|
EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
IP
|
$35.76
|
|
|
Service Code
|
HCPCS J0166
|
| Hospital Charge Code |
116787
|
|
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 INFUSION (IV PREMIX)
|
Facility
|
OP
|
$10.50
|
|
|
Service Code
|
HCPCS J0171
|
| Hospital Charge Code |
301238
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.88 |
| Max. Negotiated Rate |
$9.45 |
| Rate for Payer: Aetna American Axle |
$6.83
|
| Rate for Payer: Aetna Commercial |
$8.93
|
| Rate for Payer: Aetna Medicare |
$5.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.83
|
| Rate for Payer: BCBS Complete |
$4.20
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cofinity Advantage |
$7.35
|
| Rate for Payer: Cofinity Commercial |
$9.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.40
|
| Rate for Payer: Healthscope Commercial |
$9.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.88
|
| Rate for Payer: PHP Commercial |
$8.93
|
| Rate for Payer: Priority Health SBD |
$6.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.83
|
| Rate for Payer: UHC Core |
$5.47
|
| Rate for Payer: UHC Exchange |
$4.13
|
| Rate for Payer: UMR Bronson Commercial |
$3.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.88
|
|
|
EPINEPHRINE INFUSION (IV PREMIX)
|
Facility
|
IP
|
$10.50
|
|
|
Service Code
|
HCPCS J0171
|
| Hospital Charge Code |
301238
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$9.45 |
| Rate for Payer: Aetna American Axle |
$6.83
|
| Rate for Payer: Aetna Commercial |
$8.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.83
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cofinity Advantage |
$7.35
|
| Rate for Payer: Cofinity Commercial |
$9.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.40
|
| Rate for Payer: Healthscope Commercial |
$9.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.88
|
| Rate for Payer: PHP Commercial |
$8.93
|
| Rate for Payer: Priority Health SBD |
$6.62
|
| Rate for Payer: UMR Bronson Commercial |
$4.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.88
|
|
|
EPINEPHRINE (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR
|
Facility
|
IP
|
$1,793.09
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
29031
|
|
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 (JR) 0.15 MG/0.3 ML INJECTION,AUTO-INJECTOR
|
Facility
|
OP
|
$1,793.09
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
29031
|
|
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
|
|
|
EPIRUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$470.99
|
|
|
Service Code
|
HCPCS J9178
|
| Hospital Charge Code |
13671
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.25 |
| Max. Negotiated Rate |
$423.89 |
| Rate for Payer: Aetna American Axle |
$306.14
|
| Rate for Payer: Aetna Commercial |
$400.34
|
| Rate for Payer: Aetna Medicare |
$235.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$306.14
|
| Rate for Payer: BCBS Complete |
$188.40
|
| Rate for Payer: BCBS Trust/PPO |
$6.40
|
| Rate for Payer: BCN Commercial |
$6.40
|
| Rate for Payer: Cash Price |
$376.79
|
| Rate for Payer: Cash Price |
$376.79
|
| Rate for Payer: Cofinity Advantage |
$329.69
|
| Rate for Payer: Cofinity Commercial |
$405.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.79
|
| Rate for Payer: Healthscope Commercial |
$423.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$329.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$353.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$376.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$400.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$353.24
|
| Rate for Payer: PHP Commercial |
$400.34
|
| Rate for Payer: Priority Health SBD |
$296.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.25
|
| Rate for Payer: UHC Core |
$3.25
|
| Rate for Payer: UHC Exchange |
$3.25
|
| Rate for Payer: UMR Bronson Commercial |
$174.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$353.24
|
|
|
EPIRUBICIN 50 MG/25 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$470.99
|
|
|
Service Code
|
HCPCS J9178
|
| Hospital Charge Code |
13671
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$207.24 |
| Max. Negotiated Rate |
$423.89 |
| Rate for Payer: Aetna American Axle |
$306.14
|
| Rate for Payer: Aetna Commercial |
$400.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$306.14
|
| Rate for Payer: Cash Price |
$376.79
|
| Rate for Payer: Cofinity Advantage |
$329.69
|
| Rate for Payer: Cofinity Commercial |
$405.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.79
|
| Rate for Payer: Healthscope Commercial |
$423.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$329.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$353.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$400.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$353.24
|
| Rate for Payer: PHP Commercial |
$400.34
|
| Rate for Payer: Priority Health SBD |
$296.72
|
| Rate for Payer: UMR Bronson Commercial |
$207.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$353.24
|
|
|
EPISIOTOMY OR VAGINAL REPAIR, BY OTHER THAN ATTENDING
|
Facility
|
OP
|
$10,430.93
|
|
|
Service Code
|
CPT 59300
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$145.72 |
| Max. Negotiated Rate |
$10,430.93 |
| Rate for Payer: Aetna Medicare |
$3,354.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$145.72
|
| Rate for Payer: BCN Commercial |
$145.72
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$3,386.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Nomi Health Commercial |
$9,676.47
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,430.93
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health Tiered Network |
$8,344.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: VA VA |
$3,225.49
|
|
|
EPISTAXIS WITH MCC
|
Facility
|
IP
|
$34,868.26
|
|
|
Service Code
|
MSDRG 150
|
| Min. Negotiated Rate |
$11,141.50 |
| Max. Negotiated Rate |
$34,868.26 |
| Rate for Payer: Aetna Medicare |
$12,197.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,659.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,659.86
|
| Rate for Payer: BCBS MAPPO |
$11,727.89
|
| Rate for Payer: BCBS Trust/PPO |
$34,868.26
|
| Rate for Payer: BCN Commercial |
$34,868.26
|
| Rate for Payer: BCN Medicare Advantage |
$11,727.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,727.89
|
| Rate for Payer: Mclaren Medicare |
$11,727.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,314.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,487.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,900.68
|
| Rate for Payer: Nomi Health Commercial |
$17,176.35
|
| Rate for Payer: PACE Medicare |
$11,141.50
|
| Rate for Payer: PACE SWMI |
$11,727.89
|
| Rate for Payer: PHP Medicare Advantage |
$11,727.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21,466.63
|
| Rate for Payer: Priority Health Medicare |
$11,727.89
|
| Rate for Payer: Priority Health Tiered Network |
$17,173.30
|
| Rate for Payer: Railroad Medicare Medicare |
$11,727.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21,703.45
|
| Rate for Payer: UHC Core |
$18,157.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,727.89
|
| Rate for Payer: UHC Exchange |
$14,828.92
|
| Rate for Payer: VA VA |
$11,727.89
|
|
|
EPISTAXIS WITHOUT MCC
|
Facility
|
IP
|
$17,469.82
|
|
|
Service Code
|
MSDRG 151
|
| Min. Negotiated Rate |
$6,394.63 |
| Max. Negotiated Rate |
$17,469.82 |
| Rate for Payer: Aetna Medicare |
$7,000.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,413.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,413.99
|
| Rate for Payer: BCBS MAPPO |
$6,731.19
|
| Rate for Payer: BCBS Trust/PPO |
$17,469.82
|
| Rate for Payer: BCN Commercial |
$17,469.82
|
| Rate for Payer: BCN Medicare Advantage |
$6,731.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,731.19
|
| Rate for Payer: Mclaren Medicare |
$6,731.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,067.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,740.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,404.31
|
| Rate for Payer: Nomi Health Commercial |
$9,468.60
|
| Rate for Payer: PACE Medicare |
$6,394.63
|
| Rate for Payer: PACE SWMI |
$6,731.19
|
| Rate for Payer: PHP Medicare Advantage |
$6,731.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,833.65
|
| Rate for Payer: Priority Health Medicare |
$6,731.19
|
| Rate for Payer: Priority Health Tiered Network |
$9,466.92
|
| Rate for Payer: Railroad Medicare Medicare |
$6,731.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,964.20
|
| Rate for Payer: UHC Core |
$10,009.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,731.19
|
| Rate for Payer: UHC Exchange |
$8,174.56
|
| Rate for Payer: VA VA |
$6,731.19
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
OP
|
$187.35
|
|
|
Service Code
|
NDC 66993034330
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$69.32 |
| Max. Negotiated Rate |
$168.62 |
| Rate for Payer: Aetna American Axle |
$121.78
|
| Rate for Payer: Aetna Commercial |
$159.25
|
| Rate for Payer: Aetna Medicare |
$93.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.78
|
| Rate for Payer: BCBS Complete |
$74.94
|
| Rate for Payer: Cash Price |
$149.88
|
| Rate for Payer: Cofinity Advantage |
$131.15
|
| Rate for Payer: Cofinity Commercial |
$161.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.88
|
| Rate for Payer: Healthscope Commercial |
$168.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$149.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.51
|
| Rate for Payer: PHP Commercial |
$159.25
|
| Rate for Payer: Priority Health SBD |
$118.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.78
|
| Rate for Payer: UHC Core |
$97.61
|
| Rate for Payer: UHC Exchange |
$73.63
|
| Rate for Payer: UMR Bronson Commercial |
$69.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.51
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
OP
|
$121.26
|
|
|
Service Code
|
NDC 16729029310
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$44.87 |
| Max. Negotiated Rate |
$109.13 |
| Rate for Payer: Aetna American Axle |
$78.82
|
| Rate for Payer: Aetna Commercial |
$103.07
|
| Rate for Payer: Aetna Medicare |
$60.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.82
|
| Rate for Payer: BCBS Complete |
$48.50
|
| Rate for Payer: Cash Price |
$97.01
|
| Rate for Payer: Cofinity Advantage |
$84.88
|
| Rate for Payer: Cofinity Commercial |
$104.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.01
|
| Rate for Payer: Healthscope Commercial |
$109.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.94
|
| Rate for Payer: PHP Commercial |
$103.07
|
| Rate for Payer: Priority Health SBD |
$76.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.82
|
| Rate for Payer: UHC Core |
$63.18
|
| Rate for Payer: UHC Exchange |
$47.66
|
| Rate for Payer: UMR Bronson Commercial |
$44.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.94
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
IP
|
$15.96
|
|
|
Service Code
|
NDC 60687045111
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$14.36 |
| Rate for Payer: Aetna American Axle |
$10.37
|
| Rate for Payer: Aetna Commercial |
$13.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.37
|
| Rate for Payer: Cash Price |
$12.77
|
| Rate for Payer: Cofinity Advantage |
$11.17
|
| Rate for Payer: Cofinity Commercial |
$13.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.77
|
| Rate for Payer: Healthscope Commercial |
$14.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.97
|
| Rate for Payer: PHP Commercial |
$13.57
|
| Rate for Payer: Priority Health SBD |
$10.05
|
| Rate for Payer: UMR Bronson Commercial |
$7.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.97
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
OP
|
$478.75
|
|
|
Service Code
|
NDC 60687045121
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$177.14 |
| Max. Negotiated Rate |
$430.88 |
| Rate for Payer: Aetna American Axle |
$311.19
|
| Rate for Payer: Aetna Commercial |
$406.94
|
| Rate for Payer: Aetna Medicare |
$239.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.19
|
| Rate for Payer: BCBS Complete |
$191.50
|
| Rate for Payer: Cash Price |
$383.00
|
| Rate for Payer: Cofinity Advantage |
$335.12
|
| Rate for Payer: Cofinity Commercial |
$411.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.00
|
| Rate for Payer: Healthscope Commercial |
$430.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$335.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$383.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$406.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$359.06
|
| Rate for Payer: PHP Commercial |
$406.94
|
| Rate for Payer: Priority Health SBD |
$301.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.19
|
| Rate for Payer: UHC Core |
$249.43
|
| Rate for Payer: UHC Exchange |
$188.15
|
| Rate for Payer: UMR Bronson Commercial |
$177.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.06
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
IP
|
$121.26
|
|
|
Service Code
|
NDC 16729029310
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$53.35 |
| Max. Negotiated Rate |
$109.13 |
| Rate for Payer: Aetna American Axle |
$78.82
|
| Rate for Payer: Aetna Commercial |
$103.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.82
|
| Rate for Payer: Cash Price |
$97.01
|
| Rate for Payer: Cofinity Advantage |
$84.88
|
| Rate for Payer: Cofinity Commercial |
$104.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.01
|
| Rate for Payer: Healthscope Commercial |
$109.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.94
|
| Rate for Payer: PHP Commercial |
$103.07
|
| Rate for Payer: Priority Health SBD |
$76.39
|
| Rate for Payer: UMR Bronson Commercial |
$53.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.94
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
OP
|
$187.35
|
|
|
Service Code
|
NDC 59762171002
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$69.32 |
| Max. Negotiated Rate |
$168.62 |
| Rate for Payer: Aetna American Axle |
$121.78
|
| Rate for Payer: Aetna Commercial |
$159.25
|
| Rate for Payer: Aetna Medicare |
$93.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.78
|
| Rate for Payer: BCBS Complete |
$74.94
|
| Rate for Payer: Cash Price |
$149.88
|
| Rate for Payer: Cofinity Advantage |
$131.15
|
| Rate for Payer: Cofinity Commercial |
$161.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.88
|
| Rate for Payer: Healthscope Commercial |
$168.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$149.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.51
|
| Rate for Payer: PHP Commercial |
$159.25
|
| Rate for Payer: Priority Health SBD |
$118.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.78
|
| Rate for Payer: UHC Core |
$97.61
|
| Rate for Payer: UHC Exchange |
$73.63
|
| Rate for Payer: UMR Bronson Commercial |
$69.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.51
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
IP
|
$187.35
|
|
|
Service Code
|
NDC 66993034330
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.43 |
| Max. Negotiated Rate |
$168.62 |
| Rate for Payer: Aetna American Axle |
$121.78
|
| Rate for Payer: Aetna Commercial |
$159.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.78
|
| Rate for Payer: Cash Price |
$149.88
|
| Rate for Payer: Cofinity Advantage |
$131.15
|
| Rate for Payer: Cofinity Commercial |
$161.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.88
|
| Rate for Payer: Healthscope Commercial |
$168.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.51
|
| Rate for Payer: PHP Commercial |
$159.25
|
| Rate for Payer: Priority Health SBD |
$118.03
|
| Rate for Payer: UMR Bronson Commercial |
$82.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.51
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
OP
|
$15.96
|
|
|
Service Code
|
NDC 60687045111
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.91 |
| Max. Negotiated Rate |
$14.36 |
| Rate for Payer: Aetna American Axle |
$10.37
|
| Rate for Payer: Aetna Commercial |
$13.57
|
| Rate for Payer: Aetna Medicare |
$7.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.37
|
| Rate for Payer: BCBS Complete |
$6.38
|
| Rate for Payer: Cash Price |
$12.77
|
| Rate for Payer: Cofinity Advantage |
$11.17
|
| Rate for Payer: Cofinity Commercial |
$13.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.77
|
| Rate for Payer: Healthscope Commercial |
$14.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.97
|
| Rate for Payer: PHP Commercial |
$13.57
|
| Rate for Payer: Priority Health SBD |
$10.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.37
|
| Rate for Payer: UHC Core |
$8.32
|
| Rate for Payer: UHC Exchange |
$6.27
|
| Rate for Payer: UMR Bronson Commercial |
$5.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.97
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
IP
|
$187.35
|
|
|
Service Code
|
NDC 59762171002
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.43 |
| Max. Negotiated Rate |
$168.62 |
| Rate for Payer: Aetna American Axle |
$121.78
|
| Rate for Payer: Aetna Commercial |
$159.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.78
|
| Rate for Payer: Cash Price |
$149.88
|
| Rate for Payer: Cofinity Advantage |
$131.15
|
| Rate for Payer: Cofinity Commercial |
$161.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.88
|
| Rate for Payer: Healthscope Commercial |
$168.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.51
|
| Rate for Payer: PHP Commercial |
$159.25
|
| Rate for Payer: Priority Health SBD |
$118.03
|
| Rate for Payer: UMR Bronson Commercial |
$82.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.51
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
IP
|
$478.75
|
|
|
Service Code
|
NDC 60687045121
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$210.65 |
| Max. Negotiated Rate |
$430.88 |
| Rate for Payer: Aetna American Axle |
$311.19
|
| Rate for Payer: Aetna Commercial |
$406.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.19
|
| Rate for Payer: Cash Price |
$383.00
|
| Rate for Payer: Cofinity Advantage |
$335.12
|
| Rate for Payer: Cofinity Commercial |
$411.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.00
|
| Rate for Payer: Healthscope Commercial |
$430.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$335.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$406.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$359.06
|
| Rate for Payer: PHP Commercial |
$406.94
|
| Rate for Payer: Priority Health SBD |
$301.61
|
| Rate for Payer: UMR Bronson Commercial |
$210.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.06
|
|
|
EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$499.51
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
9938
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$219.78 |
| Max. Negotiated Rate |
$449.56 |
| Rate for Payer: Aetna American Axle |
$324.68
|
| Rate for Payer: Aetna Commercial |
$424.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.68
|
| Rate for Payer: Cash Price |
$399.61
|
| Rate for Payer: Cofinity Advantage |
$349.66
|
| Rate for Payer: Cofinity Commercial |
$429.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.61
|
| Rate for Payer: Healthscope Commercial |
$449.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$349.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.63
|
| Rate for Payer: PHP Commercial |
$424.58
|
| Rate for Payer: Priority Health SBD |
$314.69
|
| Rate for Payer: UMR Bronson Commercial |
$219.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.63
|
|
|
EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$499.51
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
9938
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$449.56 |
| Rate for Payer: Aetna American Axle |
$324.68
|
| Rate for Payer: Aetna Commercial |
$424.58
|
| Rate for Payer: Aetna Medicare |
$7.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.14
|
| Rate for Payer: BCBS Complete |
$4.01
|
| Rate for Payer: BCBS MAPPO |
$7.31
|
| Rate for Payer: BCBS Trust/PPO |
$24.63
|
| Rate for Payer: BCN Commercial |
$24.63
|
| Rate for Payer: BCN Medicare Advantage |
$7.31
|
| Rate for Payer: Cash Price |
$399.61
|
| Rate for Payer: Cash Price |
$399.61
|
| Rate for Payer: Cofinity Advantage |
$349.66
|
| Rate for Payer: Cofinity Commercial |
$429.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.31
|
| Rate for Payer: Healthscope Commercial |
$449.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$349.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.63
|
| Rate for Payer: Mclaren Medicaid |
$7.31
|
| Rate for Payer: Mclaren Medicare |
$7.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.68
|
| Rate for Payer: Meridian Medicaid |
$7.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.58
|
| Rate for Payer: Nomi Health Commercial |
$21.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.63
|
| Rate for Payer: PACE Medicare |
$6.94
|
| Rate for Payer: PACE SWMI |
$7.31
|
| Rate for Payer: PHP Commercial |
$424.58
|
| Rate for Payer: PHP Medicare Advantage |
$7.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26.96
|
| Rate for Payer: Priority Health Medicare |
$7.31
|
| Rate for Payer: Priority Health SBD |
$314.69
|
| Rate for Payer: Priority Health Tiered Network |
$21.57
|
| Rate for Payer: Railroad Medicare Medicare |
$7.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.77
|
| Rate for Payer: UHC Core |
$12.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.31
|
| Rate for Payer: UHC Exchange |
$12.77
|
| Rate for Payer: UHC Medicaid |
$3.82
|
| Rate for Payer: UHCCP Medicaid |
$3.82
|
| Rate for Payer: UMR Bronson Commercial |
$184.82
|
| Rate for Payer: VA VA |
$7.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.63
|
|
|
EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$1,024.25
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
14643
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$921.83 |
| Rate for Payer: Aetna American Axle |
$665.76
|
| Rate for Payer: Aetna American Axle |
$649.37
|
| Rate for Payer: Aetna Commercial |
$870.61
|
| Rate for Payer: Aetna Commercial |
$849.18
|
| Rate for Payer: Aetna Medicare |
$7.60
|
| Rate for Payer: Aetna Medicare |
$7.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.14
|
| Rate for Payer: BCBS Complete |
$4.01
|
| Rate for Payer: BCBS Complete |
$4.01
|
| Rate for Payer: BCBS MAPPO |
$7.31
|
| Rate for Payer: BCBS MAPPO |
$7.31
|
| Rate for Payer: BCBS Trust/PPO |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$24.63
|
| Rate for Payer: BCN Commercial |
$24.63
|
| Rate for Payer: BCN Commercial |
$24.63
|
| Rate for Payer: BCN Medicare Advantage |
$7.31
|
| Rate for Payer: BCN Medicare Advantage |
$7.31
|
| Rate for Payer: Cash Price |
$799.22
|
| Rate for Payer: Cash Price |
$819.40
|
| Rate for Payer: Cash Price |
$819.40
|
| Rate for Payer: Cash Price |
$799.22
|
| Rate for Payer: Cofinity Advantage |
$699.32
|
| Rate for Payer: Cofinity Advantage |
$716.98
|
| Rate for Payer: Cofinity Commercial |
$880.86
|
| Rate for Payer: Cofinity Commercial |
$859.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$799.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$819.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.31
|
| Rate for Payer: Healthscope Commercial |
$921.83
|
| Rate for Payer: Healthscope Commercial |
$899.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$716.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$699.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$749.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$768.19
|
| Rate for Payer: Mclaren Medicaid |
$7.31
|
| Rate for Payer: Mclaren Medicaid |
$7.31
|
| Rate for Payer: Mclaren Medicare |
$7.31
|
| Rate for Payer: Mclaren Medicare |
$7.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.68
|
| Rate for Payer: Meridian Medicaid |
$7.68
|
| Rate for Payer: Meridian Medicaid |
$7.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$849.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$870.61
|
| Rate for Payer: Nomi Health Commercial |
$21.93
|
| Rate for Payer: Nomi Health Commercial |
$21.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$768.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$749.27
|
| Rate for Payer: PACE Medicare |
$6.94
|
| Rate for Payer: PACE Medicare |
$6.94
|
| Rate for Payer: PACE SWMI |
$7.31
|
| Rate for Payer: PACE SWMI |
$7.31
|
| Rate for Payer: PHP Commercial |
$870.61
|
| Rate for Payer: PHP Commercial |
$849.18
|
| Rate for Payer: PHP Medicare Advantage |
$7.31
|
| Rate for Payer: PHP Medicare Advantage |
$7.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26.96
|
| Rate for Payer: Priority Health Medicare |
$7.31
|
| Rate for Payer: Priority Health Medicare |
$7.31
|
| Rate for Payer: Priority Health SBD |
$629.39
|
| Rate for Payer: Priority Health SBD |
$645.28
|
| Rate for Payer: Priority Health Tiered Network |
$21.57
|
| Rate for Payer: Priority Health Tiered Network |
$21.57
|
| Rate for Payer: Railroad Medicare Medicare |
$7.31
|
| Rate for Payer: Railroad Medicare Medicare |
$7.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.77
|
| Rate for Payer: UHC Core |
$12.77
|
| Rate for Payer: UHC Core |
$12.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.31
|
| Rate for Payer: UHC Exchange |
$12.77
|
| Rate for Payer: UHC Exchange |
$12.77
|
| Rate for Payer: UHC Medicaid |
$3.82
|
| Rate for Payer: UHC Medicaid |
$3.82
|
| Rate for Payer: UHCCP Medicaid |
$3.82
|
| Rate for Payer: UHCCP Medicaid |
$3.82
|
| Rate for Payer: UMR Bronson Commercial |
$378.97
|
| Rate for Payer: UMR Bronson Commercial |
$369.64
|
| Rate for Payer: VA VA |
$7.31
|
| Rate for Payer: VA VA |
$7.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$768.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$749.27
|
|
|
EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$999.03
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
14643
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$439.57 |
| Max. Negotiated Rate |
$899.13 |
| Rate for Payer: Aetna American Axle |
$649.37
|
| Rate for Payer: Aetna Commercial |
$849.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.37
|
| Rate for Payer: Cash Price |
$799.22
|
| Rate for Payer: Cofinity Advantage |
$699.32
|
| Rate for Payer: Cofinity Commercial |
$859.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$799.22
|
| Rate for Payer: Healthscope Commercial |
$899.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$699.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$749.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$849.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$749.27
|
| Rate for Payer: PHP Commercial |
$849.18
|
| Rate for Payer: Priority Health SBD |
$629.39
|
| Rate for Payer: UMR Bronson Commercial |
$439.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$749.27
|
|
|
EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$183.19
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
9939
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$80.60 |
| Max. Negotiated Rate |
$164.87 |
| Rate for Payer: Aetna American Axle |
$119.07
|
| Rate for Payer: Aetna Commercial |
$155.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.07
|
| Rate for Payer: Cash Price |
$146.55
|
| Rate for Payer: Cofinity Advantage |
$128.23
|
| Rate for Payer: Cofinity Commercial |
$157.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.55
|
| Rate for Payer: Healthscope Commercial |
$164.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$128.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$137.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$137.39
|
| Rate for Payer: PHP Commercial |
$155.71
|
| Rate for Payer: Priority Health SBD |
$115.41
|
| Rate for Payer: UMR Bronson Commercial |
$80.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$137.39
|
|
