|
URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION
|
Facility
|
IP
|
$13,202.74
|
|
|
Service Code
|
APR-DRG 4654
|
| Min. Negotiated Rate |
$12,574.04 |
| Max. Negotiated Rate |
$13,202.74 |
| Rate for Payer: BCBS Complete |
$13,202.74
|
| Rate for Payer: Mclaren Medicaid |
$12,574.04
|
| Rate for Payer: Meridian Medicaid |
$13,202.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,574.04
|
| Rate for Payer: UHC Medicaid |
$12,574.04
|
| Rate for Payer: UHCCP Medicaid |
$12,574.04
|
|
|
URINARY STONES WITH MCC
|
Facility
|
IP
|
$21,915.35
|
|
|
Service Code
|
MSDRG 693
|
| Min. Negotiated Rate |
$11,244.79 |
| Max. Negotiated Rate |
$21,915.35 |
| Rate for Payer: Aetna Medicare |
$12,310.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,795.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,795.77
|
| Rate for Payer: BCBS MAPPO |
$11,836.62
|
| Rate for Payer: BCBS Trust/PPO |
$17,843.15
|
| Rate for Payer: BCN Commercial |
$17,843.15
|
| Rate for Payer: BCN Medicare Advantage |
$11,836.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,836.62
|
| Rate for Payer: Mclaren Medicare |
$11,836.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,428.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,612.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,020.28
|
| Rate for Payer: Nomi Health Commercial |
$17,344.05
|
| Rate for Payer: PACE Medicare |
$11,244.79
|
| Rate for Payer: PACE SWMI |
$11,836.62
|
| Rate for Payer: PHP Medicare Advantage |
$11,836.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21,676.22
|
| Rate for Payer: Priority Health Medicare |
$11,836.62
|
| Rate for Payer: Priority Health Tiered Network |
$17,340.97
|
| Rate for Payer: Railroad Medicare Medicare |
$11,836.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21,915.35
|
| Rate for Payer: UHC Core |
$18,334.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,836.62
|
| Rate for Payer: UHC Exchange |
$14,973.70
|
| Rate for Payer: VA VA |
$11,836.62
|
|
|
URINARY STONES WITHOUT MCC
|
Facility
|
IP
|
$13,881.97
|
|
|
Service Code
|
MSDRG 694
|
| Min. Negotiated Rate |
$6,773.60 |
| Max. Negotiated Rate |
$13,881.97 |
| Rate for Payer: Aetna Medicare |
$7,415.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,912.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,912.62
|
| Rate for Payer: BCBS MAPPO |
$7,130.10
|
| Rate for Payer: BCBS Trust/PPO |
$13,881.97
|
| Rate for Payer: BCN Commercial |
$13,881.97
|
| Rate for Payer: BCN Medicare Advantage |
$7,130.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,130.10
|
| Rate for Payer: Mclaren Medicare |
$7,130.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,486.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,199.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,843.11
|
| Rate for Payer: Nomi Health Commercial |
$10,083.93
|
| Rate for Payer: PACE Medicare |
$6,773.60
|
| Rate for Payer: PACE SWMI |
$7,130.10
|
| Rate for Payer: PHP Medicare Advantage |
$7,130.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,602.68
|
| Rate for Payer: Priority Health Medicare |
$7,130.10
|
| Rate for Payer: Priority Health Tiered Network |
$10,082.14
|
| Rate for Payer: Railroad Medicare Medicare |
$7,130.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,741.71
|
| Rate for Payer: UHC Core |
$10,660.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,130.10
|
| Rate for Payer: UHC Exchange |
$8,705.79
|
| Rate for Payer: VA VA |
$7,130.10
|
|
|
URSODIOL 250 MG TABLET
|
Facility
|
OP
|
$632.64
|
|
|
Service Code
|
NDC 70710112701
|
| Hospital Charge Code |
22660
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$234.08 |
| Max. Negotiated Rate |
$569.38 |
| Rate for Payer: Aetna American Axle |
$411.22
|
| Rate for Payer: Aetna Commercial |
$537.74
|
| Rate for Payer: Aetna Medicare |
$316.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$411.22
|
| Rate for Payer: BCBS Complete |
$253.06
|
| Rate for Payer: Cash Price |
$506.11
|
| Rate for Payer: Cofinity Advantage |
$442.85
|
| Rate for Payer: Cofinity Commercial |
$544.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$506.11
|
| Rate for Payer: Healthscope Commercial |
$569.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$442.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$474.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$506.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$537.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$474.48
|
| Rate for Payer: PHP Commercial |
$537.74
|
| Rate for Payer: Priority Health SBD |
$398.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$411.22
|
| Rate for Payer: UHC Core |
$329.61
|
| Rate for Payer: UHC Exchange |
$248.63
|
| Rate for Payer: UMR Bronson Commercial |
$234.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$474.48
|
|
|
URSODIOL 250 MG TABLET
|
Facility
|
OP
|
$474.05
|
|
|
Service Code
|
NDC 64380091806
|
| Hospital Charge Code |
22660
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$175.40 |
| Max. Negotiated Rate |
$426.64 |
| Rate for Payer: Aetna American Axle |
$308.13
|
| Rate for Payer: Aetna Commercial |
$402.94
|
| Rate for Payer: Aetna Medicare |
$237.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$308.13
|
| Rate for Payer: BCBS Complete |
$189.62
|
| Rate for Payer: Cash Price |
$379.24
|
| Rate for Payer: Cofinity Advantage |
$331.83
|
| Rate for Payer: Cofinity Commercial |
$407.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$379.24
|
| Rate for Payer: Healthscope Commercial |
$426.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$331.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$355.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$379.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$355.54
|
| Rate for Payer: PHP Commercial |
$402.94
|
| Rate for Payer: Priority Health SBD |
$298.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.13
|
| Rate for Payer: UHC Core |
$246.98
|
| Rate for Payer: UHC Exchange |
$186.30
|
| Rate for Payer: UMR Bronson Commercial |
$175.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$355.54
|
|
|
URSODIOL 250 MG TABLET
|
Facility
|
IP
|
$632.64
|
|
|
Service Code
|
NDC 49884041201
|
| Hospital Charge Code |
22660
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$278.36 |
| Max. Negotiated Rate |
$569.38 |
| Rate for Payer: Aetna American Axle |
$411.22
|
| Rate for Payer: Aetna Commercial |
$537.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$411.22
|
| Rate for Payer: Cash Price |
$506.11
|
| Rate for Payer: Cofinity Advantage |
$442.85
|
| Rate for Payer: Cofinity Commercial |
$544.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$506.11
|
| Rate for Payer: Healthscope Commercial |
$569.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$442.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$474.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$537.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$474.48
|
| Rate for Payer: PHP Commercial |
$537.74
|
| Rate for Payer: Priority Health SBD |
$398.56
|
| Rate for Payer: UMR Bronson Commercial |
$278.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$474.48
|
|
|
URSODIOL 250 MG TABLET
|
Facility
|
IP
|
$474.05
|
|
|
Service Code
|
NDC 64380091806
|
| Hospital Charge Code |
22660
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$208.58 |
| Max. Negotiated Rate |
$426.64 |
| Rate for Payer: Aetna American Axle |
$308.13
|
| Rate for Payer: Aetna Commercial |
$402.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$308.13
|
| Rate for Payer: Cash Price |
$379.24
|
| Rate for Payer: Cofinity Advantage |
$331.83
|
| Rate for Payer: Cofinity Commercial |
$407.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$379.24
|
| Rate for Payer: Healthscope Commercial |
$426.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$331.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$355.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$355.54
|
| Rate for Payer: PHP Commercial |
$402.94
|
| Rate for Payer: Priority Health SBD |
$298.65
|
| Rate for Payer: UMR Bronson Commercial |
$208.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$355.54
|
|
|
URSODIOL 250 MG TABLET
|
Facility
|
IP
|
$632.64
|
|
|
Service Code
|
NDC 70710112701
|
| Hospital Charge Code |
22660
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$278.36 |
| Max. Negotiated Rate |
$569.38 |
| Rate for Payer: Aetna American Axle |
$411.22
|
| Rate for Payer: Aetna Commercial |
$537.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$411.22
|
| Rate for Payer: Cash Price |
$506.11
|
| Rate for Payer: Cofinity Advantage |
$442.85
|
| Rate for Payer: Cofinity Commercial |
$544.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$506.11
|
| Rate for Payer: Healthscope Commercial |
$569.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$442.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$474.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$537.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$474.48
|
| Rate for Payer: PHP Commercial |
$537.74
|
| Rate for Payer: Priority Health SBD |
$398.56
|
| Rate for Payer: UMR Bronson Commercial |
$278.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$474.48
|
|
|
URSODIOL 250 MG TABLET
|
Facility
|
IP
|
$754.43
|
|
|
Service Code
|
NDC 00591299801
|
| Hospital Charge Code |
22660
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$331.95 |
| Max. Negotiated Rate |
$678.99 |
| Rate for Payer: Aetna American Axle |
$490.38
|
| Rate for Payer: Aetna Commercial |
$641.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$490.38
|
| Rate for Payer: Cash Price |
$603.54
|
| Rate for Payer: Cofinity Advantage |
$528.10
|
| Rate for Payer: Cofinity Commercial |
$648.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$603.54
|
| Rate for Payer: Healthscope Commercial |
$678.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$528.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$565.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$641.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$565.82
|
| Rate for Payer: PHP Commercial |
$641.27
|
| Rate for Payer: Priority Health SBD |
$475.29
|
| Rate for Payer: UMR Bronson Commercial |
$331.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$565.82
|
|
|
URSODIOL 250 MG TABLET
|
Facility
|
OP
|
$754.43
|
|
|
Service Code
|
NDC 00591299801
|
| Hospital Charge Code |
22660
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$279.14 |
| Max. Negotiated Rate |
$678.99 |
| Rate for Payer: Aetna American Axle |
$490.38
|
| Rate for Payer: Aetna Commercial |
$641.27
|
| Rate for Payer: Aetna Medicare |
$377.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$490.38
|
| Rate for Payer: BCBS Complete |
$301.77
|
| Rate for Payer: Cash Price |
$603.54
|
| Rate for Payer: Cofinity Advantage |
$528.10
|
| Rate for Payer: Cofinity Commercial |
$648.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$603.54
|
| Rate for Payer: Healthscope Commercial |
$678.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$528.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$565.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$603.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$641.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$565.82
|
| Rate for Payer: PHP Commercial |
$641.27
|
| Rate for Payer: Priority Health SBD |
$475.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$490.38
|
| Rate for Payer: UHC Core |
$393.06
|
| Rate for Payer: UHC Exchange |
$296.49
|
| Rate for Payer: UMR Bronson Commercial |
$279.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$565.82
|
|
|
URSODIOL 250 MG TABLET
|
Facility
|
OP
|
$632.64
|
|
|
Service Code
|
NDC 49884041201
|
| Hospital Charge Code |
22660
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$234.08 |
| Max. Negotiated Rate |
$569.38 |
| Rate for Payer: Aetna American Axle |
$411.22
|
| Rate for Payer: Aetna Commercial |
$537.74
|
| Rate for Payer: Aetna Medicare |
$316.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$411.22
|
| Rate for Payer: BCBS Complete |
$253.06
|
| Rate for Payer: Cash Price |
$506.11
|
| Rate for Payer: Cofinity Advantage |
$442.85
|
| Rate for Payer: Cofinity Commercial |
$544.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$506.11
|
| Rate for Payer: Healthscope Commercial |
$569.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$442.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$474.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$506.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$537.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$474.48
|
| Rate for Payer: PHP Commercial |
$537.74
|
| Rate for Payer: Priority Health SBD |
$398.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$411.22
|
| Rate for Payer: UHC Core |
$329.61
|
| Rate for Payer: UHC Exchange |
$248.63
|
| Rate for Payer: UMR Bronson Commercial |
$234.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$474.48
|
|
|
URSODIOL 300 MG CAPSULE
|
Facility
|
IP
|
$558.24
|
|
|
Service Code
|
NDC 00527132601
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$245.63 |
| Max. Negotiated Rate |
$502.42 |
| Rate for Payer: Aetna American Axle |
$362.86
|
| Rate for Payer: Aetna Commercial |
$474.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$362.86
|
| Rate for Payer: Cash Price |
$446.59
|
| Rate for Payer: Cofinity Advantage |
$390.77
|
| Rate for Payer: Cofinity Commercial |
$480.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$446.59
|
| Rate for Payer: Healthscope Commercial |
$502.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$390.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$418.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$474.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$418.68
|
| Rate for Payer: PHP Commercial |
$474.50
|
| Rate for Payer: Priority Health SBD |
$351.69
|
| Rate for Payer: UMR Bronson Commercial |
$245.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$418.68
|
|
|
URSODIOL 300 MG CAPSULE
|
Facility
|
OP
|
$468.96
|
|
|
Service Code
|
NDC 69238154001
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$173.52 |
| Max. Negotiated Rate |
$422.06 |
| Rate for Payer: Aetna American Axle |
$304.82
|
| Rate for Payer: Aetna Commercial |
$398.62
|
| Rate for Payer: Aetna Medicare |
$234.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.82
|
| Rate for Payer: BCBS Complete |
$187.58
|
| Rate for Payer: Cash Price |
$375.17
|
| Rate for Payer: Cofinity Advantage |
$328.27
|
| Rate for Payer: Cofinity Commercial |
$403.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.17
|
| Rate for Payer: Healthscope Commercial |
$422.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$328.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$375.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.72
|
| Rate for Payer: PHP Commercial |
$398.62
|
| Rate for Payer: Priority Health SBD |
$295.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$304.82
|
| Rate for Payer: UHC Core |
$244.33
|
| Rate for Payer: UHC Exchange |
$184.30
|
| Rate for Payer: UMR Bronson Commercial |
$173.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.72
|
|
|
URSODIOL 300 MG CAPSULE
|
Facility
|
IP
|
$468.96
|
|
|
Service Code
|
NDC 69238154001
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$206.34 |
| Max. Negotiated Rate |
$422.06 |
| Rate for Payer: Aetna American Axle |
$304.82
|
| Rate for Payer: Aetna Commercial |
$398.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.82
|
| Rate for Payer: Cash Price |
$375.17
|
| Rate for Payer: Cofinity Advantage |
$328.27
|
| Rate for Payer: Cofinity Commercial |
$403.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.17
|
| Rate for Payer: Healthscope Commercial |
$422.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$328.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.72
|
| Rate for Payer: PHP Commercial |
$398.62
|
| Rate for Payer: Priority Health SBD |
$295.44
|
| Rate for Payer: UMR Bronson Commercial |
$206.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.72
|
|
|
URSODIOL 300 MG CAPSULE
|
Facility
|
OP
|
$558.24
|
|
|
Service Code
|
NDC 00527132601
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$206.55 |
| Max. Negotiated Rate |
$502.42 |
| Rate for Payer: Aetna American Axle |
$362.86
|
| Rate for Payer: Aetna Commercial |
$474.50
|
| Rate for Payer: Aetna Medicare |
$279.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$362.86
|
| Rate for Payer: BCBS Complete |
$223.30
|
| Rate for Payer: Cash Price |
$446.59
|
| Rate for Payer: Cofinity Advantage |
$390.77
|
| Rate for Payer: Cofinity Commercial |
$480.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$446.59
|
| Rate for Payer: Healthscope Commercial |
$502.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$390.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$418.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$446.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$474.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$418.68
|
| Rate for Payer: PHP Commercial |
$474.50
|
| Rate for Payer: Priority Health SBD |
$351.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.86
|
| Rate for Payer: UHC Core |
$290.84
|
| Rate for Payer: UHC Exchange |
$219.39
|
| Rate for Payer: UMR Bronson Commercial |
$206.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$418.68
|
|
|
URSODIOL 300 MG CAPSULE
|
Facility
|
OP
|
$456.00
|
|
|
Service Code
|
NDC 00591315901
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$168.72 |
| Max. Negotiated Rate |
$410.40 |
| Rate for Payer: Aetna American Axle |
$296.40
|
| Rate for Payer: Aetna Commercial |
$387.60
|
| Rate for Payer: Aetna Medicare |
$228.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$296.40
|
| Rate for Payer: BCBS Complete |
$182.40
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cofinity Advantage |
$319.20
|
| Rate for Payer: Cofinity Commercial |
$392.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$364.80
|
| Rate for Payer: Healthscope Commercial |
$410.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$319.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$342.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$364.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$387.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$342.00
|
| Rate for Payer: PHP Commercial |
$387.60
|
| Rate for Payer: Priority Health SBD |
$287.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$296.40
|
| Rate for Payer: UHC Core |
$237.58
|
| Rate for Payer: UHC Exchange |
$179.21
|
| Rate for Payer: UMR Bronson Commercial |
$168.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$342.00
|
|
|
URSODIOL 300 MG CAPSULE
|
Facility
|
IP
|
$456.00
|
|
|
Service Code
|
NDC 00591315901
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$200.64 |
| Max. Negotiated Rate |
$410.40 |
| Rate for Payer: Aetna American Axle |
$296.40
|
| Rate for Payer: Aetna Commercial |
$387.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$296.40
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cofinity Advantage |
$319.20
|
| Rate for Payer: Cofinity Commercial |
$392.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$364.80
|
| Rate for Payer: Healthscope Commercial |
$410.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$319.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$342.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$387.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$342.00
|
| Rate for Payer: PHP Commercial |
$387.60
|
| Rate for Payer: Priority Health SBD |
$287.28
|
| Rate for Payer: UMR Bronson Commercial |
$200.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$342.00
|
|
|
URSODIOL 300 MG CAPSULE
|
Facility
|
OP
|
$402.80
|
|
|
Service Code
|
NDC 42806050301
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$149.04 |
| Max. Negotiated Rate |
$362.52 |
| Rate for Payer: Aetna American Axle |
$261.82
|
| Rate for Payer: Aetna Commercial |
$342.38
|
| Rate for Payer: Aetna Medicare |
$201.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.82
|
| Rate for Payer: BCBS Complete |
$161.12
|
| Rate for Payer: Cash Price |
$322.24
|
| Rate for Payer: Cofinity Advantage |
$281.96
|
| Rate for Payer: Cofinity Commercial |
$346.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.24
|
| Rate for Payer: Healthscope Commercial |
$362.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$281.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$302.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$322.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$342.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$302.10
|
| Rate for Payer: PHP Commercial |
$342.38
|
| Rate for Payer: Priority Health SBD |
$253.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.82
|
| Rate for Payer: UHC Core |
$209.86
|
| Rate for Payer: UHC Exchange |
$158.30
|
| Rate for Payer: UMR Bronson Commercial |
$149.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$302.10
|
|
|
URSODIOL 300 MG CAPSULE
|
Facility
|
IP
|
$402.80
|
|
|
Service Code
|
NDC 42806050301
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$177.23 |
| Max. Negotiated Rate |
$362.52 |
| Rate for Payer: Aetna American Axle |
$261.82
|
| Rate for Payer: Aetna Commercial |
$342.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.82
|
| Rate for Payer: Cash Price |
$322.24
|
| Rate for Payer: Cofinity Advantage |
$281.96
|
| Rate for Payer: Cofinity Commercial |
$346.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.24
|
| Rate for Payer: Healthscope Commercial |
$362.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$281.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$302.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$342.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$302.10
|
| Rate for Payer: PHP Commercial |
$342.38
|
| Rate for Payer: Priority Health SBD |
$253.76
|
| Rate for Payer: UMR Bronson Commercial |
$177.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$302.10
|
|
|
USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$5,508.39
|
|
|
Service Code
|
HCPCS J3358
|
| Hospital Charge Code |
180872
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.08 |
| Max. Negotiated Rate |
$4,957.55 |
| Rate for Payer: Aetna American Axle |
$3,580.45
|
| Rate for Payer: Aetna Commercial |
$4,682.13
|
| Rate for Payer: Aetna Medicare |
$12.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,580.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.53
|
| Rate for Payer: BCBS Complete |
$6.38
|
| Rate for Payer: BCBS MAPPO |
$11.62
|
| Rate for Payer: BCBS Trust/PPO |
$40.48
|
| Rate for Payer: BCN Commercial |
$40.48
|
| Rate for Payer: BCN Medicare Advantage |
$11.62
|
| Rate for Payer: Cash Price |
$4,406.71
|
| Rate for Payer: Cash Price |
$4,406.71
|
| Rate for Payer: Cofinity Advantage |
$3,855.87
|
| Rate for Payer: Cofinity Commercial |
$4,737.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,406.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.62
|
| Rate for Payer: Healthscope Commercial |
$4,957.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,855.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,131.29
|
| Rate for Payer: Mclaren Medicaid |
$11.62
|
| Rate for Payer: Mclaren Medicare |
$11.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.20
|
| Rate for Payer: Meridian Medicaid |
$12.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,682.13
|
| Rate for Payer: Nomi Health Commercial |
$34.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,131.29
|
| Rate for Payer: PACE Medicare |
$11.04
|
| Rate for Payer: PACE SWMI |
$11.62
|
| Rate for Payer: PHP Commercial |
$4,682.13
|
| Rate for Payer: PHP Medicare Advantage |
$11.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$40.97
|
| Rate for Payer: Priority Health Medicare |
$11.62
|
| Rate for Payer: Priority Health SBD |
$3,470.29
|
| Rate for Payer: Priority Health Tiered Network |
$32.78
|
| Rate for Payer: Railroad Medicare Medicare |
$11.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.61
|
| Rate for Payer: UHC Core |
$20.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.62
|
| Rate for Payer: UHC Exchange |
$20.61
|
| Rate for Payer: UHC Medicaid |
$6.08
|
| Rate for Payer: UHCCP Medicaid |
$6.08
|
| Rate for Payer: UMR Bronson Commercial |
$2,038.10
|
| Rate for Payer: VA VA |
$11.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,131.29
|
|
|
USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$5,508.39
|
|
|
Service Code
|
HCPCS J3358
|
| Hospital Charge Code |
180872
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,423.69 |
| Max. Negotiated Rate |
$4,957.55 |
| Rate for Payer: Aetna American Axle |
$3,580.45
|
| Rate for Payer: Aetna Commercial |
$4,682.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,580.45
|
| Rate for Payer: Cash Price |
$4,406.71
|
| Rate for Payer: Cofinity Advantage |
$3,855.87
|
| Rate for Payer: Cofinity Commercial |
$4,737.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,406.71
|
| Rate for Payer: Healthscope Commercial |
$4,957.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,855.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,131.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,682.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,131.29
|
| Rate for Payer: PHP Commercial |
$4,682.13
|
| Rate for Payer: Priority Health SBD |
$3,470.29
|
| Rate for Payer: UMR Bronson Commercial |
$2,423.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,131.29
|
|
|
USTEKINUMAB 90 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$77,593.88
|
|
|
Service Code
|
HCPCS J3357
|
| Hospital Charge Code |
119469
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$240.34 |
| Max. Negotiated Rate |
$69,834.49 |
| Rate for Payer: Aetna American Axle |
$50,436.02
|
| Rate for Payer: Aetna Commercial |
$65,954.80
|
| Rate for Payer: Aetna Medicare |
$38,796.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50,436.02
|
| Rate for Payer: BCBS Complete |
$31,037.55
|
| Rate for Payer: Cash Price |
$62,075.10
|
| Rate for Payer: Cash Price |
$62,075.10
|
| Rate for Payer: Cofinity Advantage |
$54,315.72
|
| Rate for Payer: Cofinity Commercial |
$66,730.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62,075.10
|
| Rate for Payer: Healthscope Commercial |
$69,834.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54,315.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58,195.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62,075.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65,954.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58,195.41
|
| Rate for Payer: PHP Commercial |
$65,954.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$300.43
|
| Rate for Payer: Priority Health SBD |
$48,884.14
|
| Rate for Payer: Priority Health Tiered Network |
$240.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$672.72
|
| Rate for Payer: UHC Core |
$672.72
|
| Rate for Payer: UHC Exchange |
$672.72
|
| Rate for Payer: UMR Bronson Commercial |
$28,709.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58,195.41
|
|
|
USTEKINUMAB 90 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$77,593.88
|
|
|
Service Code
|
HCPCS J3357
|
| Hospital Charge Code |
119469
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$34,141.31 |
| Max. Negotiated Rate |
$69,834.49 |
| Rate for Payer: Aetna American Axle |
$50,436.02
|
| Rate for Payer: Aetna Commercial |
$65,954.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50,436.02
|
| Rate for Payer: Cash Price |
$62,075.10
|
| Rate for Payer: Cofinity Advantage |
$54,315.72
|
| Rate for Payer: Cofinity Commercial |
$66,730.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62,075.10
|
| Rate for Payer: Healthscope Commercial |
$69,834.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54,315.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58,195.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65,954.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58,195.41
|
| Rate for Payer: PHP Commercial |
$65,954.80
|
| Rate for Payer: Priority Health SBD |
$48,884.14
|
| Rate for Payer: UMR Bronson Commercial |
$34,141.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58,195.41
|
|
|
USTEKINUMAB-KFCE 130 MG/26 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$1,247.92
|
|
|
Service Code
|
HCPCS Q5100
|
| Hospital Charge Code |
209995
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.75 |
| Max. Negotiated Rate |
$1,123.13 |
| Rate for Payer: Aetna American Axle |
$811.15
|
| Rate for Payer: Aetna Commercial |
$1,060.73
|
| Rate for Payer: Aetna Medicare |
$3.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$811.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.19
|
| Rate for Payer: BCBS Complete |
$1.84
|
| Rate for Payer: BCBS MAPPO |
$3.35
|
| Rate for Payer: BCBS Trust/PPO |
$81.60
|
| Rate for Payer: BCN Commercial |
$81.60
|
| Rate for Payer: BCN Medicare Advantage |
$3.35
|
| Rate for Payer: Cash Price |
$998.34
|
| Rate for Payer: Cash Price |
$998.34
|
| Rate for Payer: Cofinity Advantage |
$873.54
|
| Rate for Payer: Cofinity Commercial |
$1,073.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$998.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.35
|
| Rate for Payer: Healthscope Commercial |
$1,123.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$873.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$935.94
|
| Rate for Payer: Mclaren Medicaid |
$3.35
|
| Rate for Payer: Mclaren Medicare |
$3.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.52
|
| Rate for Payer: Meridian Medicaid |
$3.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,060.73
|
| Rate for Payer: Nomi Health Commercial |
$10.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$935.94
|
| Rate for Payer: PACE Medicare |
$3.18
|
| Rate for Payer: PACE SWMI |
$3.35
|
| Rate for Payer: PHP Commercial |
$1,060.73
|
| Rate for Payer: PHP Medicare Advantage |
$3.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$78.77
|
| Rate for Payer: Priority Health Medicare |
$3.35
|
| Rate for Payer: Priority Health SBD |
$786.19
|
| Rate for Payer: Priority Health Tiered Network |
$63.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.72
|
| Rate for Payer: UHC Core |
$40.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.35
|
| Rate for Payer: UHC Exchange |
$40.72
|
| Rate for Payer: UHC Medicaid |
$1.75
|
| Rate for Payer: UHCCP Medicaid |
$1.75
|
| Rate for Payer: UMR Bronson Commercial |
$461.73
|
| Rate for Payer: VA VA |
$3.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$935.94
|
|
|
USTEKINUMAB-STBA 90 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$10,057.87
|
|
|
Service Code
|
HCPCS Q5099
|
| Hospital Charge Code |
210002
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.68 |
| Max. Negotiated Rate |
$9,052.08 |
| Rate for Payer: Aetna American Axle |
$6,537.62
|
| Rate for Payer: Aetna Commercial |
$8,549.19
|
| Rate for Payer: Aetna Medicare |
$3.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,537.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.01
|
| Rate for Payer: BCBS Complete |
$1.76
|
| Rate for Payer: BCBS MAPPO |
$3.21
|
| Rate for Payer: BCBS Trust/PPO |
$37.49
|
| Rate for Payer: BCN Commercial |
$37.49
|
| Rate for Payer: BCN Medicare Advantage |
$3.21
|
| Rate for Payer: Cash Price |
$8,046.30
|
| Rate for Payer: Cash Price |
$8,046.30
|
| Rate for Payer: Cofinity Advantage |
$7,040.51
|
| Rate for Payer: Cofinity Commercial |
$8,649.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,046.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.21
|
| Rate for Payer: Healthscope Commercial |
$9,052.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,040.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,543.40
|
| Rate for Payer: Mclaren Medicaid |
$3.21
|
| Rate for Payer: Mclaren Medicare |
$3.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.37
|
| Rate for Payer: Meridian Medicaid |
$3.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,549.19
|
| Rate for Payer: Nomi Health Commercial |
$9.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,543.40
|
| Rate for Payer: PACE Medicare |
$3.05
|
| Rate for Payer: PACE SWMI |
$3.21
|
| Rate for Payer: PHP Commercial |
$8,549.19
|
| Rate for Payer: PHP Medicare Advantage |
$3.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.85
|
| Rate for Payer: Priority Health Medicare |
$3.21
|
| Rate for Payer: Priority Health SBD |
$6,336.46
|
| Rate for Payer: Priority Health Tiered Network |
$9.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,537.62
|
| Rate for Payer: UHC Core |
$5,240.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.21
|
| Rate for Payer: UHC Exchange |
$3,952.74
|
| Rate for Payer: UHC Medicaid |
$1.68
|
| Rate for Payer: UHCCP Medicaid |
$1.68
|
| Rate for Payer: UMR Bronson Commercial |
$3,721.41
|
| Rate for Payer: VA VA |
$3.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,543.40
|
|
