|
EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$1,024.25
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
14643
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.58 |
| Max. Negotiated Rate |
$921.83 |
| Rate for Payer: Aetna American Axle |
$665.76
|
| Rate for Payer: Aetna American Axle |
$649.37
|
| Rate for Payer: Aetna Commercial |
$870.61
|
| Rate for Payer: Aetna Commercial |
$849.18
|
| Rate for Payer: Aetna Medicare |
$8.88
|
| Rate for Payer: Aetna Medicare |
$8.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.68
|
| Rate for Payer: BCBS Complete |
$4.81
|
| Rate for Payer: BCBS Complete |
$4.81
|
| Rate for Payer: BCBS MAPPO |
$8.54
|
| Rate for Payer: BCBS MAPPO |
$8.54
|
| Rate for Payer: BCN Medicare Advantage |
$8.54
|
| Rate for Payer: BCN Medicare Advantage |
$8.54
|
| Rate for Payer: Cash Price |
$819.40
|
| Rate for Payer: Cash Price |
$819.40
|
| Rate for Payer: Cash Price |
$799.22
|
| Rate for Payer: Cash Price |
$799.22
|
| Rate for Payer: Cofinity Commercial |
$716.98
|
| Rate for Payer: Cofinity Commercial |
$880.86
|
| Rate for Payer: Cofinity Commercial |
$699.32
|
| Rate for Payer: Cofinity Commercial |
$859.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$716.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$699.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$819.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$799.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.54
|
| Rate for Payer: Healthscope Commercial |
$899.13
|
| Rate for Payer: Healthscope Commercial |
$921.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$716.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$699.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$749.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$768.19
|
| Rate for Payer: Mclaren Medicaid |
$4.58
|
| Rate for Payer: Mclaren Medicaid |
$4.58
|
| Rate for Payer: Mclaren Medicare |
$8.54
|
| Rate for Payer: Mclaren Medicare |
$8.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.97
|
| Rate for Payer: Meridian Medicaid |
$4.81
|
| Rate for Payer: Meridian Medicaid |
$4.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$849.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$870.61
|
| Rate for Payer: PACE Medicare |
$8.11
|
| Rate for Payer: PACE Medicare |
$8.11
|
| Rate for Payer: PACE SWMI |
$8.54
|
| Rate for Payer: PACE SWMI |
$8.54
|
| Rate for Payer: PHP Commercial |
$849.18
|
| Rate for Payer: PHP Commercial |
$870.61
|
| Rate for Payer: PHP Medicare Advantage |
$8.54
|
| Rate for Payer: PHP Medicare Advantage |
$8.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$649.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.76
|
| Rate for Payer: Priority Health Medicare |
$8.54
|
| Rate for Payer: Priority Health Medicare |
$8.54
|
| Rate for Payer: Priority Health SBD |
$629.39
|
| Rate for Payer: Priority Health SBD |
$645.28
|
| Rate for Payer: Railroad Medicare Medicare |
$8.54
|
| Rate for Payer: Railroad Medicare Medicare |
$8.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.54
|
| Rate for Payer: UHC Exchange |
$16.32
|
| Rate for Payer: UHC Exchange |
$16.32
|
| Rate for Payer: UHC Medicare Advantage |
$8.54
|
| Rate for Payer: UHC Medicare Advantage |
$8.54
|
| Rate for Payer: UHCCP Medicaid |
$4.58
|
| Rate for Payer: UHCCP Medicaid |
$4.58
|
| Rate for Payer: UMR Bronson Commercial |
$378.97
|
| Rate for Payer: UMR Bronson Commercial |
$369.64
|
| Rate for Payer: VA VA |
$8.54
|
| Rate for Payer: VA VA |
$8.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$749.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$768.19
|
|
|
EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$181.34
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
9939
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.58 |
| Max. Negotiated Rate |
$163.21 |
| Rate for Payer: Aetna American Axle |
$117.87
|
| Rate for Payer: Aetna Commercial |
$154.14
|
| Rate for Payer: Aetna Medicare |
$8.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.68
|
| Rate for Payer: BCBS Complete |
$4.81
|
| Rate for Payer: BCBS MAPPO |
$8.54
|
| Rate for Payer: BCN Medicare Advantage |
$8.54
|
| Rate for Payer: Cash Price |
$145.07
|
| Rate for Payer: Cash Price |
$145.07
|
| Rate for Payer: Cofinity Commercial |
$155.95
|
| Rate for Payer: Cofinity Commercial |
$126.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$126.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.54
|
| Rate for Payer: Healthscope Commercial |
$163.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.00
|
| Rate for Payer: Mclaren Medicaid |
$4.58
|
| Rate for Payer: Mclaren Medicare |
$8.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.97
|
| Rate for Payer: Meridian Medicaid |
$4.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.14
|
| Rate for Payer: PACE Medicare |
$8.11
|
| Rate for Payer: PACE SWMI |
$8.54
|
| Rate for Payer: PHP Commercial |
$154.14
|
| Rate for Payer: PHP Medicare Advantage |
$8.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.87
|
| Rate for Payer: Priority Health Medicare |
$8.54
|
| Rate for Payer: Priority Health SBD |
$114.24
|
| Rate for Payer: Railroad Medicare Medicare |
$8.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.54
|
| Rate for Payer: UHC Exchange |
$16.32
|
| Rate for Payer: UHC Medicare Advantage |
$8.54
|
| Rate for Payer: UHCCP Medicaid |
$4.58
|
| Rate for Payer: UMR Bronson Commercial |
$67.10
|
| Rate for Payer: VA VA |
$8.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.00
|
|
|
EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$181.34
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
9939
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$79.79 |
| Max. Negotiated Rate |
$163.21 |
| Rate for Payer: Aetna American Axle |
$117.87
|
| Rate for Payer: Aetna Commercial |
$154.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.87
|
| Rate for Payer: Cash Price |
$145.07
|
| Rate for Payer: Cofinity Commercial |
$126.94
|
| Rate for Payer: Cofinity Commercial |
$155.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$126.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.07
|
| Rate for Payer: Healthscope Commercial |
$163.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.14
|
| Rate for Payer: PHP Commercial |
$154.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.87
|
| Rate for Payer: Priority Health SBD |
$114.24
|
| Rate for Payer: UMR Bronson Commercial |
$79.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.00
|
|
|
EPOETIN ALFA 40,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$1,801.05
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
24513
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$792.46 |
| Max. Negotiated Rate |
$1,620.94 |
| Rate for Payer: Aetna American Axle |
$1,170.68
|
| Rate for Payer: Aetna Commercial |
$1,530.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,170.68
|
| Rate for Payer: Cash Price |
$1,440.84
|
| Rate for Payer: Cofinity Commercial |
$1,260.73
|
| Rate for Payer: Cofinity Commercial |
$1,548.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,260.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,440.84
|
| Rate for Payer: Healthscope Commercial |
$1,620.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,260.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,350.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,530.89
|
| Rate for Payer: PHP Commercial |
$1,530.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,170.68
|
| Rate for Payer: Priority Health SBD |
$1,134.66
|
| Rate for Payer: UMR Bronson Commercial |
$792.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,350.79
|
|
|
EPOETIN ALFA 40,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$1,801.05
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
24513
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.58 |
| Max. Negotiated Rate |
$1,620.94 |
| Rate for Payer: Aetna American Axle |
$1,170.68
|
| Rate for Payer: Aetna Commercial |
$1,530.89
|
| Rate for Payer: Aetna Medicare |
$8.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,170.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.68
|
| Rate for Payer: BCBS Complete |
$4.81
|
| Rate for Payer: BCBS MAPPO |
$8.54
|
| Rate for Payer: BCN Medicare Advantage |
$8.54
|
| Rate for Payer: Cash Price |
$1,440.84
|
| Rate for Payer: Cash Price |
$1,440.84
|
| Rate for Payer: Cofinity Commercial |
$1,548.90
|
| Rate for Payer: Cofinity Commercial |
$1,260.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,260.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,440.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.54
|
| Rate for Payer: Healthscope Commercial |
$1,620.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,260.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,350.79
|
| Rate for Payer: Mclaren Medicaid |
$4.58
|
| Rate for Payer: Mclaren Medicare |
$8.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.97
|
| Rate for Payer: Meridian Medicaid |
$4.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,530.89
|
| Rate for Payer: PACE Medicare |
$8.11
|
| Rate for Payer: PACE SWMI |
$8.54
|
| Rate for Payer: PHP Commercial |
$1,530.89
|
| Rate for Payer: PHP Medicare Advantage |
$8.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,170.68
|
| Rate for Payer: Priority Health Medicare |
$8.54
|
| Rate for Payer: Priority Health SBD |
$1,134.66
|
| Rate for Payer: Railroad Medicare Medicare |
$8.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.54
|
| Rate for Payer: UHC Exchange |
$16.32
|
| Rate for Payer: UHC Medicare Advantage |
$8.54
|
| Rate for Payer: UHCCP Medicaid |
$4.58
|
| Rate for Payer: UMR Bronson Commercial |
$666.39
|
| Rate for Payer: VA VA |
$8.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,350.79
|
|
|
EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$362.61
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
9941
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$159.55 |
| Max. Negotiated Rate |
$326.35 |
| Rate for Payer: Aetna American Axle |
$235.70
|
| Rate for Payer: Aetna Commercial |
$308.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.70
|
| Rate for Payer: Cash Price |
$290.09
|
| Rate for Payer: Cofinity Commercial |
$253.83
|
| Rate for Payer: Cofinity Commercial |
$311.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$253.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.09
|
| Rate for Payer: Healthscope Commercial |
$326.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$253.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.22
|
| Rate for Payer: PHP Commercial |
$308.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.70
|
| Rate for Payer: Priority Health SBD |
$228.44
|
| Rate for Payer: UMR Bronson Commercial |
$159.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.96
|
|
|
EPOETIN ALFA 4,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$227.26
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
9941
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.58 |
| Max. Negotiated Rate |
$204.53 |
| Rate for Payer: Aetna American Axle |
$147.72
|
| Rate for Payer: Aetna American Axle |
$235.70
|
| Rate for Payer: Aetna Commercial |
$193.17
|
| Rate for Payer: Aetna Commercial |
$308.22
|
| Rate for Payer: Aetna Medicare |
$8.88
|
| Rate for Payer: Aetna Medicare |
$8.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.68
|
| Rate for Payer: BCBS Complete |
$4.81
|
| Rate for Payer: BCBS Complete |
$4.81
|
| Rate for Payer: BCBS MAPPO |
$8.54
|
| Rate for Payer: BCBS MAPPO |
$8.54
|
| Rate for Payer: BCN Medicare Advantage |
$8.54
|
| Rate for Payer: BCN Medicare Advantage |
$8.54
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cash Price |
$290.09
|
| Rate for Payer: Cash Price |
$290.09
|
| Rate for Payer: Cofinity Commercial |
$159.08
|
| Rate for Payer: Cofinity Commercial |
$195.44
|
| Rate for Payer: Cofinity Commercial |
$253.83
|
| Rate for Payer: Cofinity Commercial |
$311.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$159.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$253.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.54
|
| Rate for Payer: Healthscope Commercial |
$326.35
|
| Rate for Payer: Healthscope Commercial |
$204.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$159.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$253.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.44
|
| Rate for Payer: Mclaren Medicaid |
$4.58
|
| Rate for Payer: Mclaren Medicaid |
$4.58
|
| Rate for Payer: Mclaren Medicare |
$8.54
|
| Rate for Payer: Mclaren Medicare |
$8.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.97
|
| Rate for Payer: Meridian Medicaid |
$4.81
|
| Rate for Payer: Meridian Medicaid |
$4.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.17
|
| Rate for Payer: PACE Medicare |
$8.11
|
| Rate for Payer: PACE Medicare |
$8.11
|
| Rate for Payer: PACE SWMI |
$8.54
|
| Rate for Payer: PACE SWMI |
$8.54
|
| Rate for Payer: PHP Commercial |
$308.22
|
| Rate for Payer: PHP Commercial |
$193.17
|
| Rate for Payer: PHP Medicare Advantage |
$8.54
|
| Rate for Payer: PHP Medicare Advantage |
$8.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.72
|
| Rate for Payer: Priority Health Medicare |
$8.54
|
| Rate for Payer: Priority Health Medicare |
$8.54
|
| Rate for Payer: Priority Health SBD |
$228.44
|
| Rate for Payer: Priority Health SBD |
$143.17
|
| Rate for Payer: Railroad Medicare Medicare |
$8.54
|
| Rate for Payer: Railroad Medicare Medicare |
$8.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.54
|
| Rate for Payer: UHC Exchange |
$16.32
|
| Rate for Payer: UHC Exchange |
$16.32
|
| Rate for Payer: UHC Medicare Advantage |
$8.54
|
| Rate for Payer: UHC Medicare Advantage |
$8.54
|
| Rate for Payer: UHCCP Medicaid |
$4.58
|
| Rate for Payer: UHCCP Medicaid |
$4.58
|
| Rate for Payer: UMR Bronson Commercial |
$84.09
|
| Rate for Payer: UMR Bronson Commercial |
$134.17
|
| Rate for Payer: VA VA |
$8.54
|
| Rate for Payer: VA VA |
$8.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.44
|
|
|
EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$309.24
|
|
|
Service Code
|
HCPCS Q5106
|
| Hospital Charge Code |
186988
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$136.07 |
| Max. Negotiated Rate |
$278.32 |
| Rate for Payer: Aetna American Axle |
$201.01
|
| Rate for Payer: Aetna Commercial |
$262.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.01
|
| Rate for Payer: Cash Price |
$247.39
|
| Rate for Payer: Cofinity Commercial |
$216.47
|
| Rate for Payer: Cofinity Commercial |
$265.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$216.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.39
|
| Rate for Payer: Healthscope Commercial |
$278.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.85
|
| Rate for Payer: PHP Commercial |
$262.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.01
|
| Rate for Payer: Priority Health SBD |
$194.82
|
| Rate for Payer: UMR Bronson Commercial |
$136.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.93
|
|
|
EPOETIN ALFA-EPBX 10,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$309.24
|
|
|
Service Code
|
HCPCS Q5106
|
| Hospital Charge Code |
186988
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$278.32 |
| Rate for Payer: Aetna American Axle |
$201.01
|
| Rate for Payer: Aetna Commercial |
$262.85
|
| Rate for Payer: Aetna Medicare |
$8.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.81
|
| Rate for Payer: BCBS Complete |
$4.42
|
| Rate for Payer: BCBS MAPPO |
$7.85
|
| Rate for Payer: BCN Medicare Advantage |
$7.85
|
| Rate for Payer: Cash Price |
$247.39
|
| Rate for Payer: Cash Price |
$247.39
|
| Rate for Payer: Cofinity Commercial |
$265.95
|
| Rate for Payer: Cofinity Commercial |
$216.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$216.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.85
|
| Rate for Payer: Healthscope Commercial |
$278.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.93
|
| Rate for Payer: Mclaren Medicaid |
$4.21
|
| Rate for Payer: Mclaren Medicare |
$7.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.24
|
| Rate for Payer: Meridian Medicaid |
$4.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.85
|
| Rate for Payer: PACE Medicare |
$7.46
|
| Rate for Payer: PACE SWMI |
$7.85
|
| Rate for Payer: PHP Commercial |
$262.85
|
| Rate for Payer: PHP Medicare Advantage |
$7.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.01
|
| Rate for Payer: Priority Health Medicare |
$7.85
|
| Rate for Payer: Priority Health SBD |
$194.82
|
| Rate for Payer: Railroad Medicare Medicare |
$7.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.85
|
| Rate for Payer: UHC Exchange |
$15.00
|
| Rate for Payer: UHC Medicare Advantage |
$7.85
|
| Rate for Payer: UHCCP Medicaid |
$4.21
|
| Rate for Payer: UMR Bronson Commercial |
$114.42
|
| Rate for Payer: VA VA |
$7.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.93
|
|
|
EPOETIN ALFA-EPBX 20,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$618.48
|
|
|
Service Code
|
HCPCS Q5106
|
| Hospital Charge Code |
195677
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$556.63 |
| Rate for Payer: Aetna American Axle |
$402.01
|
| Rate for Payer: Aetna Commercial |
$525.71
|
| Rate for Payer: Aetna Medicare |
$8.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.81
|
| Rate for Payer: BCBS Complete |
$4.42
|
| Rate for Payer: BCBS MAPPO |
$7.85
|
| Rate for Payer: BCN Medicare Advantage |
$7.85
|
| Rate for Payer: Cash Price |
$494.78
|
| Rate for Payer: Cash Price |
$494.78
|
| Rate for Payer: Cofinity Commercial |
$531.89
|
| Rate for Payer: Cofinity Commercial |
$432.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$432.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$494.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.85
|
| Rate for Payer: Healthscope Commercial |
$556.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$432.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$463.86
|
| Rate for Payer: Mclaren Medicaid |
$4.21
|
| Rate for Payer: Mclaren Medicare |
$7.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.24
|
| Rate for Payer: Meridian Medicaid |
$4.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$525.71
|
| Rate for Payer: PACE Medicare |
$7.46
|
| Rate for Payer: PACE SWMI |
$7.85
|
| Rate for Payer: PHP Commercial |
$525.71
|
| Rate for Payer: PHP Medicare Advantage |
$7.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$402.01
|
| Rate for Payer: Priority Health Medicare |
$7.85
|
| Rate for Payer: Priority Health SBD |
$389.64
|
| Rate for Payer: Railroad Medicare Medicare |
$7.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.85
|
| Rate for Payer: UHC Exchange |
$15.00
|
| Rate for Payer: UHC Medicare Advantage |
$7.85
|
| Rate for Payer: UHCCP Medicaid |
$4.21
|
| Rate for Payer: UMR Bronson Commercial |
$228.84
|
| Rate for Payer: VA VA |
$7.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$463.86
|
|
|
EPOETIN ALFA-EPBX 20,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$618.48
|
|
|
Service Code
|
HCPCS Q5106
|
| Hospital Charge Code |
195677
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$272.13 |
| Max. Negotiated Rate |
$556.63 |
| Rate for Payer: Aetna American Axle |
$402.01
|
| Rate for Payer: Aetna Commercial |
$525.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.01
|
| Rate for Payer: Cash Price |
$494.78
|
| Rate for Payer: Cofinity Commercial |
$432.94
|
| Rate for Payer: Cofinity Commercial |
$531.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$432.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$494.78
|
| Rate for Payer: Healthscope Commercial |
$556.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$432.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$463.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$525.71
|
| Rate for Payer: PHP Commercial |
$525.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$402.01
|
| Rate for Payer: Priority Health SBD |
$389.64
|
| Rate for Payer: UMR Bronson Commercial |
$272.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$463.86
|
|
|
EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$77.53
|
|
|
Service Code
|
HCPCS Q5106
|
| Hospital Charge Code |
186985
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$34.11 |
| Max. Negotiated Rate |
$69.78 |
| Rate for Payer: Aetna American Axle |
$50.39
|
| Rate for Payer: Aetna Commercial |
$65.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.39
|
| Rate for Payer: Cash Price |
$62.02
|
| Rate for Payer: Cofinity Commercial |
$54.27
|
| Rate for Payer: Cofinity Commercial |
$66.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.02
|
| Rate for Payer: Healthscope Commercial |
$69.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.90
|
| Rate for Payer: PHP Commercial |
$65.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.39
|
| Rate for Payer: Priority Health SBD |
$48.84
|
| Rate for Payer: UMR Bronson Commercial |
$34.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.15
|
|
|
EPOETIN ALFA-EPBX 2,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$77.53
|
|
|
Service Code
|
HCPCS Q5106
|
| Hospital Charge Code |
186985
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$69.78 |
| Rate for Payer: Aetna American Axle |
$50.39
|
| Rate for Payer: Aetna Commercial |
$65.90
|
| Rate for Payer: Aetna Medicare |
$8.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.81
|
| Rate for Payer: BCBS Complete |
$4.42
|
| Rate for Payer: BCBS MAPPO |
$7.85
|
| Rate for Payer: BCN Medicare Advantage |
$7.85
|
| Rate for Payer: Cash Price |
$62.02
|
| Rate for Payer: Cash Price |
$62.02
|
| Rate for Payer: Cofinity Commercial |
$66.68
|
| Rate for Payer: Cofinity Commercial |
$54.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.85
|
| Rate for Payer: Healthscope Commercial |
$69.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.15
|
| Rate for Payer: Mclaren Medicaid |
$4.21
|
| Rate for Payer: Mclaren Medicare |
$7.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.24
|
| Rate for Payer: Meridian Medicaid |
$4.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.90
|
| Rate for Payer: PACE Medicare |
$7.46
|
| Rate for Payer: PACE SWMI |
$7.85
|
| Rate for Payer: PHP Commercial |
$65.90
|
| Rate for Payer: PHP Medicare Advantage |
$7.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.39
|
| Rate for Payer: Priority Health Medicare |
$7.85
|
| Rate for Payer: Priority Health SBD |
$48.84
|
| Rate for Payer: Railroad Medicare Medicare |
$7.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.85
|
| Rate for Payer: UHC Exchange |
$15.00
|
| Rate for Payer: UHC Medicare Advantage |
$7.85
|
| Rate for Payer: UHCCP Medicaid |
$4.21
|
| Rate for Payer: UMR Bronson Commercial |
$28.69
|
| Rate for Payer: VA VA |
$7.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.15
|
|
|
EPOETIN ALFA-EPBX 40,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$1,115.01
|
|
|
Service Code
|
HCPCS Q5106
|
| Hospital Charge Code |
186989
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$490.60 |
| Max. Negotiated Rate |
$1,003.51 |
| Rate for Payer: Aetna American Axle |
$724.76
|
| Rate for Payer: Aetna Commercial |
$947.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.76
|
| Rate for Payer: Cash Price |
$892.01
|
| Rate for Payer: Cofinity Commercial |
$780.51
|
| Rate for Payer: Cofinity Commercial |
$958.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$780.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$892.01
|
| Rate for Payer: Healthscope Commercial |
$1,003.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$780.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$836.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.76
|
| Rate for Payer: PHP Commercial |
$947.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.76
|
| Rate for Payer: Priority Health SBD |
$702.46
|
| Rate for Payer: UMR Bronson Commercial |
$490.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$836.26
|
|
|
EPOETIN ALFA-EPBX 40,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$1,115.01
|
|
|
Service Code
|
HCPCS Q5106
|
| Hospital Charge Code |
186989
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$1,003.51 |
| Rate for Payer: Aetna American Axle |
$724.76
|
| Rate for Payer: Aetna Commercial |
$947.76
|
| Rate for Payer: Aetna Medicare |
$8.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.81
|
| Rate for Payer: BCBS Complete |
$4.42
|
| Rate for Payer: BCBS MAPPO |
$7.85
|
| Rate for Payer: BCN Medicare Advantage |
$7.85
|
| Rate for Payer: Cash Price |
$892.01
|
| Rate for Payer: Cash Price |
$892.01
|
| Rate for Payer: Cofinity Commercial |
$958.91
|
| Rate for Payer: Cofinity Commercial |
$780.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$780.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$892.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.85
|
| Rate for Payer: Healthscope Commercial |
$1,003.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$780.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$836.26
|
| Rate for Payer: Mclaren Medicaid |
$4.21
|
| Rate for Payer: Mclaren Medicare |
$7.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.24
|
| Rate for Payer: Meridian Medicaid |
$4.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.76
|
| Rate for Payer: PACE Medicare |
$7.46
|
| Rate for Payer: PACE SWMI |
$7.85
|
| Rate for Payer: PHP Commercial |
$947.76
|
| Rate for Payer: PHP Medicare Advantage |
$7.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$724.76
|
| Rate for Payer: Priority Health Medicare |
$7.85
|
| Rate for Payer: Priority Health SBD |
$702.46
|
| Rate for Payer: Railroad Medicare Medicare |
$7.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.85
|
| Rate for Payer: UHC Exchange |
$15.00
|
| Rate for Payer: UHC Medicare Advantage |
$7.85
|
| Rate for Payer: UHCCP Medicaid |
$4.21
|
| Rate for Payer: UMR Bronson Commercial |
$412.55
|
| Rate for Payer: VA VA |
$7.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$836.26
|
|
|
EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$155.06
|
|
|
Service Code
|
HCPCS Q5106
|
| Hospital Charge Code |
186987
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$139.55 |
| Rate for Payer: Aetna American Axle |
$100.79
|
| Rate for Payer: Aetna Commercial |
$131.80
|
| Rate for Payer: Aetna Medicare |
$8.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.81
|
| Rate for Payer: BCBS Complete |
$4.42
|
| Rate for Payer: BCBS MAPPO |
$7.85
|
| Rate for Payer: BCN Medicare Advantage |
$7.85
|
| Rate for Payer: Cash Price |
$124.05
|
| Rate for Payer: Cash Price |
$124.05
|
| Rate for Payer: Cofinity Commercial |
$133.35
|
| Rate for Payer: Cofinity Commercial |
$108.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$108.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.85
|
| Rate for Payer: Healthscope Commercial |
$139.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$108.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.30
|
| Rate for Payer: Mclaren Medicaid |
$4.21
|
| Rate for Payer: Mclaren Medicare |
$7.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.24
|
| Rate for Payer: Meridian Medicaid |
$4.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.80
|
| Rate for Payer: PACE Medicare |
$7.46
|
| Rate for Payer: PACE SWMI |
$7.85
|
| Rate for Payer: PHP Commercial |
$131.80
|
| Rate for Payer: PHP Medicare Advantage |
$7.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.79
|
| Rate for Payer: Priority Health Medicare |
$7.85
|
| Rate for Payer: Priority Health SBD |
$97.69
|
| Rate for Payer: Railroad Medicare Medicare |
$7.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.85
|
| Rate for Payer: UHC Exchange |
$15.00
|
| Rate for Payer: UHC Medicare Advantage |
$7.85
|
| Rate for Payer: UHCCP Medicaid |
$4.21
|
| Rate for Payer: UMR Bronson Commercial |
$57.37
|
| Rate for Payer: VA VA |
$7.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.30
|
|
|
EPOETIN ALFA-EPBX 4,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$155.06
|
|
|
Service Code
|
HCPCS Q5106
|
| Hospital Charge Code |
186987
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$68.23 |
| Max. Negotiated Rate |
$139.55 |
| Rate for Payer: Aetna American Axle |
$100.79
|
| Rate for Payer: Aetna Commercial |
$131.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.79
|
| Rate for Payer: Cash Price |
$124.05
|
| Rate for Payer: Cofinity Commercial |
$108.54
|
| Rate for Payer: Cofinity Commercial |
$133.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$108.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.05
|
| Rate for Payer: Healthscope Commercial |
$139.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$108.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.80
|
| Rate for Payer: PHP Commercial |
$131.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.79
|
| Rate for Payer: Priority Health SBD |
$97.69
|
| Rate for Payer: UMR Bronson Commercial |
$68.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.30
|
|
|
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$100.15
|
|
|
Service Code
|
HCPCS J1325
|
| Hospital Charge Code |
162203
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$44.07 |
| Max. Negotiated Rate |
$90.14 |
| Rate for Payer: Aetna American Axle |
$65.10
|
| Rate for Payer: Aetna American Axle |
$85.05
|
| Rate for Payer: Aetna Commercial |
$85.13
|
| Rate for Payer: Aetna Commercial |
$111.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.05
|
| Rate for Payer: Cash Price |
$80.12
|
| Rate for Payer: Cash Price |
$104.68
|
| Rate for Payer: Cofinity Commercial |
$91.59
|
| Rate for Payer: Cofinity Commercial |
$112.53
|
| Rate for Payer: Cofinity Commercial |
$70.11
|
| Rate for Payer: Cofinity Commercial |
$86.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$70.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.68
|
| Rate for Payer: Healthscope Commercial |
$90.14
|
| Rate for Payer: Healthscope Commercial |
$117.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.13
|
| Rate for Payer: PHP Commercial |
$111.22
|
| Rate for Payer: PHP Commercial |
$85.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.05
|
| Rate for Payer: Priority Health SBD |
$63.09
|
| Rate for Payer: Priority Health SBD |
$82.44
|
| Rate for Payer: UMR Bronson Commercial |
$44.07
|
| Rate for Payer: UMR Bronson Commercial |
$57.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.14
|
|
|
EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$100.15
|
|
|
Service Code
|
HCPCS J1325
|
| Hospital Charge Code |
162203
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$37.06 |
| Max. Negotiated Rate |
$90.14 |
| Rate for Payer: Aetna American Axle |
$65.10
|
| Rate for Payer: Aetna American Axle |
$85.05
|
| Rate for Payer: Aetna Commercial |
$85.13
|
| Rate for Payer: Aetna Commercial |
$111.22
|
| Rate for Payer: Aetna Medicare |
$50.08
|
| Rate for Payer: Aetna Medicare |
$65.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.05
|
| Rate for Payer: BCBS Complete |
$52.34
|
| Rate for Payer: BCBS Complete |
$40.06
|
| Rate for Payer: Cash Price |
$80.12
|
| Rate for Payer: Cash Price |
$104.68
|
| Rate for Payer: Cofinity Commercial |
$86.13
|
| Rate for Payer: Cofinity Commercial |
$70.11
|
| Rate for Payer: Cofinity Commercial |
$112.53
|
| Rate for Payer: Cofinity Commercial |
$91.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$70.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.68
|
| Rate for Payer: Healthscope Commercial |
$117.77
|
| Rate for Payer: Healthscope Commercial |
$90.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.22
|
| Rate for Payer: PHP Commercial |
$111.22
|
| Rate for Payer: PHP Commercial |
$85.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.05
|
| Rate for Payer: Priority Health SBD |
$82.44
|
| Rate for Payer: Priority Health SBD |
$63.09
|
| Rate for Payer: UMR Bronson Commercial |
$37.06
|
| Rate for Payer: UMR Bronson Commercial |
$48.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.11
|
|
|
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$200.22
|
|
|
Service Code
|
HCPCS J1325
|
| Hospital Charge Code |
155384
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$74.08 |
| Max. Negotiated Rate |
$180.20 |
| Rate for Payer: Aetna American Axle |
$130.14
|
| Rate for Payer: Aetna Commercial |
$170.19
|
| Rate for Payer: Aetna Medicare |
$100.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.14
|
| Rate for Payer: BCBS Complete |
$80.09
|
| Rate for Payer: Cash Price |
$160.18
|
| Rate for Payer: Cofinity Commercial |
$140.15
|
| Rate for Payer: Cofinity Commercial |
$172.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$140.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.18
|
| Rate for Payer: Healthscope Commercial |
$180.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.19
|
| Rate for Payer: PHP Commercial |
$170.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.14
|
| Rate for Payer: Priority Health SBD |
$126.14
|
| Rate for Payer: UMR Bronson Commercial |
$74.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.16
|
|
|
EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$200.22
|
|
|
Service Code
|
HCPCS J1325
|
| Hospital Charge Code |
155384
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$88.10 |
| Max. Negotiated Rate |
$180.20 |
| Rate for Payer: Aetna American Axle |
$130.14
|
| Rate for Payer: Aetna Commercial |
$170.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.14
|
| Rate for Payer: Cash Price |
$160.18
|
| Rate for Payer: Cofinity Commercial |
$140.15
|
| Rate for Payer: Cofinity Commercial |
$172.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$140.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.18
|
| Rate for Payer: Healthscope Commercial |
$180.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.19
|
| Rate for Payer: PHP Commercial |
$170.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.14
|
| Rate for Payer: Priority Health SBD |
$126.14
|
| Rate for Payer: UMR Bronson Commercial |
$88.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.16
|
|
|
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$126.72
|
|
|
Service Code
|
HCPCS J1325
|
| Hospital Charge Code |
15897
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$55.76 |
| Max. Negotiated Rate |
$114.05 |
| Rate for Payer: Aetna American Axle |
$82.37
|
| Rate for Payer: Aetna Commercial |
$107.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.37
|
| Rate for Payer: Cash Price |
$101.38
|
| Rate for Payer: Cofinity Commercial |
$108.98
|
| Rate for Payer: Cofinity Commercial |
$88.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$88.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.38
|
| Rate for Payer: Healthscope Commercial |
$114.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.71
|
| Rate for Payer: PHP Commercial |
$107.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.37
|
| Rate for Payer: Priority Health SBD |
$79.83
|
| Rate for Payer: UMR Bronson Commercial |
$55.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.04
|
|
|
EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$126.72
|
|
|
Service Code
|
HCPCS J1325
|
| Hospital Charge Code |
15897
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$46.89 |
| Max. Negotiated Rate |
$114.05 |
| Rate for Payer: Aetna American Axle |
$82.37
|
| Rate for Payer: Aetna Commercial |
$107.71
|
| Rate for Payer: Aetna Medicare |
$63.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.37
|
| Rate for Payer: BCBS Complete |
$50.69
|
| Rate for Payer: Cash Price |
$101.38
|
| Rate for Payer: Cofinity Commercial |
$108.98
|
| Rate for Payer: Cofinity Commercial |
$88.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$88.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.38
|
| Rate for Payer: Healthscope Commercial |
$114.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.71
|
| Rate for Payer: PHP Commercial |
$107.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.37
|
| Rate for Payer: Priority Health SBD |
$79.83
|
| Rate for Payer: UMR Bronson Commercial |
$46.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.04
|
|
|
EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$267.73
|
|
|
Service Code
|
HCPCS J1327
|
| Hospital Charge Code |
23123
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$117.80 |
| Max. Negotiated Rate |
$240.96 |
| Rate for Payer: Aetna American Axle |
$174.02
|
| Rate for Payer: Aetna American Axle |
$698.55
|
| Rate for Payer: Aetna American Axle |
$1,095.38
|
| Rate for Payer: Aetna American Axle |
$187.90
|
| Rate for Payer: Aetna American Axle |
$167.69
|
| Rate for Payer: Aetna Commercial |
$227.57
|
| Rate for Payer: Aetna Commercial |
$1,432.42
|
| Rate for Payer: Aetna Commercial |
$913.50
|
| Rate for Payer: Aetna Commercial |
$245.72
|
| Rate for Payer: Aetna Commercial |
$219.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$698.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,095.38
|
| Rate for Payer: Cash Price |
$214.18
|
| Rate for Payer: Cash Price |
$231.26
|
| Rate for Payer: Cash Price |
$1,348.16
|
| Rate for Payer: Cash Price |
$206.39
|
| Rate for Payer: Cash Price |
$859.76
|
| Rate for Payer: Cofinity Commercial |
$202.36
|
| Rate for Payer: Cofinity Commercial |
$752.29
|
| Rate for Payer: Cofinity Commercial |
$230.25
|
| Rate for Payer: Cofinity Commercial |
$187.41
|
| Rate for Payer: Cofinity Commercial |
$180.59
|
| Rate for Payer: Cofinity Commercial |
$1,179.64
|
| Rate for Payer: Cofinity Commercial |
$1,449.27
|
| Rate for Payer: Cofinity Commercial |
$221.87
|
| Rate for Payer: Cofinity Commercial |
$924.24
|
| Rate for Payer: Cofinity Commercial |
$248.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$187.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$752.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,179.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$202.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$180.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,348.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$859.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.39
|
| Rate for Payer: Healthscope Commercial |
$1,516.68
|
| Rate for Payer: Healthscope Commercial |
$240.96
|
| Rate for Payer: Healthscope Commercial |
$232.19
|
| Rate for Payer: Healthscope Commercial |
$260.17
|
| Rate for Payer: Healthscope Commercial |
$967.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$752.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,179.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$202.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,263.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$216.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,432.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$913.50
|
| Rate for Payer: PHP Commercial |
$913.50
|
| Rate for Payer: PHP Commercial |
$245.72
|
| Rate for Payer: PHP Commercial |
$219.29
|
| Rate for Payer: PHP Commercial |
$227.57
|
| Rate for Payer: PHP Commercial |
$1,432.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,095.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$698.55
|
| Rate for Payer: Priority Health SBD |
$182.12
|
| Rate for Payer: Priority Health SBD |
$162.53
|
| Rate for Payer: Priority Health SBD |
$1,061.68
|
| Rate for Payer: Priority Health SBD |
$677.06
|
| Rate for Payer: Priority Health SBD |
$168.67
|
| Rate for Payer: UMR Bronson Commercial |
$472.87
|
| Rate for Payer: UMR Bronson Commercial |
$741.49
|
| Rate for Payer: UMR Bronson Commercial |
$117.80
|
| Rate for Payer: UMR Bronson Commercial |
$127.20
|
| Rate for Payer: UMR Bronson Commercial |
$113.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,263.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$216.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.80
|
|
|
EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$1,685.20
|
|
|
Service Code
|
HCPCS J1327
|
| Hospital Charge Code |
23123
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$623.52 |
| Max. Negotiated Rate |
$1,516.68 |
| Rate for Payer: Aetna American Axle |
$1,095.38
|
| Rate for Payer: Aetna American Axle |
$174.02
|
| Rate for Payer: Aetna American Axle |
$187.90
|
| Rate for Payer: Aetna American Axle |
$698.55
|
| Rate for Payer: Aetna American Axle |
$167.69
|
| Rate for Payer: Aetna Commercial |
$913.50
|
| Rate for Payer: Aetna Commercial |
$245.72
|
| Rate for Payer: Aetna Commercial |
$219.29
|
| Rate for Payer: Aetna Commercial |
$227.57
|
| Rate for Payer: Aetna Commercial |
$1,432.42
|
| Rate for Payer: Aetna Medicare |
$133.87
|
| Rate for Payer: Aetna Medicare |
$842.60
|
| Rate for Payer: Aetna Medicare |
$144.54
|
| Rate for Payer: Aetna Medicare |
$129.00
|
| Rate for Payer: Aetna Medicare |
$537.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$698.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,095.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.02
|
| Rate for Payer: BCBS Complete |
$115.63
|
| Rate for Payer: BCBS Complete |
$429.88
|
| Rate for Payer: BCBS Complete |
$107.09
|
| Rate for Payer: BCBS Complete |
$103.20
|
| Rate for Payer: BCBS Complete |
$674.08
|
| Rate for Payer: Cash Price |
$231.26
|
| Rate for Payer: Cash Price |
$859.76
|
| Rate for Payer: Cash Price |
$1,348.16
|
| Rate for Payer: Cash Price |
$214.18
|
| Rate for Payer: Cash Price |
$206.39
|
| Rate for Payer: Cofinity Commercial |
$202.36
|
| Rate for Payer: Cofinity Commercial |
$1,449.27
|
| Rate for Payer: Cofinity Commercial |
$230.25
|
| Rate for Payer: Cofinity Commercial |
$752.29
|
| Rate for Payer: Cofinity Commercial |
$221.87
|
| Rate for Payer: Cofinity Commercial |
$180.59
|
| Rate for Payer: Cofinity Commercial |
$187.41
|
| Rate for Payer: Cofinity Commercial |
$924.24
|
| Rate for Payer: Cofinity Commercial |
$1,179.64
|
| Rate for Payer: Cofinity Commercial |
$248.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$752.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$187.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,179.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$180.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$202.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$859.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,348.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.39
|
| Rate for Payer: Healthscope Commercial |
$967.23
|
| Rate for Payer: Healthscope Commercial |
$232.19
|
| Rate for Payer: Healthscope Commercial |
$260.17
|
| Rate for Payer: Healthscope Commercial |
$240.96
|
| Rate for Payer: Healthscope Commercial |
$1,516.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$752.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,179.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$202.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$216.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,263.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,432.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$913.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.72
|
| Rate for Payer: PHP Commercial |
$227.57
|
| Rate for Payer: PHP Commercial |
$219.29
|
| Rate for Payer: PHP Commercial |
$913.50
|
| Rate for Payer: PHP Commercial |
$1,432.42
|
| Rate for Payer: PHP Commercial |
$245.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$698.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,095.38
|
| Rate for Payer: Priority Health SBD |
$1,061.68
|
| Rate for Payer: Priority Health SBD |
$677.06
|
| Rate for Payer: Priority Health SBD |
$162.53
|
| Rate for Payer: Priority Health SBD |
$168.67
|
| Rate for Payer: Priority Health SBD |
$182.12
|
| Rate for Payer: UMR Bronson Commercial |
$106.96
|
| Rate for Payer: UMR Bronson Commercial |
$99.06
|
| Rate for Payer: UMR Bronson Commercial |
$623.52
|
| Rate for Payer: UMR Bronson Commercial |
$397.64
|
| Rate for Payer: UMR Bronson Commercial |
$95.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$216.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,263.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.49
|
|
