|
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH PLACEMENT OF ENDOSCOPIC STENT INTO BILIARY OR PANCREATIC DUCT, INCLUDING PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED, INCLUDING SPHINCTEROTOMY, WHEN PERFORMED, EACH STENT
|
Facility
|
OP
|
$19,562.14
|
|
|
Service Code
|
CPT 43274
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,163.66 |
| Max. Negotiated Rate |
$19,562.14 |
| Rate for Payer: Aetna Medicare |
$6,291.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,561.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,561.34
|
| Rate for Payer: BCBS Complete |
$3,322.15
|
| Rate for Payer: BCBS MAPPO |
$6,049.07
|
| Rate for Payer: BCBS Trust/PPO |
$5,556.38
|
| Rate for Payer: BCN Commercial |
$5,556.38
|
| Rate for Payer: BCN Medicare Advantage |
$6,049.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,049.07
|
| Rate for Payer: Mclaren Medicaid |
$6,049.07
|
| Rate for Payer: Mclaren Medicare |
$6,049.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,351.52
|
| Rate for Payer: Meridian Medicaid |
$6,351.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,956.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,653.98
|
| Rate for Payer: Nomi Health Commercial |
$18,147.21
|
| Rate for Payer: PACE Medicare |
$5,746.62
|
| Rate for Payer: PACE SWMI |
$6,049.07
|
| Rate for Payer: PHP Medicare Advantage |
$6,049.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,163.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,562.14
|
| Rate for Payer: Priority Health Medicare |
$6,049.07
|
| Rate for Payer: Priority Health Tiered Network |
$15,649.71
|
| Rate for Payer: Railroad Medicare Medicare |
$6,049.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,049.07
|
| Rate for Payer: UHC Medicaid |
$3,163.66
|
| Rate for Payer: UHCCP Medicaid |
$3,163.66
|
| Rate for Payer: VA VA |
$6,049.07
|
|
|
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH REMOVAL AND EXCHANGE OF STENT(S), BILIARY OR PANCREATIC DUCT, INCLUDING PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED, INCLUDING SPHINCTEROTOMY, WHEN PERFORMED, EACH STENT EXCHANGED
|
Facility
|
OP
|
$19,562.14
|
|
|
Service Code
|
CPT 43276
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,163.66 |
| Max. Negotiated Rate |
$19,562.14 |
| Rate for Payer: Aetna Medicare |
$6,291.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,561.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,561.34
|
| Rate for Payer: BCBS Complete |
$3,322.15
|
| Rate for Payer: BCBS MAPPO |
$6,049.07
|
| Rate for Payer: BCBS Trust/PPO |
$5,920.56
|
| Rate for Payer: BCN Commercial |
$5,920.56
|
| Rate for Payer: BCN Medicare Advantage |
$6,049.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,049.07
|
| Rate for Payer: Mclaren Medicaid |
$6,049.07
|
| Rate for Payer: Mclaren Medicare |
$6,049.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,351.52
|
| Rate for Payer: Meridian Medicaid |
$6,351.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,956.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,653.98
|
| Rate for Payer: Nomi Health Commercial |
$18,147.21
|
| Rate for Payer: PACE Medicare |
$5,746.62
|
| Rate for Payer: PACE SWMI |
$6,049.07
|
| Rate for Payer: PHP Medicare Advantage |
$6,049.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,163.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,562.14
|
| Rate for Payer: Priority Health Medicare |
$6,049.07
|
| Rate for Payer: Priority Health Tiered Network |
$15,649.71
|
| Rate for Payer: Railroad Medicare Medicare |
$6,049.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,049.07
|
| Rate for Payer: UHC Medicaid |
$3,163.66
|
| Rate for Payer: UHCCP Medicaid |
$3,163.66
|
| Rate for Payer: VA VA |
$6,049.07
|
|
|
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH REMOVAL OF CALCULI/DEBRIS FROM BILIARY/PANCREATIC DUCT(S)
|
Facility
|
OP
|
$12,423.42
|
|
|
Service Code
|
CPT 43264
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,009.16 |
| Max. Negotiated Rate |
$12,423.42 |
| Rate for Payer: Aetna Medicare |
$3,995.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,802.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,802.01
|
| Rate for Payer: BCBS Complete |
$2,109.81
|
| Rate for Payer: BCBS MAPPO |
$3,841.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,791.37
|
| Rate for Payer: BCN Commercial |
$3,791.37
|
| Rate for Payer: BCN Medicare Advantage |
$3,841.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,841.61
|
| Rate for Payer: Mclaren Medicaid |
$3,841.61
|
| Rate for Payer: Mclaren Medicare |
$3,841.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,033.69
|
| Rate for Payer: Meridian Medicaid |
$4,033.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,417.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,225.77
|
| Rate for Payer: Nomi Health Commercial |
$11,524.83
|
| Rate for Payer: PACE Medicare |
$3,649.53
|
| Rate for Payer: PACE SWMI |
$3,841.61
|
| Rate for Payer: PHP Medicare Advantage |
$3,841.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,009.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,423.42
|
| Rate for Payer: Priority Health Medicare |
$3,841.61
|
| Rate for Payer: Priority Health Tiered Network |
$9,938.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,841.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,841.61
|
| Rate for Payer: UHC Medicaid |
$2,009.16
|
| Rate for Payer: UHCCP Medicaid |
$2,009.16
|
| Rate for Payer: VA VA |
$3,841.61
|
|
|
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH REMOVAL OF FOREIGN BODY(S) OR STENT(S) FROM BILIARY/PANCREATIC DUCT(S)
|
Facility
|
OP
|
$6,183.25
|
|
|
Service Code
|
CPT 43275
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$999.98 |
| Max. Negotiated Rate |
$6,183.25 |
| Rate for Payer: Aetna Medicare |
$1,988.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,390.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,390.01
|
| Rate for Payer: BCBS Complete |
$1,050.08
|
| Rate for Payer: BCBS MAPPO |
$1,912.01
|
| Rate for Payer: BCBS Trust/PPO |
$3,815.61
|
| Rate for Payer: BCN Commercial |
$3,815.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,912.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,912.01
|
| Rate for Payer: Mclaren Medicaid |
$1,912.01
|
| Rate for Payer: Mclaren Medicare |
$1,912.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,007.61
|
| Rate for Payer: Meridian Medicaid |
$2,007.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,198.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,103.21
|
| Rate for Payer: Nomi Health Commercial |
$5,736.03
|
| Rate for Payer: PACE Medicare |
$1,816.41
|
| Rate for Payer: PACE SWMI |
$1,912.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,912.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$999.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,183.25
|
| Rate for Payer: Priority Health Medicare |
$1,912.01
|
| Rate for Payer: Priority Health Tiered Network |
$4,946.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,912.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,912.01
|
| Rate for Payer: UHC Medicaid |
$999.98
|
| Rate for Payer: UHCCP Medicaid |
$999.98
|
| Rate for Payer: VA VA |
$1,912.01
|
|
|
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH SPHINCTEROTOMY/PAPILLOTOMY
|
Facility
|
OP
|
$12,423.42
|
|
|
Service Code
|
CPT 43262
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,009.16 |
| Max. Negotiated Rate |
$12,423.42 |
| Rate for Payer: Aetna Medicare |
$3,995.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,802.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,802.01
|
| Rate for Payer: BCBS Complete |
$2,109.81
|
| Rate for Payer: BCBS MAPPO |
$3,841.61
|
| Rate for Payer: BCBS Trust/PPO |
$4,146.12
|
| Rate for Payer: BCN Commercial |
$4,146.12
|
| Rate for Payer: BCN Medicare Advantage |
$3,841.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,841.61
|
| Rate for Payer: Mclaren Medicaid |
$3,841.61
|
| Rate for Payer: Mclaren Medicare |
$3,841.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,033.69
|
| Rate for Payer: Meridian Medicaid |
$4,033.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,417.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,225.77
|
| Rate for Payer: Nomi Health Commercial |
$11,524.83
|
| Rate for Payer: PACE Medicare |
$3,649.53
|
| Rate for Payer: PACE SWMI |
$3,841.61
|
| Rate for Payer: PHP Medicare Advantage |
$3,841.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,009.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,423.42
|
| Rate for Payer: Priority Health Medicare |
$3,841.61
|
| Rate for Payer: Priority Health Tiered Network |
$9,938.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,841.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,841.61
|
| Rate for Payer: UHC Medicaid |
$2,009.16
|
| Rate for Payer: UHCCP Medicaid |
$2,009.16
|
| Rate for Payer: VA VA |
$3,841.61
|
|
|
ENDOSCOPY, WRIST, SURGICAL, WITH RELEASE OF TRANSVERSE CARPAL LIGAMENT
|
Facility
|
OP
|
$5,181.40
|
|
|
Service Code
|
CPT 29848
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$837.96 |
| Max. Negotiated Rate |
$5,181.40 |
| Rate for Payer: Aetna Medicare |
$1,666.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,089.20
|
| Rate for Payer: BCN Commercial |
$3,089.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Mclaren Medicaid |
$1,602.21
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$1,682.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Nomi Health Commercial |
$4,806.63
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,181.40
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health Tiered Network |
$4,145.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,602.21
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: VA VA |
$1,602.21
|
|
|
ENDOVASCULAR ABDOMINAL AORTA WITH ILIAC BRANCH PROCEDURES
|
Facility
|
IP
|
$107,105.57
|
|
|
Service Code
|
MSDRG 213
|
| Min. Negotiated Rate |
$45,902.12 |
| Max. Negotiated Rate |
$107,105.57 |
| Rate for Payer: Aetna Medicare |
$50,250.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60,397.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60,397.53
|
| Rate for Payer: BCBS MAPPO |
$48,318.02
|
| Rate for Payer: BCBS Trust/PPO |
$107,105.57
|
| Rate for Payer: BCN Commercial |
$107,105.57
|
| Rate for Payer: BCN Medicare Advantage |
$48,318.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48,318.02
|
| Rate for Payer: Mclaren Medicare |
$48,318.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50,733.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55,565.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$53,149.82
|
| Rate for Payer: Nomi Health Commercial |
$73,619.01
|
| Rate for Payer: PACE Medicare |
$45,902.12
|
| Rate for Payer: PACE SWMI |
$48,318.02
|
| Rate for Payer: PHP Medicare Advantage |
$48,318.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$92,007.44
|
| Rate for Payer: Priority Health Medicare |
$48,318.02
|
| Rate for Payer: Priority Health Tiered Network |
$73,605.94
|
| Rate for Payer: Railroad Medicare Medicare |
$48,318.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93,022.47
|
| Rate for Payer: UHC Core |
$77,825.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48,318.02
|
| Rate for Payer: UHC Exchange |
$63,557.75
|
| Rate for Payer: VA VA |
$48,318.02
|
|
|
ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC
|
Facility
|
IP
|
$135,432.25
|
|
|
Service Code
|
MSDRG 266
|
| Min. Negotiated Rate |
$49,250.76 |
| Max. Negotiated Rate |
$135,432.25 |
| Rate for Payer: Aetna Medicare |
$53,916.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64,803.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64,803.64
|
| Rate for Payer: BCBS MAPPO |
$51,842.91
|
| Rate for Payer: BCBS Trust/PPO |
$135,432.25
|
| Rate for Payer: BCN Commercial |
$135,432.25
|
| Rate for Payer: BCN Medicare Advantage |
$51,842.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51,842.91
|
| Rate for Payer: Mclaren Medicare |
$51,842.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54,435.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59,619.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$57,027.20
|
| Rate for Payer: Nomi Health Commercial |
$79,056.36
|
| Rate for Payer: PACE Medicare |
$49,250.76
|
| Rate for Payer: PACE SWMI |
$51,842.91
|
| Rate for Payer: PHP Medicare Advantage |
$51,842.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$98,802.92
|
| Rate for Payer: Priority Health Medicare |
$51,842.91
|
| Rate for Payer: Priority Health Tiered Network |
$79,042.33
|
| Rate for Payer: Railroad Medicare Medicare |
$51,842.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99,892.92
|
| Rate for Payer: UHC Core |
$83,572.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51,842.91
|
| Rate for Payer: UHC Exchange |
$68,251.99
|
| Rate for Payer: VA VA |
$51,842.91
|
|
|
ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$113,658.12
|
|
|
Service Code
|
MSDRG 267
|
| Min. Negotiated Rate |
$38,385.78 |
| Max. Negotiated Rate |
$113,658.12 |
| Rate for Payer: Aetna Medicare |
$42,022.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50,507.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50,507.60
|
| Rate for Payer: BCBS MAPPO |
$40,406.08
|
| Rate for Payer: BCBS Trust/PPO |
$113,658.12
|
| Rate for Payer: BCN Commercial |
$113,658.12
|
| Rate for Payer: BCN Medicare Advantage |
$40,406.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40,406.08
|
| Rate for Payer: Mclaren Medicare |
$40,406.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42,426.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46,466.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$44,446.69
|
| Rate for Payer: Nomi Health Commercial |
$61,414.32
|
| Rate for Payer: PACE Medicare |
$38,385.78
|
| Rate for Payer: PACE SWMI |
$40,406.08
|
| Rate for Payer: PHP Medicare Advantage |
$40,406.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$76,754.28
|
| Rate for Payer: Priority Health Medicare |
$40,406.08
|
| Rate for Payer: Priority Health Tiered Network |
$61,403.42
|
| Rate for Payer: Railroad Medicare Medicare |
$40,406.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77,601.04
|
| Rate for Payer: UHC Core |
$64,923.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40,406.08
|
| Rate for Payer: UHC Exchange |
$53,021.03
|
| Rate for Payer: VA VA |
$40,406.08
|
|
|
ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY, INCLUSIVE OF ALL IMAGING GUIDANCE AND MONITORING, PERCUTANEOUS, RADIOFREQUENCY; FIRST VEIN TREATED
|
Facility
|
OP
|
$10,174.29
|
|
|
Service Code
|
CPT 36475
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,312.53
|
| Rate for Payer: BCN Commercial |
$3,312.53
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY, INCLUSIVE OF ALL IMAGING GUIDANCE AND MONITORING, PERCUTANEOUS, RADIOFREQUENCY; FIRST VEIN TREATED
|
Facility
|
OP
|
$10,174.29
|
|
|
Service Code
|
CPT 36475
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,312.53
|
| Rate for Payer: BCN Commercial |
$3,312.53
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
ENFORTUMAB VEDOTIN-EJFV 20 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$12,612.41
|
|
|
Service Code
|
HCPCS J9177
|
| Hospital Charge Code |
192400
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$11,351.17 |
| Rate for Payer: Aetna American Axle |
$8,198.07
|
| Rate for Payer: Aetna Commercial |
$10,720.55
|
| Rate for Payer: Aetna Medicare |
$38.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,198.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.89
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$36.71
|
| Rate for Payer: BCBS Trust/PPO |
$119.06
|
| Rate for Payer: BCN Commercial |
$119.06
|
| Rate for Payer: BCN Medicare Advantage |
$36.71
|
| Rate for Payer: Cash Price |
$10,089.93
|
| Rate for Payer: Cash Price |
$10,089.93
|
| Rate for Payer: Cofinity Advantage |
$8,828.69
|
| Rate for Payer: Cofinity Commercial |
$10,846.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,089.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.71
|
| Rate for Payer: Healthscope Commercial |
$11,351.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,828.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,459.31
|
| Rate for Payer: Mclaren Medicaid |
$36.71
|
| Rate for Payer: Mclaren Medicare |
$36.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.55
|
| Rate for Payer: Meridian Medicaid |
$38.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,720.55
|
| Rate for Payer: Nomi Health Commercial |
$110.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,459.31
|
| Rate for Payer: PACE Medicare |
$34.87
|
| Rate for Payer: PACE SWMI |
$36.71
|
| Rate for Payer: PHP Commercial |
$10,720.55
|
| Rate for Payer: PHP Medicare Advantage |
$36.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$115.88
|
| Rate for Payer: Priority Health Medicare |
$36.71
|
| Rate for Payer: Priority Health SBD |
$7,945.82
|
| Rate for Payer: Priority Health Tiered Network |
$92.70
|
| Rate for Payer: Railroad Medicare Medicare |
$36.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.59
|
| Rate for Payer: UHC Core |
$60.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.71
|
| Rate for Payer: UHC Exchange |
$60.59
|
| Rate for Payer: UHC Medicaid |
$19.20
|
| Rate for Payer: UHCCP Medicaid |
$19.20
|
| Rate for Payer: UMR Bronson Commercial |
$4,666.59
|
| Rate for Payer: VA VA |
$36.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,459.31
|
|
|
ENFORTUMAB VEDOTIN-EJFV 30 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$18,918.62
|
|
|
Service Code
|
HCPCS J9177
|
| Hospital Charge Code |
192401
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$17,026.76 |
| Rate for Payer: Aetna American Axle |
$12,297.10
|
| Rate for Payer: Aetna Commercial |
$16,080.83
|
| Rate for Payer: Aetna Medicare |
$38.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,297.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.89
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$36.71
|
| Rate for Payer: BCBS Trust/PPO |
$119.06
|
| Rate for Payer: BCN Commercial |
$119.06
|
| Rate for Payer: BCN Medicare Advantage |
$36.71
|
| Rate for Payer: Cash Price |
$15,134.90
|
| Rate for Payer: Cash Price |
$15,134.90
|
| Rate for Payer: Cofinity Advantage |
$13,243.03
|
| Rate for Payer: Cofinity Commercial |
$16,270.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,134.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.71
|
| Rate for Payer: Healthscope Commercial |
$17,026.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,243.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,188.97
|
| Rate for Payer: Mclaren Medicaid |
$36.71
|
| Rate for Payer: Mclaren Medicare |
$36.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.55
|
| Rate for Payer: Meridian Medicaid |
$38.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,080.83
|
| Rate for Payer: Nomi Health Commercial |
$110.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,188.97
|
| Rate for Payer: PACE Medicare |
$34.87
|
| Rate for Payer: PACE SWMI |
$36.71
|
| Rate for Payer: PHP Commercial |
$16,080.83
|
| Rate for Payer: PHP Medicare Advantage |
$36.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$115.88
|
| Rate for Payer: Priority Health Medicare |
$36.71
|
| Rate for Payer: Priority Health SBD |
$11,918.73
|
| Rate for Payer: Priority Health Tiered Network |
$92.70
|
| Rate for Payer: Railroad Medicare Medicare |
$36.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.59
|
| Rate for Payer: UHC Core |
$60.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.71
|
| Rate for Payer: UHC Exchange |
$60.59
|
| Rate for Payer: UHC Medicaid |
$19.20
|
| Rate for Payer: UHCCP Medicaid |
$19.20
|
| Rate for Payer: UMR Bronson Commercial |
$6,999.89
|
| Rate for Payer: VA VA |
$36.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,188.97
|
|
|
ENFUVIRTIDE 90 MG SUBCUTANEOUS SOLUTION
|
Facility
|
IP
|
$9,322.41
|
|
|
Service Code
|
NDC 00004038140
|
| Hospital Charge Code |
159192
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4,101.86 |
| Max. Negotiated Rate |
$8,390.17 |
| Rate for Payer: Aetna American Axle |
$6,059.57
|
| Rate for Payer: Aetna Commercial |
$7,924.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,059.57
|
| Rate for Payer: Cash Price |
$7,457.93
|
| Rate for Payer: Cofinity Advantage |
$6,525.69
|
| Rate for Payer: Cofinity Commercial |
$8,017.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,457.93
|
| Rate for Payer: Healthscope Commercial |
$8,390.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,525.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,991.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,924.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,991.81
|
| Rate for Payer: PHP Commercial |
$7,924.05
|
| Rate for Payer: Priority Health SBD |
$5,873.12
|
| Rate for Payer: UMR Bronson Commercial |
$4,101.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,991.81
|
|
|
ENFUVIRTIDE 90 MG SUBCUTANEOUS SOLUTION
|
Facility
|
OP
|
$9,322.41
|
|
|
Service Code
|
NDC 00004038140
|
| Hospital Charge Code |
159192
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3,449.29 |
| Max. Negotiated Rate |
$8,390.17 |
| Rate for Payer: Aetna American Axle |
$6,059.57
|
| Rate for Payer: Aetna Commercial |
$7,924.05
|
| Rate for Payer: Aetna Medicare |
$4,661.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,059.57
|
| Rate for Payer: BCBS Complete |
$3,728.96
|
| Rate for Payer: Cash Price |
$7,457.93
|
| Rate for Payer: Cofinity Advantage |
$6,525.69
|
| Rate for Payer: Cofinity Commercial |
$8,017.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,457.93
|
| Rate for Payer: Healthscope Commercial |
$8,390.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,525.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,991.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,457.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,924.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,991.81
|
| Rate for Payer: PHP Commercial |
$7,924.05
|
| Rate for Payer: Priority Health SBD |
$5,873.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,059.57
|
| Rate for Payer: UHC Core |
$4,856.98
|
| Rate for Payer: UHC Exchange |
$3,663.71
|
| Rate for Payer: UMR Bronson Commercial |
$3,449.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,991.81
|
|
|
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$62.08
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105903
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$55.87 |
| Rate for Payer: Aetna American Axle |
$40.35
|
| Rate for Payer: Aetna American Axle |
$70.04
|
| Rate for Payer: Aetna American Axle |
$19.78
|
| Rate for Payer: Aetna American Axle |
$24.78
|
| Rate for Payer: Aetna Commercial |
$52.77
|
| Rate for Payer: Aetna Commercial |
$32.40
|
| Rate for Payer: Aetna Commercial |
$91.60
|
| Rate for Payer: Aetna Commercial |
$25.87
|
| Rate for Payer: Aetna Medicare |
$19.06
|
| Rate for Payer: Aetna Medicare |
$15.21
|
| Rate for Payer: Aetna Medicare |
$31.04
|
| Rate for Payer: Aetna Medicare |
$53.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.78
|
| Rate for Payer: BCBS Complete |
$43.10
|
| Rate for Payer: BCBS Complete |
$12.17
|
| Rate for Payer: BCBS Complete |
$15.25
|
| Rate for Payer: BCBS Complete |
$24.83
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: Cash Price |
$30.50
|
| Rate for Payer: Cash Price |
$49.66
|
| Rate for Payer: Cash Price |
$86.21
|
| Rate for Payer: Cash Price |
$49.66
|
| Rate for Payer: Cash Price |
$30.50
|
| Rate for Payer: Cash Price |
$24.34
|
| Rate for Payer: Cash Price |
$24.34
|
| Rate for Payer: Cash Price |
$86.21
|
| Rate for Payer: Cofinity Advantage |
$43.46
|
| Rate for Payer: Cofinity Advantage |
$26.68
|
| Rate for Payer: Cofinity Advantage |
$21.30
|
| Rate for Payer: Cofinity Advantage |
$75.43
|
| Rate for Payer: Cofinity Commercial |
$26.17
|
| Rate for Payer: Cofinity Commercial |
$32.78
|
| Rate for Payer: Cofinity Commercial |
$53.39
|
| Rate for Payer: Cofinity Commercial |
$92.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.21
|
| Rate for Payer: Healthscope Commercial |
$34.31
|
| Rate for Payer: Healthscope Commercial |
$96.98
|
| Rate for Payer: Healthscope Commercial |
$27.39
|
| Rate for Payer: Healthscope Commercial |
$55.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.56
|
| Rate for Payer: PHP Commercial |
$91.60
|
| Rate for Payer: PHP Commercial |
$32.40
|
| Rate for Payer: PHP Commercial |
$52.77
|
| Rate for Payer: PHP Commercial |
$25.87
|
| Rate for Payer: Priority Health SBD |
$24.02
|
| Rate for Payer: Priority Health SBD |
$67.89
|
| Rate for Payer: Priority Health SBD |
$19.17
|
| Rate for Payer: Priority Health SBD |
$39.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UMR Bronson Commercial |
$22.97
|
| Rate for Payer: UMR Bronson Commercial |
$39.87
|
| Rate for Payer: UMR Bronson Commercial |
$11.26
|
| Rate for Payer: UMR Bronson Commercial |
$14.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.56
|
|
|
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$38.12
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105903
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.77 |
| Max. Negotiated Rate |
$34.31 |
| Rate for Payer: Aetna American Axle |
$24.78
|
| Rate for Payer: Aetna American Axle |
$19.78
|
| Rate for Payer: Aetna American Axle |
$40.35
|
| Rate for Payer: Aetna American Axle |
$70.04
|
| Rate for Payer: Aetna Commercial |
$52.77
|
| Rate for Payer: Aetna Commercial |
$32.40
|
| Rate for Payer: Aetna Commercial |
$91.60
|
| Rate for Payer: Aetna Commercial |
$25.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.04
|
| Rate for Payer: Cash Price |
$86.21
|
| Rate for Payer: Cash Price |
$49.66
|
| Rate for Payer: Cash Price |
$24.34
|
| Rate for Payer: Cash Price |
$30.50
|
| Rate for Payer: Cofinity Advantage |
$21.30
|
| Rate for Payer: Cofinity Advantage |
$75.43
|
| Rate for Payer: Cofinity Advantage |
$26.68
|
| Rate for Payer: Cofinity Advantage |
$43.46
|
| Rate for Payer: Cofinity Commercial |
$32.78
|
| Rate for Payer: Cofinity Commercial |
$92.67
|
| Rate for Payer: Cofinity Commercial |
$26.17
|
| Rate for Payer: Cofinity Commercial |
$53.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.34
|
| Rate for Payer: Healthscope Commercial |
$27.39
|
| Rate for Payer: Healthscope Commercial |
$55.87
|
| Rate for Payer: Healthscope Commercial |
$34.31
|
| Rate for Payer: Healthscope Commercial |
$96.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.82
|
| Rate for Payer: PHP Commercial |
$91.60
|
| Rate for Payer: PHP Commercial |
$32.40
|
| Rate for Payer: PHP Commercial |
$25.87
|
| Rate for Payer: PHP Commercial |
$52.77
|
| Rate for Payer: Priority Health SBD |
$39.11
|
| Rate for Payer: Priority Health SBD |
$67.89
|
| Rate for Payer: Priority Health SBD |
$24.02
|
| Rate for Payer: Priority Health SBD |
$19.17
|
| Rate for Payer: UMR Bronson Commercial |
$13.39
|
| Rate for Payer: UMR Bronson Commercial |
$16.77
|
| Rate for Payer: UMR Bronson Commercial |
$47.41
|
| Rate for Payer: UMR Bronson Commercial |
$27.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.56
|
|
|
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$74.50
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105904
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$32.78 |
| Max. Negotiated Rate |
$67.05 |
| Rate for Payer: Aetna American Axle |
$48.42
|
| Rate for Payer: Aetna American Axle |
$29.65
|
| Rate for Payer: Aetna American Axle |
$22.94
|
| Rate for Payer: Aetna American Axle |
$68.97
|
| Rate for Payer: Aetna American Axle |
$17.48
|
| Rate for Payer: Aetna American Axle |
$84.08
|
| Rate for Payer: Aetna Commercial |
$63.33
|
| Rate for Payer: Aetna Commercial |
$22.86
|
| Rate for Payer: Aetna Commercial |
$30.00
|
| Rate for Payer: Aetna Commercial |
$109.96
|
| Rate for Payer: Aetna Commercial |
$38.77
|
| Rate for Payer: Aetna Commercial |
$90.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.97
|
| Rate for Payer: Cash Price |
$59.60
|
| Rate for Payer: Cash Price |
$36.49
|
| Rate for Payer: Cash Price |
$28.23
|
| Rate for Payer: Cash Price |
$84.89
|
| Rate for Payer: Cash Price |
$21.52
|
| Rate for Payer: Cash Price |
$103.49
|
| Rate for Payer: Cofinity Advantage |
$24.70
|
| Rate for Payer: Cofinity Advantage |
$90.55
|
| Rate for Payer: Cofinity Advantage |
$74.28
|
| Rate for Payer: Cofinity Advantage |
$31.93
|
| Rate for Payer: Cofinity Advantage |
$18.83
|
| Rate for Payer: Cofinity Advantage |
$52.15
|
| Rate for Payer: Cofinity Commercial |
$111.25
|
| Rate for Payer: Cofinity Commercial |
$30.35
|
| Rate for Payer: Cofinity Commercial |
$39.22
|
| Rate for Payer: Cofinity Commercial |
$91.25
|
| Rate for Payer: Cofinity Commercial |
$23.13
|
| Rate for Payer: Cofinity Commercial |
$64.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.60
|
| Rate for Payer: Healthscope Commercial |
$41.05
|
| Rate for Payer: Healthscope Commercial |
$95.50
|
| Rate for Payer: Healthscope Commercial |
$31.76
|
| Rate for Payer: Healthscope Commercial |
$116.42
|
| Rate for Payer: Healthscope Commercial |
$24.21
|
| Rate for Payer: Healthscope Commercial |
$67.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.18
|
| Rate for Payer: PHP Commercial |
$22.86
|
| Rate for Payer: PHP Commercial |
$63.33
|
| Rate for Payer: PHP Commercial |
$38.77
|
| Rate for Payer: PHP Commercial |
$30.00
|
| Rate for Payer: PHP Commercial |
$90.19
|
| Rate for Payer: PHP Commercial |
$109.96
|
| Rate for Payer: Priority Health SBD |
$28.73
|
| Rate for Payer: Priority Health SBD |
$81.50
|
| Rate for Payer: Priority Health SBD |
$66.85
|
| Rate for Payer: Priority Health SBD |
$16.95
|
| Rate for Payer: Priority Health SBD |
$22.23
|
| Rate for Payer: Priority Health SBD |
$46.94
|
| Rate for Payer: UMR Bronson Commercial |
$20.07
|
| Rate for Payer: UMR Bronson Commercial |
$11.84
|
| Rate for Payer: UMR Bronson Commercial |
$15.53
|
| Rate for Payer: UMR Bronson Commercial |
$56.92
|
| Rate for Payer: UMR Bronson Commercial |
$32.78
|
| Rate for Payer: UMR Bronson Commercial |
$46.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.18
|
|
|
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$129.36
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105904
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$116.42 |
| Rate for Payer: Aetna American Axle |
$84.08
|
| Rate for Payer: Aetna American Axle |
$22.94
|
| Rate for Payer: Aetna American Axle |
$29.65
|
| Rate for Payer: Aetna American Axle |
$68.97
|
| Rate for Payer: Aetna American Axle |
$48.42
|
| Rate for Payer: Aetna American Axle |
$17.48
|
| Rate for Payer: Aetna Commercial |
$63.33
|
| Rate for Payer: Aetna Commercial |
$38.77
|
| Rate for Payer: Aetna Commercial |
$22.86
|
| Rate for Payer: Aetna Commercial |
$90.19
|
| Rate for Payer: Aetna Commercial |
$30.00
|
| Rate for Payer: Aetna Commercial |
$109.96
|
| Rate for Payer: Aetna Medicare |
$53.05
|
| Rate for Payer: Aetna Medicare |
$64.68
|
| Rate for Payer: Aetna Medicare |
$13.45
|
| Rate for Payer: Aetna Medicare |
$37.25
|
| Rate for Payer: Aetna Medicare |
$22.80
|
| Rate for Payer: Aetna Medicare |
$17.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.94
|
| Rate for Payer: BCBS Complete |
$10.76
|
| Rate for Payer: BCBS Complete |
$51.74
|
| Rate for Payer: BCBS Complete |
$42.44
|
| Rate for Payer: BCBS Complete |
$14.12
|
| Rate for Payer: BCBS Complete |
$18.24
|
| Rate for Payer: BCBS Complete |
$29.80
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: Cash Price |
$59.60
|
| Rate for Payer: Cash Price |
$84.89
|
| Rate for Payer: Cash Price |
$84.89
|
| Rate for Payer: Cash Price |
$21.52
|
| Rate for Payer: Cash Price |
$21.52
|
| Rate for Payer: Cash Price |
$103.49
|
| Rate for Payer: Cash Price |
$103.49
|
| Rate for Payer: Cash Price |
$59.60
|
| Rate for Payer: Cash Price |
$36.49
|
| Rate for Payer: Cash Price |
$28.23
|
| Rate for Payer: Cash Price |
$36.49
|
| Rate for Payer: Cash Price |
$28.23
|
| Rate for Payer: Cofinity Advantage |
$24.70
|
| Rate for Payer: Cofinity Advantage |
$18.83
|
| Rate for Payer: Cofinity Advantage |
$52.15
|
| Rate for Payer: Cofinity Advantage |
$74.28
|
| Rate for Payer: Cofinity Advantage |
$90.55
|
| Rate for Payer: Cofinity Advantage |
$31.93
|
| Rate for Payer: Cofinity Commercial |
$39.22
|
| Rate for Payer: Cofinity Commercial |
$91.25
|
| Rate for Payer: Cofinity Commercial |
$111.25
|
| Rate for Payer: Cofinity Commercial |
$23.13
|
| Rate for Payer: Cofinity Commercial |
$30.35
|
| Rate for Payer: Cofinity Commercial |
$64.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.49
|
| Rate for Payer: Healthscope Commercial |
$95.50
|
| Rate for Payer: Healthscope Commercial |
$41.05
|
| Rate for Payer: Healthscope Commercial |
$24.21
|
| Rate for Payer: Healthscope Commercial |
$31.76
|
| Rate for Payer: Healthscope Commercial |
$67.05
|
| Rate for Payer: Healthscope Commercial |
$116.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.18
|
| Rate for Payer: PHP Commercial |
$109.96
|
| Rate for Payer: PHP Commercial |
$22.86
|
| Rate for Payer: PHP Commercial |
$30.00
|
| Rate for Payer: PHP Commercial |
$90.19
|
| Rate for Payer: PHP Commercial |
$38.77
|
| Rate for Payer: PHP Commercial |
$63.33
|
| Rate for Payer: Priority Health SBD |
$22.23
|
| Rate for Payer: Priority Health SBD |
$66.85
|
| Rate for Payer: Priority Health SBD |
$81.50
|
| Rate for Payer: Priority Health SBD |
$46.94
|
| Rate for Payer: Priority Health SBD |
$16.95
|
| Rate for Payer: Priority Health SBD |
$28.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UMR Bronson Commercial |
$13.06
|
| Rate for Payer: UMR Bronson Commercial |
$16.88
|
| Rate for Payer: UMR Bronson Commercial |
$47.86
|
| Rate for Payer: UMR Bronson Commercial |
$39.26
|
| Rate for Payer: UMR Bronson Commercial |
$27.57
|
| Rate for Payer: UMR Bronson Commercial |
$9.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.02
|
|
|
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$161.70
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
31921
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$71.15 |
| Max. Negotiated Rate |
$145.53 |
| Rate for Payer: Aetna American Axle |
$105.11
|
| Rate for Payer: Aetna American Axle |
$60.53
|
| Rate for Payer: Aetna American Axle |
$31.64
|
| Rate for Payer: Aetna Commercial |
$41.37
|
| Rate for Payer: Aetna Commercial |
$137.44
|
| Rate for Payer: Aetna Commercial |
$79.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.64
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cash Price |
$129.36
|
| Rate for Payer: Cash Price |
$74.50
|
| Rate for Payer: Cofinity Advantage |
$65.18
|
| Rate for Payer: Cofinity Advantage |
$113.19
|
| Rate for Payer: Cofinity Advantage |
$34.07
|
| Rate for Payer: Cofinity Commercial |
$80.08
|
| Rate for Payer: Cofinity Commercial |
$139.06
|
| Rate for Payer: Cofinity Commercial |
$41.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.50
|
| Rate for Payer: Healthscope Commercial |
$43.80
|
| Rate for Payer: Healthscope Commercial |
$83.81
|
| Rate for Payer: Healthscope Commercial |
$145.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.84
|
| Rate for Payer: PHP Commercial |
$41.37
|
| Rate for Payer: PHP Commercial |
$137.44
|
| Rate for Payer: PHP Commercial |
$79.15
|
| Rate for Payer: Priority Health SBD |
$101.87
|
| Rate for Payer: Priority Health SBD |
$30.66
|
| Rate for Payer: Priority Health SBD |
$58.67
|
| Rate for Payer: UMR Bronson Commercial |
$71.15
|
| Rate for Payer: UMR Bronson Commercial |
$40.97
|
| Rate for Payer: UMR Bronson Commercial |
$21.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.84
|
|
|
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$48.67
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
31921
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$43.80 |
| Rate for Payer: Aetna American Axle |
$31.64
|
| Rate for Payer: Aetna American Axle |
$105.11
|
| Rate for Payer: Aetna American Axle |
$60.53
|
| Rate for Payer: Aetna Commercial |
$41.37
|
| Rate for Payer: Aetna Commercial |
$79.15
|
| Rate for Payer: Aetna Commercial |
$137.44
|
| Rate for Payer: Aetna Medicare |
$24.34
|
| Rate for Payer: Aetna Medicare |
$80.85
|
| Rate for Payer: Aetna Medicare |
$46.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.53
|
| Rate for Payer: BCBS Complete |
$64.68
|
| Rate for Payer: BCBS Complete |
$19.47
|
| Rate for Payer: BCBS Complete |
$37.25
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: Cash Price |
$129.36
|
| Rate for Payer: Cash Price |
$129.36
|
| Rate for Payer: Cash Price |
$74.50
|
| Rate for Payer: Cash Price |
$74.50
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cofinity Advantage |
$65.18
|
| Rate for Payer: Cofinity Advantage |
$34.07
|
| Rate for Payer: Cofinity Advantage |
$113.19
|
| Rate for Payer: Cofinity Commercial |
$139.06
|
| Rate for Payer: Cofinity Commercial |
$41.86
|
| Rate for Payer: Cofinity Commercial |
$80.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.94
|
| Rate for Payer: Healthscope Commercial |
$145.53
|
| Rate for Payer: Healthscope Commercial |
$43.80
|
| Rate for Payer: Healthscope Commercial |
$83.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.84
|
| Rate for Payer: PHP Commercial |
$41.37
|
| Rate for Payer: PHP Commercial |
$137.44
|
| Rate for Payer: PHP Commercial |
$79.15
|
| Rate for Payer: Priority Health SBD |
$101.87
|
| Rate for Payer: Priority Health SBD |
$58.67
|
| Rate for Payer: Priority Health SBD |
$30.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UMR Bronson Commercial |
$34.45
|
| Rate for Payer: UMR Bronson Commercial |
$59.83
|
| Rate for Payer: UMR Bronson Commercial |
$18.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.84
|
|
|
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION
|
Facility
|
IP
|
$821.23
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105940
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$361.34 |
| Max. Negotiated Rate |
$739.11 |
| Rate for Payer: Aetna American Axle |
$533.80
|
| Rate for Payer: Aetna American Axle |
$172.57
|
| Rate for Payer: Aetna American Axle |
$53.80
|
| Rate for Payer: Aetna American Axle |
$94.70
|
| Rate for Payer: Aetna American Axle |
$86.09
|
| Rate for Payer: Aetna Commercial |
$112.57
|
| Rate for Payer: Aetna Commercial |
$225.68
|
| Rate for Payer: Aetna Commercial |
$698.05
|
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Commercial |
$123.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.80
|
| Rate for Payer: Cash Price |
$212.40
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cash Price |
$105.95
|
| Rate for Payer: Cofinity Advantage |
$92.71
|
| Rate for Payer: Cofinity Advantage |
$57.94
|
| Rate for Payer: Cofinity Advantage |
$101.98
|
| Rate for Payer: Cofinity Advantage |
$574.86
|
| Rate for Payer: Cofinity Advantage |
$185.85
|
| Rate for Payer: Cofinity Commercial |
$71.18
|
| Rate for Payer: Cofinity Commercial |
$113.90
|
| Rate for Payer: Cofinity Commercial |
$125.29
|
| Rate for Payer: Cofinity Commercial |
$228.33
|
| Rate for Payer: Cofinity Commercial |
$706.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.22
|
| Rate for Payer: Healthscope Commercial |
$119.20
|
| Rate for Payer: Healthscope Commercial |
$131.12
|
| Rate for Payer: Healthscope Commercial |
$238.95
|
| Rate for Payer: Healthscope Commercial |
$739.11
|
| Rate for Payer: Healthscope Commercial |
$74.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$185.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$574.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$615.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$615.92
|
| Rate for Payer: PHP Commercial |
$225.68
|
| Rate for Payer: PHP Commercial |
$112.57
|
| Rate for Payer: PHP Commercial |
$698.05
|
| Rate for Payer: PHP Commercial |
$70.35
|
| Rate for Payer: PHP Commercial |
$123.84
|
| Rate for Payer: Priority Health SBD |
$517.37
|
| Rate for Payer: Priority Health SBD |
$52.15
|
| Rate for Payer: Priority Health SBD |
$91.78
|
| Rate for Payer: Priority Health SBD |
$83.44
|
| Rate for Payer: Priority Health SBD |
$167.26
|
| Rate for Payer: UMR Bronson Commercial |
$64.10
|
| Rate for Payer: UMR Bronson Commercial |
$36.42
|
| Rate for Payer: UMR Bronson Commercial |
$116.82
|
| Rate for Payer: UMR Bronson Commercial |
$58.27
|
| Rate for Payer: UMR Bronson Commercial |
$361.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$615.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.27
|
|
|
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION
|
Facility
|
OP
|
$132.44
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105940
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$119.20 |
| Rate for Payer: Aetna American Axle |
$86.09
|
| Rate for Payer: Aetna American Axle |
$533.80
|
| Rate for Payer: Aetna American Axle |
$172.57
|
| Rate for Payer: Aetna American Axle |
$94.70
|
| Rate for Payer: Aetna American Axle |
$53.80
|
| Rate for Payer: Aetna Commercial |
$112.57
|
| Rate for Payer: Aetna Commercial |
$123.84
|
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Commercial |
$698.05
|
| Rate for Payer: Aetna Commercial |
$225.68
|
| Rate for Payer: Aetna Medicare |
$41.38
|
| Rate for Payer: Aetna Medicare |
$72.84
|
| Rate for Payer: Aetna Medicare |
$66.22
|
| Rate for Payer: Aetna Medicare |
$132.75
|
| Rate for Payer: Aetna Medicare |
$410.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.80
|
| Rate for Payer: BCBS Complete |
$328.49
|
| Rate for Payer: BCBS Complete |
$52.98
|
| Rate for Payer: BCBS Complete |
$58.28
|
| Rate for Payer: BCBS Complete |
$106.20
|
| Rate for Payer: BCBS Complete |
$33.11
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$105.95
|
| Rate for Payer: Cash Price |
$212.40
|
| Rate for Payer: Cash Price |
$105.95
|
| Rate for Payer: Cash Price |
$212.40
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cofinity Advantage |
$574.86
|
| Rate for Payer: Cofinity Advantage |
$101.98
|
| Rate for Payer: Cofinity Advantage |
$185.85
|
| Rate for Payer: Cofinity Advantage |
$57.94
|
| Rate for Payer: Cofinity Advantage |
$92.71
|
| Rate for Payer: Cofinity Commercial |
$706.26
|
| Rate for Payer: Cofinity Commercial |
$113.90
|
| Rate for Payer: Cofinity Commercial |
$125.29
|
| Rate for Payer: Cofinity Commercial |
$228.33
|
| Rate for Payer: Cofinity Commercial |
$71.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.40
|
| Rate for Payer: Healthscope Commercial |
$238.95
|
| Rate for Payer: Healthscope Commercial |
$74.49
|
| Rate for Payer: Healthscope Commercial |
$739.11
|
| Rate for Payer: Healthscope Commercial |
$119.20
|
| Rate for Payer: Healthscope Commercial |
$131.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$185.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$574.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$615.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$656.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$615.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.08
|
| Rate for Payer: PHP Commercial |
$123.84
|
| Rate for Payer: PHP Commercial |
$225.68
|
| Rate for Payer: PHP Commercial |
$70.35
|
| Rate for Payer: PHP Commercial |
$698.05
|
| Rate for Payer: PHP Commercial |
$112.57
|
| Rate for Payer: Priority Health SBD |
$167.26
|
| Rate for Payer: Priority Health SBD |
$83.44
|
| Rate for Payer: Priority Health SBD |
$517.37
|
| Rate for Payer: Priority Health SBD |
$52.15
|
| Rate for Payer: Priority Health SBD |
$91.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UMR Bronson Commercial |
$49.00
|
| Rate for Payer: UMR Bronson Commercial |
$303.86
|
| Rate for Payer: UMR Bronson Commercial |
$98.23
|
| Rate for Payer: UMR Bronson Commercial |
$30.62
|
| Rate for Payer: UMR Bronson Commercial |
$53.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$615.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.33
|
|
|
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION (CUSTOM)
|
Facility
|
OP
|
$132.44
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
301239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$119.20 |
| Rate for Payer: Aetna American Axle |
$86.09
|
| Rate for Payer: Aetna American Axle |
$533.80
|
| Rate for Payer: Aetna Commercial |
$112.57
|
| Rate for Payer: Aetna Commercial |
$698.05
|
| Rate for Payer: Aetna Medicare |
$66.22
|
| Rate for Payer: Aetna Medicare |
$410.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.80
|
| Rate for Payer: BCBS Complete |
$328.49
|
| Rate for Payer: BCBS Complete |
$52.98
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: Cash Price |
$105.95
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cash Price |
$105.95
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cofinity Advantage |
$92.71
|
| Rate for Payer: Cofinity Advantage |
$574.86
|
| Rate for Payer: Cofinity Commercial |
$113.90
|
| Rate for Payer: Cofinity Commercial |
$706.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.98
|
| Rate for Payer: Healthscope Commercial |
$119.20
|
| Rate for Payer: Healthscope Commercial |
$739.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$574.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$615.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$656.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$615.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.33
|
| Rate for Payer: PHP Commercial |
$112.57
|
| Rate for Payer: PHP Commercial |
$698.05
|
| Rate for Payer: Priority Health SBD |
$83.44
|
| Rate for Payer: Priority Health SBD |
$517.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UMR Bronson Commercial |
$49.00
|
| Rate for Payer: UMR Bronson Commercial |
$303.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$615.92
|
|
|
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION (CUSTOM)
|
Facility
|
IP
|
$132.44
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
301239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$58.27 |
| Max. Negotiated Rate |
$119.20 |
| Rate for Payer: Aetna American Axle |
$86.09
|
| Rate for Payer: Aetna American Axle |
$533.80
|
| Rate for Payer: Aetna Commercial |
$112.57
|
| Rate for Payer: Aetna Commercial |
$698.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.80
|
| Rate for Payer: Cash Price |
$105.95
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cofinity Advantage |
$574.86
|
| Rate for Payer: Cofinity Advantage |
$92.71
|
| Rate for Payer: Cofinity Commercial |
$706.26
|
| Rate for Payer: Cofinity Commercial |
$113.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.98
|
| Rate for Payer: Healthscope Commercial |
$119.20
|
| Rate for Payer: Healthscope Commercial |
$739.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$574.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$615.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$615.92
|
| Rate for Payer: PHP Commercial |
$112.57
|
| Rate for Payer: PHP Commercial |
$698.05
|
| Rate for Payer: Priority Health SBD |
$517.37
|
| Rate for Payer: Priority Health SBD |
$83.44
|
| Rate for Payer: UMR Bronson Commercial |
$58.27
|
| Rate for Payer: UMR Bronson Commercial |
$361.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$615.92
|
|
