|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$18.43
|
|
|
Service Code
|
NDC 65219044510
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$16.59 |
| Rate for Payer: Aetna American Axle |
$11.98
|
| Rate for Payer: Aetna Commercial |
$15.67
|
| Rate for Payer: Aetna Medicare |
$9.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.98
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cofinity Commercial |
$12.90
|
| Rate for Payer: Cofinity Commercial |
$15.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Healthscope Commercial |
$16.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.67
|
| Rate for Payer: PHP Commercial |
$15.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.98
|
| Rate for Payer: Priority Health SBD |
$11.61
|
| Rate for Payer: UMR Bronson Commercial |
$6.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.82
|
|
|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$31.24
|
|
|
Service Code
|
NDC 00517078010
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.56 |
| Max. Negotiated Rate |
$28.12 |
| Rate for Payer: Aetna American Axle |
$20.31
|
| Rate for Payer: Aetna Commercial |
$26.55
|
| Rate for Payer: Aetna Medicare |
$15.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.31
|
| Rate for Payer: BCBS Complete |
$12.50
|
| Rate for Payer: Cash Price |
$24.99
|
| Rate for Payer: Cofinity Commercial |
$21.87
|
| Rate for Payer: Cofinity Commercial |
$26.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.99
|
| Rate for Payer: Healthscope Commercial |
$28.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.55
|
| Rate for Payer: PHP Commercial |
$26.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.31
|
| Rate for Payer: Priority Health SBD |
$19.68
|
| Rate for Payer: UMR Bronson Commercial |
$11.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.43
|
|
|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$66.44
|
|
|
Service Code
|
NDC 00409806201
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$24.58 |
| Max. Negotiated Rate |
$59.80 |
| Rate for Payer: Aetna American Axle |
$43.19
|
| Rate for Payer: Aetna Commercial |
$56.47
|
| Rate for Payer: Aetna Medicare |
$33.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.19
|
| Rate for Payer: BCBS Complete |
$26.58
|
| Rate for Payer: Cash Price |
$53.15
|
| Rate for Payer: Cofinity Commercial |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$57.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.15
|
| Rate for Payer: Healthscope Commercial |
$59.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.47
|
| Rate for Payer: PHP Commercial |
$56.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.19
|
| Rate for Payer: Priority Health SBD |
$41.86
|
| Rate for Payer: UMR Bronson Commercial |
$24.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.83
|
|
|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.92
|
|
|
Service Code
|
NDC 00409669501
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.08 |
| Max. Negotiated Rate |
$20.63 |
| Rate for Payer: Aetna American Axle |
$14.90
|
| Rate for Payer: Aetna Commercial |
$19.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.90
|
| Rate for Payer: Cash Price |
$18.34
|
| Rate for Payer: Cofinity Commercial |
$16.04
|
| Rate for Payer: Cofinity Commercial |
$19.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.34
|
| Rate for Payer: Healthscope Commercial |
$20.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.48
|
| Rate for Payer: PHP Commercial |
$19.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.90
|
| Rate for Payer: Priority Health SBD |
$14.44
|
| Rate for Payer: UMR Bronson Commercial |
$10.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.19
|
|
|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$26.87
|
|
|
Service Code
|
NDC 72572016010
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$24.18 |
| Rate for Payer: Aetna American Axle |
$17.47
|
| Rate for Payer: Aetna Commercial |
$22.84
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.47
|
| Rate for Payer: BCBS Complete |
$10.75
|
| Rate for Payer: Cash Price |
$21.50
|
| Rate for Payer: Cofinity Commercial |
$18.81
|
| Rate for Payer: Cofinity Commercial |
$23.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.50
|
| Rate for Payer: Healthscope Commercial |
$24.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.84
|
| Rate for Payer: PHP Commercial |
$22.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.47
|
| Rate for Payer: Priority Health SBD |
$16.93
|
| Rate for Payer: UMR Bronson Commercial |
$9.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.15
|
|
|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$18.06
|
|
|
Service Code
|
NDC 55150022110
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.68 |
| Max. Negotiated Rate |
$16.25 |
| Rate for Payer: Aetna American Axle |
$11.74
|
| Rate for Payer: Aetna Commercial |
$15.35
|
| Rate for Payer: Aetna Medicare |
$9.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.74
|
| Rate for Payer: BCBS Complete |
$7.22
|
| Rate for Payer: Cash Price |
$14.45
|
| Rate for Payer: Cofinity Commercial |
$12.64
|
| Rate for Payer: Cofinity Commercial |
$15.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.45
|
| Rate for Payer: Healthscope Commercial |
$16.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.35
|
| Rate for Payer: PHP Commercial |
$15.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.74
|
| Rate for Payer: Priority Health SBD |
$11.38
|
| Rate for Payer: UMR Bronson Commercial |
$6.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.54
|
|
|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$26.87
|
|
|
Service Code
|
NDC 72572016001
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.82 |
| Max. Negotiated Rate |
$24.18 |
| Rate for Payer: Aetna American Axle |
$17.47
|
| Rate for Payer: Aetna Commercial |
$22.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.47
|
| Rate for Payer: Cash Price |
$21.50
|
| Rate for Payer: Cofinity Commercial |
$18.81
|
| Rate for Payer: Cofinity Commercial |
$23.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.50
|
| Rate for Payer: Healthscope Commercial |
$24.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.84
|
| Rate for Payer: PHP Commercial |
$22.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.47
|
| Rate for Payer: Priority Health SBD |
$16.93
|
| Rate for Payer: UMR Bronson Commercial |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.15
|
|
|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$22.79
|
|
|
Service Code
|
NDC 70860065210
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.43 |
| Max. Negotiated Rate |
$20.51 |
| Rate for Payer: Aetna American Axle |
$14.81
|
| Rate for Payer: Aetna Commercial |
$19.37
|
| Rate for Payer: Aetna Medicare |
$11.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.81
|
| Rate for Payer: BCBS Complete |
$9.12
|
| Rate for Payer: Cash Price |
$18.23
|
| Rate for Payer: Cofinity Commercial |
$15.95
|
| Rate for Payer: Cofinity Commercial |
$19.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.23
|
| Rate for Payer: Healthscope Commercial |
$20.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.37
|
| Rate for Payer: PHP Commercial |
$19.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.81
|
| Rate for Payer: Priority Health SBD |
$14.36
|
| Rate for Payer: UMR Bronson Commercial |
$8.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.09
|
|
|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.79
|
|
|
Service Code
|
NDC 70860065210
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.03 |
| Max. Negotiated Rate |
$20.51 |
| Rate for Payer: Aetna American Axle |
$14.81
|
| Rate for Payer: Aetna Commercial |
$19.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.81
|
| Rate for Payer: Cash Price |
$18.23
|
| Rate for Payer: Cofinity Commercial |
$15.95
|
| Rate for Payer: Cofinity Commercial |
$19.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.23
|
| Rate for Payer: Healthscope Commercial |
$20.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.37
|
| Rate for Payer: PHP Commercial |
$19.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.81
|
| Rate for Payer: Priority Health SBD |
$14.36
|
| Rate for Payer: UMR Bronson Commercial |
$10.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.09
|
|
|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$22.92
|
|
|
Service Code
|
NDC 00409669501
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.48 |
| Max. Negotiated Rate |
$20.63 |
| Rate for Payer: Aetna American Axle |
$14.90
|
| Rate for Payer: Aetna Commercial |
$19.48
|
| Rate for Payer: Aetna Medicare |
$11.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.90
|
| Rate for Payer: BCBS Complete |
$9.17
|
| Rate for Payer: Cash Price |
$18.34
|
| Rate for Payer: Cofinity Commercial |
$16.04
|
| Rate for Payer: Cofinity Commercial |
$19.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.34
|
| Rate for Payer: Healthscope Commercial |
$20.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.48
|
| Rate for Payer: PHP Commercial |
$19.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.90
|
| Rate for Payer: Priority Health SBD |
$14.44
|
| Rate for Payer: UMR Bronson Commercial |
$8.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.19
|
|
|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$26.87
|
|
|
Service Code
|
NDC 72572016001
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$24.18 |
| Rate for Payer: Aetna American Axle |
$17.47
|
| Rate for Payer: Aetna Commercial |
$22.84
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.47
|
| Rate for Payer: BCBS Complete |
$10.75
|
| Rate for Payer: Cash Price |
$21.50
|
| Rate for Payer: Cofinity Commercial |
$18.81
|
| Rate for Payer: Cofinity Commercial |
$23.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.50
|
| Rate for Payer: Healthscope Commercial |
$24.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.84
|
| Rate for Payer: PHP Commercial |
$22.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.47
|
| Rate for Payer: Priority Health SBD |
$16.93
|
| Rate for Payer: UMR Bronson Commercial |
$9.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.15
|
|
|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$18.06
|
|
|
Service Code
|
NDC 55150022110
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$16.25 |
| Rate for Payer: Aetna American Axle |
$11.74
|
| Rate for Payer: Aetna Commercial |
$15.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.74
|
| Rate for Payer: Cash Price |
$14.45
|
| Rate for Payer: Cofinity Commercial |
$12.64
|
| Rate for Payer: Cofinity Commercial |
$15.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.45
|
| Rate for Payer: Healthscope Commercial |
$16.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.35
|
| Rate for Payer: PHP Commercial |
$15.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.74
|
| Rate for Payer: Priority Health SBD |
$11.38
|
| Rate for Payer: UMR Bronson Commercial |
$7.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.54
|
|
|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$18.43
|
|
|
Service Code
|
NDC 65219044510
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.11 |
| Max. Negotiated Rate |
$16.59 |
| Rate for Payer: Aetna American Axle |
$11.98
|
| Rate for Payer: Aetna Commercial |
$15.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.98
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cofinity Commercial |
$12.90
|
| Rate for Payer: Cofinity Commercial |
$15.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Healthscope Commercial |
$16.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.67
|
| Rate for Payer: PHP Commercial |
$15.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.98
|
| Rate for Payer: Priority Health SBD |
$11.61
|
| Rate for Payer: UMR Bronson Commercial |
$8.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.82
|
|
|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$24.65
|
|
|
Service Code
|
NDC 00143950601
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.85 |
| Max. Negotiated Rate |
$22.18 |
| Rate for Payer: Aetna American Axle |
$16.02
|
| Rate for Payer: Aetna Commercial |
$20.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.02
|
| Rate for Payer: Cash Price |
$19.72
|
| Rate for Payer: Cofinity Commercial |
$17.25
|
| Rate for Payer: Cofinity Commercial |
$21.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.72
|
| Rate for Payer: Healthscope Commercial |
$22.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.95
|
| Rate for Payer: PHP Commercial |
$20.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.02
|
| Rate for Payer: Priority Health SBD |
$15.53
|
| Rate for Payer: UMR Bronson Commercial |
$10.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.49
|
|
|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$24.65
|
|
|
Service Code
|
NDC 00143950610
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.12 |
| Max. Negotiated Rate |
$22.18 |
| Rate for Payer: Aetna American Axle |
$16.02
|
| Rate for Payer: Aetna Commercial |
$20.95
|
| Rate for Payer: Aetna Medicare |
$12.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.02
|
| Rate for Payer: BCBS Complete |
$9.86
|
| Rate for Payer: Cash Price |
$19.72
|
| Rate for Payer: Cofinity Commercial |
$17.25
|
| Rate for Payer: Cofinity Commercial |
$21.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.72
|
| Rate for Payer: Healthscope Commercial |
$22.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.95
|
| Rate for Payer: PHP Commercial |
$20.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.02
|
| Rate for Payer: Priority Health SBD |
$15.53
|
| Rate for Payer: UMR Bronson Commercial |
$9.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.49
|
|
|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$24.65
|
|
|
Service Code
|
NDC 00143950610
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.85 |
| Max. Negotiated Rate |
$22.18 |
| Rate for Payer: Aetna American Axle |
$16.02
|
| Rate for Payer: Aetna Commercial |
$20.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.02
|
| Rate for Payer: Cash Price |
$19.72
|
| Rate for Payer: Cofinity Commercial |
$17.25
|
| Rate for Payer: Cofinity Commercial |
$21.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.72
|
| Rate for Payer: Healthscope Commercial |
$22.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.95
|
| Rate for Payer: PHP Commercial |
$20.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.02
|
| Rate for Payer: Priority Health SBD |
$15.53
|
| Rate for Payer: UMR Bronson Commercial |
$10.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.49
|
|
|
ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$24.65
|
|
|
Service Code
|
NDC 00143950601
|
| Hospital Charge Code |
20472
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.12 |
| Max. Negotiated Rate |
$22.18 |
| Rate for Payer: Aetna American Axle |
$16.02
|
| Rate for Payer: Aetna Commercial |
$20.95
|
| Rate for Payer: Aetna Medicare |
$12.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.02
|
| Rate for Payer: BCBS Complete |
$9.86
|
| Rate for Payer: Cash Price |
$19.72
|
| Rate for Payer: Cofinity Commercial |
$17.25
|
| Rate for Payer: Cofinity Commercial |
$21.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.72
|
| Rate for Payer: Healthscope Commercial |
$22.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.95
|
| Rate for Payer: PHP Commercial |
$20.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.02
|
| Rate for Payer: Priority Health SBD |
$15.53
|
| Rate for Payer: UMR Bronson Commercial |
$9.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.49
|
|
|
ETOMIDATE 2 MG/ML IV (CODE)
|
Facility
|
OP
|
$31.24
|
|
|
Service Code
|
NDC 00517078010
|
| Hospital Charge Code |
163720
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.56 |
| Max. Negotiated Rate |
$28.12 |
| Rate for Payer: Aetna American Axle |
$20.31
|
| Rate for Payer: Aetna Commercial |
$26.55
|
| Rate for Payer: Aetna Medicare |
$15.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.31
|
| Rate for Payer: BCBS Complete |
$12.50
|
| Rate for Payer: Cash Price |
$24.99
|
| Rate for Payer: Cofinity Commercial |
$21.87
|
| Rate for Payer: Cofinity Commercial |
$26.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.99
|
| Rate for Payer: Healthscope Commercial |
$28.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.55
|
| Rate for Payer: PHP Commercial |
$26.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.31
|
| Rate for Payer: Priority Health SBD |
$19.68
|
| Rate for Payer: UMR Bronson Commercial |
$11.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.43
|
|
|
ETOMIDATE 2 MG/ML IV (CODE)
|
Facility
|
IP
|
$66.44
|
|
|
Service Code
|
NDC 00409806201
|
| Hospital Charge Code |
163720
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$29.23 |
| Max. Negotiated Rate |
$59.80 |
| Rate for Payer: Aetna American Axle |
$43.19
|
| Rate for Payer: Aetna Commercial |
$56.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.19
|
| Rate for Payer: Cash Price |
$53.15
|
| Rate for Payer: Cofinity Commercial |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$57.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.15
|
| Rate for Payer: Healthscope Commercial |
$59.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.47
|
| Rate for Payer: PHP Commercial |
$56.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.19
|
| Rate for Payer: Priority Health SBD |
$41.86
|
| Rate for Payer: UMR Bronson Commercial |
$29.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.83
|
|
|
ETOMIDATE 2 MG/ML IV (CODE)
|
Facility
|
OP
|
$22.92
|
|
|
Service Code
|
NDC 00409669501
|
| Hospital Charge Code |
163720
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.48 |
| Max. Negotiated Rate |
$20.63 |
| Rate for Payer: Aetna American Axle |
$14.90
|
| Rate for Payer: Aetna Commercial |
$19.48
|
| Rate for Payer: Aetna Medicare |
$11.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.90
|
| Rate for Payer: BCBS Complete |
$9.17
|
| Rate for Payer: Cash Price |
$18.34
|
| Rate for Payer: Cofinity Commercial |
$16.04
|
| Rate for Payer: Cofinity Commercial |
$19.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.34
|
| Rate for Payer: Healthscope Commercial |
$20.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.48
|
| Rate for Payer: PHP Commercial |
$19.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.90
|
| Rate for Payer: Priority Health SBD |
$14.44
|
| Rate for Payer: UMR Bronson Commercial |
$8.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.19
|
|
|
ETOMIDATE 2 MG/ML IV (CODE)
|
Facility
|
IP
|
$22.92
|
|
|
Service Code
|
NDC 00409669501
|
| Hospital Charge Code |
163720
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.08 |
| Max. Negotiated Rate |
$20.63 |
| Rate for Payer: Aetna American Axle |
$14.90
|
| Rate for Payer: Aetna Commercial |
$19.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.90
|
| Rate for Payer: Cash Price |
$18.34
|
| Rate for Payer: Cofinity Commercial |
$16.04
|
| Rate for Payer: Cofinity Commercial |
$19.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.34
|
| Rate for Payer: Healthscope Commercial |
$20.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.48
|
| Rate for Payer: PHP Commercial |
$19.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.90
|
| Rate for Payer: Priority Health SBD |
$14.44
|
| Rate for Payer: UMR Bronson Commercial |
$10.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.19
|
|
|
ETOMIDATE 2 MG/ML IV (CODE)
|
Facility
|
OP
|
$66.44
|
|
|
Service Code
|
NDC 00409806201
|
| Hospital Charge Code |
163720
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$24.58 |
| Max. Negotiated Rate |
$59.80 |
| Rate for Payer: Aetna American Axle |
$43.19
|
| Rate for Payer: Aetna Commercial |
$56.47
|
| Rate for Payer: Aetna Medicare |
$33.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.19
|
| Rate for Payer: BCBS Complete |
$26.58
|
| Rate for Payer: Cash Price |
$53.15
|
| Rate for Payer: Cofinity Commercial |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$57.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.15
|
| Rate for Payer: Healthscope Commercial |
$59.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.47
|
| Rate for Payer: PHP Commercial |
$56.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.19
|
| Rate for Payer: Priority Health SBD |
$41.86
|
| Rate for Payer: UMR Bronson Commercial |
$24.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.83
|
|
|
ETOMIDATE 2 MG/ML IV (CODE)
|
Facility
|
IP
|
$31.24
|
|
|
Service Code
|
NDC 00517078010
|
| Hospital Charge Code |
163720
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$28.12 |
| Rate for Payer: Aetna American Axle |
$20.31
|
| Rate for Payer: Aetna Commercial |
$26.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.31
|
| Rate for Payer: Cash Price |
$24.99
|
| Rate for Payer: Cofinity Commercial |
$21.87
|
| Rate for Payer: Cofinity Commercial |
$26.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.99
|
| Rate for Payer: Healthscope Commercial |
$28.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.55
|
| Rate for Payer: PHP Commercial |
$26.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.31
|
| Rate for Payer: Priority Health SBD |
$19.68
|
| Rate for Payer: UMR Bronson Commercial |
$13.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.43
|
|
|
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$236.25
|
|
|
Service Code
|
HCPCS J9181
|
| Hospital Charge Code |
10000
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$103.95 |
| Max. Negotiated Rate |
$212.62 |
| Rate for Payer: Aetna American Axle |
$153.56
|
| Rate for Payer: Aetna American Axle |
$127.52
|
| Rate for Payer: Aetna American Axle |
$116.06
|
| Rate for Payer: Aetna American Axle |
$77.17
|
| Rate for Payer: Aetna American Axle |
$242.18
|
| Rate for Payer: Aetna American Axle |
$230.69
|
| Rate for Payer: Aetna American Axle |
$312.98
|
| Rate for Payer: Aetna American Axle |
$563.37
|
| Rate for Payer: Aetna Commercial |
$316.70
|
| Rate for Payer: Aetna Commercial |
$301.67
|
| Rate for Payer: Aetna Commercial |
$151.78
|
| Rate for Payer: Aetna Commercial |
$200.81
|
| Rate for Payer: Aetna Commercial |
$100.91
|
| Rate for Payer: Aetna Commercial |
$166.76
|
| Rate for Payer: Aetna Commercial |
$736.72
|
| Rate for Payer: Aetna Commercial |
$409.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.56
|
| Rate for Payer: Cash Price |
$156.95
|
| Rate for Payer: Cash Price |
$283.93
|
| Rate for Payer: Cash Price |
$693.38
|
| Rate for Payer: Cash Price |
$298.07
|
| Rate for Payer: Cash Price |
$385.20
|
| Rate for Payer: Cash Price |
$142.85
|
| Rate for Payer: Cash Price |
$94.98
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cofinity Commercial |
$102.10
|
| Rate for Payer: Cofinity Commercial |
$137.33
|
| Rate for Payer: Cofinity Commercial |
$83.10
|
| Rate for Payer: Cofinity Commercial |
$124.99
|
| Rate for Payer: Cofinity Commercial |
$153.56
|
| Rate for Payer: Cofinity Commercial |
$168.72
|
| Rate for Payer: Cofinity Commercial |
$165.38
|
| Rate for Payer: Cofinity Commercial |
$203.18
|
| Rate for Payer: Cofinity Commercial |
$248.44
|
| Rate for Payer: Cofinity Commercial |
$305.22
|
| Rate for Payer: Cofinity Commercial |
$260.81
|
| Rate for Payer: Cofinity Commercial |
$320.43
|
| Rate for Payer: Cofinity Commercial |
$337.05
|
| Rate for Payer: Cofinity Commercial |
$414.09
|
| Rate for Payer: Cofinity Commercial |
$606.71
|
| Rate for Payer: Cofinity Commercial |
$745.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$606.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$165.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$248.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$124.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$137.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$337.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$260.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$693.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.85
|
| Rate for Payer: Healthscope Commercial |
$319.42
|
| Rate for Payer: Healthscope Commercial |
$106.85
|
| Rate for Payer: Healthscope Commercial |
$176.57
|
| Rate for Payer: Healthscope Commercial |
$212.62
|
| Rate for Payer: Healthscope Commercial |
$160.70
|
| Rate for Payer: Healthscope Commercial |
$780.06
|
| Rate for Payer: Healthscope Commercial |
$433.35
|
| Rate for Payer: Healthscope Commercial |
$335.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$606.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$248.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$124.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$337.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$137.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$165.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$650.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$736.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.91
|
| Rate for Payer: PHP Commercial |
$100.91
|
| Rate for Payer: PHP Commercial |
$409.27
|
| Rate for Payer: PHP Commercial |
$736.72
|
| Rate for Payer: PHP Commercial |
$166.76
|
| Rate for Payer: PHP Commercial |
$316.70
|
| Rate for Payer: PHP Commercial |
$151.78
|
| Rate for Payer: PHP Commercial |
$301.67
|
| Rate for Payer: PHP Commercial |
$200.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.06
|
| Rate for Payer: Priority Health SBD |
$223.59
|
| Rate for Payer: Priority Health SBD |
$112.49
|
| Rate for Payer: Priority Health SBD |
$123.60
|
| Rate for Payer: Priority Health SBD |
$234.73
|
| Rate for Payer: Priority Health SBD |
$148.84
|
| Rate for Payer: Priority Health SBD |
$546.04
|
| Rate for Payer: Priority Health SBD |
$74.79
|
| Rate for Payer: Priority Health SBD |
$303.35
|
| Rate for Payer: UMR Bronson Commercial |
$156.16
|
| Rate for Payer: UMR Bronson Commercial |
$78.57
|
| Rate for Payer: UMR Bronson Commercial |
$86.32
|
| Rate for Payer: UMR Bronson Commercial |
$381.36
|
| Rate for Payer: UMR Bronson Commercial |
$52.24
|
| Rate for Payer: UMR Bronson Commercial |
$211.86
|
| Rate for Payer: UMR Bronson Commercial |
$103.95
|
| Rate for Payer: UMR Bronson Commercial |
$163.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$650.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.12
|
|
|
ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$236.25
|
|
|
Service Code
|
HCPCS J9181
|
| Hospital Charge Code |
10000
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$87.41 |
| Max. Negotiated Rate |
$212.62 |
| Rate for Payer: Aetna American Axle |
$153.56
|
| Rate for Payer: Aetna American Axle |
$116.06
|
| Rate for Payer: Aetna American Axle |
$127.52
|
| Rate for Payer: Aetna American Axle |
$563.37
|
| Rate for Payer: Aetna American Axle |
$77.17
|
| Rate for Payer: Aetna American Axle |
$312.98
|
| Rate for Payer: Aetna American Axle |
$405.85
|
| Rate for Payer: Aetna American Axle |
$230.69
|
| Rate for Payer: Aetna American Axle |
$242.18
|
| Rate for Payer: Aetna Commercial |
$301.67
|
| Rate for Payer: Aetna Commercial |
$409.27
|
| Rate for Payer: Aetna Commercial |
$151.78
|
| Rate for Payer: Aetna Commercial |
$316.70
|
| Rate for Payer: Aetna Commercial |
$100.91
|
| Rate for Payer: Aetna Commercial |
$736.72
|
| Rate for Payer: Aetna Commercial |
$530.72
|
| Rate for Payer: Aetna Commercial |
$166.76
|
| Rate for Payer: Aetna Commercial |
$200.81
|
| Rate for Payer: Aetna Medicare |
$312.19
|
| Rate for Payer: Aetna Medicare |
$433.37
|
| Rate for Payer: Aetna Medicare |
$98.09
|
| Rate for Payer: Aetna Medicare |
$59.36
|
| Rate for Payer: Aetna Medicare |
$118.12
|
| Rate for Payer: Aetna Medicare |
$89.28
|
| Rate for Payer: Aetna Medicare |
$186.29
|
| Rate for Payer: Aetna Medicare |
$240.75
|
| Rate for Payer: Aetna Medicare |
$177.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.18
|
| Rate for Payer: BCBS Complete |
$149.04
|
| Rate for Payer: BCBS Complete |
$71.42
|
| Rate for Payer: BCBS Complete |
$192.60
|
| Rate for Payer: BCBS Complete |
$78.48
|
| Rate for Payer: BCBS Complete |
$141.96
|
| Rate for Payer: BCBS Complete |
$346.69
|
| Rate for Payer: BCBS Complete |
$249.75
|
| Rate for Payer: BCBS Complete |
$94.50
|
| Rate for Payer: BCBS Complete |
$47.49
|
| Rate for Payer: Cash Price |
$693.38
|
| Rate for Payer: Cash Price |
$298.07
|
| Rate for Payer: Cash Price |
$156.95
|
| Rate for Payer: Cash Price |
$94.98
|
| Rate for Payer: Cash Price |
$142.85
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cash Price |
$499.50
|
| Rate for Payer: Cash Price |
$385.20
|
| Rate for Payer: Cash Price |
$283.93
|
| Rate for Payer: Cofinity Commercial |
$124.99
|
| Rate for Payer: Cofinity Commercial |
$248.44
|
| Rate for Payer: Cofinity Commercial |
$305.22
|
| Rate for Payer: Cofinity Commercial |
$203.18
|
| Rate for Payer: Cofinity Commercial |
$102.10
|
| Rate for Payer: Cofinity Commercial |
$536.97
|
| Rate for Payer: Cofinity Commercial |
$168.72
|
| Rate for Payer: Cofinity Commercial |
$437.07
|
| Rate for Payer: Cofinity Commercial |
$414.09
|
| Rate for Payer: Cofinity Commercial |
$337.05
|
| Rate for Payer: Cofinity Commercial |
$320.43
|
| Rate for Payer: Cofinity Commercial |
$260.81
|
| Rate for Payer: Cofinity Commercial |
$745.39
|
| Rate for Payer: Cofinity Commercial |
$137.33
|
| Rate for Payer: Cofinity Commercial |
$83.10
|
| Rate for Payer: Cofinity Commercial |
$165.38
|
| Rate for Payer: Cofinity Commercial |
$606.71
|
| Rate for Payer: Cofinity Commercial |
$153.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$248.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$606.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$137.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$437.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$124.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$260.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$337.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$165.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$693.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.07
|
| Rate for Payer: Healthscope Commercial |
$433.35
|
| Rate for Payer: Healthscope Commercial |
$212.62
|
| Rate for Payer: Healthscope Commercial |
$176.57
|
| Rate for Payer: Healthscope Commercial |
$106.85
|
| Rate for Payer: Healthscope Commercial |
$335.33
|
| Rate for Payer: Healthscope Commercial |
$561.94
|
| Rate for Payer: Healthscope Commercial |
$160.70
|
| Rate for Payer: Healthscope Commercial |
$780.06
|
| Rate for Payer: Healthscope Commercial |
$319.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$137.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$124.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$165.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$248.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$337.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$437.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$606.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$650.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$736.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.81
|
| Rate for Payer: PHP Commercial |
$100.91
|
| Rate for Payer: PHP Commercial |
$530.72
|
| Rate for Payer: PHP Commercial |
$736.72
|
| Rate for Payer: PHP Commercial |
$316.70
|
| Rate for Payer: PHP Commercial |
$301.67
|
| Rate for Payer: PHP Commercial |
$200.81
|
| Rate for Payer: PHP Commercial |
$409.27
|
| Rate for Payer: PHP Commercial |
$151.78
|
| Rate for Payer: PHP Commercial |
$166.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$405.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.37
|
| Rate for Payer: Priority Health SBD |
$234.73
|
| Rate for Payer: Priority Health SBD |
$223.59
|
| Rate for Payer: Priority Health SBD |
$148.84
|
| Rate for Payer: Priority Health SBD |
$546.04
|
| Rate for Payer: Priority Health SBD |
$393.36
|
| Rate for Payer: Priority Health SBD |
$303.35
|
| Rate for Payer: Priority Health SBD |
$123.60
|
| Rate for Payer: Priority Health SBD |
$74.79
|
| Rate for Payer: Priority Health SBD |
$112.49
|
| Rate for Payer: UMR Bronson Commercial |
$137.86
|
| Rate for Payer: UMR Bronson Commercial |
$43.93
|
| Rate for Payer: UMR Bronson Commercial |
$66.07
|
| Rate for Payer: UMR Bronson Commercial |
$231.02
|
| Rate for Payer: UMR Bronson Commercial |
$131.32
|
| Rate for Payer: UMR Bronson Commercial |
$178.16
|
| Rate for Payer: UMR Bronson Commercial |
$87.41
|
| Rate for Payer: UMR Bronson Commercial |
$72.59
|
| Rate for Payer: UMR Bronson Commercial |
$320.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$650.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.29
|
|
