|
DERMABOND SKIN ADHESIVE
|
Facility
|
OP
|
$86.16
|
|
|
Service Code
|
NDC 09900000199
|
| Hospital Charge Code |
158456
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$31.88 |
| Max. Negotiated Rate |
$77.54 |
| Rate for Payer: Aetna American Axle |
$56.00
|
| Rate for Payer: Aetna Commercial |
$73.24
|
| Rate for Payer: Aetna Medicare |
$43.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.00
|
| Rate for Payer: BCBS Complete |
$34.46
|
| Rate for Payer: Cash Price |
$68.93
|
| Rate for Payer: Cofinity Commercial |
$60.31
|
| Rate for Payer: Cofinity Commercial |
$74.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.93
|
| Rate for Payer: Healthscope Commercial |
$77.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.24
|
| Rate for Payer: PHP Commercial |
$73.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
| Rate for Payer: Priority Health SBD |
$54.28
|
| Rate for Payer: UMR Bronson Commercial |
$31.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.62
|
|
|
DERMABOND SKIN ADHESIVE
|
Facility
|
IP
|
$86.16
|
|
|
Service Code
|
NDC 09900000199
|
| Hospital Charge Code |
158456
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$37.91 |
| Max. Negotiated Rate |
$77.54 |
| Rate for Payer: Aetna American Axle |
$56.00
|
| Rate for Payer: Aetna Commercial |
$73.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.00
|
| Rate for Payer: Cash Price |
$68.93
|
| Rate for Payer: Cofinity Commercial |
$60.31
|
| Rate for Payer: Cofinity Commercial |
$74.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.93
|
| Rate for Payer: Healthscope Commercial |
$77.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.24
|
| Rate for Payer: PHP Commercial |
$73.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
| Rate for Payer: Priority Health SBD |
$54.28
|
| Rate for Payer: UMR Bronson Commercial |
$37.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.62
|
|
|
DERMAPLANNING
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS 00175
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$26.65 |
| Rate for Payer: Aetna Medicare |
$20.50
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
| Rate for Payer: UMR Bronson Commercial |
$18.86
|
|
|
DESFLURANE 100 % INHALATION LIQUID
|
Facility
|
IP
|
$1,137.72
|
|
|
Service Code
|
NDC 10019064434
|
| Hospital Charge Code |
9747
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$500.60 |
| Max. Negotiated Rate |
$1,023.95 |
| Rate for Payer: Aetna American Axle |
$739.52
|
| Rate for Payer: Aetna Commercial |
$967.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$739.52
|
| Rate for Payer: Cash Price |
$910.18
|
| Rate for Payer: Cofinity Commercial |
$796.40
|
| Rate for Payer: Cofinity Commercial |
$978.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$796.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$910.18
|
| Rate for Payer: Healthscope Commercial |
$1,023.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$796.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$853.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$967.06
|
| Rate for Payer: PHP Commercial |
$967.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$739.52
|
| Rate for Payer: Priority Health SBD |
$716.76
|
| Rate for Payer: UMR Bronson Commercial |
$500.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$853.29
|
|
|
DESFLURANE 100 % INHALATION LIQUID
|
Facility
|
OP
|
$1,137.72
|
|
|
Service Code
|
NDC 10019064434
|
| Hospital Charge Code |
9747
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$420.96 |
| Max. Negotiated Rate |
$1,023.95 |
| Rate for Payer: Aetna American Axle |
$739.52
|
| Rate for Payer: Aetna Commercial |
$967.06
|
| Rate for Payer: Aetna Medicare |
$568.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$739.52
|
| Rate for Payer: BCBS Complete |
$455.09
|
| Rate for Payer: Cash Price |
$910.18
|
| Rate for Payer: Cofinity Commercial |
$796.40
|
| Rate for Payer: Cofinity Commercial |
$978.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$796.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$910.18
|
| Rate for Payer: Healthscope Commercial |
$1,023.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$796.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$853.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$967.06
|
| Rate for Payer: PHP Commercial |
$967.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$739.52
|
| Rate for Payer: Priority Health SBD |
$716.76
|
| Rate for Payer: UMR Bronson Commercial |
$420.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$853.29
|
|
|
DESIPRAMINE 25 MG TABLET
|
Facility
|
OP
|
$453.55
|
|
|
Service Code
|
NDC 62332031631
|
| Hospital Charge Code |
2286
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$167.81 |
| Max. Negotiated Rate |
$408.19 |
| Rate for Payer: Aetna American Axle |
$294.81
|
| Rate for Payer: Aetna Commercial |
$385.52
|
| Rate for Payer: Aetna Medicare |
$226.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.81
|
| Rate for Payer: BCBS Complete |
$181.42
|
| Rate for Payer: Cash Price |
$362.84
|
| Rate for Payer: Cofinity Commercial |
$317.49
|
| Rate for Payer: Cofinity Commercial |
$390.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$317.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.84
|
| Rate for Payer: Healthscope Commercial |
$408.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$317.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$340.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.52
|
| Rate for Payer: PHP Commercial |
$385.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.81
|
| Rate for Payer: Priority Health SBD |
$285.74
|
| Rate for Payer: UMR Bronson Commercial |
$167.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$340.16
|
|
|
DESIPRAMINE 25 MG TABLET
|
Facility
|
OP
|
$259.35
|
|
|
Service Code
|
NDC 23155057901
|
| Hospital Charge Code |
2286
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$95.96 |
| Max. Negotiated Rate |
$233.41 |
| Rate for Payer: Aetna American Axle |
$168.58
|
| Rate for Payer: Aetna Commercial |
$220.45
|
| Rate for Payer: Aetna Medicare |
$129.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.58
|
| Rate for Payer: BCBS Complete |
$103.74
|
| Rate for Payer: Cash Price |
$207.48
|
| Rate for Payer: Cofinity Commercial |
$181.54
|
| Rate for Payer: Cofinity Commercial |
$223.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$181.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.48
|
| Rate for Payer: Healthscope Commercial |
$233.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.45
|
| Rate for Payer: PHP Commercial |
$220.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.58
|
| Rate for Payer: Priority Health SBD |
$163.39
|
| Rate for Payer: UMR Bronson Commercial |
$95.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.51
|
|
|
DESIPRAMINE 25 MG TABLET
|
Facility
|
IP
|
$259.35
|
|
|
Service Code
|
NDC 23155057901
|
| Hospital Charge Code |
2286
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$114.11 |
| Max. Negotiated Rate |
$233.41 |
| Rate for Payer: Aetna American Axle |
$168.58
|
| Rate for Payer: Aetna Commercial |
$220.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.58
|
| Rate for Payer: Cash Price |
$207.48
|
| Rate for Payer: Cofinity Commercial |
$181.54
|
| Rate for Payer: Cofinity Commercial |
$223.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$181.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.48
|
| Rate for Payer: Healthscope Commercial |
$233.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.45
|
| Rate for Payer: PHP Commercial |
$220.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.58
|
| Rate for Payer: Priority Health SBD |
$163.39
|
| Rate for Payer: UMR Bronson Commercial |
$114.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.51
|
|
|
DESIPRAMINE 25 MG TABLET
|
Facility
|
IP
|
$453.55
|
|
|
Service Code
|
NDC 62332031631
|
| Hospital Charge Code |
2286
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$199.56 |
| Max. Negotiated Rate |
$408.19 |
| Rate for Payer: Aetna American Axle |
$294.81
|
| Rate for Payer: Aetna Commercial |
$385.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.81
|
| Rate for Payer: Cash Price |
$362.84
|
| Rate for Payer: Cofinity Commercial |
$317.49
|
| Rate for Payer: Cofinity Commercial |
$390.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$317.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.84
|
| Rate for Payer: Healthscope Commercial |
$408.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$317.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$340.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.52
|
| Rate for Payer: PHP Commercial |
$385.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.81
|
| Rate for Payer: Priority Health SBD |
$285.74
|
| Rate for Payer: UMR Bronson Commercial |
$199.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$340.16
|
|
|
DESIPRAMINE 25 MG TABLET
|
Facility
|
IP
|
$352.50
|
|
|
Service Code
|
NDC 50742011301
|
| Hospital Charge Code |
2286
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$155.10 |
| Max. Negotiated Rate |
$317.25 |
| Rate for Payer: Aetna American Axle |
$229.12
|
| Rate for Payer: Aetna Commercial |
$299.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.12
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cofinity Commercial |
$246.75
|
| Rate for Payer: Cofinity Commercial |
$303.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$246.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.00
|
| Rate for Payer: Healthscope Commercial |
$317.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.62
|
| Rate for Payer: PHP Commercial |
$299.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.12
|
| Rate for Payer: Priority Health SBD |
$222.07
|
| Rate for Payer: UMR Bronson Commercial |
$155.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.38
|
|
|
DESIPRAMINE 25 MG TABLET
|
Facility
|
OP
|
$352.50
|
|
|
Service Code
|
NDC 50742011301
|
| Hospital Charge Code |
2286
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$130.43 |
| Max. Negotiated Rate |
$317.25 |
| Rate for Payer: Aetna American Axle |
$229.12
|
| Rate for Payer: Aetna Commercial |
$299.62
|
| Rate for Payer: Aetna Medicare |
$176.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.12
|
| Rate for Payer: BCBS Complete |
$141.00
|
| Rate for Payer: Cash Price |
$282.00
|
| Rate for Payer: Cofinity Commercial |
$246.75
|
| Rate for Payer: Cofinity Commercial |
$303.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$246.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.00
|
| Rate for Payer: Healthscope Commercial |
$317.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.62
|
| Rate for Payer: PHP Commercial |
$299.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.12
|
| Rate for Payer: Priority Health SBD |
$222.07
|
| Rate for Payer: UMR Bronson Commercial |
$130.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.38
|
|
|
DESMOPRESSIN 0.1 MG TABLET
|
Facility
|
OP
|
$478.08
|
|
|
Service Code
|
NDC 69918010101
|
| Hospital Charge Code |
16052
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$176.89 |
| Max. Negotiated Rate |
$430.27 |
| Rate for Payer: Aetna American Axle |
$310.75
|
| Rate for Payer: Aetna Commercial |
$406.37
|
| Rate for Payer: Aetna Medicare |
$239.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$310.75
|
| Rate for Payer: BCBS Complete |
$191.23
|
| Rate for Payer: Cash Price |
$382.46
|
| Rate for Payer: Cofinity Commercial |
$334.66
|
| Rate for Payer: Cofinity Commercial |
$411.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$334.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$382.46
|
| Rate for Payer: Healthscope Commercial |
$430.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$334.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$358.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$406.37
|
| Rate for Payer: PHP Commercial |
$406.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$310.75
|
| Rate for Payer: Priority Health SBD |
$301.19
|
| Rate for Payer: UMR Bronson Commercial |
$176.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$358.56
|
|
|
DESMOPRESSIN 0.1 MG TABLET
|
Facility
|
OP
|
$1,309.43
|
|
|
Service Code
|
NDC 00591246401
|
| Hospital Charge Code |
16052
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$484.49 |
| Max. Negotiated Rate |
$1,178.49 |
| Rate for Payer: Aetna American Axle |
$851.13
|
| Rate for Payer: Aetna Commercial |
$1,113.02
|
| Rate for Payer: Aetna Medicare |
$654.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$851.13
|
| Rate for Payer: BCBS Complete |
$523.77
|
| Rate for Payer: Cash Price |
$1,047.54
|
| Rate for Payer: Cofinity Commercial |
$1,126.11
|
| Rate for Payer: Cofinity Commercial |
$916.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$916.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,047.54
|
| Rate for Payer: Healthscope Commercial |
$1,178.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$916.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$982.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,113.02
|
| Rate for Payer: PHP Commercial |
$1,113.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$851.13
|
| Rate for Payer: Priority Health SBD |
$824.94
|
| Rate for Payer: UMR Bronson Commercial |
$484.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$982.07
|
|
|
DESMOPRESSIN 0.1 MG TABLET
|
Facility
|
IP
|
$327.84
|
|
|
Service Code
|
NDC 68462027501
|
| Hospital Charge Code |
16052
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$144.25 |
| Max. Negotiated Rate |
$295.06 |
| Rate for Payer: Aetna American Axle |
$213.10
|
| Rate for Payer: Aetna Commercial |
$278.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.10
|
| Rate for Payer: Cash Price |
$262.27
|
| Rate for Payer: Cofinity Commercial |
$229.49
|
| Rate for Payer: Cofinity Commercial |
$281.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$229.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.27
|
| Rate for Payer: Healthscope Commercial |
$295.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$229.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$245.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.66
|
| Rate for Payer: PHP Commercial |
$278.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.10
|
| Rate for Payer: Priority Health SBD |
$206.54
|
| Rate for Payer: UMR Bronson Commercial |
$144.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$245.88
|
|
|
DESMOPRESSIN 0.1 MG TABLET
|
Facility
|
OP
|
$327.84
|
|
|
Service Code
|
NDC 68462027501
|
| Hospital Charge Code |
16052
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$121.30 |
| Max. Negotiated Rate |
$295.06 |
| Rate for Payer: Aetna American Axle |
$213.10
|
| Rate for Payer: Aetna Commercial |
$278.66
|
| Rate for Payer: Aetna Medicare |
$163.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.10
|
| Rate for Payer: BCBS Complete |
$131.14
|
| Rate for Payer: Cash Price |
$262.27
|
| Rate for Payer: Cofinity Commercial |
$229.49
|
| Rate for Payer: Cofinity Commercial |
$281.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$229.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.27
|
| Rate for Payer: Healthscope Commercial |
$295.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$229.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$245.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.66
|
| Rate for Payer: PHP Commercial |
$278.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.10
|
| Rate for Payer: Priority Health SBD |
$206.54
|
| Rate for Payer: UMR Bronson Commercial |
$121.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$245.88
|
|
|
DESMOPRESSIN 0.1 MG TABLET
|
Facility
|
IP
|
$478.08
|
|
|
Service Code
|
NDC 69918010101
|
| Hospital Charge Code |
16052
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$210.36 |
| Max. Negotiated Rate |
$430.27 |
| Rate for Payer: Aetna American Axle |
$310.75
|
| Rate for Payer: Aetna Commercial |
$406.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$310.75
|
| Rate for Payer: Cash Price |
$382.46
|
| Rate for Payer: Cofinity Commercial |
$334.66
|
| Rate for Payer: Cofinity Commercial |
$411.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$334.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$382.46
|
| Rate for Payer: Healthscope Commercial |
$430.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$334.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$358.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$406.37
|
| Rate for Payer: PHP Commercial |
$406.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$310.75
|
| Rate for Payer: Priority Health SBD |
$301.19
|
| Rate for Payer: UMR Bronson Commercial |
$210.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$358.56
|
|
|
DESMOPRESSIN 0.1 MG TABLET
|
Facility
|
OP
|
$404.20
|
|
|
Service Code
|
NDC 23155048901
|
| Hospital Charge Code |
16052
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$149.55 |
| Max. Negotiated Rate |
$363.78 |
| Rate for Payer: Aetna American Axle |
$262.73
|
| Rate for Payer: Aetna Commercial |
$343.57
|
| Rate for Payer: Aetna Medicare |
$202.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.73
|
| Rate for Payer: BCBS Complete |
$161.68
|
| Rate for Payer: Cash Price |
$323.36
|
| Rate for Payer: Cofinity Commercial |
$282.94
|
| Rate for Payer: Cofinity Commercial |
$347.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$282.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.36
|
| Rate for Payer: Healthscope Commercial |
$363.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$282.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.57
|
| Rate for Payer: PHP Commercial |
$343.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.73
|
| Rate for Payer: Priority Health SBD |
$254.65
|
| Rate for Payer: UMR Bronson Commercial |
$149.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.15
|
|
|
DESMOPRESSIN 0.1 MG TABLET
|
Facility
|
IP
|
$1,309.43
|
|
|
Service Code
|
NDC 00591246401
|
| Hospital Charge Code |
16052
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$576.15 |
| Max. Negotiated Rate |
$1,178.49 |
| Rate for Payer: Aetna American Axle |
$851.13
|
| Rate for Payer: Aetna Commercial |
$1,113.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$851.13
|
| Rate for Payer: Cash Price |
$1,047.54
|
| Rate for Payer: Cofinity Commercial |
$1,126.11
|
| Rate for Payer: Cofinity Commercial |
$916.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$916.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,047.54
|
| Rate for Payer: Healthscope Commercial |
$1,178.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$916.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$982.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,113.02
|
| Rate for Payer: PHP Commercial |
$1,113.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$851.13
|
| Rate for Payer: Priority Health SBD |
$824.94
|
| Rate for Payer: UMR Bronson Commercial |
$576.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$982.07
|
|
|
DESMOPRESSIN 0.1 MG TABLET
|
Facility
|
IP
|
$404.20
|
|
|
Service Code
|
NDC 23155048901
|
| Hospital Charge Code |
16052
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$177.85 |
| Max. Negotiated Rate |
$363.78 |
| Rate for Payer: Aetna American Axle |
$262.73
|
| Rate for Payer: Aetna Commercial |
$343.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.73
|
| Rate for Payer: Cash Price |
$323.36
|
| Rate for Payer: Cofinity Commercial |
$282.94
|
| Rate for Payer: Cofinity Commercial |
$347.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$282.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.36
|
| Rate for Payer: Healthscope Commercial |
$363.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$282.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.57
|
| Rate for Payer: PHP Commercial |
$343.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.73
|
| Rate for Payer: Priority Health SBD |
$254.65
|
| Rate for Payer: UMR Bronson Commercial |
$177.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.15
|
|
|
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY
|
Facility
|
OP
|
$655.06
|
|
|
Service Code
|
NDC 24208034205
|
| Hospital Charge Code |
27770
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$242.37 |
| Max. Negotiated Rate |
$589.55 |
| Rate for Payer: Aetna American Axle |
$425.79
|
| Rate for Payer: Aetna Commercial |
$556.80
|
| Rate for Payer: Aetna Medicare |
$327.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$425.79
|
| Rate for Payer: BCBS Complete |
$262.02
|
| Rate for Payer: Cash Price |
$524.05
|
| Rate for Payer: Cofinity Commercial |
$458.54
|
| Rate for Payer: Cofinity Commercial |
$563.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$458.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.05
|
| Rate for Payer: Healthscope Commercial |
$589.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$458.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$491.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$556.80
|
| Rate for Payer: PHP Commercial |
$556.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$425.79
|
| Rate for Payer: Priority Health SBD |
$412.69
|
| Rate for Payer: UMR Bronson Commercial |
$242.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$491.30
|
|
|
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY
|
Facility
|
IP
|
$655.06
|
|
|
Service Code
|
NDC 24208034205
|
| Hospital Charge Code |
27770
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$288.23 |
| Max. Negotiated Rate |
$589.55 |
| Rate for Payer: Aetna American Axle |
$425.79
|
| Rate for Payer: Aetna Commercial |
$556.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$425.79
|
| Rate for Payer: Cash Price |
$524.05
|
| Rate for Payer: Cofinity Commercial |
$458.54
|
| Rate for Payer: Cofinity Commercial |
$563.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$458.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.05
|
| Rate for Payer: Healthscope Commercial |
$589.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$458.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$491.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$556.80
|
| Rate for Payer: PHP Commercial |
$556.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$425.79
|
| Rate for Payer: Priority Health SBD |
$412.69
|
| Rate for Payer: UMR Bronson Commercial |
$288.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$491.30
|
|
|
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED)
|
Facility
|
IP
|
$211.16
|
|
|
Service Code
|
NDC 60505081500
|
| Hospital Charge Code |
21135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$92.91 |
| Max. Negotiated Rate |
$190.04 |
| Rate for Payer: Aetna American Axle |
$137.25
|
| Rate for Payer: Aetna Commercial |
$179.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.25
|
| Rate for Payer: Cash Price |
$168.93
|
| Rate for Payer: Cofinity Commercial |
$147.81
|
| Rate for Payer: Cofinity Commercial |
$181.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$147.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.93
|
| Rate for Payer: Healthscope Commercial |
$190.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$147.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.49
|
| Rate for Payer: PHP Commercial |
$179.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.25
|
| Rate for Payer: Priority Health SBD |
$133.03
|
| Rate for Payer: UMR Bronson Commercial |
$92.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.37
|
|
|
DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED)
|
Facility
|
OP
|
$211.16
|
|
|
Service Code
|
NDC 60505081500
|
| Hospital Charge Code |
21135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$78.13 |
| Max. Negotiated Rate |
$190.04 |
| Rate for Payer: Aetna American Axle |
$137.25
|
| Rate for Payer: Aetna Commercial |
$179.49
|
| Rate for Payer: Aetna Medicare |
$105.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.25
|
| Rate for Payer: BCBS Complete |
$84.46
|
| Rate for Payer: Cash Price |
$168.93
|
| Rate for Payer: Cofinity Commercial |
$147.81
|
| Rate for Payer: Cofinity Commercial |
$181.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$147.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.93
|
| Rate for Payer: Healthscope Commercial |
$190.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$147.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.49
|
| Rate for Payer: PHP Commercial |
$179.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.25
|
| Rate for Payer: Priority Health SBD |
$133.03
|
| Rate for Payer: UMR Bronson Commercial |
$78.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.37
|
|
|
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$193.01
|
|
|
Service Code
|
HCPCS J2597
|
| Hospital Charge Code |
9748
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$84.92 |
| Max. Negotiated Rate |
$173.71 |
| Rate for Payer: Aetna American Axle |
$125.46
|
| Rate for Payer: Aetna American Axle |
$52.19
|
| Rate for Payer: Aetna American Axle |
$396.54
|
| Rate for Payer: Aetna American Axle |
$174.13
|
| Rate for Payer: Aetna American Axle |
$1,277.30
|
| Rate for Payer: Aetna American Axle |
$38.82
|
| Rate for Payer: Aetna American Axle |
$57.79
|
| Rate for Payer: Aetna Commercial |
$68.25
|
| Rate for Payer: Aetna Commercial |
$1,670.31
|
| Rate for Payer: Aetna Commercial |
$50.76
|
| Rate for Payer: Aetna Commercial |
$518.55
|
| Rate for Payer: Aetna Commercial |
$75.57
|
| Rate for Payer: Aetna Commercial |
$227.71
|
| Rate for Payer: Aetna Commercial |
$164.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,277.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.19
|
| Rate for Payer: Cash Price |
$47.78
|
| Rate for Payer: Cash Price |
$64.23
|
| Rate for Payer: Cash Price |
$1,572.06
|
| Rate for Payer: Cash Price |
$154.41
|
| Rate for Payer: Cash Price |
$214.31
|
| Rate for Payer: Cash Price |
$488.05
|
| Rate for Payer: Cash Price |
$71.13
|
| Rate for Payer: Cofinity Commercial |
$69.05
|
| Rate for Payer: Cofinity Commercial |
$135.11
|
| Rate for Payer: Cofinity Commercial |
$51.36
|
| Rate for Payer: Cofinity Commercial |
$41.80
|
| Rate for Payer: Cofinity Commercial |
$187.52
|
| Rate for Payer: Cofinity Commercial |
$1,375.55
|
| Rate for Payer: Cofinity Commercial |
$1,689.96
|
| Rate for Payer: Cofinity Commercial |
$230.39
|
| Rate for Payer: Cofinity Commercial |
$165.99
|
| Rate for Payer: Cofinity Commercial |
$427.04
|
| Rate for Payer: Cofinity Commercial |
$524.65
|
| Rate for Payer: Cofinity Commercial |
$56.20
|
| Rate for Payer: Cofinity Commercial |
$62.24
|
| Rate for Payer: Cofinity Commercial |
$76.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$187.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$135.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$56.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$427.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,375.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,572.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.41
|
| Rate for Payer: Healthscope Commercial |
$80.02
|
| Rate for Payer: Healthscope Commercial |
$549.05
|
| Rate for Payer: Healthscope Commercial |
$241.10
|
| Rate for Payer: Healthscope Commercial |
$53.75
|
| Rate for Payer: Healthscope Commercial |
$1,768.56
|
| Rate for Payer: Healthscope Commercial |
$173.71
|
| Rate for Payer: Healthscope Commercial |
$72.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,375.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$427.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,473.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,670.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$518.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.25
|
| Rate for Payer: PHP Commercial |
$518.55
|
| Rate for Payer: PHP Commercial |
$227.71
|
| Rate for Payer: PHP Commercial |
$50.76
|
| Rate for Payer: PHP Commercial |
$164.06
|
| Rate for Payer: PHP Commercial |
$1,670.31
|
| Rate for Payer: PHP Commercial |
$75.57
|
| Rate for Payer: PHP Commercial |
$68.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,277.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$396.54
|
| Rate for Payer: Priority Health SBD |
$168.77
|
| Rate for Payer: Priority Health SBD |
$1,237.99
|
| Rate for Payer: Priority Health SBD |
$121.60
|
| Rate for Payer: Priority Health SBD |
$56.01
|
| Rate for Payer: Priority Health SBD |
$50.58
|
| Rate for Payer: Priority Health SBD |
$384.34
|
| Rate for Payer: Priority Health SBD |
$37.62
|
| Rate for Payer: UMR Bronson Commercial |
$26.28
|
| Rate for Payer: UMR Bronson Commercial |
$39.12
|
| Rate for Payer: UMR Bronson Commercial |
$268.43
|
| Rate for Payer: UMR Bronson Commercial |
$35.33
|
| Rate for Payer: UMR Bronson Commercial |
$84.92
|
| Rate for Payer: UMR Bronson Commercial |
$117.87
|
| Rate for Payer: UMR Bronson Commercial |
$864.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,473.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.76
|
|
|
DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$59.72
|
|
|
Service Code
|
HCPCS J2597
|
| Hospital Charge Code |
9748
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.89 |
| Max. Negotiated Rate |
$53.75 |
| Rate for Payer: Aetna American Axle |
$38.82
|
| Rate for Payer: Aetna American Axle |
$125.46
|
| Rate for Payer: Aetna American Axle |
$52.19
|
| Rate for Payer: Aetna American Axle |
$174.13
|
| Rate for Payer: Aetna American Axle |
$1,277.30
|
| Rate for Payer: Aetna American Axle |
$396.54
|
| Rate for Payer: Aetna American Axle |
$57.79
|
| Rate for Payer: Aetna Commercial |
$164.06
|
| Rate for Payer: Aetna Commercial |
$50.76
|
| Rate for Payer: Aetna Commercial |
$68.25
|
| Rate for Payer: Aetna Commercial |
$518.55
|
| Rate for Payer: Aetna Commercial |
$75.57
|
| Rate for Payer: Aetna Commercial |
$227.71
|
| Rate for Payer: Aetna Commercial |
$1,670.31
|
| Rate for Payer: Aetna Medicare |
$3.66
|
| Rate for Payer: Aetna Medicare |
$3.66
|
| Rate for Payer: Aetna Medicare |
$3.66
|
| Rate for Payer: Aetna Medicare |
$3.66
|
| Rate for Payer: Aetna Medicare |
$3.66
|
| Rate for Payer: Aetna Medicare |
$3.66
|
| Rate for Payer: Aetna Medicare |
$3.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,277.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.40
|
| Rate for Payer: BCBS Complete |
$1.98
|
| Rate for Payer: BCBS Complete |
$1.98
|
| Rate for Payer: BCBS Complete |
$1.98
|
| Rate for Payer: BCBS Complete |
$1.98
|
| Rate for Payer: BCBS Complete |
$1.98
|
| Rate for Payer: BCBS Complete |
$1.98
|
| Rate for Payer: BCBS Complete |
$1.98
|
| Rate for Payer: BCBS MAPPO |
$3.52
|
| Rate for Payer: BCBS MAPPO |
$3.52
|
| Rate for Payer: BCBS MAPPO |
$3.52
|
| Rate for Payer: BCBS MAPPO |
$3.52
|
| Rate for Payer: BCBS MAPPO |
$3.52
|
| Rate for Payer: BCBS MAPPO |
$3.52
|
| Rate for Payer: BCBS MAPPO |
$3.52
|
| Rate for Payer: BCN Medicare Advantage |
$3.52
|
| Rate for Payer: BCN Medicare Advantage |
$3.52
|
| Rate for Payer: BCN Medicare Advantage |
$3.52
|
| Rate for Payer: BCN Medicare Advantage |
$3.52
|
| Rate for Payer: BCN Medicare Advantage |
$3.52
|
| Rate for Payer: BCN Medicare Advantage |
$3.52
|
| Rate for Payer: BCN Medicare Advantage |
$3.52
|
| Rate for Payer: Cash Price |
$488.05
|
| Rate for Payer: Cash Price |
$1,572.06
|
| Rate for Payer: Cash Price |
$47.78
|
| Rate for Payer: Cash Price |
$71.13
|
| Rate for Payer: Cash Price |
$71.13
|
| Rate for Payer: Cash Price |
$488.05
|
| Rate for Payer: Cash Price |
$47.78
|
| Rate for Payer: Cash Price |
$64.23
|
| Rate for Payer: Cash Price |
$1,572.06
|
| Rate for Payer: Cash Price |
$214.31
|
| Rate for Payer: Cash Price |
$64.23
|
| Rate for Payer: Cash Price |
$214.31
|
| Rate for Payer: Cash Price |
$154.41
|
| Rate for Payer: Cash Price |
$154.41
|
| Rate for Payer: Cofinity Commercial |
$51.36
|
| Rate for Payer: Cofinity Commercial |
$69.05
|
| Rate for Payer: Cofinity Commercial |
$230.39
|
| Rate for Payer: Cofinity Commercial |
$427.04
|
| Rate for Payer: Cofinity Commercial |
$524.65
|
| Rate for Payer: Cofinity Commercial |
$62.24
|
| Rate for Payer: Cofinity Commercial |
$76.46
|
| Rate for Payer: Cofinity Commercial |
$135.11
|
| Rate for Payer: Cofinity Commercial |
$41.80
|
| Rate for Payer: Cofinity Commercial |
$1,689.96
|
| Rate for Payer: Cofinity Commercial |
$1,375.55
|
| Rate for Payer: Cofinity Commercial |
$187.52
|
| Rate for Payer: Cofinity Commercial |
$165.99
|
| Rate for Payer: Cofinity Commercial |
$56.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$187.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$135.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$56.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,375.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$427.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,572.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.52
|
| Rate for Payer: Healthscope Commercial |
$80.02
|
| Rate for Payer: Healthscope Commercial |
$241.10
|
| Rate for Payer: Healthscope Commercial |
$549.05
|
| Rate for Payer: Healthscope Commercial |
$53.75
|
| Rate for Payer: Healthscope Commercial |
$72.26
|
| Rate for Payer: Healthscope Commercial |
$173.71
|
| Rate for Payer: Healthscope Commercial |
$1,768.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,375.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$427.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,473.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.79
|
| Rate for Payer: Mclaren Medicaid |
$1.89
|
| Rate for Payer: Mclaren Medicaid |
$1.89
|
| Rate for Payer: Mclaren Medicaid |
$1.89
|
| Rate for Payer: Mclaren Medicaid |
$1.89
|
| Rate for Payer: Mclaren Medicaid |
$1.89
|
| Rate for Payer: Mclaren Medicaid |
$1.89
|
| Rate for Payer: Mclaren Medicaid |
$1.89
|
| Rate for Payer: Mclaren Medicare |
$3.52
|
| Rate for Payer: Mclaren Medicare |
$3.52
|
| Rate for Payer: Mclaren Medicare |
$3.52
|
| Rate for Payer: Mclaren Medicare |
$3.52
|
| Rate for Payer: Mclaren Medicare |
$3.52
|
| Rate for Payer: Mclaren Medicare |
$3.52
|
| Rate for Payer: Mclaren Medicare |
$3.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.70
|
| Rate for Payer: Meridian Medicaid |
$1.98
|
| Rate for Payer: Meridian Medicaid |
$1.98
|
| Rate for Payer: Meridian Medicaid |
$1.98
|
| Rate for Payer: Meridian Medicaid |
$1.98
|
| Rate for Payer: Meridian Medicaid |
$1.98
|
| Rate for Payer: Meridian Medicaid |
$1.98
|
| Rate for Payer: Meridian Medicaid |
$1.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,670.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$518.55
|
| Rate for Payer: PACE Medicare |
$3.34
|
| Rate for Payer: PACE Medicare |
$3.34
|
| Rate for Payer: PACE Medicare |
$3.34
|
| Rate for Payer: PACE Medicare |
$3.34
|
| Rate for Payer: PACE Medicare |
$3.34
|
| Rate for Payer: PACE Medicare |
$3.34
|
| Rate for Payer: PACE Medicare |
$3.34
|
| Rate for Payer: PACE SWMI |
$3.52
|
| Rate for Payer: PACE SWMI |
$3.52
|
| Rate for Payer: PACE SWMI |
$3.52
|
| Rate for Payer: PACE SWMI |
$3.52
|
| Rate for Payer: PACE SWMI |
$3.52
|
| Rate for Payer: PACE SWMI |
$3.52
|
| Rate for Payer: PACE SWMI |
$3.52
|
| Rate for Payer: PHP Commercial |
$68.25
|
| Rate for Payer: PHP Commercial |
$1,670.31
|
| Rate for Payer: PHP Commercial |
$75.57
|
| Rate for Payer: PHP Commercial |
$50.76
|
| Rate for Payer: PHP Commercial |
$164.06
|
| Rate for Payer: PHP Commercial |
$227.71
|
| Rate for Payer: PHP Commercial |
$518.55
|
| Rate for Payer: PHP Medicare Advantage |
$3.52
|
| Rate for Payer: PHP Medicare Advantage |
$3.52
|
| Rate for Payer: PHP Medicare Advantage |
$3.52
|
| Rate for Payer: PHP Medicare Advantage |
$3.52
|
| Rate for Payer: PHP Medicare Advantage |
$3.52
|
| Rate for Payer: PHP Medicare Advantage |
$3.52
|
| Rate for Payer: PHP Medicare Advantage |
$3.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,277.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$396.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.82
|
| Rate for Payer: Priority Health Medicare |
$3.52
|
| Rate for Payer: Priority Health Medicare |
$3.52
|
| Rate for Payer: Priority Health Medicare |
$3.52
|
| Rate for Payer: Priority Health Medicare |
$3.52
|
| Rate for Payer: Priority Health Medicare |
$3.52
|
| Rate for Payer: Priority Health Medicare |
$3.52
|
| Rate for Payer: Priority Health Medicare |
$3.52
|
| Rate for Payer: Priority Health SBD |
$56.01
|
| Rate for Payer: Priority Health SBD |
$37.62
|
| Rate for Payer: Priority Health SBD |
$168.77
|
| Rate for Payer: Priority Health SBD |
$384.34
|
| Rate for Payer: Priority Health SBD |
$1,237.99
|
| Rate for Payer: Priority Health SBD |
$50.58
|
| Rate for Payer: Priority Health SBD |
$121.60
|
| Rate for Payer: Railroad Medicare Medicare |
$3.52
|
| Rate for Payer: Railroad Medicare Medicare |
$3.52
|
| Rate for Payer: Railroad Medicare Medicare |
$3.52
|
| Rate for Payer: Railroad Medicare Medicare |
$3.52
|
| Rate for Payer: Railroad Medicare Medicare |
$3.52
|
| Rate for Payer: Railroad Medicare Medicare |
$3.52
|
| Rate for Payer: Railroad Medicare Medicare |
$3.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.52
|
| Rate for Payer: UHC Exchange |
$6.73
|
| Rate for Payer: UHC Exchange |
$6.73
|
| Rate for Payer: UHC Exchange |
$6.73
|
| Rate for Payer: UHC Exchange |
$6.73
|
| Rate for Payer: UHC Exchange |
$6.73
|
| Rate for Payer: UHC Exchange |
$6.73
|
| Rate for Payer: UHC Exchange |
$6.73
|
| Rate for Payer: UHC Medicare Advantage |
$3.52
|
| Rate for Payer: UHC Medicare Advantage |
$3.52
|
| Rate for Payer: UHC Medicare Advantage |
$3.52
|
| Rate for Payer: UHC Medicare Advantage |
$3.52
|
| Rate for Payer: UHC Medicare Advantage |
$3.52
|
| Rate for Payer: UHC Medicare Advantage |
$3.52
|
| Rate for Payer: UHC Medicare Advantage |
$3.52
|
| Rate for Payer: UHCCP Medicaid |
$1.89
|
| Rate for Payer: UHCCP Medicaid |
$1.89
|
| Rate for Payer: UHCCP Medicaid |
$1.89
|
| Rate for Payer: UHCCP Medicaid |
$1.89
|
| Rate for Payer: UHCCP Medicaid |
$1.89
|
| Rate for Payer: UHCCP Medicaid |
$1.89
|
| Rate for Payer: UHCCP Medicaid |
$1.89
|
| Rate for Payer: UMR Bronson Commercial |
$99.12
|
| Rate for Payer: UMR Bronson Commercial |
$29.71
|
| Rate for Payer: UMR Bronson Commercial |
$727.08
|
| Rate for Payer: UMR Bronson Commercial |
$71.41
|
| Rate for Payer: UMR Bronson Commercial |
$32.90
|
| Rate for Payer: UMR Bronson Commercial |
$225.72
|
| Rate for Payer: UMR Bronson Commercial |
$22.10
|
| Rate for Payer: VA VA |
$3.52
|
| Rate for Payer: VA VA |
$3.52
|
| Rate for Payer: VA VA |
$3.52
|
| Rate for Payer: VA VA |
$3.52
|
| Rate for Payer: VA VA |
$3.52
|
| Rate for Payer: VA VA |
$3.52
|
| Rate for Payer: VA VA |
$3.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,473.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.76
|
|
