|
FRAXEL NECK
|
Professional
|
Both
|
$400.00
|
|
|
Service Code
|
HCPCS 00153
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$280.00 |
| Rate for Payer: BCBS Complete |
$160.00
|
| Rate for Payer: Cash Price |
$320.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.00
|
| Rate for Payer: UMR Bronson Commercial |
$184.00
|
|
|
FRAXEL NECK & CHEST
|
Professional
|
Both
|
$1,200.00
|
|
|
Service Code
|
HCPCS 00163
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$480.00 |
| Max. Negotiated Rate |
$840.00 |
| Rate for Payer: BCBS Complete |
$480.00
|
| Rate for Payer: Cash Price |
$960.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$840.00
|
| Rate for Payer: UMR Bronson Commercial |
$552.00
|
|
|
FRAXEL PARTIAL TREATMENT - BILATERAL EYES
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 00157
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
| Rate for Payer: UMR Bronson Commercial |
$138.00
|
|
|
FRAXEL PARTIAL TREATMENT - PERI-ORAL
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS 00156
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$200.00 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: BCBS Complete |
$200.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.00
|
| Rate for Payer: UMR Bronson Commercial |
$230.00
|
|
|
FRAXEL PARTIAL TREATMENT - UPPER LIP
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 00158
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: BCBS Complete |
$100.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.00
|
| Rate for Payer: UMR Bronson Commercial |
$115.00
|
|
|
FRAXEL RESTORE
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 00168
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: BCBS Complete |
$100.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.00
|
| Rate for Payer: UMR Bronson Commercial |
$115.00
|
|
|
FRAXEL SMALL SCAR
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 00159
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$87.50 |
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
| Rate for Payer: UMR Bronson Commercial |
$57.50
|
|
|
FRAXEL STRETCH MARKS - ENTIRE ABDOMEN
|
Professional
|
Both
|
$800.00
|
|
|
Service Code
|
HCPCS 00165
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$320.00 |
| Max. Negotiated Rate |
$560.00 |
| Rate for Payer: BCBS Complete |
$320.00
|
| Rate for Payer: Cash Price |
$640.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.00
|
| Rate for Payer: UMR Bronson Commercial |
$368.00
|
|
|
FRAXEL STRETCH MARKS - PERI-UMBILICAL
|
Professional
|
Both
|
$600.00
|
|
|
Service Code
|
HCPCS 00164
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$240.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: BCBS Complete |
$240.00
|
| Rate for Payer: Cash Price |
$480.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.00
|
| Rate for Payer: UMR Bronson Commercial |
$276.00
|
|
|
FULL TERM NEONATE WITH MAJOR PROBLEMS
|
Facility
|
IP
|
$64,208.66
|
|
|
Service Code
|
MS-DRG 793
|
| Min. Negotiated Rate |
$5,390.17 |
| Max. Negotiated Rate |
$64,208.66 |
| Rate for Payer: Aetna Medicare |
$34,267.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41,186.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41,186.71
|
| Rate for Payer: BCBS MAPPO |
$32,949.37
|
| Rate for Payer: BCBS Trust/PPO |
$5,390.17
|
| Rate for Payer: BCN Medicare Advantage |
$32,949.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32,949.37
|
| Rate for Payer: Mclaren Medicare |
$32,949.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34,596.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37,891.78
|
| Rate for Payer: PACE Medicare |
$31,301.90
|
| Rate for Payer: PACE SWMI |
$32,949.37
|
| Rate for Payer: PHP Medicare Advantage |
$32,949.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60,403.12
|
| Rate for Payer: Priority Health Medicare |
$32,949.37
|
| Rate for Payer: Priority Health Narrow Network |
$48,322.50
|
| Rate for Payer: Railroad Medicare Medicare |
$32,949.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64,208.66
|
| Rate for Payer: UHC Core |
$52,649.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$32,949.37
|
| Rate for Payer: UHC Exchange |
$41,857.28
|
| Rate for Payer: UHC Medicare Advantage |
$33,937.85
|
| Rate for Payer: VA VA |
$32,949.37
|
|
|
FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY
|
Facility
|
IP
|
$31,919.00
|
|
|
Service Code
|
MS-DRG 934
|
| Min. Negotiated Rate |
$15,805.37 |
| Max. Negotiated Rate |
$31,919.00 |
| Rate for Payer: Aetna Medicare |
$17,302.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,796.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,796.54
|
| Rate for Payer: BCBS MAPPO |
$16,637.23
|
| Rate for Payer: BCBS Trust/PPO |
$24,860.12
|
| Rate for Payer: BCN Medicare Advantage |
$16,637.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,637.23
|
| Rate for Payer: Mclaren Medicare |
$16,637.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17,469.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,132.81
|
| Rate for Payer: PACE Medicare |
$15,805.37
|
| Rate for Payer: PACE SWMI |
$16,637.23
|
| Rate for Payer: PHP Medicare Advantage |
$16,637.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30,027.21
|
| Rate for Payer: Priority Health Medicare |
$16,637.23
|
| Rate for Payer: Priority Health Narrow Network |
$24,021.77
|
| Rate for Payer: Railroad Medicare Medicare |
$16,637.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,919.00
|
| Rate for Payer: UHC Core |
$26,172.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,637.23
|
| Rate for Payer: UHC Exchange |
$20,807.82
|
| Rate for Payer: UHC Medicare Advantage |
$17,136.35
|
| Rate for Payer: VA VA |
$16,637.23
|
|
|
FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC
|
Facility
|
IP
|
$110,376.62
|
|
|
Service Code
|
MS-DRG 928
|
| Min. Negotiated Rate |
$51,144.02 |
| Max. Negotiated Rate |
$110,376.62 |
| Rate for Payer: Aetna Medicare |
$55,989.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67,294.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67,294.76
|
| Rate for Payer: BCBS MAPPO |
$53,835.81
|
| Rate for Payer: BCBS Trust/PPO |
$110,376.62
|
| Rate for Payer: BCN Medicare Advantage |
$53,835.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53,835.81
|
| Rate for Payer: Mclaren Medicare |
$53,835.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$56,527.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61,911.18
|
| Rate for Payer: PACE Medicare |
$51,144.02
|
| Rate for Payer: PACE SWMI |
$53,835.81
|
| Rate for Payer: PHP Medicare Advantage |
$53,835.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99,297.14
|
| Rate for Payer: Priority Health Medicare |
$53,835.81
|
| Rate for Payer: Priority Health Narrow Network |
$79,437.71
|
| Rate for Payer: Railroad Medicare Medicare |
$53,835.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105,553.10
|
| Rate for Payer: UHC Core |
$86,551.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$53,835.81
|
| Rate for Payer: UHC Exchange |
$68,809.50
|
| Rate for Payer: UHC Medicare Advantage |
$55,450.88
|
| Rate for Payer: VA VA |
$53,835.81
|
|
|
FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC
|
Facility
|
IP
|
$51,290.80
|
|
|
Service Code
|
MS-DRG 929
|
| Min. Negotiated Rate |
$24,026.54 |
| Max. Negotiated Rate |
$51,290.80 |
| Rate for Payer: Aetna Medicare |
$26,302.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31,613.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31,613.88
|
| Rate for Payer: BCBS MAPPO |
$25,291.10
|
| Rate for Payer: BCBS Trust/PPO |
$51,290.80
|
| Rate for Payer: BCN Medicare Advantage |
$25,291.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,291.10
|
| Rate for Payer: Mclaren Medicare |
$25,291.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26,555.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,084.76
|
| Rate for Payer: PACE Medicare |
$24,026.54
|
| Rate for Payer: PACE SWMI |
$25,291.10
|
| Rate for Payer: PHP Medicare Advantage |
$25,291.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46,142.17
|
| Rate for Payer: Priority Health Medicare |
$25,291.10
|
| Rate for Payer: Priority Health Narrow Network |
$36,913.74
|
| Rate for Payer: Railroad Medicare Medicare |
$25,291.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,049.24
|
| Rate for Payer: UHC Core |
$40,219.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$25,291.10
|
| Rate for Payer: UHC Exchange |
$31,974.93
|
| Rate for Payer: UHC Medicare Advantage |
$26,049.83
|
| Rate for Payer: VA VA |
$25,291.10
|
|
|
FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS, AND/OR FEET; 20 SQ CM OR LESS
|
Facility
|
OP
|
$5,102.91
|
|
|
Service Code
|
CPT 15240
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$783.24 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,843.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$861.56
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$783.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: VA VA |
$1,620.98
|
|
|
FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, NOSE, EARS, EYELIDS, AND/OR LIPS; 20 SQ CM OR LESS
|
Facility
|
OP
|
$5,102.91
|
|
|
Service Code
|
CPT 15260
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$830.07 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,362.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$913.08
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$830.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: VA VA |
$1,620.98
|
|
|
FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, NOSE, EARS, EYELIDS, AND/OR LIPS; EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$945.17
|
|
|
Service Code
|
CPT 15261
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$131.63 |
| Max. Negotiated Rate |
$945.17 |
| Rate for Payer: BCBS Trust/PPO |
$945.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.79
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$131.63
|
|
|
FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, SCALP, ARMS, AND/OR LEGS; 20 SQ CM OR LESS
|
Facility
|
OP
|
$5,102.91
|
|
|
Service Code
|
CPT 15220
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$600.53 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,362.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$660.58
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$600.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: VA VA |
$1,620.98
|
|
|
FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE
|
Facility
|
IP
|
$4,244.33
|
|
|
Service Code
|
HCPCS J9395
|
| Hospital Charge Code |
32767
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,867.51 |
| Max. Negotiated Rate |
$3,819.90 |
| Rate for Payer: Aetna American Axle |
$2,758.81
|
| Rate for Payer: Aetna Commercial |
$3,607.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,758.81
|
| Rate for Payer: Cash Price |
$3,395.46
|
| Rate for Payer: Cofinity Commercial |
$2,971.03
|
| Rate for Payer: Cofinity Commercial |
$3,650.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,395.46
|
| Rate for Payer: Healthscope Commercial |
$3,819.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,971.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,183.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,607.68
|
| Rate for Payer: PHP Commercial |
$3,607.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,971.03
|
| Rate for Payer: Priority Health SBD |
$2,673.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,867.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,183.25
|
|
|
FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE
|
Facility
|
OP
|
$720.87
|
|
|
Service Code
|
HCPCS J9395
|
| Hospital Charge Code |
32767
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$648.78 |
| Rate for Payer: Aetna American Axle |
$468.57
|
| Rate for Payer: Aetna American Axle |
$556.13
|
| Rate for Payer: Aetna American Axle |
$313.13
|
| Rate for Payer: Aetna American Axle |
$517.41
|
| Rate for Payer: Aetna American Axle |
$330.56
|
| Rate for Payer: Aetna American Axle |
$2,758.81
|
| Rate for Payer: Aetna American Axle |
$526.85
|
| Rate for Payer: Aetna American Axle |
$407.20
|
| Rate for Payer: Aetna American Axle |
$225.86
|
| Rate for Payer: Aetna American Axle |
$332.96
|
| Rate for Payer: Aetna Commercial |
$432.28
|
| Rate for Payer: Aetna Commercial |
$727.24
|
| Rate for Payer: Aetna Commercial |
$295.36
|
| Rate for Payer: Aetna Commercial |
$688.96
|
| Rate for Payer: Aetna Commercial |
$3,607.68
|
| Rate for Payer: Aetna Commercial |
$676.61
|
| Rate for Payer: Aetna Commercial |
$409.48
|
| Rate for Payer: Aetna Commercial |
$612.74
|
| Rate for Payer: Aetna Commercial |
$435.41
|
| Rate for Payer: Aetna Commercial |
$532.49
|
| Rate for Payer: Aetna Medicare |
$8.78
|
| Rate for Payer: Aetna Medicare |
$8.78
|
| Rate for Payer: Aetna Medicare |
$8.78
|
| Rate for Payer: Aetna Medicare |
$8.78
|
| Rate for Payer: Aetna Medicare |
$8.78
|
| Rate for Payer: Aetna Medicare |
$8.78
|
| Rate for Payer: Aetna Medicare |
$8.78
|
| Rate for Payer: Aetna Medicare |
$8.78
|
| Rate for Payer: Aetna Medicare |
$8.78
|
| Rate for Payer: Aetna Medicare |
$8.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$468.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$526.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$517.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$407.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,758.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$556.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$332.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.56
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS MAPPO |
$8.44
|
| Rate for Payer: BCBS MAPPO |
$8.44
|
| Rate for Payer: BCBS MAPPO |
$8.44
|
| Rate for Payer: BCBS MAPPO |
$8.44
|
| Rate for Payer: BCBS MAPPO |
$8.44
|
| Rate for Payer: BCBS MAPPO |
$8.44
|
| Rate for Payer: BCBS MAPPO |
$8.44
|
| Rate for Payer: BCBS MAPPO |
$8.44
|
| Rate for Payer: BCBS MAPPO |
$8.44
|
| Rate for Payer: BCBS MAPPO |
$8.44
|
| Rate for Payer: BCBS Trust/PPO |
$27.28
|
| Rate for Payer: BCBS Trust/PPO |
$27.28
|
| Rate for Payer: BCBS Trust/PPO |
$27.28
|
| Rate for Payer: BCBS Trust/PPO |
$27.28
|
| Rate for Payer: BCBS Trust/PPO |
$27.28
|
| Rate for Payer: BCBS Trust/PPO |
$27.28
|
| Rate for Payer: BCBS Trust/PPO |
$27.28
|
| Rate for Payer: BCBS Trust/PPO |
$27.28
|
| Rate for Payer: BCBS Trust/PPO |
$27.28
|
| Rate for Payer: BCBS Trust/PPO |
$27.28
|
| Rate for Payer: BCN Medicare Advantage |
$8.44
|
| Rate for Payer: BCN Medicare Advantage |
$8.44
|
| Rate for Payer: BCN Medicare Advantage |
$8.44
|
| Rate for Payer: BCN Medicare Advantage |
$8.44
|
| Rate for Payer: BCN Medicare Advantage |
$8.44
|
| Rate for Payer: BCN Medicare Advantage |
$8.44
|
| Rate for Payer: BCN Medicare Advantage |
$8.44
|
| Rate for Payer: BCN Medicare Advantage |
$8.44
|
| Rate for Payer: BCN Medicare Advantage |
$8.44
|
| Rate for Payer: BCN Medicare Advantage |
$8.44
|
| Rate for Payer: Cash Price |
$576.70
|
| Rate for Payer: Cash Price |
$3,395.46
|
| Rate for Payer: Cash Price |
$406.85
|
| Rate for Payer: Cash Price |
$501.17
|
| Rate for Payer: Cash Price |
$636.81
|
| Rate for Payer: Cash Price |
$385.39
|
| Rate for Payer: Cash Price |
$3,395.46
|
| Rate for Payer: Cash Price |
$409.80
|
| Rate for Payer: Cash Price |
$648.43
|
| Rate for Payer: Cash Price |
$385.39
|
| Rate for Payer: Cash Price |
$409.80
|
| Rate for Payer: Cash Price |
$684.46
|
| Rate for Payer: Cash Price |
$277.98
|
| Rate for Payer: Cash Price |
$648.43
|
| Rate for Payer: Cash Price |
$684.46
|
| Rate for Payer: Cash Price |
$406.85
|
| Rate for Payer: Cash Price |
$501.17
|
| Rate for Payer: Cash Price |
$636.81
|
| Rate for Payer: Cash Price |
$277.98
|
| Rate for Payer: Cash Price |
$576.70
|
| Rate for Payer: Cofinity Commercial |
$557.21
|
| Rate for Payer: Cofinity Commercial |
$619.95
|
| Rate for Payer: Cofinity Commercial |
$504.61
|
| Rate for Payer: Cofinity Commercial |
$298.83
|
| Rate for Payer: Cofinity Commercial |
$3,650.12
|
| Rate for Payer: Cofinity Commercial |
$735.80
|
| Rate for Payer: Cofinity Commercial |
$567.38
|
| Rate for Payer: Cofinity Commercial |
$697.06
|
| Rate for Payer: Cofinity Commercial |
$358.58
|
| Rate for Payer: Cofinity Commercial |
$438.52
|
| Rate for Payer: Cofinity Commercial |
$598.91
|
| Rate for Payer: Cofinity Commercial |
$337.22
|
| Rate for Payer: Cofinity Commercial |
$414.30
|
| Rate for Payer: Cofinity Commercial |
$684.57
|
| Rate for Payer: Cofinity Commercial |
$440.54
|
| Rate for Payer: Cofinity Commercial |
$538.76
|
| Rate for Payer: Cofinity Commercial |
$2,971.03
|
| Rate for Payer: Cofinity Commercial |
$355.99
|
| Rate for Payer: Cofinity Commercial |
$437.36
|
| Rate for Payer: Cofinity Commercial |
$243.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,395.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$648.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$409.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$501.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$636.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.44
|
| Rate for Payer: Healthscope Commercial |
$3,819.90
|
| Rate for Payer: Healthscope Commercial |
$770.02
|
| Rate for Payer: Healthscope Commercial |
$563.81
|
| Rate for Payer: Healthscope Commercial |
$716.41
|
| Rate for Payer: Healthscope Commercial |
$461.02
|
| Rate for Payer: Healthscope Commercial |
$729.49
|
| Rate for Payer: Healthscope Commercial |
$312.73
|
| Rate for Payer: Healthscope Commercial |
$648.78
|
| Rate for Payer: Healthscope Commercial |
$433.57
|
| Rate for Payer: Healthscope Commercial |
$457.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$358.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$337.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$438.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$598.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,971.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$557.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$567.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$355.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$504.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$243.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$384.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$641.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,183.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$597.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$607.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$469.84
|
| Rate for Payer: Mclaren Medicaid |
$4.62
|
| Rate for Payer: Mclaren Medicaid |
$4.62
|
| Rate for Payer: Mclaren Medicaid |
$4.62
|
| Rate for Payer: Mclaren Medicaid |
$4.62
|
| Rate for Payer: Mclaren Medicaid |
$4.62
|
| Rate for Payer: Mclaren Medicaid |
$4.62
|
| Rate for Payer: Mclaren Medicaid |
$4.62
|
| Rate for Payer: Mclaren Medicaid |
$4.62
|
| Rate for Payer: Mclaren Medicaid |
$4.62
|
| Rate for Payer: Mclaren Medicaid |
$4.62
|
| Rate for Payer: Mclaren Medicare |
$8.44
|
| Rate for Payer: Mclaren Medicare |
$8.44
|
| Rate for Payer: Mclaren Medicare |
$8.44
|
| Rate for Payer: Mclaren Medicare |
$8.44
|
| Rate for Payer: Mclaren Medicare |
$8.44
|
| Rate for Payer: Mclaren Medicare |
$8.44
|
| Rate for Payer: Mclaren Medicare |
$8.44
|
| Rate for Payer: Mclaren Medicare |
$8.44
|
| Rate for Payer: Mclaren Medicare |
$8.44
|
| Rate for Payer: Mclaren Medicare |
$8.44
|
| Rate for Payer: Meridian Medicaid |
$4.85
|
| Rate for Payer: Meridian Medicaid |
$4.85
|
| Rate for Payer: Meridian Medicaid |
$4.85
|
| Rate for Payer: Meridian Medicaid |
$4.85
|
| Rate for Payer: Meridian Medicaid |
$4.85
|
| Rate for Payer: Meridian Medicaid |
$4.85
|
| Rate for Payer: Meridian Medicaid |
$4.85
|
| Rate for Payer: Meridian Medicaid |
$4.85
|
| Rate for Payer: Meridian Medicaid |
$4.85
|
| Rate for Payer: Meridian Medicaid |
$4.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$409.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$295.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$688.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$435.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$432.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$532.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$727.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,607.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$676.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$612.74
|
| Rate for Payer: PACE Medicare |
$8.02
|
| Rate for Payer: PACE Medicare |
$8.02
|
| Rate for Payer: PACE Medicare |
$8.02
|
| Rate for Payer: PACE Medicare |
$8.02
|
| Rate for Payer: PACE Medicare |
$8.02
|
| Rate for Payer: PACE Medicare |
$8.02
|
| Rate for Payer: PACE Medicare |
$8.02
|
| Rate for Payer: PACE Medicare |
$8.02
|
| Rate for Payer: PACE Medicare |
$8.02
|
| Rate for Payer: PACE Medicare |
$8.02
|
| Rate for Payer: PACE SWMI |
$8.44
|
| Rate for Payer: PACE SWMI |
$8.44
|
| Rate for Payer: PACE SWMI |
$8.44
|
| Rate for Payer: PACE SWMI |
$8.44
|
| Rate for Payer: PACE SWMI |
$8.44
|
| Rate for Payer: PACE SWMI |
$8.44
|
| Rate for Payer: PACE SWMI |
$8.44
|
| Rate for Payer: PACE SWMI |
$8.44
|
| Rate for Payer: PACE SWMI |
$8.44
|
| Rate for Payer: PACE SWMI |
$8.44
|
| Rate for Payer: PHP Commercial |
$435.41
|
| Rate for Payer: PHP Commercial |
$432.28
|
| Rate for Payer: PHP Commercial |
$532.49
|
| Rate for Payer: PHP Commercial |
$409.48
|
| Rate for Payer: PHP Commercial |
$612.74
|
| Rate for Payer: PHP Commercial |
$676.61
|
| Rate for Payer: PHP Commercial |
$3,607.68
|
| Rate for Payer: PHP Commercial |
$688.96
|
| Rate for Payer: PHP Commercial |
$295.36
|
| Rate for Payer: PHP Commercial |
$727.24
|
| Rate for Payer: PHP Medicare Advantage |
$8.44
|
| Rate for Payer: PHP Medicare Advantage |
$8.44
|
| Rate for Payer: PHP Medicare Advantage |
$8.44
|
| Rate for Payer: PHP Medicare Advantage |
$8.44
|
| Rate for Payer: PHP Medicare Advantage |
$8.44
|
| Rate for Payer: PHP Medicare Advantage |
$8.44
|
| Rate for Payer: PHP Medicare Advantage |
$8.44
|
| Rate for Payer: PHP Medicare Advantage |
$8.44
|
| Rate for Payer: PHP Medicare Advantage |
$8.44
|
| Rate for Payer: PHP Medicare Advantage |
$8.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$358.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$337.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$438.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,971.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$567.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$598.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$355.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.53
|
| Rate for Payer: Priority Health Medicare |
$8.44
|
| Rate for Payer: Priority Health Medicare |
$8.44
|
| Rate for Payer: Priority Health Medicare |
$8.44
|
| Rate for Payer: Priority Health Medicare |
$8.44
|
| Rate for Payer: Priority Health Medicare |
$8.44
|
| Rate for Payer: Priority Health Medicare |
$8.44
|
| Rate for Payer: Priority Health Medicare |
$8.44
|
| Rate for Payer: Priority Health Medicare |
$8.44
|
| Rate for Payer: Priority Health Medicare |
$8.44
|
| Rate for Payer: Priority Health Medicare |
$8.44
|
| Rate for Payer: Priority Health Narrow Network |
$19.62
|
| Rate for Payer: Priority Health Narrow Network |
$19.62
|
| Rate for Payer: Priority Health Narrow Network |
$19.62
|
| Rate for Payer: Priority Health Narrow Network |
$19.62
|
| Rate for Payer: Priority Health Narrow Network |
$19.62
|
| Rate for Payer: Priority Health Narrow Network |
$19.62
|
| Rate for Payer: Priority Health Narrow Network |
$19.62
|
| Rate for Payer: Priority Health Narrow Network |
$19.62
|
| Rate for Payer: Priority Health Narrow Network |
$19.62
|
| Rate for Payer: Priority Health Narrow Network |
$19.62
|
| Rate for Payer: Priority Health SBD |
$218.91
|
| Rate for Payer: Priority Health SBD |
$510.64
|
| Rate for Payer: Priority Health SBD |
$539.02
|
| Rate for Payer: Priority Health SBD |
$454.15
|
| Rate for Payer: Priority Health SBD |
$322.72
|
| Rate for Payer: Priority Health SBD |
$394.67
|
| Rate for Payer: Priority Health SBD |
$501.49
|
| Rate for Payer: Priority Health SBD |
$320.39
|
| Rate for Payer: Priority Health SBD |
$2,673.93
|
| Rate for Payer: Priority Health SBD |
$303.50
|
| Rate for Payer: Railroad Medicare Medicare |
$8.44
|
| Rate for Payer: Railroad Medicare Medicare |
$8.44
|
| Rate for Payer: Railroad Medicare Medicare |
$8.44
|
| Rate for Payer: Railroad Medicare Medicare |
$8.44
|
| Rate for Payer: Railroad Medicare Medicare |
$8.44
|
| Rate for Payer: Railroad Medicare Medicare |
$8.44
|
| Rate for Payer: Railroad Medicare Medicare |
$8.44
|
| Rate for Payer: Railroad Medicare Medicare |
$8.44
|
| Rate for Payer: Railroad Medicare Medicare |
$8.44
|
| Rate for Payer: Railroad Medicare Medicare |
$8.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.44
|
| Rate for Payer: UHC Medicare Advantage |
$8.70
|
| Rate for Payer: UHC Medicare Advantage |
$8.70
|
| Rate for Payer: UHC Medicare Advantage |
$8.70
|
| Rate for Payer: UHC Medicare Advantage |
$8.70
|
| Rate for Payer: UHC Medicare Advantage |
$8.70
|
| Rate for Payer: UHC Medicare Advantage |
$8.70
|
| Rate for Payer: UHC Medicare Advantage |
$8.70
|
| Rate for Payer: UHC Medicare Advantage |
$8.70
|
| Rate for Payer: UHC Medicare Advantage |
$8.70
|
| Rate for Payer: UHC Medicare Advantage |
$8.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,570.40
|
| Rate for Payer: UMR Bronson Commercial |
$189.53
|
| Rate for Payer: UMR Bronson Commercial |
$316.56
|
| Rate for Payer: UMR Bronson Commercial |
$178.24
|
| Rate for Payer: UMR Bronson Commercial |
$266.72
|
| Rate for Payer: UMR Bronson Commercial |
$231.79
|
| Rate for Payer: UMR Bronson Commercial |
$294.52
|
| Rate for Payer: UMR Bronson Commercial |
$128.57
|
| Rate for Payer: UMR Bronson Commercial |
$299.90
|
| Rate for Payer: UMR Bronson Commercial |
$188.17
|
| Rate for Payer: VA VA |
$8.44
|
| Rate for Payer: VA VA |
$8.44
|
| Rate for Payer: VA VA |
$8.44
|
| Rate for Payer: VA VA |
$8.44
|
| Rate for Payer: VA VA |
$8.44
|
| Rate for Payer: VA VA |
$8.44
|
| Rate for Payer: VA VA |
$8.44
|
| Rate for Payer: VA VA |
$8.44
|
| Rate for Payer: VA VA |
$8.44
|
| Rate for Payer: VA VA |
$8.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,183.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$607.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$384.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$597.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$469.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$641.68
|
|
|
FUROSEMIDE 10 MG/ML INJECTION (CODE)
|
Facility
|
IP
|
$25.47
|
|
|
Service Code
|
HCPCS J1940
|
| Hospital Charge Code |
163713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.21 |
| Max. Negotiated Rate |
$22.92 |
| Rate for Payer: Aetna American Axle |
$16.56
|
| Rate for Payer: Aetna American Axle |
$10.86
|
| Rate for Payer: Aetna American Axle |
$8.96
|
| Rate for Payer: Aetna American Axle |
$10.27
|
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Commercial |
$11.71
|
| Rate for Payer: Aetna Commercial |
$21.65
|
| Rate for Payer: Aetna Commercial |
$13.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.56
|
| Rate for Payer: Cash Price |
$11.02
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cash Price |
$20.38
|
| Rate for Payer: Cash Price |
$12.64
|
| Rate for Payer: Cofinity Commercial |
$9.65
|
| Rate for Payer: Cofinity Commercial |
$21.90
|
| Rate for Payer: Cofinity Commercial |
$17.83
|
| Rate for Payer: Cofinity Commercial |
$11.85
|
| Rate for Payer: Cofinity Commercial |
$11.06
|
| Rate for Payer: Cofinity Commercial |
$13.59
|
| Rate for Payer: Cofinity Commercial |
$14.36
|
| Rate for Payer: Cofinity Commercial |
$11.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$12.40
|
| Rate for Payer: Healthscope Commercial |
$14.22
|
| Rate for Payer: Healthscope Commercial |
$15.03
|
| Rate for Payer: Healthscope Commercial |
$22.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.65
|
| Rate for Payer: PHP Commercial |
$21.65
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: PHP Commercial |
$13.43
|
| Rate for Payer: PHP Commercial |
$11.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.83
|
| Rate for Payer: Priority Health SBD |
$10.52
|
| Rate for Payer: Priority Health SBD |
$8.68
|
| Rate for Payer: Priority Health SBD |
$16.05
|
| Rate for Payer: Priority Health SBD |
$9.95
|
| Rate for Payer: UMR Bronson Commercial |
$6.06
|
| Rate for Payer: UMR Bronson Commercial |
$11.21
|
| Rate for Payer: UMR Bronson Commercial |
$7.35
|
| Rate for Payer: UMR Bronson Commercial |
$6.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.10
|
|
|
FUROSEMIDE 10 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$10.94
|
|
|
Service Code
|
HCPCS J1940
|
| Hospital Charge Code |
3291
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.81 |
| Max. Negotiated Rate |
$9.85 |
| Rate for Payer: Aetna American Axle |
$7.11
|
| Rate for Payer: Aetna American Axle |
$6.66
|
| Rate for Payer: Aetna American Axle |
$10.56
|
| Rate for Payer: Aetna American Axle |
$9.85
|
| Rate for Payer: Aetna American Axle |
$8.96
|
| Rate for Payer: Aetna American Axle |
$10.86
|
| Rate for Payer: Aetna American Axle |
$17.34
|
| Rate for Payer: Aetna American Axle |
$11.88
|
| Rate for Payer: Aetna American Axle |
$14.29
|
| Rate for Payer: Aetna American Axle |
$9.13
|
| Rate for Payer: Aetna American Axle |
$8.94
|
| Rate for Payer: Aetna American Axle |
$8.71
|
| Rate for Payer: Aetna American Axle |
$16.69
|
| Rate for Payer: Aetna American Axle |
$13.38
|
| Rate for Payer: Aetna American Axle |
$10.27
|
| Rate for Payer: Aetna American Axle |
$16.56
|
| Rate for Payer: Aetna American Axle |
$7.88
|
| Rate for Payer: Aetna Commercial |
$9.30
|
| Rate for Payer: Aetna Commercial |
$11.39
|
| Rate for Payer: Aetna Commercial |
$12.88
|
| Rate for Payer: Aetna Commercial |
$11.69
|
| Rate for Payer: Aetna Commercial |
$13.80
|
| Rate for Payer: Aetna Commercial |
$21.65
|
| Rate for Payer: Aetna Commercial |
$18.68
|
| Rate for Payer: Aetna Commercial |
$11.71
|
| Rate for Payer: Aetna Commercial |
$15.53
|
| Rate for Payer: Aetna Commercial |
$17.50
|
| Rate for Payer: Aetna Commercial |
$11.93
|
| Rate for Payer: Aetna Commercial |
$22.68
|
| Rate for Payer: Aetna Commercial |
$13.43
|
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Commercial |
$21.82
|
| Rate for Payer: Aetna Commercial |
$10.31
|
| Rate for Payer: Aetna Commercial |
$8.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.13
|
| Rate for Payer: Cash Price |
$11.00
|
| Rate for Payer: Cash Price |
$12.12
|
| Rate for Payer: Cash Price |
$12.99
|
| Rate for Payer: Cash Price |
$11.23
|
| Rate for Payer: Cash Price |
$21.34
|
| Rate for Payer: Cash Price |
$8.19
|
| Rate for Payer: Cash Price |
$9.70
|
| Rate for Payer: Cash Price |
$17.58
|
| Rate for Payer: Cash Price |
$20.54
|
| Rate for Payer: Cash Price |
$20.38
|
| Rate for Payer: Cash Price |
$10.72
|
| Rate for Payer: Cash Price |
$8.75
|
| Rate for Payer: Cash Price |
$14.62
|
| Rate for Payer: Cash Price |
$16.47
|
| Rate for Payer: Cash Price |
$11.02
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cash Price |
$12.64
|
| Rate for Payer: Cofinity Commercial |
$22.08
|
| Rate for Payer: Cofinity Commercial |
$13.97
|
| Rate for Payer: Cofinity Commercial |
$11.37
|
| Rate for Payer: Cofinity Commercial |
$18.68
|
| Rate for Payer: Cofinity Commercial |
$22.94
|
| Rate for Payer: Cofinity Commercial |
$9.83
|
| Rate for Payer: Cofinity Commercial |
$11.85
|
| Rate for Payer: Cofinity Commercial |
$9.65
|
| Rate for Payer: Cofinity Commercial |
$8.81
|
| Rate for Payer: Cofinity Commercial |
$7.17
|
| Rate for Payer: Cofinity Commercial |
$13.59
|
| Rate for Payer: Cofinity Commercial |
$11.06
|
| Rate for Payer: Cofinity Commercial |
$15.39
|
| Rate for Payer: Cofinity Commercial |
$17.71
|
| Rate for Payer: Cofinity Commercial |
$14.41
|
| Rate for Payer: Cofinity Commercial |
$8.49
|
| Rate for Payer: Cofinity Commercial |
$10.43
|
| Rate for Payer: Cofinity Commercial |
$18.90
|
| Rate for Payer: Cofinity Commercial |
$11.52
|
| Rate for Payer: Cofinity Commercial |
$9.38
|
| Rate for Payer: Cofinity Commercial |
$12.07
|
| Rate for Payer: Cofinity Commercial |
$17.83
|
| Rate for Payer: Cofinity Commercial |
$21.90
|
| Rate for Payer: Cofinity Commercial |
$15.71
|
| Rate for Payer: Cofinity Commercial |
$12.79
|
| Rate for Payer: Cofinity Commercial |
$9.41
|
| Rate for Payer: Cofinity Commercial |
$7.66
|
| Rate for Payer: Cofinity Commercial |
$10.60
|
| Rate for Payer: Cofinity Commercial |
$11.82
|
| Rate for Payer: Cofinity Commercial |
$9.62
|
| Rate for Payer: Cofinity Commercial |
$17.97
|
| Rate for Payer: Cofinity Commercial |
$14.36
|
| Rate for Payer: Cofinity Commercial |
$11.69
|
| Rate for Payer: Cofinity Commercial |
$13.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.34
|
| Rate for Payer: Healthscope Commercial |
$12.06
|
| Rate for Payer: Healthscope Commercial |
$15.03
|
| Rate for Payer: Healthscope Commercial |
$23.10
|
| Rate for Payer: Healthscope Commercial |
$14.62
|
| Rate for Payer: Healthscope Commercial |
$12.40
|
| Rate for Payer: Healthscope Commercial |
$9.22
|
| Rate for Payer: Healthscope Commercial |
$22.92
|
| Rate for Payer: Healthscope Commercial |
$16.44
|
| Rate for Payer: Healthscope Commercial |
$18.53
|
| Rate for Payer: Healthscope Commercial |
$10.92
|
| Rate for Payer: Healthscope Commercial |
$12.38
|
| Rate for Payer: Healthscope Commercial |
$19.78
|
| Rate for Payer: Healthscope Commercial |
$24.01
|
| Rate for Payer: Healthscope Commercial |
$9.85
|
| Rate for Payer: Healthscope Commercial |
$13.64
|
| Rate for Payer: Healthscope Commercial |
$12.64
|
| Rate for Payer: Healthscope Commercial |
$14.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.70
|
| Rate for Payer: PHP Commercial |
$15.53
|
| Rate for Payer: PHP Commercial |
$22.68
|
| Rate for Payer: PHP Commercial |
$10.31
|
| Rate for Payer: PHP Commercial |
$13.43
|
| Rate for Payer: PHP Commercial |
$9.30
|
| Rate for Payer: PHP Commercial |
$18.68
|
| Rate for Payer: PHP Commercial |
$8.70
|
| Rate for Payer: PHP Commercial |
$21.82
|
| Rate for Payer: PHP Commercial |
$21.65
|
| Rate for Payer: PHP Commercial |
$11.71
|
| Rate for Payer: PHP Commercial |
$17.50
|
| Rate for Payer: PHP Commercial |
$11.39
|
| Rate for Payer: PHP Commercial |
$13.80
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: PHP Commercial |
$11.93
|
| Rate for Payer: PHP Commercial |
$11.69
|
| Rate for Payer: PHP Commercial |
$12.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.68
|
| Rate for Payer: Priority Health SBD |
$6.89
|
| Rate for Payer: Priority Health SBD |
$16.17
|
| Rate for Payer: Priority Health SBD |
$10.23
|
| Rate for Payer: Priority Health SBD |
$9.54
|
| Rate for Payer: Priority Health SBD |
$10.52
|
| Rate for Payer: Priority Health SBD |
$8.66
|
| Rate for Payer: Priority Health SBD |
$16.81
|
| Rate for Payer: Priority Health SBD |
$6.45
|
| Rate for Payer: Priority Health SBD |
$8.68
|
| Rate for Payer: Priority Health SBD |
$8.85
|
| Rate for Payer: Priority Health SBD |
$12.97
|
| Rate for Payer: Priority Health SBD |
$11.51
|
| Rate for Payer: Priority Health SBD |
$8.44
|
| Rate for Payer: Priority Health SBD |
$7.64
|
| Rate for Payer: Priority Health SBD |
$9.95
|
| Rate for Payer: Priority Health SBD |
$13.85
|
| Rate for Payer: Priority Health SBD |
$16.05
|
| Rate for Payer: UMR Bronson Commercial |
$6.05
|
| Rate for Payer: UMR Bronson Commercial |
$9.67
|
| Rate for Payer: UMR Bronson Commercial |
$4.81
|
| Rate for Payer: UMR Bronson Commercial |
$8.04
|
| Rate for Payer: UMR Bronson Commercial |
$5.90
|
| Rate for Payer: UMR Bronson Commercial |
$11.21
|
| Rate for Payer: UMR Bronson Commercial |
$7.35
|
| Rate for Payer: UMR Bronson Commercial |
$4.51
|
| Rate for Payer: UMR Bronson Commercial |
$7.15
|
| Rate for Payer: UMR Bronson Commercial |
$11.29
|
| Rate for Payer: UMR Bronson Commercial |
$6.95
|
| Rate for Payer: UMR Bronson Commercial |
$6.18
|
| Rate for Payer: UMR Bronson Commercial |
$6.06
|
| Rate for Payer: UMR Bronson Commercial |
$6.67
|
| Rate for Payer: UMR Bronson Commercial |
$11.74
|
| Rate for Payer: UMR Bronson Commercial |
$9.06
|
| Rate for Payer: UMR Bronson Commercial |
$5.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.01
|
|
|
FUROSEMIDE 10 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$10.94
|
|
|
Service Code
|
HCPCS J1940
|
| Hospital Charge Code |
3291
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.84 |
| Max. Negotiated Rate |
$9.85 |
| Rate for Payer: Aetna American Axle |
$7.11
|
| Rate for Payer: Aetna American Axle |
$7.88
|
| Rate for Payer: Aetna American Axle |
$9.85
|
| Rate for Payer: Aetna American Axle |
$18.32
|
| Rate for Payer: Aetna American Axle |
$10.86
|
| Rate for Payer: Aetna American Axle |
$7.28
|
| Rate for Payer: Aetna American Axle |
$10.27
|
| Rate for Payer: Aetna Commercial |
$13.43
|
| Rate for Payer: Aetna Commercial |
$12.88
|
| Rate for Payer: Aetna Commercial |
$23.96
|
| Rate for Payer: Aetna Commercial |
$9.30
|
| Rate for Payer: Aetna Commercial |
$10.31
|
| Rate for Payer: Aetna Commercial |
$9.52
|
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.86
|
| Rate for Payer: BCBS Complete |
$6.06
|
| Rate for Payer: BCBS Complete |
$4.38
|
| Rate for Payer: BCBS Complete |
$4.48
|
| Rate for Payer: BCBS Complete |
$4.85
|
| Rate for Payer: BCBS Complete |
$6.32
|
| Rate for Payer: BCBS Complete |
$6.68
|
| Rate for Payer: BCBS Complete |
$11.28
|
| Rate for Payer: BCBS Trust/PPO |
$1.84
|
| Rate for Payer: BCBS Trust/PPO |
$1.84
|
| Rate for Payer: BCBS Trust/PPO |
$1.84
|
| Rate for Payer: BCBS Trust/PPO |
$1.84
|
| Rate for Payer: BCBS Trust/PPO |
$1.84
|
| Rate for Payer: BCBS Trust/PPO |
$1.84
|
| Rate for Payer: BCBS Trust/PPO |
$1.84
|
| Rate for Payer: Cash Price |
$8.96
|
| Rate for Payer: Cash Price |
$9.70
|
| Rate for Payer: Cash Price |
$12.12
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cash Price |
$9.70
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cash Price |
$22.55
|
| Rate for Payer: Cash Price |
$12.64
|
| Rate for Payer: Cash Price |
$8.75
|
| Rate for Payer: Cash Price |
$8.75
|
| Rate for Payer: Cash Price |
$12.12
|
| Rate for Payer: Cash Price |
$12.64
|
| Rate for Payer: Cash Price |
$22.55
|
| Rate for Payer: Cash Price |
$8.96
|
| Rate for Payer: Cofinity Commercial |
$24.24
|
| Rate for Payer: Cofinity Commercial |
$7.66
|
| Rate for Payer: Cofinity Commercial |
$11.69
|
| Rate for Payer: Cofinity Commercial |
$14.36
|
| Rate for Payer: Cofinity Commercial |
$9.63
|
| Rate for Payer: Cofinity Commercial |
$7.84
|
| Rate for Payer: Cofinity Commercial |
$10.43
|
| Rate for Payer: Cofinity Commercial |
$8.49
|
| Rate for Payer: Cofinity Commercial |
$9.41
|
| Rate for Payer: Cofinity Commercial |
$19.73
|
| Rate for Payer: Cofinity Commercial |
$10.60
|
| Rate for Payer: Cofinity Commercial |
$13.03
|
| Rate for Payer: Cofinity Commercial |
$11.06
|
| Rate for Payer: Cofinity Commercial |
$13.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.70
|
| Rate for Payer: Healthscope Commercial |
$10.08
|
| Rate for Payer: Healthscope Commercial |
$14.22
|
| Rate for Payer: Healthscope Commercial |
$13.64
|
| Rate for Payer: Healthscope Commercial |
$9.85
|
| Rate for Payer: Healthscope Commercial |
$25.37
|
| Rate for Payer: Healthscope Commercial |
$15.03
|
| Rate for Payer: Healthscope Commercial |
$10.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12.88
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: PHP Commercial |
$9.52
|
| Rate for Payer: PHP Commercial |
$10.31
|
| Rate for Payer: PHP Commercial |
$9.30
|
| Rate for Payer: PHP Commercial |
$12.88
|
| Rate for Payer: PHP Commercial |
$13.43
|
| Rate for Payer: PHP Commercial |
$23.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.66
|
| Rate for Payer: Priority Health SBD |
$9.95
|
| Rate for Payer: Priority Health SBD |
$6.89
|
| Rate for Payer: Priority Health SBD |
$17.76
|
| Rate for Payer: Priority Health SBD |
$7.06
|
| Rate for Payer: Priority Health SBD |
$7.64
|
| Rate for Payer: Priority Health SBD |
$9.54
|
| Rate for Payer: Priority Health SBD |
$10.52
|
| Rate for Payer: UMR Bronson Commercial |
$5.61
|
| Rate for Payer: UMR Bronson Commercial |
$5.85
|
| Rate for Payer: UMR Bronson Commercial |
$6.18
|
| Rate for Payer: UMR Bronson Commercial |
$4.14
|
| Rate for Payer: UMR Bronson Commercial |
$4.49
|
| Rate for Payer: UMR Bronson Commercial |
$4.05
|
| Rate for Payer: UMR Bronson Commercial |
$10.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.14
|
|
|
FUROSEMIDE 10 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$46.02
|
|
|
Service Code
|
HCPCS J1940
|
| Hospital Charge Code |
111372
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$41.42 |
| Rate for Payer: Aetna American Axle |
$29.91
|
| Rate for Payer: Aetna Commercial |
$39.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.91
|
| Rate for Payer: Cash Price |
$36.82
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Cofinity Commercial |
$39.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.82
|
| Rate for Payer: Healthscope Commercial |
$41.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.12
|
| Rate for Payer: PHP Commercial |
$39.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.21
|
| Rate for Payer: Priority Health SBD |
$28.99
|
| Rate for Payer: UMR Bronson Commercial |
$20.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.52
|
|
|
FUROSEMIDE 10 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$160.74
|
|
|
Service Code
|
NDC 60432-613-60
|
| Hospital Charge Code |
3292
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$70.73 |
| Max. Negotiated Rate |
$144.67 |
| Rate for Payer: Aetna American Axle |
$104.48
|
| Rate for Payer: Aetna Commercial |
$136.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.48
|
| Rate for Payer: Cash Price |
$128.59
|
| Rate for Payer: Cofinity Commercial |
$112.52
|
| Rate for Payer: Cofinity Commercial |
$138.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.59
|
| Rate for Payer: Healthscope Commercial |
$144.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$136.63
|
| Rate for Payer: PHP Commercial |
$136.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.52
|
| Rate for Payer: Priority Health SBD |
$101.27
|
| Rate for Payer: UMR Bronson Commercial |
$70.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.56
|
|
|
FUROSEMIDE 10 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$124.08
|
|
|
Service Code
|
NDC 0054-3294-46
|
| Hospital Charge Code |
3292
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$111.67 |
| Rate for Payer: Aetna American Axle |
$80.65
|
| Rate for Payer: Aetna Commercial |
$105.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.65
|
| Rate for Payer: Cash Price |
$99.26
|
| Rate for Payer: Cofinity Commercial |
$106.71
|
| Rate for Payer: Cofinity Commercial |
$86.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.26
|
| Rate for Payer: Healthscope Commercial |
$111.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$105.47
|
| Rate for Payer: PHP Commercial |
$105.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.86
|
| Rate for Payer: Priority Health SBD |
$78.17
|
| Rate for Payer: UMR Bronson Commercial |
$54.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.06
|
|
