|
SIMVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$298.45
|
|
|
Service Code
|
NDC 63739057310
|
| Hospital Charge Code |
11366
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$131.32 |
| Max. Negotiated Rate |
$268.61 |
| Rate for Payer: Aetna American Axle |
$193.99
|
| Rate for Payer: Aetna Commercial |
$253.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.99
|
| Rate for Payer: Cash Price |
$238.76
|
| Rate for Payer: Cofinity Commercial |
$208.91
|
| Rate for Payer: Cofinity Commercial |
$256.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$208.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.76
|
| Rate for Payer: Healthscope Commercial |
$268.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.68
|
| Rate for Payer: PHP Commercial |
$253.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.99
|
| Rate for Payer: Priority Health SBD |
$188.02
|
| Rate for Payer: UMR Bronson Commercial |
$131.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.84
|
|
|
SIMVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$206.80
|
|
|
Service Code
|
NDC 51079045620
|
| Hospital Charge Code |
11366
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$76.52 |
| Max. Negotiated Rate |
$186.12 |
| Rate for Payer: Aetna American Axle |
$134.42
|
| Rate for Payer: Aetna Commercial |
$175.78
|
| Rate for Payer: Aetna Medicare |
$103.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.42
|
| Rate for Payer: BCBS Complete |
$82.72
|
| Rate for Payer: Cash Price |
$165.44
|
| Rate for Payer: Cofinity Commercial |
$144.76
|
| Rate for Payer: Cofinity Commercial |
$177.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$144.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.44
|
| Rate for Payer: Healthscope Commercial |
$186.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$144.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.78
|
| Rate for Payer: PHP Commercial |
$175.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.42
|
| Rate for Payer: Priority Health SBD |
$130.28
|
| Rate for Payer: UMR Bronson Commercial |
$76.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.10
|
|
|
SIMVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$298.45
|
|
|
Service Code
|
NDC 63739057310
|
| Hospital Charge Code |
11366
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$110.43 |
| Max. Negotiated Rate |
$268.61 |
| Rate for Payer: Aetna American Axle |
$193.99
|
| Rate for Payer: Aetna Commercial |
$253.68
|
| Rate for Payer: Aetna Medicare |
$149.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.99
|
| Rate for Payer: BCBS Complete |
$119.38
|
| Rate for Payer: Cash Price |
$238.76
|
| Rate for Payer: Cofinity Commercial |
$208.91
|
| Rate for Payer: Cofinity Commercial |
$256.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$208.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.76
|
| Rate for Payer: Healthscope Commercial |
$268.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.68
|
| Rate for Payer: PHP Commercial |
$253.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.99
|
| Rate for Payer: Priority Health SBD |
$188.02
|
| Rate for Payer: UMR Bronson Commercial |
$110.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.84
|
|
|
SINCALIDE 5 MCG SOLUTION FOR INJECTION
|
Facility
|
OP
|
$265.81
|
|
|
Service Code
|
HCPCS J2805
|
| Hospital Charge Code |
11368
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$98.35 |
| Max. Negotiated Rate |
$239.23 |
| Rate for Payer: Aetna American Axle |
$172.78
|
| Rate for Payer: Aetna American Axle |
$285.57
|
| Rate for Payer: Aetna Commercial |
$225.94
|
| Rate for Payer: Aetna Commercial |
$373.44
|
| Rate for Payer: Aetna Medicare |
$132.91
|
| Rate for Payer: Aetna Medicare |
$219.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.57
|
| Rate for Payer: BCBS Complete |
$175.74
|
| Rate for Payer: BCBS Complete |
$106.32
|
| Rate for Payer: Cash Price |
$212.65
|
| Rate for Payer: Cash Price |
$351.47
|
| Rate for Payer: Cofinity Commercial |
$228.60
|
| Rate for Payer: Cofinity Commercial |
$186.07
|
| Rate for Payer: Cofinity Commercial |
$307.54
|
| Rate for Payer: Cofinity Commercial |
$377.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$307.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$186.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.47
|
| Rate for Payer: Healthscope Commercial |
$395.41
|
| Rate for Payer: Healthscope Commercial |
$239.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$186.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$307.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.44
|
| Rate for Payer: PHP Commercial |
$373.44
|
| Rate for Payer: PHP Commercial |
$225.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.57
|
| Rate for Payer: Priority Health SBD |
$276.78
|
| Rate for Payer: Priority Health SBD |
$167.46
|
| Rate for Payer: UMR Bronson Commercial |
$98.35
|
| Rate for Payer: UMR Bronson Commercial |
$162.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.36
|
|
|
SINCALIDE 5 MCG SOLUTION FOR INJECTION
|
Facility
|
IP
|
$265.81
|
|
|
Service Code
|
HCPCS J2805
|
| Hospital Charge Code |
11368
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$116.96 |
| Max. Negotiated Rate |
$239.23 |
| Rate for Payer: Aetna American Axle |
$172.78
|
| Rate for Payer: Aetna American Axle |
$285.57
|
| Rate for Payer: Aetna Commercial |
$225.94
|
| Rate for Payer: Aetna Commercial |
$373.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.57
|
| Rate for Payer: Cash Price |
$212.65
|
| Rate for Payer: Cash Price |
$351.47
|
| Rate for Payer: Cofinity Commercial |
$377.83
|
| Rate for Payer: Cofinity Commercial |
$307.54
|
| Rate for Payer: Cofinity Commercial |
$186.07
|
| Rate for Payer: Cofinity Commercial |
$228.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$186.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$307.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.47
|
| Rate for Payer: Healthscope Commercial |
$239.23
|
| Rate for Payer: Healthscope Commercial |
$395.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$186.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$307.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.94
|
| Rate for Payer: PHP Commercial |
$373.44
|
| Rate for Payer: PHP Commercial |
$225.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.57
|
| Rate for Payer: Priority Health SBD |
$167.46
|
| Rate for Payer: Priority Health SBD |
$276.78
|
| Rate for Payer: UMR Bronson Commercial |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$193.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.50
|
|
|
SINUSOTOMY, MAXILLARY (ANTROTOMY); INTRANASAL
|
Facility
|
OP
|
$8,903.25
|
|
|
Service Code
|
CPT 31020
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$8,903.25 |
| Rate for Payer: Aetna Medicare |
$3,289.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.90
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,903.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Exchange |
$6,044.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,695.31
|
| Rate for Payer: VA VA |
$3,162.90
|
|
|
SIPULEUCEL-T IN LACTATED RINGERS 50 MILLION CELL/250 ML IV SUSPENSION
|
Facility
|
OP
|
$328,138.18
|
|
|
Service Code
|
HCPCS Q2043
|
| Hospital Charge Code |
104852
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29,625.96 |
| Max. Negotiated Rate |
$295,324.36 |
| Rate for Payer: Aetna American Axle |
$213,289.82
|
| Rate for Payer: Aetna Commercial |
$278,917.45
|
| Rate for Payer: Aetna Medicare |
$57,483.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213,289.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69,090.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69,090.40
|
| Rate for Payer: BCBS Complete |
$31,107.26
|
| Rate for Payer: BCBS MAPPO |
$55,272.32
|
| Rate for Payer: BCN Medicare Advantage |
$55,272.32
|
| Rate for Payer: Cash Price |
$262,510.54
|
| Rate for Payer: Cash Price |
$262,510.54
|
| Rate for Payer: Cofinity Commercial |
$229,696.73
|
| Rate for Payer: Cofinity Commercial |
$282,198.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$229,696.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262,510.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55,272.32
|
| Rate for Payer: Healthscope Commercial |
$295,324.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$229,696.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246,103.64
|
| Rate for Payer: Mclaren Medicaid |
$29,625.96
|
| Rate for Payer: Mclaren Medicare |
$55,272.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58,035.94
|
| Rate for Payer: Meridian Medicaid |
$31,107.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63,563.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278,917.45
|
| Rate for Payer: PACE Medicare |
$52,508.70
|
| Rate for Payer: PACE SWMI |
$55,272.32
|
| Rate for Payer: PHP Commercial |
$278,917.45
|
| Rate for Payer: PHP Medicare Advantage |
$55,272.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$29,625.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213,289.82
|
| Rate for Payer: Priority Health Medicare |
$55,272.32
|
| Rate for Payer: Priority Health SBD |
$206,727.05
|
| Rate for Payer: Railroad Medicare Medicare |
$55,272.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155,586.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$55,272.32
|
| Rate for Payer: UHC Exchange |
$105,630.93
|
| Rate for Payer: UHC Medicare Advantage |
$55,272.32
|
| Rate for Payer: UHCCP Medicaid |
$29,625.96
|
| Rate for Payer: UMR Bronson Commercial |
$121,411.13
|
| Rate for Payer: VA VA |
$55,272.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246,103.64
|
|
|
SIROLIMUS 0.5 MG TABLET
|
Facility
|
OP
|
$1,498.50
|
|
|
Service Code
|
NDC 59762100101
|
| Hospital Charge Code |
104764
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$554.45 |
| Max. Negotiated Rate |
$1,348.65 |
| Rate for Payer: Aetna American Axle |
$974.02
|
| Rate for Payer: Aetna Commercial |
$1,273.72
|
| Rate for Payer: Aetna Medicare |
$749.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.02
|
| Rate for Payer: BCBS Complete |
$599.40
|
| Rate for Payer: Cash Price |
$1,198.80
|
| Rate for Payer: Cofinity Commercial |
$1,048.95
|
| Rate for Payer: Cofinity Commercial |
$1,288.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,048.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,198.80
|
| Rate for Payer: Healthscope Commercial |
$1,348.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,048.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,123.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,273.72
|
| Rate for Payer: PHP Commercial |
$1,273.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.02
|
| Rate for Payer: Priority Health SBD |
$944.05
|
| Rate for Payer: UMR Bronson Commercial |
$554.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,123.88
|
|
|
SIROLIMUS 0.5 MG TABLET
|
Facility
|
IP
|
$1,498.50
|
|
|
Service Code
|
NDC 59762100101
|
| Hospital Charge Code |
104764
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$659.34 |
| Max. Negotiated Rate |
$1,348.65 |
| Rate for Payer: Aetna American Axle |
$974.02
|
| Rate for Payer: Aetna Commercial |
$1,273.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.02
|
| Rate for Payer: Cash Price |
$1,198.80
|
| Rate for Payer: Cofinity Commercial |
$1,048.95
|
| Rate for Payer: Cofinity Commercial |
$1,288.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,048.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,198.80
|
| Rate for Payer: Healthscope Commercial |
$1,348.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,048.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,123.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,273.72
|
| Rate for Payer: PHP Commercial |
$1,273.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.02
|
| Rate for Payer: Priority Health SBD |
$944.05
|
| Rate for Payer: UMR Bronson Commercial |
$659.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,123.88
|
|
|
SIROLIMUS 1 MG TABLET
|
Facility
|
IP
|
$11,896.61
|
|
|
Service Code
|
HCPCS J7520
|
| Hospital Charge Code |
28958
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5,234.51 |
| Max. Negotiated Rate |
$10,706.95 |
| Rate for Payer: Aetna American Axle |
$7,732.80
|
| Rate for Payer: Aetna American Axle |
$579.44
|
| Rate for Payer: Aetna Commercial |
$10,112.12
|
| Rate for Payer: Aetna Commercial |
$757.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,732.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$579.44
|
| Rate for Payer: Cash Price |
$9,517.29
|
| Rate for Payer: Cash Price |
$713.16
|
| Rate for Payer: Cofinity Commercial |
$766.65
|
| Rate for Payer: Cofinity Commercial |
$624.01
|
| Rate for Payer: Cofinity Commercial |
$10,231.08
|
| Rate for Payer: Cofinity Commercial |
$8,327.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,327.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$624.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,517.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$713.16
|
| Rate for Payer: Healthscope Commercial |
$10,706.95
|
| Rate for Payer: Healthscope Commercial |
$802.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,327.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$624.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,922.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$668.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$757.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,112.12
|
| Rate for Payer: PHP Commercial |
$757.73
|
| Rate for Payer: PHP Commercial |
$10,112.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,732.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$579.44
|
| Rate for Payer: Priority Health SBD |
$7,494.86
|
| Rate for Payer: Priority Health SBD |
$561.61
|
| Rate for Payer: UMR Bronson Commercial |
$5,234.51
|
| Rate for Payer: UMR Bronson Commercial |
$392.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,922.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$668.59
|
|
|
SIROLIMUS 1 MG TABLET
|
Facility
|
OP
|
$11,896.61
|
|
|
Service Code
|
HCPCS J7520
|
| Hospital Charge Code |
28958
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4,401.75 |
| Max. Negotiated Rate |
$10,706.95 |
| Rate for Payer: Aetna American Axle |
$7,732.80
|
| Rate for Payer: Aetna American Axle |
$579.44
|
| Rate for Payer: Aetna Commercial |
$10,112.12
|
| Rate for Payer: Aetna Commercial |
$757.73
|
| Rate for Payer: Aetna Medicare |
$5,948.31
|
| Rate for Payer: Aetna Medicare |
$445.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,732.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$579.44
|
| Rate for Payer: BCBS Complete |
$356.58
|
| Rate for Payer: BCBS Complete |
$4,758.64
|
| Rate for Payer: Cash Price |
$9,517.29
|
| Rate for Payer: Cash Price |
$713.16
|
| Rate for Payer: Cofinity Commercial |
$8,327.63
|
| Rate for Payer: Cofinity Commercial |
$10,231.08
|
| Rate for Payer: Cofinity Commercial |
$624.01
|
| Rate for Payer: Cofinity Commercial |
$766.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$624.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,327.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,517.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$713.16
|
| Rate for Payer: Healthscope Commercial |
$802.30
|
| Rate for Payer: Healthscope Commercial |
$10,706.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,327.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$624.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,922.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$668.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,112.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$757.73
|
| Rate for Payer: PHP Commercial |
$757.73
|
| Rate for Payer: PHP Commercial |
$10,112.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,732.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$579.44
|
| Rate for Payer: Priority Health SBD |
$561.61
|
| Rate for Payer: Priority Health SBD |
$7,494.86
|
| Rate for Payer: UMR Bronson Commercial |
$4,401.75
|
| Rate for Payer: UMR Bronson Commercial |
$329.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$668.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,922.46
|
|
|
SITAGLIPTIN PHOSPHATE 100 MG TABLET
|
Facility
|
OP
|
$1,135.31
|
|
|
Service Code
|
NDC 00006027731
|
| Hospital Charge Code |
77617
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$420.06 |
| Max. Negotiated Rate |
$1,021.78 |
| Rate for Payer: Aetna American Axle |
$737.95
|
| Rate for Payer: Aetna Commercial |
$965.01
|
| Rate for Payer: Aetna Medicare |
$567.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.95
|
| Rate for Payer: BCBS Complete |
$454.12
|
| Rate for Payer: Cash Price |
$908.25
|
| Rate for Payer: Cofinity Commercial |
$794.72
|
| Rate for Payer: Cofinity Commercial |
$976.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$794.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.25
|
| Rate for Payer: Healthscope Commercial |
$1,021.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$794.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$851.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$965.01
|
| Rate for Payer: PHP Commercial |
$965.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.95
|
| Rate for Payer: Priority Health SBD |
$715.25
|
| Rate for Payer: UMR Bronson Commercial |
$420.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$851.48
|
|
|
SITAGLIPTIN PHOSPHATE 100 MG TABLET
|
Facility
|
OP
|
$3,785.10
|
|
|
Service Code
|
NDC 00006027728
|
| Hospital Charge Code |
77617
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,400.49 |
| Max. Negotiated Rate |
$3,406.59 |
| Rate for Payer: Aetna American Axle |
$2,460.32
|
| Rate for Payer: Aetna Commercial |
$3,217.34
|
| Rate for Payer: Aetna Medicare |
$1,892.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,460.32
|
| Rate for Payer: BCBS Complete |
$1,514.04
|
| Rate for Payer: Cash Price |
$3,028.08
|
| Rate for Payer: Cofinity Commercial |
$2,649.57
|
| Rate for Payer: Cofinity Commercial |
$3,255.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,649.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,028.08
|
| Rate for Payer: Healthscope Commercial |
$3,406.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,649.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,838.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,217.34
|
| Rate for Payer: PHP Commercial |
$3,217.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,460.32
|
| Rate for Payer: Priority Health SBD |
$2,384.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,400.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,838.82
|
|
|
SITAGLIPTIN PHOSPHATE 100 MG TABLET
|
Facility
|
IP
|
$1,135.31
|
|
|
Service Code
|
NDC 00006027731
|
| Hospital Charge Code |
77617
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$499.54 |
| Max. Negotiated Rate |
$1,021.78 |
| Rate for Payer: Aetna American Axle |
$737.95
|
| Rate for Payer: Aetna Commercial |
$965.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.95
|
| Rate for Payer: Cash Price |
$908.25
|
| Rate for Payer: Cofinity Commercial |
$794.72
|
| Rate for Payer: Cofinity Commercial |
$976.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$794.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.25
|
| Rate for Payer: Healthscope Commercial |
$1,021.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$794.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$851.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$965.01
|
| Rate for Payer: PHP Commercial |
$965.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.95
|
| Rate for Payer: Priority Health SBD |
$715.25
|
| Rate for Payer: UMR Bronson Commercial |
$499.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$851.48
|
|
|
SITAGLIPTIN PHOSPHATE 100 MG TABLET
|
Facility
|
IP
|
$37.86
|
|
|
Service Code
|
NDC 00006027701
|
| Hospital Charge Code |
77617
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$16.66 |
| Max. Negotiated Rate |
$34.07 |
| Rate for Payer: Aetna American Axle |
$24.61
|
| Rate for Payer: Aetna Commercial |
$32.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.61
|
| Rate for Payer: Cash Price |
$30.29
|
| Rate for Payer: Cofinity Commercial |
$26.50
|
| Rate for Payer: Cofinity Commercial |
$32.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.29
|
| Rate for Payer: Healthscope Commercial |
$34.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.18
|
| Rate for Payer: PHP Commercial |
$32.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.61
|
| Rate for Payer: Priority Health SBD |
$23.85
|
| Rate for Payer: UMR Bronson Commercial |
$16.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.39
|
|
|
SITAGLIPTIN PHOSPHATE 100 MG TABLET
|
Facility
|
OP
|
$37.86
|
|
|
Service Code
|
NDC 00006027701
|
| Hospital Charge Code |
77617
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$14.01 |
| Max. Negotiated Rate |
$34.07 |
| Rate for Payer: Aetna American Axle |
$24.61
|
| Rate for Payer: Aetna Commercial |
$32.18
|
| Rate for Payer: Aetna Medicare |
$18.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.61
|
| Rate for Payer: BCBS Complete |
$15.14
|
| Rate for Payer: Cash Price |
$30.29
|
| Rate for Payer: Cofinity Commercial |
$26.50
|
| Rate for Payer: Cofinity Commercial |
$32.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.29
|
| Rate for Payer: Healthscope Commercial |
$34.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.18
|
| Rate for Payer: PHP Commercial |
$32.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.61
|
| Rate for Payer: Priority Health SBD |
$23.85
|
| Rate for Payer: UMR Bronson Commercial |
$14.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.39
|
|
|
SITAGLIPTIN PHOSPHATE 100 MG TABLET
|
Facility
|
IP
|
$3,785.10
|
|
|
Service Code
|
NDC 00006027728
|
| Hospital Charge Code |
77617
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,665.44 |
| Max. Negotiated Rate |
$3,406.59 |
| Rate for Payer: Aetna American Axle |
$2,460.32
|
| Rate for Payer: Aetna Commercial |
$3,217.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,460.32
|
| Rate for Payer: Cash Price |
$3,028.08
|
| Rate for Payer: Cofinity Commercial |
$2,649.57
|
| Rate for Payer: Cofinity Commercial |
$3,255.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,649.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,028.08
|
| Rate for Payer: Healthscope Commercial |
$3,406.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,649.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,838.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,217.34
|
| Rate for Payer: PHP Commercial |
$3,217.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,460.32
|
| Rate for Payer: Priority Health SBD |
$2,384.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,665.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,838.82
|
|
|
SITAGLIPTIN PHOSPHATE 50 MG TABLET
|
Facility
|
IP
|
$1,135.31
|
|
|
Service Code
|
NDC 00006011231
|
| Hospital Charge Code |
77616
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$499.54 |
| Max. Negotiated Rate |
$1,021.78 |
| Rate for Payer: Aetna American Axle |
$737.95
|
| Rate for Payer: Aetna Commercial |
$965.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.95
|
| Rate for Payer: Cash Price |
$908.25
|
| Rate for Payer: Cofinity Commercial |
$794.72
|
| Rate for Payer: Cofinity Commercial |
$976.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$794.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.25
|
| Rate for Payer: Healthscope Commercial |
$1,021.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$794.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$851.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$965.01
|
| Rate for Payer: PHP Commercial |
$965.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.95
|
| Rate for Payer: Priority Health SBD |
$715.25
|
| Rate for Payer: UMR Bronson Commercial |
$499.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$851.48
|
|
|
SITAGLIPTIN PHOSPHATE 50 MG TABLET
|
Facility
|
OP
|
$3,785.10
|
|
|
Service Code
|
NDC 00006011228
|
| Hospital Charge Code |
77616
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,400.49 |
| Max. Negotiated Rate |
$3,406.59 |
| Rate for Payer: Aetna American Axle |
$2,460.32
|
| Rate for Payer: Aetna Commercial |
$3,217.34
|
| Rate for Payer: Aetna Medicare |
$1,892.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,460.32
|
| Rate for Payer: BCBS Complete |
$1,514.04
|
| Rate for Payer: Cash Price |
$3,028.08
|
| Rate for Payer: Cofinity Commercial |
$2,649.57
|
| Rate for Payer: Cofinity Commercial |
$3,255.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,649.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,028.08
|
| Rate for Payer: Healthscope Commercial |
$3,406.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,649.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,838.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,217.34
|
| Rate for Payer: PHP Commercial |
$3,217.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,460.32
|
| Rate for Payer: Priority Health SBD |
$2,384.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,400.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,838.82
|
|
|
SITAGLIPTIN PHOSPHATE 50 MG TABLET
|
Facility
|
OP
|
$1,135.31
|
|
|
Service Code
|
NDC 00006011231
|
| Hospital Charge Code |
77616
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$420.06 |
| Max. Negotiated Rate |
$1,021.78 |
| Rate for Payer: Aetna American Axle |
$737.95
|
| Rate for Payer: Aetna Commercial |
$965.01
|
| Rate for Payer: Aetna Medicare |
$567.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.95
|
| Rate for Payer: BCBS Complete |
$454.12
|
| Rate for Payer: Cash Price |
$908.25
|
| Rate for Payer: Cofinity Commercial |
$794.72
|
| Rate for Payer: Cofinity Commercial |
$976.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$794.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.25
|
| Rate for Payer: Healthscope Commercial |
$1,021.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$794.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$851.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$965.01
|
| Rate for Payer: PHP Commercial |
$965.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.95
|
| Rate for Payer: Priority Health SBD |
$715.25
|
| Rate for Payer: UMR Bronson Commercial |
$420.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$851.48
|
|
|
SITAGLIPTIN PHOSPHATE 50 MG TABLET
|
Facility
|
IP
|
$3,785.10
|
|
|
Service Code
|
NDC 00006011228
|
| Hospital Charge Code |
77616
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,665.44 |
| Max. Negotiated Rate |
$3,406.59 |
| Rate for Payer: Aetna American Axle |
$2,460.32
|
| Rate for Payer: Aetna Commercial |
$3,217.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,460.32
|
| Rate for Payer: Cash Price |
$3,028.08
|
| Rate for Payer: Cofinity Commercial |
$2,649.57
|
| Rate for Payer: Cofinity Commercial |
$3,255.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,649.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,028.08
|
| Rate for Payer: Healthscope Commercial |
$3,406.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,649.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,838.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,217.34
|
| Rate for Payer: PHP Commercial |
$3,217.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,460.32
|
| Rate for Payer: Priority Health SBD |
$2,384.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,665.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,838.82
|
|
|
SKIN CARE CONSULT
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS 00177
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$16.90 |
| Rate for Payer: Aetna Medicare |
$13.00
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.90
|
| Rate for Payer: UMR Bronson Commercial |
$11.96
|
|
|
SLING OPERATION FOR CORRECTION OF MALE URINARY INCONTINENCE (EG, FASCIA OR SYNTHETIC)
|
Facility
|
OP
|
$35,668.30
|
|
|
Service Code
|
CPT 53440
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,791.79 |
| Max. Negotiated Rate |
$35,668.30 |
| Rate for Payer: Aetna Medicare |
$13,178.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,839.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,839.06
|
| Rate for Payer: BCBS Complete |
$7,131.38
|
| Rate for Payer: BCBS MAPPO |
$12,671.25
|
| Rate for Payer: BCN Medicare Advantage |
$12,671.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,671.25
|
| Rate for Payer: Mclaren Medicaid |
$6,791.79
|
| Rate for Payer: Mclaren Medicare |
$12,671.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,304.81
|
| Rate for Payer: Meridian Medicaid |
$7,131.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,571.94
|
| Rate for Payer: PACE Medicare |
$12,037.69
|
| Rate for Payer: PACE SWMI |
$12,671.25
|
| Rate for Payer: PHP Medicare Advantage |
$12,671.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,791.79
|
| Rate for Payer: Priority Health Medicare |
$12,671.25
|
| Rate for Payer: Railroad Medicare Medicare |
$12,671.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35,668.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,671.25
|
| Rate for Payer: UHC Exchange |
$24,216.03
|
| Rate for Payer: UHC Medicare Advantage |
$12,671.25
|
| Rate for Payer: UHCCP Medicaid |
$6,791.79
|
| Rate for Payer: VA VA |
$12,671.25
|
|
|
SLING OPERATION FOR STRESS INCONTINENCE (EG, FASCIA OR SYNTHETIC)
|
Facility
|
OP
|
$13,552.11
|
|
|
Service Code
|
CPT 57288
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,580.53 |
| Max. Negotiated Rate |
$13,552.11 |
| Rate for Payer: Aetna Medicare |
$5,007.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,018.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,018.02
|
| Rate for Payer: BCBS Complete |
$2,709.56
|
| Rate for Payer: BCBS MAPPO |
$4,814.42
|
| Rate for Payer: BCN Medicare Advantage |
$4,814.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,814.42
|
| Rate for Payer: Mclaren Medicaid |
$2,580.53
|
| Rate for Payer: Mclaren Medicare |
$4,814.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,055.14
|
| Rate for Payer: Meridian Medicaid |
$2,709.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,536.58
|
| Rate for Payer: PACE Medicare |
$4,573.70
|
| Rate for Payer: PACE SWMI |
$4,814.42
|
| Rate for Payer: PHP Medicare Advantage |
$4,814.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,580.53
|
| Rate for Payer: Priority Health Medicare |
$4,814.42
|
| Rate for Payer: Railroad Medicare Medicare |
$4,814.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,552.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,814.42
|
| Rate for Payer: UHC Exchange |
$9,200.84
|
| Rate for Payer: UHC Medicare Advantage |
$4,814.42
|
| Rate for Payer: UHCCP Medicaid |
$2,580.53
|
| Rate for Payer: VA VA |
$4,814.42
|
|
|
SLITTING OF PREPUCE, DORSAL OR LATERAL (SEPARATE PROCEDURE); EXCEPT NEWBORN
|
Facility
|
OP
|
$5,623.80
|
|
|
Service Code
|
CPT 54001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$5,623.80 |
| Rate for Payer: Aetna Medicare |
$2,077.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,623.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Exchange |
$3,818.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,070.86
|
| Rate for Payer: VA VA |
$1,997.87
|
|
