|
EFGARTIGIMOD ALFA 1008 MG-HYALURON-QVFC 11,200 UNIT/5.6 ML SUBCUT SOLN
|
Facility
|
OP
|
$41,830.00
|
|
|
Service Code
|
HCPCS J9334
|
| Hospital Charge Code |
204386
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.17 |
| Max. Negotiated Rate |
$37,647.00 |
| Rate for Payer: Aetna American Axle |
$27,189.50
|
| Rate for Payer: Aetna Commercial |
$35,555.50
|
| Rate for Payer: Aetna Medicare |
$35.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27,189.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.36
|
| Rate for Payer: BCBS Complete |
$19.07
|
| Rate for Payer: BCBS MAPPO |
$33.89
|
| Rate for Payer: BCN Medicare Advantage |
$33.89
|
| Rate for Payer: Cash Price |
$33,464.00
|
| Rate for Payer: Cash Price |
$33,464.00
|
| Rate for Payer: Cofinity Commercial |
$35,973.80
|
| Rate for Payer: Cofinity Commercial |
$29,281.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$29,281.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33,464.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.89
|
| Rate for Payer: Healthscope Commercial |
$37,647.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29,281.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31,372.50
|
| Rate for Payer: Mclaren Medicaid |
$18.17
|
| Rate for Payer: Mclaren Medicare |
$33.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.58
|
| Rate for Payer: Meridian Medicaid |
$19.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,555.50
|
| Rate for Payer: PACE Medicare |
$32.20
|
| Rate for Payer: PACE SWMI |
$33.89
|
| Rate for Payer: PHP Commercial |
$35,555.50
|
| Rate for Payer: PHP Medicare Advantage |
$33.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27,189.50
|
| Rate for Payer: Priority Health Medicare |
$33.89
|
| Rate for Payer: Priority Health SBD |
$26,352.90
|
| Rate for Payer: Railroad Medicare Medicare |
$33.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.89
|
| Rate for Payer: UHC Exchange |
$64.77
|
| Rate for Payer: UHC Medicare Advantage |
$33.89
|
| Rate for Payer: UHCCP Medicaid |
$18.17
|
| Rate for Payer: UMR Bronson Commercial |
$15,477.10
|
| Rate for Payer: VA VA |
$33.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31,372.50
|
|
|
EFGARTIGIMOD ALFA 1008 MG-HYALURON-QVFC 11,200 UNIT/5.6 ML SUBCUT SOLN
|
Facility
|
IP
|
$41,830.00
|
|
|
Service Code
|
HCPCS J9334
|
| Hospital Charge Code |
204386
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18,405.20 |
| Max. Negotiated Rate |
$37,647.00 |
| Rate for Payer: Aetna American Axle |
$27,189.50
|
| Rate for Payer: Aetna Commercial |
$35,555.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27,189.50
|
| Rate for Payer: Cash Price |
$33,464.00
|
| Rate for Payer: Cofinity Commercial |
$29,281.00
|
| Rate for Payer: Cofinity Commercial |
$35,973.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$29,281.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33,464.00
|
| Rate for Payer: Healthscope Commercial |
$37,647.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29,281.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31,372.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,555.50
|
| Rate for Payer: PHP Commercial |
$35,555.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27,189.50
|
| Rate for Payer: Priority Health SBD |
$26,352.90
|
| Rate for Payer: UMR Bronson Commercial |
$18,405.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31,372.50
|
|
|
EFGARTIGIMOD ALFA-FCAB 20 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$16,094.99
|
|
|
Service Code
|
HCPCS J9332
|
| Hospital Charge Code |
198972
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.23 |
| Max. Negotiated Rate |
$14,485.49 |
| Rate for Payer: Aetna American Axle |
$10,461.74
|
| Rate for Payer: Aetna Commercial |
$13,680.74
|
| Rate for Payer: Aetna Medicare |
$33.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,461.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.19
|
| Rate for Payer: BCBS Complete |
$18.09
|
| Rate for Payer: BCBS MAPPO |
$32.15
|
| Rate for Payer: BCN Medicare Advantage |
$32.15
|
| Rate for Payer: Cash Price |
$12,875.99
|
| Rate for Payer: Cash Price |
$12,875.99
|
| Rate for Payer: Cofinity Commercial |
$13,841.69
|
| Rate for Payer: Cofinity Commercial |
$11,266.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,266.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,875.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.15
|
| Rate for Payer: Healthscope Commercial |
$14,485.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,266.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,071.24
|
| Rate for Payer: Mclaren Medicaid |
$17.23
|
| Rate for Payer: Mclaren Medicare |
$32.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.76
|
| Rate for Payer: Meridian Medicaid |
$18.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,680.74
|
| Rate for Payer: PACE Medicare |
$30.54
|
| Rate for Payer: PACE SWMI |
$32.15
|
| Rate for Payer: PHP Commercial |
$13,680.74
|
| Rate for Payer: PHP Medicare Advantage |
$32.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,461.74
|
| Rate for Payer: Priority Health Medicare |
$32.15
|
| Rate for Payer: Priority Health SBD |
$10,139.84
|
| Rate for Payer: Railroad Medicare Medicare |
$32.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.15
|
| Rate for Payer: UHC Exchange |
$61.44
|
| Rate for Payer: UHC Medicare Advantage |
$32.15
|
| Rate for Payer: UHCCP Medicaid |
$17.23
|
| Rate for Payer: UMR Bronson Commercial |
$5,955.15
|
| Rate for Payer: VA VA |
$32.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,071.24
|
|
|
EFGARTIGIMOD ALFA-FCAB 20 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$16,094.99
|
|
|
Service Code
|
HCPCS J9332
|
| Hospital Charge Code |
198972
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7,081.80 |
| Max. Negotiated Rate |
$14,485.49 |
| Rate for Payer: Aetna American Axle |
$10,461.74
|
| Rate for Payer: Aetna Commercial |
$13,680.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,461.74
|
| Rate for Payer: Cash Price |
$12,875.99
|
| Rate for Payer: Cofinity Commercial |
$11,266.49
|
| Rate for Payer: Cofinity Commercial |
$13,841.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,266.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,875.99
|
| Rate for Payer: Healthscope Commercial |
$14,485.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,266.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,071.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,680.74
|
| Rate for Payer: PHP Commercial |
$13,680.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,461.74
|
| Rate for Payer: Priority Health SBD |
$10,139.84
|
| Rate for Payer: UMR Bronson Commercial |
$7,081.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,071.24
|
|
|
ELECARE INFANT UNFLAVORED INFANT CONTINUOUS FEED
|
Facility
|
OP
|
$109.52
|
|
|
Service Code
|
NDC 70074053511
|
| Hospital Charge Code |
168951
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$40.52 |
| Max. Negotiated Rate |
$98.57 |
| Rate for Payer: Aetna American Axle |
$71.19
|
| Rate for Payer: Aetna Commercial |
$93.09
|
| Rate for Payer: Aetna Medicare |
$54.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.19
|
| Rate for Payer: BCBS Complete |
$43.81
|
| Rate for Payer: Cash Price |
$87.62
|
| Rate for Payer: Cofinity Commercial |
$76.66
|
| Rate for Payer: Cofinity Commercial |
$94.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.62
|
| Rate for Payer: Healthscope Commercial |
$98.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.09
|
| Rate for Payer: PHP Commercial |
$93.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.19
|
| Rate for Payer: Priority Health SBD |
$69.00
|
| Rate for Payer: UMR Bronson Commercial |
$40.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.14
|
|
|
ELECARE INFANT UNFLAVORED INFANT CONTINUOUS FEED
|
Facility
|
IP
|
$109.52
|
|
|
Service Code
|
NDC 70074053511
|
| Hospital Charge Code |
168951
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.19 |
| Max. Negotiated Rate |
$98.57 |
| Rate for Payer: Aetna American Axle |
$71.19
|
| Rate for Payer: Aetna Commercial |
$93.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.19
|
| Rate for Payer: Cash Price |
$87.62
|
| Rate for Payer: Cofinity Commercial |
$76.66
|
| Rate for Payer: Cofinity Commercial |
$94.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.62
|
| Rate for Payer: Healthscope Commercial |
$98.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.09
|
| Rate for Payer: PHP Commercial |
$93.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.19
|
| Rate for Payer: Priority Health SBD |
$69.00
|
| Rate for Payer: UMR Bronson Commercial |
$48.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.14
|
|
|
ELECARE INFANT UNFLAVORED ORAL POWDER CUSTOM
|
Facility
|
OP
|
$109.52
|
|
|
Service Code
|
NDC 70074053511
|
| Hospital Charge Code |
150852
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$40.52 |
| Max. Negotiated Rate |
$98.57 |
| Rate for Payer: Aetna American Axle |
$71.19
|
| Rate for Payer: Aetna Commercial |
$93.09
|
| Rate for Payer: Aetna Medicare |
$54.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.19
|
| Rate for Payer: BCBS Complete |
$43.81
|
| Rate for Payer: Cash Price |
$87.62
|
| Rate for Payer: Cofinity Commercial |
$76.66
|
| Rate for Payer: Cofinity Commercial |
$94.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.62
|
| Rate for Payer: Healthscope Commercial |
$98.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.09
|
| Rate for Payer: PHP Commercial |
$93.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.19
|
| Rate for Payer: Priority Health SBD |
$69.00
|
| Rate for Payer: UMR Bronson Commercial |
$40.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.14
|
|
|
ELECARE INFANT UNFLAVORED ORAL POWDER CUSTOM
|
Facility
|
IP
|
$109.52
|
|
|
Service Code
|
NDC 70074053511
|
| Hospital Charge Code |
150852
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.19 |
| Max. Negotiated Rate |
$98.57 |
| Rate for Payer: Aetna American Axle |
$71.19
|
| Rate for Payer: Aetna Commercial |
$93.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.19
|
| Rate for Payer: Cash Price |
$87.62
|
| Rate for Payer: Cofinity Commercial |
$76.66
|
| Rate for Payer: Cofinity Commercial |
$94.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.62
|
| Rate for Payer: Healthscope Commercial |
$98.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.09
|
| Rate for Payer: PHP Commercial |
$93.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.19
|
| Rate for Payer: Priority Health SBD |
$69.00
|
| Rate for Payer: UMR Bronson Commercial |
$48.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.14
|
|
|
ELECARE JR (VANILLA) ORAL POWDER CUSTOM
|
Facility
|
OP
|
$109.52
|
|
|
Service Code
|
NDC 70074056586
|
| Hospital Charge Code |
163630
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$40.52 |
| Max. Negotiated Rate |
$98.57 |
| Rate for Payer: Aetna American Axle |
$71.19
|
| Rate for Payer: Aetna Commercial |
$93.09
|
| Rate for Payer: Aetna Medicare |
$54.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.19
|
| Rate for Payer: BCBS Complete |
$43.81
|
| Rate for Payer: Cash Price |
$87.62
|
| Rate for Payer: Cofinity Commercial |
$76.66
|
| Rate for Payer: Cofinity Commercial |
$94.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.62
|
| Rate for Payer: Healthscope Commercial |
$98.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.09
|
| Rate for Payer: PHP Commercial |
$93.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.19
|
| Rate for Payer: Priority Health SBD |
$69.00
|
| Rate for Payer: UMR Bronson Commercial |
$40.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.14
|
|
|
ELECARE JR (VANILLA) ORAL POWDER CUSTOM
|
Facility
|
IP
|
$109.52
|
|
|
Service Code
|
NDC 70074056586
|
| Hospital Charge Code |
163630
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.19 |
| Max. Negotiated Rate |
$98.57 |
| Rate for Payer: Aetna American Axle |
$71.19
|
| Rate for Payer: Aetna Commercial |
$93.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.19
|
| Rate for Payer: Cash Price |
$87.62
|
| Rate for Payer: Cofinity Commercial |
$76.66
|
| Rate for Payer: Cofinity Commercial |
$94.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.62
|
| Rate for Payer: Healthscope Commercial |
$98.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.09
|
| Rate for Payer: PHP Commercial |
$93.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.19
|
| Rate for Payer: Priority Health SBD |
$69.00
|
| Rate for Payer: UMR Bronson Commercial |
$48.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.14
|
|
|
ELECARE JUNIOR VANILLA CONTINUOUS FEED
|
Facility
|
OP
|
$113.96
|
|
|
Service Code
|
NDC 09900000581
|
| Hospital Charge Code |
168952
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$42.17 |
| Max. Negotiated Rate |
$102.56 |
| Rate for Payer: Aetna American Axle |
$74.07
|
| Rate for Payer: Aetna Commercial |
$96.87
|
| Rate for Payer: Aetna Medicare |
$56.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.07
|
| Rate for Payer: BCBS Complete |
$45.58
|
| Rate for Payer: Cash Price |
$91.17
|
| Rate for Payer: Cofinity Commercial |
$79.77
|
| Rate for Payer: Cofinity Commercial |
$98.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.17
|
| Rate for Payer: Healthscope Commercial |
$102.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.87
|
| Rate for Payer: PHP Commercial |
$96.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.07
|
| Rate for Payer: Priority Health SBD |
$71.79
|
| Rate for Payer: UMR Bronson Commercial |
$42.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.47
|
|
|
ELECARE JUNIOR VANILLA CONTINUOUS FEED
|
Facility
|
IP
|
$109.52
|
|
|
Service Code
|
NDC 70074056586
|
| Hospital Charge Code |
168952
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.19 |
| Max. Negotiated Rate |
$98.57 |
| Rate for Payer: Aetna American Axle |
$71.19
|
| Rate for Payer: Aetna Commercial |
$93.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.19
|
| Rate for Payer: Cash Price |
$87.62
|
| Rate for Payer: Cofinity Commercial |
$76.66
|
| Rate for Payer: Cofinity Commercial |
$94.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.62
|
| Rate for Payer: Healthscope Commercial |
$98.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.09
|
| Rate for Payer: PHP Commercial |
$93.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.19
|
| Rate for Payer: Priority Health SBD |
$69.00
|
| Rate for Payer: UMR Bronson Commercial |
$48.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.14
|
|
|
ELECARE JUNIOR VANILLA CONTINUOUS FEED
|
Facility
|
IP
|
$113.96
|
|
|
Service Code
|
NDC 09900000581
|
| Hospital Charge Code |
168952
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$50.14 |
| Max. Negotiated Rate |
$102.56 |
| Rate for Payer: Aetna American Axle |
$74.07
|
| Rate for Payer: Aetna Commercial |
$96.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.07
|
| Rate for Payer: Cash Price |
$91.17
|
| Rate for Payer: Cofinity Commercial |
$79.77
|
| Rate for Payer: Cofinity Commercial |
$98.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.17
|
| Rate for Payer: Healthscope Commercial |
$102.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.87
|
| Rate for Payer: PHP Commercial |
$96.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.07
|
| Rate for Payer: Priority Health SBD |
$71.79
|
| Rate for Payer: UMR Bronson Commercial |
$50.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.47
|
|
|
ELECARE JUNIOR VANILLA CONTINUOUS FEED
|
Facility
|
OP
|
$109.52
|
|
|
Service Code
|
NDC 70074056586
|
| Hospital Charge Code |
168952
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$40.52 |
| Max. Negotiated Rate |
$98.57 |
| Rate for Payer: Aetna American Axle |
$71.19
|
| Rate for Payer: Aetna Commercial |
$93.09
|
| Rate for Payer: Aetna Medicare |
$54.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.19
|
| Rate for Payer: BCBS Complete |
$43.81
|
| Rate for Payer: Cash Price |
$87.62
|
| Rate for Payer: Cofinity Commercial |
$76.66
|
| Rate for Payer: Cofinity Commercial |
$94.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.62
|
| Rate for Payer: Healthscope Commercial |
$98.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.09
|
| Rate for Payer: PHP Commercial |
$93.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.19
|
| Rate for Payer: Priority Health SBD |
$69.00
|
| Rate for Payer: UMR Bronson Commercial |
$40.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.14
|
|
|
ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; TRACING ONLY, WITHOUT INTERPRETATION AND REPORT
|
Facility
|
OP
|
$163.07
|
|
|
Service Code
|
CPT 93005
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$163.07 |
| Rate for Payer: Aetna Medicare |
$60.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$110.71
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: VA VA |
$57.93
|
|
|
ELECTROLYTE-A INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$47.85
|
|
|
Service Code
|
NDC 00338022104
|
| Hospital Charge Code |
28113
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.70 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna American Axle |
$31.10
|
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna Medicare |
$23.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.10
|
| Rate for Payer: BCBS Complete |
$19.14
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Commercial |
$33.49
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.10
|
| Rate for Payer: Priority Health SBD |
$30.15
|
| Rate for Payer: UMR Bronson Commercial |
$17.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.89
|
|
|
ELECTROLYTE-A INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$47.85
|
|
|
Service Code
|
NDC 00338022104
|
| Hospital Charge Code |
28113
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.05 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna American Axle |
$31.10
|
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.10
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Commercial |
$33.49
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.10
|
| Rate for Payer: Priority Health SBD |
$30.15
|
| Rate for Payer: UMR Bronson Commercial |
$21.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.89
|
|
|
ELECTROLYTE-A IV - BOLUS
|
Facility
|
OP
|
$47.85
|
|
|
Service Code
|
NDC 00338022104
|
| Hospital Charge Code |
168933
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.70 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna American Axle |
$31.10
|
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna Medicare |
$23.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.10
|
| Rate for Payer: BCBS Complete |
$19.14
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Commercial |
$33.49
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.10
|
| Rate for Payer: Priority Health SBD |
$30.15
|
| Rate for Payer: UMR Bronson Commercial |
$17.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.89
|
|
|
ELECTROLYTE-A IV - BOLUS
|
Facility
|
IP
|
$47.85
|
|
|
Service Code
|
NDC 00338022104
|
| Hospital Charge Code |
168933
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.05 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna American Axle |
$31.10
|
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.10
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Commercial |
$33.49
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.10
|
| Rate for Payer: Priority Health SBD |
$30.15
|
| Rate for Payer: UMR Bronson Commercial |
$21.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.89
|
|
|
ELECTROLYTE-A IV - DKA
|
Facility
|
OP
|
$47.85
|
|
|
Service Code
|
NDC 00338022104
|
| Hospital Charge Code |
168932
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.70 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna American Axle |
$31.10
|
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna Medicare |
$23.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.10
|
| Rate for Payer: BCBS Complete |
$19.14
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Commercial |
$33.49
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.10
|
| Rate for Payer: Priority Health SBD |
$30.15
|
| Rate for Payer: UMR Bronson Commercial |
$17.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.89
|
|
|
ELECTROLYTE-A IV - DKA
|
Facility
|
IP
|
$47.85
|
|
|
Service Code
|
NDC 00338022104
|
| Hospital Charge Code |
168932
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.05 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna American Axle |
$31.10
|
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.10
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Commercial |
$33.49
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.10
|
| Rate for Payer: Priority Health SBD |
$30.15
|
| Rate for Payer: UMR Bronson Commercial |
$21.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.89
|
|
|
ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR/TRANSMITTER (EG, CONTACT GROUP[S], INTERLEAVING, AMPLITUDE, PULSE WIDTH, FREQUENCY [HZ], ON/OFF CYCLING, BURST, MAGNET MODE, DOSE LOCKOUT, PATIENT SELECTABLE PARAMETERS, RESPONSIVE NEUROSTIMULATION, DETECTION ALGORITHMS, CLOSED LOOP PARAMETERS, AND PASSIVE PARAMETERS) BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL; WITH COMPLEX SPINAL CORD OR PERIPHERAL NERVE (EG, SACRAL NERVE) NEUROSTIMULATOR PULSE GENERATOR/TRANSMITTER PROGRAMMING BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL
|
Facility
|
OP
|
$251.99
|
|
|
Service Code
|
CPT 95972
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$47.98 |
| Max. Negotiated Rate |
$251.99 |
| Rate for Payer: Aetna Medicare |
$93.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.90
|
| Rate for Payer: BCBS Complete |
$50.38
|
| Rate for Payer: BCBS MAPPO |
$89.52
|
| Rate for Payer: BCN Medicare Advantage |
$89.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.52
|
| Rate for Payer: Mclaren Medicaid |
$47.98
|
| Rate for Payer: Mclaren Medicare |
$89.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.00
|
| Rate for Payer: Meridian Medicaid |
$50.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.95
|
| Rate for Payer: PACE Medicare |
$85.04
|
| Rate for Payer: PACE SWMI |
$89.52
|
| Rate for Payer: PHP Medicare Advantage |
$89.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.98
|
| Rate for Payer: Priority Health Medicare |
$89.52
|
| Rate for Payer: Railroad Medicare Medicare |
$89.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.52
|
| Rate for Payer: UHC Exchange |
$171.08
|
| Rate for Payer: UHC Medicare Advantage |
$89.52
|
| Rate for Payer: UHCCP Medicaid |
$47.98
|
| Rate for Payer: VA VA |
$89.52
|
|
|
ELOSULFASE ALFA 5 MG/5 ML (1 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$6,667.65
|
|
|
Service Code
|
HCPCS J1322
|
| Hospital Charge Code |
169847
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$165.45 |
| Max. Negotiated Rate |
$6,000.89 |
| Rate for Payer: Aetna American Axle |
$4,333.97
|
| Rate for Payer: Aetna Commercial |
$5,667.50
|
| Rate for Payer: Aetna Medicare |
$321.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,333.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$385.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$385.85
|
| Rate for Payer: BCBS Complete |
$173.73
|
| Rate for Payer: BCBS MAPPO |
$308.68
|
| Rate for Payer: BCN Medicare Advantage |
$308.68
|
| Rate for Payer: Cash Price |
$5,334.12
|
| Rate for Payer: Cash Price |
$5,334.12
|
| Rate for Payer: Cofinity Commercial |
$5,734.18
|
| Rate for Payer: Cofinity Commercial |
$4,667.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,667.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,334.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.68
|
| Rate for Payer: Healthscope Commercial |
$6,000.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,667.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,000.74
|
| Rate for Payer: Mclaren Medicaid |
$165.45
|
| Rate for Payer: Mclaren Medicare |
$308.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.11
|
| Rate for Payer: Meridian Medicaid |
$173.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$354.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,667.50
|
| Rate for Payer: PACE Medicare |
$293.25
|
| Rate for Payer: PACE SWMI |
$308.68
|
| Rate for Payer: PHP Commercial |
$5,667.50
|
| Rate for Payer: PHP Medicare Advantage |
$308.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,333.97
|
| Rate for Payer: Priority Health Medicare |
$308.68
|
| Rate for Payer: Priority Health SBD |
$4,200.62
|
| Rate for Payer: Railroad Medicare Medicare |
$308.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$868.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.68
|
| Rate for Payer: UHC Exchange |
$589.92
|
| Rate for Payer: UHC Medicare Advantage |
$308.68
|
| Rate for Payer: UHCCP Medicaid |
$165.45
|
| Rate for Payer: UMR Bronson Commercial |
$2,467.03
|
| Rate for Payer: VA VA |
$308.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,000.74
|
|
|
ELOSULFASE ALFA 5 MG/5 ML (1 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$6,667.65
|
|
|
Service Code
|
HCPCS J1322
|
| Hospital Charge Code |
169847
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,933.77 |
| Max. Negotiated Rate |
$6,000.89 |
| Rate for Payer: Aetna American Axle |
$4,333.97
|
| Rate for Payer: Aetna Commercial |
$5,667.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,333.97
|
| Rate for Payer: Cash Price |
$5,334.12
|
| Rate for Payer: Cofinity Commercial |
$4,667.35
|
| Rate for Payer: Cofinity Commercial |
$5,734.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,667.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,334.12
|
| Rate for Payer: Healthscope Commercial |
$6,000.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,667.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,000.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,667.50
|
| Rate for Payer: PHP Commercial |
$5,667.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,333.97
|
| Rate for Payer: Priority Health SBD |
$4,200.62
|
| Rate for Payer: UMR Bronson Commercial |
$2,933.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,000.74
|
|
|
ELOTUZUMAB 300 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$5,916.72
|
|
|
Service Code
|
HCPCS J9176
|
| Hospital Charge Code |
176616
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$5,325.05 |
| Rate for Payer: Aetna American Axle |
$3,845.87
|
| Rate for Payer: Aetna Commercial |
$5,029.21
|
| Rate for Payer: Aetna Medicare |
$8.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,845.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.86
|
| Rate for Payer: BCBS Complete |
$4.44
|
| Rate for Payer: BCBS MAPPO |
$7.89
|
| Rate for Payer: BCN Medicare Advantage |
$7.89
|
| Rate for Payer: Cash Price |
$4,733.38
|
| Rate for Payer: Cash Price |
$4,733.38
|
| Rate for Payer: Cofinity Commercial |
$5,088.38
|
| Rate for Payer: Cofinity Commercial |
$4,141.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,141.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,733.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.89
|
| Rate for Payer: Healthscope Commercial |
$5,325.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,141.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,437.54
|
| Rate for Payer: Mclaren Medicaid |
$4.23
|
| Rate for Payer: Mclaren Medicare |
$7.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.28
|
| Rate for Payer: Meridian Medicaid |
$4.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,029.21
|
| Rate for Payer: PACE Medicare |
$7.50
|
| Rate for Payer: PACE SWMI |
$7.89
|
| Rate for Payer: PHP Commercial |
$5,029.21
|
| Rate for Payer: PHP Medicare Advantage |
$7.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,845.87
|
| Rate for Payer: Priority Health Medicare |
$7.89
|
| Rate for Payer: Priority Health SBD |
$3,727.53
|
| Rate for Payer: Railroad Medicare Medicare |
$7.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.89
|
| Rate for Payer: UHC Exchange |
$15.08
|
| Rate for Payer: UHC Medicare Advantage |
$7.89
|
| Rate for Payer: UHCCP Medicaid |
$4.23
|
| Rate for Payer: UMR Bronson Commercial |
$2,189.19
|
| Rate for Payer: VA VA |
$7.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,437.54
|
|
