|
FENTANYL 50 MCG/HR TRANSDERMAL PATCH
|
Facility
|
OP
|
$134.25
|
|
|
Service Code
|
NDC 50742055205
|
| Hospital Charge Code |
27906
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.67 |
| Max. Negotiated Rate |
$120.83 |
| Rate for Payer: Aetna American Axle |
$87.26
|
| Rate for Payer: Aetna Commercial |
$114.11
|
| Rate for Payer: Aetna Medicare |
$67.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.26
|
| Rate for Payer: BCBS Complete |
$53.70
|
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Cofinity Advantage |
$93.97
|
| Rate for Payer: Cofinity Commercial |
$115.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.40
|
| Rate for Payer: Healthscope Commercial |
$120.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.69
|
| Rate for Payer: PHP Commercial |
$114.11
|
| Rate for Payer: Priority Health SBD |
$84.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.26
|
| Rate for Payer: UHC Core |
$69.94
|
| Rate for Payer: UHC Exchange |
$52.76
|
| Rate for Payer: UMR Bronson Commercial |
$49.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.69
|
|
|
FENTANYL 50 MCG/HR TRANSDERMAL PATCH
|
Facility
|
IP
|
$194.37
|
|
|
Service Code
|
NDC 47781042647
|
| Hospital Charge Code |
27906
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$85.52 |
| Max. Negotiated Rate |
$174.93 |
| Rate for Payer: Aetna American Axle |
$126.34
|
| Rate for Payer: Aetna Commercial |
$165.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.34
|
| Rate for Payer: Cash Price |
$155.50
|
| Rate for Payer: Cofinity Advantage |
$136.06
|
| Rate for Payer: Cofinity Commercial |
$167.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.50
|
| Rate for Payer: Healthscope Commercial |
$174.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.78
|
| Rate for Payer: PHP Commercial |
$165.21
|
| Rate for Payer: Priority Health SBD |
$122.45
|
| Rate for Payer: UMR Bronson Commercial |
$85.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.78
|
|
|
FENTANYL 50 MCG/HR TRANSDERMAL PATCH
|
Facility
|
OP
|
$26.85
|
|
|
Service Code
|
NDC 50742055201
|
| Hospital Charge Code |
27906
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$24.16 |
| Rate for Payer: Aetna American Axle |
$17.45
|
| Rate for Payer: Aetna Commercial |
$22.82
|
| Rate for Payer: Aetna Medicare |
$13.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.45
|
| Rate for Payer: BCBS Complete |
$10.74
|
| Rate for Payer: Cash Price |
$21.48
|
| Rate for Payer: Cofinity Advantage |
$18.80
|
| Rate for Payer: Cofinity Commercial |
$23.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.48
|
| Rate for Payer: Healthscope Commercial |
$24.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.14
|
| Rate for Payer: PHP Commercial |
$22.82
|
| Rate for Payer: Priority Health SBD |
$16.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.45
|
| Rate for Payer: UHC Core |
$13.99
|
| Rate for Payer: UHC Exchange |
$10.55
|
| Rate for Payer: UMR Bronson Commercial |
$9.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.14
|
|
|
FENTANYL 50 MCG/HR TRANSDERMAL PATCH
|
Facility
|
IP
|
$38.88
|
|
|
Service Code
|
NDC 47781042611
|
| Hospital Charge Code |
27906
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$17.11 |
| Max. Negotiated Rate |
$34.99 |
| Rate for Payer: Aetna American Axle |
$25.27
|
| Rate for Payer: Aetna Commercial |
$33.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.27
|
| Rate for Payer: Cash Price |
$31.10
|
| Rate for Payer: Cofinity Advantage |
$27.22
|
| Rate for Payer: Cofinity Commercial |
$33.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.10
|
| Rate for Payer: Healthscope Commercial |
$34.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.16
|
| Rate for Payer: PHP Commercial |
$33.05
|
| Rate for Payer: Priority Health SBD |
$24.49
|
| Rate for Payer: UMR Bronson Commercial |
$17.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.16
|
|
|
FENTANYL 50 MCG/HR TRANSDERMAL PATCH
|
Facility
|
IP
|
$194.37
|
|
|
Service Code
|
NDC 00406915076
|
| Hospital Charge Code |
27906
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$85.52 |
| Max. Negotiated Rate |
$174.93 |
| Rate for Payer: Aetna American Axle |
$126.34
|
| Rate for Payer: Aetna Commercial |
$165.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.34
|
| Rate for Payer: Cash Price |
$155.50
|
| Rate for Payer: Cofinity Advantage |
$136.06
|
| Rate for Payer: Cofinity Commercial |
$167.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.50
|
| Rate for Payer: Healthscope Commercial |
$174.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.78
|
| Rate for Payer: PHP Commercial |
$165.21
|
| Rate for Payer: Priority Health SBD |
$122.45
|
| Rate for Payer: UMR Bronson Commercial |
$85.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.78
|
|
|
FENTANYL 50 MCG/HR TRANSDERMAL PATCH
|
Facility
|
OP
|
$38.88
|
|
|
Service Code
|
NDC 47781042611
|
| Hospital Charge Code |
27906
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$14.39 |
| Max. Negotiated Rate |
$34.99 |
| Rate for Payer: Aetna American Axle |
$25.27
|
| Rate for Payer: Aetna Commercial |
$33.05
|
| Rate for Payer: Aetna Medicare |
$19.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.27
|
| Rate for Payer: BCBS Complete |
$15.55
|
| Rate for Payer: Cash Price |
$31.10
|
| Rate for Payer: Cofinity Advantage |
$27.22
|
| Rate for Payer: Cofinity Commercial |
$33.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.10
|
| Rate for Payer: Healthscope Commercial |
$34.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.16
|
| Rate for Payer: PHP Commercial |
$33.05
|
| Rate for Payer: Priority Health SBD |
$24.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.27
|
| Rate for Payer: UHC Core |
$20.26
|
| Rate for Payer: UHC Exchange |
$15.28
|
| Rate for Payer: UMR Bronson Commercial |
$14.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.16
|
|
|
FENTANYL 50 MCG/HR TRANSDERMAL PATCH
|
Facility
|
OP
|
$194.37
|
|
|
Service Code
|
NDC 00406915076
|
| Hospital Charge Code |
27906
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$71.92 |
| Max. Negotiated Rate |
$174.93 |
| Rate for Payer: Aetna American Axle |
$126.34
|
| Rate for Payer: Aetna Commercial |
$165.21
|
| Rate for Payer: Aetna Medicare |
$97.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.34
|
| Rate for Payer: BCBS Complete |
$77.75
|
| Rate for Payer: Cash Price |
$155.50
|
| Rate for Payer: Cofinity Advantage |
$136.06
|
| Rate for Payer: Cofinity Commercial |
$167.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.50
|
| Rate for Payer: Healthscope Commercial |
$174.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$155.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.78
|
| Rate for Payer: PHP Commercial |
$165.21
|
| Rate for Payer: Priority Health SBD |
$122.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.34
|
| Rate for Payer: UHC Core |
$101.27
|
| Rate for Payer: UHC Exchange |
$76.39
|
| Rate for Payer: UMR Bronson Commercial |
$71.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.78
|
|
|
FENTANYL 50 MCG/ML 2ML VIAL (BULK CHARGE)
|
Facility
|
IP
|
$22.04
|
|
|
Service Code
|
HCPCS J3010
|
| Hospital Charge Code |
180136
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.70 |
| Max. Negotiated Rate |
$19.84 |
| Rate for Payer: Aetna American Axle |
$14.33
|
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.33
|
| Rate for Payer: Cash Price |
$17.63
|
| Rate for Payer: Cofinity Advantage |
$15.43
|
| Rate for Payer: Cofinity Commercial |
$18.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.63
|
| Rate for Payer: Healthscope Commercial |
$19.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.53
|
| Rate for Payer: PHP Commercial |
$18.73
|
| Rate for Payer: Priority Health SBD |
$13.89
|
| Rate for Payer: UMR Bronson Commercial |
$9.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.53
|
|
|
FENTANYL 50 MCG/ML 2ML VIAL (BULK CHARGE)
|
Facility
|
OP
|
$22.04
|
|
|
Service Code
|
HCPCS J3010
|
| Hospital Charge Code |
180136
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.96 |
| Max. Negotiated Rate |
$19.84 |
| Rate for Payer: Aetna American Axle |
$14.33
|
| Rate for Payer: Aetna Commercial |
$18.73
|
| Rate for Payer: Aetna Medicare |
$11.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.33
|
| Rate for Payer: BCBS Complete |
$8.82
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: Cash Price |
$17.63
|
| Rate for Payer: Cash Price |
$17.63
|
| Rate for Payer: Cofinity Advantage |
$15.43
|
| Rate for Payer: Cofinity Commercial |
$18.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.63
|
| Rate for Payer: Healthscope Commercial |
$19.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.53
|
| Rate for Payer: PHP Commercial |
$18.73
|
| Rate for Payer: Priority Health SBD |
$13.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UMR Bronson Commercial |
$8.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.53
|
|
|
FENTANYL 50 MCG/ML INHALATION
|
Facility
|
OP
|
$17.56
|
|
|
Service Code
|
HCPCS J3010
|
| Hospital Charge Code |
300141
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.96 |
| Max. Negotiated Rate |
$15.80 |
| Rate for Payer: Aetna American Axle |
$11.41
|
| Rate for Payer: Aetna American Axle |
$9.35
|
| Rate for Payer: Aetna American Axle |
$13.64
|
| Rate for Payer: Aetna Commercial |
$14.93
|
| Rate for Payer: Aetna Commercial |
$17.83
|
| Rate for Payer: Aetna Commercial |
$12.23
|
| Rate for Payer: Aetna Medicare |
$8.78
|
| Rate for Payer: Aetna Medicare |
$7.20
|
| Rate for Payer: Aetna Medicare |
$10.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.64
|
| Rate for Payer: BCBS Complete |
$5.76
|
| Rate for Payer: BCBS Complete |
$7.02
|
| Rate for Payer: BCBS Complete |
$8.39
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: Cash Price |
$11.51
|
| Rate for Payer: Cash Price |
$11.51
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cash Price |
$14.05
|
| Rate for Payer: Cash Price |
$14.05
|
| Rate for Payer: Cofinity Advantage |
$14.69
|
| Rate for Payer: Cofinity Advantage |
$12.29
|
| Rate for Payer: Cofinity Advantage |
$10.07
|
| Rate for Payer: Cofinity Commercial |
$12.38
|
| Rate for Payer: Cofinity Commercial |
$15.10
|
| Rate for Payer: Cofinity Commercial |
$18.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.05
|
| Rate for Payer: Healthscope Commercial |
$12.95
|
| Rate for Payer: Healthscope Commercial |
$15.80
|
| Rate for Payer: Healthscope Commercial |
$18.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.73
|
| Rate for Payer: PHP Commercial |
$14.93
|
| Rate for Payer: PHP Commercial |
$12.23
|
| Rate for Payer: PHP Commercial |
$17.83
|
| Rate for Payer: Priority Health SBD |
$9.07
|
| Rate for Payer: Priority Health SBD |
$13.22
|
| Rate for Payer: Priority Health SBD |
$11.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UMR Bronson Commercial |
$7.76
|
| Rate for Payer: UMR Bronson Commercial |
$5.32
|
| Rate for Payer: UMR Bronson Commercial |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.73
|
|
|
FENTANYL 50 MCG/ML INHALATION
|
Facility
|
IP
|
$14.39
|
|
|
Service Code
|
HCPCS J3010
|
| Hospital Charge Code |
300141
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$12.95 |
| Rate for Payer: Aetna American Axle |
$9.35
|
| Rate for Payer: Aetna American Axle |
$13.64
|
| Rate for Payer: Aetna American Axle |
$11.41
|
| Rate for Payer: Aetna Commercial |
$14.93
|
| Rate for Payer: Aetna Commercial |
$12.23
|
| Rate for Payer: Aetna Commercial |
$17.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.41
|
| Rate for Payer: Cash Price |
$14.05
|
| Rate for Payer: Cash Price |
$11.51
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cofinity Advantage |
$14.69
|
| Rate for Payer: Cofinity Advantage |
$10.07
|
| Rate for Payer: Cofinity Advantage |
$12.29
|
| Rate for Payer: Cofinity Commercial |
$18.04
|
| Rate for Payer: Cofinity Commercial |
$12.38
|
| Rate for Payer: Cofinity Commercial |
$15.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.78
|
| Rate for Payer: Healthscope Commercial |
$15.80
|
| Rate for Payer: Healthscope Commercial |
$18.88
|
| Rate for Payer: Healthscope Commercial |
$12.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.73
|
| Rate for Payer: PHP Commercial |
$14.93
|
| Rate for Payer: PHP Commercial |
$12.23
|
| Rate for Payer: PHP Commercial |
$17.83
|
| Rate for Payer: Priority Health SBD |
$9.07
|
| Rate for Payer: Priority Health SBD |
$11.06
|
| Rate for Payer: Priority Health SBD |
$13.22
|
| Rate for Payer: UMR Bronson Commercial |
$6.33
|
| Rate for Payer: UMR Bronson Commercial |
$9.23
|
| Rate for Payer: UMR Bronson Commercial |
$7.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.73
|
|
|
FENTANYL (PF) 10 MCG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS
|
Facility
|
IP
|
$125.16
|
|
|
Service Code
|
HCPCS J3010
|
| Hospital Charge Code |
30807
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$55.07 |
| Max. Negotiated Rate |
$112.64 |
| Rate for Payer: Aetna American Axle |
$81.35
|
| Rate for Payer: Aetna Commercial |
$106.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.35
|
| Rate for Payer: Cash Price |
$100.13
|
| Rate for Payer: Cofinity Advantage |
$87.61
|
| Rate for Payer: Cofinity Commercial |
$107.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.13
|
| Rate for Payer: Healthscope Commercial |
$112.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.87
|
| Rate for Payer: PHP Commercial |
$106.39
|
| Rate for Payer: Priority Health SBD |
$78.85
|
| Rate for Payer: UMR Bronson Commercial |
$55.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.87
|
|
|
FENTANYL (PF) 10 MCG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS
|
Facility
|
OP
|
$125.16
|
|
|
Service Code
|
HCPCS J3010
|
| Hospital Charge Code |
30807
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.96 |
| Max. Negotiated Rate |
$112.64 |
| Rate for Payer: Aetna American Axle |
$81.35
|
| Rate for Payer: Aetna Commercial |
$106.39
|
| Rate for Payer: Aetna Medicare |
$62.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.35
|
| Rate for Payer: BCBS Complete |
$50.06
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: Cash Price |
$100.13
|
| Rate for Payer: Cash Price |
$100.13
|
| Rate for Payer: Cofinity Advantage |
$87.61
|
| Rate for Payer: Cofinity Commercial |
$107.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.13
|
| Rate for Payer: Healthscope Commercial |
$112.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.87
|
| Rate for Payer: PHP Commercial |
$106.39
|
| Rate for Payer: Priority Health SBD |
$78.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UMR Bronson Commercial |
$46.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.87
|
|
|
FENTANYL (PF) 2 MCG/ML-BUPIVACAINE 0.1 %-NACL INJECTION SOLUTION
|
Facility
|
IP
|
$86.78
|
|
|
Service Code
|
NDC 09900001023
|
| Hospital Charge Code |
30863
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$38.18 |
| Max. Negotiated Rate |
$78.10 |
| Rate for Payer: Aetna American Axle |
$56.41
|
| Rate for Payer: Aetna Commercial |
$73.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.41
|
| Rate for Payer: Cash Price |
$69.42
|
| Rate for Payer: Cofinity Advantage |
$60.75
|
| Rate for Payer: Cofinity Commercial |
$74.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.42
|
| Rate for Payer: Healthscope Commercial |
$78.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.08
|
| Rate for Payer: PHP Commercial |
$73.76
|
| Rate for Payer: Priority Health SBD |
$54.67
|
| Rate for Payer: UMR Bronson Commercial |
$38.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.08
|
|
|
FENTANYL (PF) 2 MCG/ML-BUPIVACAINE 0.1 %-NACL INJECTION SOLUTION
|
Facility
|
OP
|
$86.78
|
|
|
Service Code
|
NDC 09900001023
|
| Hospital Charge Code |
30863
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$32.11 |
| Max. Negotiated Rate |
$78.10 |
| Rate for Payer: Aetna American Axle |
$56.41
|
| Rate for Payer: Aetna Commercial |
$73.76
|
| Rate for Payer: Aetna Medicare |
$43.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.41
|
| Rate for Payer: BCBS Complete |
$34.71
|
| Rate for Payer: Cash Price |
$69.42
|
| Rate for Payer: Cofinity Advantage |
$60.75
|
| Rate for Payer: Cofinity Commercial |
$74.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.42
|
| Rate for Payer: Healthscope Commercial |
$78.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.08
|
| Rate for Payer: PHP Commercial |
$73.76
|
| Rate for Payer: Priority Health SBD |
$54.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.41
|
| Rate for Payer: UHC Core |
$45.21
|
| Rate for Payer: UHC Exchange |
$34.10
|
| Rate for Payer: UMR Bronson Commercial |
$32.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.08
|
|
|
FENTANYL (PF) 4 MCG/ML SD (NICU)
|
Facility
|
IP
|
$0.25
|
|
|
Service Code
|
HCPCS J3010
|
| Hospital Charge Code |
165999
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.23 |
| Rate for Payer: Aetna American Axle |
$0.16
|
| Rate for Payer: Aetna Commercial |
$0.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.16
|
| Rate for Payer: Cash Price |
$0.20
|
| Rate for Payer: Cofinity Advantage |
$0.18
|
| Rate for Payer: Cofinity Commercial |
$0.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.20
|
| Rate for Payer: Healthscope Commercial |
$0.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.19
|
| Rate for Payer: PHP Commercial |
$0.21
|
| Rate for Payer: Priority Health SBD |
$0.16
|
| Rate for Payer: UMR Bronson Commercial |
$0.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.19
|
|
|
FENTANYL (PF) 4 MCG/ML SD (NICU)
|
Facility
|
OP
|
$0.25
|
|
|
Service Code
|
HCPCS J3010
|
| Hospital Charge Code |
165999
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$3.85 |
| Rate for Payer: Aetna American Axle |
$0.16
|
| Rate for Payer: Aetna Commercial |
$0.21
|
| Rate for Payer: Aetna Medicare |
$0.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.16
|
| Rate for Payer: BCBS Complete |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: Cash Price |
$0.20
|
| Rate for Payer: Cash Price |
$0.20
|
| Rate for Payer: Cofinity Advantage |
$0.18
|
| Rate for Payer: Cofinity Commercial |
$0.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.20
|
| Rate for Payer: Healthscope Commercial |
$0.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.19
|
| Rate for Payer: PHP Commercial |
$0.21
|
| Rate for Payer: Priority Health SBD |
$0.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UMR Bronson Commercial |
$0.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.19
|
|
|
FENTANYL (PF) 50 MCG/ML INJECTION (CODE)
|
Facility
|
OP
|
$54.54
|
|
|
Service Code
|
HCPCS J3010
|
| Hospital Charge Code |
163724
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.96 |
| Max. Negotiated Rate |
$49.09 |
| Rate for Payer: Aetna American Axle |
$35.45
|
| Rate for Payer: Aetna American Axle |
$27.77
|
| Rate for Payer: Aetna American Axle |
$16.07
|
| Rate for Payer: Aetna American Axle |
$17.73
|
| Rate for Payer: Aetna American Axle |
$26.59
|
| Rate for Payer: Aetna American Axle |
$117.12
|
| Rate for Payer: Aetna American Axle |
$13.64
|
| Rate for Payer: Aetna American Axle |
$45.02
|
| Rate for Payer: Aetna Commercial |
$21.01
|
| Rate for Payer: Aetna Commercial |
$153.16
|
| Rate for Payer: Aetna Commercial |
$34.77
|
| Rate for Payer: Aetna Commercial |
$23.18
|
| Rate for Payer: Aetna Commercial |
$36.32
|
| Rate for Payer: Aetna Commercial |
$46.36
|
| Rate for Payer: Aetna Commercial |
$58.87
|
| Rate for Payer: Aetna Commercial |
$17.83
|
| Rate for Payer: Aetna Medicare |
$12.36
|
| Rate for Payer: Aetna Medicare |
$10.49
|
| Rate for Payer: Aetna Medicare |
$27.27
|
| Rate for Payer: Aetna Medicare |
$90.09
|
| Rate for Payer: Aetna Medicare |
$20.45
|
| Rate for Payer: Aetna Medicare |
$13.63
|
| Rate for Payer: Aetna Medicare |
$34.63
|
| Rate for Payer: Aetna Medicare |
$21.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.59
|
| Rate for Payer: BCBS Complete |
$27.70
|
| Rate for Payer: BCBS Complete |
$17.09
|
| Rate for Payer: BCBS Complete |
$10.91
|
| Rate for Payer: BCBS Complete |
$72.08
|
| Rate for Payer: BCBS Complete |
$9.89
|
| Rate for Payer: BCBS Complete |
$8.39
|
| Rate for Payer: BCBS Complete |
$21.82
|
| Rate for Payer: BCBS Complete |
$16.36
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cash Price |
$144.15
|
| Rate for Payer: Cash Price |
$144.15
|
| Rate for Payer: Cash Price |
$19.78
|
| Rate for Payer: Cash Price |
$19.78
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cash Price |
$21.82
|
| Rate for Payer: Cash Price |
$21.82
|
| Rate for Payer: Cash Price |
$32.73
|
| Rate for Payer: Cash Price |
$32.73
|
| Rate for Payer: Cash Price |
$34.18
|
| Rate for Payer: Cash Price |
$34.18
|
| Rate for Payer: Cash Price |
$43.63
|
| Rate for Payer: Cash Price |
$43.63
|
| Rate for Payer: Cash Price |
$55.41
|
| Rate for Payer: Cash Price |
$55.41
|
| Rate for Payer: Cofinity Advantage |
$29.91
|
| Rate for Payer: Cofinity Advantage |
$48.48
|
| Rate for Payer: Cofinity Advantage |
$17.30
|
| Rate for Payer: Cofinity Advantage |
$28.64
|
| Rate for Payer: Cofinity Advantage |
$38.18
|
| Rate for Payer: Cofinity Advantage |
$19.09
|
| Rate for Payer: Cofinity Advantage |
$126.13
|
| Rate for Payer: Cofinity Advantage |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$23.45
|
| Rate for Payer: Cofinity Commercial |
$36.75
|
| Rate for Payer: Cofinity Commercial |
$59.56
|
| Rate for Payer: Cofinity Commercial |
$154.96
|
| Rate for Payer: Cofinity Commercial |
$18.04
|
| Rate for Payer: Cofinity Commercial |
$21.26
|
| Rate for Payer: Cofinity Commercial |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$35.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.63
|
| Rate for Payer: Healthscope Commercial |
$162.17
|
| Rate for Payer: Healthscope Commercial |
$62.33
|
| Rate for Payer: Healthscope Commercial |
$22.25
|
| Rate for Payer: Healthscope Commercial |
$24.54
|
| Rate for Payer: Healthscope Commercial |
$49.09
|
| Rate for Payer: Healthscope Commercial |
$38.46
|
| Rate for Payer: Healthscope Commercial |
$18.88
|
| Rate for Payer: Healthscope Commercial |
$36.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.54
|
| Rate for Payer: PHP Commercial |
$153.16
|
| Rate for Payer: PHP Commercial |
$23.18
|
| Rate for Payer: PHP Commercial |
$36.32
|
| Rate for Payer: PHP Commercial |
$21.01
|
| Rate for Payer: PHP Commercial |
$58.87
|
| Rate for Payer: PHP Commercial |
$46.36
|
| Rate for Payer: PHP Commercial |
$34.77
|
| Rate for Payer: PHP Commercial |
$17.83
|
| Rate for Payer: Priority Health SBD |
$13.22
|
| Rate for Payer: Priority Health SBD |
$43.63
|
| Rate for Payer: Priority Health SBD |
$113.52
|
| Rate for Payer: Priority Health SBD |
$26.92
|
| Rate for Payer: Priority Health SBD |
$34.36
|
| Rate for Payer: Priority Health SBD |
$15.57
|
| Rate for Payer: Priority Health SBD |
$17.18
|
| Rate for Payer: Priority Health SBD |
$25.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UMR Bronson Commercial |
$20.18
|
| Rate for Payer: UMR Bronson Commercial |
$25.63
|
| Rate for Payer: UMR Bronson Commercial |
$15.14
|
| Rate for Payer: UMR Bronson Commercial |
$9.15
|
| Rate for Payer: UMR Bronson Commercial |
$15.81
|
| Rate for Payer: UMR Bronson Commercial |
$66.67
|
| Rate for Payer: UMR Bronson Commercial |
$7.76
|
| Rate for Payer: UMR Bronson Commercial |
$10.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.91
|
|
|
FENTANYL (PF) 50 MCG/ML INJECTION (CODE)
|
Facility
|
IP
|
$27.27
|
|
|
Service Code
|
HCPCS J3010
|
| Hospital Charge Code |
163724
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$24.54 |
| Rate for Payer: Aetna American Axle |
$17.73
|
| Rate for Payer: Aetna American Axle |
$27.77
|
| Rate for Payer: Aetna American Axle |
$35.45
|
| Rate for Payer: Aetna American Axle |
$117.12
|
| Rate for Payer: Aetna American Axle |
$16.07
|
| Rate for Payer: Aetna American Axle |
$13.64
|
| Rate for Payer: Aetna American Axle |
$45.02
|
| Rate for Payer: Aetna American Axle |
$26.59
|
| Rate for Payer: Aetna Commercial |
$58.87
|
| Rate for Payer: Aetna Commercial |
$46.36
|
| Rate for Payer: Aetna Commercial |
$23.18
|
| Rate for Payer: Aetna Commercial |
$153.16
|
| Rate for Payer: Aetna Commercial |
$17.83
|
| Rate for Payer: Aetna Commercial |
$36.32
|
| Rate for Payer: Aetna Commercial |
$21.01
|
| Rate for Payer: Aetna Commercial |
$34.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.77
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cash Price |
$55.41
|
| Rate for Payer: Cash Price |
$21.82
|
| Rate for Payer: Cash Price |
$144.15
|
| Rate for Payer: Cash Price |
$19.78
|
| Rate for Payer: Cash Price |
$32.73
|
| Rate for Payer: Cash Price |
$34.18
|
| Rate for Payer: Cash Price |
$43.63
|
| Rate for Payer: Cofinity Advantage |
$48.48
|
| Rate for Payer: Cofinity Advantage |
$14.69
|
| Rate for Payer: Cofinity Advantage |
$19.09
|
| Rate for Payer: Cofinity Advantage |
$17.30
|
| Rate for Payer: Cofinity Advantage |
$126.13
|
| Rate for Payer: Cofinity Advantage |
$29.91
|
| Rate for Payer: Cofinity Advantage |
$38.18
|
| Rate for Payer: Cofinity Advantage |
$28.64
|
| Rate for Payer: Cofinity Commercial |
$18.04
|
| Rate for Payer: Cofinity Commercial |
$154.96
|
| Rate for Payer: Cofinity Commercial |
$21.26
|
| Rate for Payer: Cofinity Commercial |
$23.45
|
| Rate for Payer: Cofinity Commercial |
$59.56
|
| Rate for Payer: Cofinity Commercial |
$35.18
|
| Rate for Payer: Cofinity Commercial |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$36.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.15
|
| Rate for Payer: Healthscope Commercial |
$36.82
|
| Rate for Payer: Healthscope Commercial |
$24.54
|
| Rate for Payer: Healthscope Commercial |
$162.17
|
| Rate for Payer: Healthscope Commercial |
$62.33
|
| Rate for Payer: Healthscope Commercial |
$49.09
|
| Rate for Payer: Healthscope Commercial |
$22.25
|
| Rate for Payer: Healthscope Commercial |
$18.88
|
| Rate for Payer: Healthscope Commercial |
$38.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.95
|
| Rate for Payer: PHP Commercial |
$23.18
|
| Rate for Payer: PHP Commercial |
$34.77
|
| Rate for Payer: PHP Commercial |
$58.87
|
| Rate for Payer: PHP Commercial |
$21.01
|
| Rate for Payer: PHP Commercial |
$17.83
|
| Rate for Payer: PHP Commercial |
$153.16
|
| Rate for Payer: PHP Commercial |
$36.32
|
| Rate for Payer: PHP Commercial |
$46.36
|
| Rate for Payer: Priority Health SBD |
$26.92
|
| Rate for Payer: Priority Health SBD |
$34.36
|
| Rate for Payer: Priority Health SBD |
$43.63
|
| Rate for Payer: Priority Health SBD |
$13.22
|
| Rate for Payer: Priority Health SBD |
$113.52
|
| Rate for Payer: Priority Health SBD |
$15.57
|
| Rate for Payer: Priority Health SBD |
$17.18
|
| Rate for Payer: Priority Health SBD |
$25.77
|
| Rate for Payer: UMR Bronson Commercial |
$79.28
|
| Rate for Payer: UMR Bronson Commercial |
$18.00
|
| Rate for Payer: UMR Bronson Commercial |
$10.88
|
| Rate for Payer: UMR Bronson Commercial |
$30.47
|
| Rate for Payer: UMR Bronson Commercial |
$24.00
|
| Rate for Payer: UMR Bronson Commercial |
$12.00
|
| Rate for Payer: UMR Bronson Commercial |
$9.23
|
| Rate for Payer: UMR Bronson Commercial |
$18.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.91
|
|
|
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$13.37
|
|
|
Service Code
|
HCPCS J3010
|
| Hospital Charge Code |
3037
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.88 |
| Max. Negotiated Rate |
$12.03 |
| Rate for Payer: Aetna American Axle |
$8.69
|
| Rate for Payer: Aetna American Axle |
$31.66
|
| Rate for Payer: Aetna American Axle |
$92.30
|
| Rate for Payer: Aetna American Axle |
$6.40
|
| Rate for Payer: Aetna American Axle |
$13.42
|
| Rate for Payer: Aetna American Axle |
$51.02
|
| Rate for Payer: Aetna American Axle |
$12.69
|
| Rate for Payer: Aetna American Axle |
$25.22
|
| Rate for Payer: Aetna American Axle |
$47.45
|
| Rate for Payer: Aetna American Axle |
$13.64
|
| Rate for Payer: Aetna American Axle |
$30.61
|
| Rate for Payer: Aetna American Axle |
$10.25
|
| Rate for Payer: Aetna American Axle |
$9.35
|
| Rate for Payer: Aetna American Axle |
$12.15
|
| Rate for Payer: Aetna American Axle |
$20.92
|
| Rate for Payer: Aetna Commercial |
$40.03
|
| Rate for Payer: Aetna Commercial |
$41.40
|
| Rate for Payer: Aetna Commercial |
$120.70
|
| Rate for Payer: Aetna Commercial |
$62.05
|
| Rate for Payer: Aetna Commercial |
$12.23
|
| Rate for Payer: Aetna Commercial |
$17.83
|
| Rate for Payer: Aetna Commercial |
$17.54
|
| Rate for Payer: Aetna Commercial |
$27.36
|
| Rate for Payer: Aetna Commercial |
$32.98
|
| Rate for Payer: Aetna Commercial |
$11.36
|
| Rate for Payer: Aetna Commercial |
$16.59
|
| Rate for Payer: Aetna Commercial |
$66.72
|
| Rate for Payer: Aetna Commercial |
$8.37
|
| Rate for Payer: Aetna Commercial |
$15.89
|
| Rate for Payer: Aetna Commercial |
$13.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.42
|
| Rate for Payer: Cash Price |
$31.04
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cash Price |
$12.62
|
| Rate for Payer: Cash Price |
$10.70
|
| Rate for Payer: Cash Price |
$11.51
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$7.88
|
| Rate for Payer: Cash Price |
$62.80
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$38.96
|
| Rate for Payer: Cash Price |
$37.68
|
| Rate for Payer: Cash Price |
$14.95
|
| Rate for Payer: Cash Price |
$15.62
|
| Rate for Payer: Cash Price |
$25.75
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cofinity Advantage |
$10.07
|
| Rate for Payer: Cofinity Advantage |
$51.10
|
| Rate for Payer: Cofinity Advantage |
$27.16
|
| Rate for Payer: Cofinity Advantage |
$9.36
|
| Rate for Payer: Cofinity Advantage |
$14.69
|
| Rate for Payer: Cofinity Advantage |
$22.53
|
| Rate for Payer: Cofinity Advantage |
$13.66
|
| Rate for Payer: Cofinity Advantage |
$32.97
|
| Rate for Payer: Cofinity Advantage |
$13.08
|
| Rate for Payer: Cofinity Advantage |
$14.45
|
| Rate for Payer: Cofinity Advantage |
$34.09
|
| Rate for Payer: Cofinity Advantage |
$99.40
|
| Rate for Payer: Cofinity Advantage |
$6.89
|
| Rate for Payer: Cofinity Advantage |
$54.95
|
| Rate for Payer: Cofinity Advantage |
$11.04
|
| Rate for Payer: Cofinity Commercial |
$11.50
|
| Rate for Payer: Cofinity Commercial |
$40.51
|
| Rate for Payer: Cofinity Commercial |
$67.51
|
| Rate for Payer: Cofinity Commercial |
$17.75
|
| Rate for Payer: Cofinity Commercial |
$16.07
|
| Rate for Payer: Cofinity Commercial |
$8.47
|
| Rate for Payer: Cofinity Commercial |
$33.37
|
| Rate for Payer: Cofinity Commercial |
$16.79
|
| Rate for Payer: Cofinity Commercial |
$13.56
|
| Rate for Payer: Cofinity Commercial |
$12.38
|
| Rate for Payer: Cofinity Commercial |
$122.12
|
| Rate for Payer: Cofinity Commercial |
$27.68
|
| Rate for Payer: Cofinity Commercial |
$41.88
|
| Rate for Payer: Cofinity Commercial |
$18.04
|
| Rate for Payer: Cofinity Commercial |
$62.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.68
|
| Rate for Payer: Healthscope Commercial |
$14.19
|
| Rate for Payer: Healthscope Commercial |
$12.03
|
| Rate for Payer: Healthscope Commercial |
$127.80
|
| Rate for Payer: Healthscope Commercial |
$12.95
|
| Rate for Payer: Healthscope Commercial |
$16.82
|
| Rate for Payer: Healthscope Commercial |
$17.57
|
| Rate for Payer: Healthscope Commercial |
$18.58
|
| Rate for Payer: Healthscope Commercial |
$18.88
|
| Rate for Payer: Healthscope Commercial |
$28.97
|
| Rate for Payer: Healthscope Commercial |
$34.92
|
| Rate for Payer: Healthscope Commercial |
$42.39
|
| Rate for Payer: Healthscope Commercial |
$43.83
|
| Rate for Payer: Healthscope Commercial |
$65.70
|
| Rate for Payer: Healthscope Commercial |
$70.65
|
| Rate for Payer: Healthscope Commercial |
$8.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.33
|
| Rate for Payer: PHP Commercial |
$15.89
|
| Rate for Payer: PHP Commercial |
$17.83
|
| Rate for Payer: PHP Commercial |
$32.98
|
| Rate for Payer: PHP Commercial |
$16.59
|
| Rate for Payer: PHP Commercial |
$40.03
|
| Rate for Payer: PHP Commercial |
$8.37
|
| Rate for Payer: PHP Commercial |
$41.40
|
| Rate for Payer: PHP Commercial |
$13.40
|
| Rate for Payer: PHP Commercial |
$11.36
|
| Rate for Payer: PHP Commercial |
$120.70
|
| Rate for Payer: PHP Commercial |
$12.23
|
| Rate for Payer: PHP Commercial |
$62.05
|
| Rate for Payer: PHP Commercial |
$17.54
|
| Rate for Payer: PHP Commercial |
$66.72
|
| Rate for Payer: PHP Commercial |
$27.36
|
| Rate for Payer: Priority Health SBD |
$89.46
|
| Rate for Payer: Priority Health SBD |
$24.44
|
| Rate for Payer: Priority Health SBD |
$8.42
|
| Rate for Payer: Priority Health SBD |
$29.67
|
| Rate for Payer: Priority Health SBD |
$13.00
|
| Rate for Payer: Priority Health SBD |
$30.68
|
| Rate for Payer: Priority Health SBD |
$13.22
|
| Rate for Payer: Priority Health SBD |
$45.99
|
| Rate for Payer: Priority Health SBD |
$49.45
|
| Rate for Payer: Priority Health SBD |
$12.30
|
| Rate for Payer: Priority Health SBD |
$11.77
|
| Rate for Payer: Priority Health SBD |
$6.21
|
| Rate for Payer: Priority Health SBD |
$20.28
|
| Rate for Payer: Priority Health SBD |
$9.94
|
| Rate for Payer: Priority Health SBD |
$9.07
|
| Rate for Payer: UMR Bronson Commercial |
$34.54
|
| Rate for Payer: UMR Bronson Commercial |
$17.07
|
| Rate for Payer: UMR Bronson Commercial |
$9.08
|
| Rate for Payer: UMR Bronson Commercial |
$62.48
|
| Rate for Payer: UMR Bronson Commercial |
$32.12
|
| Rate for Payer: UMR Bronson Commercial |
$6.94
|
| Rate for Payer: UMR Bronson Commercial |
$5.88
|
| Rate for Payer: UMR Bronson Commercial |
$6.33
|
| Rate for Payer: UMR Bronson Commercial |
$20.72
|
| Rate for Payer: UMR Bronson Commercial |
$4.33
|
| Rate for Payer: UMR Bronson Commercial |
$8.22
|
| Rate for Payer: UMR Bronson Commercial |
$9.23
|
| Rate for Payer: UMR Bronson Commercial |
$8.59
|
| Rate for Payer: UMR Bronson Commercial |
$21.43
|
| Rate for Payer: UMR Bronson Commercial |
$14.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.79
|
|
|
FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$19.52
|
|
|
Service Code
|
HCPCS J3010
|
| Hospital Charge Code |
3037
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.96 |
| Max. Negotiated Rate |
$17.57 |
| Rate for Payer: Aetna American Axle |
$12.69
|
| Rate for Payer: Aetna American Axle |
$13.42
|
| Rate for Payer: Aetna American Axle |
$30.61
|
| Rate for Payer: Aetna American Axle |
$13.64
|
| Rate for Payer: Aetna American Axle |
$8.69
|
| Rate for Payer: Aetna American Axle |
$25.22
|
| Rate for Payer: Aetna American Axle |
$10.25
|
| Rate for Payer: Aetna American Axle |
$6.40
|
| Rate for Payer: Aetna American Axle |
$20.92
|
| Rate for Payer: Aetna American Axle |
$47.45
|
| Rate for Payer: Aetna American Axle |
$12.15
|
| Rate for Payer: Aetna American Axle |
$9.35
|
| Rate for Payer: Aetna American Axle |
$92.30
|
| Rate for Payer: Aetna American Axle |
$31.66
|
| Rate for Payer: Aetna American Axle |
$51.02
|
| Rate for Payer: Aetna Commercial |
$27.36
|
| Rate for Payer: Aetna Commercial |
$66.72
|
| Rate for Payer: Aetna Commercial |
$120.70
|
| Rate for Payer: Aetna Commercial |
$32.98
|
| Rate for Payer: Aetna Commercial |
$17.83
|
| Rate for Payer: Aetna Commercial |
$40.03
|
| Rate for Payer: Aetna Commercial |
$17.54
|
| Rate for Payer: Aetna Commercial |
$11.36
|
| Rate for Payer: Aetna Commercial |
$16.59
|
| Rate for Payer: Aetna Commercial |
$41.40
|
| Rate for Payer: Aetna Commercial |
$12.23
|
| Rate for Payer: Aetna Commercial |
$15.89
|
| Rate for Payer: Aetna Commercial |
$62.05
|
| Rate for Payer: Aetna Commercial |
$8.37
|
| Rate for Payer: Aetna Commercial |
$13.40
|
| Rate for Payer: Aetna Medicare |
$7.20
|
| Rate for Payer: Aetna Medicare |
$9.76
|
| Rate for Payer: Aetna Medicare |
$36.50
|
| Rate for Payer: Aetna Medicare |
$16.09
|
| Rate for Payer: Aetna Medicare |
$24.35
|
| Rate for Payer: Aetna Medicare |
$39.25
|
| Rate for Payer: Aetna Medicare |
$9.35
|
| Rate for Payer: Aetna Medicare |
$7.88
|
| Rate for Payer: Aetna Medicare |
$19.40
|
| Rate for Payer: Aetna Medicare |
$10.49
|
| Rate for Payer: Aetna Medicare |
$4.92
|
| Rate for Payer: Aetna Medicare |
$23.55
|
| Rate for Payer: Aetna Medicare |
$71.00
|
| Rate for Payer: Aetna Medicare |
$10.32
|
| Rate for Payer: Aetna Medicare |
$6.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.25
|
| Rate for Payer: BCBS Complete |
$12.88
|
| Rate for Payer: BCBS Complete |
$5.35
|
| Rate for Payer: BCBS Complete |
$56.80
|
| Rate for Payer: BCBS Complete |
$5.76
|
| Rate for Payer: BCBS Complete |
$3.94
|
| Rate for Payer: BCBS Complete |
$31.40
|
| Rate for Payer: BCBS Complete |
$6.31
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS Complete |
$7.48
|
| Rate for Payer: BCBS Complete |
$19.48
|
| Rate for Payer: BCBS Complete |
$7.81
|
| Rate for Payer: BCBS Complete |
$18.84
|
| Rate for Payer: BCBS Complete |
$8.26
|
| Rate for Payer: BCBS Complete |
$8.39
|
| Rate for Payer: BCBS Complete |
$15.52
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cash Price |
$37.68
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cash Price |
$62.80
|
| Rate for Payer: Cash Price |
$25.75
|
| Rate for Payer: Cash Price |
$7.88
|
| Rate for Payer: Cash Price |
$7.88
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$14.95
|
| Rate for Payer: Cash Price |
$25.75
|
| Rate for Payer: Cash Price |
$31.04
|
| Rate for Payer: Cash Price |
$14.95
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cash Price |
$12.62
|
| Rate for Payer: Cash Price |
$38.96
|
| Rate for Payer: Cash Price |
$31.04
|
| Rate for Payer: Cash Price |
$15.62
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cash Price |
$62.80
|
| Rate for Payer: Cash Price |
$15.62
|
| Rate for Payer: Cash Price |
$37.68
|
| Rate for Payer: Cash Price |
$10.70
|
| Rate for Payer: Cash Price |
$38.96
|
| Rate for Payer: Cash Price |
$10.70
|
| Rate for Payer: Cash Price |
$11.51
|
| Rate for Payer: Cash Price |
$11.51
|
| Rate for Payer: Cash Price |
$12.62
|
| Rate for Payer: Cofinity Advantage |
$11.04
|
| Rate for Payer: Cofinity Advantage |
$99.40
|
| Rate for Payer: Cofinity Advantage |
$13.66
|
| Rate for Payer: Cofinity Advantage |
$54.95
|
| Rate for Payer: Cofinity Advantage |
$34.09
|
| Rate for Payer: Cofinity Advantage |
$22.53
|
| Rate for Payer: Cofinity Advantage |
$14.69
|
| Rate for Payer: Cofinity Advantage |
$10.07
|
| Rate for Payer: Cofinity Advantage |
$51.10
|
| Rate for Payer: Cofinity Advantage |
$32.97
|
| Rate for Payer: Cofinity Advantage |
$13.08
|
| Rate for Payer: Cofinity Advantage |
$27.16
|
| Rate for Payer: Cofinity Advantage |
$6.89
|
| Rate for Payer: Cofinity Advantage |
$14.45
|
| Rate for Payer: Cofinity Advantage |
$9.36
|
| Rate for Payer: Cofinity Commercial |
$33.37
|
| Rate for Payer: Cofinity Commercial |
$62.78
|
| Rate for Payer: Cofinity Commercial |
$67.51
|
| Rate for Payer: Cofinity Commercial |
$13.56
|
| Rate for Payer: Cofinity Commercial |
$8.47
|
| Rate for Payer: Cofinity Commercial |
$16.07
|
| Rate for Payer: Cofinity Commercial |
$41.88
|
| Rate for Payer: Cofinity Commercial |
$12.38
|
| Rate for Payer: Cofinity Commercial |
$122.12
|
| Rate for Payer: Cofinity Commercial |
$16.79
|
| Rate for Payer: Cofinity Commercial |
$11.50
|
| Rate for Payer: Cofinity Commercial |
$40.51
|
| Rate for Payer: Cofinity Commercial |
$27.68
|
| Rate for Payer: Cofinity Commercial |
$17.75
|
| Rate for Payer: Cofinity Commercial |
$18.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.51
|
| Rate for Payer: Healthscope Commercial |
$18.58
|
| Rate for Payer: Healthscope Commercial |
$42.39
|
| Rate for Payer: Healthscope Commercial |
$17.57
|
| Rate for Payer: Healthscope Commercial |
$127.80
|
| Rate for Payer: Healthscope Commercial |
$34.92
|
| Rate for Payer: Healthscope Commercial |
$12.03
|
| Rate for Payer: Healthscope Commercial |
$43.83
|
| Rate for Payer: Healthscope Commercial |
$16.82
|
| Rate for Payer: Healthscope Commercial |
$65.70
|
| Rate for Payer: Healthscope Commercial |
$18.88
|
| Rate for Payer: Healthscope Commercial |
$28.97
|
| Rate for Payer: Healthscope Commercial |
$8.87
|
| Rate for Payer: Healthscope Commercial |
$14.19
|
| Rate for Payer: Healthscope Commercial |
$12.95
|
| Rate for Payer: Healthscope Commercial |
$70.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.14
|
| Rate for Payer: PHP Commercial |
$15.89
|
| Rate for Payer: PHP Commercial |
$40.03
|
| Rate for Payer: PHP Commercial |
$66.72
|
| Rate for Payer: PHP Commercial |
$12.23
|
| Rate for Payer: PHP Commercial |
$13.40
|
| Rate for Payer: PHP Commercial |
$17.83
|
| Rate for Payer: PHP Commercial |
$27.36
|
| Rate for Payer: PHP Commercial |
$17.54
|
| Rate for Payer: PHP Commercial |
$32.98
|
| Rate for Payer: PHP Commercial |
$41.40
|
| Rate for Payer: PHP Commercial |
$62.05
|
| Rate for Payer: PHP Commercial |
$16.59
|
| Rate for Payer: PHP Commercial |
$8.37
|
| Rate for Payer: PHP Commercial |
$11.36
|
| Rate for Payer: PHP Commercial |
$120.70
|
| Rate for Payer: Priority Health SBD |
$24.44
|
| Rate for Payer: Priority Health SBD |
$6.21
|
| Rate for Payer: Priority Health SBD |
$45.99
|
| Rate for Payer: Priority Health SBD |
$9.07
|
| Rate for Payer: Priority Health SBD |
$13.00
|
| Rate for Payer: Priority Health SBD |
$20.28
|
| Rate for Payer: Priority Health SBD |
$12.30
|
| Rate for Payer: Priority Health SBD |
$29.67
|
| Rate for Payer: Priority Health SBD |
$89.46
|
| Rate for Payer: Priority Health SBD |
$8.42
|
| Rate for Payer: Priority Health SBD |
$11.77
|
| Rate for Payer: Priority Health SBD |
$49.45
|
| Rate for Payer: Priority Health SBD |
$30.68
|
| Rate for Payer: Priority Health SBD |
$9.94
|
| Rate for Payer: Priority Health SBD |
$13.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UMR Bronson Commercial |
$7.22
|
| Rate for Payer: UMR Bronson Commercial |
$7.64
|
| Rate for Payer: UMR Bronson Commercial |
$14.36
|
| Rate for Payer: UMR Bronson Commercial |
$3.64
|
| Rate for Payer: UMR Bronson Commercial |
$7.76
|
| Rate for Payer: UMR Bronson Commercial |
$27.01
|
| Rate for Payer: UMR Bronson Commercial |
$5.32
|
| Rate for Payer: UMR Bronson Commercial |
$5.83
|
| Rate for Payer: UMR Bronson Commercial |
$18.02
|
| Rate for Payer: UMR Bronson Commercial |
$29.05
|
| Rate for Payer: UMR Bronson Commercial |
$4.95
|
| Rate for Payer: UMR Bronson Commercial |
$11.91
|
| Rate for Payer: UMR Bronson Commercial |
$6.92
|
| Rate for Payer: UMR Bronson Commercial |
$52.54
|
| Rate for Payer: UMR Bronson Commercial |
$17.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.79
|
|
|
FENTANYL (PF) 50 MCG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$14.26
|
|
|
Service Code
|
HCPCS J3010
|
| Hospital Charge Code |
112217
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.96 |
| Max. Negotiated Rate |
$12.83 |
| Rate for Payer: Aetna American Axle |
$9.27
|
| Rate for Payer: Aetna Commercial |
$12.12
|
| Rate for Payer: Aetna Medicare |
$7.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.27
|
| Rate for Payer: BCBS Complete |
$5.70
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: Cash Price |
$11.41
|
| Rate for Payer: Cash Price |
$11.41
|
| Rate for Payer: Cofinity Advantage |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$12.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.41
|
| Rate for Payer: Healthscope Commercial |
$12.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.70
|
| Rate for Payer: PHP Commercial |
$12.12
|
| Rate for Payer: Priority Health SBD |
$8.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.96
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.96
|
| Rate for Payer: UMR Bronson Commercial |
$5.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.70
|
|
|
FENTANYL (PF) 50 MCG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$14.26
|
|
|
Service Code
|
HCPCS J3010
|
| Hospital Charge Code |
112217
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$12.83 |
| Rate for Payer: Aetna American Axle |
$9.27
|
| Rate for Payer: Aetna Commercial |
$12.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.27
|
| Rate for Payer: Cash Price |
$11.41
|
| Rate for Payer: Cofinity Advantage |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$12.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.41
|
| Rate for Payer: Healthscope Commercial |
$12.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.70
|
| Rate for Payer: PHP Commercial |
$12.12
|
| Rate for Payer: Priority Health SBD |
$8.98
|
| Rate for Payer: UMR Bronson Commercial |
$6.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.70
|
|
|
FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$3,750.00
|
|
|
Service Code
|
HCPCS J1439
|
| Hospital Charge Code |
167398
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,650.00 |
| Max. Negotiated Rate |
$3,375.00 |
| Rate for Payer: Aetna American Axle |
$2,437.50
|
| Rate for Payer: Aetna Commercial |
$3,187.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,437.50
|
| Rate for Payer: Cash Price |
$3,000.00
|
| Rate for Payer: Cofinity Advantage |
$2,625.00
|
| Rate for Payer: Cofinity Commercial |
$3,225.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,000.00
|
| Rate for Payer: Healthscope Commercial |
$3,375.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,625.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,812.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,187.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,812.50
|
| Rate for Payer: PHP Commercial |
$3,187.50
|
| Rate for Payer: Priority Health SBD |
$2,362.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,650.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,812.50
|
|
|
FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$3,750.00
|
|
|
Service Code
|
HCPCS J1439
|
| Hospital Charge Code |
167398
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$3,375.00 |
| Rate for Payer: Aetna American Axle |
$2,437.50
|
| Rate for Payer: Aetna Commercial |
$3,187.50
|
| Rate for Payer: Aetna Medicare |
$1.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,437.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.38
|
| Rate for Payer: BCBS Complete |
$0.60
|
| Rate for Payer: BCBS MAPPO |
$1.10
|
| Rate for Payer: BCBS Trust/PPO |
$3.91
|
| Rate for Payer: BCN Commercial |
$3.91
|
| Rate for Payer: BCN Medicare Advantage |
$1.10
|
| Rate for Payer: Cash Price |
$3,000.00
|
| Rate for Payer: Cash Price |
$3,000.00
|
| Rate for Payer: Cofinity Advantage |
$2,625.00
|
| Rate for Payer: Cofinity Commercial |
$3,225.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,000.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.10
|
| Rate for Payer: Healthscope Commercial |
$3,375.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,625.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,812.50
|
| Rate for Payer: Mclaren Medicaid |
$1.10
|
| Rate for Payer: Mclaren Medicare |
$1.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.16
|
| Rate for Payer: Meridian Medicaid |
$1.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,187.50
|
| Rate for Payer: Nomi Health Commercial |
$3.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,812.50
|
| Rate for Payer: PACE Medicare |
$1.04
|
| Rate for Payer: PACE SWMI |
$1.10
|
| Rate for Payer: PHP Commercial |
$3,187.50
|
| Rate for Payer: PHP Medicare Advantage |
$1.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3.49
|
| Rate for Payer: Priority Health Medicare |
$1.10
|
| Rate for Payer: Priority Health SBD |
$2,362.50
|
| Rate for Payer: Priority Health Tiered Network |
$2.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.85
|
| Rate for Payer: UHC Core |
$1.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.10
|
| Rate for Payer: UHC Exchange |
$1.85
|
| Rate for Payer: UHC Medicaid |
$0.58
|
| Rate for Payer: UHCCP Medicaid |
$0.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,387.50
|
| Rate for Payer: VA VA |
$1.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,812.50
|
|
