|
THYROID DISORDERS
|
Facility
|
IP
|
$14,380.71
|
|
|
Service Code
|
APR-DRG 4274
|
| Min. Negotiated Rate |
$13,695.91 |
| Max. Negotiated Rate |
$14,380.71 |
| Rate for Payer: BCBS Complete |
$14,380.71
|
| Rate for Payer: Mclaren Medicaid |
$13,695.91
|
| Rate for Payer: Meridian Medicaid |
$14,380.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,695.91
|
| Rate for Payer: UHC Medicaid |
$13,695.91
|
| Rate for Payer: UHCCP Medicaid |
$13,695.91
|
|
|
THYROID DISORDERS
|
Facility
|
IP
|
$5,099.86
|
|
|
Service Code
|
APR-DRG 4272
|
| Min. Negotiated Rate |
$4,857.01 |
| Max. Negotiated Rate |
$5,099.86 |
| Rate for Payer: BCBS Complete |
$5,099.86
|
| Rate for Payer: Mclaren Medicaid |
$4,857.01
|
| Rate for Payer: Meridian Medicaid |
$5,099.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,857.01
|
| Rate for Payer: UHC Medicaid |
$4,857.01
|
| Rate for Payer: UHCCP Medicaid |
$4,857.01
|
|
|
THYROID DISORDERS
|
Facility
|
IP
|
$8,193.68
|
|
|
Service Code
|
APR-DRG 4273
|
| Min. Negotiated Rate |
$7,803.50 |
| Max. Negotiated Rate |
$8,193.68 |
| Rate for Payer: BCBS Complete |
$8,193.68
|
| Rate for Payer: Mclaren Medicaid |
$7,803.50
|
| Rate for Payer: Meridian Medicaid |
$8,193.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,803.50
|
| Rate for Payer: UHC Medicaid |
$7,803.50
|
| Rate for Payer: UHCCP Medicaid |
$7,803.50
|
|
|
THYROIDECTOMY, INCLUDING SUBSTERNAL THYROID; CERVICAL APPROACH
|
Facility
|
OP
|
$19,075.37
|
|
|
Service Code
|
CPT 60271
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,084.94 |
| Max. Negotiated Rate |
$19,075.37 |
| Rate for Payer: Aetna Medicare |
$6,134.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,373.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,373.18
|
| Rate for Payer: BCBS Complete |
$3,239.48
|
| Rate for Payer: BCBS MAPPO |
$5,898.54
|
| Rate for Payer: BCBS Trust/PPO |
$9,416.83
|
| Rate for Payer: BCN Commercial |
$9,416.83
|
| Rate for Payer: BCN Medicare Advantage |
$5,898.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,898.54
|
| Rate for Payer: Mclaren Medicaid |
$5,898.54
|
| Rate for Payer: Mclaren Medicare |
$5,898.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,193.47
|
| Rate for Payer: Meridian Medicaid |
$6,193.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,783.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,488.39
|
| Rate for Payer: Nomi Health Commercial |
$17,695.62
|
| Rate for Payer: PACE Medicare |
$5,603.61
|
| Rate for Payer: PACE SWMI |
$5,898.54
|
| Rate for Payer: PHP Medicare Advantage |
$5,898.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,084.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,075.37
|
| Rate for Payer: Priority Health Medicare |
$5,898.54
|
| Rate for Payer: Priority Health Tiered Network |
$15,260.30
|
| Rate for Payer: Railroad Medicare Medicare |
$5,898.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,898.54
|
| Rate for Payer: UHC Medicaid |
$3,084.94
|
| Rate for Payer: UHCCP Medicaid |
$3,084.94
|
| Rate for Payer: VA VA |
$5,898.54
|
|
|
THYROIDECTOMY, REMOVAL OF ALL REMAINING THYROID TISSUE FOLLOWING PREVIOUS REMOVAL OF A PORTION OF THYROID
|
Facility
|
OP
|
$19,075.37
|
|
|
Service Code
|
CPT 60260
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,084.94 |
| Max. Negotiated Rate |
$19,075.37 |
| Rate for Payer: Aetna Medicare |
$6,134.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,373.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,373.18
|
| Rate for Payer: BCBS Complete |
$3,239.48
|
| Rate for Payer: BCBS MAPPO |
$5,898.54
|
| Rate for Payer: BCBS Trust/PPO |
$7,453.16
|
| Rate for Payer: BCN Commercial |
$7,453.16
|
| Rate for Payer: BCN Medicare Advantage |
$5,898.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,898.54
|
| Rate for Payer: Mclaren Medicaid |
$5,898.54
|
| Rate for Payer: Mclaren Medicare |
$5,898.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,193.47
|
| Rate for Payer: Meridian Medicaid |
$6,193.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,783.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,488.39
|
| Rate for Payer: Nomi Health Commercial |
$17,695.62
|
| Rate for Payer: PACE Medicare |
$5,603.61
|
| Rate for Payer: PACE SWMI |
$5,898.54
|
| Rate for Payer: PHP Medicare Advantage |
$5,898.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,084.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,075.37
|
| Rate for Payer: Priority Health Medicare |
$5,898.54
|
| Rate for Payer: Priority Health Tiered Network |
$15,260.30
|
| Rate for Payer: Railroad Medicare Medicare |
$5,898.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,898.54
|
| Rate for Payer: UHC Medicaid |
$3,084.94
|
| Rate for Payer: UHCCP Medicaid |
$3,084.94
|
| Rate for Payer: VA VA |
$5,898.54
|
|
|
THYROIDECTOMY, TOTAL OR COMPLETE
|
Facility
|
OP
|
$19,480.40
|
|
|
Service Code
|
CPT 60240
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,150.44 |
| Max. Negotiated Rate |
$19,480.40 |
| Rate for Payer: Aetna Medicare |
$6,264.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,529.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,529.74
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$8,887.49
|
| Rate for Payer: BCN Commercial |
$8,887.49
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Mclaren Medicaid |
$6,023.79
|
| Rate for Payer: Mclaren Medicare |
$6,023.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,324.98
|
| Rate for Payer: Meridian Medicaid |
$6,324.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,927.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,626.17
|
| Rate for Payer: Nomi Health Commercial |
$18,071.37
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Medicare Advantage |
$6,023.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,150.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,480.40
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health Tiered Network |
$15,584.32
|
| Rate for Payer: Railroad Medicare Medicare |
$6,023.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,023.79
|
| Rate for Payer: UHC Medicaid |
$3,150.44
|
| Rate for Payer: UHCCP Medicaid |
$3,150.44
|
| Rate for Payer: VA VA |
$6,023.79
|
|
|
THYROIDECTOMY, TOTAL OR SUBTOTAL FOR MALIGNANCY; WITH LIMITED NECK DISSECTION
|
Facility
|
OP
|
$19,075.37
|
|
|
Service Code
|
CPT 60252
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,084.94 |
| Max. Negotiated Rate |
$19,075.37 |
| Rate for Payer: Aetna Medicare |
$6,134.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,373.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,373.18
|
| Rate for Payer: BCBS Complete |
$3,239.48
|
| Rate for Payer: BCBS MAPPO |
$5,898.54
|
| Rate for Payer: BCBS Trust/PPO |
$10,434.14
|
| Rate for Payer: BCN Commercial |
$10,434.14
|
| Rate for Payer: BCN Medicare Advantage |
$5,898.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,898.54
|
| Rate for Payer: Mclaren Medicaid |
$5,898.54
|
| Rate for Payer: Mclaren Medicare |
$5,898.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,193.47
|
| Rate for Payer: Meridian Medicaid |
$6,193.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,783.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,488.39
|
| Rate for Payer: Nomi Health Commercial |
$17,695.62
|
| Rate for Payer: PACE Medicare |
$5,603.61
|
| Rate for Payer: PACE SWMI |
$5,898.54
|
| Rate for Payer: PHP Medicare Advantage |
$5,898.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,084.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,075.37
|
| Rate for Payer: Priority Health Medicare |
$5,898.54
|
| Rate for Payer: Priority Health Tiered Network |
$15,260.30
|
| Rate for Payer: Railroad Medicare Medicare |
$5,898.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,898.54
|
| Rate for Payer: UHC Medicaid |
$3,084.94
|
| Rate for Payer: UHCCP Medicaid |
$3,084.94
|
| Rate for Payer: VA VA |
$5,898.54
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES
|
Facility
|
IP
|
$26,762.63
|
|
|
Service Code
|
APR-DRG 4044
|
| Min. Negotiated Rate |
$25,488.22 |
| Max. Negotiated Rate |
$26,762.63 |
| Rate for Payer: BCBS Complete |
$26,762.63
|
| Rate for Payer: Mclaren Medicaid |
$25,488.22
|
| Rate for Payer: Meridian Medicaid |
$26,762.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$25,488.22
|
| Rate for Payer: UHC Medicaid |
$25,488.22
|
| Rate for Payer: UHCCP Medicaid |
$25,488.22
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES
|
Facility
|
IP
|
$13,196.69
|
|
|
Service Code
|
APR-DRG 4043
|
| Min. Negotiated Rate |
$12,568.28 |
| Max. Negotiated Rate |
$13,196.69 |
| Rate for Payer: BCBS Complete |
$13,196.69
|
| Rate for Payer: Mclaren Medicaid |
$12,568.28
|
| Rate for Payer: Meridian Medicaid |
$13,196.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,568.28
|
| Rate for Payer: UHC Medicaid |
$12,568.28
|
| Rate for Payer: UHCCP Medicaid |
$12,568.28
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES
|
Facility
|
IP
|
$11,101.06
|
|
|
Service Code
|
APR-DRG 4042
|
| Min. Negotiated Rate |
$10,572.43 |
| Max. Negotiated Rate |
$11,101.06 |
| Rate for Payer: BCBS Complete |
$11,101.06
|
| Rate for Payer: Mclaren Medicaid |
$10,572.43
|
| Rate for Payer: Meridian Medicaid |
$11,101.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,572.43
|
| Rate for Payer: UHC Medicaid |
$10,572.43
|
| Rate for Payer: UHCCP Medicaid |
$10,572.43
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES
|
Facility
|
IP
|
$7,674.31
|
|
|
Service Code
|
APR-DRG 4041
|
| Min. Negotiated Rate |
$7,308.87 |
| Max. Negotiated Rate |
$7,674.31 |
| Rate for Payer: BCBS Complete |
$7,674.31
|
| Rate for Payer: Mclaren Medicaid |
$7,308.87
|
| Rate for Payer: Meridian Medicaid |
$7,674.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,308.87
|
| Rate for Payer: UHC Medicaid |
$7,308.87
|
| Rate for Payer: UHCCP Medicaid |
$7,308.87
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC
|
Facility
|
IP
|
$36,663.56
|
|
|
Service Code
|
MSDRG 626
|
| Min. Negotiated Rate |
$12,475.38 |
| Max. Negotiated Rate |
$36,663.56 |
| Rate for Payer: Aetna Medicare |
$13,657.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,414.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,414.97
|
| Rate for Payer: BCBS MAPPO |
$13,131.98
|
| Rate for Payer: BCBS Trust/PPO |
$36,663.56
|
| Rate for Payer: BCN Commercial |
$36,663.56
|
| Rate for Payer: BCN Medicare Advantage |
$13,131.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,131.98
|
| Rate for Payer: Mclaren Medicare |
$13,131.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,788.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,101.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,445.18
|
| Rate for Payer: Nomi Health Commercial |
$19,342.26
|
| Rate for Payer: PACE Medicare |
$12,475.38
|
| Rate for Payer: PACE SWMI |
$13,131.98
|
| Rate for Payer: PHP Medicare Advantage |
$13,131.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24,173.54
|
| Rate for Payer: Priority Health Medicare |
$13,131.98
|
| Rate for Payer: Priority Health Tiered Network |
$19,338.83
|
| Rate for Payer: Railroad Medicare Medicare |
$13,131.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,440.22
|
| Rate for Payer: UHC Core |
$20,447.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,131.98
|
| Rate for Payer: UHC Exchange |
$16,698.82
|
| Rate for Payer: VA VA |
$13,131.98
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$49,389.84
|
|
|
Service Code
|
MSDRG 625
|
| Min. Negotiated Rate |
$24,556.67 |
| Max. Negotiated Rate |
$49,389.84 |
| Rate for Payer: Aetna Medicare |
$26,883.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,311.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,311.41
|
| Rate for Payer: BCBS MAPPO |
$25,849.13
|
| Rate for Payer: BCBS Trust/PPO |
$49,389.84
|
| Rate for Payer: BCN Commercial |
$49,389.84
|
| Rate for Payer: BCN Medicare Advantage |
$25,849.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,849.13
|
| Rate for Payer: Mclaren Medicare |
$25,849.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27,141.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,726.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$28,434.04
|
| Rate for Payer: Nomi Health Commercial |
$38,959.29
|
| Rate for Payer: PACE Medicare |
$24,556.67
|
| Rate for Payer: PACE SWMI |
$25,849.13
|
| Rate for Payer: PHP Medicare Advantage |
$25,849.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$48,690.48
|
| Rate for Payer: Priority Health Medicare |
$25,849.13
|
| Rate for Payer: Priority Health Tiered Network |
$38,952.37
|
| Rate for Payer: Railroad Medicare Medicare |
$25,849.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,227.63
|
| Rate for Payer: UHC Core |
$41,185.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25,849.13
|
| Rate for Payer: UHC Exchange |
$33,634.85
|
| Rate for Payer: VA VA |
$25,849.13
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$30,374.53
|
|
|
Service Code
|
MSDRG 627
|
| Min. Negotiated Rate |
$11,116.08 |
| Max. Negotiated Rate |
$30,374.53 |
| Rate for Payer: Aetna Medicare |
$12,169.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,626.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,626.42
|
| Rate for Payer: BCBS MAPPO |
$11,701.14
|
| Rate for Payer: BCBS Trust/PPO |
$30,374.53
|
| Rate for Payer: BCN Commercial |
$30,374.53
|
| Rate for Payer: BCN Medicare Advantage |
$11,701.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,701.14
|
| Rate for Payer: Mclaren Medicare |
$11,701.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,286.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,456.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,871.25
|
| Rate for Payer: Nomi Health Commercial |
$17,135.07
|
| Rate for Payer: PACE Medicare |
$11,116.08
|
| Rate for Payer: PACE SWMI |
$11,701.14
|
| Rate for Payer: PHP Medicare Advantage |
$11,701.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21,415.04
|
| Rate for Payer: Priority Health Medicare |
$11,701.14
|
| Rate for Payer: Priority Health Tiered Network |
$17,132.03
|
| Rate for Payer: Railroad Medicare Medicare |
$11,701.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21,651.29
|
| Rate for Payer: UHC Core |
$18,114.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,701.14
|
| Rate for Payer: UHC Exchange |
$14,793.28
|
| Rate for Payer: VA VA |
$11,701.14
|
|
|
THYROID (PORK) 30 MG TABLET
|
Facility
|
IP
|
$496.80
|
|
|
Service Code
|
NDC 00456045801
|
| Hospital Charge Code |
119104
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$218.59 |
| Max. Negotiated Rate |
$447.12 |
| Rate for Payer: Aetna American Axle |
$322.92
|
| Rate for Payer: Aetna Commercial |
$422.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.92
|
| Rate for Payer: Cash Price |
$397.44
|
| Rate for Payer: Cofinity Advantage |
$347.76
|
| Rate for Payer: Cofinity Commercial |
$427.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$397.44
|
| Rate for Payer: Healthscope Commercial |
$447.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$347.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$372.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$422.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$372.60
|
| Rate for Payer: PHP Commercial |
$422.28
|
| Rate for Payer: Priority Health SBD |
$312.98
|
| Rate for Payer: UMR Bronson Commercial |
$218.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$372.60
|
|
|
THYROID (PORK) 30 MG TABLET
|
Facility
|
IP
|
$275.04
|
|
|
Service Code
|
NDC 62559074101
|
| Hospital Charge Code |
119104
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$121.02 |
| Max. Negotiated Rate |
$247.54 |
| Rate for Payer: Aetna American Axle |
$178.78
|
| Rate for Payer: Aetna Commercial |
$233.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.78
|
| Rate for Payer: Cash Price |
$220.03
|
| Rate for Payer: Cofinity Advantage |
$192.53
|
| Rate for Payer: Cofinity Commercial |
$236.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.03
|
| Rate for Payer: Healthscope Commercial |
$247.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$192.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.28
|
| Rate for Payer: PHP Commercial |
$233.78
|
| Rate for Payer: Priority Health SBD |
$173.28
|
| Rate for Payer: UMR Bronson Commercial |
$121.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.28
|
|
|
THYROID (PORK) 30 MG TABLET
|
Facility
|
OP
|
$496.80
|
|
|
Service Code
|
NDC 00456045801
|
| Hospital Charge Code |
119104
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$183.82 |
| Max. Negotiated Rate |
$447.12 |
| Rate for Payer: Aetna American Axle |
$322.92
|
| Rate for Payer: Aetna Commercial |
$422.28
|
| Rate for Payer: Aetna Medicare |
$248.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.92
|
| Rate for Payer: BCBS Complete |
$198.72
|
| Rate for Payer: Cash Price |
$397.44
|
| Rate for Payer: Cofinity Advantage |
$347.76
|
| Rate for Payer: Cofinity Commercial |
$427.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$397.44
|
| Rate for Payer: Healthscope Commercial |
$447.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$347.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$372.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$397.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$422.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$372.60
|
| Rate for Payer: PHP Commercial |
$422.28
|
| Rate for Payer: Priority Health SBD |
$312.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.92
|
| Rate for Payer: UHC Core |
$258.83
|
| Rate for Payer: UHC Exchange |
$195.24
|
| Rate for Payer: UMR Bronson Commercial |
$183.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$372.60
|
|
|
THYROID (PORK) 30 MG TABLET
|
Facility
|
OP
|
$275.04
|
|
|
Service Code
|
NDC 62559074101
|
| Hospital Charge Code |
119104
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$101.76 |
| Max. Negotiated Rate |
$247.54 |
| Rate for Payer: Aetna American Axle |
$178.78
|
| Rate for Payer: Aetna Commercial |
$233.78
|
| Rate for Payer: Aetna Medicare |
$137.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.78
|
| Rate for Payer: BCBS Complete |
$110.02
|
| Rate for Payer: Cash Price |
$220.03
|
| Rate for Payer: Cofinity Advantage |
$192.53
|
| Rate for Payer: Cofinity Commercial |
$236.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.03
|
| Rate for Payer: Healthscope Commercial |
$247.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$192.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$220.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.28
|
| Rate for Payer: PHP Commercial |
$233.78
|
| Rate for Payer: Priority Health SBD |
$173.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.78
|
| Rate for Payer: UHC Core |
$143.30
|
| Rate for Payer: UHC Exchange |
$108.09
|
| Rate for Payer: UMR Bronson Commercial |
$101.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.28
|
|
|
THYROID (PORK) 30 MG TABLET
|
Facility
|
IP
|
$307.20
|
|
|
Service Code
|
NDC 42192032901
|
| Hospital Charge Code |
119104
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$135.17 |
| Max. Negotiated Rate |
$276.48 |
| Rate for Payer: Aetna American Axle |
$199.68
|
| Rate for Payer: Aetna Commercial |
$261.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.68
|
| Rate for Payer: Cash Price |
$245.76
|
| Rate for Payer: Cofinity Advantage |
$215.04
|
| Rate for Payer: Cofinity Commercial |
$264.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.76
|
| Rate for Payer: Healthscope Commercial |
$276.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$215.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$230.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.40
|
| Rate for Payer: PHP Commercial |
$261.12
|
| Rate for Payer: Priority Health SBD |
$193.54
|
| Rate for Payer: UMR Bronson Commercial |
$135.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$230.40
|
|
|
THYROID (PORK) 30 MG TABLET
|
Facility
|
OP
|
$307.20
|
|
|
Service Code
|
NDC 42192032901
|
| Hospital Charge Code |
119104
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$113.66 |
| Max. Negotiated Rate |
$276.48 |
| Rate for Payer: Aetna American Axle |
$199.68
|
| Rate for Payer: Aetna Commercial |
$261.12
|
| Rate for Payer: Aetna Medicare |
$153.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.68
|
| Rate for Payer: BCBS Complete |
$122.88
|
| Rate for Payer: Cash Price |
$245.76
|
| Rate for Payer: Cofinity Advantage |
$215.04
|
| Rate for Payer: Cofinity Commercial |
$264.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.76
|
| Rate for Payer: Healthscope Commercial |
$276.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$215.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$230.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$245.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.40
|
| Rate for Payer: PHP Commercial |
$261.12
|
| Rate for Payer: Priority Health SBD |
$193.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.68
|
| Rate for Payer: UHC Core |
$160.05
|
| Rate for Payer: UHC Exchange |
$120.73
|
| Rate for Payer: UMR Bronson Commercial |
$113.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$230.40
|
|
|
THYROID (PORK) 60 MG TABLET
|
Facility
|
IP
|
$552.00
|
|
|
Service Code
|
NDC 00456045901
|
| Hospital Charge Code |
119105
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$242.88 |
| Max. Negotiated Rate |
$496.80 |
| Rate for Payer: Aetna American Axle |
$358.80
|
| Rate for Payer: Aetna Commercial |
$469.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$358.80
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cofinity Advantage |
$386.40
|
| Rate for Payer: Cofinity Commercial |
$474.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$441.60
|
| Rate for Payer: Healthscope Commercial |
$496.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$386.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$414.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$469.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$414.00
|
| Rate for Payer: PHP Commercial |
$469.20
|
| Rate for Payer: Priority Health SBD |
$347.76
|
| Rate for Payer: UMR Bronson Commercial |
$242.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$414.00
|
|
|
THYROID (PORK) 60 MG TABLET
|
Facility
|
OP
|
$340.80
|
|
|
Service Code
|
NDC 42192033001
|
| Hospital Charge Code |
119105
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$126.10 |
| Max. Negotiated Rate |
$306.72 |
| Rate for Payer: Aetna American Axle |
$221.52
|
| Rate for Payer: Aetna Commercial |
$289.68
|
| Rate for Payer: Aetna Medicare |
$170.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.52
|
| Rate for Payer: BCBS Complete |
$136.32
|
| Rate for Payer: Cash Price |
$272.64
|
| Rate for Payer: Cofinity Advantage |
$238.56
|
| Rate for Payer: Cofinity Commercial |
$293.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.64
|
| Rate for Payer: Healthscope Commercial |
$306.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.60
|
| Rate for Payer: PHP Commercial |
$289.68
|
| Rate for Payer: Priority Health SBD |
$214.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.52
|
| Rate for Payer: UHC Core |
$177.56
|
| Rate for Payer: UHC Exchange |
$133.93
|
| Rate for Payer: UMR Bronson Commercial |
$126.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.60
|
|
|
THYROID (PORK) 60 MG TABLET
|
Facility
|
IP
|
$354.24
|
|
|
Service Code
|
NDC 62559074201
|
| Hospital Charge Code |
119105
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$155.87 |
| Max. Negotiated Rate |
$318.82 |
| Rate for Payer: Aetna American Axle |
$230.26
|
| Rate for Payer: Aetna Commercial |
$301.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.26
|
| Rate for Payer: Cash Price |
$283.39
|
| Rate for Payer: Cofinity Advantage |
$247.97
|
| Rate for Payer: Cofinity Commercial |
$304.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.39
|
| Rate for Payer: Healthscope Commercial |
$318.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$247.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.68
|
| Rate for Payer: PHP Commercial |
$301.10
|
| Rate for Payer: Priority Health SBD |
$223.17
|
| Rate for Payer: UMR Bronson Commercial |
$155.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.68
|
|
|
THYROID (PORK) 60 MG TABLET
|
Facility
|
IP
|
$340.80
|
|
|
Service Code
|
NDC 42192033001
|
| Hospital Charge Code |
119105
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$149.95 |
| Max. Negotiated Rate |
$306.72 |
| Rate for Payer: Aetna American Axle |
$221.52
|
| Rate for Payer: Aetna Commercial |
$289.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.52
|
| Rate for Payer: Cash Price |
$272.64
|
| Rate for Payer: Cofinity Advantage |
$238.56
|
| Rate for Payer: Cofinity Commercial |
$293.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.64
|
| Rate for Payer: Healthscope Commercial |
$306.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.60
|
| Rate for Payer: PHP Commercial |
$289.68
|
| Rate for Payer: Priority Health SBD |
$214.70
|
| Rate for Payer: UMR Bronson Commercial |
$149.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.60
|
|
|
THYROID (PORK) 60 MG TABLET
|
Facility
|
OP
|
$354.24
|
|
|
Service Code
|
NDC 62559074201
|
| Hospital Charge Code |
119105
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$131.07 |
| Max. Negotiated Rate |
$318.82 |
| Rate for Payer: Aetna American Axle |
$230.26
|
| Rate for Payer: Aetna Commercial |
$301.10
|
| Rate for Payer: Aetna Medicare |
$177.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.26
|
| Rate for Payer: BCBS Complete |
$141.70
|
| Rate for Payer: Cash Price |
$283.39
|
| Rate for Payer: Cofinity Advantage |
$247.97
|
| Rate for Payer: Cofinity Commercial |
$304.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.39
|
| Rate for Payer: Healthscope Commercial |
$318.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$247.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$283.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.68
|
| Rate for Payer: PHP Commercial |
$301.10
|
| Rate for Payer: Priority Health SBD |
$223.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.26
|
| Rate for Payer: UHC Core |
$184.56
|
| Rate for Payer: UHC Exchange |
$139.22
|
| Rate for Payer: UMR Bronson Commercial |
$131.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.68
|
|
