|
DEXAMETHASONE 4 MG TABLET
|
Facility
|
OP
|
$470.88
|
|
|
Service Code
|
NDC 00054817525
|
| Hospital Charge Code |
2327
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$174.23 |
| Max. Negotiated Rate |
$423.79 |
| Rate for Payer: Aetna American Axle |
$306.07
|
| Rate for Payer: Aetna Commercial |
$400.25
|
| Rate for Payer: Aetna Medicare |
$235.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$306.07
|
| Rate for Payer: BCBS Complete |
$188.35
|
| Rate for Payer: Cash Price |
$376.70
|
| Rate for Payer: Cofinity Advantage |
$329.62
|
| Rate for Payer: Cofinity Commercial |
$404.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.70
|
| Rate for Payer: Healthscope Commercial |
$423.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$329.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$353.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$376.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$400.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$353.16
|
| Rate for Payer: PHP Commercial |
$400.25
|
| Rate for Payer: Priority Health SBD |
$296.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.07
|
| Rate for Payer: UHC Core |
$245.33
|
| Rate for Payer: UHC Exchange |
$185.06
|
| Rate for Payer: UMR Bronson Commercial |
$174.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$353.16
|
|
|
DEXAMETHASONE 4 MG TABLET
|
Facility
|
OP
|
$4.70
|
|
|
Service Code
|
NDC 60687071811
|
| Hospital Charge Code |
2327
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$4.23 |
| Rate for Payer: Aetna American Axle |
$3.06
|
| Rate for Payer: Aetna Commercial |
$4.00
|
| Rate for Payer: Aetna Medicare |
$2.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.06
|
| Rate for Payer: BCBS Complete |
$1.88
|
| Rate for Payer: Cash Price |
$3.76
|
| Rate for Payer: Cofinity Advantage |
$3.29
|
| Rate for Payer: Cofinity Commercial |
$4.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.76
|
| Rate for Payer: Healthscope Commercial |
$4.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.52
|
| Rate for Payer: PHP Commercial |
$4.00
|
| Rate for Payer: Priority Health SBD |
$2.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.06
|
| Rate for Payer: UHC Core |
$2.45
|
| Rate for Payer: UHC Exchange |
$1.85
|
| Rate for Payer: UMR Bronson Commercial |
$1.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.52
|
|
|
DEXAMETHASONE 4 MG TABLET
|
Facility
|
OP
|
$469.92
|
|
|
Service Code
|
NDC 60687071801
|
| Hospital Charge Code |
2327
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$173.87 |
| Max. Negotiated Rate |
$422.93 |
| Rate for Payer: Aetna American Axle |
$305.45
|
| Rate for Payer: Aetna Commercial |
$399.43
|
| Rate for Payer: Aetna Medicare |
$234.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.45
|
| Rate for Payer: BCBS Complete |
$187.97
|
| Rate for Payer: Cash Price |
$375.94
|
| Rate for Payer: Cofinity Advantage |
$328.94
|
| Rate for Payer: Cofinity Commercial |
$404.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.94
|
| Rate for Payer: Healthscope Commercial |
$422.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$328.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$352.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$375.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$352.44
|
| Rate for Payer: PHP Commercial |
$399.43
|
| Rate for Payer: Priority Health SBD |
$296.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$305.45
|
| Rate for Payer: UHC Core |
$244.83
|
| Rate for Payer: UHC Exchange |
$184.68
|
| Rate for Payer: UMR Bronson Commercial |
$173.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$352.44
|
|
|
DEXAMETHASONE 4 MG TABLET
|
Facility
|
IP
|
$4.70
|
|
|
Service Code
|
NDC 60687071811
|
| Hospital Charge Code |
2327
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.07 |
| Max. Negotiated Rate |
$4.23 |
| Rate for Payer: Aetna American Axle |
$3.06
|
| Rate for Payer: Aetna Commercial |
$4.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.06
|
| Rate for Payer: Cash Price |
$3.76
|
| Rate for Payer: Cofinity Advantage |
$3.29
|
| Rate for Payer: Cofinity Commercial |
$4.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.76
|
| Rate for Payer: Healthscope Commercial |
$4.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.52
|
| Rate for Payer: PHP Commercial |
$4.00
|
| Rate for Payer: Priority Health SBD |
$2.96
|
| Rate for Payer: UMR Bronson Commercial |
$2.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.52
|
|
|
DEXAMETHASONE 4 MG TABLET
|
Facility
|
OP
|
$409.45
|
|
|
Service Code
|
NDC 00054418425
|
| Hospital Charge Code |
2327
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$151.50 |
| Max. Negotiated Rate |
$368.50 |
| Rate for Payer: Aetna American Axle |
$266.14
|
| Rate for Payer: Aetna Commercial |
$348.03
|
| Rate for Payer: Aetna Medicare |
$204.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.14
|
| Rate for Payer: BCBS Complete |
$163.78
|
| Rate for Payer: Cash Price |
$327.56
|
| Rate for Payer: Cofinity Advantage |
$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: MI Amish Medical Board Commercial |
$327.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.09
|
| Rate for Payer: PHP Commercial |
$348.03
|
| Rate for Payer: Priority Health SBD |
$257.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.14
|
| Rate for Payer: UHC Core |
$213.32
|
| Rate for Payer: UHC Exchange |
$160.91
|
| Rate for Payer: UMR Bronson Commercial |
$151.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$307.09
|
|
|
DEXAMETHASONE 6 MG TABLET
|
Facility
|
IP
|
$811.68
|
|
|
Service Code
|
NDC 60687072901
|
| Hospital Charge Code |
2328
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$357.14 |
| Max. Negotiated Rate |
$730.51 |
| Rate for Payer: Aetna American Axle |
$527.59
|
| Rate for Payer: Aetna Commercial |
$689.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$527.59
|
| Rate for Payer: Cash Price |
$649.34
|
| Rate for Payer: Cofinity Advantage |
$568.18
|
| Rate for Payer: Cofinity Commercial |
$698.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$649.34
|
| Rate for Payer: Healthscope Commercial |
$730.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$568.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$608.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$689.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$608.76
|
| Rate for Payer: PHP Commercial |
$689.93
|
| Rate for Payer: Priority Health SBD |
$511.36
|
| Rate for Payer: UMR Bronson Commercial |
$357.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$608.76
|
|
|
DEXAMETHASONE 6 MG TABLET
|
Facility
|
OP
|
$813.60
|
|
|
Service Code
|
NDC 54818325
|
| Hospital Charge Code |
2328
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$301.03 |
| Max. Negotiated Rate |
$732.24 |
| Rate for Payer: Aetna American Axle |
$528.84
|
| Rate for Payer: Aetna Commercial |
$691.56
|
| Rate for Payer: Aetna Medicare |
$406.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.84
|
| Rate for Payer: BCBS Complete |
$325.44
|
| Rate for Payer: Cash Price |
$650.88
|
| Rate for Payer: Cofinity Advantage |
$569.52
|
| Rate for Payer: Cofinity Commercial |
$699.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.88
|
| Rate for Payer: Healthscope Commercial |
$732.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$569.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$650.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$610.20
|
| Rate for Payer: PHP Commercial |
$691.56
|
| Rate for Payer: Priority Health SBD |
$512.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.84
|
| Rate for Payer: UHC Core |
$423.89
|
| Rate for Payer: UHC Exchange |
$319.74
|
| Rate for Payer: UMR Bronson Commercial |
$301.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.20
|
|
|
DEXAMETHASONE 6 MG TABLET
|
Facility
|
OP
|
$8.12
|
|
|
Service Code
|
NDC 60687072911
|
| Hospital Charge Code |
2328
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$7.31 |
| Rate for Payer: Aetna American Axle |
$5.28
|
| Rate for Payer: Aetna Commercial |
$6.90
|
| Rate for Payer: Aetna Medicare |
$4.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.28
|
| Rate for Payer: BCBS Complete |
$3.25
|
| Rate for Payer: Cash Price |
$6.50
|
| Rate for Payer: Cofinity Advantage |
$5.68
|
| Rate for Payer: Cofinity Commercial |
$6.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$7.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.09
|
| Rate for Payer: PHP Commercial |
$6.90
|
| Rate for Payer: Priority Health SBD |
$5.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.28
|
| Rate for Payer: UHC Core |
$4.23
|
| Rate for Payer: UHC Exchange |
$3.19
|
| Rate for Payer: UMR Bronson Commercial |
$3.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.09
|
|
|
DEXAMETHASONE 6 MG TABLET
|
Facility
|
IP
|
$813.60
|
|
|
Service Code
|
NDC 00054818325
|
| Hospital Charge Code |
2328
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$357.98 |
| Max. Negotiated Rate |
$732.24 |
| Rate for Payer: Aetna American Axle |
$528.84
|
| Rate for Payer: Aetna Commercial |
$691.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.84
|
| Rate for Payer: Cash Price |
$650.88
|
| Rate for Payer: Cofinity Advantage |
$569.52
|
| Rate for Payer: Cofinity Commercial |
$699.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.88
|
| Rate for Payer: Healthscope Commercial |
$732.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$569.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$610.20
|
| Rate for Payer: PHP Commercial |
$691.56
|
| Rate for Payer: Priority Health SBD |
$512.57
|
| Rate for Payer: UMR Bronson Commercial |
$357.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.20
|
|
|
DEXAMETHASONE 6 MG TABLET
|
Facility
|
IP
|
$675.84
|
|
|
Service Code
|
NDC 00054418625
|
| Hospital Charge Code |
2328
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$297.37 |
| Max. Negotiated Rate |
$608.26 |
| Rate for Payer: Aetna American Axle |
$439.30
|
| Rate for Payer: Aetna Commercial |
$574.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.30
|
| Rate for Payer: Cash Price |
$540.67
|
| Rate for Payer: Cofinity Advantage |
$473.09
|
| Rate for Payer: Cofinity Commercial |
$581.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.67
|
| Rate for Payer: Healthscope Commercial |
$608.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$473.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$506.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.88
|
| Rate for Payer: PHP Commercial |
$574.46
|
| Rate for Payer: Priority Health SBD |
$425.78
|
| Rate for Payer: UMR Bronson Commercial |
$297.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$506.88
|
|
|
DEXAMETHASONE 6 MG TABLET
|
Facility
|
OP
|
$813.60
|
|
|
Service Code
|
NDC 00054818325
|
| Hospital Charge Code |
2328
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$301.03 |
| Max. Negotiated Rate |
$732.24 |
| Rate for Payer: Aetna American Axle |
$528.84
|
| Rate for Payer: Aetna Commercial |
$691.56
|
| Rate for Payer: Aetna Medicare |
$406.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$528.84
|
| Rate for Payer: BCBS Complete |
$325.44
|
| Rate for Payer: Cash Price |
$650.88
|
| Rate for Payer: Cofinity Advantage |
$569.52
|
| Rate for Payer: Cofinity Commercial |
$699.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.88
|
| Rate for Payer: Healthscope Commercial |
$732.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$569.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$650.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$610.20
|
| Rate for Payer: PHP Commercial |
$691.56
|
| Rate for Payer: Priority Health SBD |
$512.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.84
|
| Rate for Payer: UHC Core |
$423.89
|
| Rate for Payer: UHC Exchange |
$319.74
|
| Rate for Payer: UMR Bronson Commercial |
$301.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.20
|
|
|
DEXAMETHASONE 6 MG TABLET
|
Facility
|
IP
|
$8.12
|
|
|
Service Code
|
NDC 60687072911
|
| Hospital Charge Code |
2328
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.57 |
| Max. Negotiated Rate |
$7.31 |
| Rate for Payer: Aetna American Axle |
$5.28
|
| Rate for Payer: Aetna Commercial |
$6.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.28
|
| Rate for Payer: Cash Price |
$6.50
|
| Rate for Payer: Cofinity Advantage |
$5.68
|
| Rate for Payer: Cofinity Commercial |
$6.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$7.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.09
|
| Rate for Payer: PHP Commercial |
$6.90
|
| Rate for Payer: Priority Health SBD |
$5.12
|
| Rate for Payer: UMR Bronson Commercial |
$3.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.09
|
|
|
DEXAMETHASONE 6 MG TABLET
|
Facility
|
OP
|
$675.84
|
|
|
Service Code
|
NDC 00054418625
|
| Hospital Charge Code |
2328
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$250.06 |
| Max. Negotiated Rate |
$608.26 |
| Rate for Payer: Aetna American Axle |
$439.30
|
| Rate for Payer: Aetna Commercial |
$574.46
|
| Rate for Payer: Aetna Medicare |
$337.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.30
|
| Rate for Payer: BCBS Complete |
$270.34
|
| Rate for Payer: Cash Price |
$540.67
|
| Rate for Payer: Cofinity Advantage |
$473.09
|
| Rate for Payer: Cofinity Commercial |
$581.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.67
|
| Rate for Payer: Healthscope Commercial |
$608.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$473.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$506.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$540.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.88
|
| Rate for Payer: PHP Commercial |
$574.46
|
| Rate for Payer: Priority Health SBD |
$425.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.30
|
| Rate for Payer: UHC Core |
$352.11
|
| Rate for Payer: UHC Exchange |
$265.61
|
| Rate for Payer: UMR Bronson Commercial |
$250.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$506.88
|
|
|
DEXAMETHASONE 6 MG TABLET
|
Facility
|
OP
|
$811.68
|
|
|
Service Code
|
NDC 60687072901
|
| Hospital Charge Code |
2328
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$300.32 |
| Max. Negotiated Rate |
$730.51 |
| Rate for Payer: Aetna American Axle |
$527.59
|
| Rate for Payer: Aetna Commercial |
$689.93
|
| Rate for Payer: Aetna Medicare |
$405.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$527.59
|
| Rate for Payer: BCBS Complete |
$324.67
|
| Rate for Payer: Cash Price |
$649.34
|
| Rate for Payer: Cofinity Advantage |
$568.18
|
| Rate for Payer: Cofinity Commercial |
$698.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$649.34
|
| Rate for Payer: Healthscope Commercial |
$730.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$568.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$608.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$649.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$689.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$608.76
|
| Rate for Payer: PHP Commercial |
$689.93
|
| Rate for Payer: Priority Health SBD |
$511.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$527.59
|
| Rate for Payer: UHC Core |
$422.89
|
| Rate for Payer: UHC Exchange |
$318.99
|
| Rate for Payer: UMR Bronson Commercial |
$300.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$608.76
|
|
|
DEXAMETHASONE, MICRONIZED (BULK) 100 % POWDER
|
Facility
|
OP
|
$217.35
|
|
|
Service Code
|
NDC 38779040503
|
| Hospital Charge Code |
116458
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$80.42 |
| Max. Negotiated Rate |
$195.62 |
| Rate for Payer: Aetna American Axle |
$141.28
|
| Rate for Payer: Aetna Commercial |
$184.75
|
| Rate for Payer: Aetna Medicare |
$108.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.28
|
| Rate for Payer: BCBS Complete |
$86.94
|
| Rate for Payer: Cash Price |
$173.88
|
| Rate for Payer: Cofinity Advantage |
$152.15
|
| Rate for Payer: Cofinity Commercial |
$186.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.88
|
| Rate for Payer: Healthscope Commercial |
$195.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$173.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.01
|
| Rate for Payer: PHP Commercial |
$184.75
|
| Rate for Payer: Priority Health SBD |
$136.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.28
|
| Rate for Payer: UHC Core |
$113.24
|
| Rate for Payer: UHC Exchange |
$85.42
|
| Rate for Payer: UMR Bronson Commercial |
$80.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.01
|
|
|
DEXAMETHASONE, MICRONIZED (BULK) 100 % POWDER
|
Facility
|
IP
|
$217.35
|
|
|
Service Code
|
NDC 38779040503
|
| Hospital Charge Code |
116458
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$95.63 |
| Max. Negotiated Rate |
$195.62 |
| Rate for Payer: Aetna American Axle |
$141.28
|
| Rate for Payer: Aetna Commercial |
$184.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.28
|
| Rate for Payer: Cash Price |
$173.88
|
| Rate for Payer: Cofinity Advantage |
$152.15
|
| Rate for Payer: Cofinity Commercial |
$186.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.88
|
| Rate for Payer: Healthscope Commercial |
$195.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.01
|
| Rate for Payer: PHP Commercial |
$184.75
|
| Rate for Payer: Priority Health SBD |
$136.93
|
| Rate for Payer: UMR Bronson Commercial |
$95.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.01
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML IM INJECTION SOLUTION
|
Facility
|
OP
|
$39.34
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
301171
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$35.41 |
| Rate for Payer: Aetna American Axle |
$25.57
|
| Rate for Payer: Aetna American Axle |
$11.97
|
| Rate for Payer: Aetna American Axle |
$7.13
|
| Rate for Payer: Aetna American Axle |
$41.65
|
| Rate for Payer: Aetna Commercial |
$15.66
|
| Rate for Payer: Aetna Commercial |
$9.32
|
| Rate for Payer: Aetna Commercial |
$33.44
|
| Rate for Payer: Aetna Commercial |
$54.47
|
| Rate for Payer: Aetna Medicare |
$32.04
|
| Rate for Payer: Aetna Medicare |
$19.67
|
| Rate for Payer: Aetna Medicare |
$5.49
|
| Rate for Payer: Aetna Medicare |
$9.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.13
|
| Rate for Payer: BCBS Complete |
$25.63
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS Complete |
$4.39
|
| Rate for Payer: BCBS Complete |
$15.74
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: Cash Price |
$51.26
|
| Rate for Payer: Cash Price |
$8.78
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Cash Price |
$8.78
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Cash Price |
$51.26
|
| Rate for Payer: Cofinity Advantage |
$44.86
|
| Rate for Payer: Cofinity Advantage |
$12.89
|
| Rate for Payer: Cofinity Advantage |
$7.68
|
| Rate for Payer: Cofinity Advantage |
$27.54
|
| Rate for Payer: Cofinity Commercial |
$55.11
|
| Rate for Payer: Cofinity Commercial |
$33.83
|
| Rate for Payer: Cofinity Commercial |
$9.43
|
| Rate for Payer: Cofinity Commercial |
$15.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.78
|
| Rate for Payer: Healthscope Commercial |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$57.67
|
| Rate for Payer: Healthscope Commercial |
$35.41
|
| Rate for Payer: Healthscope Commercial |
$9.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.81
|
| Rate for Payer: PHP Commercial |
$9.32
|
| Rate for Payer: PHP Commercial |
$54.47
|
| Rate for Payer: PHP Commercial |
$15.66
|
| Rate for Payer: PHP Commercial |
$33.44
|
| Rate for Payer: Priority Health SBD |
$6.91
|
| Rate for Payer: Priority Health SBD |
$24.78
|
| Rate for Payer: Priority Health SBD |
$11.60
|
| Rate for Payer: Priority Health SBD |
$40.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UMR Bronson Commercial |
$6.82
|
| Rate for Payer: UMR Bronson Commercial |
$14.56
|
| Rate for Payer: UMR Bronson Commercial |
$23.71
|
| Rate for Payer: UMR Bronson Commercial |
$4.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.23
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$64.08
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
2331
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.20 |
| Max. Negotiated Rate |
$57.67 |
| Rate for Payer: Aetna American Axle |
$41.65
|
| Rate for Payer: Aetna American Axle |
$11.69
|
| Rate for Payer: Aetna Commercial |
$15.28
|
| Rate for Payer: Aetna Commercial |
$54.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.65
|
| Rate for Payer: Cash Price |
$51.26
|
| Rate for Payer: Cash Price |
$14.38
|
| Rate for Payer: Cofinity Advantage |
$44.86
|
| Rate for Payer: Cofinity Advantage |
$12.59
|
| Rate for Payer: Cofinity Commercial |
$15.46
|
| Rate for Payer: Cofinity Commercial |
$55.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.26
|
| Rate for Payer: Healthscope Commercial |
$57.67
|
| Rate for Payer: Healthscope Commercial |
$16.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.06
|
| Rate for Payer: PHP Commercial |
$15.28
|
| Rate for Payer: PHP Commercial |
$54.47
|
| Rate for Payer: Priority Health SBD |
$11.33
|
| Rate for Payer: Priority Health SBD |
$40.37
|
| Rate for Payer: UMR Bronson Commercial |
$28.20
|
| Rate for Payer: UMR Bronson Commercial |
$7.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.48
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$10.97
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
2331
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$9.87 |
| Rate for Payer: Aetna American Axle |
$7.13
|
| Rate for Payer: Aetna American Axle |
$25.57
|
| Rate for Payer: Aetna American Axle |
$11.97
|
| Rate for Payer: Aetna American Axle |
$11.69
|
| Rate for Payer: Aetna American Axle |
$41.65
|
| Rate for Payer: Aetna Commercial |
$9.32
|
| Rate for Payer: Aetna Commercial |
$15.28
|
| Rate for Payer: Aetna Commercial |
$54.47
|
| Rate for Payer: Aetna Commercial |
$33.44
|
| Rate for Payer: Aetna Commercial |
$15.66
|
| Rate for Payer: Aetna Medicare |
$32.04
|
| Rate for Payer: Aetna Medicare |
$8.99
|
| Rate for Payer: Aetna Medicare |
$5.49
|
| Rate for Payer: Aetna Medicare |
$9.21
|
| Rate for Payer: Aetna Medicare |
$19.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.65
|
| Rate for Payer: BCBS Complete |
$15.74
|
| Rate for Payer: BCBS Complete |
$4.39
|
| Rate for Payer: BCBS Complete |
$7.19
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS Complete |
$25.63
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Cash Price |
$51.26
|
| Rate for Payer: Cash Price |
$14.38
|
| Rate for Payer: Cash Price |
$8.78
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cash Price |
$8.78
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cash Price |
$31.47
|
| Rate for Payer: Cash Price |
$14.38
|
| Rate for Payer: Cash Price |
$51.26
|
| Rate for Payer: Cofinity Advantage |
$27.54
|
| Rate for Payer: Cofinity Advantage |
$12.59
|
| Rate for Payer: Cofinity Advantage |
$12.89
|
| Rate for Payer: Cofinity Advantage |
$44.86
|
| Rate for Payer: Cofinity Advantage |
$7.68
|
| Rate for Payer: Cofinity Commercial |
$33.83
|
| Rate for Payer: Cofinity Commercial |
$9.43
|
| Rate for Payer: Cofinity Commercial |
$15.46
|
| Rate for Payer: Cofinity Commercial |
$15.84
|
| Rate for Payer: Cofinity Commercial |
$55.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Healthscope Commercial |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$57.67
|
| Rate for Payer: Healthscope Commercial |
$35.41
|
| Rate for Payer: Healthscope Commercial |
$9.87
|
| Rate for Payer: Healthscope Commercial |
$16.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.06
|
| Rate for Payer: PHP Commercial |
$15.28
|
| Rate for Payer: PHP Commercial |
$15.66
|
| Rate for Payer: PHP Commercial |
$54.47
|
| Rate for Payer: PHP Commercial |
$33.44
|
| Rate for Payer: PHP Commercial |
$9.32
|
| Rate for Payer: Priority Health SBD |
$11.60
|
| Rate for Payer: Priority Health SBD |
$6.91
|
| Rate for Payer: Priority Health SBD |
$24.78
|
| Rate for Payer: Priority Health SBD |
$40.37
|
| Rate for Payer: Priority Health SBD |
$11.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UMR Bronson Commercial |
$4.06
|
| Rate for Payer: UMR Bronson Commercial |
$14.56
|
| Rate for Payer: UMR Bronson Commercial |
$6.82
|
| Rate for Payer: UMR Bronson Commercial |
$23.71
|
| Rate for Payer: UMR Bronson Commercial |
$6.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.23
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML FOR IM INJECTION
|
Facility
|
OP
|
$11.75
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
301229
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$10.57 |
| Rate for Payer: Aetna American Axle |
$7.64
|
| Rate for Payer: Aetna Commercial |
$9.99
|
| Rate for Payer: Aetna Medicare |
$5.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.64
|
| Rate for Payer: BCBS Complete |
$4.70
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cofinity Advantage |
$8.22
|
| Rate for Payer: Cofinity Commercial |
$10.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.40
|
| Rate for Payer: Healthscope Commercial |
$10.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.81
|
| Rate for Payer: PHP Commercial |
$9.99
|
| Rate for Payer: Priority Health SBD |
$7.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UMR Bronson Commercial |
$4.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.81
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML FOR IM INJECTION
|
Facility
|
IP
|
$11.75
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
301229
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$10.57 |
| Rate for Payer: Aetna American Axle |
$7.64
|
| Rate for Payer: Aetna Commercial |
$9.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.64
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cofinity Advantage |
$8.22
|
| Rate for Payer: Cofinity Commercial |
$10.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.40
|
| Rate for Payer: Healthscope Commercial |
$10.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.81
|
| Rate for Payer: PHP Commercial |
$9.99
|
| Rate for Payer: Priority Health SBD |
$7.40
|
| Rate for Payer: UMR Bronson Commercial |
$5.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.81
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$13.05
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
2332
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.74 |
| Max. Negotiated Rate |
$11.74 |
| Rate for Payer: Aetna American Axle |
$8.48
|
| Rate for Payer: Aetna American Axle |
$297.45
|
| Rate for Payer: Aetna American Axle |
$50.43
|
| Rate for Payer: Aetna American Axle |
$7.34
|
| Rate for Payer: Aetna American Axle |
$80.92
|
| Rate for Payer: Aetna American Axle |
$7.64
|
| Rate for Payer: Aetna American Axle |
$5.49
|
| Rate for Payer: Aetna American Axle |
$12.84
|
| Rate for Payer: Aetna Commercial |
$7.18
|
| Rate for Payer: Aetna Commercial |
$65.94
|
| Rate for Payer: Aetna Commercial |
$11.09
|
| Rate for Payer: Aetna Commercial |
$9.61
|
| Rate for Payer: Aetna Commercial |
$9.99
|
| Rate for Payer: Aetna Commercial |
$388.98
|
| Rate for Payer: Aetna Commercial |
$105.83
|
| Rate for Payer: Aetna Commercial |
$16.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$297.45
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cash Price |
$6.76
|
| Rate for Payer: Cash Price |
$10.44
|
| Rate for Payer: Cash Price |
$9.04
|
| Rate for Payer: Cash Price |
$99.60
|
| Rate for Payer: Cash Price |
$15.81
|
| Rate for Payer: Cash Price |
$366.10
|
| Rate for Payer: Cash Price |
$62.06
|
| Rate for Payer: Cofinity Advantage |
$5.92
|
| Rate for Payer: Cofinity Advantage |
$8.22
|
| Rate for Payer: Cofinity Advantage |
$9.13
|
| Rate for Payer: Cofinity Advantage |
$87.15
|
| Rate for Payer: Cofinity Advantage |
$7.91
|
| Rate for Payer: Cofinity Advantage |
$320.33
|
| Rate for Payer: Cofinity Advantage |
$54.31
|
| Rate for Payer: Cofinity Advantage |
$13.83
|
| Rate for Payer: Cofinity Commercial |
$10.11
|
| Rate for Payer: Cofinity Commercial |
$9.72
|
| Rate for Payer: Cofinity Commercial |
$107.07
|
| Rate for Payer: Cofinity Commercial |
$11.22
|
| Rate for Payer: Cofinity Commercial |
$7.27
|
| Rate for Payer: Cofinity Commercial |
$16.99
|
| Rate for Payer: Cofinity Commercial |
$66.72
|
| Rate for Payer: Cofinity Commercial |
$393.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$366.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.04
|
| Rate for Payer: Healthscope Commercial |
$17.78
|
| Rate for Payer: Healthscope Commercial |
$11.74
|
| Rate for Payer: Healthscope Commercial |
$10.17
|
| Rate for Payer: Healthscope Commercial |
$7.61
|
| Rate for Payer: Healthscope Commercial |
$69.82
|
| Rate for Payer: Healthscope Commercial |
$112.05
|
| Rate for Payer: Healthscope Commercial |
$10.57
|
| Rate for Payer: Healthscope Commercial |
$411.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$320.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$343.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$343.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.34
|
| Rate for Payer: PHP Commercial |
$11.09
|
| Rate for Payer: PHP Commercial |
$16.80
|
| Rate for Payer: PHP Commercial |
$7.18
|
| Rate for Payer: PHP Commercial |
$105.83
|
| Rate for Payer: PHP Commercial |
$9.99
|
| Rate for Payer: PHP Commercial |
$9.61
|
| Rate for Payer: PHP Commercial |
$388.98
|
| Rate for Payer: PHP Commercial |
$65.94
|
| Rate for Payer: Priority Health SBD |
$288.30
|
| Rate for Payer: Priority Health SBD |
$48.88
|
| Rate for Payer: Priority Health SBD |
$5.32
|
| Rate for Payer: Priority Health SBD |
$7.40
|
| Rate for Payer: Priority Health SBD |
$7.12
|
| Rate for Payer: Priority Health SBD |
$78.44
|
| Rate for Payer: Priority Health SBD |
$8.22
|
| Rate for Payer: Priority Health SBD |
$12.45
|
| Rate for Payer: UMR Bronson Commercial |
$4.97
|
| Rate for Payer: UMR Bronson Commercial |
$8.69
|
| Rate for Payer: UMR Bronson Commercial |
$54.78
|
| Rate for Payer: UMR Bronson Commercial |
$3.72
|
| Rate for Payer: UMR Bronson Commercial |
$34.14
|
| Rate for Payer: UMR Bronson Commercial |
$5.74
|
| Rate for Payer: UMR Bronson Commercial |
$5.17
|
| Rate for Payer: UMR Bronson Commercial |
$201.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$343.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.19
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$77.58
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
2332
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$69.82 |
| Rate for Payer: Aetna American Axle |
$50.43
|
| Rate for Payer: Aetna American Axle |
$297.45
|
| Rate for Payer: Aetna American Axle |
$80.92
|
| Rate for Payer: Aetna American Axle |
$8.48
|
| Rate for Payer: Aetna American Axle |
$12.84
|
| Rate for Payer: Aetna American Axle |
$7.34
|
| Rate for Payer: Aetna American Axle |
$7.64
|
| Rate for Payer: Aetna American Axle |
$5.49
|
| Rate for Payer: Aetna Commercial |
$105.83
|
| Rate for Payer: Aetna Commercial |
$9.61
|
| Rate for Payer: Aetna Commercial |
$16.80
|
| Rate for Payer: Aetna Commercial |
$11.09
|
| Rate for Payer: Aetna Commercial |
$388.98
|
| Rate for Payer: Aetna Commercial |
$65.94
|
| Rate for Payer: Aetna Commercial |
$7.18
|
| Rate for Payer: Aetna Commercial |
$9.99
|
| Rate for Payer: Aetna Medicare |
$62.25
|
| Rate for Payer: Aetna Medicare |
$5.88
|
| Rate for Payer: Aetna Medicare |
$38.79
|
| Rate for Payer: Aetna Medicare |
$5.65
|
| Rate for Payer: Aetna Medicare |
$9.88
|
| Rate for Payer: Aetna Medicare |
$6.53
|
| Rate for Payer: Aetna Medicare |
$4.22
|
| Rate for Payer: Aetna Medicare |
$228.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$297.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.84
|
| Rate for Payer: BCBS Complete |
$3.38
|
| Rate for Payer: BCBS Complete |
$183.05
|
| Rate for Payer: BCBS Complete |
$5.22
|
| Rate for Payer: BCBS Complete |
$4.52
|
| Rate for Payer: BCBS Complete |
$49.80
|
| Rate for Payer: BCBS Complete |
$4.70
|
| Rate for Payer: BCBS Complete |
$31.03
|
| Rate for Payer: BCBS Complete |
$7.90
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cash Price |
$9.04
|
| Rate for Payer: Cash Price |
$9.04
|
| Rate for Payer: Cash Price |
$99.60
|
| Rate for Payer: Cash Price |
$99.60
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cash Price |
$10.44
|
| Rate for Payer: Cash Price |
$10.44
|
| Rate for Payer: Cash Price |
$15.81
|
| Rate for Payer: Cash Price |
$15.81
|
| Rate for Payer: Cash Price |
$366.10
|
| Rate for Payer: Cash Price |
$366.10
|
| Rate for Payer: Cash Price |
$62.06
|
| Rate for Payer: Cash Price |
$62.06
|
| Rate for Payer: Cash Price |
$6.76
|
| Rate for Payer: Cash Price |
$6.76
|
| Rate for Payer: Cofinity Advantage |
$320.33
|
| Rate for Payer: Cofinity Advantage |
$5.92
|
| Rate for Payer: Cofinity Advantage |
$87.15
|
| Rate for Payer: Cofinity Advantage |
$13.83
|
| Rate for Payer: Cofinity Advantage |
$54.31
|
| Rate for Payer: Cofinity Advantage |
$9.13
|
| Rate for Payer: Cofinity Advantage |
$7.91
|
| Rate for Payer: Cofinity Advantage |
$8.22
|
| Rate for Payer: Cofinity Commercial |
$11.22
|
| Rate for Payer: Cofinity Commercial |
$393.55
|
| Rate for Payer: Cofinity Commercial |
$7.27
|
| Rate for Payer: Cofinity Commercial |
$9.72
|
| Rate for Payer: Cofinity Commercial |
$10.11
|
| Rate for Payer: Cofinity Commercial |
$107.07
|
| Rate for Payer: Cofinity Commercial |
$66.72
|
| Rate for Payer: Cofinity Commercial |
$16.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$366.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.06
|
| Rate for Payer: Healthscope Commercial |
$10.17
|
| Rate for Payer: Healthscope Commercial |
$7.61
|
| Rate for Payer: Healthscope Commercial |
$112.05
|
| Rate for Payer: Healthscope Commercial |
$11.74
|
| Rate for Payer: Healthscope Commercial |
$69.82
|
| Rate for Payer: Healthscope Commercial |
$411.86
|
| Rate for Payer: Healthscope Commercial |
$10.57
|
| Rate for Payer: Healthscope Commercial |
$17.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$320.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$343.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$366.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$343.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.38
|
| Rate for Payer: PHP Commercial |
$9.61
|
| Rate for Payer: PHP Commercial |
$11.09
|
| Rate for Payer: PHP Commercial |
$388.98
|
| Rate for Payer: PHP Commercial |
$105.83
|
| Rate for Payer: PHP Commercial |
$7.18
|
| Rate for Payer: PHP Commercial |
$65.94
|
| Rate for Payer: PHP Commercial |
$16.80
|
| Rate for Payer: PHP Commercial |
$9.99
|
| Rate for Payer: Priority Health SBD |
$7.40
|
| Rate for Payer: Priority Health SBD |
$5.32
|
| Rate for Payer: Priority Health SBD |
$7.12
|
| Rate for Payer: Priority Health SBD |
$288.30
|
| Rate for Payer: Priority Health SBD |
$48.88
|
| Rate for Payer: Priority Health SBD |
$78.44
|
| Rate for Payer: Priority Health SBD |
$8.22
|
| Rate for Payer: Priority Health SBD |
$12.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UMR Bronson Commercial |
$28.70
|
| Rate for Payer: UMR Bronson Commercial |
$3.13
|
| Rate for Payer: UMR Bronson Commercial |
$7.31
|
| Rate for Payer: UMR Bronson Commercial |
$46.06
|
| Rate for Payer: UMR Bronson Commercial |
$169.32
|
| Rate for Payer: UMR Bronson Commercial |
$4.18
|
| Rate for Payer: UMR Bronson Commercial |
$4.35
|
| Rate for Payer: UMR Bronson Commercial |
$4.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$343.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.19
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML IM INJECTION SOLUTION
|
Facility
|
IP
|
$14.00
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
301178
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.16 |
| Max. Negotiated Rate |
$12.60 |
| Rate for Payer: Aetna American Axle |
$9.10
|
| Rate for Payer: Aetna American Axle |
$10.95
|
| Rate for Payer: Aetna American Axle |
$10.87
|
| Rate for Payer: Aetna Commercial |
$14.21
|
| Rate for Payer: Aetna Commercial |
$11.90
|
| Rate for Payer: Aetna Commercial |
$14.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.87
|
| Rate for Payer: Cash Price |
$13.38
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$13.48
|
| Rate for Payer: Cofinity Advantage |
$11.79
|
| Rate for Payer: Cofinity Advantage |
$9.80
|
| Rate for Payer: Cofinity Advantage |
$11.70
|
| Rate for Payer: Cofinity Commercial |
$14.49
|
| Rate for Payer: Cofinity Commercial |
$12.04
|
| Rate for Payer: Cofinity Commercial |
$14.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.48
|
| Rate for Payer: Healthscope Commercial |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$15.16
|
| Rate for Payer: Healthscope Commercial |
$12.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.64
|
| Rate for Payer: PHP Commercial |
$14.21
|
| Rate for Payer: PHP Commercial |
$11.90
|
| Rate for Payer: PHP Commercial |
$14.32
|
| Rate for Payer: Priority Health SBD |
$8.82
|
| Rate for Payer: Priority Health SBD |
$10.53
|
| Rate for Payer: Priority Health SBD |
$10.62
|
| Rate for Payer: UMR Bronson Commercial |
$6.16
|
| Rate for Payer: UMR Bronson Commercial |
$7.41
|
| Rate for Payer: UMR Bronson Commercial |
$7.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.64
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML IM INJECTION SOLUTION
|
Facility
|
OP
|
$16.72
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
301178
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$15.05 |
| Rate for Payer: Aetna American Axle |
$10.87
|
| Rate for Payer: Aetna American Axle |
$9.10
|
| Rate for Payer: Aetna American Axle |
$10.95
|
| Rate for Payer: Aetna Commercial |
$14.21
|
| Rate for Payer: Aetna Commercial |
$14.32
|
| Rate for Payer: Aetna Commercial |
$11.90
|
| Rate for Payer: Aetna Medicare |
$8.36
|
| Rate for Payer: Aetna Medicare |
$7.00
|
| Rate for Payer: Aetna Medicare |
$8.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.95
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Complete |
$6.69
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$13.48
|
| Rate for Payer: Cash Price |
$13.48
|
| Rate for Payer: Cash Price |
$13.38
|
| Rate for Payer: Cash Price |
$13.38
|
| Rate for Payer: Cofinity Advantage |
$11.79
|
| Rate for Payer: Cofinity Advantage |
$11.70
|
| Rate for Payer: Cofinity Advantage |
$9.80
|
| Rate for Payer: Cofinity Commercial |
$12.04
|
| Rate for Payer: Cofinity Commercial |
$14.38
|
| Rate for Payer: Cofinity Commercial |
$14.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.38
|
| Rate for Payer: Healthscope Commercial |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$15.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.64
|
| Rate for Payer: PHP Commercial |
$14.21
|
| Rate for Payer: PHP Commercial |
$11.90
|
| Rate for Payer: PHP Commercial |
$14.32
|
| Rate for Payer: Priority Health SBD |
$8.82
|
| Rate for Payer: Priority Health SBD |
$10.62
|
| Rate for Payer: Priority Health SBD |
$10.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Core |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UHC Exchange |
$0.18
|
| Rate for Payer: UMR Bronson Commercial |
$6.23
|
| Rate for Payer: UMR Bronson Commercial |
$5.18
|
| Rate for Payer: UMR Bronson Commercial |
$6.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.64
|
|
