|
CEFTAROLINE FOSAMIL 600 MG IV MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$671.51
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
301724
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$295.46 |
| Max. Negotiated Rate |
$604.36 |
| Rate for Payer: Aetna American Axle |
$436.48
|
| Rate for Payer: Aetna Commercial |
$570.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.48
|
| Rate for Payer: Cash Price |
$537.21
|
| Rate for Payer: Cofinity Commercial |
$470.06
|
| Rate for Payer: Cofinity Commercial |
$577.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$470.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.21
|
| Rate for Payer: Healthscope Commercial |
$604.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$470.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.78
|
| Rate for Payer: PHP Commercial |
$570.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.48
|
| Rate for Payer: Priority Health SBD |
$423.05
|
| Rate for Payer: UMR Bronson Commercial |
$295.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.63
|
|
|
CEFTAROLINE FOSAMIL 600 MG IV MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$671.51
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
301724
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$604.36 |
| Rate for Payer: Aetna American Axle |
$436.48
|
| Rate for Payer: Aetna Commercial |
$570.78
|
| Rate for Payer: Aetna Medicare |
$4.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.94
|
| Rate for Payer: BCBS Complete |
$2.22
|
| Rate for Payer: BCBS MAPPO |
$3.95
|
| Rate for Payer: BCBS Trust/PPO |
$10.59
|
| Rate for Payer: BCN Commercial |
$10.59
|
| Rate for Payer: BCN Medicare Advantage |
$3.95
|
| Rate for Payer: Cash Price |
$537.21
|
| Rate for Payer: Cash Price |
$537.21
|
| Rate for Payer: Cofinity Commercial |
$577.50
|
| Rate for Payer: Cofinity Commercial |
$470.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$470.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.95
|
| Rate for Payer: Healthscope Commercial |
$604.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$470.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.63
|
| Rate for Payer: Mclaren Medicaid |
$2.12
|
| Rate for Payer: Mclaren Medicare |
$3.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.15
|
| Rate for Payer: Meridian Medicaid |
$2.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.78
|
| Rate for Payer: Nomi Health Commercial |
$11.85
|
| Rate for Payer: PACE Medicare |
$3.75
|
| Rate for Payer: PACE SWMI |
$3.95
|
| Rate for Payer: PHP Commercial |
$570.78
|
| Rate for Payer: PHP Medicare Advantage |
$3.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.32
|
| Rate for Payer: Priority Health Medicare |
$3.95
|
| Rate for Payer: Priority Health Narrow Network |
$9.06
|
| Rate for Payer: Priority Health SBD |
$423.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.95
|
| Rate for Payer: UHC Exchange |
$7.55
|
| Rate for Payer: UHC Medicare Advantage |
$3.95
|
| Rate for Payer: UHCCP Medicaid |
$2.12
|
| Rate for Payer: UMR Bronson Commercial |
$248.46
|
| Rate for Payer: VA VA |
$3.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.63
|
|
|
CEFTAROLINE FOSAMIL 60 MCG CUSTOM IV FOR DESENSITIZATION
|
Facility
|
OP
|
$0.35
|
|
|
Service Code
|
NDC 09900000954
|
| Hospital Charge Code |
168966
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$0.32 |
| Rate for Payer: Aetna American Axle |
$0.23
|
| Rate for Payer: Aetna Commercial |
$0.30
|
| Rate for Payer: Aetna Medicare |
$0.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.23
|
| Rate for Payer: BCBS Complete |
$0.14
|
| Rate for Payer: Cash Price |
$0.28
|
| Rate for Payer: Cofinity Commercial |
$0.25
|
| Rate for Payer: Cofinity Commercial |
$0.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.28
|
| Rate for Payer: Healthscope Commercial |
$0.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.30
|
| Rate for Payer: PHP Commercial |
$0.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.23
|
| Rate for Payer: Priority Health SBD |
$0.22
|
| Rate for Payer: UMR Bronson Commercial |
$0.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.26
|
|
|
CEFTAROLINE FOSAMIL 60 MCG CUSTOM IV FOR DESENSITIZATION
|
Facility
|
IP
|
$0.35
|
|
|
Service Code
|
NDC 09900000954
|
| Hospital Charge Code |
168966
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$0.32 |
| Rate for Payer: Aetna American Axle |
$0.23
|
| Rate for Payer: Aetna Commercial |
$0.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.23
|
| Rate for Payer: Cash Price |
$0.28
|
| Rate for Payer: Cofinity Commercial |
$0.25
|
| Rate for Payer: Cofinity Commercial |
$0.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.28
|
| Rate for Payer: Healthscope Commercial |
$0.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.30
|
| Rate for Payer: PHP Commercial |
$0.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.23
|
| Rate for Payer: Priority Health SBD |
$0.22
|
| Rate for Payer: UMR Bronson Commercial |
$0.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.26
|
|
|
CEFTAROLINE FOSAMIL 6 MCG CUSTOM IV FOR DESENSITIZATION
|
Facility
|
IP
|
$0.05
|
|
|
Service Code
|
NDC 09900000957
|
| Hospital Charge Code |
180578
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.05 |
| Rate for Payer: Aetna American Axle |
$0.03
|
| Rate for Payer: Aetna Commercial |
$0.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.03
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Cofinity Commercial |
$0.04
|
| Rate for Payer: Cofinity Commercial |
$0.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.04
|
| Rate for Payer: Healthscope Commercial |
$0.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.04
|
| Rate for Payer: PHP Commercial |
$0.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.03
|
| Rate for Payer: Priority Health SBD |
$0.03
|
| Rate for Payer: UMR Bronson Commercial |
$0.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.04
|
|
|
CEFTAROLINE FOSAMIL 6 MCG CUSTOM IV FOR DESENSITIZATION
|
Facility
|
OP
|
$0.05
|
|
|
Service Code
|
NDC 09900000957
|
| Hospital Charge Code |
180578
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.05 |
| Rate for Payer: Aetna American Axle |
$0.03
|
| Rate for Payer: Aetna Commercial |
$0.04
|
| Rate for Payer: Aetna Medicare |
$0.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.03
|
| Rate for Payer: BCBS Complete |
$0.02
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Cofinity Commercial |
$0.04
|
| Rate for Payer: Cofinity Commercial |
$0.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.04
|
| Rate for Payer: Healthscope Commercial |
$0.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.04
|
| Rate for Payer: PHP Commercial |
$0.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.03
|
| Rate for Payer: Priority Health SBD |
$0.03
|
| Rate for Payer: UMR Bronson Commercial |
$0.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.04
|
|
|
CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$1,174.32
|
|
|
Service Code
|
HCPCS J0714
|
| Hospital Charge Code |
161545
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$516.70 |
| Max. Negotiated Rate |
$1,056.89 |
| Rate for Payer: Aetna American Axle |
$763.31
|
| Rate for Payer: Aetna Commercial |
$998.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$763.31
|
| Rate for Payer: Cash Price |
$939.46
|
| Rate for Payer: Cofinity Commercial |
$1,009.92
|
| Rate for Payer: Cofinity Commercial |
$822.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$822.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$939.46
|
| Rate for Payer: Healthscope Commercial |
$1,056.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$822.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$880.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.17
|
| Rate for Payer: PHP Commercial |
$998.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.31
|
| Rate for Payer: Priority Health SBD |
$739.82
|
| Rate for Payer: UMR Bronson Commercial |
$516.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$880.74
|
|
|
CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$1,174.32
|
|
|
Service Code
|
HCPCS J0714
|
| Hospital Charge Code |
161545
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$53.99 |
| Max. Negotiated Rate |
$1,056.89 |
| Rate for Payer: Aetna American Axle |
$763.31
|
| Rate for Payer: Aetna Commercial |
$998.17
|
| Rate for Payer: Aetna Medicare |
$104.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$763.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$125.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$125.91
|
| Rate for Payer: BCBS Complete |
$56.69
|
| Rate for Payer: BCBS MAPPO |
$100.73
|
| Rate for Payer: BCBS Trust/PPO |
$271.57
|
| Rate for Payer: BCN Commercial |
$271.57
|
| Rate for Payer: BCN Medicare Advantage |
$100.73
|
| Rate for Payer: Cash Price |
$939.46
|
| Rate for Payer: Cash Price |
$939.46
|
| Rate for Payer: Cofinity Commercial |
$822.02
|
| Rate for Payer: Cofinity Commercial |
$1,009.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$822.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$939.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.73
|
| Rate for Payer: Healthscope Commercial |
$1,056.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$822.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$880.74
|
| Rate for Payer: Mclaren Medicaid |
$53.99
|
| Rate for Payer: Mclaren Medicare |
$100.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.77
|
| Rate for Payer: Meridian Medicaid |
$56.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$115.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.17
|
| Rate for Payer: Nomi Health Commercial |
$302.19
|
| Rate for Payer: PACE Medicare |
$95.69
|
| Rate for Payer: PACE SWMI |
$100.73
|
| Rate for Payer: PHP Commercial |
$998.17
|
| Rate for Payer: PHP Medicare Advantage |
$100.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$289.48
|
| Rate for Payer: Priority Health Medicare |
$100.73
|
| Rate for Payer: Priority Health Narrow Network |
$231.58
|
| Rate for Payer: Priority Health SBD |
$739.82
|
| Rate for Payer: Railroad Medicare Medicare |
$100.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.73
|
| Rate for Payer: UHC Exchange |
$192.51
|
| Rate for Payer: UHC Medicare Advantage |
$100.73
|
| Rate for Payer: UHCCP Medicaid |
$53.99
|
| Rate for Payer: UMR Bronson Commercial |
$434.50
|
| Rate for Payer: VA VA |
$100.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$880.74
|
|
|
CEFTAZIDIME-AVIBACTAM 2.5 GRAM IV MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$1,174.32
|
|
|
Service Code
|
HCPCS J0714
|
| Hospital Charge Code |
301756
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$53.99 |
| Max. Negotiated Rate |
$1,056.89 |
| Rate for Payer: Aetna American Axle |
$763.31
|
| Rate for Payer: Aetna Commercial |
$998.17
|
| Rate for Payer: Aetna Medicare |
$104.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$763.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$125.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$125.91
|
| Rate for Payer: BCBS Complete |
$56.69
|
| Rate for Payer: BCBS MAPPO |
$100.73
|
| Rate for Payer: BCBS Trust/PPO |
$271.57
|
| Rate for Payer: BCN Commercial |
$271.57
|
| Rate for Payer: BCN Medicare Advantage |
$100.73
|
| Rate for Payer: Cash Price |
$939.46
|
| Rate for Payer: Cash Price |
$939.46
|
| Rate for Payer: Cofinity Commercial |
$822.02
|
| Rate for Payer: Cofinity Commercial |
$1,009.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$822.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$939.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.73
|
| Rate for Payer: Healthscope Commercial |
$1,056.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$822.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$880.74
|
| Rate for Payer: Mclaren Medicaid |
$53.99
|
| Rate for Payer: Mclaren Medicare |
$100.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.77
|
| Rate for Payer: Meridian Medicaid |
$56.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$115.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.17
|
| Rate for Payer: Nomi Health Commercial |
$302.19
|
| Rate for Payer: PACE Medicare |
$95.69
|
| Rate for Payer: PACE SWMI |
$100.73
|
| Rate for Payer: PHP Commercial |
$998.17
|
| Rate for Payer: PHP Medicare Advantage |
$100.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$289.48
|
| Rate for Payer: Priority Health Medicare |
$100.73
|
| Rate for Payer: Priority Health Narrow Network |
$231.58
|
| Rate for Payer: Priority Health SBD |
$739.82
|
| Rate for Payer: Railroad Medicare Medicare |
$100.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.73
|
| Rate for Payer: UHC Exchange |
$192.51
|
| Rate for Payer: UHC Medicare Advantage |
$100.73
|
| Rate for Payer: UHCCP Medicaid |
$53.99
|
| Rate for Payer: UMR Bronson Commercial |
$434.50
|
| Rate for Payer: VA VA |
$100.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$880.74
|
|
|
CEFTAZIDIME-AVIBACTAM 2.5 GRAM IV MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$1,174.32
|
|
|
Service Code
|
HCPCS J0714
|
| Hospital Charge Code |
301756
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$516.70 |
| Max. Negotiated Rate |
$1,056.89 |
| Rate for Payer: Aetna American Axle |
$763.31
|
| Rate for Payer: Aetna Commercial |
$998.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$763.31
|
| Rate for Payer: Cash Price |
$939.46
|
| Rate for Payer: Cofinity Commercial |
$1,009.92
|
| Rate for Payer: Cofinity Commercial |
$822.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$822.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$939.46
|
| Rate for Payer: Healthscope Commercial |
$1,056.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$822.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$880.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.17
|
| Rate for Payer: PHP Commercial |
$998.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.31
|
| Rate for Payer: Priority Health SBD |
$739.82
|
| Rate for Payer: UMR Bronson Commercial |
$516.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$880.74
|
|
|
CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$523.77
|
|
|
Service Code
|
HCPCS J0695
|
| Hospital Charge Code |
173413
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$230.46 |
| Max. Negotiated Rate |
$471.39 |
| Rate for Payer: Aetna American Axle |
$340.45
|
| Rate for Payer: Aetna Commercial |
$445.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.45
|
| Rate for Payer: Cash Price |
$419.02
|
| Rate for Payer: Cofinity Commercial |
$366.64
|
| Rate for Payer: Cofinity Commercial |
$450.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$366.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.02
|
| Rate for Payer: Healthscope Commercial |
$471.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$366.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$392.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.20
|
| Rate for Payer: PHP Commercial |
$445.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$340.45
|
| Rate for Payer: Priority Health SBD |
$329.98
|
| Rate for Payer: UMR Bronson Commercial |
$230.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$392.83
|
|
|
CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$523.77
|
|
|
Service Code
|
HCPCS J0695
|
| Hospital Charge Code |
173413
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.37 |
| Max. Negotiated Rate |
$471.39 |
| Rate for Payer: Aetna American Axle |
$340.45
|
| Rate for Payer: Aetna Commercial |
$445.20
|
| Rate for Payer: Aetna Medicare |
$8.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.19
|
| Rate for Payer: BCBS Complete |
$4.59
|
| Rate for Payer: BCBS MAPPO |
$8.15
|
| Rate for Payer: BCBS Trust/PPO |
$22.18
|
| Rate for Payer: BCN Commercial |
$22.18
|
| Rate for Payer: BCN Medicare Advantage |
$8.15
|
| Rate for Payer: Cash Price |
$419.02
|
| Rate for Payer: Cash Price |
$419.02
|
| Rate for Payer: Cofinity Commercial |
$450.44
|
| Rate for Payer: Cofinity Commercial |
$366.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$366.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.15
|
| Rate for Payer: Healthscope Commercial |
$471.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$366.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$392.83
|
| Rate for Payer: Mclaren Medicaid |
$4.37
|
| Rate for Payer: Mclaren Medicare |
$8.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.56
|
| Rate for Payer: Meridian Medicaid |
$4.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.20
|
| Rate for Payer: Nomi Health Commercial |
$24.45
|
| Rate for Payer: PACE Medicare |
$7.74
|
| Rate for Payer: PACE SWMI |
$8.15
|
| Rate for Payer: PHP Commercial |
$445.20
|
| Rate for Payer: PHP Medicare Advantage |
$8.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$340.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.69
|
| Rate for Payer: Priority Health Medicare |
$8.15
|
| Rate for Payer: Priority Health Narrow Network |
$18.95
|
| Rate for Payer: Priority Health SBD |
$329.98
|
| Rate for Payer: Railroad Medicare Medicare |
$8.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.15
|
| Rate for Payer: UHC Exchange |
$15.58
|
| Rate for Payer: UHC Medicare Advantage |
$8.15
|
| Rate for Payer: UHCCP Medicaid |
$4.37
|
| Rate for Payer: UMR Bronson Commercial |
$193.79
|
| Rate for Payer: VA VA |
$8.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$392.83
|
|
|
CEFTOLOZANE-TAZOBACTAM 1.5 GRAM IV MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$523.77
|
|
|
Service Code
|
HCPCS J0695
|
| Hospital Charge Code |
301725
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.37 |
| Max. Negotiated Rate |
$471.39 |
| Rate for Payer: Aetna American Axle |
$340.45
|
| Rate for Payer: Aetna Commercial |
$445.20
|
| Rate for Payer: Aetna Medicare |
$8.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.19
|
| Rate for Payer: BCBS Complete |
$4.59
|
| Rate for Payer: BCBS MAPPO |
$8.15
|
| Rate for Payer: BCBS Trust/PPO |
$22.18
|
| Rate for Payer: BCN Commercial |
$22.18
|
| Rate for Payer: BCN Medicare Advantage |
$8.15
|
| Rate for Payer: Cash Price |
$419.02
|
| Rate for Payer: Cash Price |
$419.02
|
| Rate for Payer: Cofinity Commercial |
$450.44
|
| Rate for Payer: Cofinity Commercial |
$366.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$366.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.15
|
| Rate for Payer: Healthscope Commercial |
$471.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$366.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$392.83
|
| Rate for Payer: Mclaren Medicaid |
$4.37
|
| Rate for Payer: Mclaren Medicare |
$8.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.56
|
| Rate for Payer: Meridian Medicaid |
$4.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.20
|
| Rate for Payer: Nomi Health Commercial |
$24.45
|
| Rate for Payer: PACE Medicare |
$7.74
|
| Rate for Payer: PACE SWMI |
$8.15
|
| Rate for Payer: PHP Commercial |
$445.20
|
| Rate for Payer: PHP Medicare Advantage |
$8.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$340.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.69
|
| Rate for Payer: Priority Health Medicare |
$8.15
|
| Rate for Payer: Priority Health Narrow Network |
$18.95
|
| Rate for Payer: Priority Health SBD |
$329.98
|
| Rate for Payer: Railroad Medicare Medicare |
$8.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.15
|
| Rate for Payer: UHC Exchange |
$15.58
|
| Rate for Payer: UHC Medicare Advantage |
$8.15
|
| Rate for Payer: UHCCP Medicaid |
$4.37
|
| Rate for Payer: UMR Bronson Commercial |
$193.79
|
| Rate for Payer: VA VA |
$8.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$392.83
|
|
|
CEFTOLOZANE-TAZOBACTAM 1.5 GRAM IV MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$523.77
|
|
|
Service Code
|
HCPCS J0695
|
| Hospital Charge Code |
301725
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$230.46 |
| Max. Negotiated Rate |
$471.39 |
| Rate for Payer: Aetna American Axle |
$340.45
|
| Rate for Payer: Aetna Commercial |
$445.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.45
|
| Rate for Payer: Cash Price |
$419.02
|
| Rate for Payer: Cofinity Commercial |
$366.64
|
| Rate for Payer: Cofinity Commercial |
$450.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$366.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.02
|
| Rate for Payer: Healthscope Commercial |
$471.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$366.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$392.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.20
|
| Rate for Payer: PHP Commercial |
$445.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$340.45
|
| Rate for Payer: Priority Health SBD |
$329.98
|
| Rate for Payer: UMR Bronson Commercial |
$230.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$392.83
|
|
|
CEFTRIAXONE 100 GRAM SOLUTION FOR INJECTION
|
Facility
|
OP
|
$2,175.00
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
78580
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.19 |
| Max. Negotiated Rate |
$1,957.50 |
| Rate for Payer: Aetna American Axle |
$1,413.75
|
| Rate for Payer: Aetna Commercial |
$1,848.75
|
| Rate for Payer: Aetna Medicare |
$1,087.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,413.75
|
| Rate for Payer: BCBS Complete |
$870.00
|
| Rate for Payer: BCBS Trust/PPO |
$1.19
|
| Rate for Payer: BCN Commercial |
$1.19
|
| Rate for Payer: Cash Price |
$1,740.00
|
| Rate for Payer: Cash Price |
$1,740.00
|
| Rate for Payer: Cofinity Commercial |
$1,522.50
|
| Rate for Payer: Cofinity Commercial |
$1,870.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,522.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.00
|
| Rate for Payer: Healthscope Commercial |
$1,957.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,522.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,631.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,848.75
|
| Rate for Payer: PHP Commercial |
$1,848.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,413.75
|
| Rate for Payer: Priority Health SBD |
$1,370.25
|
| Rate for Payer: UMR Bronson Commercial |
$804.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,631.25
|
|
|
CEFTRIAXONE 100 GRAM SOLUTION FOR INJECTION
|
Facility
|
IP
|
$2,175.00
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
78580
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$957.00 |
| Max. Negotiated Rate |
$1,957.50 |
| Rate for Payer: Aetna American Axle |
$1,413.75
|
| Rate for Payer: Aetna Commercial |
$1,848.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,413.75
|
| Rate for Payer: Cash Price |
$1,740.00
|
| Rate for Payer: Cofinity Commercial |
$1,522.50
|
| Rate for Payer: Cofinity Commercial |
$1,870.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,522.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.00
|
| Rate for Payer: Healthscope Commercial |
$1,957.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,522.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,631.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,848.75
|
| Rate for Payer: PHP Commercial |
$1,848.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,413.75
|
| Rate for Payer: Priority Health SBD |
$1,370.25
|
| Rate for Payer: UMR Bronson Commercial |
$957.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,631.25
|
|
|
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION
|
Facility
|
IP
|
$52.03
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
9491
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$46.83 |
| Rate for Payer: Aetna American Axle |
$33.82
|
| Rate for Payer: Aetna American Axle |
$122.70
|
| Rate for Payer: Aetna American Axle |
$24.56
|
| Rate for Payer: Aetna American Axle |
$51.12
|
| Rate for Payer: Aetna American Axle |
$26.88
|
| Rate for Payer: Aetna Commercial |
$44.23
|
| Rate for Payer: Aetna Commercial |
$32.12
|
| Rate for Payer: Aetna Commercial |
$160.45
|
| Rate for Payer: Aetna Commercial |
$66.84
|
| Rate for Payer: Aetna Commercial |
$35.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.56
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$62.91
|
| Rate for Payer: Cash Price |
$30.23
|
| Rate for Payer: Cash Price |
$33.08
|
| Rate for Payer: Cash Price |
$151.02
|
| Rate for Payer: Cofinity Commercial |
$55.05
|
| Rate for Payer: Cofinity Commercial |
$132.14
|
| Rate for Payer: Cofinity Commercial |
$44.75
|
| Rate for Payer: Cofinity Commercial |
$36.42
|
| Rate for Payer: Cofinity Commercial |
$28.94
|
| Rate for Payer: Cofinity Commercial |
$26.45
|
| Rate for Payer: Cofinity Commercial |
$32.50
|
| Rate for Payer: Cofinity Commercial |
$35.56
|
| Rate for Payer: Cofinity Commercial |
$162.34
|
| Rate for Payer: Cofinity Commercial |
$67.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$132.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$55.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$28.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.08
|
| Rate for Payer: Healthscope Commercial |
$34.01
|
| Rate for Payer: Healthscope Commercial |
$46.83
|
| Rate for Payer: Healthscope Commercial |
$37.22
|
| Rate for Payer: Healthscope Commercial |
$70.78
|
| Rate for Payer: Healthscope Commercial |
$169.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$132.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.45
|
| Rate for Payer: PHP Commercial |
$160.45
|
| Rate for Payer: PHP Commercial |
$66.84
|
| Rate for Payer: PHP Commercial |
$35.15
|
| Rate for Payer: PHP Commercial |
$44.23
|
| Rate for Payer: PHP Commercial |
$32.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.70
|
| Rate for Payer: Priority Health SBD |
$49.54
|
| Rate for Payer: Priority Health SBD |
$26.05
|
| Rate for Payer: Priority Health SBD |
$23.81
|
| Rate for Payer: Priority Health SBD |
$118.93
|
| Rate for Payer: Priority Health SBD |
$32.78
|
| Rate for Payer: UMR Bronson Commercial |
$83.06
|
| Rate for Payer: UMR Bronson Commercial |
$16.63
|
| Rate for Payer: UMR Bronson Commercial |
$22.89
|
| Rate for Payer: UMR Bronson Commercial |
$34.60
|
| Rate for Payer: UMR Bronson Commercial |
$18.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
CEFTRIAXONE 10 GRAM SOLUTION FOR INJECTION
|
Facility
|
OP
|
$37.79
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
9491
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.19 |
| Max. Negotiated Rate |
$34.01 |
| Rate for Payer: Aetna American Axle |
$24.56
|
| Rate for Payer: Aetna American Axle |
$33.82
|
| Rate for Payer: Aetna American Axle |
$26.88
|
| Rate for Payer: Aetna American Axle |
$122.70
|
| Rate for Payer: Aetna American Axle |
$51.12
|
| Rate for Payer: Aetna Commercial |
$32.12
|
| Rate for Payer: Aetna Commercial |
$160.45
|
| Rate for Payer: Aetna Commercial |
$66.84
|
| Rate for Payer: Aetna Commercial |
$35.15
|
| Rate for Payer: Aetna Commercial |
$44.23
|
| Rate for Payer: Aetna Medicare |
$20.68
|
| Rate for Payer: Aetna Medicare |
$26.02
|
| Rate for Payer: Aetna Medicare |
$18.90
|
| Rate for Payer: Aetna Medicare |
$94.38
|
| Rate for Payer: Aetna Medicare |
$39.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.88
|
| Rate for Payer: BCBS Complete |
$15.12
|
| Rate for Payer: BCBS Complete |
$75.51
|
| Rate for Payer: BCBS Complete |
$20.81
|
| Rate for Payer: BCBS Complete |
$31.46
|
| Rate for Payer: BCBS Complete |
$16.54
|
| Rate for Payer: BCBS Trust/PPO |
$1.19
|
| Rate for Payer: BCBS Trust/PPO |
$1.19
|
| Rate for Payer: BCBS Trust/PPO |
$1.19
|
| Rate for Payer: BCBS Trust/PPO |
$1.19
|
| Rate for Payer: BCBS Trust/PPO |
$1.19
|
| Rate for Payer: BCN Commercial |
$1.19
|
| Rate for Payer: BCN Commercial |
$1.19
|
| Rate for Payer: BCN Commercial |
$1.19
|
| Rate for Payer: BCN Commercial |
$1.19
|
| Rate for Payer: BCN Commercial |
$1.19
|
| Rate for Payer: Cash Price |
$30.23
|
| Rate for Payer: Cash Price |
$33.08
|
| Rate for Payer: Cash Price |
$151.02
|
| Rate for Payer: Cash Price |
$30.23
|
| Rate for Payer: Cash Price |
$151.02
|
| Rate for Payer: Cash Price |
$33.08
|
| Rate for Payer: Cash Price |
$62.91
|
| Rate for Payer: Cash Price |
$62.91
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$26.45
|
| Rate for Payer: Cofinity Commercial |
$67.63
|
| Rate for Payer: Cofinity Commercial |
$132.14
|
| Rate for Payer: Cofinity Commercial |
$35.56
|
| Rate for Payer: Cofinity Commercial |
$28.94
|
| Rate for Payer: Cofinity Commercial |
$55.05
|
| Rate for Payer: Cofinity Commercial |
$44.75
|
| Rate for Payer: Cofinity Commercial |
$36.42
|
| Rate for Payer: Cofinity Commercial |
$32.50
|
| Rate for Payer: Cofinity Commercial |
$162.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$55.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$28.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$132.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.83
|
| Rate for Payer: Healthscope Commercial |
$169.89
|
| Rate for Payer: Healthscope Commercial |
$34.01
|
| Rate for Payer: Healthscope Commercial |
$37.22
|
| Rate for Payer: Healthscope Commercial |
$70.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$132.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.45
|
| Rate for Payer: PHP Commercial |
$66.84
|
| Rate for Payer: PHP Commercial |
$44.23
|
| Rate for Payer: PHP Commercial |
$32.12
|
| Rate for Payer: PHP Commercial |
$160.45
|
| Rate for Payer: PHP Commercial |
$35.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.56
|
| Rate for Payer: Priority Health SBD |
$23.81
|
| Rate for Payer: Priority Health SBD |
$49.54
|
| Rate for Payer: Priority Health SBD |
$32.78
|
| Rate for Payer: Priority Health SBD |
$118.93
|
| Rate for Payer: Priority Health SBD |
$26.05
|
| Rate for Payer: UMR Bronson Commercial |
$69.84
|
| Rate for Payer: UMR Bronson Commercial |
$15.30
|
| Rate for Payer: UMR Bronson Commercial |
$13.98
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: UMR Bronson Commercial |
$29.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.58
|
|
|
CEFTRIAXONE 1 GM IV SYRINGE
|
Facility
|
IP
|
$17.98
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
500542
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.91 |
| Max. Negotiated Rate |
$16.18 |
| Rate for Payer: Aetna American Axle |
$11.69
|
| Rate for Payer: Aetna Commercial |
$15.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.69
|
| Rate for Payer: Cash Price |
$14.38
|
| Rate for Payer: Cofinity Commercial |
$12.59
|
| Rate for Payer: Cofinity Commercial |
$15.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.38
|
| Rate for Payer: Healthscope Commercial |
$16.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.28
|
| Rate for Payer: PHP Commercial |
$15.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.69
|
| Rate for Payer: Priority Health SBD |
$11.33
|
| Rate for Payer: UMR Bronson Commercial |
$7.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.48
|
|
|
CEFTRIAXONE 1 GM IV SYRINGE
|
Facility
|
OP
|
$17.98
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
500542
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.19 |
| Max. Negotiated Rate |
$16.18 |
| Rate for Payer: Aetna American Axle |
$11.69
|
| Rate for Payer: Aetna Commercial |
$15.28
|
| Rate for Payer: Aetna Medicare |
$8.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.69
|
| Rate for Payer: BCBS Complete |
$7.19
|
| Rate for Payer: BCBS Trust/PPO |
$1.19
|
| Rate for Payer: BCN Commercial |
$1.19
|
| Rate for Payer: Cash Price |
$14.38
|
| Rate for Payer: Cash Price |
$14.38
|
| Rate for Payer: Cofinity Commercial |
$12.59
|
| Rate for Payer: Cofinity Commercial |
$15.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.38
|
| Rate for Payer: Healthscope Commercial |
$16.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.28
|
| Rate for Payer: PHP Commercial |
$15.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.69
|
| Rate for Payer: Priority Health SBD |
$11.33
|
| Rate for Payer: UMR Bronson Commercial |
$6.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.48
|
|
|
CEFTRIAXONE 1 GRAM CUSTOM IM SOLUTION
|
Facility
|
OP
|
$14.84
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
150848
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.19 |
| Max. Negotiated Rate |
$13.36 |
| Rate for Payer: Aetna American Axle |
$9.65
|
| Rate for Payer: Aetna American Axle |
$15.76
|
| Rate for Payer: Aetna American Axle |
$15.08
|
| Rate for Payer: Aetna American Axle |
$8.63
|
| Rate for Payer: Aetna American Axle |
$18.95
|
| Rate for Payer: Aetna Commercial |
$12.61
|
| Rate for Payer: Aetna Commercial |
$11.28
|
| Rate for Payer: Aetna Commercial |
$24.79
|
| Rate for Payer: Aetna Commercial |
$19.72
|
| Rate for Payer: Aetna Commercial |
$20.61
|
| Rate for Payer: Aetna Medicare |
$11.60
|
| Rate for Payer: Aetna Medicare |
$12.12
|
| Rate for Payer: Aetna Medicare |
$7.42
|
| Rate for Payer: Aetna Medicare |
$6.64
|
| Rate for Payer: Aetna Medicare |
$14.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.08
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS Complete |
$5.31
|
| Rate for Payer: BCBS Complete |
$9.70
|
| Rate for Payer: BCBS Complete |
$11.66
|
| Rate for Payer: BCBS Complete |
$9.28
|
| Rate for Payer: BCBS Trust/PPO |
$1.19
|
| Rate for Payer: BCBS Trust/PPO |
$1.19
|
| Rate for Payer: BCBS Trust/PPO |
$1.19
|
| Rate for Payer: BCBS Trust/PPO |
$1.19
|
| Rate for Payer: BCBS Trust/PPO |
$1.19
|
| Rate for Payer: BCN Commercial |
$1.19
|
| Rate for Payer: BCN Commercial |
$1.19
|
| Rate for Payer: BCN Commercial |
$1.19
|
| Rate for Payer: BCN Commercial |
$1.19
|
| Rate for Payer: BCN Commercial |
$1.19
|
| Rate for Payer: Cash Price |
$11.87
|
| Rate for Payer: Cash Price |
$18.56
|
| Rate for Payer: Cash Price |
$10.62
|
| Rate for Payer: Cash Price |
$11.87
|
| Rate for Payer: Cash Price |
$10.62
|
| Rate for Payer: Cash Price |
$18.56
|
| Rate for Payer: Cash Price |
$23.33
|
| Rate for Payer: Cash Price |
$23.33
|
| Rate for Payer: Cash Price |
$19.40
|
| Rate for Payer: Cash Price |
$19.40
|
| Rate for Payer: Cofinity Commercial |
$10.39
|
| Rate for Payer: Cofinity Commercial |
$25.08
|
| Rate for Payer: Cofinity Commercial |
$11.41
|
| Rate for Payer: Cofinity Commercial |
$19.95
|
| Rate for Payer: Cofinity Commercial |
$16.24
|
| Rate for Payer: Cofinity Commercial |
$20.41
|
| Rate for Payer: Cofinity Commercial |
$20.86
|
| Rate for Payer: Cofinity Commercial |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$12.76
|
| Rate for Payer: Cofinity Commercial |
$9.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.40
|
| Rate for Payer: Healthscope Commercial |
$21.82
|
| Rate for Payer: Healthscope Commercial |
$11.94
|
| Rate for Payer: Healthscope Commercial |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$20.88
|
| Rate for Payer: Healthscope Commercial |
$26.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.28
|
| Rate for Payer: PHP Commercial |
$24.79
|
| Rate for Payer: PHP Commercial |
$20.61
|
| Rate for Payer: PHP Commercial |
$12.61
|
| Rate for Payer: PHP Commercial |
$11.28
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.65
|
| Rate for Payer: Priority Health SBD |
$9.35
|
| Rate for Payer: Priority Health SBD |
$18.37
|
| Rate for Payer: Priority Health SBD |
$15.28
|
| Rate for Payer: Priority Health SBD |
$8.36
|
| Rate for Payer: Priority Health SBD |
$14.62
|
| Rate for Payer: UMR Bronson Commercial |
$4.91
|
| Rate for Payer: UMR Bronson Commercial |
$8.58
|
| Rate for Payer: UMR Bronson Commercial |
$5.49
|
| Rate for Payer: UMR Bronson Commercial |
$8.97
|
| Rate for Payer: UMR Bronson Commercial |
$10.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.95
|
|
|
CEFTRIAXONE 1 GRAM CUSTOM IM SOLUTION
|
Facility
|
IP
|
$13.27
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
150848
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.84 |
| Max. Negotiated Rate |
$11.94 |
| Rate for Payer: Aetna American Axle |
$8.63
|
| Rate for Payer: Aetna American Axle |
$15.08
|
| Rate for Payer: Aetna American Axle |
$9.65
|
| Rate for Payer: Aetna American Axle |
$15.76
|
| Rate for Payer: Aetna Commercial |
$20.61
|
| Rate for Payer: Aetna Commercial |
$11.28
|
| Rate for Payer: Aetna Commercial |
$19.72
|
| Rate for Payer: Aetna Commercial |
$12.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.08
|
| Rate for Payer: Cash Price |
$18.56
|
| Rate for Payer: Cash Price |
$10.62
|
| Rate for Payer: Cash Price |
$11.87
|
| Rate for Payer: Cash Price |
$19.40
|
| Rate for Payer: Cofinity Commercial |
$16.24
|
| Rate for Payer: Cofinity Commercial |
$12.76
|
| Rate for Payer: Cofinity Commercial |
$9.29
|
| Rate for Payer: Cofinity Commercial |
$10.39
|
| Rate for Payer: Cofinity Commercial |
$11.41
|
| Rate for Payer: Cofinity Commercial |
$20.86
|
| Rate for Payer: Cofinity Commercial |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$19.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.40
|
| Rate for Payer: Healthscope Commercial |
$21.82
|
| Rate for Payer: Healthscope Commercial |
$11.94
|
| Rate for Payer: Healthscope Commercial |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$20.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.61
|
| Rate for Payer: PHP Commercial |
$12.61
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Commercial |
$11.28
|
| Rate for Payer: PHP Commercial |
$20.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.63
|
| Rate for Payer: Priority Health SBD |
$15.28
|
| Rate for Payer: Priority Health SBD |
$14.62
|
| Rate for Payer: Priority Health SBD |
$8.36
|
| Rate for Payer: Priority Health SBD |
$9.35
|
| Rate for Payer: UMR Bronson Commercial |
$10.67
|
| Rate for Payer: UMR Bronson Commercial |
$10.21
|
| Rate for Payer: UMR Bronson Commercial |
$6.53
|
| Rate for Payer: UMR Bronson Commercial |
$5.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.95
|
|
|
CEFTRIAXONE 1 GRAM CUSTOM SOLUTION FOR DESENSITIZATION
|
Facility
|
IP
|
$17.98
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
180569
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.91 |
| Max. Negotiated Rate |
$16.18 |
| Rate for Payer: Aetna American Axle |
$11.69
|
| Rate for Payer: Aetna Commercial |
$15.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.69
|
| Rate for Payer: Cash Price |
$14.38
|
| Rate for Payer: Cofinity Commercial |
$12.59
|
| Rate for Payer: Cofinity Commercial |
$15.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.38
|
| Rate for Payer: Healthscope Commercial |
$16.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.28
|
| Rate for Payer: PHP Commercial |
$15.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.69
|
| Rate for Payer: Priority Health SBD |
$11.33
|
| Rate for Payer: UMR Bronson Commercial |
$7.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.48
|
|
|
CEFTRIAXONE 1 GRAM CUSTOM SOLUTION FOR DESENSITIZATION
|
Facility
|
OP
|
$17.98
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
180569
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.19 |
| Max. Negotiated Rate |
$16.18 |
| Rate for Payer: Aetna American Axle |
$11.69
|
| Rate for Payer: Aetna Commercial |
$15.28
|
| Rate for Payer: Aetna Medicare |
$8.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.69
|
| Rate for Payer: BCBS Complete |
$7.19
|
| Rate for Payer: BCBS Trust/PPO |
$1.19
|
| Rate for Payer: BCN Commercial |
$1.19
|
| Rate for Payer: Cash Price |
$14.38
|
| Rate for Payer: Cash Price |
$14.38
|
| Rate for Payer: Cofinity Commercial |
$12.59
|
| Rate for Payer: Cofinity Commercial |
$15.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.38
|
| Rate for Payer: Healthscope Commercial |
$16.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.28
|
| Rate for Payer: PHP Commercial |
$15.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.69
|
| Rate for Payer: Priority Health SBD |
$11.33
|
| Rate for Payer: UMR Bronson Commercial |
$6.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.48
|
|
|
CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION
|
Facility
|
IP
|
$13.27
|
|
|
Service Code
|
HCPCS J0696
|
| Hospital Charge Code |
9487
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.84 |
| Max. Negotiated Rate |
$11.94 |
| Rate for Payer: Aetna American Axle |
$8.63
|
| Rate for Payer: Aetna American Axle |
$15.76
|
| Rate for Payer: Aetna American Axle |
$15.75
|
| Rate for Payer: Aetna American Axle |
$13.35
|
| Rate for Payer: Aetna American Axle |
$9.65
|
| Rate for Payer: Aetna American Axle |
$15.08
|
| Rate for Payer: Aetna American Axle |
$18.95
|
| Rate for Payer: Aetna Commercial |
$20.61
|
| Rate for Payer: Aetna Commercial |
$12.61
|
| Rate for Payer: Aetna Commercial |
$19.72
|
| Rate for Payer: Aetna Commercial |
$20.60
|
| Rate for Payer: Aetna Commercial |
$24.79
|
| Rate for Payer: Aetna Commercial |
$17.46
|
| Rate for Payer: Aetna Commercial |
$11.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.76
|
| Rate for Payer: Cash Price |
$18.56
|
| Rate for Payer: Cash Price |
$19.40
|
| Rate for Payer: Cash Price |
$11.87
|
| Rate for Payer: Cash Price |
$10.62
|
| Rate for Payer: Cash Price |
$16.43
|
| Rate for Payer: Cash Price |
$19.38
|
| Rate for Payer: Cash Price |
$23.33
|
| Rate for Payer: Cofinity Commercial |
$20.86
|
| Rate for Payer: Cofinity Commercial |
$11.41
|
| Rate for Payer: Cofinity Commercial |
$19.95
|
| Rate for Payer: Cofinity Commercial |
$16.24
|
| Rate for Payer: Cofinity Commercial |
$14.38
|
| Rate for Payer: Cofinity Commercial |
$10.39
|
| Rate for Payer: Cofinity Commercial |
$12.76
|
| Rate for Payer: Cofinity Commercial |
$17.66
|
| Rate for Payer: Cofinity Commercial |
$9.29
|
| Rate for Payer: Cofinity Commercial |
$16.96
|
| Rate for Payer: Cofinity Commercial |
$20.84
|
| Rate for Payer: Cofinity Commercial |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$20.41
|
| Rate for Payer: Cofinity Commercial |
$25.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.62
|
| Rate for Payer: Healthscope Commercial |
$26.24
|
| Rate for Payer: Healthscope Commercial |
$21.81
|
| Rate for Payer: Healthscope Commercial |
$18.49
|
| Rate for Payer: Healthscope Commercial |
$20.88
|
| Rate for Payer: Healthscope Commercial |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$11.94
|
| Rate for Payer: Healthscope Commercial |
$21.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.61
|
| Rate for Payer: PHP Commercial |
$20.60
|
| Rate for Payer: PHP Commercial |
$17.46
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Commercial |
$11.28
|
| Rate for Payer: PHP Commercial |
$12.61
|
| Rate for Payer: PHP Commercial |
$24.79
|
| Rate for Payer: PHP Commercial |
$20.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.75
|
| Rate for Payer: Priority Health SBD |
$12.94
|
| Rate for Payer: Priority Health SBD |
$9.35
|
| Rate for Payer: Priority Health SBD |
$8.36
|
| Rate for Payer: Priority Health SBD |
$18.37
|
| Rate for Payer: Priority Health SBD |
$15.28
|
| Rate for Payer: Priority Health SBD |
$15.26
|
| Rate for Payer: Priority Health SBD |
$14.62
|
| Rate for Payer: UMR Bronson Commercial |
$10.21
|
| Rate for Payer: UMR Bronson Commercial |
$12.83
|
| Rate for Payer: UMR Bronson Commercial |
$10.66
|
| Rate for Payer: UMR Bronson Commercial |
$10.67
|
| Rate for Payer: UMR Bronson Commercial |
$5.84
|
| Rate for Payer: UMR Bronson Commercial |
$9.04
|
| Rate for Payer: UMR Bronson Commercial |
$6.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.95
|
|
