|
VANCOMYCIN 750 MG/150 ML IN DILUENT COMBINATION IV PIGGYBACK
|
Facility
|
OP
|
$41.39
|
|
|
Service Code
|
HCPCS J3372
|
| Hospital Charge Code |
194728
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.31 |
| Max. Negotiated Rate |
$37.25 |
| Rate for Payer: Aetna American Axle |
$26.90
|
| Rate for Payer: Aetna Commercial |
$35.18
|
| Rate for Payer: Aetna Medicare |
$20.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.90
|
| Rate for Payer: BCBS Complete |
$16.56
|
| Rate for Payer: BCBS Trust/PPO |
$17.28
|
| Rate for Payer: BCN Commercial |
$17.28
|
| Rate for Payer: Cash Price |
$33.11
|
| Rate for Payer: Cash Price |
$33.11
|
| Rate for Payer: Cofinity Commercial |
$28.97
|
| Rate for Payer: Cofinity Commercial |
$35.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$28.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.11
|
| Rate for Payer: Healthscope Commercial |
$37.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.18
|
| Rate for Payer: PHP Commercial |
$35.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.90
|
| Rate for Payer: Priority Health SBD |
$26.08
|
| Rate for Payer: UMR Bronson Commercial |
$15.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.04
|
|
|
VANCOMYCIN 750 MG/150 ML IN DILUENT COMBINATION IV PIGGYBACK
|
Facility
|
IP
|
$41.39
|
|
|
Service Code
|
HCPCS J3372
|
| Hospital Charge Code |
194728
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.21 |
| Max. Negotiated Rate |
$37.25 |
| Rate for Payer: Aetna American Axle |
$26.90
|
| Rate for Payer: Aetna Commercial |
$35.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.90
|
| Rate for Payer: Cash Price |
$33.11
|
| Rate for Payer: Cofinity Commercial |
$28.97
|
| Rate for Payer: Cofinity Commercial |
$35.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$28.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.11
|
| Rate for Payer: Healthscope Commercial |
$37.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.18
|
| Rate for Payer: PHP Commercial |
$35.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.90
|
| Rate for Payer: Priority Health SBD |
$26.08
|
| Rate for Payer: UMR Bronson Commercial |
$18.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.04
|
|
|
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 |
$5.82 |
| 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: BCBS Trust/PPO |
$5.82
|
| Rate for Payer: BCN Commercial |
$5.82
|
| Rate for Payer: Cash Price |
$23.27
|
| Rate for Payer: Cash Price |
$23.27
|
| Rate for Payer: Cofinity Commercial |
$20.36
|
| Rate for Payer: Cofinity Commercial |
$25.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.36
|
| 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: PHP Commercial |
$24.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.91
|
| Rate for Payer: Priority Health SBD |
$18.33
|
| Rate for Payer: UMR Bronson Commercial |
$10.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.82
|
|
|
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 Commercial |
$20.36
|
| Rate for Payer: Cofinity Commercial |
$25.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.36
|
| 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: PHP Commercial |
$24.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.91
|
| 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 IVPB (BMH IV-PREMIX)
|
Facility
|
IP
|
$118.11
|
|
|
Service Code
|
HCPCS J3370
|
| Hospital Charge Code |
180476
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$106.30 |
| Rate for Payer: Aetna American Axle |
$76.77
|
| Rate for Payer: Aetna Commercial |
$100.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.77
|
| Rate for Payer: Cash Price |
$94.49
|
| Rate for Payer: Cofinity Commercial |
$101.57
|
| Rate for Payer: Cofinity Commercial |
$82.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.49
|
| Rate for Payer: Healthscope Commercial |
$106.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.39
|
| Rate for Payer: PHP Commercial |
$100.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.77
|
| Rate for Payer: Priority Health SBD |
$74.41
|
| Rate for Payer: UMR Bronson Commercial |
$51.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.58
|
|
|
VANCOMYCIN IVPB (BMH IV-PREMIX)
|
Facility
|
OP
|
$118.11
|
|
|
Service Code
|
HCPCS J3370
|
| Hospital Charge Code |
180476
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.82 |
| Max. Negotiated Rate |
$106.30 |
| Rate for Payer: Aetna American Axle |
$76.77
|
| Rate for Payer: Aetna Commercial |
$100.39
|
| Rate for Payer: Aetna Medicare |
$59.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.77
|
| Rate for Payer: BCBS Complete |
$47.24
|
| Rate for Payer: BCBS Trust/PPO |
$5.82
|
| Rate for Payer: BCN Commercial |
$5.82
|
| Rate for Payer: Cash Price |
$94.49
|
| Rate for Payer: Cash Price |
$94.49
|
| Rate for Payer: Cofinity Commercial |
$101.57
|
| Rate for Payer: Cofinity Commercial |
$82.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.49
|
| Rate for Payer: Healthscope Commercial |
$106.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.39
|
| Rate for Payer: PHP Commercial |
$100.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.77
|
| Rate for Payer: Priority Health SBD |
$74.41
|
| Rate for Payer: UMR Bronson Commercial |
$43.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.58
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
IP
|
$960.38
|
|
|
Service Code
|
NDC 70710161406
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$422.57 |
| Max. Negotiated Rate |
$864.34 |
| Rate for Payer: Aetna American Axle |
$624.25
|
| Rate for Payer: Aetna Commercial |
$816.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.25
|
| Rate for Payer: Cash Price |
$768.30
|
| Rate for Payer: Cofinity Commercial |
$672.27
|
| Rate for Payer: Cofinity Commercial |
$825.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$672.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$768.30
|
| Rate for Payer: Healthscope Commercial |
$864.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$672.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$720.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$816.32
|
| Rate for Payer: PHP Commercial |
$816.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.25
|
| Rate for Payer: Priority Health SBD |
$605.04
|
| Rate for Payer: UMR Bronson Commercial |
$422.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$720.28
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
IP
|
$250.53
|
|
|
Service Code
|
NDC 49884015676
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$110.23 |
| Max. Negotiated Rate |
$225.48 |
| Rate for Payer: Aetna American Axle |
$162.84
|
| Rate for Payer: Aetna Commercial |
$212.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.84
|
| Rate for Payer: Cash Price |
$200.42
|
| Rate for Payer: Cofinity Commercial |
$175.37
|
| Rate for Payer: Cofinity Commercial |
$215.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$175.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.42
|
| Rate for Payer: Healthscope Commercial |
$225.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.95
|
| Rate for Payer: PHP Commercial |
$212.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.84
|
| Rate for Payer: Priority Health SBD |
$157.83
|
| Rate for Payer: UMR Bronson Commercial |
$110.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.90
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
OP
|
$960.38
|
|
|
Service Code
|
NDC 70710161406
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$355.34 |
| Max. Negotiated Rate |
$864.34 |
| Rate for Payer: Aetna American Axle |
$624.25
|
| Rate for Payer: Aetna Commercial |
$816.32
|
| Rate for Payer: Aetna Medicare |
$480.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.25
|
| Rate for Payer: BCBS Complete |
$384.15
|
| Rate for Payer: Cash Price |
$768.30
|
| Rate for Payer: Cofinity Commercial |
$672.27
|
| Rate for Payer: Cofinity Commercial |
$825.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$672.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$768.30
|
| Rate for Payer: Healthscope Commercial |
$864.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$672.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$720.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$816.32
|
| Rate for Payer: PHP Commercial |
$816.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.25
|
| Rate for Payer: Priority Health SBD |
$605.04
|
| Rate for Payer: UMR Bronson Commercial |
$355.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$720.28
|
|
|
VARENICLINE TARTRATE 1 MG TABLET
|
Facility
|
OP
|
$250.53
|
|
|
Service Code
|
NDC 49884015676
|
| Hospital Charge Code |
76445
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$92.70 |
| Max. Negotiated Rate |
$225.48 |
| Rate for Payer: Aetna American Axle |
$162.84
|
| Rate for Payer: Aetna Commercial |
$212.95
|
| Rate for Payer: Aetna Medicare |
$125.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.84
|
| Rate for Payer: BCBS Complete |
$100.21
|
| Rate for Payer: Cash Price |
$200.42
|
| Rate for Payer: Cofinity Commercial |
$175.37
|
| Rate for Payer: Cofinity Commercial |
$215.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$175.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.42
|
| Rate for Payer: Healthscope Commercial |
$225.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.95
|
| Rate for Payer: PHP Commercial |
$212.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.84
|
| Rate for Payer: Priority Health SBD |
$157.83
|
| Rate for Payer: UMR Bronson Commercial |
$92.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.90
|
|
|
VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP
|
Facility
|
OP
|
$618.83
|
|
|
Service Code
|
HCPCS 90716
|
| Hospital Charge Code |
14757
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$166.78 |
| Max. Negotiated Rate |
$556.95 |
| Rate for Payer: Aetna American Axle |
$402.24
|
| Rate for Payer: Aetna Commercial |
$526.01
|
| Rate for Payer: Aetna Medicare |
$309.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.24
|
| Rate for Payer: BCBS Complete |
$247.53
|
| Rate for Payer: BCBS Trust/PPO |
$476.19
|
| Rate for Payer: BCN Commercial |
$476.19
|
| Rate for Payer: Cash Price |
$495.06
|
| Rate for Payer: Cash Price |
$495.06
|
| Rate for Payer: Cofinity Commercial |
$433.18
|
| Rate for Payer: Cofinity Commercial |
$532.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$433.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$495.06
|
| Rate for Payer: Healthscope Commercial |
$556.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$433.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$464.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$526.01
|
| Rate for Payer: PHP Commercial |
$526.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$402.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.48
|
| Rate for Payer: Priority Health Narrow Network |
$166.78
|
| Rate for Payer: Priority Health SBD |
$389.86
|
| Rate for Payer: UMR Bronson Commercial |
$228.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$464.12
|
|
|
VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP
|
Facility
|
IP
|
$618.83
|
|
|
Service Code
|
HCPCS 90716
|
| Hospital Charge Code |
14757
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$272.29 |
| Max. Negotiated Rate |
$556.95 |
| Rate for Payer: Aetna American Axle |
$402.24
|
| Rate for Payer: Aetna Commercial |
$526.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.24
|
| Rate for Payer: Cash Price |
$495.06
|
| Rate for Payer: Cofinity Commercial |
$433.18
|
| Rate for Payer: Cofinity Commercial |
$532.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$433.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$495.06
|
| Rate for Payer: Healthscope Commercial |
$556.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$433.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$464.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$526.01
|
| Rate for Payer: PHP Commercial |
$526.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$402.24
|
| Rate for Payer: Priority Health SBD |
$389.86
|
| Rate for Payer: UMR Bronson Commercial |
$272.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$464.12
|
|
|
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 |
$1,207.22 |
| Max. Negotiated Rate |
$6,756.84 |
| Rate for Payer: Aetna American Axle |
$3,688.55
|
| Rate for Payer: Aetna Commercial |
$4,823.49
|
| Rate for Payer: Aetna Medicare |
$2,342.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,688.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,815.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,815.35
|
| Rate for Payer: BCBS Complete |
$1,267.58
|
| Rate for Payer: BCBS MAPPO |
$2,252.28
|
| Rate for Payer: BCBS Trust/PPO |
$5,683.54
|
| Rate for Payer: BCN Commercial |
$5,683.54
|
| Rate for Payer: BCN Medicare Advantage |
$2,252.28
|
| Rate for Payer: Cash Price |
$4,539.75
|
| Rate for Payer: Cash Price |
$4,539.75
|
| Rate for Payer: Cofinity Commercial |
$4,880.23
|
| Rate for Payer: Cofinity Commercial |
$3,972.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,972.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,539.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,252.28
|
| 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 |
$1,207.22
|
| Rate for Payer: Mclaren Medicare |
$2,252.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,364.89
|
| Rate for Payer: Meridian Medicaid |
$1,267.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,590.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,823.49
|
| Rate for Payer: Nomi Health Commercial |
$6,756.84
|
| Rate for Payer: PACE Medicare |
$2,139.67
|
| Rate for Payer: PACE SWMI |
$2,252.28
|
| Rate for Payer: PHP Commercial |
$4,823.49
|
| Rate for Payer: PHP Medicare Advantage |
$2,252.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,207.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,688.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,477.57
|
| Rate for Payer: Priority Health Medicare |
$2,252.28
|
| Rate for Payer: Priority Health Narrow Network |
$5,182.06
|
| Rate for Payer: Priority Health SBD |
$3,575.05
|
| Rate for Payer: Railroad Medicare Medicare |
$2,252.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,339.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,252.28
|
| Rate for Payer: UHC Exchange |
$4,304.33
|
| Rate for Payer: UHC Medicare Advantage |
$2,252.28
|
| Rate for Payer: UHCCP Medicaid |
$1,207.22
|
| Rate for Payer: UMR Bronson Commercial |
$2,099.64
|
| Rate for Payer: VA VA |
$2,252.28
|
| 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 Commercial |
$3,972.28
|
| Rate for Payer: Cofinity Commercial |
$4,880.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,972.28
|
| 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: PHP Commercial |
$4,823.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,688.55
|
| 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; ARTERIAL, OTHER THAN HEMORRHAGE OR TUMOR (EG, CONGENITAL OR ACQUIRED ARTERIAL MALFORMATIONS, ARTERIOVENOUS MALFORMATIONS, ARTERIOVENOUS FISTULAS, ANEURYSMS, PSEUDOANEURYSMS)
|
Facility
|
OP
|
$55,296.52
|
|
|
Service Code
|
CPT 37242
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$454.62 |
| Max. Negotiated Rate |
$55,296.52 |
| Rate for Payer: Aetna Medicare |
$18,297.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,992.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,992.05
|
| Rate for Payer: BCBS Complete |
$9,901.70
|
| Rate for Payer: BCBS MAPPO |
$17,593.64
|
| Rate for Payer: BCBS Trust/PPO |
$12,945.20
|
| Rate for Payer: BCN Commercial |
$12,945.20
|
| Rate for Payer: BCN Medicare Advantage |
$17,593.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,593.64
|
| Rate for Payer: Mclaren Medicaid |
$9,430.19
|
| Rate for Payer: Mclaren Medicare |
$17,593.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,473.32
|
| Rate for Payer: Meridian Medicaid |
$9,901.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,232.69
|
| Rate for Payer: Nomi Health Commercial |
$36,946.64
|
| Rate for Payer: PACE Medicare |
$16,713.96
|
| Rate for Payer: PACE SWMI |
$17,593.64
|
| Rate for Payer: PHP Medicare Advantage |
$17,593.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,430.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55,296.52
|
| Rate for Payer: Priority Health Medicare |
$17,593.64
|
| Rate for Payer: Priority Health Narrow Network |
$44,237.22
|
| Rate for Payer: Railroad Medicare Medicare |
$17,593.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$500.08
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,593.64
|
| Rate for Payer: UHC Exchange |
$454.62
|
| Rate for Payer: UHC Medicare Advantage |
$17,593.64
|
| Rate for Payer: UHCCP Medicaid |
$9,430.19
|
| Rate for Payer: VA VA |
$17,593.64
|
|
|
VASCULAR EMBOLIZATION OR OCCLUSION, INCLUSIVE OF ALL RADIOLOGICAL SUPERVISION AND INTERPRETATION, INTRAPROCEDURAL ROADMAPPING, AND IMAGING GUIDANCE NECESSARY TO COMPLETE THE INTERVENTION; FOR ARTERIAL OR VENOUS HEMORRHAGE OR LYMPHATIC EXTRAVASATION
|
Facility
|
OP
|
$34,922.52
|
|
|
Service Code
|
CPT 37244
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$624.78 |
| Max. Negotiated Rate |
$34,922.52 |
| Rate for Payer: Aetna Medicare |
$11,555.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$9,108.64
|
| Rate for Payer: BCN Commercial |
$9,108.64
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Nomi Health Commercial |
$23,333.65
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34,922.52
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$27,938.02
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$687.26
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$624.78
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: VA VA |
$11,111.26
|
|
|
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
|
$34,922.52
|
|
|
Service Code
|
CPT 37241
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$407.35 |
| Max. Negotiated Rate |
$34,922.52 |
| Rate for Payer: Aetna Medicare |
$11,555.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$11,699.99
|
| Rate for Payer: BCN Commercial |
$11,699.99
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Nomi Health Commercial |
$23,333.65
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34,922.52
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$27,938.02
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$448.08
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$407.35
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: VA VA |
$11,111.26
|
|
|
VASECTOMY, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE), INCLUDING POSTOPERATIVE SEMEN EXAMINATION(S)
|
Facility
|
OP
|
$6,308.24
|
|
|
Service Code
|
CPT 55250
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,075.80 |
| Max. Negotiated Rate |
$6,308.24 |
| Rate for Payer: Aetna Medicare |
$2,087.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,369.87
|
| Rate for Payer: BCN Commercial |
$1,369.87
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Mclaren Medicaid |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Nomi Health Commercial |
$4,214.89
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,308.24
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$5,046.59
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,649.76
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$3,835.75
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: VA VA |
$2,007.09
|
|
|
VASOPRESSIN 20 UNIT/ML INJECTION (CODE)
|
Facility
|
OP
|
$93.29
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
163709
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.34 |
| Max. Negotiated Rate |
$83.96 |
| Rate for Payer: Aetna American Axle |
$60.64
|
| Rate for Payer: Aetna Commercial |
$79.30
|
| Rate for Payer: Aetna Medicare |
$46.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.64
|
| Rate for Payer: BCBS Complete |
$37.32
|
| Rate for Payer: BCBS Trust/PPO |
$4.34
|
| Rate for Payer: BCN Commercial |
$4.34
|
| Rate for Payer: Cash Price |
$74.63
|
| Rate for Payer: Cash Price |
$74.63
|
| Rate for Payer: Cofinity Commercial |
$65.30
|
| Rate for Payer: Cofinity Commercial |
$80.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.63
|
| Rate for Payer: Healthscope Commercial |
$83.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.30
|
| Rate for Payer: PHP Commercial |
$79.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.64
|
| Rate for Payer: Priority Health SBD |
$58.77
|
| Rate for Payer: UMR Bronson Commercial |
$34.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.97
|
|
|
VASOPRESSIN 20 UNIT/ML INJECTION (CODE)
|
Facility
|
IP
|
$93.29
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
163709
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.05 |
| Max. Negotiated Rate |
$83.96 |
| Rate for Payer: Aetna American Axle |
$60.64
|
| Rate for Payer: Aetna Commercial |
$79.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.64
|
| Rate for Payer: Cash Price |
$74.63
|
| Rate for Payer: Cofinity Commercial |
$65.30
|
| Rate for Payer: Cofinity Commercial |
$80.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.63
|
| Rate for Payer: Healthscope Commercial |
$83.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.30
|
| Rate for Payer: PHP Commercial |
$79.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.64
|
| Rate for Payer: Priority Health SBD |
$58.77
|
| Rate for Payer: UMR Bronson Commercial |
$41.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.97
|
|
|
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$56.21
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
173104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.73 |
| Max. Negotiated Rate |
$50.59 |
| Rate for Payer: Aetna American Axle |
$36.54
|
| Rate for Payer: Aetna American Axle |
$65.97
|
| Rate for Payer: Aetna American Axle |
$100.66
|
| Rate for Payer: Aetna American Axle |
$78.11
|
| Rate for Payer: Aetna American Axle |
$41.62
|
| Rate for Payer: Aetna American Axle |
$63.49
|
| Rate for Payer: Aetna American Axle |
$61.87
|
| Rate for Payer: Aetna American Axle |
$34.92
|
| Rate for Payer: Aetna American Axle |
$60.64
|
| Rate for Payer: Aetna Commercial |
$45.67
|
| Rate for Payer: Aetna Commercial |
$80.91
|
| Rate for Payer: Aetna Commercial |
$79.30
|
| Rate for Payer: Aetna Commercial |
$131.63
|
| Rate for Payer: Aetna Commercial |
$47.78
|
| Rate for Payer: Aetna Commercial |
$54.43
|
| Rate for Payer: Aetna Commercial |
$102.14
|
| Rate for Payer: Aetna Commercial |
$86.27
|
| Rate for Payer: Aetna Commercial |
$83.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.11
|
| Rate for Payer: Cash Price |
$96.14
|
| Rate for Payer: Cash Price |
$44.97
|
| Rate for Payer: Cash Price |
$51.22
|
| Rate for Payer: Cash Price |
$76.15
|
| Rate for Payer: Cash Price |
$81.19
|
| Rate for Payer: Cash Price |
$78.14
|
| Rate for Payer: Cash Price |
$42.98
|
| Rate for Payer: Cash Price |
$74.63
|
| Rate for Payer: Cash Price |
$123.89
|
| Rate for Payer: Cofinity Commercial |
$39.35
|
| Rate for Payer: Cofinity Commercial |
$48.34
|
| Rate for Payer: Cofinity Commercial |
$87.28
|
| Rate for Payer: Cofinity Commercial |
$71.04
|
| Rate for Payer: Cofinity Commercial |
$103.35
|
| Rate for Payer: Cofinity Commercial |
$84.12
|
| Rate for Payer: Cofinity Commercial |
$108.40
|
| Rate for Payer: Cofinity Commercial |
$133.18
|
| Rate for Payer: Cofinity Commercial |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$68.37
|
| Rate for Payer: Cofinity Commercial |
$81.86
|
| Rate for Payer: Cofinity Commercial |
$66.63
|
| Rate for Payer: Cofinity Commercial |
$80.23
|
| Rate for Payer: Cofinity Commercial |
$65.30
|
| Rate for Payer: Cofinity Commercial |
$37.61
|
| Rate for Payer: Cofinity Commercial |
$46.21
|
| Rate for Payer: Cofinity Commercial |
$55.07
|
| Rate for Payer: Cofinity Commercial |
$44.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$108.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$84.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.97
|
| Rate for Payer: Healthscope Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$91.34
|
| Rate for Payer: Healthscope Commercial |
$139.37
|
| Rate for Payer: Healthscope Commercial |
$108.15
|
| Rate for Payer: Healthscope Commercial |
$48.36
|
| Rate for Payer: Healthscope Commercial |
$57.63
|
| Rate for Payer: Healthscope Commercial |
$83.96
|
| Rate for Payer: Healthscope Commercial |
$85.67
|
| Rate for Payer: Healthscope Commercial |
$87.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$108.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.30
|
| Rate for Payer: PHP Commercial |
$102.14
|
| Rate for Payer: PHP Commercial |
$79.30
|
| Rate for Payer: PHP Commercial |
$83.02
|
| Rate for Payer: PHP Commercial |
$47.78
|
| Rate for Payer: PHP Commercial |
$86.27
|
| Rate for Payer: PHP Commercial |
$80.91
|
| Rate for Payer: PHP Commercial |
$54.43
|
| Rate for Payer: PHP Commercial |
$131.63
|
| Rate for Payer: PHP Commercial |
$45.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.87
|
| Rate for Payer: Priority Health SBD |
$75.71
|
| Rate for Payer: Priority Health SBD |
$58.77
|
| Rate for Payer: Priority Health SBD |
$35.41
|
| Rate for Payer: Priority Health SBD |
$59.97
|
| Rate for Payer: Priority Health SBD |
$61.53
|
| Rate for Payer: Priority Health SBD |
$97.56
|
| Rate for Payer: Priority Health SBD |
$40.34
|
| Rate for Payer: Priority Health SBD |
$33.85
|
| Rate for Payer: Priority Health SBD |
$63.94
|
| Rate for Payer: UMR Bronson Commercial |
$68.14
|
| Rate for Payer: UMR Bronson Commercial |
$42.97
|
| Rate for Payer: UMR Bronson Commercial |
$52.87
|
| Rate for Payer: UMR Bronson Commercial |
$44.66
|
| Rate for Payer: UMR Bronson Commercial |
$41.05
|
| Rate for Payer: UMR Bronson Commercial |
$28.17
|
| Rate for Payer: UMR Bronson Commercial |
$23.64
|
| Rate for Payer: UMR Bronson Commercial |
$24.73
|
| Rate for Payer: UMR Bronson Commercial |
$41.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.16
|
|
|
VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$64.03
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
173104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.34 |
| Max. Negotiated Rate |
$57.63 |
| Rate for Payer: Aetna American Axle |
$41.62
|
| Rate for Payer: Aetna American Axle |
$63.49
|
| Rate for Payer: Aetna American Axle |
$100.66
|
| Rate for Payer: Aetna American Axle |
$34.92
|
| Rate for Payer: Aetna American Axle |
$60.64
|
| Rate for Payer: Aetna American Axle |
$65.97
|
| Rate for Payer: Aetna American Axle |
$78.11
|
| Rate for Payer: Aetna American Axle |
$36.54
|
| Rate for Payer: Aetna American Axle |
$61.87
|
| Rate for Payer: Aetna Commercial |
$47.78
|
| Rate for Payer: Aetna Commercial |
$80.91
|
| Rate for Payer: Aetna Commercial |
$45.67
|
| Rate for Payer: Aetna Commercial |
$79.30
|
| Rate for Payer: Aetna Commercial |
$83.02
|
| Rate for Payer: Aetna Commercial |
$54.43
|
| Rate for Payer: Aetna Commercial |
$131.63
|
| Rate for Payer: Aetna Commercial |
$86.27
|
| Rate for Payer: Aetna Commercial |
$102.14
|
| Rate for Payer: Aetna Medicare |
$46.64
|
| Rate for Payer: Aetna Medicare |
$26.86
|
| Rate for Payer: Aetna Medicare |
$60.08
|
| Rate for Payer: Aetna Medicare |
$50.74
|
| Rate for Payer: Aetna Medicare |
$28.10
|
| Rate for Payer: Aetna Medicare |
$77.43
|
| Rate for Payer: Aetna Medicare |
$48.84
|
| Rate for Payer: Aetna Medicare |
$32.02
|
| Rate for Payer: Aetna Medicare |
$47.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.97
|
| Rate for Payer: BCBS Complete |
$25.61
|
| Rate for Payer: BCBS Complete |
$21.49
|
| Rate for Payer: BCBS Complete |
$37.32
|
| Rate for Payer: BCBS Complete |
$22.48
|
| Rate for Payer: BCBS Complete |
$39.07
|
| Rate for Payer: BCBS Complete |
$38.08
|
| Rate for Payer: BCBS Complete |
$61.94
|
| Rate for Payer: BCBS Complete |
$40.60
|
| Rate for Payer: BCBS Complete |
$48.07
|
| Rate for Payer: BCBS Trust/PPO |
$4.34
|
| Rate for Payer: BCBS Trust/PPO |
$4.34
|
| Rate for Payer: BCBS Trust/PPO |
$4.34
|
| Rate for Payer: BCBS Trust/PPO |
$4.34
|
| Rate for Payer: BCBS Trust/PPO |
$4.34
|
| Rate for Payer: BCBS Trust/PPO |
$4.34
|
| Rate for Payer: BCBS Trust/PPO |
$4.34
|
| Rate for Payer: BCBS Trust/PPO |
$4.34
|
| Rate for Payer: BCBS Trust/PPO |
$4.34
|
| Rate for Payer: BCN Commercial |
$4.34
|
| Rate for Payer: BCN Commercial |
$4.34
|
| Rate for Payer: BCN Commercial |
$4.34
|
| Rate for Payer: BCN Commercial |
$4.34
|
| Rate for Payer: BCN Commercial |
$4.34
|
| Rate for Payer: BCN Commercial |
$4.34
|
| Rate for Payer: BCN Commercial |
$4.34
|
| Rate for Payer: BCN Commercial |
$4.34
|
| Rate for Payer: BCN Commercial |
$4.34
|
| Rate for Payer: Cash Price |
$42.98
|
| Rate for Payer: Cash Price |
$51.22
|
| Rate for Payer: Cash Price |
$96.14
|
| Rate for Payer: Cash Price |
$123.89
|
| Rate for Payer: Cash Price |
$81.19
|
| Rate for Payer: Cash Price |
$96.14
|
| Rate for Payer: Cash Price |
$81.19
|
| Rate for Payer: Cash Price |
$123.89
|
| Rate for Payer: Cash Price |
$78.14
|
| Rate for Payer: Cash Price |
$78.14
|
| Rate for Payer: Cash Price |
$76.15
|
| Rate for Payer: Cash Price |
$76.15
|
| Rate for Payer: Cash Price |
$74.63
|
| Rate for Payer: Cash Price |
$42.98
|
| Rate for Payer: Cash Price |
$74.63
|
| Rate for Payer: Cash Price |
$51.22
|
| Rate for Payer: Cash Price |
$44.97
|
| Rate for Payer: Cash Price |
$44.97
|
| Rate for Payer: Cofinity Commercial |
$55.07
|
| Rate for Payer: Cofinity Commercial |
$44.82
|
| Rate for Payer: Cofinity Commercial |
$48.34
|
| Rate for Payer: Cofinity Commercial |
$80.23
|
| Rate for Payer: Cofinity Commercial |
$66.63
|
| Rate for Payer: Cofinity Commercial |
$81.86
|
| Rate for Payer: Cofinity Commercial |
$68.37
|
| Rate for Payer: Cofinity Commercial |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$133.18
|
| Rate for Payer: Cofinity Commercial |
$39.35
|
| Rate for Payer: Cofinity Commercial |
$108.40
|
| Rate for Payer: Cofinity Commercial |
$103.35
|
| Rate for Payer: Cofinity Commercial |
$87.28
|
| Rate for Payer: Cofinity Commercial |
$71.04
|
| Rate for Payer: Cofinity Commercial |
$46.21
|
| Rate for Payer: Cofinity Commercial |
$84.12
|
| Rate for Payer: Cofinity Commercial |
$37.61
|
| Rate for Payer: Cofinity Commercial |
$65.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$108.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$84.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.19
|
| Rate for Payer: Healthscope Commercial |
$83.96
|
| Rate for Payer: Healthscope Commercial |
$87.90
|
| Rate for Payer: Healthscope Commercial |
$57.63
|
| Rate for Payer: Healthscope Commercial |
$48.36
|
| Rate for Payer: Healthscope Commercial |
$85.67
|
| Rate for Payer: Healthscope Commercial |
$108.15
|
| Rate for Payer: Healthscope Commercial |
$139.37
|
| Rate for Payer: Healthscope Commercial |
$91.34
|
| Rate for Payer: Healthscope Commercial |
$50.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$108.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.30
|
| Rate for Payer: PHP Commercial |
$45.67
|
| Rate for Payer: PHP Commercial |
$83.02
|
| Rate for Payer: PHP Commercial |
$79.30
|
| Rate for Payer: PHP Commercial |
$47.78
|
| Rate for Payer: PHP Commercial |
$80.91
|
| Rate for Payer: PHP Commercial |
$102.14
|
| Rate for Payer: PHP Commercial |
$86.27
|
| Rate for Payer: PHP Commercial |
$131.63
|
| Rate for Payer: PHP Commercial |
$54.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.97
|
| Rate for Payer: Priority Health SBD |
$35.41
|
| Rate for Payer: Priority Health SBD |
$33.85
|
| Rate for Payer: Priority Health SBD |
$40.34
|
| Rate for Payer: Priority Health SBD |
$63.94
|
| Rate for Payer: Priority Health SBD |
$97.56
|
| Rate for Payer: Priority Health SBD |
$61.53
|
| Rate for Payer: Priority Health SBD |
$58.77
|
| Rate for Payer: Priority Health SBD |
$75.71
|
| Rate for Payer: Priority Health SBD |
$59.97
|
| Rate for Payer: UMR Bronson Commercial |
$35.22
|
| Rate for Payer: UMR Bronson Commercial |
$34.52
|
| Rate for Payer: UMR Bronson Commercial |
$57.30
|
| Rate for Payer: UMR Bronson Commercial |
$37.55
|
| Rate for Payer: UMR Bronson Commercial |
$23.69
|
| Rate for Payer: UMR Bronson Commercial |
$19.88
|
| Rate for Payer: UMR Bronson Commercial |
$36.14
|
| Rate for Payer: UMR Bronson Commercial |
$44.46
|
| Rate for Payer: UMR Bronson Commercial |
$20.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.16
|
|
|
VASOPRESSIN 40 UNIT/100 ML (0.4 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
OP
|
$384.20
|
|
|
Service Code
|
HCPCS J2601
|
| Hospital Charge Code |
184045
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$345.78 |
| Rate for Payer: Aetna American Axle |
$249.73
|
| Rate for Payer: Aetna American Axle |
$290.53
|
| Rate for Payer: Aetna Commercial |
$379.92
|
| Rate for Payer: Aetna Commercial |
$326.57
|
| Rate for Payer: Aetna Medicare |
$3.78
|
| Rate for Payer: Aetna Medicare |
$3.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.54
|
| Rate for Payer: BCBS Complete |
$2.04
|
| Rate for Payer: BCBS Complete |
$2.04
|
| Rate for Payer: BCBS MAPPO |
$3.63
|
| Rate for Payer: BCBS MAPPO |
$3.63
|
| Rate for Payer: BCBS Trust/PPO |
$9.79
|
| Rate for Payer: BCBS Trust/PPO |
$9.79
|
| Rate for Payer: BCN Commercial |
$9.79
|
| Rate for Payer: BCN Commercial |
$9.79
|
| Rate for Payer: BCN Medicare Advantage |
$3.63
|
| Rate for Payer: BCN Medicare Advantage |
$3.63
|
| Rate for Payer: Cash Price |
$357.58
|
| Rate for Payer: Cash Price |
$307.36
|
| Rate for Payer: Cash Price |
$357.58
|
| Rate for Payer: Cash Price |
$307.36
|
| Rate for Payer: Cofinity Commercial |
$312.88
|
| Rate for Payer: Cofinity Commercial |
$268.94
|
| Rate for Payer: Cofinity Commercial |
$330.41
|
| Rate for Payer: Cofinity Commercial |
$384.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$268.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$312.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.63
|
| Rate for Payer: Healthscope Commercial |
$345.78
|
| Rate for Payer: Healthscope Commercial |
$402.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$268.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.23
|
| Rate for Payer: Mclaren Medicaid |
$1.95
|
| Rate for Payer: Mclaren Medicaid |
$1.95
|
| Rate for Payer: Mclaren Medicare |
$3.63
|
| Rate for Payer: Mclaren Medicare |
$3.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.81
|
| Rate for Payer: Meridian Medicaid |
$2.04
|
| Rate for Payer: Meridian Medicaid |
$2.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.92
|
| Rate for Payer: Nomi Health Commercial |
$10.89
|
| Rate for Payer: Nomi Health Commercial |
$10.89
|
| Rate for Payer: PACE Medicare |
$3.45
|
| Rate for Payer: PACE Medicare |
$3.45
|
| Rate for Payer: PACE SWMI |
$3.63
|
| Rate for Payer: PACE SWMI |
$3.63
|
| Rate for Payer: PHP Commercial |
$326.57
|
| Rate for Payer: PHP Commercial |
$379.92
|
| Rate for Payer: PHP Medicare Advantage |
$3.63
|
| Rate for Payer: PHP Medicare Advantage |
$3.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.86
|
| Rate for Payer: Priority Health Medicare |
$3.63
|
| Rate for Payer: Priority Health Medicare |
$3.63
|
| Rate for Payer: Priority Health Narrow Network |
$8.69
|
| Rate for Payer: Priority Health Narrow Network |
$8.69
|
| Rate for Payer: Priority Health SBD |
$242.05
|
| Rate for Payer: Priority Health SBD |
$281.59
|
| Rate for Payer: Railroad Medicare Medicare |
$3.63
|
| Rate for Payer: Railroad Medicare Medicare |
$3.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.63
|
| Rate for Payer: UHC Exchange |
$6.94
|
| Rate for Payer: UHC Exchange |
$6.94
|
| Rate for Payer: UHC Medicare Advantage |
$3.63
|
| Rate for Payer: UHC Medicare Advantage |
$3.63
|
| Rate for Payer: UHCCP Medicaid |
$1.95
|
| Rate for Payer: UHCCP Medicaid |
$1.95
|
| Rate for Payer: UMR Bronson Commercial |
$142.15
|
| Rate for Payer: UMR Bronson Commercial |
$165.38
|
| Rate for Payer: VA VA |
$3.63
|
| Rate for Payer: VA VA |
$3.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.23
|
|
|
VASOPRESSIN 40 UNIT/100 ML (0.4 UNIT/ML) IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
IP
|
$384.20
|
|
|
Service Code
|
HCPCS J2601
|
| Hospital Charge Code |
184045
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$169.05 |
| Max. Negotiated Rate |
$345.78 |
| Rate for Payer: Aetna American Axle |
$249.73
|
| Rate for Payer: Aetna American Axle |
$290.53
|
| Rate for Payer: Aetna Commercial |
$326.57
|
| Rate for Payer: Aetna Commercial |
$379.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.53
|
| Rate for Payer: Cash Price |
$307.36
|
| Rate for Payer: Cash Price |
$357.58
|
| Rate for Payer: Cofinity Commercial |
$384.39
|
| Rate for Payer: Cofinity Commercial |
$312.88
|
| Rate for Payer: Cofinity Commercial |
$268.94
|
| Rate for Payer: Cofinity Commercial |
$330.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$268.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$312.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.58
|
| Rate for Payer: Healthscope Commercial |
$345.78
|
| Rate for Payer: Healthscope Commercial |
$402.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$268.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.57
|
| Rate for Payer: PHP Commercial |
$379.92
|
| Rate for Payer: PHP Commercial |
$326.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.53
|
| Rate for Payer: Priority Health SBD |
$242.05
|
| Rate for Payer: Priority Health SBD |
$281.59
|
| Rate for Payer: UMR Bronson Commercial |
$169.05
|
| Rate for Payer: UMR Bronson Commercial |
$196.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.23
|
|
|
VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$23.59
|
|
|
Service Code
|
NDC 67457043810
|
| Hospital Charge Code |
11634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.73 |
| Max. Negotiated Rate |
$21.23 |
| Rate for Payer: Aetna American Axle |
$15.33
|
| Rate for Payer: Aetna Commercial |
$20.05
|
| Rate for Payer: Aetna Medicare |
$11.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.33
|
| Rate for Payer: BCBS Complete |
$9.44
|
| Rate for Payer: Cash Price |
$18.87
|
| Rate for Payer: Cofinity Commercial |
$16.51
|
| Rate for Payer: Cofinity Commercial |
$20.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.87
|
| Rate for Payer: Healthscope Commercial |
$21.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.05
|
| Rate for Payer: PHP Commercial |
$20.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.33
|
| Rate for Payer: Priority Health SBD |
$14.86
|
| Rate for Payer: UMR Bronson Commercial |
$8.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.69
|
|
