|
ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$74.50
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105904
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$32.78 |
| Max. Negotiated Rate |
$67.05 |
| Rate for Payer: Aetna American Axle |
$48.42
|
| Rate for Payer: Aetna American Axle |
$47.97
|
| Rate for Payer: Aetna American Axle |
$29.65
|
| Rate for Payer: Aetna American Axle |
$18.92
|
| Rate for Payer: Aetna American Axle |
$68.97
|
| Rate for Payer: Aetna American Axle |
$84.08
|
| Rate for Payer: Aetna American Axle |
$22.94
|
| Rate for Payer: Aetna American Axle |
$49.46
|
| Rate for Payer: Aetna Commercial |
$64.68
|
| Rate for Payer: Aetna Commercial |
$63.32
|
| Rate for Payer: Aetna Commercial |
$24.74
|
| Rate for Payer: Aetna Commercial |
$30.00
|
| Rate for Payer: Aetna Commercial |
$109.96
|
| Rate for Payer: Aetna Commercial |
$90.19
|
| Rate for Payer: Aetna Commercial |
$62.73
|
| Rate for Payer: Aetna Commercial |
$38.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.65
|
| Rate for Payer: Cash Price |
$28.23
|
| Rate for Payer: Cash Price |
$59.60
|
| Rate for Payer: Cash Price |
$36.49
|
| Rate for Payer: Cash Price |
$60.88
|
| Rate for Payer: Cash Price |
$103.49
|
| Rate for Payer: Cash Price |
$23.28
|
| Rate for Payer: Cash Price |
$84.89
|
| Rate for Payer: Cash Price |
$59.04
|
| Rate for Payer: Cofinity Commercial |
$30.35
|
| Rate for Payer: Cofinity Commercial |
$74.28
|
| Rate for Payer: Cofinity Commercial |
$24.70
|
| Rate for Payer: Cofinity Commercial |
$20.37
|
| Rate for Payer: Cofinity Commercial |
$111.25
|
| Rate for Payer: Cofinity Commercial |
$90.55
|
| Rate for Payer: Cofinity Commercial |
$25.03
|
| Rate for Payer: Cofinity Commercial |
$91.25
|
| Rate for Payer: Cofinity Commercial |
$31.93
|
| Rate for Payer: Cofinity Commercial |
$39.22
|
| Rate for Payer: Cofinity Commercial |
$51.66
|
| Rate for Payer: Cofinity Commercial |
$63.47
|
| Rate for Payer: Cofinity Commercial |
$52.15
|
| Rate for Payer: Cofinity Commercial |
$64.07
|
| Rate for Payer: Cofinity Commercial |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$65.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$90.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.28
|
| Rate for Payer: Healthscope Commercial |
$95.50
|
| Rate for Payer: Healthscope Commercial |
$68.49
|
| Rate for Payer: Healthscope Commercial |
$67.05
|
| Rate for Payer: Healthscope Commercial |
$41.05
|
| Rate for Payer: Healthscope Commercial |
$66.42
|
| Rate for Payer: Healthscope Commercial |
$31.76
|
| Rate for Payer: Healthscope Commercial |
$26.19
|
| Rate for Payer: Healthscope Commercial |
$116.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.74
|
| Rate for Payer: PHP Commercial |
$63.32
|
| Rate for Payer: PHP Commercial |
$24.74
|
| Rate for Payer: PHP Commercial |
$62.73
|
| Rate for Payer: PHP Commercial |
$30.00
|
| Rate for Payer: PHP Commercial |
$64.68
|
| Rate for Payer: PHP Commercial |
$90.19
|
| Rate for Payer: PHP Commercial |
$38.77
|
| Rate for Payer: PHP Commercial |
$109.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.92
|
| Rate for Payer: Priority Health SBD |
$18.33
|
| Rate for Payer: Priority Health SBD |
$81.50
|
| Rate for Payer: Priority Health SBD |
$66.85
|
| Rate for Payer: Priority Health SBD |
$22.23
|
| Rate for Payer: Priority Health SBD |
$46.49
|
| Rate for Payer: Priority Health SBD |
$28.73
|
| Rate for Payer: Priority Health SBD |
$47.94
|
| Rate for Payer: Priority Health SBD |
$46.94
|
| Rate for Payer: UMR Bronson Commercial |
$12.80
|
| Rate for Payer: UMR Bronson Commercial |
$15.53
|
| Rate for Payer: UMR Bronson Commercial |
$32.47
|
| Rate for Payer: UMR Bronson Commercial |
$32.78
|
| Rate for Payer: UMR Bronson Commercial |
$56.92
|
| Rate for Payer: UMR Bronson Commercial |
$33.48
|
| Rate for Payer: UMR Bronson Commercial |
$20.07
|
| Rate for Payer: UMR Bronson Commercial |
$46.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.21
|
|
|
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$95.12
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
31921
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$85.61 |
| Rate for Payer: Aetna American Axle |
$61.83
|
| Rate for Payer: Aetna American Axle |
$60.53
|
| Rate for Payer: Aetna American Axle |
$105.10
|
| Rate for Payer: Aetna American Axle |
$31.64
|
| Rate for Payer: Aetna Commercial |
$80.85
|
| Rate for Payer: Aetna Commercial |
$41.37
|
| Rate for Payer: Aetna Commercial |
$137.44
|
| Rate for Payer: Aetna Commercial |
$79.15
|
| Rate for Payer: Aetna Medicare |
$46.56
|
| Rate for Payer: Aetna Medicare |
$24.34
|
| Rate for Payer: Aetna Medicare |
$80.85
|
| Rate for Payer: Aetna Medicare |
$47.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.64
|
| Rate for Payer: BCBS Complete |
$37.25
|
| Rate for Payer: BCBS Complete |
$64.68
|
| Rate for Payer: BCBS Complete |
$38.05
|
| Rate for Payer: BCBS Complete |
$19.47
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cash Price |
$76.10
|
| Rate for Payer: Cash Price |
$74.50
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cash Price |
$129.36
|
| Rate for Payer: Cash Price |
$129.36
|
| Rate for Payer: Cash Price |
$74.50
|
| Rate for Payer: Cash Price |
$76.10
|
| Rate for Payer: Cofinity Commercial |
$81.80
|
| Rate for Payer: Cofinity Commercial |
$41.86
|
| Rate for Payer: Cofinity Commercial |
$113.19
|
| Rate for Payer: Cofinity Commercial |
$139.06
|
| Rate for Payer: Cofinity Commercial |
$34.07
|
| Rate for Payer: Cofinity Commercial |
$65.18
|
| Rate for Payer: Cofinity Commercial |
$80.08
|
| Rate for Payer: Cofinity Commercial |
$66.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$113.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.36
|
| Rate for Payer: Healthscope Commercial |
$145.53
|
| Rate for Payer: Healthscope Commercial |
$85.61
|
| Rate for Payer: Healthscope Commercial |
$83.81
|
| Rate for Payer: Healthscope Commercial |
$43.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.44
|
| Rate for Payer: PHP Commercial |
$80.85
|
| Rate for Payer: PHP Commercial |
$41.37
|
| Rate for Payer: PHP Commercial |
$137.44
|
| Rate for Payer: PHP Commercial |
$79.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.53
|
| Rate for Payer: Priority Health SBD |
$101.87
|
| Rate for Payer: Priority Health SBD |
$58.67
|
| Rate for Payer: Priority Health SBD |
$30.66
|
| Rate for Payer: Priority Health SBD |
$59.93
|
| Rate for Payer: UMR Bronson Commercial |
$59.83
|
| Rate for Payer: UMR Bronson Commercial |
$34.45
|
| Rate for Payer: UMR Bronson Commercial |
$35.19
|
| Rate for Payer: UMR Bronson Commercial |
$18.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.34
|
|
|
ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$93.12
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
31921
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.97 |
| Max. Negotiated Rate |
$83.81 |
| Rate for Payer: Aetna American Axle |
$60.53
|
| Rate for Payer: Aetna American Axle |
$31.64
|
| Rate for Payer: Aetna American Axle |
$105.10
|
| Rate for Payer: Aetna American Axle |
$61.83
|
| Rate for Payer: Aetna Commercial |
$79.15
|
| Rate for Payer: Aetna Commercial |
$80.85
|
| Rate for Payer: Aetna Commercial |
$41.37
|
| Rate for Payer: Aetna Commercial |
$137.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.53
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cash Price |
$74.50
|
| Rate for Payer: Cash Price |
$129.36
|
| Rate for Payer: Cash Price |
$76.10
|
| Rate for Payer: Cofinity Commercial |
$113.19
|
| Rate for Payer: Cofinity Commercial |
$81.80
|
| Rate for Payer: Cofinity Commercial |
$66.58
|
| Rate for Payer: Cofinity Commercial |
$65.18
|
| Rate for Payer: Cofinity Commercial |
$34.07
|
| Rate for Payer: Cofinity Commercial |
$41.86
|
| Rate for Payer: Cofinity Commercial |
$80.08
|
| Rate for Payer: Cofinity Commercial |
$139.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$113.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.94
|
| Rate for Payer: Healthscope Commercial |
$83.81
|
| Rate for Payer: Healthscope Commercial |
$145.53
|
| Rate for Payer: Healthscope Commercial |
$43.80
|
| Rate for Payer: Healthscope Commercial |
$85.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.15
|
| Rate for Payer: PHP Commercial |
$79.15
|
| Rate for Payer: PHP Commercial |
$80.85
|
| Rate for Payer: PHP Commercial |
$137.44
|
| Rate for Payer: PHP Commercial |
$41.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.10
|
| Rate for Payer: Priority Health SBD |
$59.93
|
| Rate for Payer: Priority Health SBD |
$101.87
|
| Rate for Payer: Priority Health SBD |
$30.66
|
| Rate for Payer: Priority Health SBD |
$58.67
|
| Rate for Payer: UMR Bronson Commercial |
$40.97
|
| Rate for Payer: UMR Bronson Commercial |
$41.85
|
| Rate for Payer: UMR Bronson Commercial |
$21.41
|
| Rate for Payer: UMR Bronson Commercial |
$71.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.84
|
|
|
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION
|
Facility
|
IP
|
$821.23
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105940
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$361.34 |
| Max. Negotiated Rate |
$739.11 |
| Rate for Payer: Aetna American Axle |
$533.80
|
| Rate for Payer: Aetna American Axle |
$92.53
|
| Rate for Payer: Aetna American Axle |
$94.70
|
| Rate for Payer: Aetna American Axle |
$53.80
|
| Rate for Payer: Aetna American Axle |
$172.58
|
| Rate for Payer: Aetna Commercial |
$698.05
|
| Rate for Payer: Aetna Commercial |
$123.84
|
| Rate for Payer: Aetna Commercial |
$121.01
|
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Commercial |
$225.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.70
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$212.40
|
| Rate for Payer: Cash Price |
$113.89
|
| Rate for Payer: Cofinity Commercial |
$57.94
|
| Rate for Payer: Cofinity Commercial |
$122.43
|
| Rate for Payer: Cofinity Commercial |
$706.26
|
| Rate for Payer: Cofinity Commercial |
$574.86
|
| Rate for Payer: Cofinity Commercial |
$185.85
|
| Rate for Payer: Cofinity Commercial |
$101.98
|
| Rate for Payer: Cofinity Commercial |
$125.29
|
| Rate for Payer: Cofinity Commercial |
$228.33
|
| Rate for Payer: Cofinity Commercial |
$99.65
|
| Rate for Payer: Cofinity Commercial |
$71.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$574.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$99.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$101.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$57.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$185.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.40
|
| Rate for Payer: Healthscope Commercial |
$131.12
|
| Rate for Payer: Healthscope Commercial |
$739.11
|
| Rate for Payer: Healthscope Commercial |
$238.95
|
| Rate for Payer: Healthscope Commercial |
$74.49
|
| Rate for Payer: Healthscope Commercial |
$128.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$574.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$185.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$615.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.01
|
| Rate for Payer: PHP Commercial |
$121.01
|
| Rate for Payer: PHP Commercial |
$70.35
|
| Rate for Payer: PHP Commercial |
$225.68
|
| Rate for Payer: PHP Commercial |
$698.05
|
| Rate for Payer: PHP Commercial |
$123.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.53
|
| Rate for Payer: Priority Health SBD |
$52.15
|
| Rate for Payer: Priority Health SBD |
$167.26
|
| Rate for Payer: Priority Health SBD |
$91.78
|
| Rate for Payer: Priority Health SBD |
$89.69
|
| Rate for Payer: Priority Health SBD |
$517.37
|
| Rate for Payer: UMR Bronson Commercial |
$62.64
|
| Rate for Payer: UMR Bronson Commercial |
$64.10
|
| Rate for Payer: UMR Bronson Commercial |
$361.34
|
| Rate for Payer: UMR Bronson Commercial |
$36.42
|
| Rate for Payer: UMR Bronson Commercial |
$116.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$615.92
|
|
|
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION
|
Facility
|
OP
|
$145.69
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105940
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$131.12 |
| Rate for Payer: Aetna American Axle |
$94.70
|
| Rate for Payer: Aetna American Axle |
$533.80
|
| Rate for Payer: Aetna American Axle |
$172.58
|
| Rate for Payer: Aetna American Axle |
$92.53
|
| Rate for Payer: Aetna American Axle |
$53.80
|
| Rate for Payer: Aetna Commercial |
$123.84
|
| Rate for Payer: Aetna Commercial |
$121.01
|
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Commercial |
$225.68
|
| Rate for Payer: Aetna Commercial |
$698.05
|
| Rate for Payer: Aetna Medicare |
$132.75
|
| Rate for Payer: Aetna Medicare |
$410.62
|
| Rate for Payer: Aetna Medicare |
$72.84
|
| Rate for Payer: Aetna Medicare |
$71.18
|
| Rate for Payer: Aetna Medicare |
$41.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.58
|
| Rate for Payer: BCBS Complete |
$58.28
|
| Rate for Payer: BCBS Complete |
$56.94
|
| Rate for Payer: BCBS Complete |
$328.49
|
| Rate for Payer: BCBS Complete |
$33.11
|
| Rate for Payer: BCBS Complete |
$106.20
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$212.40
|
| Rate for Payer: Cash Price |
$113.89
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$113.89
|
| Rate for Payer: Cash Price |
$212.40
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cofinity Commercial |
$101.98
|
| Rate for Payer: Cofinity Commercial |
$71.18
|
| Rate for Payer: Cofinity Commercial |
$122.43
|
| Rate for Payer: Cofinity Commercial |
$228.33
|
| Rate for Payer: Cofinity Commercial |
$185.85
|
| Rate for Payer: Cofinity Commercial |
$57.94
|
| Rate for Payer: Cofinity Commercial |
$706.26
|
| Rate for Payer: Cofinity Commercial |
$574.86
|
| Rate for Payer: Cofinity Commercial |
$125.29
|
| Rate for Payer: Cofinity Commercial |
$99.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$574.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$57.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$185.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$101.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$99.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.98
|
| Rate for Payer: Healthscope Commercial |
$739.11
|
| Rate for Payer: Healthscope Commercial |
$128.12
|
| Rate for Payer: Healthscope Commercial |
$131.12
|
| Rate for Payer: Healthscope Commercial |
$238.95
|
| Rate for Payer: Healthscope Commercial |
$74.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$185.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$574.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$615.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.01
|
| Rate for Payer: PHP Commercial |
$70.35
|
| Rate for Payer: PHP Commercial |
$698.05
|
| Rate for Payer: PHP Commercial |
$123.84
|
| Rate for Payer: PHP Commercial |
$121.01
|
| Rate for Payer: PHP Commercial |
$225.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.70
|
| Rate for Payer: Priority Health SBD |
$91.78
|
| Rate for Payer: Priority Health SBD |
$52.15
|
| Rate for Payer: Priority Health SBD |
$517.37
|
| Rate for Payer: Priority Health SBD |
$89.69
|
| Rate for Payer: Priority Health SBD |
$167.26
|
| Rate for Payer: UMR Bronson Commercial |
$52.67
|
| Rate for Payer: UMR Bronson Commercial |
$98.24
|
| Rate for Payer: UMR Bronson Commercial |
$53.91
|
| Rate for Payer: UMR Bronson Commercial |
$303.86
|
| Rate for Payer: UMR Bronson Commercial |
$30.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$615.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.77
|
|
|
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION (CUSTOM)
|
Facility
|
OP
|
$142.36
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
301239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$128.12 |
| Rate for Payer: Aetna American Axle |
$92.53
|
| Rate for Payer: Aetna American Axle |
$533.80
|
| Rate for Payer: Aetna Commercial |
$698.05
|
| Rate for Payer: Aetna Commercial |
$121.01
|
| Rate for Payer: Aetna Medicare |
$71.18
|
| Rate for Payer: Aetna Medicare |
$410.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.80
|
| Rate for Payer: BCBS Complete |
$328.49
|
| Rate for Payer: BCBS Complete |
$56.94
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cash Price |
$113.89
|
| Rate for Payer: Cash Price |
$113.89
|
| Rate for Payer: Cofinity Commercial |
$706.26
|
| Rate for Payer: Cofinity Commercial |
$122.43
|
| Rate for Payer: Cofinity Commercial |
$574.86
|
| Rate for Payer: Cofinity Commercial |
$99.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$99.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$574.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.89
|
| Rate for Payer: Healthscope Commercial |
$739.11
|
| Rate for Payer: Healthscope Commercial |
$128.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$574.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$615.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.05
|
| Rate for Payer: PHP Commercial |
$121.01
|
| Rate for Payer: PHP Commercial |
$698.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.80
|
| Rate for Payer: Priority Health SBD |
$517.37
|
| Rate for Payer: Priority Health SBD |
$89.69
|
| Rate for Payer: UMR Bronson Commercial |
$52.67
|
| Rate for Payer: UMR Bronson Commercial |
$303.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$615.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.77
|
|
|
ENOXAPARIN 300 MG/3 ML SUBCUTANEOUS SOLUTION (CUSTOM)
|
Facility
|
IP
|
$142.36
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
301239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$62.64 |
| Max. Negotiated Rate |
$128.12 |
| Rate for Payer: Aetna American Axle |
$92.53
|
| Rate for Payer: Aetna American Axle |
$533.80
|
| Rate for Payer: Aetna Commercial |
$121.01
|
| Rate for Payer: Aetna Commercial |
$698.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.80
|
| Rate for Payer: Cash Price |
$113.89
|
| Rate for Payer: Cash Price |
$656.98
|
| Rate for Payer: Cofinity Commercial |
$706.26
|
| Rate for Payer: Cofinity Commercial |
$574.86
|
| Rate for Payer: Cofinity Commercial |
$122.43
|
| Rate for Payer: Cofinity Commercial |
$99.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$99.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$574.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.98
|
| Rate for Payer: Healthscope Commercial |
$128.12
|
| Rate for Payer: Healthscope Commercial |
$739.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$574.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$615.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.01
|
| Rate for Payer: PHP Commercial |
$698.05
|
| Rate for Payer: PHP Commercial |
$121.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.80
|
| Rate for Payer: Priority Health SBD |
$89.69
|
| Rate for Payer: Priority Health SBD |
$517.37
|
| Rate for Payer: UMR Bronson Commercial |
$62.64
|
| Rate for Payer: UMR Bronson Commercial |
$361.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$615.92
|
|
|
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$27.78
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105899
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.22 |
| Max. Negotiated Rate |
$25.00 |
| Rate for Payer: Aetna American Axle |
$18.06
|
| Rate for Payer: Aetna American Axle |
$9.65
|
| Rate for Payer: Aetna American Axle |
$12.37
|
| Rate for Payer: Aetna American Axle |
$20.99
|
| Rate for Payer: Aetna American Axle |
$17.26
|
| Rate for Payer: Aetna Commercial |
$23.61
|
| Rate for Payer: Aetna Commercial |
$16.18
|
| Rate for Payer: Aetna Commercial |
$12.61
|
| Rate for Payer: Aetna Commercial |
$27.45
|
| Rate for Payer: Aetna Commercial |
$22.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.37
|
| Rate for Payer: Cash Price |
$22.22
|
| Rate for Payer: Cash Price |
$25.83
|
| Rate for Payer: Cash Price |
$15.22
|
| Rate for Payer: Cash Price |
$21.24
|
| Rate for Payer: Cash Price |
$11.87
|
| Rate for Payer: Cofinity Commercial |
$22.60
|
| Rate for Payer: Cofinity Commercial |
$10.39
|
| Rate for Payer: Cofinity Commercial |
$23.89
|
| Rate for Payer: Cofinity Commercial |
$19.45
|
| Rate for Payer: Cofinity Commercial |
$18.58
|
| Rate for Payer: Cofinity Commercial |
$13.32
|
| Rate for Payer: Cofinity Commercial |
$16.37
|
| Rate for Payer: Cofinity Commercial |
$22.83
|
| Rate for Payer: Cofinity Commercial |
$12.76
|
| Rate for Payer: Cofinity Commercial |
$27.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.24
|
| Rate for Payer: Healthscope Commercial |
$17.13
|
| Rate for Payer: Healthscope Commercial |
$25.00
|
| Rate for Payer: Healthscope Commercial |
$23.90
|
| Rate for Payer: Healthscope Commercial |
$29.06
|
| Rate for Payer: Healthscope Commercial |
$13.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.61
|
| Rate for Payer: PHP Commercial |
$12.61
|
| Rate for Payer: PHP Commercial |
$27.45
|
| Rate for Payer: PHP Commercial |
$22.57
|
| Rate for Payer: PHP Commercial |
$23.61
|
| Rate for Payer: PHP Commercial |
$16.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.65
|
| Rate for Payer: Priority Health SBD |
$20.34
|
| Rate for Payer: Priority Health SBD |
$16.73
|
| Rate for Payer: Priority Health SBD |
$11.99
|
| Rate for Payer: Priority Health SBD |
$9.35
|
| Rate for Payer: Priority Health SBD |
$17.50
|
| Rate for Payer: UMR Bronson Commercial |
$6.53
|
| Rate for Payer: UMR Bronson Commercial |
$8.37
|
| Rate for Payer: UMR Bronson Commercial |
$12.22
|
| Rate for Payer: UMR Bronson Commercial |
$14.21
|
| Rate for Payer: UMR Bronson Commercial |
$11.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.84
|
|
|
ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$19.03
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105899
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$17.13 |
| Rate for Payer: Aetna American Axle |
$12.37
|
| Rate for Payer: Aetna American Axle |
$18.06
|
| Rate for Payer: Aetna American Axle |
$17.26
|
| Rate for Payer: Aetna American Axle |
$9.65
|
| Rate for Payer: Aetna American Axle |
$20.99
|
| Rate for Payer: Aetna Commercial |
$16.18
|
| Rate for Payer: Aetna Commercial |
$12.61
|
| Rate for Payer: Aetna Commercial |
$27.45
|
| Rate for Payer: Aetna Commercial |
$22.57
|
| Rate for Payer: Aetna Commercial |
$23.61
|
| Rate for Payer: Aetna Medicare |
$13.28
|
| Rate for Payer: Aetna Medicare |
$13.89
|
| Rate for Payer: Aetna Medicare |
$9.52
|
| Rate for Payer: Aetna Medicare |
$7.42
|
| Rate for Payer: Aetna Medicare |
$16.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.26
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS Complete |
$11.11
|
| Rate for Payer: BCBS Complete |
$12.92
|
| Rate for Payer: BCBS Complete |
$10.62
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: Cash Price |
$15.22
|
| Rate for Payer: Cash Price |
$21.24
|
| Rate for Payer: Cash Price |
$11.87
|
| Rate for Payer: Cash Price |
$15.22
|
| Rate for Payer: Cash Price |
$11.87
|
| Rate for Payer: Cash Price |
$21.24
|
| Rate for Payer: Cash Price |
$25.83
|
| Rate for Payer: Cash Price |
$25.83
|
| Rate for Payer: Cash Price |
$22.22
|
| Rate for Payer: Cash Price |
$22.22
|
| Rate for Payer: Cofinity Commercial |
$13.32
|
| Rate for Payer: Cofinity Commercial |
$27.77
|
| Rate for Payer: Cofinity Commercial |
$10.39
|
| Rate for Payer: Cofinity Commercial |
$22.83
|
| Rate for Payer: Cofinity Commercial |
$18.58
|
| Rate for Payer: Cofinity Commercial |
$22.60
|
| Rate for Payer: Cofinity Commercial |
$23.89
|
| Rate for Payer: Cofinity Commercial |
$19.45
|
| Rate for Payer: Cofinity Commercial |
$16.37
|
| Rate for Payer: Cofinity Commercial |
$12.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.22
|
| Rate for Payer: Healthscope Commercial |
$25.00
|
| Rate for Payer: Healthscope Commercial |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$17.13
|
| Rate for Payer: Healthscope Commercial |
$23.90
|
| Rate for Payer: Healthscope Commercial |
$29.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.61
|
| Rate for Payer: PHP Commercial |
$27.45
|
| Rate for Payer: PHP Commercial |
$23.61
|
| Rate for Payer: PHP Commercial |
$16.18
|
| Rate for Payer: PHP Commercial |
$12.61
|
| Rate for Payer: PHP Commercial |
$22.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.37
|
| Rate for Payer: Priority Health SBD |
$11.99
|
| Rate for Payer: Priority Health SBD |
$20.34
|
| Rate for Payer: Priority Health SBD |
$17.50
|
| Rate for Payer: Priority Health SBD |
$9.35
|
| Rate for Payer: Priority Health SBD |
$16.73
|
| Rate for Payer: UMR Bronson Commercial |
$5.49
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: UMR Bronson Commercial |
$7.04
|
| Rate for Payer: UMR Bronson Commercial |
$10.28
|
| Rate for Payer: UMR Bronson Commercial |
$11.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.13
|
|
|
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$43.06
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105900
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$38.75 |
| Rate for Payer: Aetna American Axle |
$27.99
|
| Rate for Payer: Aetna American Axle |
$16.11
|
| Rate for Payer: Aetna American Axle |
$10.97
|
| Rate for Payer: Aetna American Axle |
$16.15
|
| Rate for Payer: Aetna American Axle |
$16.17
|
| Rate for Payer: Aetna American Axle |
$16.49
|
| Rate for Payer: Aetna Commercial |
$21.11
|
| Rate for Payer: Aetna Commercial |
$21.56
|
| Rate for Payer: Aetna Commercial |
$21.07
|
| Rate for Payer: Aetna Commercial |
$14.34
|
| Rate for Payer: Aetna Commercial |
$36.60
|
| Rate for Payer: Aetna Commercial |
$21.14
|
| Rate for Payer: Aetna Medicare |
$21.53
|
| Rate for Payer: Aetna Medicare |
$12.44
|
| Rate for Payer: Aetna Medicare |
$12.40
|
| Rate for Payer: Aetna Medicare |
$12.68
|
| Rate for Payer: Aetna Medicare |
$12.42
|
| Rate for Payer: Aetna Medicare |
$8.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.49
|
| Rate for Payer: BCBS Complete |
$10.15
|
| Rate for Payer: BCBS Complete |
$9.95
|
| Rate for Payer: BCBS Complete |
$6.75
|
| Rate for Payer: BCBS Complete |
$9.94
|
| Rate for Payer: BCBS Complete |
$9.92
|
| Rate for Payer: BCBS Complete |
$17.22
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: Cash Price |
$34.45
|
| Rate for Payer: Cash Price |
$19.87
|
| Rate for Payer: Cash Price |
$20.30
|
| Rate for Payer: Cash Price |
$19.83
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$19.83
|
| Rate for Payer: Cash Price |
$19.87
|
| Rate for Payer: Cash Price |
$20.30
|
| Rate for Payer: Cash Price |
$34.45
|
| Rate for Payer: Cash Price |
$19.90
|
| Rate for Payer: Cash Price |
$19.90
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cofinity Commercial |
$17.39
|
| Rate for Payer: Cofinity Commercial |
$30.14
|
| Rate for Payer: Cofinity Commercial |
$17.35
|
| Rate for Payer: Cofinity Commercial |
$14.51
|
| Rate for Payer: Cofinity Commercial |
$11.81
|
| Rate for Payer: Cofinity Commercial |
$21.32
|
| Rate for Payer: Cofinity Commercial |
$21.82
|
| Rate for Payer: Cofinity Commercial |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$21.39
|
| Rate for Payer: Cofinity Commercial |
$17.41
|
| Rate for Payer: Cofinity Commercial |
$21.36
|
| Rate for Payer: Cofinity Commercial |
$37.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.45
|
| Rate for Payer: Healthscope Commercial |
$22.83
|
| Rate for Payer: Healthscope Commercial |
$38.75
|
| Rate for Payer: Healthscope Commercial |
$22.38
|
| Rate for Payer: Healthscope Commercial |
$22.36
|
| Rate for Payer: Healthscope Commercial |
$22.31
|
| Rate for Payer: Healthscope Commercial |
$15.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.14
|
| Rate for Payer: PHP Commercial |
$21.11
|
| Rate for Payer: PHP Commercial |
$21.14
|
| Rate for Payer: PHP Commercial |
$21.07
|
| Rate for Payer: PHP Commercial |
$14.34
|
| Rate for Payer: PHP Commercial |
$21.56
|
| Rate for Payer: PHP Commercial |
$36.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.11
|
| Rate for Payer: Priority Health SBD |
$15.98
|
| Rate for Payer: Priority Health SBD |
$15.62
|
| Rate for Payer: Priority Health SBD |
$15.65
|
| Rate for Payer: Priority Health SBD |
$15.67
|
| Rate for Payer: Priority Health SBD |
$10.63
|
| Rate for Payer: Priority Health SBD |
$27.13
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: UMR Bronson Commercial |
$15.93
|
| Rate for Payer: UMR Bronson Commercial |
$9.19
|
| Rate for Payer: UMR Bronson Commercial |
$6.24
|
| Rate for Payer: UMR Bronson Commercial |
$9.17
|
| Rate for Payer: UMR Bronson Commercial |
$9.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.65
|
|
|
ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$16.87
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105900
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.42 |
| Max. Negotiated Rate |
$15.18 |
| Rate for Payer: Aetna American Axle |
$10.97
|
| Rate for Payer: Aetna American Axle |
$16.49
|
| Rate for Payer: Aetna American Axle |
$16.17
|
| Rate for Payer: Aetna American Axle |
$16.11
|
| Rate for Payer: Aetna American Axle |
$16.15
|
| Rate for Payer: Aetna American Axle |
$27.99
|
| Rate for Payer: Aetna Commercial |
$14.34
|
| Rate for Payer: Aetna Commercial |
$21.07
|
| Rate for Payer: Aetna Commercial |
$21.14
|
| Rate for Payer: Aetna Commercial |
$36.60
|
| Rate for Payer: Aetna Commercial |
$21.56
|
| Rate for Payer: Aetna Commercial |
$21.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.49
|
| Rate for Payer: Cash Price |
$20.30
|
| Rate for Payer: Cash Price |
$19.90
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$19.87
|
| Rate for Payer: Cash Price |
$19.83
|
| Rate for Payer: Cash Price |
$34.45
|
| Rate for Payer: Cofinity Commercial |
$21.82
|
| Rate for Payer: Cofinity Commercial |
$11.81
|
| Rate for Payer: Cofinity Commercial |
$21.39
|
| Rate for Payer: Cofinity Commercial |
$17.41
|
| Rate for Payer: Cofinity Commercial |
$17.39
|
| Rate for Payer: Cofinity Commercial |
$17.35
|
| Rate for Payer: Cofinity Commercial |
$21.32
|
| Rate for Payer: Cofinity Commercial |
$21.36
|
| Rate for Payer: Cofinity Commercial |
$14.51
|
| Rate for Payer: Cofinity Commercial |
$37.03
|
| Rate for Payer: Cofinity Commercial |
$30.14
|
| Rate for Payer: Cofinity Commercial |
$17.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.45
|
| Rate for Payer: Healthscope Commercial |
$22.38
|
| Rate for Payer: Healthscope Commercial |
$38.75
|
| Rate for Payer: Healthscope Commercial |
$22.83
|
| Rate for Payer: Healthscope Commercial |
$22.31
|
| Rate for Payer: Healthscope Commercial |
$22.36
|
| Rate for Payer: Healthscope Commercial |
$15.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.11
|
| Rate for Payer: PHP Commercial |
$14.34
|
| Rate for Payer: PHP Commercial |
$21.07
|
| Rate for Payer: PHP Commercial |
$21.14
|
| Rate for Payer: PHP Commercial |
$21.56
|
| Rate for Payer: PHP Commercial |
$21.11
|
| Rate for Payer: PHP Commercial |
$36.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.99
|
| Rate for Payer: Priority Health SBD |
$15.98
|
| Rate for Payer: Priority Health SBD |
$15.67
|
| Rate for Payer: Priority Health SBD |
$10.63
|
| Rate for Payer: Priority Health SBD |
$15.62
|
| Rate for Payer: Priority Health SBD |
$15.65
|
| Rate for Payer: Priority Health SBD |
$27.13
|
| Rate for Payer: UMR Bronson Commercial |
$18.95
|
| Rate for Payer: UMR Bronson Commercial |
$10.91
|
| Rate for Payer: UMR Bronson Commercial |
$10.93
|
| Rate for Payer: UMR Bronson Commercial |
$11.16
|
| Rate for Payer: UMR Bronson Commercial |
$10.94
|
| Rate for Payer: UMR Bronson Commercial |
$7.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.65
|
|
|
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$18.75
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105901
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$16.88 |
| Rate for Payer: Aetna American Axle |
$12.19
|
| Rate for Payer: Aetna American Axle |
$24.21
|
| Rate for Payer: Aetna American Axle |
$24.17
|
| Rate for Payer: Aetna American Axle |
$17.54
|
| Rate for Payer: Aetna American Axle |
$23.98
|
| Rate for Payer: Aetna American Axle |
$42.03
|
| Rate for Payer: Aetna Commercial |
$15.94
|
| Rate for Payer: Aetna Commercial |
$22.94
|
| Rate for Payer: Aetna Commercial |
$31.60
|
| Rate for Payer: Aetna Commercial |
$54.96
|
| Rate for Payer: Aetna Commercial |
$31.66
|
| Rate for Payer: Aetna Commercial |
$31.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.21
|
| Rate for Payer: Cash Price |
$29.80
|
| Rate for Payer: Cash Price |
$29.74
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cash Price |
$29.52
|
| Rate for Payer: Cash Price |
$21.59
|
| Rate for Payer: Cash Price |
$51.73
|
| Rate for Payer: Cofinity Commercial |
$32.04
|
| Rate for Payer: Cofinity Commercial |
$13.12
|
| Rate for Payer: Cofinity Commercial |
$31.97
|
| Rate for Payer: Cofinity Commercial |
$26.03
|
| Rate for Payer: Cofinity Commercial |
$25.83
|
| Rate for Payer: Cofinity Commercial |
$18.89
|
| Rate for Payer: Cofinity Commercial |
$23.21
|
| Rate for Payer: Cofinity Commercial |
$31.73
|
| Rate for Payer: Cofinity Commercial |
$16.12
|
| Rate for Payer: Cofinity Commercial |
$55.61
|
| Rate for Payer: Cofinity Commercial |
$45.26
|
| Rate for Payer: Cofinity Commercial |
$26.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.73
|
| Rate for Payer: Healthscope Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$58.19
|
| Rate for Payer: Healthscope Commercial |
$33.52
|
| Rate for Payer: Healthscope Commercial |
$24.29
|
| Rate for Payer: Healthscope Commercial |
$33.21
|
| Rate for Payer: Healthscope Commercial |
$16.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.36
|
| Rate for Payer: PHP Commercial |
$15.94
|
| Rate for Payer: PHP Commercial |
$22.94
|
| Rate for Payer: PHP Commercial |
$31.60
|
| Rate for Payer: PHP Commercial |
$31.66
|
| Rate for Payer: PHP Commercial |
$31.36
|
| Rate for Payer: PHP Commercial |
$54.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.03
|
| Rate for Payer: Priority Health SBD |
$23.47
|
| Rate for Payer: Priority Health SBD |
$23.42
|
| Rate for Payer: Priority Health SBD |
$11.81
|
| Rate for Payer: Priority Health SBD |
$17.00
|
| Rate for Payer: Priority Health SBD |
$23.25
|
| Rate for Payer: Priority Health SBD |
$40.74
|
| Rate for Payer: UMR Bronson Commercial |
$28.45
|
| Rate for Payer: UMR Bronson Commercial |
$11.88
|
| Rate for Payer: UMR Bronson Commercial |
$16.24
|
| Rate for Payer: UMR Bronson Commercial |
$16.39
|
| Rate for Payer: UMR Bronson Commercial |
$16.36
|
| Rate for Payer: UMR Bronson Commercial |
$8.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.06
|
|
|
ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$64.66
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105901
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$58.19 |
| Rate for Payer: Aetna American Axle |
$42.03
|
| Rate for Payer: Aetna American Axle |
$17.54
|
| Rate for Payer: Aetna American Axle |
$12.19
|
| Rate for Payer: Aetna American Axle |
$23.98
|
| Rate for Payer: Aetna American Axle |
$24.17
|
| Rate for Payer: Aetna American Axle |
$24.21
|
| Rate for Payer: Aetna Commercial |
$31.36
|
| Rate for Payer: Aetna Commercial |
$31.66
|
| Rate for Payer: Aetna Commercial |
$22.94
|
| Rate for Payer: Aetna Commercial |
$15.94
|
| Rate for Payer: Aetna Commercial |
$54.96
|
| Rate for Payer: Aetna Commercial |
$31.60
|
| Rate for Payer: Aetna Medicare |
$32.33
|
| Rate for Payer: Aetna Medicare |
$18.59
|
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: Aetna Medicare |
$18.62
|
| Rate for Payer: Aetna Medicare |
$18.45
|
| Rate for Payer: Aetna Medicare |
$9.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.21
|
| Rate for Payer: BCBS Complete |
$14.90
|
| Rate for Payer: BCBS Complete |
$14.87
|
| Rate for Payer: BCBS Complete |
$7.50
|
| Rate for Payer: BCBS Complete |
$14.76
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS Complete |
$25.86
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: Cash Price |
$51.73
|
| Rate for Payer: Cash Price |
$29.52
|
| Rate for Payer: Cash Price |
$29.80
|
| Rate for Payer: Cash Price |
$21.59
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cash Price |
$21.59
|
| Rate for Payer: Cash Price |
$29.52
|
| Rate for Payer: Cash Price |
$29.80
|
| Rate for Payer: Cash Price |
$51.73
|
| Rate for Payer: Cash Price |
$29.74
|
| Rate for Payer: Cash Price |
$29.74
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cofinity Commercial |
$25.83
|
| Rate for Payer: Cofinity Commercial |
$45.26
|
| Rate for Payer: Cofinity Commercial |
$18.89
|
| Rate for Payer: Cofinity Commercial |
$16.12
|
| Rate for Payer: Cofinity Commercial |
$13.12
|
| Rate for Payer: Cofinity Commercial |
$23.21
|
| Rate for Payer: Cofinity Commercial |
$32.04
|
| Rate for Payer: Cofinity Commercial |
$26.08
|
| Rate for Payer: Cofinity Commercial |
$31.97
|
| Rate for Payer: Cofinity Commercial |
$26.03
|
| Rate for Payer: Cofinity Commercial |
$31.73
|
| Rate for Payer: Cofinity Commercial |
$55.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.73
|
| Rate for Payer: Healthscope Commercial |
$33.52
|
| Rate for Payer: Healthscope Commercial |
$58.19
|
| Rate for Payer: Healthscope Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$33.21
|
| Rate for Payer: Healthscope Commercial |
$24.29
|
| Rate for Payer: Healthscope Commercial |
$16.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.60
|
| Rate for Payer: PHP Commercial |
$31.36
|
| Rate for Payer: PHP Commercial |
$31.60
|
| Rate for Payer: PHP Commercial |
$22.94
|
| Rate for Payer: PHP Commercial |
$15.94
|
| Rate for Payer: PHP Commercial |
$31.66
|
| Rate for Payer: PHP Commercial |
$54.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.54
|
| Rate for Payer: Priority Health SBD |
$23.47
|
| Rate for Payer: Priority Health SBD |
$17.00
|
| Rate for Payer: Priority Health SBD |
$23.25
|
| Rate for Payer: Priority Health SBD |
$23.42
|
| Rate for Payer: Priority Health SBD |
$11.81
|
| Rate for Payer: Priority Health SBD |
$40.74
|
| Rate for Payer: UMR Bronson Commercial |
$13.78
|
| Rate for Payer: UMR Bronson Commercial |
$23.92
|
| Rate for Payer: UMR Bronson Commercial |
$13.65
|
| Rate for Payer: UMR Bronson Commercial |
$6.94
|
| Rate for Payer: UMR Bronson Commercial |
$9.99
|
| Rate for Payer: UMR Bronson Commercial |
$13.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.88
|
|
|
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
IP
|
$70.74
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105902
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna American Axle |
$45.98
|
| Rate for Payer: Aetna American Axle |
$32.29
|
| Rate for Payer: Aetna American Axle |
$14.50
|
| Rate for Payer: Aetna American Axle |
$56.04
|
| Rate for Payer: Aetna Commercial |
$60.13
|
| Rate for Payer: Aetna Commercial |
$73.28
|
| Rate for Payer: Aetna Commercial |
$42.22
|
| Rate for Payer: Aetna Commercial |
$18.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.98
|
| Rate for Payer: Cash Price |
$39.74
|
| Rate for Payer: Cash Price |
$56.59
|
| Rate for Payer: Cash Price |
$17.85
|
| Rate for Payer: Cash Price |
$68.97
|
| Rate for Payer: Cofinity Commercial |
$15.62
|
| Rate for Payer: Cofinity Commercial |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$60.35
|
| Rate for Payer: Cofinity Commercial |
$49.52
|
| Rate for Payer: Cofinity Commercial |
$34.77
|
| Rate for Payer: Cofinity Commercial |
$42.72
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Cofinity Commercial |
$19.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.74
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$20.08
|
| Rate for Payer: Healthscope Commercial |
$44.70
|
| Rate for Payer: Healthscope Commercial |
$77.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.13
|
| Rate for Payer: PHP Commercial |
$60.13
|
| Rate for Payer: PHP Commercial |
$73.28
|
| Rate for Payer: PHP Commercial |
$18.96
|
| Rate for Payer: PHP Commercial |
$42.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.50
|
| Rate for Payer: Priority Health SBD |
$54.31
|
| Rate for Payer: Priority Health SBD |
$14.06
|
| Rate for Payer: Priority Health SBD |
$31.29
|
| Rate for Payer: Priority Health SBD |
$44.57
|
| Rate for Payer: UMR Bronson Commercial |
$31.13
|
| Rate for Payer: UMR Bronson Commercial |
$37.93
|
| Rate for Payer: UMR Bronson Commercial |
$21.85
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE
|
Facility
|
OP
|
$86.21
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
105902
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$77.59 |
| Rate for Payer: Aetna American Axle |
$56.04
|
| Rate for Payer: Aetna American Axle |
$45.98
|
| Rate for Payer: Aetna American Axle |
$14.50
|
| Rate for Payer: Aetna American Axle |
$32.29
|
| Rate for Payer: Aetna Commercial |
$73.28
|
| Rate for Payer: Aetna Commercial |
$42.22
|
| Rate for Payer: Aetna Commercial |
$18.96
|
| Rate for Payer: Aetna Commercial |
$60.13
|
| Rate for Payer: Aetna Medicare |
$35.37
|
| Rate for Payer: Aetna Medicare |
$24.84
|
| Rate for Payer: Aetna Medicare |
$11.16
|
| Rate for Payer: Aetna Medicare |
$43.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.29
|
| Rate for Payer: BCBS Complete |
$28.30
|
| Rate for Payer: BCBS Complete |
$8.92
|
| Rate for Payer: BCBS Complete |
$34.48
|
| Rate for Payer: BCBS Complete |
$19.87
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: Cash Price |
$39.74
|
| Rate for Payer: Cash Price |
$68.97
|
| Rate for Payer: Cash Price |
$56.59
|
| Rate for Payer: Cash Price |
$39.74
|
| Rate for Payer: Cash Price |
$17.85
|
| Rate for Payer: Cash Price |
$17.85
|
| Rate for Payer: Cash Price |
$56.59
|
| Rate for Payer: Cash Price |
$68.97
|
| Rate for Payer: Cofinity Commercial |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$42.72
|
| Rate for Payer: Cofinity Commercial |
$15.62
|
| Rate for Payer: Cofinity Commercial |
$19.19
|
| Rate for Payer: Cofinity Commercial |
$34.77
|
| Rate for Payer: Cofinity Commercial |
$49.52
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Cofinity Commercial |
$60.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.85
|
| Rate for Payer: Healthscope Commercial |
$20.08
|
| Rate for Payer: Healthscope Commercial |
$77.59
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$44.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.96
|
| Rate for Payer: PHP Commercial |
$73.28
|
| Rate for Payer: PHP Commercial |
$42.22
|
| Rate for Payer: PHP Commercial |
$18.96
|
| Rate for Payer: PHP Commercial |
$60.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.98
|
| Rate for Payer: Priority Health SBD |
$14.06
|
| Rate for Payer: Priority Health SBD |
$44.57
|
| Rate for Payer: Priority Health SBD |
$31.29
|
| Rate for Payer: Priority Health SBD |
$54.31
|
| Rate for Payer: UMR Bronson Commercial |
$8.25
|
| Rate for Payer: UMR Bronson Commercial |
$26.17
|
| Rate for Payer: UMR Bronson Commercial |
$31.90
|
| Rate for Payer: UMR Bronson Commercial |
$18.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.66
|
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
IP
|
$252.96
|
|
|
Service Code
|
NDC 65862065401
|
| Hospital Charge Code |
26547
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$111.30 |
| Max. Negotiated Rate |
$227.66 |
| Rate for Payer: Aetna American Axle |
$164.42
|
| Rate for Payer: Aetna Commercial |
$215.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.42
|
| Rate for Payer: Cash Price |
$202.37
|
| Rate for Payer: Cofinity Commercial |
$177.07
|
| Rate for Payer: Cofinity Commercial |
$217.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$177.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.37
|
| Rate for Payer: Healthscope Commercial |
$227.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$177.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.02
|
| Rate for Payer: PHP Commercial |
$215.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.42
|
| Rate for Payer: Priority Health SBD |
$159.36
|
| Rate for Payer: UMR Bronson Commercial |
$111.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.72
|
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
IP
|
$288.00
|
|
|
Service Code
|
NDC 27241004910
|
| Hospital Charge Code |
26547
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$126.72 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Aetna American Axle |
$187.20
|
| Rate for Payer: Aetna Commercial |
$244.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.20
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cofinity Commercial |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$247.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$201.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$230.40
|
| Rate for Payer: Healthscope Commercial |
$259.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$216.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.80
|
| Rate for Payer: PHP Commercial |
$244.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.20
|
| Rate for Payer: Priority Health SBD |
$181.44
|
| Rate for Payer: UMR Bronson Commercial |
$126.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$216.00
|
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
OP
|
$252.96
|
|
|
Service Code
|
NDC 65862065401
|
| Hospital Charge Code |
26547
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$93.60 |
| Max. Negotiated Rate |
$227.66 |
| Rate for Payer: Aetna American Axle |
$164.42
|
| Rate for Payer: Aetna Commercial |
$215.02
|
| Rate for Payer: Aetna Medicare |
$126.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.42
|
| Rate for Payer: BCBS Complete |
$101.18
|
| Rate for Payer: Cash Price |
$202.37
|
| Rate for Payer: Cofinity Commercial |
$177.07
|
| Rate for Payer: Cofinity Commercial |
$217.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$177.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.37
|
| Rate for Payer: Healthscope Commercial |
$227.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$177.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.02
|
| Rate for Payer: PHP Commercial |
$215.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.42
|
| Rate for Payer: Priority Health SBD |
$159.36
|
| Rate for Payer: UMR Bronson Commercial |
$93.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.72
|
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
OP
|
$1,308.69
|
|
|
Service Code
|
NDC 47335000788
|
| Hospital Charge Code |
26547
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$484.22 |
| Max. Negotiated Rate |
$1,177.82 |
| Rate for Payer: Aetna American Axle |
$850.65
|
| Rate for Payer: Aetna Commercial |
$1,112.39
|
| Rate for Payer: Aetna Medicare |
$654.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$850.65
|
| Rate for Payer: BCBS Complete |
$523.48
|
| Rate for Payer: Cash Price |
$1,046.95
|
| Rate for Payer: Cofinity Commercial |
$1,125.47
|
| Rate for Payer: Cofinity Commercial |
$916.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$916.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,046.95
|
| Rate for Payer: Healthscope Commercial |
$1,177.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$916.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$981.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,112.39
|
| Rate for Payer: PHP Commercial |
$1,112.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.65
|
| Rate for Payer: Priority Health SBD |
$824.47
|
| Rate for Payer: UMR Bronson Commercial |
$484.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$981.52
|
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
IP
|
$1,308.69
|
|
|
Service Code
|
NDC 47335000788
|
| Hospital Charge Code |
26547
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$575.82 |
| Max. Negotiated Rate |
$1,177.82 |
| Rate for Payer: Aetna American Axle |
$850.65
|
| Rate for Payer: Aetna Commercial |
$1,112.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$850.65
|
| Rate for Payer: Cash Price |
$1,046.95
|
| Rate for Payer: Cofinity Commercial |
$1,125.47
|
| Rate for Payer: Cofinity Commercial |
$916.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$916.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,046.95
|
| Rate for Payer: Healthscope Commercial |
$1,177.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$916.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$981.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,112.39
|
| Rate for Payer: PHP Commercial |
$1,112.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.65
|
| Rate for Payer: Priority Health SBD |
$824.47
|
| Rate for Payer: UMR Bronson Commercial |
$575.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$981.52
|
|
|
ENTACAPONE 200 MG TABLET
|
Facility
|
OP
|
$288.00
|
|
|
Service Code
|
NDC 27241004910
|
| Hospital Charge Code |
26547
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$106.56 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Aetna American Axle |
$187.20
|
| Rate for Payer: Aetna Commercial |
$244.80
|
| Rate for Payer: Aetna Medicare |
$144.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.20
|
| Rate for Payer: BCBS Complete |
$115.20
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cofinity Commercial |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$247.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$201.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$230.40
|
| Rate for Payer: Healthscope Commercial |
$259.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$216.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.80
|
| Rate for Payer: PHP Commercial |
$244.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.20
|
| Rate for Payer: Priority Health SBD |
$181.44
|
| Rate for Payer: UMR Bronson Commercial |
$106.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$216.00
|
|
|
ENTEROENTEROSTOMY, ANASTOMOSIS OF INTESTINE, WITH OR WITHOUT CUTANEOUS ENTEROSTOMY (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$4,808.79
|
|
|
Service Code
|
CPT 44130
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,285.54 |
| Max. Negotiated Rate |
$4,808.79 |
| Rate for Payer: BCBS Trust/PPO |
$4,808.79
|
| Rate for Payer: BCN Commercial |
$4,808.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,414.09
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UHC Exchange |
$1,285.54
|
|
|
EPCORITAMAB-BYSP 0.16 MG/ML SUBCUTANEOUS SOLUTION
|
Facility
|
OP
|
$2,371.17
|
|
|
Service Code
|
HCPCS J9321
|
| Hospital Charge Code |
301958
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.58 |
| Max. Negotiated Rate |
$2,134.05 |
| Rate for Payer: Aetna American Axle |
$1,541.26
|
| Rate for Payer: Aetna Commercial |
$2,015.49
|
| Rate for Payer: Aetna Medicare |
$57.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,541.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.99
|
| Rate for Payer: BCBS Complete |
$31.06
|
| Rate for Payer: BCBS MAPPO |
$55.19
|
| Rate for Payer: BCBS Trust/PPO |
$148.78
|
| Rate for Payer: BCN Commercial |
$148.78
|
| Rate for Payer: BCN Medicare Advantage |
$55.19
|
| Rate for Payer: Cash Price |
$1,896.94
|
| Rate for Payer: Cash Price |
$1,896.94
|
| Rate for Payer: Cofinity Commercial |
$2,039.21
|
| Rate for Payer: Cofinity Commercial |
$1,659.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,659.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,896.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.19
|
| Rate for Payer: Healthscope Commercial |
$2,134.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,659.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,778.38
|
| Rate for Payer: Mclaren Medicaid |
$29.58
|
| Rate for Payer: Mclaren Medicare |
$55.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.95
|
| Rate for Payer: Meridian Medicaid |
$31.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,015.49
|
| Rate for Payer: Nomi Health Commercial |
$165.57
|
| Rate for Payer: PACE Medicare |
$52.43
|
| Rate for Payer: PACE SWMI |
$55.19
|
| Rate for Payer: PHP Commercial |
$2,015.49
|
| Rate for Payer: PHP Medicare Advantage |
$55.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,541.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.90
|
| Rate for Payer: Priority Health Medicare |
$55.19
|
| Rate for Payer: Priority Health Narrow Network |
$124.72
|
| Rate for Payer: Priority Health SBD |
$1,493.84
|
| Rate for Payer: Railroad Medicare Medicare |
$55.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.19
|
| Rate for Payer: UHC Exchange |
$105.47
|
| Rate for Payer: UHC Medicare Advantage |
$55.19
|
| Rate for Payer: UHCCP Medicaid |
$29.58
|
| Rate for Payer: UMR Bronson Commercial |
$877.33
|
| Rate for Payer: VA VA |
$55.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,778.38
|
|
|
EPCORITAMAB-BYSP 0.16 MG/ML SUBCUTANEOUS SOLUTION
|
Facility
|
IP
|
$2,371.17
|
|
|
Service Code
|
HCPCS J9321
|
| Hospital Charge Code |
301958
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,043.31 |
| Max. Negotiated Rate |
$2,134.05 |
| Rate for Payer: Aetna American Axle |
$1,541.26
|
| Rate for Payer: Aetna Commercial |
$2,015.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,541.26
|
| Rate for Payer: Cash Price |
$1,896.94
|
| Rate for Payer: Cofinity Commercial |
$1,659.82
|
| Rate for Payer: Cofinity Commercial |
$2,039.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,659.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,896.94
|
| Rate for Payer: Healthscope Commercial |
$2,134.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,659.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,778.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,015.49
|
| Rate for Payer: PHP Commercial |
$2,015.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,541.26
|
| Rate for Payer: Priority Health SBD |
$1,493.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,043.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,778.38
|
|
|
EPCORITAMAB-BYSP 0.8 MG/ML SUBCUTANEOUS SOLUTION
|
Facility
|
IP
|
$5,927.03
|
|
|
Service Code
|
HCPCS J9321
|
| Hospital Charge Code |
301960
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,607.89 |
| Max. Negotiated Rate |
$5,334.33 |
| Rate for Payer: Aetna American Axle |
$3,852.57
|
| Rate for Payer: Aetna Commercial |
$5,037.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,852.57
|
| Rate for Payer: Cash Price |
$4,741.62
|
| Rate for Payer: Cofinity Commercial |
$4,148.92
|
| Rate for Payer: Cofinity Commercial |
$5,097.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,148.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,741.62
|
| Rate for Payer: Healthscope Commercial |
$5,334.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,148.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,445.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,037.98
|
| Rate for Payer: PHP Commercial |
$5,037.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,852.57
|
| Rate for Payer: Priority Health SBD |
$3,734.03
|
| Rate for Payer: UMR Bronson Commercial |
$2,607.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,445.27
|
|
