|
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$16.72
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
116809
|
|
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
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$14.00
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
116809
|
|
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 INJECTION SYRINGE
|
Facility
|
IP
|
$19.42
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
192063
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.54 |
| Max. Negotiated Rate |
$17.48 |
| Rate for Payer: Aetna American Axle |
$12.62
|
| Rate for Payer: Aetna Commercial |
$16.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.62
|
| Rate for Payer: Cash Price |
$15.54
|
| Rate for Payer: Cofinity Advantage |
$13.59
|
| Rate for Payer: Cofinity Commercial |
$16.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.54
|
| Rate for Payer: Healthscope Commercial |
$17.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.56
|
| Rate for Payer: PHP Commercial |
$16.51
|
| Rate for Payer: Priority Health SBD |
$12.23
|
| Rate for Payer: UMR Bronson Commercial |
$8.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.56
|
|
|
DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$19.42
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
192063
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$17.48 |
| Rate for Payer: Aetna American Axle |
$12.62
|
| Rate for Payer: Aetna Commercial |
$16.51
|
| Rate for Payer: Aetna Medicare |
$9.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.62
|
| Rate for Payer: BCBS Complete |
$7.77
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: Cash Price |
$15.54
|
| Rate for Payer: Cash Price |
$15.54
|
| Rate for Payer: Cofinity Advantage |
$13.59
|
| Rate for Payer: Cofinity Commercial |
$16.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.54
|
| Rate for Payer: Healthscope Commercial |
$17.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.56
|
| Rate for Payer: PHP Commercial |
$16.51
|
| Rate for Payer: Priority Health SBD |
$12.23
|
| 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 |
$7.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.56
|
|
|
DEXLANSOPRAZOLE 60 MG CAPSULE,BIPHASE DELAYED RELEASE
|
Facility
|
OP
|
$3,183.48
|
|
|
Service Code
|
NDC 64764017590
|
| Hospital Charge Code |
97009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,177.89 |
| Max. Negotiated Rate |
$2,865.13 |
| Rate for Payer: Aetna American Axle |
$2,069.26
|
| Rate for Payer: Aetna Commercial |
$2,705.96
|
| Rate for Payer: Aetna Medicare |
$1,591.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,069.26
|
| Rate for Payer: BCBS Complete |
$1,273.39
|
| Rate for Payer: Cash Price |
$2,546.78
|
| Rate for Payer: Cofinity Advantage |
$2,228.44
|
| Rate for Payer: Cofinity Commercial |
$2,737.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,546.78
|
| Rate for Payer: Healthscope Commercial |
$2,865.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,228.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,387.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,546.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,705.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,387.61
|
| Rate for Payer: PHP Commercial |
$2,705.96
|
| Rate for Payer: Priority Health SBD |
$2,005.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,069.26
|
| Rate for Payer: UHC Core |
$1,658.59
|
| Rate for Payer: UHC Exchange |
$1,251.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,177.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,387.61
|
|
|
DEXLANSOPRAZOLE 60 MG CAPSULE,BIPHASE DELAYED RELEASE
|
Facility
|
OP
|
$1,061.16
|
|
|
Service Code
|
NDC 64764017530
|
| Hospital Charge Code |
97009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$392.63 |
| Max. Negotiated Rate |
$955.04 |
| Rate for Payer: Aetna American Axle |
$689.75
|
| Rate for Payer: Aetna Commercial |
$901.99
|
| Rate for Payer: Aetna Medicare |
$530.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$689.75
|
| Rate for Payer: BCBS Complete |
$424.46
|
| Rate for Payer: Cash Price |
$848.93
|
| Rate for Payer: Cofinity Advantage |
$742.81
|
| Rate for Payer: Cofinity Commercial |
$912.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$848.93
|
| Rate for Payer: Healthscope Commercial |
$955.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$742.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$795.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$848.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$901.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$795.87
|
| Rate for Payer: PHP Commercial |
$901.99
|
| Rate for Payer: Priority Health SBD |
$668.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$689.75
|
| Rate for Payer: UHC Core |
$552.86
|
| Rate for Payer: UHC Exchange |
$417.04
|
| Rate for Payer: UMR Bronson Commercial |
$392.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$795.87
|
|
|
DEXLANSOPRAZOLE 60 MG CAPSULE,BIPHASE DELAYED RELEASE
|
Facility
|
IP
|
$1,061.16
|
|
|
Service Code
|
NDC 64764017530
|
| Hospital Charge Code |
97009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$466.91 |
| Max. Negotiated Rate |
$955.04 |
| Rate for Payer: Aetna American Axle |
$689.75
|
| Rate for Payer: Aetna Commercial |
$901.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$689.75
|
| Rate for Payer: Cash Price |
$848.93
|
| Rate for Payer: Cofinity Advantage |
$742.81
|
| Rate for Payer: Cofinity Commercial |
$912.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$848.93
|
| Rate for Payer: Healthscope Commercial |
$955.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$742.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$795.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$901.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$795.87
|
| Rate for Payer: PHP Commercial |
$901.99
|
| Rate for Payer: Priority Health SBD |
$668.53
|
| Rate for Payer: UMR Bronson Commercial |
$466.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$795.87
|
|
|
DEXLANSOPRAZOLE 60 MG CAPSULE,BIPHASE DELAYED RELEASE
|
Facility
|
IP
|
$3,183.48
|
|
|
Service Code
|
NDC 64764017590
|
| Hospital Charge Code |
97009
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,400.73 |
| Max. Negotiated Rate |
$2,865.13 |
| Rate for Payer: Aetna American Axle |
$2,069.26
|
| Rate for Payer: Aetna Commercial |
$2,705.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,069.26
|
| Rate for Payer: Cash Price |
$2,546.78
|
| Rate for Payer: Cofinity Advantage |
$2,228.44
|
| Rate for Payer: Cofinity Commercial |
$2,737.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,546.78
|
| Rate for Payer: Healthscope Commercial |
$2,865.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,228.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,387.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,705.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,387.61
|
| Rate for Payer: PHP Commercial |
$2,705.96
|
| Rate for Payer: Priority Health SBD |
$2,005.59
|
| Rate for Payer: UMR Bronson Commercial |
$1,400.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,387.61
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$73.00
|
|
|
Service Code
|
NDC 00143953201
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$27.01 |
| Max. Negotiated Rate |
$65.70 |
| Rate for Payer: Aetna American Axle |
$47.45
|
| Rate for Payer: Aetna Commercial |
$62.05
|
| Rate for Payer: Aetna Medicare |
$36.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.45
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cofinity Advantage |
$51.10
|
| Rate for Payer: Cofinity Commercial |
$62.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.40
|
| Rate for Payer: Healthscope Commercial |
$65.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.75
|
| Rate for Payer: PHP Commercial |
$62.05
|
| Rate for Payer: Priority Health SBD |
$45.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.45
|
| Rate for Payer: UHC Core |
$38.03
|
| Rate for Payer: UHC Exchange |
$28.69
|
| Rate for Payer: UMR Bronson Commercial |
$27.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.75
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$67.27
|
|
|
Service Code
|
NDC 16729023993
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$29.60 |
| Max. Negotiated Rate |
$60.54 |
| Rate for Payer: Aetna American Axle |
$43.73
|
| Rate for Payer: Aetna Commercial |
$57.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.73
|
| Rate for Payer: Cash Price |
$53.82
|
| Rate for Payer: Cofinity Advantage |
$47.09
|
| Rate for Payer: Cofinity Commercial |
$57.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.82
|
| Rate for Payer: Healthscope Commercial |
$60.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.45
|
| Rate for Payer: PHP Commercial |
$57.18
|
| Rate for Payer: Priority Health SBD |
$42.38
|
| Rate for Payer: UMR Bronson Commercial |
$29.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.45
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$72.86
|
|
|
Service Code
|
NDC 66794023342
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$32.06 |
| Max. Negotiated Rate |
$65.57 |
| Rate for Payer: Aetna American Axle |
$47.36
|
| Rate for Payer: Aetna Commercial |
$61.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.36
|
| Rate for Payer: Cash Price |
$58.29
|
| Rate for Payer: Cofinity Advantage |
$51.00
|
| Rate for Payer: Cofinity Commercial |
$62.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.29
|
| Rate for Payer: Healthscope Commercial |
$65.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.65
|
| Rate for Payer: PHP Commercial |
$61.93
|
| Rate for Payer: Priority Health SBD |
$45.90
|
| Rate for Payer: UMR Bronson Commercial |
$32.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.65
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$71.95
|
|
|
Service Code
|
NDC 70860060541
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$31.66 |
| Max. Negotiated Rate |
$64.75 |
| Rate for Payer: Aetna American Axle |
$46.77
|
| Rate for Payer: Aetna Commercial |
$61.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.77
|
| Rate for Payer: Cash Price |
$57.56
|
| Rate for Payer: Cofinity Advantage |
$50.37
|
| Rate for Payer: Cofinity Commercial |
$61.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.56
|
| Rate for Payer: Healthscope Commercial |
$64.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.96
|
| Rate for Payer: PHP Commercial |
$61.16
|
| Rate for Payer: Priority Health SBD |
$45.33
|
| Rate for Payer: UMR Bronson Commercial |
$31.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.96
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$42.40
|
|
|
Service Code
|
NDC 67457025102
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.69 |
| Max. Negotiated Rate |
$38.16 |
| Rate for Payer: Aetna American Axle |
$27.56
|
| Rate for Payer: Aetna Commercial |
$36.04
|
| Rate for Payer: Aetna Medicare |
$21.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.56
|
| Rate for Payer: BCBS Complete |
$16.96
|
| Rate for Payer: Cash Price |
$33.92
|
| Rate for Payer: Cofinity Advantage |
$29.68
|
| Rate for Payer: Cofinity Commercial |
$36.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.92
|
| Rate for Payer: Healthscope Commercial |
$38.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.80
|
| Rate for Payer: PHP Commercial |
$36.04
|
| Rate for Payer: Priority Health SBD |
$26.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.56
|
| Rate for Payer: UHC Core |
$22.09
|
| Rate for Payer: UHC Exchange |
$16.66
|
| Rate for Payer: UMR Bronson Commercial |
$15.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.80
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$42.40
|
|
|
Service Code
|
NDC 67457025100
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.66 |
| Max. Negotiated Rate |
$38.16 |
| Rate for Payer: Aetna American Axle |
$27.56
|
| Rate for Payer: Aetna Commercial |
$36.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.56
|
| Rate for Payer: Cash Price |
$33.92
|
| Rate for Payer: Cofinity Advantage |
$29.68
|
| Rate for Payer: Cofinity Commercial |
$36.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.92
|
| Rate for Payer: Healthscope Commercial |
$38.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.80
|
| Rate for Payer: PHP Commercial |
$36.04
|
| Rate for Payer: Priority Health SBD |
$26.71
|
| Rate for Payer: UMR Bronson Commercial |
$18.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.80
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$72.86
|
|
|
Service Code
|
NDC 66794023342
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$26.96 |
| Max. Negotiated Rate |
$65.57 |
| Rate for Payer: Aetna American Axle |
$47.36
|
| Rate for Payer: Aetna Commercial |
$61.93
|
| Rate for Payer: Aetna Medicare |
$36.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.36
|
| Rate for Payer: BCBS Complete |
$29.14
|
| Rate for Payer: Cash Price |
$58.29
|
| Rate for Payer: Cofinity Advantage |
$51.00
|
| Rate for Payer: Cofinity Commercial |
$62.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.29
|
| Rate for Payer: Healthscope Commercial |
$65.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.65
|
| Rate for Payer: PHP Commercial |
$61.93
|
| Rate for Payer: Priority Health SBD |
$45.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.36
|
| Rate for Payer: UHC Core |
$37.96
|
| Rate for Payer: UHC Exchange |
$28.63
|
| Rate for Payer: UMR Bronson Commercial |
$26.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.65
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$71.95
|
|
|
Service Code
|
NDC 70860060503
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$31.66 |
| Max. Negotiated Rate |
$64.75 |
| Rate for Payer: Aetna American Axle |
$46.77
|
| Rate for Payer: Aetna Commercial |
$61.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.77
|
| Rate for Payer: Cash Price |
$57.56
|
| Rate for Payer: Cofinity Advantage |
$50.37
|
| Rate for Payer: Cofinity Commercial |
$61.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.56
|
| Rate for Payer: Healthscope Commercial |
$64.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.96
|
| Rate for Payer: PHP Commercial |
$61.16
|
| Rate for Payer: Priority Health SBD |
$45.33
|
| Rate for Payer: UMR Bronson Commercial |
$31.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.96
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$71.95
|
|
|
Service Code
|
NDC 70860060541
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$26.62 |
| Max. Negotiated Rate |
$64.75 |
| Rate for Payer: Aetna American Axle |
$46.77
|
| Rate for Payer: Aetna Commercial |
$61.16
|
| Rate for Payer: Aetna Medicare |
$35.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.77
|
| Rate for Payer: BCBS Complete |
$28.78
|
| Rate for Payer: Cash Price |
$57.56
|
| Rate for Payer: Cofinity Advantage |
$50.37
|
| Rate for Payer: Cofinity Commercial |
$61.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.56
|
| Rate for Payer: Healthscope Commercial |
$64.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.96
|
| Rate for Payer: PHP Commercial |
$61.16
|
| Rate for Payer: Priority Health SBD |
$45.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.77
|
| Rate for Payer: UHC Core |
$37.49
|
| Rate for Payer: UHC Exchange |
$28.28
|
| Rate for Payer: UMR Bronson Commercial |
$26.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.96
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$67.27
|
|
|
Service Code
|
NDC 16729023930
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$29.60 |
| Max. Negotiated Rate |
$60.54 |
| Rate for Payer: Aetna American Axle |
$43.73
|
| Rate for Payer: Aetna Commercial |
$57.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.73
|
| Rate for Payer: Cash Price |
$53.82
|
| Rate for Payer: Cofinity Advantage |
$47.09
|
| Rate for Payer: Cofinity Commercial |
$57.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.82
|
| Rate for Payer: Healthscope Commercial |
$60.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.45
|
| Rate for Payer: PHP Commercial |
$57.18
|
| Rate for Payer: Priority Health SBD |
$42.38
|
| Rate for Payer: UMR Bronson Commercial |
$29.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.45
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$42.40
|
|
|
Service Code
|
NDC 67457025102
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.66 |
| Max. Negotiated Rate |
$38.16 |
| Rate for Payer: Aetna American Axle |
$27.56
|
| Rate for Payer: Aetna Commercial |
$36.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.56
|
| Rate for Payer: Cash Price |
$33.92
|
| Rate for Payer: Cofinity Advantage |
$29.68
|
| Rate for Payer: Cofinity Commercial |
$36.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.92
|
| Rate for Payer: Healthscope Commercial |
$38.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.80
|
| Rate for Payer: PHP Commercial |
$36.04
|
| Rate for Payer: Priority Health SBD |
$26.71
|
| Rate for Payer: UMR Bronson Commercial |
$18.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.80
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$84.57
|
|
|
Service Code
|
NDC 00409163802
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$31.29 |
| Max. Negotiated Rate |
$76.11 |
| Rate for Payer: Aetna American Axle |
$54.97
|
| Rate for Payer: Aetna Commercial |
$71.88
|
| Rate for Payer: Aetna Medicare |
$42.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.97
|
| Rate for Payer: BCBS Complete |
$33.83
|
| Rate for Payer: Cash Price |
$67.66
|
| Rate for Payer: Cofinity Advantage |
$59.20
|
| Rate for Payer: Cofinity Commercial |
$72.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.66
|
| Rate for Payer: Healthscope Commercial |
$76.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.43
|
| Rate for Payer: PHP Commercial |
$71.88
|
| Rate for Payer: Priority Health SBD |
$53.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.97
|
| Rate for Payer: UHC Core |
$44.06
|
| Rate for Payer: UHC Exchange |
$33.24
|
| Rate for Payer: UMR Bronson Commercial |
$31.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.43
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$63.07
|
|
|
Service Code
|
NDC 55150020902
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$27.75 |
| Max. Negotiated Rate |
$56.76 |
| Rate for Payer: Aetna American Axle |
$41.00
|
| Rate for Payer: Aetna Commercial |
$53.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.00
|
| Rate for Payer: Cash Price |
$50.46
|
| Rate for Payer: Cofinity Advantage |
$44.15
|
| Rate for Payer: Cofinity Commercial |
$54.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.46
|
| Rate for Payer: Healthscope Commercial |
$56.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.30
|
| Rate for Payer: PHP Commercial |
$53.61
|
| Rate for Payer: Priority Health SBD |
$39.73
|
| Rate for Payer: UMR Bronson Commercial |
$27.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.30
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$63.07
|
|
|
Service Code
|
NDC 55150020902
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$23.34 |
| Max. Negotiated Rate |
$56.76 |
| Rate for Payer: Aetna American Axle |
$41.00
|
| Rate for Payer: Aetna Commercial |
$53.61
|
| Rate for Payer: Aetna Medicare |
$31.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.00
|
| Rate for Payer: BCBS Complete |
$25.23
|
| Rate for Payer: Cash Price |
$50.46
|
| Rate for Payer: Cofinity Advantage |
$44.15
|
| Rate for Payer: Cofinity Commercial |
$54.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.46
|
| Rate for Payer: Healthscope Commercial |
$56.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.30
|
| Rate for Payer: PHP Commercial |
$53.61
|
| Rate for Payer: Priority Health SBD |
$39.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.00
|
| Rate for Payer: UHC Core |
$32.86
|
| Rate for Payer: UHC Exchange |
$24.79
|
| Rate for Payer: UMR Bronson Commercial |
$23.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.30
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$72.86
|
|
|
Service Code
|
NDC 66794023302
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$26.96 |
| Max. Negotiated Rate |
$65.57 |
| Rate for Payer: Aetna American Axle |
$47.36
|
| Rate for Payer: Aetna Commercial |
$61.93
|
| Rate for Payer: Aetna Medicare |
$36.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.36
|
| Rate for Payer: BCBS Complete |
$29.14
|
| Rate for Payer: Cash Price |
$58.29
|
| Rate for Payer: Cofinity Advantage |
$51.00
|
| Rate for Payer: Cofinity Commercial |
$62.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.29
|
| Rate for Payer: Healthscope Commercial |
$65.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.65
|
| Rate for Payer: PHP Commercial |
$61.93
|
| Rate for Payer: Priority Health SBD |
$45.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.36
|
| Rate for Payer: UHC Core |
$37.96
|
| Rate for Payer: UHC Exchange |
$28.63
|
| Rate for Payer: UMR Bronson Commercial |
$26.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.65
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$50.44
|
|
|
Service Code
|
NDC 42023014625
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$22.19 |
| Max. Negotiated Rate |
$45.40 |
| Rate for Payer: Aetna American Axle |
$32.79
|
| Rate for Payer: Aetna Commercial |
$42.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.79
|
| Rate for Payer: Cash Price |
$40.35
|
| Rate for Payer: Cofinity Advantage |
$35.31
|
| Rate for Payer: Cofinity Commercial |
$43.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.35
|
| Rate for Payer: Healthscope Commercial |
$45.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.83
|
| Rate for Payer: PHP Commercial |
$42.87
|
| Rate for Payer: Priority Health SBD |
$31.78
|
| Rate for Payer: UMR Bronson Commercial |
$22.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.83
|
|
|
DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$70.27
|
|
|
Service Code
|
NDC 70860060502
|
| Hospital Charge Code |
27103
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$30.92 |
| Max. Negotiated Rate |
$63.24 |
| Rate for Payer: Aetna American Axle |
$45.68
|
| Rate for Payer: Aetna Commercial |
$59.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.68
|
| Rate for Payer: Cash Price |
$56.22
|
| Rate for Payer: Cofinity Advantage |
$49.19
|
| Rate for Payer: Cofinity Commercial |
$60.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.22
|
| Rate for Payer: Healthscope Commercial |
$63.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.70
|
| Rate for Payer: PHP Commercial |
$59.73
|
| Rate for Payer: Priority Health SBD |
$44.27
|
| Rate for Payer: UMR Bronson Commercial |
$30.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.70
|
|
