|
EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR
|
Facility
|
IP
|
$1,793.09
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
100491
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$788.96 |
| Max. Negotiated Rate |
$1,613.78 |
| Rate for Payer: Aetna American Axle |
$1,165.51
|
| Rate for Payer: Aetna American Axle |
$611.60
|
| Rate for Payer: Aetna American Axle |
$305.81
|
| Rate for Payer: Aetna Commercial |
$399.90
|
| Rate for Payer: Aetna Commercial |
$1,524.13
|
| Rate for Payer: Aetna Commercial |
$799.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,165.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.81
|
| Rate for Payer: Cash Price |
$376.38
|
| Rate for Payer: Cash Price |
$1,434.47
|
| Rate for Payer: Cash Price |
$752.74
|
| Rate for Payer: Cofinity Advantage |
$658.65
|
| Rate for Payer: Cofinity Advantage |
$1,255.16
|
| Rate for Payer: Cofinity Advantage |
$329.33
|
| Rate for Payer: Cofinity Commercial |
$809.20
|
| Rate for Payer: Cofinity Commercial |
$1,542.06
|
| Rate for Payer: Cofinity Commercial |
$404.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,434.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.74
|
| Rate for Payer: Healthscope Commercial |
$423.42
|
| Rate for Payer: Healthscope Commercial |
$846.84
|
| Rate for Payer: Healthscope Commercial |
$1,613.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$329.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,255.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$658.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$705.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,344.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$352.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,524.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$799.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,344.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$352.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.70
|
| Rate for Payer: PHP Commercial |
$399.90
|
| Rate for Payer: PHP Commercial |
$1,524.13
|
| Rate for Payer: PHP Commercial |
$799.79
|
| Rate for Payer: Priority Health SBD |
$1,129.65
|
| Rate for Payer: Priority Health SBD |
$296.40
|
| Rate for Payer: Priority Health SBD |
$592.79
|
| Rate for Payer: UMR Bronson Commercial |
$788.96
|
| Rate for Payer: UMR Bronson Commercial |
$414.01
|
| Rate for Payer: UMR Bronson Commercial |
$207.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$352.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,344.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$705.70
|
|
|
EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR
|
Facility
|
OP
|
$1,793.09
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
100491
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$663.44 |
| Max. Negotiated Rate |
$1,613.78 |
| Rate for Payer: Aetna American Axle |
$1,165.51
|
| Rate for Payer: Aetna American Axle |
$305.81
|
| Rate for Payer: Aetna American Axle |
$611.60
|
| Rate for Payer: Aetna Commercial |
$399.90
|
| Rate for Payer: Aetna Commercial |
$799.79
|
| Rate for Payer: Aetna Commercial |
$1,524.13
|
| Rate for Payer: Aetna Medicare |
$235.24
|
| Rate for Payer: Aetna Medicare |
$896.54
|
| Rate for Payer: Aetna Medicare |
$470.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,165.51
|
| Rate for Payer: BCBS Complete |
$717.24
|
| Rate for Payer: BCBS Complete |
$188.19
|
| Rate for Payer: BCBS Complete |
$376.37
|
| Rate for Payer: Cash Price |
$1,434.47
|
| Rate for Payer: Cash Price |
$376.38
|
| Rate for Payer: Cash Price |
$752.74
|
| Rate for Payer: Cofinity Advantage |
$658.65
|
| Rate for Payer: Cofinity Advantage |
$1,255.16
|
| Rate for Payer: Cofinity Advantage |
$329.33
|
| Rate for Payer: Cofinity Commercial |
$404.60
|
| Rate for Payer: Cofinity Commercial |
$1,542.06
|
| Rate for Payer: Cofinity Commercial |
$809.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,434.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.38
|
| Rate for Payer: Healthscope Commercial |
$423.42
|
| Rate for Payer: Healthscope Commercial |
$1,613.78
|
| Rate for Payer: Healthscope Commercial |
$846.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,255.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$329.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$658.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$352.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,344.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$705.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,434.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$376.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$752.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,524.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$799.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,344.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$352.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.70
|
| Rate for Payer: PHP Commercial |
$799.79
|
| Rate for Payer: PHP Commercial |
$399.90
|
| Rate for Payer: PHP Commercial |
$1,524.13
|
| Rate for Payer: Priority Health SBD |
$296.40
|
| Rate for Payer: Priority Health SBD |
$1,129.65
|
| Rate for Payer: Priority Health SBD |
$592.79
|
| Rate for Payer: UMR Bronson Commercial |
$348.14
|
| Rate for Payer: UMR Bronson Commercial |
$663.44
|
| Rate for Payer: UMR Bronson Commercial |
$174.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,344.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$352.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$705.70
|
|
|
EPINEPHRINE 1 MG/10 ML (100 MCG/ML) IN SODIUM CHLOR,ISO-OSM IV SYRINGE
|
Facility
|
IP
|
$22.25
|
|
|
Service Code
|
HCPCS J7999
|
| Hospital Charge Code |
190398
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$20.02 |
| Rate for Payer: Aetna American Axle |
$14.46
|
| Rate for Payer: Aetna Commercial |
$18.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.46
|
| Rate for Payer: Cash Price |
$17.80
|
| Rate for Payer: Cofinity Advantage |
$15.57
|
| Rate for Payer: Cofinity Commercial |
$19.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.80
|
| Rate for Payer: Healthscope Commercial |
$20.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.69
|
| Rate for Payer: PHP Commercial |
$18.91
|
| Rate for Payer: Priority Health SBD |
$14.02
|
| Rate for Payer: UMR Bronson Commercial |
$9.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.69
|
|
|
EPINEPHRINE 1 MG/10 ML (100 MCG/ML) IN SODIUM CHLOR,ISO-OSM IV SYRINGE
|
Facility
|
OP
|
$22.25
|
|
|
Service Code
|
HCPCS J7999
|
| Hospital Charge Code |
190398
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$20.02 |
| Rate for Payer: Aetna American Axle |
$14.46
|
| Rate for Payer: Aetna Commercial |
$18.91
|
| Rate for Payer: Aetna Medicare |
$11.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.46
|
| Rate for Payer: BCBS Complete |
$8.90
|
| Rate for Payer: Cash Price |
$17.80
|
| Rate for Payer: Cofinity Advantage |
$15.57
|
| Rate for Payer: Cofinity Commercial |
$19.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.80
|
| Rate for Payer: Healthscope Commercial |
$20.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.69
|
| Rate for Payer: PHP Commercial |
$18.91
|
| Rate for Payer: Priority Health SBD |
$14.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.46
|
| Rate for Payer: UHC Core |
$11.59
|
| Rate for Payer: UHC Exchange |
$8.74
|
| Rate for Payer: UMR Bronson Commercial |
$8.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.69
|
|
|
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
IP
|
$20.73
|
|
|
Service Code
|
HCPCS J0165
|
| Hospital Charge Code |
152715
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.12 |
| Max. Negotiated Rate |
$18.66 |
| Rate for Payer: Aetna American Axle |
$13.47
|
| Rate for Payer: Aetna Commercial |
$17.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.47
|
| Rate for Payer: Cash Price |
$16.58
|
| Rate for Payer: Cofinity Advantage |
$14.51
|
| Rate for Payer: Cofinity Commercial |
$17.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$18.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.55
|
| Rate for Payer: PHP Commercial |
$17.62
|
| Rate for Payer: Priority Health SBD |
$13.06
|
| Rate for Payer: UMR Bronson Commercial |
$9.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.55
|
|
|
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
OP
|
$20.73
|
|
|
Service Code
|
HCPCS J0165
|
| Hospital Charge Code |
152715
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.71 |
| Max. Negotiated Rate |
$18.66 |
| Rate for Payer: Aetna American Axle |
$13.47
|
| Rate for Payer: Aetna Commercial |
$17.62
|
| Rate for Payer: Aetna Medicare |
$10.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.47
|
| Rate for Payer: BCBS Complete |
$8.29
|
| Rate for Payer: BCBS Trust/PPO |
$1.40
|
| Rate for Payer: BCN Commercial |
$1.40
|
| Rate for Payer: Cash Price |
$16.58
|
| Rate for Payer: Cash Price |
$16.58
|
| Rate for Payer: Cofinity Advantage |
$14.51
|
| Rate for Payer: Cofinity Commercial |
$17.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$18.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.55
|
| Rate for Payer: PHP Commercial |
$17.62
|
| Rate for Payer: Priority Health SBD |
$13.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.71
|
| Rate for Payer: UHC Core |
$0.71
|
| Rate for Payer: UHC Exchange |
$0.71
|
| Rate for Payer: UMR Bronson Commercial |
$7.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.55
|
|
|
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
IP
|
$35.67
|
|
|
Service Code
|
HCPCS J0166
|
| Hospital Charge Code |
152715
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.69 |
| Max. Negotiated Rate |
$32.10 |
| Rate for Payer: Aetna American Axle |
$23.19
|
| Rate for Payer: Aetna Commercial |
$30.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.19
|
| Rate for Payer: Cash Price |
$28.54
|
| Rate for Payer: Cofinity Advantage |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$30.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.54
|
| Rate for Payer: Healthscope Commercial |
$32.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.75
|
| Rate for Payer: PHP Commercial |
$30.32
|
| Rate for Payer: Priority Health SBD |
$22.47
|
| Rate for Payer: UMR Bronson Commercial |
$15.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.75
|
|
|
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
IP
|
$33.11
|
|
|
Service Code
|
HCPCS J0169
|
| Hospital Charge Code |
152715
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.57 |
| Max. Negotiated Rate |
$29.80 |
| Rate for Payer: Aetna American Axle |
$21.52
|
| Rate for Payer: Aetna Commercial |
$28.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.52
|
| Rate for Payer: Cash Price |
$26.49
|
| Rate for Payer: Cofinity Advantage |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$28.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.49
|
| Rate for Payer: Healthscope Commercial |
$29.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.83
|
| Rate for Payer: PHP Commercial |
$28.14
|
| Rate for Payer: Priority Health SBD |
$20.86
|
| Rate for Payer: UMR Bronson Commercial |
$14.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.83
|
|
|
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
OP
|
$33.11
|
|
|
Service Code
|
HCPCS J0169
|
| Hospital Charge Code |
152715
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$29.80 |
| Rate for Payer: Aetna American Axle |
$21.52
|
| Rate for Payer: Aetna Commercial |
$28.14
|
| Rate for Payer: Aetna Medicare |
$16.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.52
|
| Rate for Payer: BCBS Complete |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$4.46
|
| Rate for Payer: BCN Commercial |
$4.46
|
| Rate for Payer: Cash Price |
$26.49
|
| Rate for Payer: Cash Price |
$26.49
|
| Rate for Payer: Cofinity Advantage |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$28.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.49
|
| Rate for Payer: Healthscope Commercial |
$29.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.83
|
| Rate for Payer: PHP Commercial |
$28.14
|
| Rate for Payer: Priority Health SBD |
$20.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.28
|
| Rate for Payer: UHC Core |
$2.28
|
| Rate for Payer: UHC Exchange |
$2.28
|
| Rate for Payer: UMR Bronson Commercial |
$12.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.83
|
|
|
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
OP
|
$35.67
|
|
|
Service Code
|
HCPCS J0166
|
| Hospital Charge Code |
152715
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$32.10 |
| Rate for Payer: Aetna American Axle |
$23.19
|
| Rate for Payer: Aetna Commercial |
$30.32
|
| Rate for Payer: Aetna Medicare |
$17.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.19
|
| Rate for Payer: BCBS Complete |
$14.27
|
| Rate for Payer: BCBS Trust/PPO |
$3.56
|
| Rate for Payer: BCN Commercial |
$3.56
|
| Rate for Payer: Cash Price |
$28.54
|
| Rate for Payer: Cash Price |
$28.54
|
| Rate for Payer: Cofinity Advantage |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$30.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.54
|
| Rate for Payer: Healthscope Commercial |
$32.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.75
|
| Rate for Payer: PHP Commercial |
$30.32
|
| Rate for Payer: Priority Health SBD |
$22.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.83
|
| Rate for Payer: UHC Core |
$1.83
|
| Rate for Payer: UHC Exchange |
$1.83
|
| Rate for Payer: UMR Bronson Commercial |
$13.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.75
|
|
|
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION WRAPPER
|
Facility
|
IP
|
$35.76
|
|
|
Service Code
|
HCPCS J0166
|
| Hospital Charge Code |
301918
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.73 |
| Max. Negotiated Rate |
$32.18 |
| Rate for Payer: Aetna American Axle |
$23.24
|
| Rate for Payer: Aetna Commercial |
$30.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.24
|
| Rate for Payer: Cash Price |
$28.61
|
| Rate for Payer: Cofinity Advantage |
$25.03
|
| Rate for Payer: Cofinity Commercial |
$30.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.61
|
| Rate for Payer: Healthscope Commercial |
$32.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.82
|
| Rate for Payer: PHP Commercial |
$30.40
|
| Rate for Payer: Priority Health SBD |
$22.53
|
| Rate for Payer: UMR Bronson Commercial |
$15.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.82
|
|
|
EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION WRAPPER
|
Facility
|
OP
|
$35.76
|
|
|
Service Code
|
HCPCS J0166
|
| Hospital Charge Code |
301918
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$32.18 |
| Rate for Payer: Aetna American Axle |
$23.24
|
| Rate for Payer: Aetna Commercial |
$30.40
|
| Rate for Payer: Aetna Medicare |
$17.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.24
|
| Rate for Payer: BCBS Complete |
$14.30
|
| Rate for Payer: BCBS Trust/PPO |
$3.56
|
| Rate for Payer: BCN Commercial |
$3.56
|
| Rate for Payer: Cash Price |
$28.61
|
| Rate for Payer: Cash Price |
$28.61
|
| Rate for Payer: Cofinity Advantage |
$25.03
|
| Rate for Payer: Cofinity Commercial |
$30.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.61
|
| Rate for Payer: Healthscope Commercial |
$32.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.82
|
| Rate for Payer: PHP Commercial |
$30.40
|
| Rate for Payer: Priority Health SBD |
$22.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.83
|
| Rate for Payer: UHC Core |
$1.83
|
| Rate for Payer: UHC Exchange |
$1.83
|
| Rate for Payer: UMR Bronson Commercial |
$13.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.82
|
|
|
EPINEPHRINE 1 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$364.55
|
|
|
Service Code
|
HCPCS J0166
|
| Hospital Charge Code |
2850
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$328.10 |
| Rate for Payer: Aetna American Axle |
$236.96
|
| Rate for Payer: Aetna Commercial |
$309.87
|
| Rate for Payer: Aetna Medicare |
$182.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.96
|
| Rate for Payer: BCBS Complete |
$145.82
|
| Rate for Payer: BCBS Trust/PPO |
$3.56
|
| Rate for Payer: BCN Commercial |
$3.56
|
| Rate for Payer: Cash Price |
$291.64
|
| Rate for Payer: Cash Price |
$291.64
|
| Rate for Payer: Cofinity Advantage |
$255.19
|
| Rate for Payer: Cofinity Commercial |
$313.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.64
|
| Rate for Payer: Healthscope Commercial |
$328.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$291.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.41
|
| Rate for Payer: PHP Commercial |
$309.87
|
| Rate for Payer: Priority Health SBD |
$229.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.83
|
| Rate for Payer: UHC Core |
$1.83
|
| Rate for Payer: UHC Exchange |
$1.83
|
| Rate for Payer: UMR Bronson Commercial |
$134.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.41
|
|
|
EPINEPHRINE 1 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$364.55
|
|
|
Service Code
|
HCPCS J0166
|
| Hospital Charge Code |
2850
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$160.40 |
| Max. Negotiated Rate |
$328.10 |
| Rate for Payer: Aetna American Axle |
$236.96
|
| Rate for Payer: Aetna Commercial |
$309.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.96
|
| Rate for Payer: Cash Price |
$291.64
|
| Rate for Payer: Cofinity Advantage |
$255.19
|
| Rate for Payer: Cofinity Commercial |
$313.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.64
|
| Rate for Payer: Healthscope Commercial |
$328.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.41
|
| Rate for Payer: PHP Commercial |
$309.87
|
| Rate for Payer: Priority Health SBD |
$229.67
|
| Rate for Payer: UMR Bronson Commercial |
$160.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.41
|
|
|
EPINEPHRINE 1 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$600.98
|
|
|
Service Code
|
HCPCS J0165
|
| Hospital Charge Code |
2850
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.71 |
| Max. Negotiated Rate |
$540.88 |
| Rate for Payer: Aetna American Axle |
$390.64
|
| Rate for Payer: Aetna Commercial |
$510.83
|
| Rate for Payer: Aetna Medicare |
$300.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.64
|
| Rate for Payer: BCBS Complete |
$240.39
|
| Rate for Payer: BCBS Trust/PPO |
$1.40
|
| Rate for Payer: BCN Commercial |
$1.40
|
| Rate for Payer: Cash Price |
$480.78
|
| Rate for Payer: Cash Price |
$480.78
|
| Rate for Payer: Cofinity Advantage |
$420.69
|
| Rate for Payer: Cofinity Commercial |
$516.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.78
|
| Rate for Payer: Healthscope Commercial |
$540.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$480.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$450.74
|
| Rate for Payer: PHP Commercial |
$510.83
|
| Rate for Payer: Priority Health SBD |
$378.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.71
|
| Rate for Payer: UHC Core |
$0.71
|
| Rate for Payer: UHC Exchange |
$0.71
|
| Rate for Payer: UMR Bronson Commercial |
$222.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.74
|
|
|
EPINEPHRINE 1 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$600.98
|
|
|
Service Code
|
HCPCS J0165
|
| Hospital Charge Code |
2850
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$264.43 |
| Max. Negotiated Rate |
$540.88 |
| Rate for Payer: Aetna American Axle |
$390.64
|
| Rate for Payer: Aetna Commercial |
$510.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.64
|
| Rate for Payer: Cash Price |
$480.78
|
| Rate for Payer: Cofinity Advantage |
$420.69
|
| Rate for Payer: Cofinity Commercial |
$516.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.78
|
| Rate for Payer: Healthscope Commercial |
$540.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$450.74
|
| Rate for Payer: PHP Commercial |
$510.83
|
| Rate for Payer: Priority Health SBD |
$378.62
|
| Rate for Payer: UMR Bronson Commercial |
$264.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.74
|
|
|
EPINEPHRINE 1 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$310.13
|
|
|
Service Code
|
HCPCS J0169
|
| Hospital Charge Code |
2850
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$279.12 |
| Rate for Payer: Aetna American Axle |
$201.58
|
| Rate for Payer: Aetna Commercial |
$263.61
|
| Rate for Payer: Aetna Medicare |
$155.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.58
|
| Rate for Payer: BCBS Complete |
$124.05
|
| Rate for Payer: BCBS Trust/PPO |
$4.46
|
| Rate for Payer: BCN Commercial |
$4.46
|
| Rate for Payer: Cash Price |
$248.10
|
| Rate for Payer: Cash Price |
$248.10
|
| Rate for Payer: Cofinity Advantage |
$217.09
|
| Rate for Payer: Cofinity Commercial |
$266.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.10
|
| Rate for Payer: Healthscope Commercial |
$279.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$248.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$232.60
|
| Rate for Payer: PHP Commercial |
$263.61
|
| Rate for Payer: Priority Health SBD |
$195.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.28
|
| Rate for Payer: UHC Core |
$2.28
|
| Rate for Payer: UHC Exchange |
$2.28
|
| Rate for Payer: UMR Bronson Commercial |
$114.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.60
|
|
|
EPINEPHRINE 1 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$310.13
|
|
|
Service Code
|
HCPCS J0169
|
| Hospital Charge Code |
2850
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$136.46 |
| Max. Negotiated Rate |
$279.12 |
| Rate for Payer: Aetna American Axle |
$201.58
|
| Rate for Payer: Aetna Commercial |
$263.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.58
|
| Rate for Payer: Cash Price |
$248.10
|
| Rate for Payer: Cofinity Advantage |
$217.09
|
| Rate for Payer: Cofinity Commercial |
$266.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.10
|
| Rate for Payer: Healthscope Commercial |
$279.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$232.60
|
| Rate for Payer: PHP Commercial |
$263.61
|
| Rate for Payer: Priority Health SBD |
$195.38
|
| Rate for Payer: UMR Bronson Commercial |
$136.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.60
|
|
|
EPINEPHRINE ANAPHYLAXIS KIT
|
Facility
|
OP
|
$62.31
|
|
|
Service Code
|
HCPCS J0165
|
| Hospital Charge Code |
181607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.71 |
| Max. Negotiated Rate |
$56.08 |
| Rate for Payer: Aetna American Axle |
$40.50
|
| Rate for Payer: Aetna Commercial |
$52.96
|
| Rate for Payer: Aetna Medicare |
$31.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.50
|
| Rate for Payer: BCBS Complete |
$24.92
|
| Rate for Payer: BCBS Trust/PPO |
$1.40
|
| Rate for Payer: BCN Commercial |
$1.40
|
| Rate for Payer: Cash Price |
$49.85
|
| Rate for Payer: Cash Price |
$49.85
|
| Rate for Payer: Cofinity Advantage |
$43.62
|
| Rate for Payer: Cofinity Commercial |
$53.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.85
|
| Rate for Payer: Healthscope Commercial |
$56.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.73
|
| Rate for Payer: PHP Commercial |
$52.96
|
| Rate for Payer: Priority Health SBD |
$39.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.71
|
| Rate for Payer: UHC Core |
$0.71
|
| Rate for Payer: UHC Exchange |
$0.71
|
| Rate for Payer: UMR Bronson Commercial |
$23.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.73
|
|
|
EPINEPHRINE ANAPHYLAXIS KIT
|
Facility
|
IP
|
$62.31
|
|
|
Service Code
|
HCPCS J0165
|
| Hospital Charge Code |
181607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.42 |
| Max. Negotiated Rate |
$56.08 |
| Rate for Payer: Aetna American Axle |
$40.50
|
| Rate for Payer: Aetna Commercial |
$52.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.50
|
| Rate for Payer: Cash Price |
$49.85
|
| Rate for Payer: Cofinity Advantage |
$43.62
|
| Rate for Payer: Cofinity Commercial |
$53.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.85
|
| Rate for Payer: Healthscope Commercial |
$56.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.73
|
| Rate for Payer: PHP Commercial |
$52.96
|
| Rate for Payer: Priority Health SBD |
$39.26
|
| Rate for Payer: UMR Bronson Commercial |
$27.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.73
|
|
|
EPINEPHRINE BITARTRATE (BULK) POWDER
|
Facility
|
IP
|
$52.50
|
|
|
Service Code
|
NDC 51552045409
|
| Hospital Charge Code |
22363
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$23.10 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: Aetna American Axle |
$34.12
|
| Rate for Payer: Aetna Commercial |
$44.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.12
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Cofinity Advantage |
$36.75
|
| Rate for Payer: Cofinity Commercial |
$45.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.00
|
| Rate for Payer: Healthscope Commercial |
$47.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.38
|
| Rate for Payer: PHP Commercial |
$44.62
|
| Rate for Payer: Priority Health SBD |
$33.08
|
| Rate for Payer: UMR Bronson Commercial |
$23.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.38
|
|
|
EPINEPHRINE BITARTRATE (BULK) POWDER
|
Facility
|
OP
|
$52.50
|
|
|
Service Code
|
NDC 51552045409
|
| Hospital Charge Code |
22363
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: Aetna American Axle |
$34.12
|
| Rate for Payer: Aetna Commercial |
$44.62
|
| Rate for Payer: Aetna Medicare |
$26.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.12
|
| Rate for Payer: BCBS Complete |
$21.00
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Cofinity Advantage |
$36.75
|
| Rate for Payer: Cofinity Commercial |
$45.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.00
|
| Rate for Payer: Healthscope Commercial |
$47.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.38
|
| Rate for Payer: PHP Commercial |
$44.62
|
| Rate for Payer: Priority Health SBD |
$33.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.12
|
| Rate for Payer: UHC Core |
$27.35
|
| Rate for Payer: UHC Exchange |
$20.63
|
| Rate for Payer: UMR Bronson Commercial |
$19.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.38
|
|
|
EPINEPHRINE HCL 0.1 MG/ML SYRINGE (CODE)
|
Facility
|
OP
|
$47.31
|
|
|
Service Code
|
HCPCS J0168
|
| Hospital Charge Code |
163700
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$42.58 |
| Rate for Payer: Aetna American Axle |
$30.75
|
| Rate for Payer: Aetna Commercial |
$40.21
|
| Rate for Payer: Aetna Medicare |
$23.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.75
|
| Rate for Payer: BCBS Complete |
$18.92
|
| Rate for Payer: BCBS Trust/PPO |
$9.71
|
| Rate for Payer: BCN Commercial |
$9.71
|
| Rate for Payer: Cash Price |
$37.85
|
| Rate for Payer: Cash Price |
$37.85
|
| Rate for Payer: Cofinity Advantage |
$33.12
|
| Rate for Payer: Cofinity Commercial |
$40.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.85
|
| Rate for Payer: Healthscope Commercial |
$42.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.48
|
| Rate for Payer: PHP Commercial |
$40.21
|
| Rate for Payer: Priority Health SBD |
$29.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.95
|
| Rate for Payer: UHC Core |
$4.95
|
| Rate for Payer: UHC Exchange |
$4.95
|
| Rate for Payer: UMR Bronson Commercial |
$17.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.48
|
|
|
EPINEPHRINE HCL 0.1 MG/ML SYRINGE (CODE)
|
Facility
|
IP
|
$47.31
|
|
|
Service Code
|
HCPCS J0168
|
| Hospital Charge Code |
163700
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.82 |
| Max. Negotiated Rate |
$42.58 |
| Rate for Payer: Aetna American Axle |
$30.75
|
| Rate for Payer: Aetna Commercial |
$40.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.75
|
| Rate for Payer: Cash Price |
$37.85
|
| Rate for Payer: Cofinity Advantage |
$33.12
|
| Rate for Payer: Cofinity Commercial |
$40.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.85
|
| Rate for Payer: Healthscope Commercial |
$42.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.48
|
| Rate for Payer: PHP Commercial |
$40.21
|
| Rate for Payer: Priority Health SBD |
$29.81
|
| Rate for Payer: UMR Bronson Commercial |
$20.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.48
|
|
|
EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
OP
|
$35.76
|
|
|
Service Code
|
HCPCS J0166
|
| Hospital Charge Code |
116787
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$32.18 |
| Rate for Payer: Aetna American Axle |
$23.24
|
| Rate for Payer: Aetna Commercial |
$30.40
|
| Rate for Payer: Aetna Medicare |
$17.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.24
|
| Rate for Payer: BCBS Complete |
$14.30
|
| Rate for Payer: BCBS Trust/PPO |
$3.56
|
| Rate for Payer: BCN Commercial |
$3.56
|
| Rate for Payer: Cash Price |
$28.61
|
| Rate for Payer: Cash Price |
$28.61
|
| Rate for Payer: Cofinity Advantage |
$25.03
|
| Rate for Payer: Cofinity Commercial |
$30.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.61
|
| Rate for Payer: Healthscope Commercial |
$32.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.82
|
| Rate for Payer: PHP Commercial |
$30.40
|
| Rate for Payer: Priority Health SBD |
$22.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.83
|
| Rate for Payer: UHC Core |
$1.83
|
| Rate for Payer: UHC Exchange |
$1.83
|
| Rate for Payer: UMR Bronson Commercial |
$13.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.82
|
|
