|
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$57.10
|
|
|
Service Code
|
HCPCS J3376
|
| Hospital Charge Code |
8444
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$25.12 |
| Max. Negotiated Rate |
$51.39 |
| Rate for Payer: Aetna American Axle |
$37.12
|
| Rate for Payer: Aetna Commercial |
$48.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.12
|
| Rate for Payer: Cash Price |
$45.68
|
| Rate for Payer: Cofinity Advantage |
$39.97
|
| Rate for Payer: Cofinity Commercial |
$49.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.68
|
| Rate for Payer: Healthscope Commercial |
$51.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.83
|
| Rate for Payer: PHP Commercial |
$48.53
|
| Rate for Payer: Priority Health SBD |
$35.97
|
| Rate for Payer: UMR Bronson Commercial |
$25.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.83
|
|
|
VANCOMYCIN 5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$81.53
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
8444
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$73.38 |
| Rate for Payer: Aetna American Axle |
$52.99
|
| Rate for Payer: Aetna American Axle |
$49.26
|
| Rate for Payer: Aetna American Axle |
$24.21
|
| Rate for Payer: Aetna American Axle |
$47.09
|
| Rate for Payer: Aetna American Axle |
$47.53
|
| Rate for Payer: Aetna American Axle |
$170.62
|
| Rate for Payer: Aetna American Axle |
$188.69
|
| Rate for Payer: Aetna American Axle |
$64.21
|
| Rate for Payer: Aetna Commercial |
$31.66
|
| Rate for Payer: Aetna Commercial |
$223.12
|
| Rate for Payer: Aetna Commercial |
$62.15
|
| Rate for Payer: Aetna Commercial |
$61.58
|
| Rate for Payer: Aetna Commercial |
$64.42
|
| Rate for Payer: Aetna Commercial |
$69.30
|
| Rate for Payer: Aetna Commercial |
$83.97
|
| Rate for Payer: Aetna Commercial |
$246.75
|
| Rate for Payer: Aetna Medicare |
$18.62
|
| Rate for Payer: Aetna Medicare |
$145.15
|
| Rate for Payer: Aetna Medicare |
$40.77
|
| Rate for Payer: Aetna Medicare |
$131.25
|
| Rate for Payer: Aetna Medicare |
$36.56
|
| Rate for Payer: Aetna Medicare |
$36.23
|
| Rate for Payer: Aetna Medicare |
$49.40
|
| Rate for Payer: Aetna Medicare |
$37.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.53
|
| Rate for Payer: BCBS Complete |
$39.52
|
| Rate for Payer: BCBS Complete |
$30.32
|
| Rate for Payer: BCBS Complete |
$28.98
|
| Rate for Payer: BCBS Complete |
$105.00
|
| Rate for Payer: BCBS Complete |
$14.90
|
| Rate for Payer: BCBS Complete |
$116.12
|
| Rate for Payer: BCBS Complete |
$32.61
|
| Rate for Payer: BCBS Complete |
$29.25
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: Cash Price |
$232.23
|
| Rate for Payer: Cash Price |
$209.99
|
| Rate for Payer: Cash Price |
$209.99
|
| Rate for Payer: Cash Price |
$29.80
|
| Rate for Payer: Cash Price |
$29.80
|
| Rate for Payer: Cash Price |
$232.23
|
| Rate for Payer: Cash Price |
$57.96
|
| Rate for Payer: Cash Price |
$57.96
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Cash Price |
$58.50
|
| Rate for Payer: Cash Price |
$60.63
|
| Rate for Payer: Cash Price |
$60.63
|
| Rate for Payer: Cash Price |
$65.22
|
| Rate for Payer: Cash Price |
$65.22
|
| Rate for Payer: Cash Price |
$79.03
|
| Rate for Payer: Cash Price |
$79.03
|
| Rate for Payer: Cofinity Advantage |
$53.05
|
| Rate for Payer: Cofinity Advantage |
$69.15
|
| Rate for Payer: Cofinity Advantage |
$26.07
|
| Rate for Payer: Cofinity Advantage |
$51.18
|
| Rate for Payer: Cofinity Advantage |
$57.07
|
| Rate for Payer: Cofinity Advantage |
$50.72
|
| Rate for Payer: Cofinity Advantage |
$183.74
|
| Rate for Payer: Cofinity Advantage |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$62.31
|
| Rate for Payer: Cofinity Commercial |
$65.18
|
| Rate for Payer: Cofinity Commercial |
$84.96
|
| Rate for Payer: Cofinity Commercial |
$225.74
|
| Rate for Payer: Cofinity Commercial |
$249.65
|
| Rate for Payer: Cofinity Commercial |
$32.03
|
| Rate for Payer: Cofinity Commercial |
$70.12
|
| Rate for Payer: Cofinity Commercial |
$62.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.22
|
| Rate for Payer: Healthscope Commercial |
$236.24
|
| Rate for Payer: Healthscope Commercial |
$88.91
|
| Rate for Payer: Healthscope Commercial |
$33.52
|
| Rate for Payer: Healthscope Commercial |
$65.20
|
| Rate for Payer: Healthscope Commercial |
$73.38
|
| Rate for Payer: Healthscope Commercial |
$68.21
|
| Rate for Payer: Healthscope Commercial |
$261.26
|
| Rate for Payer: Healthscope Commercial |
$65.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$183.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$203.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$209.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$232.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.94
|
| Rate for Payer: PHP Commercial |
$223.12
|
| Rate for Payer: PHP Commercial |
$61.58
|
| Rate for Payer: PHP Commercial |
$64.42
|
| Rate for Payer: PHP Commercial |
$31.66
|
| Rate for Payer: PHP Commercial |
$83.97
|
| Rate for Payer: PHP Commercial |
$69.30
|
| Rate for Payer: PHP Commercial |
$62.15
|
| Rate for Payer: PHP Commercial |
$246.75
|
| Rate for Payer: Priority Health SBD |
$182.88
|
| Rate for Payer: Priority Health SBD |
$62.24
|
| Rate for Payer: Priority Health SBD |
$165.37
|
| Rate for Payer: Priority Health SBD |
$47.75
|
| Rate for Payer: Priority Health SBD |
$51.36
|
| Rate for Payer: Priority Health SBD |
$23.47
|
| Rate for Payer: Priority Health SBD |
$45.64
|
| Rate for Payer: Priority Health SBD |
$46.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UMR Bronson Commercial |
$30.17
|
| Rate for Payer: UMR Bronson Commercial |
$36.55
|
| Rate for Payer: UMR Bronson Commercial |
$27.05
|
| Rate for Payer: UMR Bronson Commercial |
$13.78
|
| Rate for Payer: UMR Bronson Commercial |
$28.04
|
| Rate for Payer: UMR Bronson Commercial |
$97.12
|
| Rate for Payer: UMR Bronson Commercial |
$107.41
|
| Rate for Payer: UMR Bronson Commercial |
$26.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.15
|
|
|
VANCOMYCIN 5 MG/ML IV SPECIAL DILUTION
|
Facility
|
OP
|
$10.38
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
154952
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$9.34 |
| Rate for Payer: Aetna American Axle |
$6.75
|
| Rate for Payer: Aetna Commercial |
$8.82
|
| Rate for Payer: Aetna Medicare |
$5.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.75
|
| Rate for Payer: BCBS Complete |
$4.15
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: Cash Price |
$8.30
|
| Rate for Payer: Cash Price |
$8.30
|
| Rate for Payer: Cofinity Advantage |
$7.27
|
| Rate for Payer: Cofinity Commercial |
$8.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.30
|
| Rate for Payer: Healthscope Commercial |
$9.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.79
|
| Rate for Payer: PHP Commercial |
$8.82
|
| Rate for Payer: Priority Health SBD |
$6.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UMR Bronson Commercial |
$3.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.79
|
|
|
VANCOMYCIN 5 MG/ML IV SPECIAL DILUTION
|
Facility
|
IP
|
$10.38
|
|
|
Service Code
|
HCPCS J3373
|
| Hospital Charge Code |
154952
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$9.34 |
| Rate for Payer: Aetna American Axle |
$6.75
|
| Rate for Payer: Aetna Commercial |
$8.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.75
|
| Rate for Payer: Cash Price |
$8.30
|
| Rate for Payer: Cofinity Advantage |
$7.27
|
| Rate for Payer: Cofinity Commercial |
$8.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.30
|
| Rate for Payer: Healthscope Commercial |
$9.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.79
|
| Rate for Payer: PHP Commercial |
$8.82
|
| Rate for Payer: Priority Health SBD |
$6.54
|
| Rate for Payer: UMR Bronson Commercial |
$4.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.79
|
|
|
VANCOMYCIN FORTIFIED 50 MG/ML OPHTHALMIC DROPS
|
Facility
|
IP
|
$29.09
|
|
|
Service Code
|
HCPCS J3370
|
| Hospital Charge Code |
500596
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$26.18 |
| Rate for Payer: Aetna American Axle |
$18.91
|
| Rate for Payer: Aetna Commercial |
$24.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.91
|
| Rate for Payer: Cash Price |
$23.27
|
| Rate for Payer: Cofinity Advantage |
$20.36
|
| Rate for Payer: Cofinity Commercial |
$25.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.27
|
| Rate for Payer: Healthscope Commercial |
$26.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.82
|
| Rate for Payer: PHP Commercial |
$24.73
|
| Rate for Payer: Priority Health SBD |
$18.33
|
| Rate for Payer: UMR Bronson Commercial |
$12.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.82
|
|
|
VANCOMYCIN FORTIFIED 50 MG/ML OPHTHALMIC DROPS
|
Facility
|
OP
|
$29.09
|
|
|
Service Code
|
HCPCS J3370
|
| Hospital Charge Code |
500596
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.76 |
| Max. Negotiated Rate |
$26.18 |
| Rate for Payer: Aetna American Axle |
$18.91
|
| Rate for Payer: Aetna Commercial |
$24.73
|
| Rate for Payer: Aetna Medicare |
$14.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.91
|
| Rate for Payer: BCBS Complete |
$11.64
|
| Rate for Payer: Cash Price |
$23.27
|
| Rate for Payer: Cofinity Advantage |
$20.36
|
| Rate for Payer: Cofinity Commercial |
$25.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.27
|
| Rate for Payer: Healthscope Commercial |
$26.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.82
|
| Rate for Payer: PHP Commercial |
$24.73
|
| Rate for Payer: Priority Health SBD |
$18.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.54
|
| Rate for Payer: UHC Core |
$14.54
|
| Rate for Payer: UHC Exchange |
$14.54
|
| Rate for Payer: UMR Bronson Commercial |
$10.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.82
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
OP
|
$940.69
|
|
|
Service Code
|
NDC 70710161406
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$348.06 |
| Max. Negotiated Rate |
$846.62 |
| Rate for Payer: Aetna American Axle |
$611.45
|
| Rate for Payer: Aetna Commercial |
$799.59
|
| Rate for Payer: Aetna Medicare |
$470.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.45
|
| Rate for Payer: BCBS Complete |
$376.28
|
| Rate for Payer: Cash Price |
$752.55
|
| Rate for Payer: Cofinity Advantage |
$658.48
|
| Rate for Payer: Cofinity Commercial |
$808.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.55
|
| Rate for Payer: Healthscope Commercial |
$846.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$658.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$705.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$752.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$799.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.52
|
| Rate for Payer: PHP Commercial |
$799.59
|
| Rate for Payer: Priority Health SBD |
$592.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$611.45
|
| Rate for Payer: UHC Core |
$490.10
|
| Rate for Payer: UHC Exchange |
$369.69
|
| Rate for Payer: UMR Bronson Commercial |
$348.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$705.52
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
IP
|
$461.80
|
|
|
Service Code
|
NDC 49884015676
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$203.19 |
| Max. Negotiated Rate |
$415.62 |
| Rate for Payer: Aetna American Axle |
$300.17
|
| Rate for Payer: Aetna Commercial |
$392.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.17
|
| Rate for Payer: Cash Price |
$369.44
|
| Rate for Payer: Cofinity Advantage |
$323.26
|
| Rate for Payer: Cofinity Commercial |
$397.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.44
|
| Rate for Payer: Healthscope Commercial |
$415.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$323.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$346.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.35
|
| Rate for Payer: PHP Commercial |
$392.53
|
| Rate for Payer: Priority Health SBD |
$290.93
|
| Rate for Payer: UMR Bronson Commercial |
$203.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$346.35
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
OP
|
$461.80
|
|
|
Service Code
|
NDC 49884015676
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$170.87 |
| Max. Negotiated Rate |
$415.62 |
| Rate for Payer: Aetna American Axle |
$300.17
|
| Rate for Payer: Aetna Commercial |
$392.53
|
| Rate for Payer: Aetna Medicare |
$230.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.17
|
| Rate for Payer: BCBS Complete |
$184.72
|
| Rate for Payer: Cash Price |
$369.44
|
| Rate for Payer: Cofinity Advantage |
$323.26
|
| Rate for Payer: Cofinity Commercial |
$397.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.44
|
| Rate for Payer: Healthscope Commercial |
$415.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$323.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$346.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$369.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.35
|
| Rate for Payer: PHP Commercial |
$392.53
|
| Rate for Payer: Priority Health SBD |
$290.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$300.17
|
| Rate for Payer: UHC Core |
$240.60
|
| Rate for Payer: UHC Exchange |
$181.49
|
| Rate for Payer: UMR Bronson Commercial |
$170.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$346.35
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
IP
|
$423.36
|
|
|
Service Code
|
NDC 71921030956
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$186.28 |
| Max. Negotiated Rate |
$381.02 |
| Rate for Payer: Aetna American Axle |
$275.18
|
| Rate for Payer: Aetna Commercial |
$359.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.18
|
| Rate for Payer: Cash Price |
$338.69
|
| Rate for Payer: Cofinity Advantage |
$296.35
|
| Rate for Payer: Cofinity Commercial |
$364.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.69
|
| Rate for Payer: Healthscope Commercial |
$381.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$296.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$317.52
|
| Rate for Payer: PHP Commercial |
$359.86
|
| Rate for Payer: Priority Health SBD |
$266.72
|
| Rate for Payer: UMR Bronson Commercial |
$186.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.52
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
IP
|
$244.34
|
|
|
Service Code
|
NDC 43598090856
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$107.51 |
| Max. Negotiated Rate |
$219.91 |
| Rate for Payer: Aetna American Axle |
$158.82
|
| Rate for Payer: Aetna Commercial |
$207.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.82
|
| Rate for Payer: Cash Price |
$195.47
|
| Rate for Payer: Cofinity Advantage |
$171.04
|
| Rate for Payer: Cofinity Commercial |
$210.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.47
|
| Rate for Payer: Healthscope Commercial |
$219.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.25
|
| Rate for Payer: PHP Commercial |
$207.69
|
| Rate for Payer: Priority Health SBD |
$153.93
|
| Rate for Payer: UMR Bronson Commercial |
$107.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.25
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
IP
|
$940.69
|
|
|
Service Code
|
NDC 70710161406
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$413.90 |
| Max. Negotiated Rate |
$846.62 |
| Rate for Payer: Aetna American Axle |
$611.45
|
| Rate for Payer: Aetna Commercial |
$799.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.45
|
| Rate for Payer: Cash Price |
$752.55
|
| Rate for Payer: Cofinity Advantage |
$658.48
|
| Rate for Payer: Cofinity Commercial |
$808.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.55
|
| Rate for Payer: Healthscope Commercial |
$846.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$658.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$705.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$799.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.52
|
| Rate for Payer: PHP Commercial |
$799.59
|
| Rate for Payer: Priority Health SBD |
$592.63
|
| Rate for Payer: UMR Bronson Commercial |
$413.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$705.52
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
OP
|
$423.36
|
|
|
Service Code
|
NDC 71921030956
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$156.64 |
| Max. Negotiated Rate |
$381.02 |
| Rate for Payer: Aetna American Axle |
$275.18
|
| Rate for Payer: Aetna Commercial |
$359.86
|
| Rate for Payer: Aetna Medicare |
$211.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.18
|
| Rate for Payer: BCBS Complete |
$169.34
|
| Rate for Payer: Cash Price |
$338.69
|
| Rate for Payer: Cofinity Advantage |
$296.35
|
| Rate for Payer: Cofinity Commercial |
$364.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.69
|
| Rate for Payer: Healthscope Commercial |
$381.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$296.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$338.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$317.52
|
| Rate for Payer: PHP Commercial |
$359.86
|
| Rate for Payer: Priority Health SBD |
$266.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.18
|
| Rate for Payer: UHC Core |
$220.57
|
| Rate for Payer: UHC Exchange |
$166.38
|
| Rate for Payer: UMR Bronson Commercial |
$156.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.52
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
OP
|
$244.34
|
|
|
Service Code
|
NDC 43598090856
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$90.41 |
| Max. Negotiated Rate |
$219.91 |
| Rate for Payer: Aetna American Axle |
$158.82
|
| Rate for Payer: Aetna Commercial |
$207.69
|
| Rate for Payer: Aetna Medicare |
$122.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.82
|
| Rate for Payer: BCBS Complete |
$97.74
|
| Rate for Payer: Cash Price |
$195.47
|
| Rate for Payer: Cofinity Advantage |
$171.04
|
| Rate for Payer: Cofinity Commercial |
$210.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.47
|
| Rate for Payer: Healthscope Commercial |
$219.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.25
|
| Rate for Payer: PHP Commercial |
$207.69
|
| Rate for Payer: Priority Health SBD |
$153.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.82
|
| Rate for Payer: UHC Core |
$127.30
|
| Rate for Payer: UHC Exchange |
$96.03
|
| Rate for Payer: UMR Bronson Commercial |
$90.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.25
|
|
|
VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP
|
Facility
|
IP
|
$648.05
|
|
|
Service Code
|
HCPCS 90716
|
| Hospital Charge Code |
14757
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$285.14 |
| Max. Negotiated Rate |
$583.25 |
| Rate for Payer: Aetna American Axle |
$421.23
|
| Rate for Payer: Aetna Commercial |
$550.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$421.23
|
| Rate for Payer: Cash Price |
$518.44
|
| Rate for Payer: Cofinity Advantage |
$453.63
|
| Rate for Payer: Cofinity Commercial |
$557.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.44
|
| Rate for Payer: Healthscope Commercial |
$583.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$453.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$486.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$486.04
|
| Rate for Payer: PHP Commercial |
$550.84
|
| Rate for Payer: Priority Health SBD |
$408.27
|
| Rate for Payer: UMR Bronson Commercial |
$285.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$486.04
|
|
|
VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP
|
Facility
|
OP
|
$648.05
|
|
|
Service Code
|
HCPCS 90716
|
| Hospital Charge Code |
14757
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$175.10 |
| Max. Negotiated Rate |
$611.44 |
| Rate for Payer: Aetna American Axle |
$421.23
|
| Rate for Payer: Aetna Commercial |
$550.84
|
| Rate for Payer: Aetna Medicare |
$324.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$421.23
|
| Rate for Payer: BCBS Complete |
$259.22
|
| Rate for Payer: BCBS Trust/PPO |
$611.44
|
| Rate for Payer: BCN Commercial |
$611.44
|
| Rate for Payer: Cash Price |
$518.44
|
| Rate for Payer: Cash Price |
$518.44
|
| Rate for Payer: Cofinity Advantage |
$453.63
|
| Rate for Payer: Cofinity Commercial |
$557.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.44
|
| Rate for Payer: Healthscope Commercial |
$583.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$453.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$486.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$518.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$486.04
|
| Rate for Payer: PHP Commercial |
$550.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$218.87
|
| Rate for Payer: Priority Health SBD |
$408.27
|
| Rate for Payer: Priority Health Tiered Network |
$175.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$380.14
|
| Rate for Payer: UHC Core |
$380.14
|
| Rate for Payer: UHC Exchange |
$380.14
|
| Rate for Payer: UMR Bronson Commercial |
$239.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$486.04
|
|
|
VARICELLA-ZOSTER IMMUNE GLOB-MALTOSE 125 UNIT/1.2 ML IM SOLUTION
|
Facility
|
OP
|
$5,674.69
|
|
|
Service Code
|
HCPCS 90396
|
| Hospital Charge Code |
169165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,235.98 |
| Max. Negotiated Rate |
$7,449.12 |
| Rate for Payer: Aetna American Axle |
$3,688.55
|
| Rate for Payer: Aetna Commercial |
$4,823.49
|
| Rate for Payer: Aetna Medicare |
$2,457.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,688.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,954.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,954.06
|
| Rate for Payer: BCBS Complete |
$1,297.90
|
| Rate for Payer: BCBS MAPPO |
$2,363.25
|
| Rate for Payer: BCBS Trust/PPO |
$7,258.75
|
| Rate for Payer: BCN Commercial |
$7,258.75
|
| Rate for Payer: BCN Medicare Advantage |
$2,363.25
|
| Rate for Payer: Cash Price |
$4,539.75
|
| Rate for Payer: Cash Price |
$4,539.75
|
| Rate for Payer: Cofinity Advantage |
$3,972.28
|
| Rate for Payer: Cofinity Commercial |
$4,880.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,539.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,363.25
|
| Rate for Payer: Healthscope Commercial |
$5,107.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,972.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,256.02
|
| Rate for Payer: Mclaren Medicaid |
$2,363.25
|
| Rate for Payer: Mclaren Medicare |
$2,363.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,481.41
|
| Rate for Payer: Meridian Medicaid |
$2,481.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,717.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,599.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,823.49
|
| Rate for Payer: Nomi Health Commercial |
$7,089.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,256.02
|
| Rate for Payer: PACE Medicare |
$2,245.09
|
| Rate for Payer: PACE SWMI |
$2,363.25
|
| Rate for Payer: PHP Commercial |
$4,823.49
|
| Rate for Payer: PHP Medicare Advantage |
$2,363.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,235.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7,449.12
|
| Rate for Payer: Priority Health Medicare |
$2,363.25
|
| Rate for Payer: Priority Health SBD |
$3,575.05
|
| Rate for Payer: Priority Health Tiered Network |
$5,959.30
|
| Rate for Payer: Railroad Medicare Medicare |
$2,363.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,899.59
|
| Rate for Payer: UHC Core |
$3,899.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,363.25
|
| Rate for Payer: UHC Exchange |
$3,899.59
|
| Rate for Payer: UHC Medicaid |
$1,235.98
|
| Rate for Payer: UHCCP Medicaid |
$1,235.98
|
| Rate for Payer: UMR Bronson Commercial |
$2,099.64
|
| Rate for Payer: VA VA |
$2,363.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,256.02
|
|
|
VARICELLA-ZOSTER IMMUNE GLOB-MALTOSE 125 UNIT/1.2 ML IM SOLUTION
|
Facility
|
IP
|
$5,674.69
|
|
|
Service Code
|
HCPCS 90396
|
| Hospital Charge Code |
169165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,496.86 |
| Max. Negotiated Rate |
$5,107.22 |
| Rate for Payer: Aetna American Axle |
$3,688.55
|
| Rate for Payer: Aetna Commercial |
$4,823.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,688.55
|
| Rate for Payer: Cash Price |
$4,539.75
|
| Rate for Payer: Cofinity Advantage |
$3,972.28
|
| Rate for Payer: Cofinity Commercial |
$4,880.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,539.75
|
| Rate for Payer: Healthscope Commercial |
$5,107.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,972.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,256.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,823.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,256.02
|
| Rate for Payer: PHP Commercial |
$4,823.49
|
| Rate for Payer: Priority Health SBD |
$3,575.05
|
| Rate for Payer: UMR Bronson Commercial |
$2,496.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,256.02
|
|
|
VASCULAR EMBOLIZATION OR OCCLUSION, INCLUSIVE OF ALL RADIOLOGICAL SUPERVISION AND INTERPRETATION, INTRAPROCEDURAL ROADMAPPING, AND IMAGING GUIDANCE NECESSARY TO COMPLETE THE INTERVENTION; VENOUS, OTHER THAN HEMORRHAGE (EG, CONGENITAL OR ACQUIRED VENOUS MALFORMATIONS, VENOUS AND CAPILLARY HEMANGIOMAS, VARICES, VARICOCELES)
|
Facility
|
OP
|
$37,198.61
|
|
|
Service Code
|
CPT 37241
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$37,198.61 |
| Rate for Payer: Aetna Medicare |
$11,962.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$14,134.71
|
| Rate for Payer: BCN Commercial |
$14,134.71
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$12,077.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Nomi Health Commercial |
$34,508.04
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,198.61
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health Tiered Network |
$29,758.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: VA VA |
$11,502.68
|
|
|
VASECTOMY, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE), INCLUDING POSTOPERATIVE SEMEN EXAMINATION(S)
|
Facility
|
OP
|
$6,735.82
|
|
|
Service Code
|
CPT 55250
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,654.93
|
| Rate for Payer: BCN Commercial |
$1,654.93
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$2,187.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,735.82
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: VA VA |
$2,082.87
|
|
|
VASOPRESSIN 20 UNIT/ML INJECTION (CODE)
|
Facility
|
IP
|
$42.96
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
163709
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna American Axle |
$27.92
|
| Rate for Payer: Aetna American Axle |
$36.35
|
| Rate for Payer: Aetna Commercial |
$36.52
|
| Rate for Payer: Aetna Commercial |
$47.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.35
|
| Rate for Payer: Cash Price |
$34.37
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Advantage |
$39.15
|
| Rate for Payer: Cofinity Advantage |
$30.07
|
| Rate for Payer: Cofinity Commercial |
$48.10
|
| Rate for Payer: Cofinity Commercial |
$36.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: PHP Commercial |
$36.52
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: Priority Health SBD |
$35.24
|
| Rate for Payer: Priority Health SBD |
$27.06
|
| Rate for Payer: UMR Bronson Commercial |
$18.90
|
| Rate for Payer: UMR Bronson Commercial |
$24.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.95
|
|
|
VASOPRESSIN 20 UNIT/ML INJECTION (CODE)
|
Facility
|
OP
|
$42.96
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
163709
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna American Axle |
$27.92
|
| Rate for Payer: Aetna American Axle |
$36.35
|
| Rate for Payer: Aetna Commercial |
$36.52
|
| Rate for Payer: Aetna Commercial |
$47.54
|
| Rate for Payer: Aetna Medicare |
$21.48
|
| Rate for Payer: Aetna Medicare |
$27.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.35
|
| Rate for Payer: BCBS Complete |
$22.37
|
| Rate for Payer: BCBS Complete |
$17.18
|
| Rate for Payer: BCBS Trust/PPO |
$1.69
|
| Rate for Payer: BCBS Trust/PPO |
$1.69
|
| Rate for Payer: BCN Commercial |
$1.69
|
| Rate for Payer: BCN Commercial |
$1.69
|
| Rate for Payer: Cash Price |
$34.37
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cash Price |
$34.37
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Advantage |
$30.07
|
| Rate for Payer: Cofinity Advantage |
$39.15
|
| Rate for Payer: Cofinity Commercial |
$36.95
|
| Rate for Payer: Cofinity Commercial |
$48.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.22
|
| Rate for Payer: PHP Commercial |
$36.52
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: Priority Health SBD |
$27.06
|
| Rate for Payer: Priority Health SBD |
$35.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UMR Bronson Commercial |
$15.90
|
| Rate for Payer: UMR Bronson Commercial |
$20.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.95
|
|
|
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$42.96
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
173104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna American Axle |
$27.92
|
| Rate for Payer: Aetna American Axle |
$28.79
|
| Rate for Payer: Aetna American Axle |
$30.00
|
| Rate for Payer: Aetna American Axle |
$29.14
|
| Rate for Payer: Aetna American Axle |
$100.66
|
| Rate for Payer: Aetna American Axle |
$79.07
|
| Rate for Payer: Aetna American Axle |
$61.87
|
| Rate for Payer: Aetna American Axle |
$36.35
|
| Rate for Payer: Aetna American Axle |
$30.40
|
| Rate for Payer: Aetna Commercial |
$38.11
|
| Rate for Payer: Aetna Commercial |
$131.63
|
| Rate for Payer: Aetna Commercial |
$36.52
|
| Rate for Payer: Aetna Commercial |
$103.40
|
| Rate for Payer: Aetna Commercial |
$37.65
|
| Rate for Payer: Aetna Commercial |
$39.23
|
| Rate for Payer: Aetna Commercial |
$39.75
|
| Rate for Payer: Aetna Commercial |
$47.54
|
| Rate for Payer: Aetna Commercial |
$80.91
|
| Rate for Payer: Aetna Medicare |
$21.48
|
| Rate for Payer: Aetna Medicare |
$77.43
|
| Rate for Payer: Aetna Medicare |
$23.39
|
| Rate for Payer: Aetna Medicare |
$60.83
|
| Rate for Payer: Aetna Medicare |
$47.59
|
| Rate for Payer: Aetna Medicare |
$22.41
|
| Rate for Payer: Aetna Medicare |
$22.14
|
| Rate for Payer: Aetna Medicare |
$27.96
|
| Rate for Payer: Aetna Medicare |
$23.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.79
|
| Rate for Payer: BCBS Complete |
$61.94
|
| Rate for Payer: BCBS Complete |
$17.18
|
| Rate for Payer: BCBS Complete |
$18.46
|
| Rate for Payer: BCBS Complete |
$17.72
|
| Rate for Payer: BCBS Complete |
$18.71
|
| Rate for Payer: BCBS Complete |
$17.93
|
| Rate for Payer: BCBS Complete |
$38.08
|
| Rate for Payer: BCBS Complete |
$22.37
|
| Rate for Payer: BCBS Complete |
$48.66
|
| Rate for Payer: BCBS Trust/PPO |
$1.69
|
| Rate for Payer: BCBS Trust/PPO |
$1.69
|
| Rate for Payer: BCBS Trust/PPO |
$1.69
|
| Rate for Payer: BCBS Trust/PPO |
$1.69
|
| Rate for Payer: BCBS Trust/PPO |
$1.69
|
| Rate for Payer: BCBS Trust/PPO |
$1.69
|
| Rate for Payer: BCBS Trust/PPO |
$1.69
|
| Rate for Payer: BCBS Trust/PPO |
$1.69
|
| Rate for Payer: BCBS Trust/PPO |
$1.69
|
| Rate for Payer: BCN Commercial |
$1.69
|
| Rate for Payer: BCN Commercial |
$1.69
|
| Rate for Payer: BCN Commercial |
$1.69
|
| Rate for Payer: BCN Commercial |
$1.69
|
| Rate for Payer: BCN Commercial |
$1.69
|
| Rate for Payer: BCN Commercial |
$1.69
|
| Rate for Payer: BCN Commercial |
$1.69
|
| Rate for Payer: BCN Commercial |
$1.69
|
| Rate for Payer: BCN Commercial |
$1.69
|
| Rate for Payer: Cash Price |
$36.92
|
| Rate for Payer: Cash Price |
$123.89
|
| Rate for Payer: Cash Price |
$37.42
|
| Rate for Payer: Cash Price |
$35.86
|
| Rate for Payer: Cash Price |
$35.43
|
| Rate for Payer: Cash Price |
$37.42
|
| Rate for Payer: Cash Price |
$76.15
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cash Price |
$97.32
|
| Rate for Payer: Cash Price |
$35.86
|
| Rate for Payer: Cash Price |
$34.37
|
| Rate for Payer: Cash Price |
$97.32
|
| Rate for Payer: Cash Price |
$76.15
|
| Rate for Payer: Cash Price |
$34.37
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cash Price |
$123.89
|
| Rate for Payer: Cash Price |
$35.43
|
| Rate for Payer: Cash Price |
$36.92
|
| Rate for Payer: Cofinity Advantage |
$108.40
|
| Rate for Payer: Cofinity Advantage |
$30.07
|
| Rate for Payer: Cofinity Advantage |
$85.16
|
| Rate for Payer: Cofinity Advantage |
$31.00
|
| Rate for Payer: Cofinity Advantage |
$31.38
|
| Rate for Payer: Cofinity Advantage |
$32.30
|
| Rate for Payer: Cofinity Advantage |
$32.74
|
| Rate for Payer: Cofinity Advantage |
$39.15
|
| Rate for Payer: Cofinity Advantage |
$66.63
|
| Rate for Payer: Cofinity Commercial |
$133.18
|
| Rate for Payer: Cofinity Commercial |
$48.10
|
| Rate for Payer: Cofinity Commercial |
$40.22
|
| Rate for Payer: Cofinity Commercial |
$104.62
|
| Rate for Payer: Cofinity Commercial |
$38.55
|
| Rate for Payer: Cofinity Commercial |
$36.95
|
| Rate for Payer: Cofinity Commercial |
$81.86
|
| Rate for Payer: Cofinity Commercial |
$38.09
|
| Rate for Payer: Cofinity Commercial |
$39.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.37
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Commercial |
$139.37
|
| Rate for Payer: Healthscope Commercial |
$109.48
|
| Rate for Payer: Healthscope Commercial |
$85.67
|
| Rate for Payer: Healthscope Commercial |
$39.86
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: Healthscope Commercial |
$42.09
|
| Rate for Payer: Healthscope Commercial |
$41.53
|
| Rate for Payer: Healthscope Commercial |
$40.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$108.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: PHP Commercial |
$36.52
|
| Rate for Payer: PHP Commercial |
$37.65
|
| Rate for Payer: PHP Commercial |
$38.11
|
| Rate for Payer: PHP Commercial |
$80.91
|
| Rate for Payer: PHP Commercial |
$39.23
|
| Rate for Payer: PHP Commercial |
$103.40
|
| Rate for Payer: PHP Commercial |
$131.63
|
| Rate for Payer: PHP Commercial |
$39.75
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: Priority Health SBD |
$28.24
|
| Rate for Payer: Priority Health SBD |
$29.47
|
| Rate for Payer: Priority Health SBD |
$97.56
|
| Rate for Payer: Priority Health SBD |
$27.06
|
| Rate for Payer: Priority Health SBD |
$29.07
|
| Rate for Payer: Priority Health SBD |
$59.97
|
| Rate for Payer: Priority Health SBD |
$76.64
|
| Rate for Payer: Priority Health SBD |
$27.90
|
| Rate for Payer: Priority Health SBD |
$35.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UMR Bronson Commercial |
$17.08
|
| Rate for Payer: UMR Bronson Commercial |
$15.90
|
| Rate for Payer: UMR Bronson Commercial |
$16.59
|
| Rate for Payer: UMR Bronson Commercial |
$17.30
|
| Rate for Payer: UMR Bronson Commercial |
$20.69
|
| Rate for Payer: UMR Bronson Commercial |
$35.22
|
| Rate for Payer: UMR Bronson Commercial |
$45.01
|
| Rate for Payer: UMR Bronson Commercial |
$57.30
|
| Rate for Payer: UMR Bronson Commercial |
$16.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.14
|
|
|
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$42.96
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
173104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna American Axle |
$27.92
|
| Rate for Payer: Aetna American Axle |
$29.14
|
| Rate for Payer: Aetna American Axle |
$61.87
|
| Rate for Payer: Aetna American Axle |
$79.07
|
| Rate for Payer: Aetna American Axle |
$30.00
|
| Rate for Payer: Aetna American Axle |
$100.66
|
| Rate for Payer: Aetna American Axle |
$30.40
|
| Rate for Payer: Aetna American Axle |
$36.35
|
| Rate for Payer: Aetna American Axle |
$28.79
|
| Rate for Payer: Aetna Commercial |
$39.23
|
| Rate for Payer: Aetna Commercial |
$38.11
|
| Rate for Payer: Aetna Commercial |
$47.54
|
| Rate for Payer: Aetna Commercial |
$103.40
|
| Rate for Payer: Aetna Commercial |
$131.63
|
| Rate for Payer: Aetna Commercial |
$80.91
|
| Rate for Payer: Aetna Commercial |
$39.75
|
| Rate for Payer: Aetna Commercial |
$37.65
|
| Rate for Payer: Aetna Commercial |
$36.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.35
|
| Rate for Payer: Cash Price |
$36.92
|
| Rate for Payer: Cash Price |
$76.15
|
| Rate for Payer: Cash Price |
$37.42
|
| Rate for Payer: Cash Price |
$97.32
|
| Rate for Payer: Cash Price |
$123.89
|
| Rate for Payer: Cash Price |
$34.37
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cash Price |
$35.43
|
| Rate for Payer: Cash Price |
$35.86
|
| Rate for Payer: Cofinity Advantage |
$31.00
|
| Rate for Payer: Cofinity Advantage |
$108.40
|
| Rate for Payer: Cofinity Advantage |
$85.16
|
| Rate for Payer: Cofinity Advantage |
$66.63
|
| Rate for Payer: Cofinity Advantage |
$31.38
|
| Rate for Payer: Cofinity Advantage |
$39.15
|
| Rate for Payer: Cofinity Advantage |
$30.07
|
| Rate for Payer: Cofinity Advantage |
$32.30
|
| Rate for Payer: Cofinity Advantage |
$32.74
|
| Rate for Payer: Cofinity Commercial |
$38.09
|
| Rate for Payer: Cofinity Commercial |
$36.95
|
| Rate for Payer: Cofinity Commercial |
$104.62
|
| Rate for Payer: Cofinity Commercial |
$133.18
|
| Rate for Payer: Cofinity Commercial |
$81.86
|
| Rate for Payer: Cofinity Commercial |
$48.10
|
| Rate for Payer: Cofinity Commercial |
$40.22
|
| Rate for Payer: Cofinity Commercial |
$39.69
|
| Rate for Payer: Cofinity Commercial |
$38.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.43
|
| Rate for Payer: Healthscope Commercial |
$42.09
|
| Rate for Payer: Healthscope Commercial |
$39.86
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: Healthscope Commercial |
$85.67
|
| Rate for Payer: Healthscope Commercial |
$41.53
|
| Rate for Payer: Healthscope Commercial |
$139.37
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Commercial |
$109.48
|
| Rate for Payer: Healthscope Commercial |
$40.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$108.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: PHP Commercial |
$38.11
|
| Rate for Payer: PHP Commercial |
$37.65
|
| Rate for Payer: PHP Commercial |
$80.91
|
| Rate for Payer: PHP Commercial |
$39.23
|
| Rate for Payer: PHP Commercial |
$36.52
|
| Rate for Payer: PHP Commercial |
$39.75
|
| Rate for Payer: PHP Commercial |
$131.63
|
| Rate for Payer: PHP Commercial |
$103.40
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: Priority Health SBD |
$76.64
|
| Rate for Payer: Priority Health SBD |
$35.24
|
| Rate for Payer: Priority Health SBD |
$29.47
|
| Rate for Payer: Priority Health SBD |
$59.97
|
| Rate for Payer: Priority Health SBD |
$27.06
|
| Rate for Payer: Priority Health SBD |
$29.07
|
| Rate for Payer: Priority Health SBD |
$27.90
|
| Rate for Payer: Priority Health SBD |
$28.24
|
| Rate for Payer: Priority Health SBD |
$97.56
|
| Rate for Payer: UMR Bronson Commercial |
$24.61
|
| Rate for Payer: UMR Bronson Commercial |
$20.58
|
| Rate for Payer: UMR Bronson Commercial |
$68.14
|
| Rate for Payer: UMR Bronson Commercial |
$53.53
|
| Rate for Payer: UMR Bronson Commercial |
$19.49
|
| Rate for Payer: UMR Bronson Commercial |
$18.90
|
| Rate for Payer: UMR Bronson Commercial |
$20.31
|
| Rate for Payer: UMR Bronson Commercial |
$19.73
|
| Rate for Payer: UMR Bronson Commercial |
$41.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.61
|
|
|
VASOPRESSIN 40 UNIT/100 ML (0.4 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
OP
|
$330.84
|
|
|
Service Code
|
HCPCS J2601
|
| Hospital Charge Code |
184045
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$297.76 |
| Rate for Payer: Aetna American Axle |
$215.05
|
| Rate for Payer: Aetna American Axle |
$162.86
|
| Rate for Payer: Aetna Commercial |
$212.98
|
| Rate for Payer: Aetna Commercial |
$281.21
|
| Rate for Payer: Aetna Medicare |
$1.59
|
| Rate for Payer: Aetna Medicare |
$1.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.91
|
| Rate for Payer: BCBS Complete |
$0.84
|
| Rate for Payer: BCBS Complete |
$0.84
|
| Rate for Payer: BCBS MAPPO |
$1.53
|
| Rate for Payer: BCBS MAPPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$7.19
|
| Rate for Payer: BCBS Trust/PPO |
$7.19
|
| Rate for Payer: BCN Commercial |
$7.19
|
| Rate for Payer: BCN Commercial |
$7.19
|
| Rate for Payer: BCN Medicare Advantage |
$1.53
|
| Rate for Payer: BCN Medicare Advantage |
$1.53
|
| Rate for Payer: Cash Price |
$200.45
|
| Rate for Payer: Cash Price |
$264.67
|
| Rate for Payer: Cash Price |
$264.67
|
| Rate for Payer: Cash Price |
$200.45
|
| Rate for Payer: Cofinity Advantage |
$231.59
|
| Rate for Payer: Cofinity Advantage |
$175.39
|
| Rate for Payer: Cofinity Commercial |
$215.48
|
| Rate for Payer: Cofinity Commercial |
$284.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.53
|
| Rate for Payer: Healthscope Commercial |
$225.50
|
| Rate for Payer: Healthscope Commercial |
$297.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$231.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.13
|
| Rate for Payer: Mclaren Medicaid |
$1.53
|
| Rate for Payer: Mclaren Medicaid |
$1.53
|
| Rate for Payer: Mclaren Medicare |
$1.53
|
| Rate for Payer: Mclaren Medicare |
$1.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.61
|
| Rate for Payer: Meridian Medicaid |
$1.61
|
| Rate for Payer: Meridian Medicaid |
$1.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.21
|
| Rate for Payer: Nomi Health Commercial |
$4.59
|
| Rate for Payer: Nomi Health Commercial |
$4.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.92
|
| Rate for Payer: PACE Medicare |
$1.45
|
| Rate for Payer: PACE Medicare |
$1.45
|
| Rate for Payer: PACE SWMI |
$1.53
|
| Rate for Payer: PACE SWMI |
$1.53
|
| Rate for Payer: PHP Commercial |
$212.98
|
| Rate for Payer: PHP Commercial |
$281.21
|
| Rate for Payer: PHP Medicare Advantage |
$1.53
|
| Rate for Payer: PHP Medicare Advantage |
$1.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.34
|
| Rate for Payer: Priority Health Medicare |
$1.53
|
| Rate for Payer: Priority Health Medicare |
$1.53
|
| Rate for Payer: Priority Health SBD |
$157.85
|
| Rate for Payer: Priority Health SBD |
$208.43
|
| Rate for Payer: Priority Health Tiered Network |
$5.07
|
| Rate for Payer: Priority Health Tiered Network |
$5.07
|
| Rate for Payer: Railroad Medicare Medicare |
$1.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.66
|
| Rate for Payer: UHC Core |
$3.66
|
| Rate for Payer: UHC Core |
$3.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.53
|
| Rate for Payer: UHC Exchange |
$3.66
|
| Rate for Payer: UHC Exchange |
$3.66
|
| Rate for Payer: UHC Medicaid |
$0.80
|
| Rate for Payer: UHC Medicaid |
$0.80
|
| Rate for Payer: UHCCP Medicaid |
$0.80
|
| Rate for Payer: UHCCP Medicaid |
$0.80
|
| Rate for Payer: UMR Bronson Commercial |
$92.71
|
| Rate for Payer: UMR Bronson Commercial |
$122.41
|
| Rate for Payer: VA VA |
$1.53
|
| Rate for Payer: VA VA |
$1.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.92
|
|
