|
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$2,561.16
|
|
|
Service Code
|
HCPCS J0630
|
| Hospital Charge Code |
9347
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$259.94 |
| Max. Negotiated Rate |
$2,305.04 |
| Rate for Payer: Aetna American Axle |
$1,664.75
|
| Rate for Payer: Aetna American Axle |
$1,537.85
|
| Rate for Payer: Aetna American Axle |
$1,479.82
|
| Rate for Payer: Aetna Commercial |
$2,176.99
|
| Rate for Payer: Aetna Commercial |
$1,935.14
|
| Rate for Payer: Aetna Commercial |
$2,011.03
|
| Rate for Payer: Aetna Medicare |
$504.37
|
| Rate for Payer: Aetna Medicare |
$504.37
|
| Rate for Payer: Aetna Medicare |
$504.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,479.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,537.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,664.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$606.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$606.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$606.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$606.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$606.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$606.21
|
| Rate for Payer: BCBS Complete |
$272.94
|
| Rate for Payer: BCBS Complete |
$272.94
|
| Rate for Payer: BCBS Complete |
$272.94
|
| Rate for Payer: BCBS MAPPO |
$484.97
|
| Rate for Payer: BCBS MAPPO |
$484.97
|
| Rate for Payer: BCBS MAPPO |
$484.97
|
| Rate for Payer: BCN Medicare Advantage |
$484.97
|
| Rate for Payer: BCN Medicare Advantage |
$484.97
|
| Rate for Payer: BCN Medicare Advantage |
$484.97
|
| Rate for Payer: Cash Price |
$1,892.74
|
| Rate for Payer: Cash Price |
$1,892.74
|
| Rate for Payer: Cash Price |
$1,821.31
|
| Rate for Payer: Cash Price |
$1,821.31
|
| Rate for Payer: Cash Price |
$2,048.93
|
| Rate for Payer: Cash Price |
$2,048.93
|
| Rate for Payer: Cofinity Commercial |
$1,593.65
|
| Rate for Payer: Cofinity Commercial |
$2,202.60
|
| Rate for Payer: Cofinity Commercial |
$1,792.81
|
| Rate for Payer: Cofinity Commercial |
$1,656.14
|
| Rate for Payer: Cofinity Commercial |
$1,957.91
|
| Rate for Payer: Cofinity Commercial |
$2,034.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,792.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,656.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,593.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,048.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,892.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,821.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.97
|
| Rate for Payer: Healthscope Commercial |
$2,048.98
|
| Rate for Payer: Healthscope Commercial |
$2,305.04
|
| Rate for Payer: Healthscope Commercial |
$2,129.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,656.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,792.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,593.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,920.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,707.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,774.44
|
| Rate for Payer: Mclaren Medicaid |
$259.94
|
| Rate for Payer: Mclaren Medicaid |
$259.94
|
| Rate for Payer: Mclaren Medicaid |
$259.94
|
| Rate for Payer: Mclaren Medicare |
$484.97
|
| Rate for Payer: Mclaren Medicare |
$484.97
|
| Rate for Payer: Mclaren Medicare |
$484.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.22
|
| Rate for Payer: Meridian Medicaid |
$272.94
|
| Rate for Payer: Meridian Medicaid |
$272.94
|
| Rate for Payer: Meridian Medicaid |
$272.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$557.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$557.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$557.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,011.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,176.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,935.14
|
| Rate for Payer: PACE Medicare |
$460.72
|
| Rate for Payer: PACE Medicare |
$460.72
|
| Rate for Payer: PACE Medicare |
$460.72
|
| Rate for Payer: PACE SWMI |
$484.97
|
| Rate for Payer: PACE SWMI |
$484.97
|
| Rate for Payer: PACE SWMI |
$484.97
|
| Rate for Payer: PHP Commercial |
$2,176.99
|
| Rate for Payer: PHP Commercial |
$1,935.14
|
| Rate for Payer: PHP Commercial |
$2,011.03
|
| Rate for Payer: PHP Medicare Advantage |
$484.97
|
| Rate for Payer: PHP Medicare Advantage |
$484.97
|
| Rate for Payer: PHP Medicare Advantage |
$484.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,664.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,479.82
|
| Rate for Payer: Priority Health Medicare |
$484.97
|
| Rate for Payer: Priority Health Medicare |
$484.97
|
| Rate for Payer: Priority Health Medicare |
$484.97
|
| Rate for Payer: Priority Health SBD |
$1,434.28
|
| Rate for Payer: Priority Health SBD |
$1,490.53
|
| Rate for Payer: Priority Health SBD |
$1,613.53
|
| Rate for Payer: Railroad Medicare Medicare |
$484.97
|
| Rate for Payer: Railroad Medicare Medicare |
$484.97
|
| Rate for Payer: Railroad Medicare Medicare |
$484.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,365.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,365.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,365.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$484.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$484.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$484.97
|
| Rate for Payer: UHC Exchange |
$926.83
|
| Rate for Payer: UHC Exchange |
$926.83
|
| Rate for Payer: UHC Exchange |
$926.83
|
| Rate for Payer: UHC Medicare Advantage |
$484.97
|
| Rate for Payer: UHC Medicare Advantage |
$484.97
|
| Rate for Payer: UHC Medicare Advantage |
$484.97
|
| Rate for Payer: UHCCP Medicaid |
$259.94
|
| Rate for Payer: UHCCP Medicaid |
$259.94
|
| Rate for Payer: UHCCP Medicaid |
$259.94
|
| Rate for Payer: UMR Bronson Commercial |
$875.39
|
| Rate for Payer: UMR Bronson Commercial |
$947.63
|
| Rate for Payer: UMR Bronson Commercial |
$842.36
|
| Rate for Payer: VA VA |
$484.97
|
| Rate for Payer: VA VA |
$484.97
|
| Rate for Payer: VA VA |
$484.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,774.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,920.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,707.48
|
|
|
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$2,276.64
|
|
|
Service Code
|
HCPCS J0630
|
| Hospital Charge Code |
9347
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,001.72 |
| Max. Negotiated Rate |
$2,048.98 |
| Rate for Payer: Aetna American Axle |
$1,479.82
|
| Rate for Payer: Aetna American Axle |
$1,537.85
|
| Rate for Payer: Aetna American Axle |
$1,664.75
|
| Rate for Payer: Aetna Commercial |
$2,011.03
|
| Rate for Payer: Aetna Commercial |
$1,935.14
|
| Rate for Payer: Aetna Commercial |
$2,176.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,479.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,664.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,537.85
|
| Rate for Payer: Cash Price |
$2,048.93
|
| Rate for Payer: Cash Price |
$1,892.74
|
| Rate for Payer: Cash Price |
$1,821.31
|
| Rate for Payer: Cofinity Commercial |
$1,957.91
|
| Rate for Payer: Cofinity Commercial |
$2,034.69
|
| Rate for Payer: Cofinity Commercial |
$1,656.14
|
| Rate for Payer: Cofinity Commercial |
$2,202.60
|
| Rate for Payer: Cofinity Commercial |
$1,792.81
|
| Rate for Payer: Cofinity Commercial |
$1,593.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,656.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,593.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,792.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,048.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,821.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,892.74
|
| Rate for Payer: Healthscope Commercial |
$2,129.33
|
| Rate for Payer: Healthscope Commercial |
$2,048.98
|
| Rate for Payer: Healthscope Commercial |
$2,305.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,593.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,656.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,792.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,774.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,707.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,920.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,935.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,176.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,011.03
|
| Rate for Payer: PHP Commercial |
$2,176.99
|
| Rate for Payer: PHP Commercial |
$2,011.03
|
| Rate for Payer: PHP Commercial |
$1,935.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,664.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,479.82
|
| Rate for Payer: Priority Health SBD |
$1,613.53
|
| Rate for Payer: Priority Health SBD |
$1,490.53
|
| Rate for Payer: Priority Health SBD |
$1,434.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,001.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,126.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,041.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,920.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,707.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,774.44
|
|
|
CALCITRIOL 0.25 MCG CAPSULE
|
Facility
|
IP
|
$71.82
|
|
|
Service Code
|
NDC 69452020713
|
| Hospital Charge Code |
9350
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$64.64 |
| Rate for Payer: Aetna American Axle |
$46.68
|
| Rate for Payer: Aetna Commercial |
$61.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.68
|
| Rate for Payer: Cash Price |
$57.46
|
| Rate for Payer: Cofinity Commercial |
$50.27
|
| Rate for Payer: Cofinity Commercial |
$61.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$50.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.46
|
| Rate for Payer: Healthscope Commercial |
$64.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.05
|
| Rate for Payer: PHP Commercial |
$61.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.68
|
| Rate for Payer: Priority Health SBD |
$45.25
|
| Rate for Payer: UMR Bronson Commercial |
$31.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.87
|
|
|
CALCITRIOL 0.25 MCG CAPSULE
|
Facility
|
IP
|
$228.39
|
|
|
Service Code
|
NDC 30698014323
|
| Hospital Charge Code |
9350
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$100.49 |
| Max. Negotiated Rate |
$205.55 |
| Rate for Payer: Aetna American Axle |
$148.45
|
| Rate for Payer: Aetna Commercial |
$194.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.45
|
| Rate for Payer: Cash Price |
$182.71
|
| Rate for Payer: Cofinity Commercial |
$159.87
|
| Rate for Payer: Cofinity Commercial |
$196.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$159.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.71
|
| Rate for Payer: Healthscope Commercial |
$205.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$159.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.13
|
| Rate for Payer: PHP Commercial |
$194.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.45
|
| Rate for Payer: Priority Health SBD |
$143.89
|
| Rate for Payer: UMR Bronson Commercial |
$100.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.29
|
|
|
CALCITRIOL 0.25 MCG CAPSULE
|
Facility
|
OP
|
$3.23
|
|
|
Service Code
|
NDC 60687034511
|
| Hospital Charge Code |
9350
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$2.91 |
| Rate for Payer: Aetna American Axle |
$2.10
|
| Rate for Payer: Aetna Commercial |
$2.75
|
| Rate for Payer: Aetna Medicare |
$1.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.10
|
| Rate for Payer: BCBS Complete |
$1.29
|
| Rate for Payer: Cash Price |
$2.58
|
| Rate for Payer: Cofinity Commercial |
$2.26
|
| Rate for Payer: Cofinity Commercial |
$2.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.58
|
| Rate for Payer: Healthscope Commercial |
$2.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.75
|
| Rate for Payer: PHP Commercial |
$2.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.10
|
| Rate for Payer: Priority Health SBD |
$2.03
|
| Rate for Payer: UMR Bronson Commercial |
$1.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.42
|
|
|
CALCITRIOL 0.25 MCG CAPSULE
|
Facility
|
OP
|
$352.50
|
|
|
Service Code
|
NDC 23155066201
|
| Hospital Charge Code |
9350
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$130.43 |
| Max. Negotiated Rate |
$317.25 |
| Rate for Payer: Aetna American Axle |
$229.12
|
| Rate for Payer: Aetna Commercial |
$299.62
|
| Rate for Payer: Aetna Medicare |
$176.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.12
|
| Rate for Payer: BCBS Complete |
$141.00
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cofinity Commercial |
$246.75
|
| Rate for Payer: Cofinity Commercial |
$303.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$246.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.00
|
| Rate for Payer: Healthscope Commercial |
$317.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.62
|
| Rate for Payer: PHP Commercial |
$299.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.12
|
| Rate for Payer: Priority Health SBD |
$222.07
|
| Rate for Payer: UMR Bronson Commercial |
$130.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.38
|
|
|
CALCITRIOL 0.25 MCG CAPSULE
|
Facility
|
IP
|
$352.50
|
|
|
Service Code
|
NDC 23155066201
|
| Hospital Charge Code |
9350
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$155.10 |
| Max. Negotiated Rate |
$317.25 |
| Rate for Payer: Aetna American Axle |
$229.12
|
| Rate for Payer: Aetna Commercial |
$299.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.12
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cofinity Commercial |
$246.75
|
| Rate for Payer: Cofinity Commercial |
$303.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$246.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.00
|
| Rate for Payer: Healthscope Commercial |
$317.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.62
|
| Rate for Payer: PHP Commercial |
$299.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.12
|
| Rate for Payer: Priority Health SBD |
$222.07
|
| Rate for Payer: UMR Bronson Commercial |
$155.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.38
|
|
|
CALCITRIOL 0.25 MCG CAPSULE
|
Facility
|
IP
|
$63.84
|
|
|
Service Code
|
NDC 23155066203
|
| Hospital Charge Code |
9350
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$28.09 |
| Max. Negotiated Rate |
$57.46 |
| Rate for Payer: Aetna American Axle |
$41.50
|
| Rate for Payer: Aetna Commercial |
$54.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.50
|
| Rate for Payer: Cash Price |
$51.07
|
| Rate for Payer: Cofinity Commercial |
$44.69
|
| Rate for Payer: Cofinity Commercial |
$54.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.07
|
| Rate for Payer: Healthscope Commercial |
$57.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.26
|
| Rate for Payer: PHP Commercial |
$54.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.50
|
| Rate for Payer: Priority Health SBD |
$40.22
|
| Rate for Payer: UMR Bronson Commercial |
$28.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.88
|
|
|
CALCITRIOL 0.25 MCG CAPSULE
|
Facility
|
IP
|
$137.09
|
|
|
Service Code
|
NDC 00054000713
|
| Hospital Charge Code |
9350
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$60.32 |
| Max. Negotiated Rate |
$123.38 |
| Rate for Payer: Aetna American Axle |
$89.11
|
| Rate for Payer: Aetna Commercial |
$116.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.11
|
| Rate for Payer: Cash Price |
$109.67
|
| Rate for Payer: Cofinity Commercial |
$117.90
|
| Rate for Payer: Cofinity Commercial |
$95.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$95.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.67
|
| Rate for Payer: Healthscope Commercial |
$123.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.53
|
| Rate for Payer: PHP Commercial |
$116.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.11
|
| Rate for Payer: Priority Health SBD |
$86.37
|
| Rate for Payer: UMR Bronson Commercial |
$60.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.82
|
|
|
CALCITRIOL 0.25 MCG CAPSULE
|
Facility
|
OP
|
$71.82
|
|
|
Service Code
|
NDC 69452020713
|
| Hospital Charge Code |
9350
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$26.57 |
| Max. Negotiated Rate |
$64.64 |
| Rate for Payer: Aetna American Axle |
$46.68
|
| Rate for Payer: Aetna Commercial |
$61.05
|
| Rate for Payer: Aetna Medicare |
$35.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.68
|
| Rate for Payer: BCBS Complete |
$28.73
|
| Rate for Payer: Cash Price |
$57.46
|
| Rate for Payer: Cofinity Commercial |
$50.27
|
| Rate for Payer: Cofinity Commercial |
$61.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$50.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.46
|
| Rate for Payer: Healthscope Commercial |
$64.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.05
|
| Rate for Payer: PHP Commercial |
$61.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.68
|
| Rate for Payer: Priority Health SBD |
$45.25
|
| Rate for Payer: UMR Bronson Commercial |
$26.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.87
|
|
|
CALCITRIOL 0.25 MCG CAPSULE
|
Facility
|
IP
|
$322.56
|
|
|
Service Code
|
NDC 60687034501
|
| Hospital Charge Code |
9350
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$141.93 |
| Max. Negotiated Rate |
$290.30 |
| Rate for Payer: Aetna American Axle |
$209.66
|
| Rate for Payer: Aetna Commercial |
$274.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.66
|
| Rate for Payer: Cash Price |
$258.05
|
| Rate for Payer: Cofinity Commercial |
$225.79
|
| Rate for Payer: Cofinity Commercial |
$277.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$225.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.05
|
| Rate for Payer: Healthscope Commercial |
$290.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$225.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.18
|
| Rate for Payer: PHP Commercial |
$274.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.66
|
| Rate for Payer: Priority Health SBD |
$203.21
|
| Rate for Payer: UMR Bronson Commercial |
$141.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.92
|
|
|
CALCITRIOL 0.25 MCG CAPSULE
|
Facility
|
OP
|
$137.09
|
|
|
Service Code
|
NDC 00054000713
|
| Hospital Charge Code |
9350
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$123.38 |
| Rate for Payer: Aetna American Axle |
$89.11
|
| Rate for Payer: Aetna Commercial |
$116.53
|
| Rate for Payer: Aetna Medicare |
$68.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.11
|
| Rate for Payer: BCBS Complete |
$54.84
|
| Rate for Payer: Cash Price |
$109.67
|
| Rate for Payer: Cofinity Commercial |
$117.90
|
| Rate for Payer: Cofinity Commercial |
$95.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$95.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.67
|
| Rate for Payer: Healthscope Commercial |
$123.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.53
|
| Rate for Payer: PHP Commercial |
$116.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.11
|
| Rate for Payer: Priority Health SBD |
$86.37
|
| Rate for Payer: UMR Bronson Commercial |
$50.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.82
|
|
|
CALCITRIOL 0.25 MCG CAPSULE
|
Facility
|
OP
|
$63.84
|
|
|
Service Code
|
NDC 23155066203
|
| Hospital Charge Code |
9350
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$23.62 |
| Max. Negotiated Rate |
$57.46 |
| Rate for Payer: Aetna American Axle |
$41.50
|
| Rate for Payer: Aetna Commercial |
$54.26
|
| Rate for Payer: Aetna Medicare |
$31.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.50
|
| Rate for Payer: BCBS Complete |
$25.54
|
| Rate for Payer: Cash Price |
$51.07
|
| Rate for Payer: Cofinity Commercial |
$44.69
|
| Rate for Payer: Cofinity Commercial |
$54.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.07
|
| Rate for Payer: Healthscope Commercial |
$57.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.26
|
| Rate for Payer: PHP Commercial |
$54.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.50
|
| Rate for Payer: Priority Health SBD |
$40.22
|
| Rate for Payer: UMR Bronson Commercial |
$23.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.88
|
|
|
CALCITRIOL 0.25 MCG CAPSULE
|
Facility
|
OP
|
$322.56
|
|
|
Service Code
|
NDC 60687034501
|
| Hospital Charge Code |
9350
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.35 |
| Max. Negotiated Rate |
$290.30 |
| Rate for Payer: Aetna American Axle |
$209.66
|
| Rate for Payer: Aetna Commercial |
$274.18
|
| Rate for Payer: Aetna Medicare |
$161.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.66
|
| Rate for Payer: BCBS Complete |
$129.02
|
| Rate for Payer: Cash Price |
$258.05
|
| Rate for Payer: Cofinity Commercial |
$225.79
|
| Rate for Payer: Cofinity Commercial |
$277.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$225.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.05
|
| Rate for Payer: Healthscope Commercial |
$290.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$225.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.18
|
| Rate for Payer: PHP Commercial |
$274.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.66
|
| Rate for Payer: Priority Health SBD |
$203.21
|
| Rate for Payer: UMR Bronson Commercial |
$119.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.92
|
|
|
CALCITRIOL 0.25 MCG CAPSULE
|
Facility
|
OP
|
$228.39
|
|
|
Service Code
|
NDC 30698014323
|
| Hospital Charge Code |
9350
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$84.50 |
| Max. Negotiated Rate |
$205.55 |
| Rate for Payer: Aetna American Axle |
$148.45
|
| Rate for Payer: Aetna Commercial |
$194.13
|
| Rate for Payer: Aetna Medicare |
$114.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.45
|
| Rate for Payer: BCBS Complete |
$91.36
|
| Rate for Payer: Cash Price |
$182.71
|
| Rate for Payer: Cofinity Commercial |
$159.87
|
| Rate for Payer: Cofinity Commercial |
$196.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$159.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.71
|
| Rate for Payer: Healthscope Commercial |
$205.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$159.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.13
|
| Rate for Payer: PHP Commercial |
$194.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.45
|
| Rate for Payer: Priority Health SBD |
$143.89
|
| Rate for Payer: UMR Bronson Commercial |
$84.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.29
|
|
|
CALCITRIOL 0.25 MCG CAPSULE
|
Facility
|
IP
|
$3.23
|
|
|
Service Code
|
NDC 60687034511
|
| Hospital Charge Code |
9350
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.42 |
| Max. Negotiated Rate |
$2.91 |
| Rate for Payer: Aetna American Axle |
$2.10
|
| Rate for Payer: Aetna Commercial |
$2.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.10
|
| Rate for Payer: Cash Price |
$2.58
|
| Rate for Payer: Cofinity Commercial |
$2.26
|
| Rate for Payer: Cofinity Commercial |
$2.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.58
|
| Rate for Payer: Healthscope Commercial |
$2.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.75
|
| Rate for Payer: PHP Commercial |
$2.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.10
|
| Rate for Payer: Priority Health SBD |
$2.03
|
| Rate for Payer: UMR Bronson Commercial |
$1.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.42
|
|
|
CALCITRIOL 1 MCG/ML ORAL SOLUTION
|
Facility
|
OP
|
$406.32
|
|
|
Service Code
|
NDC 00054312041
|
| Hospital Charge Code |
16218
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$150.34 |
| Max. Negotiated Rate |
$365.69 |
| Rate for Payer: Aetna American Axle |
$264.11
|
| Rate for Payer: Aetna Commercial |
$345.37
|
| Rate for Payer: Aetna Medicare |
$203.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.11
|
| Rate for Payer: BCBS Complete |
$162.53
|
| Rate for Payer: Cash Price |
$325.06
|
| Rate for Payer: Cofinity Commercial |
$284.42
|
| Rate for Payer: Cofinity Commercial |
$349.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$284.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.06
|
| Rate for Payer: Healthscope Commercial |
$365.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.37
|
| Rate for Payer: PHP Commercial |
$345.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$264.11
|
| Rate for Payer: Priority Health SBD |
$255.98
|
| Rate for Payer: UMR Bronson Commercial |
$150.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.74
|
|
|
CALCITRIOL 1 MCG/ML ORAL SOLUTION
|
Facility
|
OP
|
$468.15
|
|
|
Service Code
|
NDC 63304024159
|
| Hospital Charge Code |
16218
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$173.22 |
| Max. Negotiated Rate |
$421.33 |
| Rate for Payer: Aetna American Axle |
$304.30
|
| Rate for Payer: Aetna Commercial |
$397.93
|
| Rate for Payer: Aetna Medicare |
$234.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.30
|
| Rate for Payer: BCBS Complete |
$187.26
|
| Rate for Payer: Cash Price |
$374.52
|
| Rate for Payer: Cofinity Commercial |
$327.70
|
| Rate for Payer: Cofinity Commercial |
$402.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$327.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.52
|
| Rate for Payer: Healthscope Commercial |
$421.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$327.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$397.93
|
| Rate for Payer: PHP Commercial |
$397.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.30
|
| Rate for Payer: Priority Health SBD |
$294.93
|
| Rate for Payer: UMR Bronson Commercial |
$173.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.11
|
|
|
CALCITRIOL 1 MCG/ML ORAL SOLUTION
|
Facility
|
IP
|
$468.15
|
|
|
Service Code
|
NDC 63304024159
|
| Hospital Charge Code |
16218
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$205.99 |
| Max. Negotiated Rate |
$421.33 |
| Rate for Payer: Aetna American Axle |
$304.30
|
| Rate for Payer: Aetna Commercial |
$397.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.30
|
| Rate for Payer: Cash Price |
$374.52
|
| Rate for Payer: Cofinity Commercial |
$327.70
|
| Rate for Payer: Cofinity Commercial |
$402.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$327.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.52
|
| Rate for Payer: Healthscope Commercial |
$421.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$327.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$397.93
|
| Rate for Payer: PHP Commercial |
$397.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.30
|
| Rate for Payer: Priority Health SBD |
$294.93
|
| Rate for Payer: UMR Bronson Commercial |
$205.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.11
|
|
|
CALCITRIOL 1 MCG/ML ORAL SOLUTION
|
Facility
|
OP
|
$738.60
|
|
|
Service Code
|
NDC 30698091115
|
| Hospital Charge Code |
16218
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$273.28 |
| Max. Negotiated Rate |
$664.74 |
| Rate for Payer: Aetna American Axle |
$480.09
|
| Rate for Payer: Aetna Commercial |
$627.81
|
| Rate for Payer: Aetna Medicare |
$369.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.09
|
| Rate for Payer: BCBS Complete |
$295.44
|
| Rate for Payer: Cash Price |
$590.88
|
| Rate for Payer: Cofinity Commercial |
$517.02
|
| Rate for Payer: Cofinity Commercial |
$635.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$517.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$590.88
|
| Rate for Payer: Healthscope Commercial |
$664.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$517.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$553.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$627.81
|
| Rate for Payer: PHP Commercial |
$627.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$480.09
|
| Rate for Payer: Priority Health SBD |
$465.32
|
| Rate for Payer: UMR Bronson Commercial |
$273.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$553.95
|
|
|
CALCITRIOL 1 MCG/ML ORAL SOLUTION
|
Facility
|
IP
|
$738.60
|
|
|
Service Code
|
NDC 30698091115
|
| Hospital Charge Code |
16218
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$324.98 |
| Max. Negotiated Rate |
$664.74 |
| Rate for Payer: Aetna American Axle |
$480.09
|
| Rate for Payer: Aetna Commercial |
$627.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.09
|
| Rate for Payer: Cash Price |
$590.88
|
| Rate for Payer: Cofinity Commercial |
$517.02
|
| Rate for Payer: Cofinity Commercial |
$635.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$517.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$590.88
|
| Rate for Payer: Healthscope Commercial |
$664.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$517.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$553.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$627.81
|
| Rate for Payer: PHP Commercial |
$627.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$480.09
|
| Rate for Payer: Priority Health SBD |
$465.32
|
| Rate for Payer: UMR Bronson Commercial |
$324.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$553.95
|
|
|
CALCITRIOL 1 MCG/ML ORAL SOLUTION
|
Facility
|
OP
|
$1,376.40
|
|
|
Service Code
|
NDC 64980044715
|
| Hospital Charge Code |
16218
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$509.27 |
| Max. Negotiated Rate |
$1,238.76 |
| Rate for Payer: Aetna American Axle |
$894.66
|
| Rate for Payer: Aetna Commercial |
$1,169.94
|
| Rate for Payer: Aetna Medicare |
$688.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$894.66
|
| Rate for Payer: BCBS Complete |
$550.56
|
| Rate for Payer: Cash Price |
$1,101.12
|
| Rate for Payer: Cofinity Commercial |
$1,183.70
|
| Rate for Payer: Cofinity Commercial |
$963.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$963.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.12
|
| Rate for Payer: Healthscope Commercial |
$1,238.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$963.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,169.94
|
| Rate for Payer: PHP Commercial |
$1,169.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$894.66
|
| Rate for Payer: Priority Health SBD |
$867.13
|
| Rate for Payer: UMR Bronson Commercial |
$509.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.30
|
|
|
CALCITRIOL 1 MCG/ML ORAL SOLUTION
|
Facility
|
IP
|
$406.32
|
|
|
Service Code
|
NDC 00054312041
|
| Hospital Charge Code |
16218
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$178.78 |
| Max. Negotiated Rate |
$365.69 |
| Rate for Payer: Aetna American Axle |
$264.11
|
| Rate for Payer: Aetna Commercial |
$345.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.11
|
| Rate for Payer: Cash Price |
$325.06
|
| Rate for Payer: Cofinity Commercial |
$284.42
|
| Rate for Payer: Cofinity Commercial |
$349.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$284.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.06
|
| Rate for Payer: Healthscope Commercial |
$365.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.37
|
| Rate for Payer: PHP Commercial |
$345.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$264.11
|
| Rate for Payer: Priority Health SBD |
$255.98
|
| Rate for Payer: UMR Bronson Commercial |
$178.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.74
|
|
|
CALCITRIOL 1 MCG/ML ORAL SOLUTION
|
Facility
|
IP
|
$1,376.40
|
|
|
Service Code
|
NDC 64980044715
|
| Hospital Charge Code |
16218
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$605.62 |
| Max. Negotiated Rate |
$1,238.76 |
| Rate for Payer: Aetna American Axle |
$894.66
|
| Rate for Payer: Aetna Commercial |
$1,169.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$894.66
|
| Rate for Payer: Cash Price |
$1,101.12
|
| Rate for Payer: Cofinity Commercial |
$1,183.70
|
| Rate for Payer: Cofinity Commercial |
$963.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$963.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.12
|
| Rate for Payer: Healthscope Commercial |
$1,238.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$963.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,169.94
|
| Rate for Payer: PHP Commercial |
$1,169.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$894.66
|
| Rate for Payer: Priority Health SBD |
$867.13
|
| Rate for Payer: UMR Bronson Commercial |
$605.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.30
|
|
|
CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET
|
Facility
|
IP
|
$141.75
|
|
|
Service Code
|
NDC 70000003401
|
| Hospital Charge Code |
9385
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$127.58 |
| Rate for Payer: Aetna American Axle |
$92.14
|
| Rate for Payer: Aetna Commercial |
$120.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.14
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: Cofinity Commercial |
$121.91
|
| Rate for Payer: Cofinity Commercial |
$99.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$99.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.40
|
| Rate for Payer: Healthscope Commercial |
$127.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.49
|
| Rate for Payer: PHP Commercial |
$120.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.14
|
| Rate for Payer: Priority Health SBD |
$89.30
|
| Rate for Payer: UMR Bronson Commercial |
$62.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.31
|
|
