: Cofinity Commercial |
$56.72
|
| Rate for Payer: Cofinity Commercial |
$34.98
|
| Rate for Payer: Cofinity Commercial |
$51.80
|
| Rate for Payer: Cofinity Commercial |
$63.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$100.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$56.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$28.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$115.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.70
|
| Rate for Payer: Healthscope Commercial |
$66.60
|
| Rate for Payer: Healthscope Commercial |
$89.58
|
| Rate for Payer: Healthscope Commercial |
$67.59
|
| Rate for Payer: Healthscope Commercial |
$129.61
|
| Rate for Payer: Healthscope Commercial |
$36.61
|
| Rate for Payer: Healthscope Commercial |
$66.03
|
| Rate for Payer: Healthscope Commercial |
$72.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.60
|
| Rate for Payer: PHP Commercial |
$34.58
|
| Rate for Payer: PHP Commercial |
$62.90
|
| Rate for Payer: PHP Commercial |
$84.60
|
| Rate for Payer: PHP Commercial |
$62.36
|
| Rate for Payer: PHP Commercial |
$122.41
|
| Rate for Payer: PHP Commercial |
$63.84
|
| Rate for Payer: PHP Commercial |
$68.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.69
|
| Rate for Payer: Priority Health SBD |
$46.62
|
| Rate for Payer: Priority Health SBD |
$47.31
|
| Rate for Payer: Priority Health SBD |
$62.70
|
| Rate for Payer: Priority Health SBD |
$51.05
|
| Rate for Payer: Priority Health SBD |
$25.63
|
| Rate for Payer: Priority Health SBD |
$46.22
|
| Rate for Payer: Priority Health SBD |
$90.73
|
| Rate for Payer: UMR Bronson Commercial |
$27.79
|
| Rate for Payer: UMR Bronson Commercial |
$27.15
|
| Rate for Payer: UMR Bronson Commercial |
$53.28
|
| Rate for Payer: UMR Bronson Commercial |
$15.05
|
| Rate for Payer: UMR Bronson Commercial |
$27.38
|
| Rate for Payer: UMR Bronson Commercial |
$29.98
|
| Rate for Payer: UMR Bronson Commercial |
$36.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.77
|
|
|
ROPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION
|
Facility
|
IP
|
$144.01
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
18194
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$63.36 |
| Max. Negotiated Rate |
$129.61 |
| Rate for Payer: Aetna American Axle |
$93.61
|
| Rate for Payer: Aetna American Axle |
$52.67
|
| Rate for Payer: Aetna American Axle |
$48.82
|
| Rate for Payer: Aetna American Axle |
$47.69
|
| Rate for Payer: Aetna American Axle |
$26.44
|
| Rate for Payer: Aetna American Axle |
$48.10
|
| Rate for Payer: Aetna American Axle |
$64.69
|
| Rate for Payer: Aetna Commercial |
$68.88
|
| Rate for Payer: Aetna Commercial |
$34.58
|
| Rate for Payer: Aetna Commercial |
$62.90
|
| Rate for Payer: Aetna Commercial |
$63.84
|
| Rate for Payer: Aetna Commercial |
$84.60
|
| Rate for Payer: Aetna Commercial |
$62.36
|
| Rate for Payer: Aetna Commercial |
$122.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.67
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$64.82
|
| Rate for Payer: Cash Price |
$32.54
|
| Rate for Payer: Cash Price |
$115.21
|
| Rate for Payer: Cash Price |
$58.70
|
| Rate for Payer: Cash Price |
$60.08
|
| Rate for Payer: Cash Price |
$79.62
|
| Rate for Payer: Cofinity Commercial |
$69.69
|
| Rate for Payer: Cofinity Commercial |
$100.81
|
| Rate for Payer: Cofinity Commercial |
$63.64
|
| Rate for Payer: Cofinity Commercial |
$51.80
|
| Rate for Payer: Cofinity Commercial |
$51.36
|
| Rate for Payer: Cofinity Commercial |
$28.48
|
| Rate for Payer: Cofinity Commercial |
$34.98
|
| Rate for Payer: Cofinity Commercial |
$63.10
|
| Rate for Payer: Cofinity Commercial |
$123.85
|
| Rate for Payer: Cofinity Commercial |
$52.57
|
| Rate for Payer: Cofinity Commercial |
$64.59
|
| Rate for Payer: Cofinity Commercial |
$56.72
|
| Rate for Payer: Cofinity Commercial |
$69.67
|
| Rate for Payer: Cofinity Commercial |
$85.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$100.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$56.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$28.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$115.21
|
| Rate for Payer: Healthscope Commercial |
$89.58
|
| Rate for Payer: Healthscope Commercial |
$67.59
|
| Rate for Payer: Healthscope Commercial |
$66.03
|
| Rate for Payer: Healthscope Commercial |
$66.60
|
| Rate for Payer: Healthscope Commercial |
$36.61
|
| Rate for Payer: Healthscope Commercial |
$129.61
|
| Rate for Payer: Healthscope Commercial |
$72.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.88
|
| Rate for Payer: PHP Commercial |
$63.84
|
| Rate for Payer: PHP Commercial |
$62.36
|
| Rate for Payer: PHP Commercial |
$62.90
|
| Rate for Payer: PHP Commercial |
$122.41
|
| Rate for Payer: PHP Commercial |
$34.58
|
| Rate for Payer: PHP Commercial |
$84.60
|
| Rate for Payer: PHP Commercial |
$68.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.82
|
| Rate for Payer: Priority Health SBD |
$46.22
|
| Rate for Payer: Priority Health SBD |
$25.63
|
| Rate for Payer: Priority Health SBD |
$90.73
|
| Rate for Payer: Priority Health SBD |
$62.70
|
| Rate for Payer: Priority Health SBD |
$51.05
|
| Rate for Payer: Priority Health SBD |
$47.31
|
| Rate for Payer: Priority Health SBD |
$46.62
|
| Rate for Payer: UMR Bronson Commercial |
$32.56
|
| Rate for Payer: UMR Bronson Commercial |
$43.79
|
| Rate for Payer: UMR Bronson Commercial |
$33.04
|
| Rate for Payer: UMR Bronson Commercial |
$35.65
|
| Rate for Payer: UMR Bronson Commercial |
$63.36
|
| Rate for Payer: UMR Bronson Commercial |
$32.28
|
| Rate for Payer: UMR Bronson Commercial |
$17.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.01
|
|
|
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION
|
Facility
|
IP
|
$169.83
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
169800
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$74.73 |
| Max. Negotiated Rate |
$152.85 |
| Rate for Payer: Aetna American Axle |
$110.39
|
| Rate for Payer: Aetna Commercial |
$144.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.39
|
| Rate for Payer: Cash Price |
$135.86
|
| Rate for Payer: Cofinity Commercial |
$118.88
|
| Rate for Payer: Cofinity Commercial |
$146.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$118.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.86
|
| Rate for Payer: Healthscope Commercial |
$152.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.36
|
| Rate for Payer: PHP Commercial |
$144.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.39
|
| Rate for Payer: Priority Health SBD |
$106.99
|
| Rate for Payer: UMR Bronson Commercial |
$74.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.37
|
|
|
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION
|
Facility
|
IP
|
$119.33
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
18192
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$52.51 |
| Max. Negotiated Rate |
$107.40 |
| Rate for Payer: Aetna American Axle |
$77.56
|
| Rate for Payer: Aetna American Axle |
$110.39
|
| Rate for Payer: Aetna American Axle |
$106.77
|
| Rate for Payer: Aetna American Axle |
$79.33
|
| Rate for Payer: Aetna American Axle |
$85.05
|
| Rate for Payer: Aetna American Axle |
$198.46
|
| Rate for Payer: Aetna Commercial |
$101.43
|
| Rate for Payer: Aetna Commercial |
$103.73
|
| Rate for Payer: Aetna Commercial |
$139.62
|
| Rate for Payer: Aetna Commercial |
$259.52
|
| Rate for Payer: Aetna Commercial |
$144.36
|
| Rate for Payer: Aetna Commercial |
$111.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.39
|
| Rate for Payer: Cash Price |
$135.86
|
| Rate for Payer: Cash Price |
$131.41
|
| Rate for Payer: Cash Price |
$95.46
|
| Rate for Payer: Cash Price |
$104.68
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cash Price |
$244.26
|
| Rate for Payer: Cofinity Commercial |
$146.05
|
| Rate for Payer: Cofinity Commercial |
$102.62
|
| Rate for Payer: Cofinity Commercial |
$141.26
|
| Rate for Payer: Cofinity Commercial |
$114.98
|
| Rate for Payer: Cofinity Commercial |
$112.53
|
| Rate for Payer: Cofinity Commercial |
$104.95
|
| Rate for Payer: Cofinity Commercial |
$85.43
|
| Rate for Payer: Cofinity Commercial |
$91.60
|
| Rate for Payer: Cofinity Commercial |
$83.53
|
| Rate for Payer: Cofinity Commercial |
$262.58
|
| Rate for Payer: Cofinity Commercial |
$213.72
|
| Rate for Payer: Cofinity Commercial |
$118.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$114.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$85.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$213.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$118.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.26
|
| Rate for Payer: Healthscope Commercial |
$147.83
|
| Rate for Payer: Healthscope Commercial |
$274.79
|
| Rate for Payer: Healthscope Commercial |
$152.85
|
| Rate for Payer: Healthscope Commercial |
$109.84
|
| Rate for Payer: Healthscope Commercial |
$117.76
|
| Rate for Payer: Healthscope Commercial |
$107.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.22
|
| Rate for Payer: PHP Commercial |
$101.43
|
| Rate for Payer: PHP Commercial |
$103.73
|
| Rate for Payer: PHP Commercial |
$139.62
|
| Rate for Payer: PHP Commercial |
$144.36
|
| Rate for Payer: PHP Commercial |
$111.22
|
| Rate for Payer: PHP Commercial |
$259.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.46
|
| Rate for Payer: Priority Health SBD |
$106.99
|
| Rate for Payer: Priority Health SBD |
$103.48
|
| Rate for Payer: Priority Health SBD |
$75.18
|
| Rate for Payer: Priority Health SBD |
$76.89
|
| Rate for Payer: Priority Health SBD |
$82.44
|
| Rate for Payer: Priority Health SBD |
$192.35
|
| Rate for Payer: UMR Bronson Commercial |
$134.34
|
| Rate for Payer: UMR Bronson Commercial |
$53.70
|
| Rate for Payer: UMR Bronson Commercial |
$57.57
|
| Rate for Payer: UMR Bronson Commercial |
$74.73
|
| Rate for Payer: UMR Bronson Commercial |
$72.27
|
| Rate for Payer: UMR Bronson Commercial |
$52.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.50
|
|
|
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION
|
Facility
|
OP
|
$169.83
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
169800
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$152.85 |
| Rate for Payer: Aetna American Axle |
$110.39
|
| Rate for Payer: Aetna Commercial |
$144.36
|
| Rate for Payer: Aetna Medicare |
$84.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.39
|
| Rate for Payer: BCBS Complete |
$67.93
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: Cash Price |
$135.86
|
| Rate for Payer: Cash Price |
$135.86
|
| Rate for Payer: Cofinity Commercial |
$118.88
|
| Rate for Payer: Cofinity Commercial |
$146.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$118.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.86
|
| Rate for Payer: Healthscope Commercial |
$152.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.36
|
| Rate for Payer: PHP Commercial |
$144.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.39
|
| Rate for Payer: Priority Health SBD |
$106.99
|
| Rate for Payer: UMR Bronson Commercial |
$62.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.37
|
|
|
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION
|
Facility
|
OP
|
$305.32
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
18192
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$274.79 |
| Rate for Payer: Aetna American Axle |
$198.46
|
| Rate for Payer: Aetna American Axle |
$79.33
|
| Rate for Payer: Aetna American Axle |
$77.56
|
| Rate for Payer: Aetna American Axle |
$85.05
|
| Rate for Payer: Aetna American Axle |
$106.77
|
| Rate for Payer: Aetna American Axle |
$110.39
|
| Rate for Payer: Aetna Commercial |
$111.22
|
| Rate for Payer: Aetna Commercial |
$144.36
|
| Rate for Payer: Aetna Commercial |
$103.73
|
| Rate for Payer: Aetna Commercial |
$101.43
|
| Rate for Payer: Aetna Commercial |
$259.52
|
| Rate for Payer: Aetna Commercial |
$139.62
|
| Rate for Payer: Aetna Medicare |
$152.66
|
| Rate for Payer: Aetna Medicare |
$82.13
|
| Rate for Payer: Aetna Medicare |
$61.02
|
| Rate for Payer: Aetna Medicare |
$84.92
|
| Rate for Payer: Aetna Medicare |
$65.42
|
| Rate for Payer: Aetna Medicare |
$59.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.39
|
| Rate for Payer: BCBS Complete |
$67.93
|
| Rate for Payer: BCBS Complete |
$65.70
|
| Rate for Payer: BCBS Complete |
$47.73
|
| Rate for Payer: BCBS Complete |
$52.34
|
| Rate for Payer: BCBS Complete |
$48.82
|
| Rate for Payer: BCBS Complete |
$122.13
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: Cash Price |
$244.26
|
| Rate for Payer: Cash Price |
$104.68
|
| Rate for Payer: Cash Price |
$135.86
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cash Price |
$95.46
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cash Price |
$104.68
|
| Rate for Payer: Cash Price |
$135.86
|
| Rate for Payer: Cash Price |
$244.26
|
| Rate for Payer: Cash Price |
$131.41
|
| Rate for Payer: Cash Price |
$131.41
|
| Rate for Payer: Cash Price |
$95.46
|
| Rate for Payer: Cofinity Commercial |
$112.53
|
| Rate for Payer: Cofinity Commercial |
$213.72
|
| Rate for Payer: Cofinity Commercial |
$104.95
|
| Rate for Payer: Cofinity Commercial |
$83.53
|
| Rate for Payer: Cofinity Commercial |
$102.62
|
| Rate for Payer: Cofinity Commercial |
$85.43
|
| Rate for Payer: Cofinity Commercial |
$146.05
|
| Rate for Payer: Cofinity Commercial |
$118.88
|
| Rate for Payer: Cofinity Commercial |
$141.26
|
| Rate for Payer: Cofinity Commercial |
$114.98
|
| Rate for Payer: Cofinity Commercial |
$91.60
|
| Rate for Payer: Cofinity Commercial |
$262.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$118.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$85.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$114.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$213.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.26
|
| Rate for Payer: Healthscope Commercial |
$152.85
|
| Rate for Payer: Healthscope Commercial |
$274.79
|
| Rate for Payer: Healthscope Commercial |
$147.83
|
| Rate for Payer: Healthscope Commercial |
$117.76
|
| Rate for Payer: Healthscope Commercial |
$109.84
|
| Rate for Payer: Healthscope Commercial |
$107.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.62
|
| Rate for Payer: PHP Commercial |
$111.22
|
| Rate for Payer: PHP Commercial |
$139.62
|
| Rate for Payer: PHP Commercial |
$103.73
|
| Rate for Payer: PHP Commercial |
$101.43
|
| Rate for Payer: PHP Commercial |
$144.36
|
| Rate for Payer: PHP Commercial |
$259.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.33
|
| Rate for Payer: Priority Health SBD |
$106.99
|
| Rate for Payer: Priority Health SBD |
$76.89
|
| Rate for Payer: Priority Health SBD |
$82.44
|
| Rate for Payer: Priority Health SBD |
$103.48
|
| Rate for Payer: Priority Health SBD |
$75.18
|
| Rate for Payer: Priority Health SBD |
$192.35
|
| Rate for Payer: UMR Bronson Commercial |
$62.84
|
| Rate for Payer: UMR Bronson Commercial |
$112.97
|
| Rate for Payer: UMR Bronson Commercial |
$48.41
|
| Rate for Payer: UMR Bronson Commercial |
$44.15
|
| Rate for Payer: UMR Bronson Commercial |
$45.15
|
| Rate for Payer: UMR Bronson Commercial |
$60.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.20
|
|
|
ROPIVACAINE (PF) 2 MG/ML (0.2 %) PAIN PUMP (BMH)
|
Facility
|
IP
|
$688.83
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
154973
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$303.09 |
| Max. Negotiated Rate |
$619.95 |
| Rate for Payer: Aetna American Axle |
$447.74
|
| Rate for Payer: Aetna American Axle |
$542.22
|
| Rate for Payer: Aetna Commercial |
$585.51
|
| Rate for Payer: Aetna Commercial |
$709.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.22
|
| Rate for Payer: Cash Price |
$551.06
|
| Rate for Payer: Cash Price |
$667.34
|
| Rate for Payer: Cofinity Commercial |
$717.39
|
| Rate for Payer: Cofinity Commercial |
$583.93
|
| Rate for Payer: Cofinity Commercial |
$482.18
|
| Rate for Payer: Cofinity Commercial |
$592.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$482.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$583.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$551.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.34
|
| Rate for Payer: Healthscope Commercial |
$619.95
|
| Rate for Payer: Healthscope Commercial |
$750.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$482.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$583.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$516.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$625.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$709.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.51
|
| Rate for Payer: PHP Commercial |
$709.05
|
| Rate for Payer: PHP Commercial |
$585.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$542.22
|
| Rate for Payer: Priority Health SBD |
$433.96
|
| Rate for Payer: Priority Health SBD |
$525.53
|
| Rate for Payer: UMR Bronson Commercial |
$303.09
|
| Rate for Payer: UMR Bronson Commercial |
$367.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$516.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$625.64
|
|
|
ROPIVACAINE (PF) 2 MG/ML (0.2 %) PAIN PUMP (BMH)
|
Facility
|
OP
|
$688.83
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
154973
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$619.95 |
| Rate for Payer: Aetna American Axle |
$447.74
|
| Rate for Payer: Aetna American Axle |
$542.22
|
| Rate for Payer: Aetna Commercial |
$709.05
|
| Rate for Payer: Aetna Commercial |
$585.51
|
| Rate for Payer: Aetna Medicare |
$344.42
|
| Rate for Payer: Aetna Medicare |
$417.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.22
|
| Rate for Payer: BCBS Complete |
$333.67
|
| Rate for Payer: BCBS Complete |
$275.53
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCBS Trust/PPO |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: BCN Commercial |
$0.16
|
| Rate for Payer: Cash Price |
$667.34
|
| Rate for Payer: Cash Price |
$667.34
|
| Rate for Payer: Cash Price |
$551.06
|
| Rate for Payer: Cash Price |
$551.06
|
| Rate for Payer: Cofinity Commercial |
$717.39
|
| Rate for Payer: Cofinity Commercial |
$482.18
|
| Rate for Payer: Cofinity Commercial |
$583.93
|
| Rate for Payer: Cofinity Commercial |
$592.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$482.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$583.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$551.06
|
| Rate for Payer: Healthscope Commercial |
$750.76
|
| Rate for Payer: Healthscope Commercial |
$619.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$583.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$482.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$625.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$516.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$709.05
|
| Rate for Payer: PHP Commercial |
$585.51
|
| Rate for Payer: PHP Commercial |
$709.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$542.22
|
| Rate for Payer: Priority Health SBD |
$525.53
|
| Rate for Payer: Priority Health SBD |
$433.96
|
| Rate for Payer: UMR Bronson Commercial |
$254.87
|
| Rate for Payer: UMR Bronson Commercial |
$308.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$625.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$516.62
|
|
