|
CLARITHROMYCIN 500 MG TABLET
|
Facility
|
OP
|
$261.80
|
|
|
Service Code
|
NDC 00781196260
|
| Hospital Charge Code |
9617
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$96.87 |
| Max. Negotiated Rate |
$235.62 |
| Rate for Payer: Aetna American Axle |
$170.17
|
| Rate for Payer: Aetna Commercial |
$222.53
|
| Rate for Payer: Aetna Medicare |
$130.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.17
|
| Rate for Payer: BCBS Complete |
$104.72
|
| Rate for Payer: Cash Price |
$209.44
|
| Rate for Payer: Cofinity Advantage |
$183.26
|
| Rate for Payer: Cofinity Commercial |
$225.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.44
|
| Rate for Payer: Healthscope Commercial |
$235.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$183.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$209.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.35
|
| Rate for Payer: PHP Commercial |
$222.53
|
| Rate for Payer: Priority Health SBD |
$164.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.17
|
| Rate for Payer: UHC Core |
$136.40
|
| Rate for Payer: UHC Exchange |
$102.89
|
| Rate for Payer: UMR Bronson Commercial |
$96.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.35
|
|
|
CLARITHROMYCIN 500 MG TABLET
|
Facility
|
OP
|
$251.14
|
|
|
Service Code
|
NDC 00527193206
|
| Hospital Charge Code |
9617
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$92.92 |
| Max. Negotiated Rate |
$226.03 |
| Rate for Payer: Aetna American Axle |
$163.24
|
| Rate for Payer: Aetna Commercial |
$213.47
|
| Rate for Payer: Aetna Medicare |
$125.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.24
|
| Rate for Payer: BCBS Complete |
$100.46
|
| Rate for Payer: Cash Price |
$200.91
|
| Rate for Payer: Cofinity Advantage |
$175.80
|
| Rate for Payer: Cofinity Commercial |
$215.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.91
|
| Rate for Payer: Healthscope Commercial |
$226.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$188.35
|
| Rate for Payer: PHP Commercial |
$213.47
|
| Rate for Payer: Priority Health SBD |
$158.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.24
|
| Rate for Payer: UHC Core |
$130.84
|
| Rate for Payer: UHC Exchange |
$98.70
|
| Rate for Payer: UMR Bronson Commercial |
$92.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.35
|
|
|
CLARITHROMYCIN 500 MG TABLET
|
Facility
|
IP
|
$261.80
|
|
|
Service Code
|
NDC 00781196260
|
| Hospital Charge Code |
9617
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$115.19 |
| Max. Negotiated Rate |
$235.62 |
| Rate for Payer: Aetna American Axle |
$170.17
|
| Rate for Payer: Aetna Commercial |
$222.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.17
|
| Rate for Payer: Cash Price |
$209.44
|
| Rate for Payer: Cofinity Advantage |
$183.26
|
| Rate for Payer: Cofinity Commercial |
$225.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.44
|
| Rate for Payer: Healthscope Commercial |
$235.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$183.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.35
|
| Rate for Payer: PHP Commercial |
$222.53
|
| Rate for Payer: Priority Health SBD |
$164.93
|
| Rate for Payer: UMR Bronson Commercial |
$115.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.35
|
|
|
CLAVICULECTOMY; PARTIAL
|
Facility
|
OP
|
$10,543.31
|
|
|
Service Code
|
CPT 23120
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,705.10 |
| Max. Negotiated Rate |
$10,543.31 |
| Rate for Payer: Aetna Medicare |
$3,390.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,675.66
|
| Rate for Payer: BCN Commercial |
$2,675.66
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Mclaren Medicaid |
$3,260.23
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$3,423.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Nomi Health Commercial |
$9,780.69
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,543.31
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health Tiered Network |
$8,434.65
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP Medicaid |
$1,705.10
|
| Rate for Payer: VA VA |
$3,260.23
|
|
|
CLEFT LIP AND PALATE REPAIR
|
Facility
|
IP
|
$23,834.67
|
|
|
Service Code
|
APR-DRG 0954
|
| Min. Negotiated Rate |
$22,699.69 |
| Max. Negotiated Rate |
$23,834.67 |
| Rate for Payer: BCBS Complete |
$23,834.67
|
| Rate for Payer: Mclaren Medicaid |
$22,699.69
|
| Rate for Payer: Meridian Medicaid |
$23,834.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$22,699.69
|
| Rate for Payer: UHC Medicaid |
$22,699.69
|
| Rate for Payer: UHCCP Medicaid |
$22,699.69
|
|
|
CLEFT LIP AND PALATE REPAIR
|
Facility
|
IP
|
$13,613.15
|
|
|
Service Code
|
APR-DRG 0953
|
| Min. Negotiated Rate |
$12,964.91 |
| Max. Negotiated Rate |
$13,613.15 |
| Rate for Payer: BCBS Complete |
$13,613.15
|
| Rate for Payer: Mclaren Medicaid |
$12,964.91
|
| Rate for Payer: Meridian Medicaid |
$13,613.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,964.91
|
| Rate for Payer: UHC Medicaid |
$12,964.91
|
| Rate for Payer: UHCCP Medicaid |
$12,964.91
|
|
|
CLEFT LIP AND PALATE REPAIR
|
Facility
|
IP
|
$8,559.30
|
|
|
Service Code
|
APR-DRG 0951
|
| Min. Negotiated Rate |
$8,151.71 |
| Max. Negotiated Rate |
$8,559.30 |
| Rate for Payer: BCBS Complete |
$8,559.30
|
| Rate for Payer: Mclaren Medicaid |
$8,151.71
|
| Rate for Payer: Meridian Medicaid |
$8,559.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,151.71
|
| Rate for Payer: UHC Medicaid |
$8,151.71
|
| Rate for Payer: UHCCP Medicaid |
$8,151.71
|
|
|
CLEFT LIP AND PALATE REPAIR
|
Facility
|
IP
|
$11,490.88
|
|
|
Service Code
|
APR-DRG 0952
|
| Min. Negotiated Rate |
$10,943.70 |
| Max. Negotiated Rate |
$11,490.88 |
| Rate for Payer: BCBS Complete |
$11,490.88
|
| Rate for Payer: Mclaren Medicaid |
$10,943.70
|
| Rate for Payer: Meridian Medicaid |
$11,490.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,943.70
|
| Rate for Payer: UHC Medicaid |
$10,943.70
|
| Rate for Payer: UHCCP Medicaid |
$10,943.70
|
|
|
CLINDAMYCIN 100 MG/ML CUSTOM INJECTION
|
Facility
|
OP
|
$561.00
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
500550
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$504.90 |
| Rate for Payer: Aetna American Axle |
$364.65
|
| Rate for Payer: Aetna American Axle |
$44.56
|
| Rate for Payer: Aetna Commercial |
$476.85
|
| Rate for Payer: Aetna Commercial |
$58.27
|
| Rate for Payer: Aetna Medicare |
$280.50
|
| Rate for Payer: Aetna Medicare |
$34.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.56
|
| Rate for Payer: BCBS Complete |
$27.42
|
| Rate for Payer: BCBS Complete |
$224.40
|
| Rate for Payer: BCBS Trust/PPO |
$6.17
|
| Rate for Payer: BCBS Trust/PPO |
$6.17
|
| Rate for Payer: BCN Commercial |
$6.17
|
| Rate for Payer: BCN Commercial |
$6.17
|
| Rate for Payer: Cash Price |
$448.80
|
| Rate for Payer: Cash Price |
$54.84
|
| Rate for Payer: Cash Price |
$448.80
|
| Rate for Payer: Cash Price |
$54.84
|
| Rate for Payer: Cofinity Advantage |
$392.70
|
| Rate for Payer: Cofinity Advantage |
$47.98
|
| Rate for Payer: Cofinity Commercial |
$482.46
|
| Rate for Payer: Cofinity Commercial |
$58.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$448.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.84
|
| Rate for Payer: Healthscope Commercial |
$504.90
|
| Rate for Payer: Healthscope Commercial |
$61.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$392.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$420.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$476.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$420.75
|
| Rate for Payer: PHP Commercial |
$476.85
|
| Rate for Payer: PHP Commercial |
$58.27
|
| Rate for Payer: Priority Health SBD |
$353.43
|
| Rate for Payer: Priority Health SBD |
$43.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.15
|
| Rate for Payer: UHC Core |
$3.15
|
| Rate for Payer: UHC Core |
$3.15
|
| Rate for Payer: UHC Exchange |
$3.15
|
| Rate for Payer: UHC Exchange |
$3.15
|
| Rate for Payer: UMR Bronson Commercial |
$207.57
|
| Rate for Payer: UMR Bronson Commercial |
$25.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$420.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.41
|
|
|
CLINDAMYCIN 100 MG/ML CUSTOM INJECTION
|
Facility
|
IP
|
$561.00
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
500550
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$246.84 |
| Max. Negotiated Rate |
$504.90 |
| Rate for Payer: Aetna American Axle |
$364.65
|
| Rate for Payer: Aetna American Axle |
$44.56
|
| Rate for Payer: Aetna Commercial |
$476.85
|
| Rate for Payer: Aetna Commercial |
$58.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.56
|
| Rate for Payer: Cash Price |
$448.80
|
| Rate for Payer: Cash Price |
$54.84
|
| Rate for Payer: Cofinity Advantage |
$47.98
|
| Rate for Payer: Cofinity Advantage |
$392.70
|
| Rate for Payer: Cofinity Commercial |
$58.95
|
| Rate for Payer: Cofinity Commercial |
$482.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$448.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.84
|
| Rate for Payer: Healthscope Commercial |
$504.90
|
| Rate for Payer: Healthscope Commercial |
$61.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$392.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$420.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$476.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$420.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.41
|
| Rate for Payer: PHP Commercial |
$476.85
|
| Rate for Payer: PHP Commercial |
$58.27
|
| Rate for Payer: Priority Health SBD |
$43.19
|
| Rate for Payer: Priority Health SBD |
$353.43
|
| Rate for Payer: UMR Bronson Commercial |
$246.84
|
| Rate for Payer: UMR Bronson Commercial |
$30.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$420.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.41
|
|
|
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$99.86
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
1743
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$43.94 |
| Max. Negotiated Rate |
$89.87 |
| Rate for Payer: Aetna American Axle |
$64.91
|
| Rate for Payer: Aetna American Axle |
$13.66
|
| Rate for Payer: Aetna American Axle |
$12.32
|
| Rate for Payer: Aetna American Axle |
$13.20
|
| Rate for Payer: Aetna American Axle |
$61.96
|
| Rate for Payer: Aetna Commercial |
$16.12
|
| Rate for Payer: Aetna Commercial |
$17.25
|
| Rate for Payer: Aetna Commercial |
$17.87
|
| Rate for Payer: Aetna Commercial |
$81.02
|
| Rate for Payer: Aetna Commercial |
$84.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.96
|
| Rate for Payer: Cash Price |
$16.82
|
| Rate for Payer: Cash Price |
$15.17
|
| Rate for Payer: Cash Price |
$79.89
|
| Rate for Payer: Cash Price |
$76.26
|
| Rate for Payer: Cash Price |
$16.24
|
| Rate for Payer: Cofinity Advantage |
$69.90
|
| Rate for Payer: Cofinity Advantage |
$14.71
|
| Rate for Payer: Cofinity Advantage |
$13.27
|
| Rate for Payer: Cofinity Advantage |
$14.21
|
| Rate for Payer: Cofinity Advantage |
$66.72
|
| Rate for Payer: Cofinity Commercial |
$85.88
|
| Rate for Payer: Cofinity Commercial |
$18.08
|
| Rate for Payer: Cofinity Commercial |
$16.31
|
| Rate for Payer: Cofinity Commercial |
$17.46
|
| Rate for Payer: Cofinity Commercial |
$81.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.17
|
| Rate for Payer: Healthscope Commercial |
$18.27
|
| Rate for Payer: Healthscope Commercial |
$17.06
|
| Rate for Payer: Healthscope Commercial |
$85.79
|
| Rate for Payer: Healthscope Commercial |
$89.87
|
| Rate for Payer: Healthscope Commercial |
$18.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.89
|
| Rate for Payer: PHP Commercial |
$17.25
|
| Rate for Payer: PHP Commercial |
$16.12
|
| Rate for Payer: PHP Commercial |
$81.02
|
| Rate for Payer: PHP Commercial |
$84.88
|
| Rate for Payer: PHP Commercial |
$17.87
|
| Rate for Payer: Priority Health SBD |
$11.94
|
| Rate for Payer: Priority Health SBD |
$12.79
|
| Rate for Payer: Priority Health SBD |
$60.05
|
| Rate for Payer: Priority Health SBD |
$13.24
|
| Rate for Payer: Priority Health SBD |
$62.91
|
| Rate for Payer: UMR Bronson Commercial |
$9.25
|
| Rate for Payer: UMR Bronson Commercial |
$43.94
|
| Rate for Payer: UMR Bronson Commercial |
$41.94
|
| Rate for Payer: UMR Bronson Commercial |
$8.34
|
| Rate for Payer: UMR Bronson Commercial |
$8.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.49
|
|
|
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$18.96
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
1743
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$17.06 |
| Rate for Payer: Aetna American Axle |
$12.32
|
| Rate for Payer: Aetna American Axle |
$61.96
|
| Rate for Payer: Aetna American Axle |
$13.66
|
| Rate for Payer: Aetna American Axle |
$13.20
|
| Rate for Payer: Aetna American Axle |
$64.91
|
| Rate for Payer: Aetna Commercial |
$16.12
|
| Rate for Payer: Aetna Commercial |
$17.25
|
| Rate for Payer: Aetna Commercial |
$84.88
|
| Rate for Payer: Aetna Commercial |
$81.02
|
| Rate for Payer: Aetna Commercial |
$17.87
|
| Rate for Payer: Aetna Medicare |
$49.93
|
| Rate for Payer: Aetna Medicare |
$10.15
|
| Rate for Payer: Aetna Medicare |
$9.48
|
| Rate for Payer: Aetna Medicare |
$10.51
|
| Rate for Payer: Aetna Medicare |
$47.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.91
|
| Rate for Payer: BCBS Complete |
$38.13
|
| Rate for Payer: BCBS Complete |
$7.58
|
| Rate for Payer: BCBS Complete |
$8.12
|
| Rate for Payer: BCBS Complete |
$8.41
|
| Rate for Payer: BCBS Complete |
$39.94
|
| Rate for Payer: BCBS Trust/PPO |
$6.17
|
| Rate for Payer: BCBS Trust/PPO |
$6.17
|
| Rate for Payer: BCBS Trust/PPO |
$6.17
|
| Rate for Payer: BCBS Trust/PPO |
$6.17
|
| Rate for Payer: BCBS Trust/PPO |
$6.17
|
| Rate for Payer: BCN Commercial |
$6.17
|
| Rate for Payer: BCN Commercial |
$6.17
|
| Rate for Payer: BCN Commercial |
$6.17
|
| Rate for Payer: BCN Commercial |
$6.17
|
| Rate for Payer: BCN Commercial |
$6.17
|
| Rate for Payer: Cash Price |
$76.26
|
| Rate for Payer: Cash Price |
$79.89
|
| Rate for Payer: Cash Price |
$16.24
|
| Rate for Payer: Cash Price |
$15.17
|
| Rate for Payer: Cash Price |
$16.82
|
| Rate for Payer: Cash Price |
$15.17
|
| Rate for Payer: Cash Price |
$16.82
|
| Rate for Payer: Cash Price |
$76.26
|
| Rate for Payer: Cash Price |
$16.24
|
| Rate for Payer: Cash Price |
$79.89
|
| Rate for Payer: Cofinity Advantage |
$66.72
|
| Rate for Payer: Cofinity Advantage |
$14.21
|
| Rate for Payer: Cofinity Advantage |
$14.71
|
| Rate for Payer: Cofinity Advantage |
$69.90
|
| Rate for Payer: Cofinity Advantage |
$13.27
|
| Rate for Payer: Cofinity Commercial |
$81.98
|
| Rate for Payer: Cofinity Commercial |
$16.31
|
| Rate for Payer: Cofinity Commercial |
$17.46
|
| Rate for Payer: Cofinity Commercial |
$18.08
|
| Rate for Payer: Cofinity Commercial |
$85.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.82
|
| Rate for Payer: Healthscope Commercial |
$18.92
|
| Rate for Payer: Healthscope Commercial |
$89.87
|
| Rate for Payer: Healthscope Commercial |
$85.79
|
| Rate for Payer: Healthscope Commercial |
$17.06
|
| Rate for Payer: Healthscope Commercial |
$18.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.89
|
| Rate for Payer: PHP Commercial |
$17.25
|
| Rate for Payer: PHP Commercial |
$17.87
|
| Rate for Payer: PHP Commercial |
$84.88
|
| Rate for Payer: PHP Commercial |
$81.02
|
| Rate for Payer: PHP Commercial |
$16.12
|
| Rate for Payer: Priority Health SBD |
$13.24
|
| Rate for Payer: Priority Health SBD |
$11.94
|
| Rate for Payer: Priority Health SBD |
$60.05
|
| Rate for Payer: Priority Health SBD |
$62.91
|
| Rate for Payer: Priority Health SBD |
$12.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.15
|
| Rate for Payer: UHC Core |
$3.15
|
| Rate for Payer: UHC Core |
$3.15
|
| Rate for Payer: UHC Core |
$3.15
|
| Rate for Payer: UHC Core |
$3.15
|
| Rate for Payer: UHC Core |
$3.15
|
| Rate for Payer: UHC Exchange |
$3.15
|
| Rate for Payer: UHC Exchange |
$3.15
|
| Rate for Payer: UHC Exchange |
$3.15
|
| Rate for Payer: UHC Exchange |
$3.15
|
| Rate for Payer: UHC Exchange |
$3.15
|
| Rate for Payer: UMR Bronson Commercial |
$7.02
|
| Rate for Payer: UMR Bronson Commercial |
$35.27
|
| Rate for Payer: UMR Bronson Commercial |
$7.78
|
| Rate for Payer: UMR Bronson Commercial |
$36.95
|
| Rate for Payer: UMR Bronson Commercial |
$7.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.22
|
|
|
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION (BMH OSC)
|
Facility
|
IP
|
$99.86
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
169407
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$43.94 |
| Max. Negotiated Rate |
$89.87 |
| Rate for Payer: Aetna American Axle |
$64.91
|
| Rate for Payer: Aetna Commercial |
$84.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.91
|
| Rate for Payer: Cash Price |
$79.89
|
| Rate for Payer: Cofinity Advantage |
$69.90
|
| Rate for Payer: Cofinity Commercial |
$85.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.89
|
| Rate for Payer: Healthscope Commercial |
$89.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.89
|
| Rate for Payer: PHP Commercial |
$84.88
|
| Rate for Payer: Priority Health SBD |
$62.91
|
| Rate for Payer: UMR Bronson Commercial |
$43.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.89
|
|
|
CLINDAMYCIN 150 MG/ML INJECTION SOLUTION (BMH OSC)
|
Facility
|
OP
|
$99.86
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
169407
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$89.87 |
| Rate for Payer: Aetna American Axle |
$64.91
|
| Rate for Payer: Aetna Commercial |
$84.88
|
| Rate for Payer: Aetna Medicare |
$49.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.91
|
| Rate for Payer: BCBS Complete |
$39.94
|
| Rate for Payer: BCBS Trust/PPO |
$6.17
|
| Rate for Payer: BCN Commercial |
$6.17
|
| Rate for Payer: Cash Price |
$79.89
|
| Rate for Payer: Cash Price |
$79.89
|
| Rate for Payer: Cofinity Advantage |
$69.90
|
| Rate for Payer: Cofinity Commercial |
$85.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.89
|
| Rate for Payer: Healthscope Commercial |
$89.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.89
|
| Rate for Payer: PHP Commercial |
$84.88
|
| Rate for Payer: Priority Health SBD |
$62.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.15
|
| Rate for Payer: UHC Core |
$3.15
|
| Rate for Payer: UHC Exchange |
$3.15
|
| Rate for Payer: UMR Bronson Commercial |
$36.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.89
|
|
|
CLINDAMYCIN 2 % VAGINAL CREAM
|
Facility
|
IP
|
$245.42
|
|
|
Service Code
|
NDC 00168027740
|
| Hospital Charge Code |
9624
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$107.98 |
| Max. Negotiated Rate |
$220.88 |
| Rate for Payer: Aetna American Axle |
$159.52
|
| Rate for Payer: Aetna Commercial |
$208.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.52
|
| Rate for Payer: Cash Price |
$196.34
|
| Rate for Payer: Cofinity Advantage |
$171.79
|
| Rate for Payer: Cofinity Commercial |
$211.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.34
|
| Rate for Payer: Healthscope Commercial |
$220.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.06
|
| Rate for Payer: PHP Commercial |
$208.61
|
| Rate for Payer: Priority Health SBD |
$154.61
|
| Rate for Payer: UMR Bronson Commercial |
$107.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.06
|
|
|
CLINDAMYCIN 2 % VAGINAL CREAM
|
Facility
|
OP
|
$245.42
|
|
|
Service Code
|
NDC 00168027740
|
| Hospital Charge Code |
9624
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$90.81 |
| Max. Negotiated Rate |
$220.88 |
| Rate for Payer: Aetna American Axle |
$159.52
|
| Rate for Payer: Aetna Commercial |
$208.61
|
| Rate for Payer: Aetna Medicare |
$122.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.52
|
| Rate for Payer: BCBS Complete |
$98.17
|
| Rate for Payer: Cash Price |
$196.34
|
| Rate for Payer: Cofinity Advantage |
$171.79
|
| Rate for Payer: Cofinity Commercial |
$211.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.34
|
| Rate for Payer: Healthscope Commercial |
$220.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$196.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.06
|
| Rate for Payer: PHP Commercial |
$208.61
|
| Rate for Payer: Priority Health SBD |
$154.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.52
|
| Rate for Payer: UHC Core |
$127.86
|
| Rate for Payer: UHC Exchange |
$96.45
|
| Rate for Payer: UMR Bronson Commercial |
$90.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.06
|
|
|
CLINDAMYCIN 2 % VAGINAL CREAM
|
Facility
|
IP
|
$282.80
|
|
|
Service Code
|
NDC 59762500901
|
| Hospital Charge Code |
9624
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$124.43 |
| Max. Negotiated Rate |
$254.52 |
| Rate for Payer: Aetna American Axle |
$183.82
|
| Rate for Payer: Aetna Commercial |
$240.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.82
|
| Rate for Payer: Cash Price |
$226.24
|
| Rate for Payer: Cofinity Advantage |
$197.96
|
| Rate for Payer: Cofinity Commercial |
$243.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.24
|
| Rate for Payer: Healthscope Commercial |
$254.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$197.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.10
|
| Rate for Payer: PHP Commercial |
$240.38
|
| Rate for Payer: Priority Health SBD |
$178.16
|
| Rate for Payer: UMR Bronson Commercial |
$124.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.10
|
|
|
CLINDAMYCIN 2 % VAGINAL CREAM
|
Facility
|
OP
|
$282.80
|
|
|
Service Code
|
NDC 59762500901
|
| Hospital Charge Code |
9624
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$104.64 |
| Max. Negotiated Rate |
$254.52 |
| Rate for Payer: Aetna American Axle |
$183.82
|
| Rate for Payer: Aetna Commercial |
$240.38
|
| Rate for Payer: Aetna Medicare |
$141.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.82
|
| Rate for Payer: BCBS Complete |
$113.12
|
| Rate for Payer: Cash Price |
$226.24
|
| Rate for Payer: Cofinity Advantage |
$197.96
|
| Rate for Payer: Cofinity Commercial |
$243.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.24
|
| Rate for Payer: Healthscope Commercial |
$254.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$197.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.10
|
| Rate for Payer: PHP Commercial |
$240.38
|
| Rate for Payer: Priority Health SBD |
$178.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.82
|
| Rate for Payer: UHC Core |
$147.34
|
| Rate for Payer: UHC Exchange |
$111.14
|
| Rate for Payer: UMR Bronson Commercial |
$104.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.10
|
|
|
CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK
|
Facility
|
IP
|
$21.36
|
|
|
Service Code
|
HCPCS J0737
|
| Hospital Charge Code |
183289
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.40 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna American Axle |
$13.88
|
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Advantage |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.02
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health SBD |
$13.46
|
| Rate for Payer: UMR Bronson Commercial |
$9.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.02
|
|
|
CLINDAMYCIN 600 MG/50 ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS PIGGYBACK
|
Facility
|
OP
|
$21.36
|
|
|
Service Code
|
HCPCS J0737
|
| Hospital Charge Code |
183289
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.88 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna American Axle |
$13.88
|
| Rate for Payer: Aetna Commercial |
$18.16
|
| Rate for Payer: Aetna Medicare |
$10.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: BCBS Complete |
$8.54
|
| Rate for Payer: BCBS Trust/PPO |
$7.61
|
| Rate for Payer: BCN Commercial |
$7.61
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Cofinity Advantage |
$14.95
|
| Rate for Payer: Cofinity Commercial |
$18.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.09
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.02
|
| Rate for Payer: PHP Commercial |
$18.16
|
| Rate for Payer: Priority Health SBD |
$13.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.88
|
| Rate for Payer: UHC Core |
$3.88
|
| Rate for Payer: UHC Exchange |
$3.88
|
| Rate for Payer: UMR Bronson Commercial |
$7.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.02
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$29.82
|
|
|
Service Code
|
NDC 00781328991
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.03 |
| Max. Negotiated Rate |
$26.84 |
| Rate for Payer: Aetna American Axle |
$19.38
|
| Rate for Payer: Aetna Commercial |
$25.35
|
| Rate for Payer: Aetna Medicare |
$14.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.38
|
| Rate for Payer: BCBS Complete |
$11.93
|
| Rate for Payer: Cash Price |
$23.86
|
| Rate for Payer: Cofinity Advantage |
$20.87
|
| Rate for Payer: Cofinity Commercial |
$25.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.86
|
| Rate for Payer: Healthscope Commercial |
$26.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.36
|
| Rate for Payer: PHP Commercial |
$25.35
|
| Rate for Payer: Priority Health SBD |
$18.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.38
|
| Rate for Payer: UHC Core |
$15.54
|
| Rate for Payer: UHC Exchange |
$11.72
|
| Rate for Payer: UMR Bronson Commercial |
$11.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.36
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
OP
|
$44.28
|
|
|
Service Code
|
NDC 43066099324
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.38 |
| Max. Negotiated Rate |
$39.85 |
| Rate for Payer: Aetna American Axle |
$28.78
|
| Rate for Payer: Aetna Commercial |
$37.64
|
| Rate for Payer: Aetna Medicare |
$22.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.78
|
| Rate for Payer: BCBS Complete |
$17.71
|
| Rate for Payer: Cash Price |
$35.42
|
| Rate for Payer: Cofinity Advantage |
$31.00
|
| Rate for Payer: Cofinity Commercial |
$38.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.42
|
| Rate for Payer: Healthscope Commercial |
$39.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.21
|
| Rate for Payer: PHP Commercial |
$37.64
|
| Rate for Payer: Priority Health SBD |
$27.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.78
|
| Rate for Payer: UHC Core |
$23.07
|
| Rate for Payer: UHC Exchange |
$17.40
|
| Rate for Payer: UMR Bronson Commercial |
$16.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.21
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
IP
|
$44.28
|
|
|
Service Code
|
NDC 43066099324
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$19.48 |
| Max. Negotiated Rate |
$39.85 |
| Rate for Payer: Aetna American Axle |
$28.78
|
| Rate for Payer: Aetna Commercial |
$37.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.78
|
| Rate for Payer: Cash Price |
$35.42
|
| Rate for Payer: Cofinity Advantage |
$31.00
|
| Rate for Payer: Cofinity Commercial |
$38.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.42
|
| Rate for Payer: Healthscope Commercial |
$39.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.21
|
| Rate for Payer: PHP Commercial |
$37.64
|
| Rate for Payer: Priority Health SBD |
$27.90
|
| Rate for Payer: UMR Bronson Commercial |
$19.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.21
|
|
|
CLINDAMYCIN 600 MG/50 ML IVPB IN D5W OR NS CUSTOM
|
Facility
|
IP
|
$29.82
|
|
|
Service Code
|
NDC 00781328991
|
| Hospital Charge Code |
300021
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.12 |
| Max. Negotiated Rate |
$26.84 |
| Rate for Payer: Aetna American Axle |
$19.38
|
| Rate for Payer: Aetna Commercial |
$25.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.38
|
| Rate for Payer: Cash Price |
$23.86
|
| Rate for Payer: Cofinity Advantage |
$20.87
|
| Rate for Payer: Cofinity Commercial |
$25.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.86
|
| Rate for Payer: Healthscope Commercial |
$26.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.36
|
| Rate for Payer: PHP Commercial |
$25.35
|
| Rate for Payer: Priority Health SBD |
$18.79
|
| Rate for Payer: UMR Bronson Commercial |
$13.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.36
|
|
|
CLINDAMYCIN 600 MG (IV PREMIX)
|
Facility
|
OP
|
$106.87
|
|
|
Service Code
|
HCPCS J0736
|
| Hospital Charge Code |
500559
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$96.18 |
| Rate for Payer: Aetna American Axle |
$69.47
|
| Rate for Payer: Aetna Commercial |
$90.84
|
| Rate for Payer: Aetna Medicare |
$53.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.47
|
| Rate for Payer: BCBS Complete |
$42.75
|
| Rate for Payer: BCBS Trust/PPO |
$6.17
|
| Rate for Payer: BCN Commercial |
$6.17
|
| Rate for Payer: Cash Price |
$85.50
|
| Rate for Payer: Cash Price |
$85.50
|
| Rate for Payer: Cofinity Advantage |
$74.81
|
| Rate for Payer: Cofinity Commercial |
$91.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.50
|
| Rate for Payer: Healthscope Commercial |
$96.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.15
|
| Rate for Payer: PHP Commercial |
$90.84
|
| Rate for Payer: Priority Health SBD |
$67.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.15
|
| Rate for Payer: UHC Core |
$3.15
|
| Rate for Payer: UHC Exchange |
$3.15
|
| Rate for Payer: UMR Bronson Commercial |
$39.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.15
|
|
