|
CIPROFLOXACIN 250 MG TABLET
|
Facility
|
IP
|
$3.39
|
|
|
Service Code
|
NDC 60687052811
|
| Hospital Charge Code |
25118
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.49 |
| Max. Negotiated Rate |
$3.05 |
| Rate for Payer: Aetna American Axle |
$2.20
|
| Rate for Payer: Aetna Commercial |
$2.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.20
|
| Rate for Payer: Cash Price |
$2.71
|
| Rate for Payer: Cofinity Advantage |
$2.37
|
| Rate for Payer: Cofinity Commercial |
$2.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.71
|
| Rate for Payer: Healthscope Commercial |
$3.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.54
|
| Rate for Payer: PHP Commercial |
$2.88
|
| Rate for Payer: Priority Health SBD |
$2.14
|
| Rate for Payer: UMR Bronson Commercial |
$1.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.54
|
|
|
CIPROFLOXACIN 250 MG TABLET
|
Facility
|
OP
|
$220.90
|
|
|
Service Code
|
NDC 59651086601
|
| Hospital Charge Code |
25118
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.73 |
| Max. Negotiated Rate |
$198.81 |
| Rate for Payer: Aetna American Axle |
$143.59
|
| Rate for Payer: Aetna Commercial |
$187.76
|
| Rate for Payer: Aetna Medicare |
$110.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.59
|
| Rate for Payer: BCBS Complete |
$88.36
|
| Rate for Payer: Cash Price |
$176.72
|
| Rate for Payer: Cofinity Advantage |
$154.63
|
| Rate for Payer: Cofinity Commercial |
$189.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.72
|
| Rate for Payer: Healthscope Commercial |
$198.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.68
|
| Rate for Payer: PHP Commercial |
$187.76
|
| Rate for Payer: Priority Health SBD |
$139.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.59
|
| Rate for Payer: UHC Core |
$115.09
|
| Rate for Payer: UHC Exchange |
$86.81
|
| Rate for Payer: UMR Bronson Commercial |
$81.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.68
|
|
|
CIPROFLOXACIN 250 MG TABLET
|
Facility
|
OP
|
$361.90
|
|
|
Service Code
|
NDC 65862007601
|
| Hospital Charge Code |
25118
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$133.90 |
| Max. Negotiated Rate |
$325.71 |
| Rate for Payer: Aetna American Axle |
$235.24
|
| Rate for Payer: Aetna Commercial |
$307.62
|
| Rate for Payer: Aetna Medicare |
$180.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.24
|
| Rate for Payer: BCBS Complete |
$144.76
|
| Rate for Payer: Cash Price |
$289.52
|
| Rate for Payer: Cofinity Advantage |
$253.33
|
| Rate for Payer: Cofinity Commercial |
$311.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.52
|
| Rate for Payer: Healthscope Commercial |
$325.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$253.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$289.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$307.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$271.43
|
| Rate for Payer: PHP Commercial |
$307.62
|
| Rate for Payer: Priority Health SBD |
$228.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.24
|
| Rate for Payer: UHC Core |
$188.55
|
| Rate for Payer: UHC Exchange |
$142.23
|
| Rate for Payer: UMR Bronson Commercial |
$133.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.43
|
|
|
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$41.47
|
|
|
Service Code
|
HCPCS J0744
|
| Hospital Charge Code |
9611
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.25 |
| Max. Negotiated Rate |
$37.32 |
| Rate for Payer: Aetna American Axle |
$26.96
|
| Rate for Payer: Aetna American Axle |
$44.16
|
| Rate for Payer: Aetna American Axle |
$33.18
|
| Rate for Payer: Aetna Commercial |
$43.38
|
| Rate for Payer: Aetna Commercial |
$35.25
|
| Rate for Payer: Aetna Commercial |
$57.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.18
|
| Rate for Payer: Cash Price |
$40.83
|
| Rate for Payer: Cash Price |
$33.18
|
| Rate for Payer: Cash Price |
$54.35
|
| Rate for Payer: Cofinity Advantage |
$47.56
|
| Rate for Payer: Cofinity Advantage |
$29.03
|
| Rate for Payer: Cofinity Advantage |
$35.73
|
| Rate for Payer: Cofinity Commercial |
$58.43
|
| Rate for Payer: Cofinity Commercial |
$35.66
|
| Rate for Payer: Cofinity Commercial |
$43.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.35
|
| Rate for Payer: Healthscope Commercial |
$45.94
|
| Rate for Payer: Healthscope Commercial |
$61.15
|
| Rate for Payer: Healthscope Commercial |
$37.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.95
|
| Rate for Payer: PHP Commercial |
$43.38
|
| Rate for Payer: PHP Commercial |
$35.25
|
| Rate for Payer: PHP Commercial |
$57.75
|
| Rate for Payer: Priority Health SBD |
$26.13
|
| Rate for Payer: Priority Health SBD |
$32.16
|
| Rate for Payer: Priority Health SBD |
$42.80
|
| Rate for Payer: UMR Bronson Commercial |
$18.25
|
| Rate for Payer: UMR Bronson Commercial |
$29.89
|
| Rate for Payer: UMR Bronson Commercial |
$22.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.95
|
|
|
CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$51.04
|
|
|
Service Code
|
HCPCS J0744
|
| Hospital Charge Code |
9611
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$45.94 |
| Rate for Payer: Aetna American Axle |
$33.18
|
| Rate for Payer: Aetna American Axle |
$26.96
|
| Rate for Payer: Aetna American Axle |
$44.16
|
| Rate for Payer: Aetna Commercial |
$43.38
|
| Rate for Payer: Aetna Commercial |
$57.75
|
| Rate for Payer: Aetna Commercial |
$35.25
|
| Rate for Payer: Aetna Medicare |
$25.52
|
| Rate for Payer: Aetna Medicare |
$20.73
|
| Rate for Payer: Aetna Medicare |
$33.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.16
|
| Rate for Payer: BCBS Complete |
$16.59
|
| Rate for Payer: BCBS Complete |
$20.42
|
| Rate for Payer: BCBS Complete |
$27.18
|
| Rate for Payer: BCBS Trust/PPO |
$6.46
|
| Rate for Payer: BCBS Trust/PPO |
$6.46
|
| Rate for Payer: BCBS Trust/PPO |
$6.46
|
| Rate for Payer: BCN Commercial |
$6.46
|
| Rate for Payer: BCN Commercial |
$6.46
|
| Rate for Payer: BCN Commercial |
$6.46
|
| Rate for Payer: Cash Price |
$33.18
|
| Rate for Payer: Cash Price |
$33.18
|
| Rate for Payer: Cash Price |
$54.35
|
| Rate for Payer: Cash Price |
$54.35
|
| Rate for Payer: Cash Price |
$40.83
|
| Rate for Payer: Cash Price |
$40.83
|
| Rate for Payer: Cofinity Advantage |
$47.56
|
| Rate for Payer: Cofinity Advantage |
$35.73
|
| Rate for Payer: Cofinity Advantage |
$29.03
|
| Rate for Payer: Cofinity Commercial |
$35.66
|
| Rate for Payer: Cofinity Commercial |
$43.89
|
| Rate for Payer: Cofinity Commercial |
$58.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.83
|
| Rate for Payer: Healthscope Commercial |
$37.32
|
| Rate for Payer: Healthscope Commercial |
$45.94
|
| Rate for Payer: Healthscope Commercial |
$61.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.95
|
| Rate for Payer: PHP Commercial |
$43.38
|
| Rate for Payer: PHP Commercial |
$35.25
|
| Rate for Payer: PHP Commercial |
$57.75
|
| Rate for Payer: Priority Health SBD |
$26.13
|
| Rate for Payer: Priority Health SBD |
$42.80
|
| Rate for Payer: Priority Health SBD |
$32.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.30
|
| Rate for Payer: UHC Core |
$3.30
|
| Rate for Payer: UHC Core |
$3.30
|
| Rate for Payer: UHC Core |
$3.30
|
| Rate for Payer: UHC Exchange |
$3.30
|
| Rate for Payer: UHC Exchange |
$3.30
|
| Rate for Payer: UHC Exchange |
$3.30
|
| Rate for Payer: UMR Bronson Commercial |
$25.14
|
| Rate for Payer: UMR Bronson Commercial |
$15.34
|
| Rate for Payer: UMR Bronson Commercial |
$18.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.95
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
OP
|
$247.00
|
|
|
Service Code
|
NDC 00904724361
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$91.39 |
| Max. Negotiated Rate |
$222.30 |
| Rate for Payer: Aetna American Axle |
$160.55
|
| Rate for Payer: Aetna Commercial |
$209.95
|
| Rate for Payer: Aetna Medicare |
$123.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.55
|
| Rate for Payer: BCBS Complete |
$98.80
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cofinity Advantage |
$172.90
|
| Rate for Payer: Cofinity Commercial |
$212.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.60
|
| Rate for Payer: Healthscope Commercial |
$222.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$172.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$197.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.25
|
| Rate for Payer: PHP Commercial |
$209.95
|
| Rate for Payer: Priority Health SBD |
$155.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.55
|
| Rate for Payer: UHC Core |
$128.69
|
| Rate for Payer: UHC Exchange |
$97.07
|
| Rate for Payer: UMR Bronson Commercial |
$91.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.25
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
IP
|
$350.15
|
|
|
Service Code
|
NDC 00904708361
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$154.07 |
| Max. Negotiated Rate |
$315.13 |
| Rate for Payer: Aetna American Axle |
$227.60
|
| Rate for Payer: Aetna Commercial |
$297.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.60
|
| Rate for Payer: Cash Price |
$280.12
|
| Rate for Payer: Cofinity Advantage |
$245.10
|
| Rate for Payer: Cofinity Commercial |
$301.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.12
|
| Rate for Payer: Healthscope Commercial |
$315.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$297.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.61
|
| Rate for Payer: PHP Commercial |
$297.63
|
| Rate for Payer: Priority Health SBD |
$220.59
|
| Rate for Payer: UMR Bronson Commercial |
$154.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.61
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
OP
|
$458.25
|
|
|
Service Code
|
NDC 00143992801
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$169.55 |
| Max. Negotiated Rate |
$412.43 |
| Rate for Payer: Aetna American Axle |
$297.86
|
| Rate for Payer: Aetna Commercial |
$389.51
|
| Rate for Payer: Aetna Medicare |
$229.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$297.86
|
| Rate for Payer: BCBS Complete |
$183.30
|
| Rate for Payer: Cash Price |
$366.60
|
| Rate for Payer: Cofinity Advantage |
$320.77
|
| Rate for Payer: Cofinity Commercial |
$394.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$366.60
|
| Rate for Payer: Healthscope Commercial |
$412.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$320.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$343.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$366.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$389.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$343.69
|
| Rate for Payer: PHP Commercial |
$389.51
|
| Rate for Payer: Priority Health SBD |
$288.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.86
|
| Rate for Payer: UHC Core |
$238.75
|
| Rate for Payer: UHC Exchange |
$180.09
|
| Rate for Payer: UMR Bronson Commercial |
$169.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$343.69
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
OP
|
$1,183.63
|
|
|
Service Code
|
NDC 62135030901
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$437.94 |
| Max. Negotiated Rate |
$1,065.27 |
| Rate for Payer: Aetna American Axle |
$769.36
|
| Rate for Payer: Aetna Commercial |
$1,006.09
|
| Rate for Payer: Aetna Medicare |
$591.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$769.36
|
| Rate for Payer: BCBS Complete |
$473.45
|
| Rate for Payer: Cash Price |
$946.90
|
| Rate for Payer: Cofinity Advantage |
$828.54
|
| Rate for Payer: Cofinity Commercial |
$1,017.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$946.90
|
| Rate for Payer: Healthscope Commercial |
$1,065.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$828.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$887.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$946.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,006.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$887.72
|
| Rate for Payer: PHP Commercial |
$1,006.09
|
| Rate for Payer: Priority Health SBD |
$745.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$769.36
|
| Rate for Payer: UHC Core |
$616.67
|
| Rate for Payer: UHC Exchange |
$465.17
|
| Rate for Payer: UMR Bronson Commercial |
$437.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$887.72
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
OP
|
$2.69
|
|
|
Service Code
|
NDC 68084007011
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$2.42 |
| Rate for Payer: Aetna American Axle |
$1.75
|
| Rate for Payer: Aetna Commercial |
$2.29
|
| Rate for Payer: Aetna Medicare |
$1.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.75
|
| Rate for Payer: BCBS Complete |
$1.08
|
| Rate for Payer: Cash Price |
$2.15
|
| Rate for Payer: Cofinity Advantage |
$1.88
|
| Rate for Payer: Cofinity Commercial |
$2.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.15
|
| Rate for Payer: Healthscope Commercial |
$2.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.02
|
| Rate for Payer: PHP Commercial |
$2.29
|
| Rate for Payer: Priority Health SBD |
$1.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.75
|
| Rate for Payer: UHC Core |
$1.40
|
| Rate for Payer: UHC Exchange |
$1.06
|
| Rate for Payer: UMR Bronson Commercial |
$1.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.02
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
IP
|
$2.72
|
|
|
Service Code
|
NDC 60687086011
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$2.45 |
| Rate for Payer: Aetna American Axle |
$1.77
|
| Rate for Payer: Aetna Commercial |
$2.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.77
|
| Rate for Payer: Cash Price |
$2.18
|
| Rate for Payer: Cofinity Advantage |
$1.90
|
| Rate for Payer: Cofinity Commercial |
$2.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.18
|
| Rate for Payer: Healthscope Commercial |
$2.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.04
|
| Rate for Payer: PHP Commercial |
$2.31
|
| Rate for Payer: Priority Health SBD |
$1.71
|
| Rate for Payer: UMR Bronson Commercial |
$1.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.04
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
IP
|
$271.70
|
|
|
Service Code
|
NDC 60687086001
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.55 |
| Max. Negotiated Rate |
$244.53 |
| Rate for Payer: Aetna American Axle |
$176.60
|
| Rate for Payer: Aetna Commercial |
$230.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.60
|
| Rate for Payer: Cash Price |
$217.36
|
| Rate for Payer: Cofinity Advantage |
$190.19
|
| Rate for Payer: Cofinity Commercial |
$233.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.36
|
| Rate for Payer: Healthscope Commercial |
$244.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$203.78
|
| Rate for Payer: PHP Commercial |
$230.94
|
| Rate for Payer: Priority Health SBD |
$171.17
|
| Rate for Payer: UMR Bronson Commercial |
$119.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.78
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
OP
|
$2.72
|
|
|
Service Code
|
NDC 60687086011
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.01 |
| Max. Negotiated Rate |
$2.45 |
| Rate for Payer: Aetna American Axle |
$1.77
|
| Rate for Payer: Aetna Commercial |
$2.31
|
| Rate for Payer: Aetna Medicare |
$1.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.77
|
| Rate for Payer: BCBS Complete |
$1.09
|
| Rate for Payer: Cash Price |
$2.18
|
| Rate for Payer: Cofinity Advantage |
$1.90
|
| Rate for Payer: Cofinity Commercial |
$2.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.18
|
| Rate for Payer: Healthscope Commercial |
$2.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.04
|
| Rate for Payer: PHP Commercial |
$2.31
|
| Rate for Payer: Priority Health SBD |
$1.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.77
|
| Rate for Payer: UHC Core |
$1.42
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UMR Bronson Commercial |
$1.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.04
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
IP
|
$2.69
|
|
|
Service Code
|
NDC 68084007011
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.18 |
| Max. Negotiated Rate |
$2.42 |
| Rate for Payer: Aetna American Axle |
$1.75
|
| Rate for Payer: Aetna Commercial |
$2.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.75
|
| Rate for Payer: Cash Price |
$2.15
|
| Rate for Payer: Cofinity Advantage |
$1.88
|
| Rate for Payer: Cofinity Commercial |
$2.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.15
|
| Rate for Payer: Healthscope Commercial |
$2.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.02
|
| Rate for Payer: PHP Commercial |
$2.29
|
| Rate for Payer: Priority Health SBD |
$1.69
|
| Rate for Payer: UMR Bronson Commercial |
$1.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.02
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
IP
|
$1,183.63
|
|
|
Service Code
|
NDC 62135030901
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$520.80 |
| Max. Negotiated Rate |
$1,065.27 |
| Rate for Payer: Aetna American Axle |
$769.36
|
| Rate for Payer: Aetna Commercial |
$1,006.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$769.36
|
| Rate for Payer: Cash Price |
$946.90
|
| Rate for Payer: Cofinity Advantage |
$828.54
|
| Rate for Payer: Cofinity Commercial |
$1,017.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$946.90
|
| Rate for Payer: Healthscope Commercial |
$1,065.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$828.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$887.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,006.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$887.72
|
| Rate for Payer: PHP Commercial |
$1,006.09
|
| Rate for Payer: Priority Health SBD |
$745.69
|
| Rate for Payer: UMR Bronson Commercial |
$520.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$887.72
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
OP
|
$350.15
|
|
|
Service Code
|
NDC 00904708361
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$129.56 |
| Max. Negotiated Rate |
$315.13 |
| Rate for Payer: Aetna American Axle |
$227.60
|
| Rate for Payer: Aetna Commercial |
$297.63
|
| Rate for Payer: Aetna Medicare |
$175.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.60
|
| Rate for Payer: BCBS Complete |
$140.06
|
| Rate for Payer: Cash Price |
$280.12
|
| Rate for Payer: Cofinity Advantage |
$245.10
|
| Rate for Payer: Cofinity Commercial |
$301.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.12
|
| Rate for Payer: Healthscope Commercial |
$315.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$280.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$297.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.61
|
| Rate for Payer: PHP Commercial |
$297.63
|
| Rate for Payer: Priority Health SBD |
$220.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.60
|
| Rate for Payer: UHC Core |
$182.43
|
| Rate for Payer: UHC Exchange |
$137.61
|
| Rate for Payer: UMR Bronson Commercial |
$129.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.61
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
IP
|
$268.85
|
|
|
Service Code
|
NDC 68084007001
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$118.29 |
| Max. Negotiated Rate |
$241.97 |
| Rate for Payer: Aetna American Axle |
$174.75
|
| Rate for Payer: Aetna Commercial |
$228.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.75
|
| Rate for Payer: Cash Price |
$215.08
|
| Rate for Payer: Cofinity Advantage |
$188.19
|
| Rate for Payer: Cofinity Commercial |
$231.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.08
|
| Rate for Payer: Healthscope Commercial |
$241.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$188.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.64
|
| Rate for Payer: PHP Commercial |
$228.52
|
| Rate for Payer: Priority Health SBD |
$169.38
|
| Rate for Payer: UMR Bronson Commercial |
$118.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.64
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
OP
|
$268.85
|
|
|
Service Code
|
NDC 68084007001
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.47 |
| Max. Negotiated Rate |
$241.97 |
| Rate for Payer: Aetna American Axle |
$174.75
|
| Rate for Payer: Aetna Commercial |
$228.52
|
| Rate for Payer: Aetna Medicare |
$134.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.75
|
| Rate for Payer: BCBS Complete |
$107.54
|
| Rate for Payer: Cash Price |
$215.08
|
| Rate for Payer: Cofinity Advantage |
$188.19
|
| Rate for Payer: Cofinity Commercial |
$231.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.08
|
| Rate for Payer: Healthscope Commercial |
$241.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$188.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$215.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.64
|
| Rate for Payer: PHP Commercial |
$228.52
|
| Rate for Payer: Priority Health SBD |
$169.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.75
|
| Rate for Payer: UHC Core |
$140.07
|
| Rate for Payer: UHC Exchange |
$105.66
|
| Rate for Payer: UMR Bronson Commercial |
$99.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.64
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
IP
|
$247.00
|
|
|
Service Code
|
NDC 00904724361
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$108.68 |
| Max. Negotiated Rate |
$222.30 |
| Rate for Payer: Aetna American Axle |
$160.55
|
| Rate for Payer: Aetna Commercial |
$209.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.55
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cofinity Advantage |
$172.90
|
| Rate for Payer: Cofinity Commercial |
$212.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.60
|
| Rate for Payer: Healthscope Commercial |
$222.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$172.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.25
|
| Rate for Payer: PHP Commercial |
$209.95
|
| Rate for Payer: Priority Health SBD |
$155.61
|
| Rate for Payer: UMR Bronson Commercial |
$108.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.25
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
IP
|
$3.39
|
|
|
Service Code
|
NDC 51079018201
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.49 |
| Max. Negotiated Rate |
$3.05 |
| Rate for Payer: Aetna American Axle |
$2.20
|
| Rate for Payer: Aetna Commercial |
$2.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.20
|
| Rate for Payer: Cash Price |
$2.71
|
| Rate for Payer: Cofinity Advantage |
$2.37
|
| Rate for Payer: Cofinity Commercial |
$2.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.71
|
| Rate for Payer: Healthscope Commercial |
$3.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.54
|
| Rate for Payer: PHP Commercial |
$2.88
|
| Rate for Payer: Priority Health SBD |
$2.14
|
| Rate for Payer: UMR Bronson Commercial |
$1.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.54
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
OP
|
$271.70
|
|
|
Service Code
|
NDC 60687086001
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$100.53 |
| Max. Negotiated Rate |
$244.53 |
| Rate for Payer: Aetna American Axle |
$176.60
|
| Rate for Payer: Aetna Commercial |
$230.94
|
| Rate for Payer: Aetna Medicare |
$135.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.60
|
| Rate for Payer: BCBS Complete |
$108.68
|
| Rate for Payer: Cash Price |
$217.36
|
| Rate for Payer: Cofinity Advantage |
$190.19
|
| Rate for Payer: Cofinity Commercial |
$233.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.36
|
| Rate for Payer: Healthscope Commercial |
$244.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$217.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$203.78
|
| Rate for Payer: PHP Commercial |
$230.94
|
| Rate for Payer: Priority Health SBD |
$171.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.60
|
| Rate for Payer: UHC Core |
$141.56
|
| Rate for Payer: UHC Exchange |
$106.78
|
| Rate for Payer: UMR Bronson Commercial |
$100.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.78
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
OP
|
$3.39
|
|
|
Service Code
|
NDC 51079018201
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$3.05 |
| Rate for Payer: Aetna American Axle |
$2.20
|
| Rate for Payer: Aetna Commercial |
$2.88
|
| Rate for Payer: Aetna Medicare |
$1.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.20
|
| Rate for Payer: BCBS Complete |
$1.36
|
| Rate for Payer: Cash Price |
$2.71
|
| Rate for Payer: Cofinity Advantage |
$2.37
|
| Rate for Payer: Cofinity Commercial |
$2.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.71
|
| Rate for Payer: Healthscope Commercial |
$3.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.54
|
| Rate for Payer: PHP Commercial |
$2.88
|
| Rate for Payer: Priority Health SBD |
$2.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.20
|
| Rate for Payer: UHC Core |
$1.77
|
| Rate for Payer: UHC Exchange |
$1.33
|
| Rate for Payer: UMR Bronson Commercial |
$1.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.54
|
|
|
CIPROFLOXACIN 500 MG TABLET
|
Facility
|
IP
|
$458.25
|
|
|
Service Code
|
NDC 00143992801
|
| Hospital Charge Code |
25119
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$201.63 |
| Max. Negotiated Rate |
$412.43 |
| Rate for Payer: Aetna American Axle |
$297.86
|
| Rate for Payer: Aetna Commercial |
$389.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$297.86
|
| Rate for Payer: Cash Price |
$366.60
|
| Rate for Payer: Cofinity Advantage |
$320.77
|
| Rate for Payer: Cofinity Commercial |
$394.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$366.60
|
| Rate for Payer: Healthscope Commercial |
$412.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$320.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$343.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$389.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$343.69
|
| Rate for Payer: PHP Commercial |
$389.51
|
| Rate for Payer: Priority Health SBD |
$288.70
|
| Rate for Payer: UMR Bronson Commercial |
$201.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$343.69
|
|
|
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$40,836.11
|
|
|
Service Code
|
MSDRG 286
|
| Min. Negotiated Rate |
$18,143.03 |
| Max. Negotiated Rate |
$40,836.11 |
| Rate for Payer: Aetna Medicare |
$19,861.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,872.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,872.41
|
| Rate for Payer: BCBS MAPPO |
$19,097.93
|
| Rate for Payer: BCBS Trust/PPO |
$40,836.11
|
| Rate for Payer: BCN Commercial |
$40,836.11
|
| Rate for Payer: BCN Medicare Advantage |
$19,097.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,097.93
|
| Rate for Payer: Mclaren Medicare |
$19,097.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,052.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,962.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$21,007.72
|
| Rate for Payer: Nomi Health Commercial |
$28,545.12
|
| Rate for Payer: PACE Medicare |
$18,143.03
|
| Rate for Payer: PACE SWMI |
$19,097.93
|
| Rate for Payer: PHP Medicare Advantage |
$19,097.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35,675.07
|
| Rate for Payer: Priority Health Medicare |
$19,097.93
|
| Rate for Payer: Priority Health Tiered Network |
$28,540.05
|
| Rate for Payer: Railroad Medicare Medicare |
$19,097.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36,068.64
|
| Rate for Payer: UHC Core |
$30,175.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19,097.93
|
| Rate for Payer: UHC Exchange |
$24,643.95
|
| Rate for Payer: VA VA |
$19,097.93
|
|
|
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
|
IP
|
$25,227.47
|
|
|
Service Code
|
MSDRG 287
|
| Min. Negotiated Rate |
$9,064.81 |
| Max. Negotiated Rate |
$25,227.47 |
| Rate for Payer: Aetna Medicare |
$9,923.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,927.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,927.38
|
| Rate for Payer: BCBS MAPPO |
$9,541.90
|
| Rate for Payer: BCBS Trust/PPO |
$25,227.47
|
| Rate for Payer: BCN Commercial |
$25,227.47
|
| Rate for Payer: BCN Medicare Advantage |
$9,541.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,541.90
|
| Rate for Payer: Mclaren Medicare |
$9,541.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,019.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,973.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$10,496.09
|
| Rate for Payer: Nomi Health Commercial |
$13,804.29
|
| Rate for Payer: PACE Medicare |
$9,064.81
|
| Rate for Payer: PACE SWMI |
$9,541.90
|
| Rate for Payer: PHP Medicare Advantage |
$9,541.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17,252.30
|
| Rate for Payer: Priority Health Medicare |
$9,541.90
|
| Rate for Payer: Priority Health Tiered Network |
$13,801.84
|
| Rate for Payer: Railroad Medicare Medicare |
$9,541.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,442.63
|
| Rate for Payer: UHC Core |
$14,592.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9,541.90
|
| Rate for Payer: UHC Exchange |
$11,917.70
|
| Rate for Payer: VA VA |
$9,541.90
|
|
