|
FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$169.13
|
|
|
Service Code
|
HCPCS J9190
|
| Hospital Charge Code |
82180
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$152.22 |
| Rate for Payer: Aetna American Axle |
$109.93
|
| Rate for Payer: Aetna Commercial |
$143.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.93
|
| Rate for Payer: BCBS Complete |
$67.65
|
| Rate for Payer: BCBS Trust/PPO |
$10.37
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cofinity Commercial |
$118.39
|
| Rate for Payer: Cofinity Commercial |
$145.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.30
|
| Rate for Payer: Healthscope Commercial |
$152.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$143.76
|
| Rate for Payer: PHP Commercial |
$143.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.39
|
| Rate for Payer: Priority Health SBD |
$106.55
|
| Rate for Payer: UMR Bronson Commercial |
$62.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.85
|
|
|
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$109.19
|
|
|
Service Code
|
HCPCS J9190
|
| Hospital Charge Code |
82200
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$48.04 |
| Max. Negotiated Rate |
$98.27 |
| Rate for Payer: Aetna American Axle |
$70.97
|
| Rate for Payer: Aetna American Axle |
$84.62
|
| Rate for Payer: Aetna Commercial |
$110.65
|
| Rate for Payer: Aetna Commercial |
$92.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.62
|
| Rate for Payer: Cash Price |
$87.35
|
| Rate for Payer: Cash Price |
$104.14
|
| Rate for Payer: Cofinity Commercial |
$76.43
|
| Rate for Payer: Cofinity Commercial |
$93.90
|
| Rate for Payer: Cofinity Commercial |
$111.95
|
| Rate for Payer: Cofinity Commercial |
$91.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.14
|
| Rate for Payer: Healthscope Commercial |
$117.16
|
| Rate for Payer: Healthscope Commercial |
$98.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$92.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.65
|
| Rate for Payer: PHP Commercial |
$92.81
|
| Rate for Payer: PHP Commercial |
$110.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.13
|
| Rate for Payer: Priority Health SBD |
$68.79
|
| Rate for Payer: Priority Health SBD |
$82.01
|
| Rate for Payer: UMR Bronson Commercial |
$57.28
|
| Rate for Payer: UMR Bronson Commercial |
$48.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.64
|
|
|
FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$130.18
|
|
|
Service Code
|
HCPCS J9190
|
| Hospital Charge Code |
82200
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$117.16 |
| Rate for Payer: Aetna American Axle |
$84.62
|
| Rate for Payer: Aetna Commercial |
$110.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.62
|
| Rate for Payer: BCBS Complete |
$52.07
|
| Rate for Payer: BCBS Trust/PPO |
$10.37
|
| Rate for Payer: Cash Price |
$104.14
|
| Rate for Payer: Cash Price |
$104.14
|
| Rate for Payer: Cofinity Commercial |
$91.13
|
| Rate for Payer: Cofinity Commercial |
$111.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.14
|
| Rate for Payer: Healthscope Commercial |
$117.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.65
|
| Rate for Payer: PHP Commercial |
$110.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.13
|
| Rate for Payer: Priority Health SBD |
$82.01
|
| Rate for Payer: UMR Bronson Commercial |
$48.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.64
|
|
|
FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$1,543.30
|
|
|
Service Code
|
HCPCS J9190
|
| Hospital Charge Code |
98249
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$679.05 |
| Max. Negotiated Rate |
$1,388.97 |
| Rate for Payer: Aetna American Axle |
$1,003.14
|
| Rate for Payer: Aetna American Axle |
$2,311.60
|
| Rate for Payer: Aetna American Axle |
$2,188.68
|
| Rate for Payer: Aetna American Axle |
$646.30
|
| Rate for Payer: Aetna Commercial |
$845.16
|
| Rate for Payer: Aetna Commercial |
$1,311.80
|
| Rate for Payer: Aetna Commercial |
$2,862.12
|
| Rate for Payer: Aetna Commercial |
$3,022.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,311.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,003.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,188.68
|
| Rate for Payer: Cash Price |
$2,693.76
|
| Rate for Payer: Cash Price |
$1,234.64
|
| Rate for Payer: Cash Price |
$795.44
|
| Rate for Payer: Cash Price |
$2,845.04
|
| Rate for Payer: Cofinity Commercial |
$1,327.24
|
| Rate for Payer: Cofinity Commercial |
$2,357.04
|
| Rate for Payer: Cofinity Commercial |
$2,895.79
|
| Rate for Payer: Cofinity Commercial |
$696.01
|
| Rate for Payer: Cofinity Commercial |
$3,058.42
|
| Rate for Payer: Cofinity Commercial |
$1,080.31
|
| Rate for Payer: Cofinity Commercial |
$2,489.41
|
| Rate for Payer: Cofinity Commercial |
$855.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,845.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,234.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,693.76
|
| Rate for Payer: Healthscope Commercial |
$3,200.67
|
| Rate for Payer: Healthscope Commercial |
$1,388.97
|
| Rate for Payer: Healthscope Commercial |
$3,030.48
|
| Rate for Payer: Healthscope Commercial |
$894.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,357.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,080.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,489.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$696.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,157.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,525.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,667.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$745.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,311.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,022.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,862.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$845.16
|
| Rate for Payer: PHP Commercial |
$1,311.80
|
| Rate for Payer: PHP Commercial |
$2,862.12
|
| Rate for Payer: PHP Commercial |
$3,022.86
|
| Rate for Payer: PHP Commercial |
$845.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,489.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,357.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,080.31
|
| Rate for Payer: Priority Health SBD |
$972.28
|
| Rate for Payer: Priority Health SBD |
$2,240.47
|
| Rate for Payer: Priority Health SBD |
$626.41
|
| Rate for Payer: Priority Health SBD |
$2,121.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,564.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,481.57
|
| Rate for Payer: UMR Bronson Commercial |
$437.49
|
| Rate for Payer: UMR Bronson Commercial |
$679.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$745.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,157.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,525.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,667.22
|
|
|
FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$3,556.30
|
|
|
Service Code
|
HCPCS J9190
|
| Hospital Charge Code |
98249
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$3,200.67 |
| Rate for Payer: Aetna American Axle |
$2,311.60
|
| Rate for Payer: Aetna American Axle |
$646.30
|
| Rate for Payer: Aetna American Axle |
$2,188.68
|
| Rate for Payer: Aetna American Axle |
$1,003.14
|
| Rate for Payer: Aetna Commercial |
$1,311.80
|
| Rate for Payer: Aetna Commercial |
$845.16
|
| Rate for Payer: Aetna Commercial |
$3,022.86
|
| Rate for Payer: Aetna Commercial |
$2,862.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,003.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,311.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,188.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.30
|
| Rate for Payer: BCBS Complete |
$1,346.88
|
| Rate for Payer: BCBS Complete |
$1,422.52
|
| Rate for Payer: BCBS Complete |
$617.32
|
| Rate for Payer: BCBS Complete |
$397.72
|
| Rate for Payer: BCBS Trust/PPO |
$10.37
|
| Rate for Payer: BCBS Trust/PPO |
$10.37
|
| Rate for Payer: BCBS Trust/PPO |
$10.37
|
| Rate for Payer: BCBS Trust/PPO |
$10.37
|
| Rate for Payer: Cash Price |
$2,693.76
|
| Rate for Payer: Cash Price |
$2,693.76
|
| Rate for Payer: Cash Price |
$795.44
|
| Rate for Payer: Cash Price |
$2,845.04
|
| Rate for Payer: Cash Price |
$2,845.04
|
| Rate for Payer: Cash Price |
$1,234.64
|
| Rate for Payer: Cash Price |
$795.44
|
| Rate for Payer: Cash Price |
$1,234.64
|
| Rate for Payer: Cofinity Commercial |
$2,489.41
|
| Rate for Payer: Cofinity Commercial |
$696.01
|
| Rate for Payer: Cofinity Commercial |
$855.10
|
| Rate for Payer: Cofinity Commercial |
$2,357.04
|
| Rate for Payer: Cofinity Commercial |
$2,895.79
|
| Rate for Payer: Cofinity Commercial |
$1,080.31
|
| Rate for Payer: Cofinity Commercial |
$1,327.24
|
| Rate for Payer: Cofinity Commercial |
$3,058.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,845.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,234.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,693.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.44
|
| Rate for Payer: Healthscope Commercial |
$894.87
|
| Rate for Payer: Healthscope Commercial |
$3,200.67
|
| Rate for Payer: Healthscope Commercial |
$1,388.97
|
| Rate for Payer: Healthscope Commercial |
$3,030.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,080.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,357.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,489.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$696.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,667.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$745.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,157.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,525.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,311.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,862.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$845.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,022.86
|
| Rate for Payer: PHP Commercial |
$2,862.12
|
| Rate for Payer: PHP Commercial |
$3,022.86
|
| Rate for Payer: PHP Commercial |
$845.16
|
| Rate for Payer: PHP Commercial |
$1,311.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,357.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$696.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,080.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,489.41
|
| Rate for Payer: Priority Health SBD |
$2,240.47
|
| Rate for Payer: Priority Health SBD |
$626.41
|
| Rate for Payer: Priority Health SBD |
$2,121.34
|
| Rate for Payer: Priority Health SBD |
$972.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,245.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,315.83
|
| Rate for Payer: UMR Bronson Commercial |
$571.02
|
| Rate for Payer: UMR Bronson Commercial |
$367.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,157.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,667.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$745.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,525.40
|
|
|
FLUOXETINE 10 MG CAPSULE
|
Facility
|
IP
|
$19.04
|
|
|
Service Code
|
NDC 0904-5784-61
|
| Hospital Charge Code |
10069
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8.38 |
| Max. Negotiated Rate |
$17.14 |
| Rate for Payer: Aetna American Axle |
$12.38
|
| Rate for Payer: Aetna Commercial |
$16.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.38
|
| Rate for Payer: Cash Price |
$15.23
|
| Rate for Payer: Cofinity Commercial |
$13.33
|
| Rate for Payer: Cofinity Commercial |
$16.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.23
|
| Rate for Payer: Healthscope Commercial |
$17.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.18
|
| Rate for Payer: PHP Commercial |
$16.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.33
|
| Rate for Payer: Priority Health SBD |
$12.00
|
| Rate for Payer: UMR Bronson Commercial |
$8.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.28
|
|
|
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION
|
Facility
|
IP
|
$564.00
|
|
|
Service Code
|
NDC 70954-600-10
|
| Hospital Charge Code |
38488
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$248.16 |
| Max. Negotiated Rate |
$507.60 |
| Rate for Payer: Aetna American Axle |
$366.60
|
| Rate for Payer: Aetna Commercial |
$479.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.60
|
| Rate for Payer: Cash Price |
$451.20
|
| Rate for Payer: Cofinity Commercial |
$394.80
|
| Rate for Payer: Cofinity Commercial |
$485.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$451.20
|
| Rate for Payer: Healthscope Commercial |
$507.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$394.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$479.40
|
| Rate for Payer: PHP Commercial |
$479.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$394.80
|
| Rate for Payer: Priority Health SBD |
$355.32
|
| Rate for Payer: UMR Bronson Commercial |
$248.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.00
|
|
|
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION
|
Facility
|
IP
|
$250.80
|
|
|
Service Code
|
NDC 0121-0721-04
|
| Hospital Charge Code |
38488
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$110.35 |
| Max. Negotiated Rate |
$225.72 |
| Rate for Payer: Aetna American Axle |
$163.02
|
| Rate for Payer: Aetna Commercial |
$213.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.02
|
| Rate for Payer: Cash Price |
$200.64
|
| Rate for Payer: Cofinity Commercial |
$175.56
|
| Rate for Payer: Cofinity Commercial |
$215.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.64
|
| Rate for Payer: Healthscope Commercial |
$225.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$213.18
|
| Rate for Payer: PHP Commercial |
$213.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.56
|
| Rate for Payer: Priority Health SBD |
$158.00
|
| Rate for Payer: UMR Bronson Commercial |
$110.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.10
|
|
|
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION
|
Facility
|
IP
|
$443.46
|
|
|
Service Code
|
NDC 0832-6032-12
|
| Hospital Charge Code |
38488
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$195.12 |
| Max. Negotiated Rate |
$399.11 |
| Rate for Payer: Aetna American Axle |
$288.25
|
| Rate for Payer: Aetna Commercial |
$376.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.25
|
| Rate for Payer: Cash Price |
$354.77
|
| Rate for Payer: Cofinity Commercial |
$310.42
|
| Rate for Payer: Cofinity Commercial |
$381.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.77
|
| Rate for Payer: Healthscope Commercial |
$399.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$310.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$332.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$376.94
|
| Rate for Payer: PHP Commercial |
$376.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$310.42
|
| Rate for Payer: Priority Health SBD |
$279.38
|
| Rate for Payer: UMR Bronson Commercial |
$195.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$332.60
|
|
|
FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION
|
Facility
|
IP
|
$308.16
|
|
|
Service Code
|
NDC 54838-523-40
|
| Hospital Charge Code |
38488
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$135.59 |
| Max. Negotiated Rate |
$277.34 |
| Rate for Payer: Aetna American Axle |
$200.30
|
| Rate for Payer: Aetna Commercial |
$261.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.30
|
| Rate for Payer: Cash Price |
$246.53
|
| Rate for Payer: Cofinity Commercial |
$215.71
|
| Rate for Payer: Cofinity Commercial |
$265.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$246.53
|
| Rate for Payer: Healthscope Commercial |
$277.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$215.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$261.94
|
| Rate for Payer: PHP Commercial |
$261.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.71
|
| Rate for Payer: Priority Health SBD |
$194.14
|
| Rate for Payer: UMR Bronson Commercial |
$135.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.12
|
|
|
FLUOXETINE 20 MG CAPSULE
|
Facility
|
IP
|
$2.85
|
|
|
Service Code
|
NDC 68084-605-11
|
| Hospital Charge Code |
10070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$2.56 |
| Rate for Payer: Aetna American Axle |
$1.85
|
| Rate for Payer: Aetna Commercial |
$2.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.85
|
| Rate for Payer: Cash Price |
$2.28
|
| Rate for Payer: Cofinity Commercial |
$2.00
|
| Rate for Payer: Cofinity Commercial |
$2.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.28
|
| Rate for Payer: Healthscope Commercial |
$2.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.42
|
| Rate for Payer: PHP Commercial |
$2.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.00
|
| Rate for Payer: Priority Health SBD |
$1.80
|
| Rate for Payer: UMR Bronson Commercial |
$1.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.14
|
|
|
FLUOXETINE 20 MG CAPSULE
|
Facility
|
IP
|
$56.40
|
|
|
Service Code
|
NDC 65862-193-01
|
| Hospital Charge Code |
10070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$24.82 |
| Max. Negotiated Rate |
$50.76 |
| Rate for Payer: Aetna American Axle |
$36.66
|
| Rate for Payer: Aetna Commercial |
$47.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.66
|
| Rate for Payer: Cash Price |
$45.12
|
| Rate for Payer: Cofinity Commercial |
$39.48
|
| Rate for Payer: Cofinity Commercial |
$48.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.12
|
| Rate for Payer: Healthscope Commercial |
$50.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.94
|
| Rate for Payer: PHP Commercial |
$47.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.48
|
| Rate for Payer: Priority Health SBD |
$35.53
|
| Rate for Payer: UMR Bronson Commercial |
$24.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.30
|
|
|
FLUOXETINE 20 MG CAPSULE
|
Facility
|
IP
|
$20.68
|
|
|
Service Code
|
NDC 0904-5785-61
|
| Hospital Charge Code |
10070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$18.61 |
| Rate for Payer: Aetna American Axle |
$13.44
|
| Rate for Payer: Aetna Commercial |
$17.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.44
|
| Rate for Payer: Cash Price |
$16.54
|
| Rate for Payer: Cofinity Commercial |
$14.48
|
| Rate for Payer: Cofinity Commercial |
$17.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.54
|
| Rate for Payer: Healthscope Commercial |
$18.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.58
|
| Rate for Payer: PHP Commercial |
$17.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.48
|
| Rate for Payer: Priority Health SBD |
$13.03
|
| Rate for Payer: UMR Bronson Commercial |
$9.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.51
|
|
|
FLUOXETINE 20 MG CAPSULE
|
Facility
|
IP
|
$129.25
|
|
|
Service Code
|
NDC 50111-648-01
|
| Hospital Charge Code |
10070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$56.87 |
| Max. Negotiated Rate |
$116.32 |
| Rate for Payer: Aetna American Axle |
$84.01
|
| Rate for Payer: Aetna Commercial |
$109.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.01
|
| Rate for Payer: Cash Price |
$103.40
|
| Rate for Payer: Cofinity Commercial |
$111.16
|
| Rate for Payer: Cofinity Commercial |
$90.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.40
|
| Rate for Payer: Healthscope Commercial |
$116.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.86
|
| Rate for Payer: PHP Commercial |
$109.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.48
|
| Rate for Payer: Priority Health SBD |
$81.43
|
| Rate for Payer: UMR Bronson Commercial |
$56.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.94
|
|
|
FLUOXETINE 20 MG CAPSULE
|
Facility
|
IP
|
$284.35
|
|
|
Service Code
|
NDC 68084-605-01
|
| Hospital Charge Code |
10070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$125.11 |
| Max. Negotiated Rate |
$255.92 |
| Rate for Payer: Aetna American Axle |
$184.83
|
| Rate for Payer: Aetna Commercial |
$241.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.83
|
| Rate for Payer: Cash Price |
$227.48
|
| Rate for Payer: Cofinity Commercial |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$244.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.48
|
| Rate for Payer: Healthscope Commercial |
$255.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$241.70
|
| Rate for Payer: PHP Commercial |
$241.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.04
|
| Rate for Payer: Priority Health SBD |
$179.14
|
| Rate for Payer: UMR Bronson Commercial |
$125.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.26
|
|
|
FLUPHENAZINE 1 MG TABLET
|
Facility
|
IP
|
$3.35
|
|
|
Service Code
|
NDC 51079-485-01
|
| Hospital Charge Code |
3218
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.47 |
| Max. Negotiated Rate |
$3.02 |
| Rate for Payer: Aetna American Axle |
$2.18
|
| Rate for Payer: Aetna Commercial |
$2.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.18
|
| Rate for Payer: Cash Price |
$2.68
|
| Rate for Payer: Cofinity Commercial |
$2.34
|
| Rate for Payer: Cofinity Commercial |
$2.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.68
|
| Rate for Payer: Healthscope Commercial |
$3.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.85
|
| Rate for Payer: PHP Commercial |
$2.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.34
|
| Rate for Payer: Priority Health SBD |
$2.11
|
| Rate for Payer: UMR Bronson Commercial |
$1.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.51
|
|
|
FLUPHENAZINE 1 MG TABLET
|
Facility
|
IP
|
$308.16
|
|
|
Service Code
|
NDC 69238-1678-1
|
| Hospital Charge Code |
3218
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$135.59 |
| Max. Negotiated Rate |
$277.34 |
| Rate for Payer: Aetna American Axle |
$200.30
|
| Rate for Payer: Aetna Commercial |
$261.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.30
|
| Rate for Payer: Cash Price |
$246.53
|
| Rate for Payer: Cofinity Commercial |
$215.71
|
| Rate for Payer: Cofinity Commercial |
$265.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$246.53
|
| Rate for Payer: Healthscope Commercial |
$277.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$215.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$261.94
|
| Rate for Payer: PHP Commercial |
$261.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.71
|
| Rate for Payer: Priority Health SBD |
$194.14
|
| Rate for Payer: UMR Bronson Commercial |
$135.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.12
|
|
|
FLUPHENAZINE 1 MG TABLET
|
Facility
|
IP
|
$334.40
|
|
|
Service Code
|
NDC 51079-485-20
|
| Hospital Charge Code |
3218
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$147.14 |
| Max. Negotiated Rate |
$300.96 |
| Rate for Payer: Aetna American Axle |
$217.36
|
| Rate for Payer: Aetna Commercial |
$284.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.36
|
| Rate for Payer: Cash Price |
$267.52
|
| Rate for Payer: Cofinity Commercial |
$234.08
|
| Rate for Payer: Cofinity Commercial |
$287.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.52
|
| Rate for Payer: Healthscope Commercial |
$300.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$234.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$284.24
|
| Rate for Payer: PHP Commercial |
$284.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.08
|
| Rate for Payer: Priority Health SBD |
$210.67
|
| Rate for Payer: UMR Bronson Commercial |
$147.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.80
|
|
|
FLUPHENAZINE 1 MG TABLET
|
Facility
|
IP
|
$357.20
|
|
|
Service Code
|
NDC 70954-273-10
|
| Hospital Charge Code |
3218
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$157.17 |
| Max. Negotiated Rate |
$321.48 |
| Rate for Payer: Aetna American Axle |
$232.18
|
| Rate for Payer: Aetna Commercial |
$303.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.18
|
| Rate for Payer: Cash Price |
$285.76
|
| Rate for Payer: Cofinity Commercial |
$250.04
|
| Rate for Payer: Cofinity Commercial |
$307.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.76
|
| Rate for Payer: Healthscope Commercial |
$321.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$303.62
|
| Rate for Payer: PHP Commercial |
$303.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.04
|
| Rate for Payer: Priority Health SBD |
$225.04
|
| Rate for Payer: UMR Bronson Commercial |
$157.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.90
|
|
|
FLUPHENAZINE 1 MG TABLET
|
Facility
|
IP
|
$669.12
|
|
|
Service Code
|
NDC 0527-1788-01
|
| Hospital Charge Code |
3218
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$294.41 |
| Max. Negotiated Rate |
$602.21 |
| Rate for Payer: Aetna American Axle |
$434.93
|
| Rate for Payer: Aetna Commercial |
$568.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.93
|
| Rate for Payer: Cash Price |
$535.30
|
| Rate for Payer: Cofinity Commercial |
$468.38
|
| Rate for Payer: Cofinity Commercial |
$575.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$535.30
|
| Rate for Payer: Healthscope Commercial |
$602.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$468.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$501.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$568.75
|
| Rate for Payer: PHP Commercial |
$568.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$468.38
|
| Rate for Payer: Priority Health SBD |
$421.55
|
| Rate for Payer: UMR Bronson Commercial |
$294.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$501.84
|
|
|
FLUPHENAZINE 5 MG TABLET
|
Facility
|
IP
|
$1,080.40
|
|
|
Service Code
|
NDC 0527-1790-01
|
| Hospital Charge Code |
3221
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$475.38 |
| Max. Negotiated Rate |
$972.36 |
| Rate for Payer: Aetna American Axle |
$702.26
|
| Rate for Payer: Aetna Commercial |
$918.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$702.26
|
| Rate for Payer: Cash Price |
$864.32
|
| Rate for Payer: Cofinity Commercial |
$756.28
|
| Rate for Payer: Cofinity Commercial |
$929.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$864.32
|
| Rate for Payer: Healthscope Commercial |
$972.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$756.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$810.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$918.34
|
| Rate for Payer: PHP Commercial |
$918.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$756.28
|
| Rate for Payer: Priority Health SBD |
$680.65
|
| Rate for Payer: UMR Bronson Commercial |
$475.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$810.30
|
|
|
FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$325.01
|
|
|
Service Code
|
HCPCS J2680
|
| Hospital Charge Code |
3215
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$143.00 |
| Max. Negotiated Rate |
$292.51 |
| Rate for Payer: Aetna American Axle |
$211.26
|
| Rate for Payer: Aetna American Axle |
$135.49
|
| Rate for Payer: Aetna Commercial |
$276.26
|
| Rate for Payer: Aetna Commercial |
$177.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.26
|
| Rate for Payer: Cash Price |
$260.01
|
| Rate for Payer: Cash Price |
$166.75
|
| Rate for Payer: Cofinity Commercial |
$179.26
|
| Rate for Payer: Cofinity Commercial |
$227.51
|
| Rate for Payer: Cofinity Commercial |
$279.51
|
| Rate for Payer: Cofinity Commercial |
$145.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.75
|
| Rate for Payer: Healthscope Commercial |
$292.51
|
| Rate for Payer: Healthscope Commercial |
$187.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$227.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$276.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.17
|
| Rate for Payer: PHP Commercial |
$177.17
|
| Rate for Payer: PHP Commercial |
$276.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.91
|
| Rate for Payer: Priority Health SBD |
$204.76
|
| Rate for Payer: Priority Health SBD |
$131.32
|
| Rate for Payer: UMR Bronson Commercial |
$91.71
|
| Rate for Payer: UMR Bronson Commercial |
$143.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.33
|
|
|
FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$276.87
|
|
|
Service Code
|
HCPCS J2680
|
| Hospital Charge Code |
3215
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.56 |
| Max. Negotiated Rate |
$249.18 |
| Rate for Payer: Aetna American Axle |
$179.97
|
| Rate for Payer: Aetna Commercial |
$235.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.97
|
| Rate for Payer: BCBS Complete |
$110.75
|
| Rate for Payer: BCBS Trust/PPO |
$29.56
|
| Rate for Payer: Cash Price |
$221.50
|
| Rate for Payer: Cash Price |
$221.50
|
| Rate for Payer: Cofinity Commercial |
$193.81
|
| Rate for Payer: Cofinity Commercial |
$238.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.50
|
| Rate for Payer: Healthscope Commercial |
$249.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$235.34
|
| Rate for Payer: PHP Commercial |
$235.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.81
|
| Rate for Payer: Priority Health SBD |
$174.43
|
| Rate for Payer: UMR Bronson Commercial |
$102.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.65
|
|
|
FLURAZEPAM 15 MG CAPSULE
|
Facility
|
IP
|
$409.45
|
|
|
Service Code
|
NDC 0378-4415-01
|
| Hospital Charge Code |
3223
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$180.16 |
| Max. Negotiated Rate |
$368.50 |
| Rate for Payer: Aetna American Axle |
$266.14
|
| Rate for Payer: Aetna Commercial |
$348.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.14
|
| Rate for Payer: Cash Price |
$327.56
|
| Rate for Payer: Cofinity Commercial |
$286.62
|
| Rate for Payer: Cofinity Commercial |
$352.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$327.56
|
| Rate for Payer: Healthscope Commercial |
$368.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$286.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$307.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$348.03
|
| Rate for Payer: PHP Commercial |
$348.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.62
|
| Rate for Payer: Priority Health SBD |
$257.95
|
| Rate for Payer: UMR Bronson Commercial |
$180.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$307.09
|
|
|
FLURBIPROFEN 0.03 % EYE DROPS
|
Facility
|
IP
|
$117.11
|
|
|
Service Code
|
NDC 69292-722-25
|
| Hospital Charge Code |
10080
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$51.53 |
| Max. Negotiated Rate |
$105.40 |
| Rate for Payer: Aetna American Axle |
$76.12
|
| Rate for Payer: Aetna Commercial |
$99.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.12
|
| Rate for Payer: Cash Price |
$93.69
|
| Rate for Payer: Cofinity Commercial |
$100.71
|
| Rate for Payer: Cofinity Commercial |
$81.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.69
|
| Rate for Payer: Healthscope Commercial |
$105.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.54
|
| Rate for Payer: PHP Commercial |
$99.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.98
|
| Rate for Payer: Priority Health SBD |
$73.78
|
| Rate for Payer: UMR Bronson Commercial |
$51.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.83
|
|
