|
TBO-FILGRASTIM 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$911.49
|
|
|
Service Code
|
HCPCS J1447
|
| Hospital Charge Code |
168856
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$401.06 |
| Max. Negotiated Rate |
$820.34 |
| Rate for Payer: Aetna American Axle |
$592.47
|
| Rate for Payer: Aetna American Axle |
$592.48
|
| Rate for Payer: Aetna Commercial |
$774.77
|
| Rate for Payer: Aetna Commercial |
$774.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$592.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$592.48
|
| Rate for Payer: Cash Price |
$729.19
|
| Rate for Payer: Cash Price |
$729.20
|
| Rate for Payer: Cofinity Commercial |
$783.89
|
| Rate for Payer: Cofinity Commercial |
$638.05
|
| Rate for Payer: Cofinity Commercial |
$638.04
|
| Rate for Payer: Cofinity Commercial |
$783.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$638.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$638.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$729.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$729.20
|
| Rate for Payer: Healthscope Commercial |
$820.34
|
| Rate for Payer: Healthscope Commercial |
$820.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$638.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$638.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$683.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$683.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$774.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$774.77
|
| Rate for Payer: PHP Commercial |
$774.77
|
| Rate for Payer: PHP Commercial |
$774.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.48
|
| Rate for Payer: Priority Health SBD |
$574.24
|
| Rate for Payer: Priority Health SBD |
$574.25
|
| Rate for Payer: UMR Bronson Commercial |
$401.06
|
| Rate for Payer: UMR Bronson Commercial |
$401.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$683.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$683.62
|
|
|
TEBENTAFUSP-TEBN 100 MCG/0.5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$91,955.20
|
|
|
Service Code
|
HCPCS J9274
|
| Hospital Charge Code |
199147
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40,460.29 |
| Max. Negotiated Rate |
$82,759.68 |
| Rate for Payer: Aetna American Axle |
$59,770.88
|
| Rate for Payer: Aetna Commercial |
$78,161.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59,770.88
|
| Rate for Payer: Cash Price |
$73,564.16
|
| Rate for Payer: Cofinity Commercial |
$64,368.64
|
| Rate for Payer: Cofinity Commercial |
$79,081.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$64,368.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73,564.16
|
| Rate for Payer: Healthscope Commercial |
$82,759.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64,368.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68,966.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78,161.92
|
| Rate for Payer: PHP Commercial |
$78,161.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59,770.88
|
| Rate for Payer: Priority Health SBD |
$57,931.78
|
| Rate for Payer: UMR Bronson Commercial |
$40,460.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68,966.40
|
|
|
TEBENTAFUSP-TEBN 100 MCG/0.5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$91,955.20
|
|
|
Service Code
|
HCPCS J9274
|
| Hospital Charge Code |
199147
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$116.36 |
| Max. Negotiated Rate |
$82,759.68 |
| Rate for Payer: Aetna American Axle |
$59,770.88
|
| Rate for Payer: Aetna Commercial |
$78,161.92
|
| Rate for Payer: Aetna Medicare |
$225.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59,770.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.36
|
| Rate for Payer: BCBS Complete |
$122.18
|
| Rate for Payer: BCBS MAPPO |
$217.09
|
| Rate for Payer: BCN Medicare Advantage |
$217.09
|
| Rate for Payer: Cash Price |
$73,564.16
|
| Rate for Payer: Cash Price |
$73,564.16
|
| Rate for Payer: Cofinity Commercial |
$79,081.47
|
| Rate for Payer: Cofinity Commercial |
$64,368.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$64,368.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73,564.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.09
|
| Rate for Payer: Healthscope Commercial |
$82,759.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64,368.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68,966.40
|
| Rate for Payer: Mclaren Medicaid |
$116.36
|
| Rate for Payer: Mclaren Medicare |
$217.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.94
|
| Rate for Payer: Meridian Medicaid |
$122.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78,161.92
|
| Rate for Payer: PACE Medicare |
$206.24
|
| Rate for Payer: PACE SWMI |
$217.09
|
| Rate for Payer: PHP Commercial |
$78,161.92
|
| Rate for Payer: PHP Medicare Advantage |
$217.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59,770.88
|
| Rate for Payer: Priority Health Medicare |
$217.09
|
| Rate for Payer: Priority Health SBD |
$57,931.78
|
| Rate for Payer: Railroad Medicare Medicare |
$217.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$611.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.09
|
| Rate for Payer: UHC Exchange |
$414.88
|
| Rate for Payer: UHC Medicare Advantage |
$217.09
|
| Rate for Payer: UHCCP Medicaid |
$116.36
|
| Rate for Payer: UMR Bronson Commercial |
$34,023.42
|
| Rate for Payer: VA VA |
$217.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68,966.40
|
|
|
TECLISTAMAB-CQYV 10 MG/ML SUBCUTANEOUS SOLUTION
|
Facility
|
IP
|
$6,326.46
|
|
|
Service Code
|
HCPCS J9380
|
| Hospital Charge Code |
201912
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,783.64 |
| Max. Negotiated Rate |
$5,693.81 |
| Rate for Payer: Aetna American Axle |
$4,112.20
|
| Rate for Payer: Aetna Commercial |
$5,377.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,112.20
|
| Rate for Payer: Cash Price |
$5,061.17
|
| Rate for Payer: Cofinity Commercial |
$4,428.52
|
| Rate for Payer: Cofinity Commercial |
$5,440.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,428.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,061.17
|
| Rate for Payer: Healthscope Commercial |
$5,693.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,428.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,744.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,377.49
|
| Rate for Payer: PHP Commercial |
$5,377.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,112.20
|
| Rate for Payer: Priority Health SBD |
$3,985.67
|
| Rate for Payer: UMR Bronson Commercial |
$2,783.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,744.85
|
|
|
TECLISTAMAB-CQYV 10 MG/ML SUBCUTANEOUS SOLUTION
|
Facility
|
OP
|
$6,326.46
|
|
|
Service Code
|
HCPCS J9380
|
| Hospital Charge Code |
201912
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$5,693.81 |
| Rate for Payer: Aetna American Axle |
$4,112.20
|
| Rate for Payer: Aetna Commercial |
$5,377.49
|
| Rate for Payer: Aetna Medicare |
$34.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,112.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.98
|
| Rate for Payer: BCBS Complete |
$18.90
|
| Rate for Payer: BCBS MAPPO |
$33.58
|
| Rate for Payer: BCN Medicare Advantage |
$33.58
|
| Rate for Payer: Cash Price |
$5,061.17
|
| Rate for Payer: Cash Price |
$5,061.17
|
| Rate for Payer: Cofinity Commercial |
$5,440.76
|
| Rate for Payer: Cofinity Commercial |
$4,428.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,428.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,061.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.58
|
| Rate for Payer: Healthscope Commercial |
$5,693.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,428.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,744.85
|
| Rate for Payer: Mclaren Medicaid |
$18.00
|
| Rate for Payer: Mclaren Medicare |
$33.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.26
|
| Rate for Payer: Meridian Medicaid |
$18.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,377.49
|
| Rate for Payer: PACE Medicare |
$31.90
|
| Rate for Payer: PACE SWMI |
$33.58
|
| Rate for Payer: PHP Commercial |
$5,377.49
|
| Rate for Payer: PHP Medicare Advantage |
$33.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,112.20
|
| Rate for Payer: Priority Health Medicare |
$33.58
|
| Rate for Payer: Priority Health SBD |
$3,985.67
|
| Rate for Payer: Railroad Medicare Medicare |
$33.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.58
|
| Rate for Payer: UHC Exchange |
$64.17
|
| Rate for Payer: UHC Medicare Advantage |
$33.58
|
| Rate for Payer: UHCCP Medicaid |
$18.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,340.79
|
| Rate for Payer: VA VA |
$33.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,744.85
|
|
|
TECLISTAMAB-CQYV 90 MG/ML SUBCUTANEOUS SOLUTION
|
Facility
|
OP
|
$31,957.44
|
|
|
Service Code
|
HCPCS J9380
|
| Hospital Charge Code |
201911
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$28,761.70 |
| Rate for Payer: Aetna American Axle |
$20,772.34
|
| Rate for Payer: Aetna Commercial |
$27,163.82
|
| Rate for Payer: Aetna Medicare |
$34.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20,772.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.98
|
| Rate for Payer: BCBS Complete |
$18.90
|
| Rate for Payer: BCBS MAPPO |
$33.58
|
| Rate for Payer: BCN Medicare Advantage |
$33.58
|
| Rate for Payer: Cash Price |
$25,565.95
|
| Rate for Payer: Cash Price |
$25,565.95
|
| Rate for Payer: Cofinity Commercial |
$27,483.40
|
| Rate for Payer: Cofinity Commercial |
$22,370.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$22,370.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,565.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.58
|
| Rate for Payer: Healthscope Commercial |
$28,761.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22,370.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23,968.08
|
| Rate for Payer: Mclaren Medicaid |
$18.00
|
| Rate for Payer: Mclaren Medicare |
$33.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.26
|
| Rate for Payer: Meridian Medicaid |
$18.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,163.82
|
| Rate for Payer: PACE Medicare |
$31.90
|
| Rate for Payer: PACE SWMI |
$33.58
|
| Rate for Payer: PHP Commercial |
$27,163.82
|
| Rate for Payer: PHP Medicare Advantage |
$33.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,772.34
|
| Rate for Payer: Priority Health Medicare |
$33.58
|
| Rate for Payer: Priority Health SBD |
$20,133.19
|
| Rate for Payer: Railroad Medicare Medicare |
$33.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.58
|
| Rate for Payer: UHC Exchange |
$64.17
|
| Rate for Payer: UHC Medicare Advantage |
$33.58
|
| Rate for Payer: UHCCP Medicaid |
$18.00
|
| Rate for Payer: UMR Bronson Commercial |
$11,824.25
|
| Rate for Payer: VA VA |
$33.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23,968.08
|
|
|
TECLISTAMAB-CQYV 90 MG/ML SUBCUTANEOUS SOLUTION
|
Facility
|
IP
|
$31,957.44
|
|
|
Service Code
|
HCPCS J9380
|
| Hospital Charge Code |
201911
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14,061.27 |
| Max. Negotiated Rate |
$28,761.70 |
| Rate for Payer: Aetna American Axle |
$20,772.34
|
| Rate for Payer: Aetna Commercial |
$27,163.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20,772.34
|
| Rate for Payer: Cash Price |
$25,565.95
|
| Rate for Payer: Cofinity Commercial |
$22,370.21
|
| Rate for Payer: Cofinity Commercial |
$27,483.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$22,370.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,565.95
|
| Rate for Payer: Healthscope Commercial |
$28,761.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22,370.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23,968.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,163.82
|
| Rate for Payer: PHP Commercial |
$27,163.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,772.34
|
| Rate for Payer: Priority Health SBD |
$20,133.19
|
| Rate for Payer: UMR Bronson Commercial |
$14,061.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23,968.08
|
|
|
TEMAZEPAM 15 MG CAPSULE
|
Facility
|
IP
|
$1.49
|
|
|
Service Code
|
NDC 51079041801
|
| Hospital Charge Code |
7753
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.66 |
| Max. Negotiated Rate |
$1.34 |
| Rate for Payer: Aetna American Axle |
$0.97
|
| Rate for Payer: Aetna Commercial |
$1.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.97
|
| Rate for Payer: Cash Price |
$1.19
|
| Rate for Payer: Cofinity Commercial |
$1.04
|
| Rate for Payer: Cofinity Commercial |
$1.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.19
|
| Rate for Payer: Healthscope Commercial |
$1.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.27
|
| Rate for Payer: PHP Commercial |
$1.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.97
|
| Rate for Payer: Priority Health SBD |
$0.94
|
| Rate for Payer: UMR Bronson Commercial |
$0.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.12
|
|
|
TEMAZEPAM 15 MG CAPSULE
|
Facility
|
OP
|
$152.25
|
|
|
Service Code
|
NDC 00378401001
|
| Hospital Charge Code |
7753
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$56.33 |
| Max. Negotiated Rate |
$137.03 |
| Rate for Payer: Aetna American Axle |
$98.96
|
| Rate for Payer: Aetna Commercial |
$129.41
|
| Rate for Payer: Aetna Medicare |
$76.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.96
|
| Rate for Payer: BCBS Complete |
$60.90
|
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cofinity Commercial |
$106.58
|
| Rate for Payer: Cofinity Commercial |
$130.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$106.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.80
|
| Rate for Payer: Healthscope Commercial |
$137.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.41
|
| Rate for Payer: PHP Commercial |
$129.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.96
|
| Rate for Payer: Priority Health SBD |
$95.92
|
| Rate for Payer: UMR Bronson Commercial |
$56.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.19
|
|
|
TEMAZEPAM 15 MG CAPSULE
|
Facility
|
OP
|
$1.49
|
|
|
Service Code
|
NDC 51079041801
|
| Hospital Charge Code |
7753
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$1.34 |
| Rate for Payer: Aetna American Axle |
$0.97
|
| Rate for Payer: Aetna Commercial |
$1.27
|
| Rate for Payer: Aetna Medicare |
$0.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.97
|
| Rate for Payer: BCBS Complete |
$0.60
|
| Rate for Payer: Cash Price |
$1.19
|
| Rate for Payer: Cofinity Commercial |
$1.04
|
| Rate for Payer: Cofinity Commercial |
$1.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.19
|
| Rate for Payer: Healthscope Commercial |
$1.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.27
|
| Rate for Payer: PHP Commercial |
$1.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.97
|
| Rate for Payer: Priority Health SBD |
$0.94
|
| Rate for Payer: UMR Bronson Commercial |
$0.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.12
|
|
|
TEMAZEPAM 15 MG CAPSULE
|
Facility
|
IP
|
$152.25
|
|
|
Service Code
|
NDC 00378401001
|
| Hospital Charge Code |
7753
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$66.99 |
| Max. Negotiated Rate |
$137.03 |
| Rate for Payer: Aetna American Axle |
$98.96
|
| Rate for Payer: Aetna Commercial |
$129.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.96
|
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cofinity Commercial |
$106.58
|
| Rate for Payer: Cofinity Commercial |
$130.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$106.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.80
|
| Rate for Payer: Healthscope Commercial |
$137.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.41
|
| Rate for Payer: PHP Commercial |
$129.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.96
|
| Rate for Payer: Priority Health SBD |
$95.92
|
| Rate for Payer: UMR Bronson Commercial |
$66.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.19
|
|
|
TEMAZEPAM 15 MG CAPSULE
|
Facility
|
IP
|
$148.75
|
|
|
Service Code
|
NDC 51079041820
|
| Hospital Charge Code |
7753
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$65.45 |
| Max. Negotiated Rate |
$133.88 |
| Rate for Payer: Aetna American Axle |
$96.69
|
| Rate for Payer: Aetna Commercial |
$126.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.69
|
| Rate for Payer: Cash Price |
$119.00
|
| Rate for Payer: Cofinity Commercial |
$104.12
|
| Rate for Payer: Cofinity Commercial |
$127.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$104.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.00
|
| Rate for Payer: Healthscope Commercial |
$133.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.44
|
| Rate for Payer: PHP Commercial |
$126.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.69
|
| Rate for Payer: Priority Health SBD |
$93.71
|
| Rate for Payer: UMR Bronson Commercial |
$65.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.56
|
|
|
TEMAZEPAM 15 MG CAPSULE
|
Facility
|
OP
|
$148.75
|
|
|
Service Code
|
NDC 51079041820
|
| Hospital Charge Code |
7753
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$55.04 |
| Max. Negotiated Rate |
$133.88 |
| Rate for Payer: Aetna American Axle |
$96.69
|
| Rate for Payer: Aetna Commercial |
$126.44
|
| Rate for Payer: Aetna Medicare |
$74.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.69
|
| Rate for Payer: BCBS Complete |
$59.50
|
| Rate for Payer: Cash Price |
$119.00
|
| Rate for Payer: Cofinity Commercial |
$104.12
|
| Rate for Payer: Cofinity Commercial |
$127.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$104.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.00
|
| Rate for Payer: Healthscope Commercial |
$133.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.44
|
| Rate for Payer: PHP Commercial |
$126.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.69
|
| Rate for Payer: Priority Health SBD |
$93.71
|
| Rate for Payer: UMR Bronson Commercial |
$55.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.56
|
|
|
TEMAZEPAM 15 MG CAPSULE
|
Facility
|
IP
|
$136.50
|
|
|
Service Code
|
NDC 00228207610
|
| Hospital Charge Code |
7753
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$60.06 |
| Max. Negotiated Rate |
$122.85 |
| Rate for Payer: Aetna American Axle |
$88.72
|
| Rate for Payer: Aetna Commercial |
$116.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.72
|
| Rate for Payer: Cash Price |
$109.20
|
| Rate for Payer: Cofinity Commercial |
$117.39
|
| Rate for Payer: Cofinity Commercial |
$95.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$95.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.20
|
| Rate for Payer: Healthscope Commercial |
$122.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.03
|
| Rate for Payer: PHP Commercial |
$116.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.72
|
| Rate for Payer: Priority Health SBD |
$86.00
|
| Rate for Payer: UMR Bronson Commercial |
$60.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.38
|
|
|
TEMAZEPAM 15 MG CAPSULE
|
Facility
|
OP
|
$136.50
|
|
|
Service Code
|
NDC 00228207610
|
| Hospital Charge Code |
7753
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$50.51 |
| Max. Negotiated Rate |
$122.85 |
| Rate for Payer: Aetna American Axle |
$88.72
|
| Rate for Payer: Aetna Commercial |
$116.03
|
| Rate for Payer: Aetna Medicare |
$68.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.72
|
| Rate for Payer: BCBS Complete |
$54.60
|
| Rate for Payer: Cash Price |
$109.20
|
| Rate for Payer: Cofinity Commercial |
$117.39
|
| Rate for Payer: Cofinity Commercial |
$95.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$95.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.20
|
| Rate for Payer: Healthscope Commercial |
$122.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.03
|
| Rate for Payer: PHP Commercial |
$116.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.72
|
| Rate for Payer: Priority Health SBD |
$86.00
|
| Rate for Payer: UMR Bronson Commercial |
$50.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.38
|
|
|
TEMAZEPAM 7.5 MG CAPSULE
|
Facility
|
OP
|
$9,078.96
|
|
|
Service Code
|
NDC 00406991501
|
| Hospital Charge Code |
11500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3,359.22 |
| Max. Negotiated Rate |
$8,171.06 |
| Rate for Payer: Aetna American Axle |
$5,901.32
|
| Rate for Payer: Aetna Commercial |
$7,717.12
|
| Rate for Payer: Aetna Medicare |
$4,539.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,901.32
|
| Rate for Payer: BCBS Complete |
$3,631.58
|
| Rate for Payer: Cash Price |
$7,263.17
|
| Rate for Payer: Cofinity Commercial |
$6,355.27
|
| Rate for Payer: Cofinity Commercial |
$7,807.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,355.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,263.17
|
| Rate for Payer: Healthscope Commercial |
$8,171.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,355.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,809.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,717.12
|
| Rate for Payer: PHP Commercial |
$7,717.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,901.32
|
| Rate for Payer: Priority Health SBD |
$5,719.74
|
| Rate for Payer: UMR Bronson Commercial |
$3,359.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,809.22
|
|
|
TEMAZEPAM 7.5 MG CAPSULE
|
Facility
|
IP
|
$308.18
|
|
|
Service Code
|
NDC 00904643604
|
| Hospital Charge Code |
11500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$135.60 |
| Max. Negotiated Rate |
$277.36 |
| Rate for Payer: Aetna American Axle |
$200.32
|
| Rate for Payer: Aetna Commercial |
$261.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.32
|
| Rate for Payer: Cash Price |
$246.54
|
| Rate for Payer: Cofinity Commercial |
$215.73
|
| Rate for Payer: Cofinity Commercial |
$265.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$215.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$246.54
|
| Rate for Payer: Healthscope Commercial |
$277.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$215.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.95
|
| Rate for Payer: PHP Commercial |
$261.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.32
|
| Rate for Payer: Priority Health SBD |
$194.15
|
| Rate for Payer: UMR Bronson Commercial |
$135.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.13
|
|
|
TEMAZEPAM 7.5 MG CAPSULE
|
Facility
|
IP
|
$964.86
|
|
|
Service Code
|
NDC 00406996001
|
| Hospital Charge Code |
11500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$424.54 |
| Max. Negotiated Rate |
$868.37 |
| Rate for Payer: Aetna American Axle |
$627.16
|
| Rate for Payer: Aetna Commercial |
$820.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$627.16
|
| Rate for Payer: Cash Price |
$771.89
|
| Rate for Payer: Cofinity Commercial |
$675.40
|
| Rate for Payer: Cofinity Commercial |
$829.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$675.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.89
|
| Rate for Payer: Healthscope Commercial |
$868.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$675.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$723.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$820.13
|
| Rate for Payer: PHP Commercial |
$820.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$627.16
|
| Rate for Payer: Priority Health SBD |
$607.86
|
| Rate for Payer: UMR Bronson Commercial |
$424.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$723.64
|
|
|
TEMAZEPAM 7.5 MG CAPSULE
|
Facility
|
OP
|
$2,127.84
|
|
|
Service Code
|
NDC 00378311001
|
| Hospital Charge Code |
11500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$787.30 |
| Max. Negotiated Rate |
$1,915.06 |
| Rate for Payer: Aetna American Axle |
$1,383.10
|
| Rate for Payer: Aetna Commercial |
$1,808.66
|
| Rate for Payer: Aetna Medicare |
$1,063.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,383.10
|
| Rate for Payer: BCBS Complete |
$851.14
|
| Rate for Payer: Cash Price |
$1,702.27
|
| Rate for Payer: Cofinity Commercial |
$1,489.49
|
| Rate for Payer: Cofinity Commercial |
$1,829.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,489.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,702.27
|
| Rate for Payer: Healthscope Commercial |
$1,915.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,489.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,595.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,808.66
|
| Rate for Payer: PHP Commercial |
$1,808.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,383.10
|
| Rate for Payer: Priority Health SBD |
$1,340.54
|
| Rate for Payer: UMR Bronson Commercial |
$787.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,595.88
|
|
|
TEMAZEPAM 7.5 MG CAPSULE
|
Facility
|
IP
|
$9,078.96
|
|
|
Service Code
|
NDC 00406991501
|
| Hospital Charge Code |
11500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3,994.74 |
| Max. Negotiated Rate |
$8,171.06 |
| Rate for Payer: Aetna American Axle |
$5,901.32
|
| Rate for Payer: Aetna Commercial |
$7,717.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,901.32
|
| Rate for Payer: Cash Price |
$7,263.17
|
| Rate for Payer: Cofinity Commercial |
$6,355.27
|
| Rate for Payer: Cofinity Commercial |
$7,807.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,355.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,263.17
|
| Rate for Payer: Healthscope Commercial |
$8,171.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,355.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,809.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,717.12
|
| Rate for Payer: PHP Commercial |
$7,717.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,901.32
|
| Rate for Payer: Priority Health SBD |
$5,719.74
|
| Rate for Payer: UMR Bronson Commercial |
$3,994.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,809.22
|
|
|
TEMAZEPAM 7.5 MG CAPSULE
|
Facility
|
OP
|
$308.18
|
|
|
Service Code
|
NDC 00904643604
|
| Hospital Charge Code |
11500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$114.03 |
| Max. Negotiated Rate |
$277.36 |
| Rate for Payer: Aetna American Axle |
$200.32
|
| Rate for Payer: Aetna Commercial |
$261.95
|
| Rate for Payer: Aetna Medicare |
$154.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.32
|
| Rate for Payer: BCBS Complete |
$123.27
|
| Rate for Payer: Cash Price |
$246.54
|
| Rate for Payer: Cofinity Commercial |
$215.73
|
| Rate for Payer: Cofinity Commercial |
$265.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$215.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$246.54
|
| Rate for Payer: Healthscope Commercial |
$277.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$215.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.95
|
| Rate for Payer: PHP Commercial |
$261.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.32
|
| Rate for Payer: Priority Health SBD |
$194.15
|
| Rate for Payer: UMR Bronson Commercial |
$114.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.13
|
|
|
TEMAZEPAM 7.5 MG CAPSULE
|
Facility
|
IP
|
$2,127.84
|
|
|
Service Code
|
NDC 00378311001
|
| Hospital Charge Code |
11500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$936.25 |
| Max. Negotiated Rate |
$1,915.06 |
| Rate for Payer: Aetna American Axle |
$1,383.10
|
| Rate for Payer: Aetna Commercial |
$1,808.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,383.10
|
| Rate for Payer: Cash Price |
$1,702.27
|
| Rate for Payer: Cofinity Commercial |
$1,489.49
|
| Rate for Payer: Cofinity Commercial |
$1,829.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,489.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,702.27
|
| Rate for Payer: Healthscope Commercial |
$1,915.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,489.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,595.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,808.66
|
| Rate for Payer: PHP Commercial |
$1,808.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,383.10
|
| Rate for Payer: Priority Health SBD |
$1,340.54
|
| Rate for Payer: UMR Bronson Commercial |
$936.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,595.88
|
|
|
TEMAZEPAM 7.5 MG CAPSULE
|
Facility
|
OP
|
$964.86
|
|
|
Service Code
|
NDC 00406996001
|
| Hospital Charge Code |
11500
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$357.00 |
| Max. Negotiated Rate |
$868.37 |
| Rate for Payer: Aetna American Axle |
$627.16
|
| Rate for Payer: Aetna Commercial |
$820.13
|
| Rate for Payer: Aetna Medicare |
$482.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$627.16
|
| Rate for Payer: BCBS Complete |
$385.94
|
| Rate for Payer: Cash Price |
$771.89
|
| Rate for Payer: Cofinity Commercial |
$675.40
|
| Rate for Payer: Cofinity Commercial |
$829.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$675.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.89
|
| Rate for Payer: Healthscope Commercial |
$868.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$675.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$723.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$820.13
|
| Rate for Payer: PHP Commercial |
$820.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$627.16
|
| Rate for Payer: Priority Health SBD |
$607.86
|
| Rate for Payer: UMR Bronson Commercial |
$357.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$723.64
|
|
|
TEMOZOLOMIDE 100 MG CAPSULE
|
Facility
|
OP
|
$220.89
|
|
|
Service Code
|
HCPCS J8700
|
| Hospital Charge Code |
25894
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$81.73 |
| Max. Negotiated Rate |
$198.80 |
| Rate for Payer: Aetna American Axle |
$143.58
|
| Rate for Payer: Aetna American Axle |
$193.91
|
| Rate for Payer: Aetna Commercial |
$187.76
|
| Rate for Payer: Aetna Commercial |
$253.57
|
| Rate for Payer: Aetna Medicare |
$110.44
|
| Rate for Payer: Aetna Medicare |
$149.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.91
|
| Rate for Payer: BCBS Complete |
$119.33
|
| Rate for Payer: BCBS Complete |
$88.36
|
| Rate for Payer: Cash Price |
$176.71
|
| Rate for Payer: Cash Price |
$238.66
|
| Rate for Payer: Cofinity Commercial |
$189.97
|
| Rate for Payer: Cofinity Commercial |
$154.62
|
| Rate for Payer: Cofinity Commercial |
$208.82
|
| Rate for Payer: Cofinity Commercial |
$256.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$208.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$154.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.66
|
| Rate for Payer: Healthscope Commercial |
$268.49
|
| Rate for Payer: Healthscope Commercial |
$198.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.57
|
| Rate for Payer: PHP Commercial |
$253.57
|
| Rate for Payer: PHP Commercial |
$187.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.91
|
| Rate for Payer: Priority Health SBD |
$187.94
|
| Rate for Payer: Priority Health SBD |
$139.16
|
| Rate for Payer: UMR Bronson Commercial |
$81.73
|
| Rate for Payer: UMR Bronson Commercial |
$110.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.67
|
|
|
TEMOZOLOMIDE 100 MG CAPSULE
|
Facility
|
IP
|
$298.32
|
|
|
Service Code
|
HCPCS J8700
|
| Hospital Charge Code |
25894
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$131.26 |
| Max. Negotiated Rate |
$268.49 |
| Rate for Payer: Aetna American Axle |
$193.91
|
| Rate for Payer: Aetna American Axle |
$143.58
|
| Rate for Payer: Aetna Commercial |
$187.76
|
| Rate for Payer: Aetna Commercial |
$253.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.91
|
| Rate for Payer: Cash Price |
$176.71
|
| Rate for Payer: Cash Price |
$238.66
|
| Rate for Payer: Cofinity Commercial |
$256.56
|
| Rate for Payer: Cofinity Commercial |
$208.82
|
| Rate for Payer: Cofinity Commercial |
$189.97
|
| Rate for Payer: Cofinity Commercial |
$154.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$208.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$154.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.66
|
| Rate for Payer: Healthscope Commercial |
$198.80
|
| Rate for Payer: Healthscope Commercial |
$268.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.57
|
| Rate for Payer: PHP Commercial |
$253.57
|
| Rate for Payer: PHP Commercial |
$187.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.91
|
| Rate for Payer: Priority Health SBD |
$187.94
|
| Rate for Payer: Priority Health SBD |
$139.16
|
| Rate for Payer: UMR Bronson Commercial |
$97.19
|
| Rate for Payer: UMR Bronson Commercial |
$131.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.74
|
|
