|
DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$645.28
|
|
|
Service Code
|
NDC 51079076708
|
| Hospital Charge Code |
81426
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$283.92 |
| Max. Negotiated Rate |
$580.75 |
| Rate for Payer: Aetna American Axle |
$419.43
|
| Rate for Payer: Aetna Commercial |
$548.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.43
|
| Rate for Payer: Cash Price |
$516.22
|
| Rate for Payer: Cofinity Advantage |
$451.70
|
| Rate for Payer: Cofinity Commercial |
$554.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$516.22
|
| Rate for Payer: Healthscope Commercial |
$580.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$451.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$483.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$548.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$483.96
|
| Rate for Payer: PHP Commercial |
$548.49
|
| Rate for Payer: Priority Health SBD |
$406.53
|
| Rate for Payer: UMR Bronson Commercial |
$283.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$483.96
|
|
|
DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$596.15
|
|
|
Service Code
|
NDC 00904636445
|
| Hospital Charge Code |
81426
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$220.58 |
| Max. Negotiated Rate |
$536.53 |
| Rate for Payer: Aetna American Axle |
$387.50
|
| Rate for Payer: Aetna Commercial |
$506.73
|
| Rate for Payer: Aetna Medicare |
$298.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.50
|
| Rate for Payer: BCBS Complete |
$238.46
|
| Rate for Payer: Cash Price |
$476.92
|
| Rate for Payer: Cofinity Advantage |
$417.31
|
| Rate for Payer: Cofinity Commercial |
$512.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.92
|
| Rate for Payer: Healthscope Commercial |
$536.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$417.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$476.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$447.11
|
| Rate for Payer: PHP Commercial |
$506.73
|
| Rate for Payer: Priority Health SBD |
$375.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.50
|
| Rate for Payer: UHC Core |
$310.59
|
| Rate for Payer: UHC Exchange |
$234.29
|
| Rate for Payer: UMR Bronson Commercial |
$220.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.11
|
|
|
DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$645.28
|
|
|
Service Code
|
NDC 51079076708
|
| Hospital Charge Code |
81426
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$238.75 |
| Max. Negotiated Rate |
$580.75 |
| Rate for Payer: Aetna American Axle |
$419.43
|
| Rate for Payer: Aetna Commercial |
$548.49
|
| Rate for Payer: Aetna Medicare |
$322.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.43
|
| Rate for Payer: BCBS Complete |
$258.11
|
| Rate for Payer: Cash Price |
$516.22
|
| Rate for Payer: Cofinity Advantage |
$451.70
|
| Rate for Payer: Cofinity Commercial |
$554.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$516.22
|
| Rate for Payer: Healthscope Commercial |
$580.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$451.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$483.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$516.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$548.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$483.96
|
| Rate for Payer: PHP Commercial |
$548.49
|
| Rate for Payer: Priority Health SBD |
$406.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$419.43
|
| Rate for Payer: UHC Core |
$336.19
|
| Rate for Payer: UHC Exchange |
$253.60
|
| Rate for Payer: UMR Bronson Commercial |
$238.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$483.96
|
|
|
DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$718.85
|
|
|
Service Code
|
NDC 00904718245
|
| Hospital Charge Code |
81426
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$316.29 |
| Max. Negotiated Rate |
$646.97 |
| Rate for Payer: Aetna American Axle |
$467.25
|
| Rate for Payer: Aetna Commercial |
$611.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.25
|
| Rate for Payer: Cash Price |
$575.08
|
| Rate for Payer: Cofinity Advantage |
$503.19
|
| Rate for Payer: Cofinity Commercial |
$618.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.08
|
| Rate for Payer: Healthscope Commercial |
$646.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$503.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.14
|
| Rate for Payer: PHP Commercial |
$611.02
|
| Rate for Payer: Priority Health SBD |
$452.88
|
| Rate for Payer: UMR Bronson Commercial |
$316.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.14
|
|
|
DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$843.84
|
|
|
Service Code
|
NDC 00904718261
|
| Hospital Charge Code |
81426
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$312.22 |
| Max. Negotiated Rate |
$759.46 |
| Rate for Payer: Aetna American Axle |
$548.50
|
| Rate for Payer: Aetna Commercial |
$717.26
|
| Rate for Payer: Aetna Medicare |
$421.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$548.50
|
| Rate for Payer: BCBS Complete |
$337.54
|
| Rate for Payer: Cash Price |
$675.07
|
| Rate for Payer: Cofinity Advantage |
$590.69
|
| Rate for Payer: Cofinity Commercial |
$725.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$675.07
|
| Rate for Payer: Healthscope Commercial |
$759.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$590.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$632.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$675.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$717.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$632.88
|
| Rate for Payer: PHP Commercial |
$717.26
|
| Rate for Payer: Priority Health SBD |
$531.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$548.50
|
| Rate for Payer: UHC Core |
$439.64
|
| Rate for Payer: UHC Exchange |
$331.63
|
| Rate for Payer: UMR Bronson Commercial |
$312.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$632.88
|
|
|
DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$718.85
|
|
|
Service Code
|
NDC 00904718245
|
| Hospital Charge Code |
81426
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$265.97 |
| Max. Negotiated Rate |
$646.97 |
| Rate for Payer: Aetna American Axle |
$467.25
|
| Rate for Payer: Aetna Commercial |
$611.02
|
| Rate for Payer: Aetna Medicare |
$359.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.25
|
| Rate for Payer: BCBS Complete |
$287.54
|
| Rate for Payer: Cash Price |
$575.08
|
| Rate for Payer: Cofinity Advantage |
$503.19
|
| Rate for Payer: Cofinity Commercial |
$618.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.08
|
| Rate for Payer: Healthscope Commercial |
$646.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$503.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$575.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.14
|
| Rate for Payer: PHP Commercial |
$611.02
|
| Rate for Payer: Priority Health SBD |
$452.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.25
|
| Rate for Payer: UHC Core |
$374.52
|
| Rate for Payer: UHC Exchange |
$282.51
|
| Rate for Payer: UMR Bronson Commercial |
$265.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.14
|
|
|
DIVERTICULITIS AND DIVERTICULOSIS
|
Facility
|
IP
|
$7,498.16
|
|
|
Service Code
|
APR-DRG 2443
|
| Min. Negotiated Rate |
$7,141.11 |
| Max. Negotiated Rate |
$7,498.16 |
| Rate for Payer: BCBS Complete |
$7,498.16
|
| Rate for Payer: Mclaren Medicaid |
$7,141.11
|
| Rate for Payer: Meridian Medicaid |
$7,498.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,141.11
|
| Rate for Payer: UHC Medicaid |
$7,141.11
|
| Rate for Payer: UHCCP Medicaid |
$7,141.11
|
|
|
DIVERTICULITIS AND DIVERTICULOSIS
|
Facility
|
IP
|
$12,575.63
|
|
|
Service Code
|
APR-DRG 2444
|
| Min. Negotiated Rate |
$11,976.79 |
| Max. Negotiated Rate |
$12,575.63 |
| Rate for Payer: BCBS Complete |
$12,575.63
|
| Rate for Payer: Mclaren Medicaid |
$11,976.79
|
| Rate for Payer: Meridian Medicaid |
$12,575.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,976.79
|
| Rate for Payer: UHC Medicaid |
$11,976.79
|
| Rate for Payer: UHCCP Medicaid |
$11,976.79
|
|
|
DIVERTICULITIS AND DIVERTICULOSIS
|
Facility
|
IP
|
$3,457.62
|
|
|
Service Code
|
APR-DRG 2441
|
| Min. Negotiated Rate |
$3,292.97 |
| Max. Negotiated Rate |
$3,457.62 |
| Rate for Payer: BCBS Complete |
$3,457.62
|
| Rate for Payer: Mclaren Medicaid |
$3,292.97
|
| Rate for Payer: Meridian Medicaid |
$3,457.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,292.97
|
| Rate for Payer: UHC Medicaid |
$3,292.97
|
| Rate for Payer: UHCCP Medicaid |
$3,292.97
|
|
|
DIVERTICULITIS AND DIVERTICULOSIS
|
Facility
|
IP
|
$4,585.34
|
|
|
Service Code
|
APR-DRG 2442
|
| Min. Negotiated Rate |
$4,366.99 |
| Max. Negotiated Rate |
$4,585.34 |
| Rate for Payer: BCBS Complete |
$4,585.34
|
| Rate for Payer: Mclaren Medicaid |
$4,366.99
|
| Rate for Payer: Meridian Medicaid |
$4,585.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,366.99
|
| Rate for Payer: UHC Medicaid |
$4,366.99
|
| Rate for Payer: UHCCP Medicaid |
$4,366.99
|
|
|
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$21.01
|
|
|
Service Code
|
HCPCS J1250
|
| Hospital Charge Code |
9892
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.24 |
| Max. Negotiated Rate |
$18.91 |
| Rate for Payer: Aetna American Axle |
$13.66
|
| Rate for Payer: Aetna American Axle |
$24.36
|
| Rate for Payer: Aetna American Axle |
$21.81
|
| Rate for Payer: Aetna Commercial |
$28.53
|
| Rate for Payer: Aetna Commercial |
$17.86
|
| Rate for Payer: Aetna Commercial |
$31.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.81
|
| Rate for Payer: Cash Price |
$26.85
|
| Rate for Payer: Cash Price |
$16.81
|
| Rate for Payer: Cash Price |
$29.98
|
| Rate for Payer: Cofinity Advantage |
$26.23
|
| Rate for Payer: Cofinity Advantage |
$14.71
|
| Rate for Payer: Cofinity Advantage |
$23.49
|
| Rate for Payer: Cofinity Commercial |
$32.22
|
| Rate for Payer: Cofinity Commercial |
$18.07
|
| Rate for Payer: Cofinity Commercial |
$28.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.98
|
| Rate for Payer: Healthscope Commercial |
$30.20
|
| Rate for Payer: Healthscope Commercial |
$33.72
|
| Rate for Payer: Healthscope Commercial |
$18.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.10
|
| Rate for Payer: PHP Commercial |
$28.53
|
| Rate for Payer: PHP Commercial |
$17.86
|
| Rate for Payer: PHP Commercial |
$31.85
|
| Rate for Payer: Priority Health SBD |
$13.24
|
| Rate for Payer: Priority Health SBD |
$21.14
|
| Rate for Payer: Priority Health SBD |
$23.61
|
| Rate for Payer: UMR Bronson Commercial |
$9.24
|
| Rate for Payer: UMR Bronson Commercial |
$16.49
|
| Rate for Payer: UMR Bronson Commercial |
$14.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.10
|
|
|
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$33.56
|
|
|
Service Code
|
HCPCS J1250
|
| Hospital Charge Code |
9892
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.42 |
| Max. Negotiated Rate |
$30.20 |
| Rate for Payer: Aetna American Axle |
$21.81
|
| Rate for Payer: Aetna American Axle |
$13.66
|
| Rate for Payer: Aetna American Axle |
$24.36
|
| Rate for Payer: Aetna Commercial |
$28.53
|
| Rate for Payer: Aetna Commercial |
$31.85
|
| Rate for Payer: Aetna Commercial |
$17.86
|
| Rate for Payer: Aetna Medicare |
$16.78
|
| Rate for Payer: Aetna Medicare |
$10.51
|
| Rate for Payer: Aetna Medicare |
$18.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.36
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS Complete |
$13.42
|
| Rate for Payer: BCBS Complete |
$14.99
|
| Rate for Payer: BCBS Trust/PPO |
$26.00
|
| Rate for Payer: BCBS Trust/PPO |
$26.00
|
| Rate for Payer: BCBS Trust/PPO |
$26.00
|
| Rate for Payer: BCN Commercial |
$26.00
|
| Rate for Payer: BCN Commercial |
$26.00
|
| Rate for Payer: BCN Commercial |
$26.00
|
| Rate for Payer: Cash Price |
$16.81
|
| Rate for Payer: Cash Price |
$16.81
|
| Rate for Payer: Cash Price |
$29.98
|
| Rate for Payer: Cash Price |
$29.98
|
| Rate for Payer: Cash Price |
$26.85
|
| Rate for Payer: Cash Price |
$26.85
|
| Rate for Payer: Cofinity Advantage |
$26.23
|
| Rate for Payer: Cofinity Advantage |
$23.49
|
| Rate for Payer: Cofinity Advantage |
$14.71
|
| Rate for Payer: Cofinity Commercial |
$18.07
|
| Rate for Payer: Cofinity Commercial |
$28.86
|
| Rate for Payer: Cofinity Commercial |
$32.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.85
|
| Rate for Payer: Healthscope Commercial |
$18.91
|
| Rate for Payer: Healthscope Commercial |
$30.20
|
| Rate for Payer: Healthscope Commercial |
$33.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.10
|
| Rate for Payer: PHP Commercial |
$28.53
|
| Rate for Payer: PHP Commercial |
$17.86
|
| Rate for Payer: PHP Commercial |
$31.85
|
| Rate for Payer: Priority Health SBD |
$13.24
|
| Rate for Payer: Priority Health SBD |
$23.61
|
| Rate for Payer: Priority Health SBD |
$21.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.23
|
| Rate for Payer: UHC Core |
$13.23
|
| Rate for Payer: UHC Core |
$13.23
|
| Rate for Payer: UHC Core |
$13.23
|
| Rate for Payer: UHC Exchange |
$13.23
|
| Rate for Payer: UHC Exchange |
$13.23
|
| Rate for Payer: UHC Exchange |
$13.23
|
| Rate for Payer: UMR Bronson Commercial |
$13.86
|
| Rate for Payer: UMR Bronson Commercial |
$7.77
|
| Rate for Payer: UMR Bronson Commercial |
$12.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.10
|
|
|
DOBUTAMINE 250 MG/250 ML (1 MG/ML) IN 5 % DEXTROSE INTRAVENOUS
|
Facility
|
OP
|
$138.99
|
|
|
Service Code
|
HCPCS J1250
|
| Hospital Charge Code |
15981
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.23 |
| Max. Negotiated Rate |
$125.09 |
| Rate for Payer: Aetna American Axle |
$90.34
|
| Rate for Payer: Aetna American Axle |
$59.62
|
| Rate for Payer: Aetna Commercial |
$118.14
|
| Rate for Payer: Aetna Commercial |
$77.96
|
| Rate for Payer: Aetna Medicare |
$69.50
|
| Rate for Payer: Aetna Medicare |
$45.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.62
|
| Rate for Payer: BCBS Complete |
$36.69
|
| Rate for Payer: BCBS Complete |
$55.60
|
| Rate for Payer: BCBS Trust/PPO |
$26.00
|
| Rate for Payer: BCBS Trust/PPO |
$26.00
|
| Rate for Payer: BCN Commercial |
$26.00
|
| Rate for Payer: BCN Commercial |
$26.00
|
| Rate for Payer: Cash Price |
$111.19
|
| Rate for Payer: Cash Price |
$73.38
|
| Rate for Payer: Cash Price |
$111.19
|
| Rate for Payer: Cash Price |
$73.38
|
| Rate for Payer: Cofinity Advantage |
$97.29
|
| Rate for Payer: Cofinity Advantage |
$64.20
|
| Rate for Payer: Cofinity Commercial |
$119.53
|
| Rate for Payer: Cofinity Commercial |
$78.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.38
|
| Rate for Payer: Healthscope Commercial |
$125.09
|
| Rate for Payer: Healthscope Commercial |
$82.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$97.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.24
|
| Rate for Payer: PHP Commercial |
$118.14
|
| Rate for Payer: PHP Commercial |
$77.96
|
| Rate for Payer: Priority Health SBD |
$87.56
|
| Rate for Payer: Priority Health SBD |
$57.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.23
|
| Rate for Payer: UHC Core |
$13.23
|
| Rate for Payer: UHC Core |
$13.23
|
| Rate for Payer: UHC Exchange |
$13.23
|
| Rate for Payer: UHC Exchange |
$13.23
|
| Rate for Payer: UMR Bronson Commercial |
$51.43
|
| Rate for Payer: UMR Bronson Commercial |
$33.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.79
|
|
|
DOBUTAMINE 250 MG/250 ML (1 MG/ML) IN 5 % DEXTROSE INTRAVENOUS
|
Facility
|
IP
|
$138.99
|
|
|
Service Code
|
HCPCS J1250
|
| Hospital Charge Code |
15981
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$61.16 |
| Max. Negotiated Rate |
$125.09 |
| Rate for Payer: Aetna American Axle |
$90.34
|
| Rate for Payer: Aetna American Axle |
$59.62
|
| Rate for Payer: Aetna Commercial |
$118.14
|
| Rate for Payer: Aetna Commercial |
$77.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.62
|
| Rate for Payer: Cash Price |
$111.19
|
| Rate for Payer: Cash Price |
$73.38
|
| Rate for Payer: Cofinity Advantage |
$64.20
|
| Rate for Payer: Cofinity Advantage |
$97.29
|
| Rate for Payer: Cofinity Commercial |
$78.88
|
| Rate for Payer: Cofinity Commercial |
$119.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.38
|
| Rate for Payer: Healthscope Commercial |
$125.09
|
| Rate for Payer: Healthscope Commercial |
$82.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$97.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.79
|
| Rate for Payer: PHP Commercial |
$118.14
|
| Rate for Payer: PHP Commercial |
$77.96
|
| Rate for Payer: Priority Health SBD |
$57.78
|
| Rate for Payer: Priority Health SBD |
$87.56
|
| Rate for Payer: UMR Bronson Commercial |
$61.16
|
| Rate for Payer: UMR Bronson Commercial |
$40.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.79
|
|
|
DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV
|
Facility
|
IP
|
$168.20
|
|
|
Service Code
|
HCPCS J1250
|
| Hospital Charge Code |
18315
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$74.01 |
| Max. Negotiated Rate |
$151.38 |
| Rate for Payer: Aetna American Axle |
$109.33
|
| Rate for Payer: Aetna American Axle |
$53.70
|
| Rate for Payer: Aetna Commercial |
$142.97
|
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.70
|
| Rate for Payer: Cash Price |
$134.56
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cofinity Advantage |
$57.83
|
| Rate for Payer: Cofinity Advantage |
$117.74
|
| Rate for Payer: Cofinity Commercial |
$71.05
|
| Rate for Payer: Cofinity Commercial |
$144.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.10
|
| Rate for Payer: Healthscope Commercial |
$151.38
|
| Rate for Payer: Healthscope Commercial |
$74.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.97
|
| Rate for Payer: PHP Commercial |
$142.97
|
| Rate for Payer: PHP Commercial |
$70.23
|
| Rate for Payer: Priority Health SBD |
$52.05
|
| Rate for Payer: Priority Health SBD |
$105.97
|
| Rate for Payer: UMR Bronson Commercial |
$74.01
|
| Rate for Payer: UMR Bronson Commercial |
$36.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.97
|
|
|
DOBUTAMINE 500 MG/250 ML (2,000 MCG/ML) IN 5 % DEXTROSE IV
|
Facility
|
OP
|
$168.20
|
|
|
Service Code
|
HCPCS J1250
|
| Hospital Charge Code |
18315
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.23 |
| Max. Negotiated Rate |
$151.38 |
| Rate for Payer: Aetna American Axle |
$109.33
|
| Rate for Payer: Aetna American Axle |
$53.70
|
| Rate for Payer: Aetna Commercial |
$142.97
|
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Medicare |
$84.10
|
| Rate for Payer: Aetna Medicare |
$41.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.70
|
| Rate for Payer: BCBS Complete |
$33.05
|
| Rate for Payer: BCBS Complete |
$67.28
|
| Rate for Payer: BCBS Trust/PPO |
$26.00
|
| Rate for Payer: BCBS Trust/PPO |
$26.00
|
| Rate for Payer: BCN Commercial |
$26.00
|
| Rate for Payer: BCN Commercial |
$26.00
|
| Rate for Payer: Cash Price |
$134.56
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cash Price |
$134.56
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cofinity Advantage |
$117.74
|
| Rate for Payer: Cofinity Advantage |
$57.83
|
| Rate for Payer: Cofinity Commercial |
$144.65
|
| Rate for Payer: Cofinity Commercial |
$71.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.10
|
| Rate for Payer: Healthscope Commercial |
$151.38
|
| Rate for Payer: Healthscope Commercial |
$74.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$134.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.15
|
| Rate for Payer: PHP Commercial |
$142.97
|
| Rate for Payer: PHP Commercial |
$70.23
|
| Rate for Payer: Priority Health SBD |
$105.97
|
| Rate for Payer: Priority Health SBD |
$52.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.23
|
| Rate for Payer: UHC Core |
$13.23
|
| Rate for Payer: UHC Core |
$13.23
|
| Rate for Payer: UHC Exchange |
$13.23
|
| Rate for Payer: UHC Exchange |
$13.23
|
| Rate for Payer: UMR Bronson Commercial |
$62.23
|
| Rate for Payer: UMR Bronson Commercial |
$30.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.97
|
|
|
DOCETAXEL 160 MG/16 ML (10 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$516.97
|
|
|
Service Code
|
HCPCS J9171
|
| Hospital Charge Code |
152336
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$465.27 |
| Rate for Payer: Aetna American Axle |
$336.03
|
| Rate for Payer: Aetna American Axle |
$435.60
|
| Rate for Payer: Aetna Commercial |
$439.42
|
| Rate for Payer: Aetna Commercial |
$569.63
|
| Rate for Payer: Aetna Medicare |
$258.49
|
| Rate for Payer: Aetna Medicare |
$335.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$435.60
|
| Rate for Payer: BCBS Complete |
$268.06
|
| Rate for Payer: BCBS Complete |
$206.79
|
| Rate for Payer: BCBS Trust/PPO |
$2.07
|
| Rate for Payer: BCBS Trust/PPO |
$2.07
|
| Rate for Payer: BCN Commercial |
$2.07
|
| Rate for Payer: BCN Commercial |
$2.07
|
| Rate for Payer: Cash Price |
$413.58
|
| Rate for Payer: Cash Price |
$536.12
|
| Rate for Payer: Cash Price |
$413.58
|
| Rate for Payer: Cash Price |
$536.12
|
| Rate for Payer: Cofinity Advantage |
$361.88
|
| Rate for Payer: Cofinity Advantage |
$469.11
|
| Rate for Payer: Cofinity Commercial |
$444.59
|
| Rate for Payer: Cofinity Commercial |
$576.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$536.12
|
| Rate for Payer: Healthscope Commercial |
$465.27
|
| Rate for Payer: Healthscope Commercial |
$603.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$361.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$469.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$387.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$502.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$413.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$536.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$439.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$569.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$502.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$387.73
|
| Rate for Payer: PHP Commercial |
$439.42
|
| Rate for Payer: PHP Commercial |
$569.63
|
| Rate for Payer: Priority Health SBD |
$325.69
|
| Rate for Payer: Priority Health SBD |
$422.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UMR Bronson Commercial |
$191.28
|
| Rate for Payer: UMR Bronson Commercial |
$247.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$387.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$502.61
|
|
|
DOCETAXEL 160 MG/8 ML (20 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$895.04
|
|
|
Service Code
|
HCPCS J9171
|
| Hospital Charge Code |
161671
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$805.54 |
| Rate for Payer: Aetna American Axle |
$581.78
|
| Rate for Payer: Aetna American Axle |
$1,249.06
|
| Rate for Payer: Aetna American Axle |
$225.19
|
| Rate for Payer: Aetna American Axle |
$468.98
|
| Rate for Payer: Aetna Commercial |
$760.78
|
| Rate for Payer: Aetna Commercial |
$613.27
|
| Rate for Payer: Aetna Commercial |
$1,633.39
|
| Rate for Payer: Aetna Commercial |
$294.48
|
| Rate for Payer: Aetna Medicare |
$360.75
|
| Rate for Payer: Aetna Medicare |
$173.22
|
| Rate for Payer: Aetna Medicare |
$447.52
|
| Rate for Payer: Aetna Medicare |
$960.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,249.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$468.98
|
| Rate for Payer: BCBS Complete |
$768.65
|
| Rate for Payer: BCBS Complete |
$138.58
|
| Rate for Payer: BCBS Complete |
$288.60
|
| Rate for Payer: BCBS Complete |
$358.02
|
| Rate for Payer: BCBS Trust/PPO |
$2.07
|
| Rate for Payer: BCBS Trust/PPO |
$2.07
|
| Rate for Payer: BCBS Trust/PPO |
$2.07
|
| Rate for Payer: BCBS Trust/PPO |
$2.07
|
| Rate for Payer: BCN Commercial |
$2.07
|
| Rate for Payer: BCN Commercial |
$2.07
|
| Rate for Payer: BCN Commercial |
$2.07
|
| Rate for Payer: BCN Commercial |
$2.07
|
| Rate for Payer: Cash Price |
$577.20
|
| Rate for Payer: Cash Price |
$716.03
|
| Rate for Payer: Cash Price |
$1,537.30
|
| Rate for Payer: Cash Price |
$716.03
|
| Rate for Payer: Cash Price |
$577.20
|
| Rate for Payer: Cash Price |
$277.16
|
| Rate for Payer: Cash Price |
$277.16
|
| Rate for Payer: Cash Price |
$1,537.30
|
| Rate for Payer: Cofinity Advantage |
$626.53
|
| Rate for Payer: Cofinity Advantage |
$505.05
|
| Rate for Payer: Cofinity Advantage |
$242.51
|
| Rate for Payer: Cofinity Advantage |
$1,345.14
|
| Rate for Payer: Cofinity Commercial |
$297.95
|
| Rate for Payer: Cofinity Commercial |
$620.49
|
| Rate for Payer: Cofinity Commercial |
$769.73
|
| Rate for Payer: Cofinity Commercial |
$1,652.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$577.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$716.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,537.30
|
| Rate for Payer: Healthscope Commercial |
$649.35
|
| Rate for Payer: Healthscope Commercial |
$1,729.47
|
| Rate for Payer: Healthscope Commercial |
$311.81
|
| Rate for Payer: Healthscope Commercial |
$805.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$242.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,345.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$505.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$626.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$541.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,441.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$671.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$716.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$277.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,537.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$577.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,633.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$760.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$613.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$541.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,441.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$671.28
|
| Rate for Payer: PHP Commercial |
$1,633.39
|
| Rate for Payer: PHP Commercial |
$613.27
|
| Rate for Payer: PHP Commercial |
$760.78
|
| Rate for Payer: PHP Commercial |
$294.48
|
| Rate for Payer: Priority Health SBD |
$454.55
|
| Rate for Payer: Priority Health SBD |
$1,210.63
|
| Rate for Payer: Priority Health SBD |
$218.26
|
| Rate for Payer: Priority Health SBD |
$563.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UMR Bronson Commercial |
$331.16
|
| Rate for Payer: UMR Bronson Commercial |
$711.00
|
| Rate for Payer: UMR Bronson Commercial |
$128.19
|
| Rate for Payer: UMR Bronson Commercial |
$266.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$541.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,441.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$671.28
|
|
|
DOCETAXEL 160 MG/8 ML (20 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$1,921.63
|
|
|
Service Code
|
HCPCS J9171
|
| Hospital Charge Code |
161671
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$845.52 |
| Max. Negotiated Rate |
$1,729.47 |
| Rate for Payer: Aetna American Axle |
$1,249.06
|
| Rate for Payer: Aetna American Axle |
$581.78
|
| Rate for Payer: Aetna Commercial |
$1,633.39
|
| Rate for Payer: Aetna Commercial |
$760.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,249.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.78
|
| Rate for Payer: Cash Price |
$1,537.30
|
| Rate for Payer: Cash Price |
$716.03
|
| Rate for Payer: Cofinity Advantage |
$626.53
|
| Rate for Payer: Cofinity Advantage |
$1,345.14
|
| Rate for Payer: Cofinity Commercial |
$769.73
|
| Rate for Payer: Cofinity Commercial |
$1,652.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,537.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$716.03
|
| Rate for Payer: Healthscope Commercial |
$1,729.47
|
| Rate for Payer: Healthscope Commercial |
$805.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$626.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,345.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,441.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$671.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,633.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$760.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,441.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$671.28
|
| Rate for Payer: PHP Commercial |
$1,633.39
|
| Rate for Payer: PHP Commercial |
$760.78
|
| Rate for Payer: Priority Health SBD |
$563.88
|
| Rate for Payer: Priority Health SBD |
$1,210.63
|
| Rate for Payer: UMR Bronson Commercial |
$845.52
|
| Rate for Payer: UMR Bronson Commercial |
$393.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,441.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$671.28
|
|
|
DOCETAXEL 20 MG/ML (1 ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$352.40
|
|
|
Service Code
|
HCPCS J9171
|
| Hospital Charge Code |
106443
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$155.06 |
| Max. Negotiated Rate |
$317.16 |
| Rate for Payer: Aetna American Axle |
$229.06
|
| Rate for Payer: Aetna Commercial |
$299.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.06
|
| Rate for Payer: Cash Price |
$281.92
|
| Rate for Payer: Cofinity Advantage |
$246.68
|
| Rate for Payer: Cofinity Commercial |
$303.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.92
|
| Rate for Payer: Healthscope Commercial |
$317.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$264.30
|
| Rate for Payer: PHP Commercial |
$299.54
|
| Rate for Payer: Priority Health SBD |
$222.01
|
| Rate for Payer: UMR Bronson Commercial |
$155.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.30
|
|
|
DOCETAXEL 20 MG/ML (1 ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$616.70
|
|
|
Service Code
|
HCPCS J9171
|
| Hospital Charge Code |
106443
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$555.03 |
| Rate for Payer: Aetna American Axle |
$400.86
|
| Rate for Payer: Aetna American Axle |
$229.06
|
| Rate for Payer: Aetna Commercial |
$299.54
|
| Rate for Payer: Aetna Commercial |
$524.20
|
| Rate for Payer: Aetna Medicare |
$308.35
|
| Rate for Payer: Aetna Medicare |
$176.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.06
|
| Rate for Payer: BCBS Complete |
$140.96
|
| Rate for Payer: BCBS Complete |
$246.68
|
| Rate for Payer: BCBS Trust/PPO |
$2.07
|
| Rate for Payer: BCBS Trust/PPO |
$2.07
|
| Rate for Payer: BCN Commercial |
$2.07
|
| Rate for Payer: BCN Commercial |
$2.07
|
| Rate for Payer: Cash Price |
$493.36
|
| Rate for Payer: Cash Price |
$281.92
|
| Rate for Payer: Cash Price |
$281.92
|
| Rate for Payer: Cash Price |
$493.36
|
| Rate for Payer: Cofinity Advantage |
$431.69
|
| Rate for Payer: Cofinity Advantage |
$246.68
|
| Rate for Payer: Cofinity Commercial |
$303.06
|
| Rate for Payer: Cofinity Commercial |
$530.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$493.36
|
| Rate for Payer: Healthscope Commercial |
$555.03
|
| Rate for Payer: Healthscope Commercial |
$317.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$431.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$462.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$281.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$493.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$524.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$462.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$264.30
|
| Rate for Payer: PHP Commercial |
$299.54
|
| Rate for Payer: PHP Commercial |
$524.20
|
| Rate for Payer: Priority Health SBD |
$388.52
|
| Rate for Payer: Priority Health SBD |
$222.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UMR Bronson Commercial |
$228.18
|
| Rate for Payer: UMR Bronson Commercial |
$130.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$462.52
|
|
|
DOCETAXEL 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$1,458.88
|
|
|
Service Code
|
HCPCS J9171
|
| Hospital Charge Code |
120029
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$641.91 |
| Max. Negotiated Rate |
$1,312.99 |
| Rate for Payer: Aetna American Axle |
$948.27
|
| Rate for Payer: Aetna American Axle |
$538.19
|
| Rate for Payer: Aetna American Axle |
$1,249.06
|
| Rate for Payer: Aetna American Axle |
$324.51
|
| Rate for Payer: Aetna Commercial |
$1,633.39
|
| Rate for Payer: Aetna Commercial |
$703.79
|
| Rate for Payer: Aetna Commercial |
$1,240.05
|
| Rate for Payer: Aetna Commercial |
$424.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$948.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$538.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,249.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.51
|
| Rate for Payer: Cash Price |
$662.39
|
| Rate for Payer: Cash Price |
$399.40
|
| Rate for Payer: Cash Price |
$1,537.30
|
| Rate for Payer: Cash Price |
$1,167.10
|
| Rate for Payer: Cofinity Advantage |
$1,021.22
|
| Rate for Payer: Cofinity Advantage |
$1,345.14
|
| Rate for Payer: Cofinity Advantage |
$349.48
|
| Rate for Payer: Cofinity Advantage |
$579.59
|
| Rate for Payer: Cofinity Commercial |
$1,254.64
|
| Rate for Payer: Cofinity Commercial |
$1,652.60
|
| Rate for Payer: Cofinity Commercial |
$429.36
|
| Rate for Payer: Cofinity Commercial |
$712.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,537.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$662.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,167.10
|
| Rate for Payer: Healthscope Commercial |
$1,729.47
|
| Rate for Payer: Healthscope Commercial |
$1,312.99
|
| Rate for Payer: Healthscope Commercial |
$745.19
|
| Rate for Payer: Healthscope Commercial |
$449.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$349.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$579.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,345.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,021.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,094.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$620.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,441.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,633.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,240.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$703.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,441.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$620.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,094.16
|
| Rate for Payer: PHP Commercial |
$1,633.39
|
| Rate for Payer: PHP Commercial |
$424.36
|
| Rate for Payer: PHP Commercial |
$1,240.05
|
| Rate for Payer: PHP Commercial |
$703.79
|
| Rate for Payer: Priority Health SBD |
$919.09
|
| Rate for Payer: Priority Health SBD |
$314.53
|
| Rate for Payer: Priority Health SBD |
$521.63
|
| Rate for Payer: Priority Health SBD |
$1,210.63
|
| Rate for Payer: UMR Bronson Commercial |
$845.52
|
| Rate for Payer: UMR Bronson Commercial |
$364.32
|
| Rate for Payer: UMR Bronson Commercial |
$219.67
|
| Rate for Payer: UMR Bronson Commercial |
$641.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,094.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$620.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,441.22
|
|
|
DOCETAXEL 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$1,921.63
|
|
|
Service Code
|
HCPCS J9171
|
| Hospital Charge Code |
120029
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$1,729.47 |
| Rate for Payer: Aetna American Axle |
$1,249.06
|
| Rate for Payer: Aetna American Axle |
$324.51
|
| Rate for Payer: Aetna American Axle |
$439.39
|
| Rate for Payer: Aetna American Axle |
$948.27
|
| Rate for Payer: Aetna American Axle |
$538.19
|
| Rate for Payer: Aetna American Axle |
$216.88
|
| Rate for Payer: Aetna Commercial |
$703.79
|
| Rate for Payer: Aetna Commercial |
$574.59
|
| Rate for Payer: Aetna Commercial |
$283.61
|
| Rate for Payer: Aetna Commercial |
$1,240.05
|
| Rate for Payer: Aetna Commercial |
$424.36
|
| Rate for Payer: Aetna Commercial |
$1,633.39
|
| Rate for Payer: Aetna Medicare |
$729.44
|
| Rate for Payer: Aetna Medicare |
$960.82
|
| Rate for Payer: Aetna Medicare |
$166.83
|
| Rate for Payer: Aetna Medicare |
$414.00
|
| Rate for Payer: Aetna Medicare |
$338.00
|
| Rate for Payer: Aetna Medicare |
$249.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$538.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$948.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,249.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.51
|
| Rate for Payer: BCBS Complete |
$133.46
|
| Rate for Payer: BCBS Complete |
$768.65
|
| Rate for Payer: BCBS Complete |
$583.55
|
| Rate for Payer: BCBS Complete |
$199.70
|
| Rate for Payer: BCBS Complete |
$270.40
|
| Rate for Payer: BCBS Complete |
$331.20
|
| Rate for Payer: BCBS Trust/PPO |
$2.07
|
| Rate for Payer: BCBS Trust/PPO |
$2.07
|
| Rate for Payer: BCBS Trust/PPO |
$2.07
|
| Rate for Payer: BCBS Trust/PPO |
$2.07
|
| Rate for Payer: BCBS Trust/PPO |
$2.07
|
| Rate for Payer: BCBS Trust/PPO |
$2.07
|
| Rate for Payer: BCN Commercial |
$2.07
|
| Rate for Payer: BCN Commercial |
$2.07
|
| Rate for Payer: BCN Commercial |
$2.07
|
| Rate for Payer: BCN Commercial |
$2.07
|
| Rate for Payer: BCN Commercial |
$2.07
|
| Rate for Payer: BCN Commercial |
$2.07
|
| Rate for Payer: Cash Price |
$662.39
|
| Rate for Payer: Cash Price |
$1,167.10
|
| Rate for Payer: Cash Price |
$1,167.10
|
| Rate for Payer: Cash Price |
$266.93
|
| Rate for Payer: Cash Price |
$266.93
|
| Rate for Payer: Cash Price |
$1,537.30
|
| Rate for Payer: Cash Price |
$1,537.30
|
| Rate for Payer: Cash Price |
$662.39
|
| Rate for Payer: Cash Price |
$540.79
|
| Rate for Payer: Cash Price |
$399.40
|
| Rate for Payer: Cash Price |
$540.79
|
| Rate for Payer: Cash Price |
$399.40
|
| Rate for Payer: Cofinity Advantage |
$349.48
|
| Rate for Payer: Cofinity Advantage |
$233.56
|
| Rate for Payer: Cofinity Advantage |
$579.59
|
| Rate for Payer: Cofinity Advantage |
$1,021.22
|
| Rate for Payer: Cofinity Advantage |
$1,345.14
|
| Rate for Payer: Cofinity Advantage |
$473.19
|
| Rate for Payer: Cofinity Commercial |
$581.35
|
| Rate for Payer: Cofinity Commercial |
$1,254.64
|
| Rate for Payer: Cofinity Commercial |
$1,652.60
|
| Rate for Payer: Cofinity Commercial |
$286.95
|
| Rate for Payer: Cofinity Commercial |
$429.36
|
| Rate for Payer: Cofinity Commercial |
$712.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,537.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,167.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$662.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.79
|
| Rate for Payer: Healthscope Commercial |
$1,312.99
|
| Rate for Payer: Healthscope Commercial |
$608.39
|
| Rate for Payer: Healthscope Commercial |
$300.29
|
| Rate for Payer: Healthscope Commercial |
$449.32
|
| Rate for Payer: Healthscope Commercial |
$745.19
|
| Rate for Payer: Healthscope Commercial |
$1,729.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,345.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,021.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$349.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$473.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$579.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$620.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,094.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,441.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$506.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$266.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,537.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$540.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,167.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$662.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$703.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,240.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,633.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$620.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,441.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,094.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$250.25
|
| Rate for Payer: PHP Commercial |
$1,633.39
|
| Rate for Payer: PHP Commercial |
$283.61
|
| Rate for Payer: PHP Commercial |
$424.36
|
| Rate for Payer: PHP Commercial |
$1,240.05
|
| Rate for Payer: PHP Commercial |
$574.59
|
| Rate for Payer: PHP Commercial |
$703.79
|
| Rate for Payer: Priority Health SBD |
$314.53
|
| Rate for Payer: Priority Health SBD |
$919.09
|
| Rate for Payer: Priority Health SBD |
$1,210.63
|
| Rate for Payer: Priority Health SBD |
$521.63
|
| Rate for Payer: Priority Health SBD |
$210.21
|
| Rate for Payer: Priority Health SBD |
$425.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Core |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UHC Exchange |
$1.07
|
| Rate for Payer: UMR Bronson Commercial |
$184.72
|
| Rate for Payer: UMR Bronson Commercial |
$250.12
|
| Rate for Payer: UMR Bronson Commercial |
$711.00
|
| Rate for Payer: UMR Bronson Commercial |
$539.79
|
| Rate for Payer: UMR Bronson Commercial |
$306.36
|
| Rate for Payer: UMR Bronson Commercial |
$123.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$620.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$506.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,094.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,441.22
|
|
|
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$462.89
|
|
|
Service Code
|
HCPCS J9172
|
| Hospital Charge Code |
152334
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$203.67 |
| Max. Negotiated Rate |
$416.60 |
| Rate for Payer: Aetna American Axle |
$300.88
|
| Rate for Payer: Aetna Commercial |
$393.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.88
|
| Rate for Payer: Cash Price |
$370.31
|
| Rate for Payer: Cofinity Advantage |
$324.02
|
| Rate for Payer: Cofinity Commercial |
$398.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.31
|
| Rate for Payer: Healthscope Commercial |
$416.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$347.17
|
| Rate for Payer: PHP Commercial |
$393.46
|
| Rate for Payer: Priority Health SBD |
$291.62
|
| Rate for Payer: UMR Bronson Commercial |
$203.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.17
|
|
|
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$462.89
|
|
|
Service Code
|
HCPCS J9172
|
| Hospital Charge Code |
152334
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.10 |
| Max. Negotiated Rate |
$416.60 |
| Rate for Payer: Aetna American Axle |
$300.88
|
| Rate for Payer: Aetna Commercial |
$393.46
|
| Rate for Payer: Aetna Medicare |
$52.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.26
|
| Rate for Payer: BCBS Complete |
$27.80
|
| Rate for Payer: BCBS MAPPO |
$50.61
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Medicare Advantage |
$50.61
|
| Rate for Payer: Cash Price |
$370.31
|
| Rate for Payer: Cash Price |
$370.31
|
| Rate for Payer: Cofinity Advantage |
$324.02
|
| Rate for Payer: Cofinity Commercial |
$398.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.61
|
| Rate for Payer: Healthscope Commercial |
$416.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.17
|
| Rate for Payer: Mclaren Medicaid |
$50.61
|
| Rate for Payer: Mclaren Medicare |
$50.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.14
|
| Rate for Payer: Meridian Medicaid |
$53.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.46
|
| Rate for Payer: Nomi Health Commercial |
$151.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$347.17
|
| Rate for Payer: PACE Medicare |
$48.08
|
| Rate for Payer: PACE SWMI |
$50.61
|
| Rate for Payer: PHP Commercial |
$393.46
|
| Rate for Payer: PHP Medicare Advantage |
$50.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$160.16
|
| Rate for Payer: Priority Health Medicare |
$50.61
|
| Rate for Payer: Priority Health SBD |
$291.62
|
| Rate for Payer: Priority Health Tiered Network |
$128.13
|
| Rate for Payer: Railroad Medicare Medicare |
$50.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.10
|
| Rate for Payer: UHC Core |
$82.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$50.61
|
| Rate for Payer: UHC Exchange |
$82.10
|
| Rate for Payer: UHC Medicaid |
$26.47
|
| Rate for Payer: UHCCP Medicaid |
$26.47
|
| Rate for Payer: UMR Bronson Commercial |
$171.27
|
| Rate for Payer: VA VA |
$50.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.17
|
|
