|
EPLERENONE 25 MG TABLET
|
Facility
|
OP
|
$121.26
|
|
|
Service Code
|
NDC 16729029310
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$44.87 |
| Max. Negotiated Rate |
$109.13 |
| Rate for Payer: Aetna American Axle |
$78.82
|
| Rate for Payer: Aetna Commercial |
$103.07
|
| Rate for Payer: Aetna Medicare |
$60.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.82
|
| Rate for Payer: BCBS Complete |
$48.50
|
| Rate for Payer: Cash Price |
$97.01
|
| Rate for Payer: Cofinity Commercial |
$104.28
|
| Rate for Payer: Cofinity Commercial |
$84.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$84.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.01
|
| Rate for Payer: Healthscope Commercial |
$109.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.07
|
| Rate for Payer: PHP Commercial |
$103.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.82
|
| Rate for Payer: Priority Health SBD |
$76.39
|
| Rate for Payer: UMR Bronson Commercial |
$44.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.94
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
IP
|
$11.66
|
|
|
Service Code
|
NDC 60687045111
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$10.49 |
| Rate for Payer: Aetna American Axle |
$7.58
|
| Rate for Payer: Aetna Commercial |
$9.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.58
|
| Rate for Payer: Cash Price |
$9.33
|
| Rate for Payer: Cofinity Commercial |
$10.03
|
| Rate for Payer: Cofinity Commercial |
$8.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.33
|
| Rate for Payer: Healthscope Commercial |
$10.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.91
|
| Rate for Payer: PHP Commercial |
$9.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.58
|
| Rate for Payer: Priority Health SBD |
$7.35
|
| Rate for Payer: UMR Bronson Commercial |
$5.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.74
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
OP
|
$187.35
|
|
|
Service Code
|
NDC 66993034330
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$69.32 |
| Max. Negotiated Rate |
$168.62 |
| Rate for Payer: Aetna American Axle |
$121.78
|
| Rate for Payer: Aetna Commercial |
$159.25
|
| Rate for Payer: Aetna Medicare |
$93.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.78
|
| Rate for Payer: BCBS Complete |
$74.94
|
| Rate for Payer: Cash Price |
$149.88
|
| Rate for Payer: Cofinity Commercial |
$131.14
|
| Rate for Payer: Cofinity Commercial |
$161.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$131.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.88
|
| Rate for Payer: Healthscope Commercial |
$168.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.25
|
| Rate for Payer: PHP Commercial |
$159.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.78
|
| Rate for Payer: Priority Health SBD |
$118.03
|
| Rate for Payer: UMR Bronson Commercial |
$69.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.51
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
OP
|
$11.66
|
|
|
Service Code
|
NDC 60687045111
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.31 |
| Max. Negotiated Rate |
$10.49 |
| Rate for Payer: Aetna American Axle |
$7.58
|
| Rate for Payer: Aetna Commercial |
$9.91
|
| Rate for Payer: Aetna Medicare |
$5.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.58
|
| Rate for Payer: BCBS Complete |
$4.66
|
| Rate for Payer: Cash Price |
$9.33
|
| Rate for Payer: Cofinity Commercial |
$10.03
|
| Rate for Payer: Cofinity Commercial |
$8.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.33
|
| Rate for Payer: Healthscope Commercial |
$10.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.91
|
| Rate for Payer: PHP Commercial |
$9.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.58
|
| Rate for Payer: Priority Health SBD |
$7.35
|
| Rate for Payer: UMR Bronson Commercial |
$4.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.74
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
OP
|
$349.65
|
|
|
Service Code
|
NDC 60687045121
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$129.37 |
| Max. Negotiated Rate |
$314.68 |
| Rate for Payer: Aetna American Axle |
$227.27
|
| Rate for Payer: Aetna Commercial |
$297.20
|
| Rate for Payer: Aetna Medicare |
$174.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.27
|
| Rate for Payer: BCBS Complete |
$139.86
|
| Rate for Payer: Cash Price |
$279.72
|
| Rate for Payer: Cofinity Commercial |
$244.76
|
| Rate for Payer: Cofinity Commercial |
$300.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$244.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.72
|
| Rate for Payer: Healthscope Commercial |
$314.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$244.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$297.20
|
| Rate for Payer: PHP Commercial |
$297.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.27
|
| Rate for Payer: Priority Health SBD |
$220.28
|
| Rate for Payer: UMR Bronson Commercial |
$129.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.24
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
OP
|
$121.40
|
|
|
Service Code
|
NDC 00378103093
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$44.92 |
| Max. Negotiated Rate |
$109.26 |
| Rate for Payer: Aetna American Axle |
$78.91
|
| Rate for Payer: Aetna Commercial |
$103.19
|
| Rate for Payer: Aetna Medicare |
$60.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.91
|
| Rate for Payer: BCBS Complete |
$48.56
|
| Rate for Payer: Cash Price |
$97.12
|
| Rate for Payer: Cofinity Commercial |
$104.40
|
| Rate for Payer: Cofinity Commercial |
$84.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$84.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.12
|
| Rate for Payer: Healthscope Commercial |
$109.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.19
|
| Rate for Payer: PHP Commercial |
$103.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.91
|
| Rate for Payer: Priority Health SBD |
$76.48
|
| Rate for Payer: UMR Bronson Commercial |
$44.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.05
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
IP
|
$121.26
|
|
|
Service Code
|
NDC 16729029310
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$53.35 |
| Max. Negotiated Rate |
$109.13 |
| Rate for Payer: Aetna American Axle |
$78.82
|
| Rate for Payer: Aetna Commercial |
$103.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.82
|
| Rate for Payer: Cash Price |
$97.01
|
| Rate for Payer: Cofinity Commercial |
$104.28
|
| Rate for Payer: Cofinity Commercial |
$84.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$84.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.01
|
| Rate for Payer: Healthscope Commercial |
$109.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.07
|
| Rate for Payer: PHP Commercial |
$103.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.82
|
| Rate for Payer: Priority Health SBD |
$76.39
|
| Rate for Payer: UMR Bronson Commercial |
$53.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.94
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
IP
|
$187.35
|
|
|
Service Code
|
NDC 66993034330
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.43 |
| Max. Negotiated Rate |
$168.62 |
| Rate for Payer: Aetna American Axle |
$121.78
|
| Rate for Payer: Aetna Commercial |
$159.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.78
|
| Rate for Payer: Cash Price |
$149.88
|
| Rate for Payer: Cofinity Commercial |
$131.14
|
| Rate for Payer: Cofinity Commercial |
$161.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$131.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.88
|
| Rate for Payer: Healthscope Commercial |
$168.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.25
|
| Rate for Payer: PHP Commercial |
$159.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.78
|
| Rate for Payer: Priority Health SBD |
$118.03
|
| Rate for Payer: UMR Bronson Commercial |
$82.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.51
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
OP
|
$187.35
|
|
|
Service Code
|
NDC 59762171002
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$69.32 |
| Max. Negotiated Rate |
$168.62 |
| Rate for Payer: Aetna American Axle |
$121.78
|
| Rate for Payer: Aetna Commercial |
$159.25
|
| Rate for Payer: Aetna Medicare |
$93.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.78
|
| Rate for Payer: BCBS Complete |
$74.94
|
| Rate for Payer: Cash Price |
$149.88
|
| Rate for Payer: Cofinity Commercial |
$131.14
|
| Rate for Payer: Cofinity Commercial |
$161.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$131.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.88
|
| Rate for Payer: Healthscope Commercial |
$168.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.25
|
| Rate for Payer: PHP Commercial |
$159.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.78
|
| Rate for Payer: Priority Health SBD |
$118.03
|
| Rate for Payer: UMR Bronson Commercial |
$69.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.51
|
|
|
EPLERENONE 25 MG TABLET
|
Facility
|
IP
|
$187.35
|
|
|
Service Code
|
NDC 59762171002
|
| Hospital Charge Code |
36983
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.43 |
| Max. Negotiated Rate |
$168.62 |
| Rate for Payer: Aetna American Axle |
$121.78
|
| Rate for Payer: Aetna Commercial |
$159.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.78
|
| Rate for Payer: Cash Price |
$149.88
|
| Rate for Payer: Cofinity Commercial |
$131.14
|
| Rate for Payer: Cofinity Commercial |
$161.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$131.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.88
|
| Rate for Payer: Healthscope Commercial |
$168.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.25
|
| Rate for Payer: PHP Commercial |
$159.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.78
|
| Rate for Payer: Priority Health SBD |
$118.03
|
| Rate for Payer: UMR Bronson Commercial |
$82.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.51
|
|
|
EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$499.51
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
9938
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$219.78 |
| Max. Negotiated Rate |
$449.56 |
| Rate for Payer: Aetna American Axle |
$324.68
|
| Rate for Payer: Aetna Commercial |
$424.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.68
|
| Rate for Payer: Cash Price |
$399.61
|
| Rate for Payer: Cofinity Commercial |
$349.66
|
| Rate for Payer: Cofinity Commercial |
$429.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$349.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.61
|
| Rate for Payer: Healthscope Commercial |
$449.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$349.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.58
|
| Rate for Payer: PHP Commercial |
$424.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.68
|
| Rate for Payer: Priority Health SBD |
$314.69
|
| Rate for Payer: UMR Bronson Commercial |
$219.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.63
|
|
|
EPOETIN ALFA 10,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$499.51
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
9938
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$449.56 |
| Rate for Payer: Aetna American Axle |
$324.68
|
| Rate for Payer: Aetna Commercial |
$424.58
|
| Rate for Payer: Aetna Medicare |
$6.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.08
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.46
|
| Rate for Payer: BCBS Trust/PPO |
$19.90
|
| Rate for Payer: BCN Commercial |
$19.90
|
| Rate for Payer: BCN Medicare Advantage |
$6.46
|
| Rate for Payer: Cash Price |
$399.61
|
| Rate for Payer: Cash Price |
$399.61
|
| Rate for Payer: Cofinity Commercial |
$429.58
|
| Rate for Payer: Cofinity Commercial |
$349.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$349.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.46
|
| Rate for Payer: Healthscope Commercial |
$449.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$349.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.63
|
| Rate for Payer: Mclaren Medicaid |
$3.46
|
| Rate for Payer: Mclaren Medicare |
$6.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.78
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.58
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: PACE Medicare |
$6.14
|
| Rate for Payer: PACE SWMI |
$6.46
|
| Rate for Payer: PHP Commercial |
$424.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.66
|
| Rate for Payer: Priority Health Medicare |
$6.46
|
| Rate for Payer: Priority Health Narrow Network |
$17.33
|
| Rate for Payer: Priority Health SBD |
$314.69
|
| Rate for Payer: Railroad Medicare Medicare |
$6.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.46
|
| Rate for Payer: UHC Exchange |
$12.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.46
|
| Rate for Payer: UHCCP Medicaid |
$3.46
|
| Rate for Payer: UMR Bronson Commercial |
$184.82
|
| Rate for Payer: VA VA |
$6.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.63
|
|
|
EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$1,024.25
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
14643
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$921.82 |
| 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 |
$6.72
|
| Rate for Payer: Aetna Medicare |
$6.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.08
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.46
|
| Rate for Payer: BCBS MAPPO |
$6.46
|
| Rate for Payer: BCBS Trust/PPO |
$19.90
|
| Rate for Payer: BCBS Trust/PPO |
$19.90
|
| Rate for Payer: BCN Commercial |
$19.90
|
| Rate for Payer: BCN Commercial |
$19.90
|
| Rate for Payer: BCN Medicare Advantage |
$6.46
|
| Rate for Payer: BCN Medicare Advantage |
$6.46
|
| Rate for Payer: Cash Price |
$799.22
|
| Rate for Payer: Cash Price |
$819.40
|
| Rate for Payer: Cash Price |
$799.22
|
| Rate for Payer: Cash Price |
$819.40
|
| Rate for Payer: Cofinity Commercial |
$859.17
|
| Rate for Payer: Cofinity Commercial |
$699.32
|
| Rate for Payer: Cofinity Commercial |
$716.98
|
| Rate for Payer: Cofinity Commercial |
$880.86
|
| 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 |
$6.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.46
|
| Rate for Payer: Healthscope Commercial |
$899.13
|
| Rate for Payer: Healthscope Commercial |
$921.82
|
| 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 |
$768.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$749.27
|
| Rate for Payer: Mclaren Medicaid |
$3.46
|
| Rate for Payer: Mclaren Medicaid |
$3.46
|
| Rate for Payer: Mclaren Medicare |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$6.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.78
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$870.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$849.18
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: PACE Medicare |
$6.14
|
| Rate for Payer: PACE Medicare |
$6.14
|
| Rate for Payer: PACE SWMI |
$6.46
|
| Rate for Payer: PACE SWMI |
$6.46
|
| Rate for Payer: PHP Commercial |
$849.18
|
| Rate for Payer: PHP Commercial |
$870.61
|
| Rate for Payer: PHP Medicare Advantage |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$6.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$649.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.66
|
| Rate for Payer: Priority Health Medicare |
$6.46
|
| Rate for Payer: Priority Health Medicare |
$6.46
|
| Rate for Payer: Priority Health Narrow Network |
$17.33
|
| Rate for Payer: Priority Health Narrow Network |
$17.33
|
| Rate for Payer: Priority Health SBD |
$645.28
|
| Rate for Payer: Priority Health SBD |
$629.39
|
| Rate for Payer: Railroad Medicare Medicare |
$6.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.46
|
| Rate for Payer: UHC Exchange |
$12.35
|
| Rate for Payer: UHC Exchange |
$12.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.46
|
| Rate for Payer: UHC Medicare Advantage |
$6.46
|
| Rate for Payer: UHCCP Medicaid |
$3.46
|
| Rate for Payer: UHCCP Medicaid |
$3.46
|
| Rate for Payer: UMR Bronson Commercial |
$378.97
|
| Rate for Payer: UMR Bronson Commercial |
$369.64
|
| Rate for Payer: VA VA |
$6.46
|
| Rate for Payer: VA VA |
$6.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$768.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$749.27
|
|
|
EPOETIN ALFA 20,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$999.03
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
14643
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$439.57 |
| Max. Negotiated Rate |
$899.13 |
| Rate for Payer: Aetna American Axle |
$649.37
|
| Rate for Payer: Aetna Commercial |
$849.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.37
|
| Rate for Payer: Cash Price |
$799.22
|
| Rate for Payer: Cofinity Commercial |
$699.32
|
| Rate for Payer: Cofinity Commercial |
$859.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$699.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$799.22
|
| Rate for Payer: Healthscope Commercial |
$899.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$699.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$749.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$849.18
|
| Rate for Payer: PHP Commercial |
$849.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$649.37
|
| Rate for Payer: Priority Health SBD |
$629.39
|
| Rate for Payer: UMR Bronson Commercial |
$439.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$749.27
|
|
|
EPOETIN ALFA 2,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$181.34
|
|
|
Service Code
|
HCPCS J0885
|
| Hospital Charge Code |
9939
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.46 |
| 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 |
$6.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.08
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.46
|
| Rate for Payer: BCBS Trust/PPO |
$19.90
|
| Rate for Payer: BCN Commercial |
$19.90
|
| Rate for Payer: BCN Medicare Advantage |
$6.46
|
| 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 |
$6.46
|
| 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 |
$3.46
|
| Rate for Payer: Mclaren Medicare |
$6.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.78
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.14
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: PACE Medicare |
$6.14
|
| Rate for Payer: PACE SWMI |
$6.46
|
| Rate for Payer: PHP Commercial |
$154.14
|
| Rate for Payer: PHP Medicare Advantage |
$6.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.66
|
| Rate for Payer: Priority Health Medicare |
$6.46
|
| Rate for Payer: Priority Health Narrow Network |
$17.33
|
| Rate for Payer: Priority Health SBD |
$114.24
|
| Rate for Payer: Railroad Medicare Medicare |
$6.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.46
|
| Rate for Payer: UHC Exchange |
$12.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.46
|
| Rate for Payer: UHCCP Medicaid |
$3.46
|
| Rate for Payer: UMR Bronson Commercial |
$67.10
|
| Rate for Payer: VA VA |
$6.46
|
| 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 |
$1,260.74
|
| Rate for Payer: Cofinity Commercial |
$1,548.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,260.74
|
| 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 |
$1,260.74
|
| 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 |
$3.46 |
| Max. Negotiated Rate |
$1,620.94 |
| Rate for Payer: UHCCP Medicaid |
$3.46
|
| Rate for Payer: UMR Bronson Commercial |
$666.39
|
| Rate for Payer: VA VA |
$6.46
|
| Rate for Payer: Aetna American Axle |
$1,170.68
|
| Rate for Payer: Aetna Commercial |
$1,530.89
|
| Rate for Payer: Aetna Medicare |
$6.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,170.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.08
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.46
|
| Rate for Payer: BCBS Trust/PPO |
$19.90
|
| Rate for Payer: BCN Commercial |
$19.90
|
| Rate for Payer: BCN Medicare Advantage |
$6.46
|
| 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 |
$1,260.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,260.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,440.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.46
|
| Rate for Payer: Healthscope Commercial |
$1,620.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,260.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,350.79
|
| Rate for Payer: Mclaren Medicaid |
$3.46
|
| Rate for Payer: Mclaren Medicare |
$6.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.78
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,530.89
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: PACE Medicare |
$6.14
|
| Rate for Payer: PACE SWMI |
$6.46
|
| Rate for Payer: PHP Commercial |
$1,530.89
|
| Rate for Payer: PHP Medicare Advantage |
$6.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,170.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.66
|
| Rate for Payer: Priority Health Medicare |
$6.46
|
| Rate for Payer: Priority Health Narrow Network |
$17.33
|
| Rate for Payer: Priority Health SBD |
$1,134.66
|
| Rate for Payer: Railroad Medicare Medicare |
$6.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.46
|
| Rate for Payer: UHC Exchange |
$12.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.46
|
| 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 |
$3.46 |
| 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 |
$6.72
|
| Rate for Payer: Aetna Medicare |
$6.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.08
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS Complete |
$3.64
|
| Rate for Payer: BCBS MAPPO |
$6.46
|
| Rate for Payer: BCBS MAPPO |
$6.46
|
| Rate for Payer: BCBS Trust/PPO |
$19.90
|
| Rate for Payer: BCBS Trust/PPO |
$19.90
|
| Rate for Payer: BCN Commercial |
$19.90
|
| Rate for Payer: BCN Commercial |
$19.90
|
| Rate for Payer: BCN Medicare Advantage |
$6.46
|
| Rate for Payer: BCN Medicare Advantage |
$6.46
|
| Rate for Payer: Cash Price |
$290.09
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cash Price |
$290.09
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$311.84
|
| Rate for Payer: Cofinity Commercial |
$253.83
|
| Rate for Payer: Cofinity Commercial |
$159.08
|
| Rate for Payer: Cofinity Commercial |
$195.44
|
| 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 |
$6.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.46
|
| 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 |
$170.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.96
|
| Rate for Payer: Mclaren Medicaid |
$3.46
|
| Rate for Payer: Mclaren Medicaid |
$3.46
|
| Rate for Payer: Mclaren Medicare |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$6.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.78
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: Meridian Medicaid |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.22
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: PACE Medicare |
$6.14
|
| Rate for Payer: PACE Medicare |
$6.14
|
| Rate for Payer: PACE SWMI |
$6.46
|
| Rate for Payer: PACE SWMI |
$6.46
|
| Rate for Payer: PHP Commercial |
$308.22
|
| Rate for Payer: PHP Commercial |
$193.17
|
| Rate for Payer: PHP Medicare Advantage |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$6.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.66
|
| Rate for Payer: Priority Health Medicare |
$6.46
|
| Rate for Payer: Priority Health Medicare |
$6.46
|
| Rate for Payer: Priority Health Narrow Network |
$17.33
|
| Rate for Payer: Priority Health Narrow Network |
$17.33
|
| Rate for Payer: Priority Health SBD |
$143.17
|
| Rate for Payer: Priority Health SBD |
$228.44
|
| Rate for Payer: Railroad Medicare Medicare |
$6.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.46
|
| Rate for Payer: UHC Exchange |
$12.35
|
| Rate for Payer: UHC Exchange |
$12.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.46
|
| Rate for Payer: UHC Medicare Advantage |
$6.46
|
| Rate for Payer: UHCCP Medicaid |
$3.46
|
| Rate for Payer: UHCCP Medicaid |
$3.46
|
| Rate for Payer: UMR Bronson Commercial |
$84.09
|
| Rate for Payer: UMR Bronson Commercial |
$134.17
|
| Rate for Payer: VA VA |
$6.46
|
| Rate for Payer: VA VA |
$6.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.96
|
|
|
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 |
$4.00 |
| 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 |
$7.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.34
|
| Rate for Payer: BCBS Complete |
$4.20
|
| Rate for Payer: BCBS MAPPO |
$7.47
|
| Rate for Payer: BCBS Trust/PPO |
$20.14
|
| Rate for Payer: BCN Commercial |
$20.14
|
| Rate for Payer: BCN Medicare Advantage |
$7.47
|
| 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 |
$7.47
|
| 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 |
$4.00
|
| Rate for Payer: Mclaren Medicare |
$7.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.84
|
| Rate for Payer: Meridian Medicaid |
$4.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.85
|
| Rate for Payer: Nomi Health Commercial |
$22.41
|
| Rate for Payer: PACE Medicare |
$7.10
|
| Rate for Payer: PACE SWMI |
$7.47
|
| Rate for Payer: PHP Commercial |
$262.85
|
| Rate for Payer: PHP Medicare Advantage |
$7.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.92
|
| Rate for Payer: Priority Health Medicare |
$7.47
|
| Rate for Payer: Priority Health Narrow Network |
$17.54
|
| Rate for Payer: Priority Health SBD |
$194.82
|
| Rate for Payer: Railroad Medicare Medicare |
$7.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.47
|
| Rate for Payer: UHC Exchange |
$14.28
|
| Rate for Payer: UHC Medicare Advantage |
$7.47
|
| Rate for Payer: UHCCP Medicaid |
$4.00
|
| Rate for Payer: UMR Bronson Commercial |
$114.42
|
| Rate for Payer: VA VA |
$7.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.93
|
|
|
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 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 |
$4.00 |
| 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 |
$7.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.34
|
| Rate for Payer: BCBS Complete |
$4.20
|
| Rate for Payer: BCBS MAPPO |
$7.47
|
| Rate for Payer: BCBS Trust/PPO |
$20.14
|
| Rate for Payer: BCN Commercial |
$20.14
|
| Rate for Payer: BCN Medicare Advantage |
$7.47
|
| 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 |
$7.47
|
| 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 |
$4.00
|
| Rate for Payer: Mclaren Medicare |
$7.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.84
|
| Rate for Payer: Meridian Medicaid |
$4.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$525.71
|
| Rate for Payer: Nomi Health Commercial |
$22.41
|
| Rate for Payer: PACE Medicare |
$7.10
|
| Rate for Payer: PACE SWMI |
$7.47
|
| Rate for Payer: PHP Commercial |
$525.71
|
| Rate for Payer: PHP Medicare Advantage |
$7.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$402.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.92
|
| Rate for Payer: Priority Health Medicare |
$7.47
|
| Rate for Payer: Priority Health Narrow Network |
$17.54
|
| Rate for Payer: Priority Health SBD |
$389.64
|
| Rate for Payer: Railroad Medicare Medicare |
$7.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.47
|
| Rate for Payer: UHC Exchange |
$14.28
|
| Rate for Payer: UHC Medicare Advantage |
$7.47
|
| Rate for Payer: UHCCP Medicaid |
$4.00
|
| Rate for Payer: UMR Bronson Commercial |
$228.84
|
| Rate for Payer: VA VA |
$7.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$463.86
|
|
|
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 |
$4.00 |
| 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 |
$7.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.34
|
| Rate for Payer: BCBS Complete |
$4.20
|
| Rate for Payer: BCBS MAPPO |
$7.47
|
| Rate for Payer: BCBS Trust/PPO |
$20.14
|
| Rate for Payer: BCN Commercial |
$20.14
|
| Rate for Payer: BCN Medicare Advantage |
$7.47
|
| 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 |
$7.47
|
| 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 |
$4.00
|
| Rate for Payer: Mclaren Medicare |
$7.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.84
|
| Rate for Payer: Meridian Medicaid |
$4.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.90
|
| Rate for Payer: Nomi Health Commercial |
$22.41
|
| Rate for Payer: PACE Medicare |
$7.10
|
| Rate for Payer: PACE SWMI |
$7.47
|
| Rate for Payer: PHP Commercial |
$65.90
|
| Rate for Payer: PHP Medicare Advantage |
$7.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.92
|
| Rate for Payer: Priority Health Medicare |
$7.47
|
| Rate for Payer: Priority Health Narrow Network |
$17.54
|
| Rate for Payer: Priority Health SBD |
$48.84
|
| Rate for Payer: Railroad Medicare Medicare |
$7.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.47
|
| Rate for Payer: UHC Exchange |
$14.28
|
| Rate for Payer: UHC Medicare Advantage |
$7.47
|
| Rate for Payer: UHCCP Medicaid |
$4.00
|
| Rate for Payer: UMR Bronson Commercial |
$28.69
|
| Rate for Payer: VA VA |
$7.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.15
|
|
