|
ANAL AND STOMAL PROCEDURES WITH CC
|
Facility
|
IP
|
$25,998.84
|
|
|
Service Code
|
MSDRG 348
|
| Min. Negotiated Rate |
$10,961.15 |
| Max. Negotiated Rate |
$25,998.84 |
| Rate for Payer: Aetna Medicare |
$11,999.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,422.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,422.56
|
| Rate for Payer: BCBS MAPPO |
$11,538.05
|
| Rate for Payer: BCBS Trust/PPO |
$25,998.84
|
| Rate for Payer: BCN Commercial |
$25,998.84
|
| Rate for Payer: BCN Medicare Advantage |
$11,538.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,538.05
|
| Rate for Payer: Mclaren Medicare |
$11,538.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,114.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,268.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,691.85
|
| Rate for Payer: Nomi Health Commercial |
$16,883.52
|
| Rate for Payer: PACE Medicare |
$10,961.15
|
| Rate for Payer: PACE SWMI |
$11,538.05
|
| Rate for Payer: PHP Medicare Advantage |
$11,538.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21,100.66
|
| Rate for Payer: Priority Health Medicare |
$11,538.05
|
| Rate for Payer: Priority Health Tiered Network |
$16,880.52
|
| Rate for Payer: Railroad Medicare Medicare |
$11,538.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21,333.44
|
| Rate for Payer: UHC Core |
$17,848.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,538.05
|
| Rate for Payer: UHC Exchange |
$14,576.11
|
| Rate for Payer: VA VA |
$11,538.05
|
|
|
ANAL AND STOMAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$74,644.76
|
|
|
Service Code
|
MSDRG 347
|
| Min. Negotiated Rate |
$18,800.85 |
| Max. Negotiated Rate |
$74,644.76 |
| Rate for Payer: Aetna Medicare |
$20,581.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,737.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,737.96
|
| Rate for Payer: BCBS MAPPO |
$19,790.37
|
| Rate for Payer: BCBS Trust/PPO |
$74,644.76
|
| Rate for Payer: BCN Commercial |
$74,644.76
|
| Rate for Payer: BCN Medicare Advantage |
$19,790.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,790.37
|
| Rate for Payer: Mclaren Medicare |
$19,790.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,779.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,758.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$21,769.41
|
| Rate for Payer: Nomi Health Commercial |
$29,613.24
|
| Rate for Payer: PACE Medicare |
$18,800.85
|
| Rate for Payer: PACE SWMI |
$19,790.37
|
| Rate for Payer: PHP Medicare Advantage |
$19,790.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,009.98
|
| Rate for Payer: Priority Health Medicare |
$19,790.37
|
| Rate for Payer: Priority Health Tiered Network |
$29,607.98
|
| Rate for Payer: Railroad Medicare Medicare |
$19,790.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37,418.28
|
| Rate for Payer: UHC Core |
$31,305.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19,790.37
|
| Rate for Payer: UHC Exchange |
$25,566.10
|
| Rate for Payer: VA VA |
$19,790.37
|
|
|
ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$24,313.35
|
|
|
Service Code
|
MSDRG 349
|
| Min. Negotiated Rate |
$7,479.86 |
| Max. Negotiated Rate |
$24,313.35 |
| Rate for Payer: Aetna Medicare |
$8,188.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,841.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,841.92
|
| Rate for Payer: BCBS MAPPO |
$7,873.54
|
| Rate for Payer: BCBS Trust/PPO |
$24,313.35
|
| Rate for Payer: BCN Commercial |
$24,313.35
|
| Rate for Payer: BCN Medicare Advantage |
$7,873.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,873.54
|
| Rate for Payer: Mclaren Medicare |
$7,873.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,267.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,054.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,660.89
|
| Rate for Payer: Nomi Health Commercial |
$11,230.74
|
| Rate for Payer: PACE Medicare |
$7,479.86
|
| Rate for Payer: PACE SWMI |
$7,873.54
|
| Rate for Payer: PHP Medicare Advantage |
$7,873.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14,035.94
|
| Rate for Payer: Priority Health Medicare |
$7,873.54
|
| Rate for Payer: Priority Health Tiered Network |
$11,228.75
|
| Rate for Payer: Railroad Medicare Medicare |
$7,873.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,190.78
|
| Rate for Payer: UHC Core |
$11,872.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,873.54
|
| Rate for Payer: UHC Exchange |
$9,695.87
|
| Rate for Payer: VA VA |
$7,873.54
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
OP
|
$79.52
|
|
|
Service Code
|
NDC 51991062033
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$29.42 |
| Max. Negotiated Rate |
$71.57 |
| Rate for Payer: Aetna American Axle |
$51.69
|
| Rate for Payer: Aetna Commercial |
$67.59
|
| Rate for Payer: Aetna Medicare |
$39.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.69
|
| Rate for Payer: BCBS Complete |
$31.81
|
| Rate for Payer: Cash Price |
$63.62
|
| Rate for Payer: Cofinity Advantage |
$55.66
|
| Rate for Payer: Cofinity Commercial |
$68.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.62
|
| Rate for Payer: Healthscope Commercial |
$71.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.64
|
| Rate for Payer: PHP Commercial |
$67.59
|
| Rate for Payer: Priority Health SBD |
$50.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.69
|
| Rate for Payer: UHC Core |
$41.43
|
| Rate for Payer: UHC Exchange |
$31.25
|
| Rate for Payer: UMR Bronson Commercial |
$29.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.64
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
IP
|
$133.95
|
|
|
Service Code
|
NDC 68382020906
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$58.94 |
| Max. Negotiated Rate |
$120.56 |
| Rate for Payer: Aetna American Axle |
$87.07
|
| Rate for Payer: Aetna Commercial |
$113.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.07
|
| Rate for Payer: Cash Price |
$107.16
|
| Rate for Payer: Cofinity Advantage |
$93.77
|
| Rate for Payer: Cofinity Commercial |
$115.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.16
|
| Rate for Payer: Healthscope Commercial |
$120.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.46
|
| Rate for Payer: PHP Commercial |
$113.86
|
| Rate for Payer: Priority Health SBD |
$84.39
|
| Rate for Payer: UMR Bronson Commercial |
$58.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.46
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
OP
|
$1,325.25
|
|
|
Service Code
|
NDC 16729003516
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$490.34 |
| Max. Negotiated Rate |
$1,192.72 |
| Rate for Payer: Aetna American Axle |
$861.41
|
| Rate for Payer: Aetna Commercial |
$1,126.46
|
| Rate for Payer: Aetna Medicare |
$662.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$861.41
|
| Rate for Payer: BCBS Complete |
$530.10
|
| Rate for Payer: Cash Price |
$1,060.20
|
| Rate for Payer: Cofinity Advantage |
$927.67
|
| Rate for Payer: Cofinity Commercial |
$1,139.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,060.20
|
| Rate for Payer: Healthscope Commercial |
$1,192.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$927.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$993.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,060.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,126.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$993.94
|
| Rate for Payer: PHP Commercial |
$1,126.46
|
| Rate for Payer: Priority Health SBD |
$834.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$861.41
|
| Rate for Payer: UHC Core |
$690.46
|
| Rate for Payer: UHC Exchange |
$520.82
|
| Rate for Payer: UMR Bronson Commercial |
$490.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$993.94
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
OP
|
$136.56
|
|
|
Service Code
|
NDC 50268007515
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$50.53 |
| Max. Negotiated Rate |
$122.90 |
| Rate for Payer: Aetna American Axle |
$88.76
|
| Rate for Payer: Aetna Commercial |
$116.08
|
| Rate for Payer: Aetna Medicare |
$68.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.76
|
| Rate for Payer: BCBS Complete |
$54.62
|
| Rate for Payer: Cash Price |
$109.25
|
| Rate for Payer: Cofinity Advantage |
$95.59
|
| Rate for Payer: Cofinity Commercial |
$117.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.25
|
| Rate for Payer: Healthscope Commercial |
$122.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.42
|
| Rate for Payer: PHP Commercial |
$116.08
|
| Rate for Payer: Priority Health SBD |
$86.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.76
|
| Rate for Payer: UHC Core |
$71.15
|
| Rate for Payer: UHC Exchange |
$53.67
|
| Rate for Payer: UMR Bronson Commercial |
$50.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.42
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
OP
|
$40.89
|
|
|
Service Code
|
NDC 16729003510
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$15.13 |
| Max. Negotiated Rate |
$36.80 |
| Rate for Payer: Aetna American Axle |
$26.58
|
| Rate for Payer: Aetna Commercial |
$34.76
|
| Rate for Payer: Aetna Medicare |
$20.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.58
|
| Rate for Payer: BCBS Complete |
$16.36
|
| Rate for Payer: Cash Price |
$32.71
|
| Rate for Payer: Cofinity Advantage |
$28.62
|
| Rate for Payer: Cofinity Commercial |
$35.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.71
|
| Rate for Payer: Healthscope Commercial |
$36.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.67
|
| Rate for Payer: PHP Commercial |
$34.76
|
| Rate for Payer: Priority Health SBD |
$25.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.58
|
| Rate for Payer: UHC Core |
$21.30
|
| Rate for Payer: UHC Exchange |
$16.07
|
| Rate for Payer: UMR Bronson Commercial |
$15.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.67
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
IP
|
$104.34
|
|
|
Service Code
|
NDC 00904619546
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$45.91 |
| Max. Negotiated Rate |
$93.91 |
| Rate for Payer: Aetna American Axle |
$67.82
|
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.82
|
| Rate for Payer: Cash Price |
$83.47
|
| Rate for Payer: Cofinity Advantage |
$73.04
|
| Rate for Payer: Cofinity Commercial |
$89.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.47
|
| Rate for Payer: Healthscope Commercial |
$93.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.25
|
| Rate for Payer: PHP Commercial |
$88.69
|
| Rate for Payer: Priority Health SBD |
$65.73
|
| Rate for Payer: UMR Bronson Commercial |
$45.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.25
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
IP
|
$136.56
|
|
|
Service Code
|
NDC 50268007515
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$60.09 |
| Max. Negotiated Rate |
$122.90 |
| Rate for Payer: Aetna American Axle |
$88.76
|
| Rate for Payer: Aetna Commercial |
$116.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.76
|
| Rate for Payer: Cash Price |
$109.25
|
| Rate for Payer: Cofinity Advantage |
$95.59
|
| Rate for Payer: Cofinity Commercial |
$117.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.25
|
| Rate for Payer: Healthscope Commercial |
$122.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.42
|
| Rate for Payer: PHP Commercial |
$116.08
|
| Rate for Payer: Priority Health SBD |
$86.03
|
| Rate for Payer: UMR Bronson Commercial |
$60.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.42
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
IP
|
$2.74
|
|
|
Service Code
|
NDC 50268007511
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.21 |
| Max. Negotiated Rate |
$2.47 |
| Rate for Payer: Aetna American Axle |
$1.78
|
| Rate for Payer: Aetna Commercial |
$2.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.78
|
| Rate for Payer: Cash Price |
$2.19
|
| Rate for Payer: Cofinity Advantage |
$1.92
|
| Rate for Payer: Cofinity Commercial |
$2.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.19
|
| Rate for Payer: Healthscope Commercial |
$2.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.06
|
| Rate for Payer: PHP Commercial |
$2.33
|
| Rate for Payer: Priority Health SBD |
$1.73
|
| Rate for Payer: UMR Bronson Commercial |
$1.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.06
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
IP
|
$1,325.25
|
|
|
Service Code
|
NDC 16729003516
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$583.11 |
| Max. Negotiated Rate |
$1,192.72 |
| Rate for Payer: Aetna American Axle |
$861.41
|
| Rate for Payer: Aetna Commercial |
$1,126.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$861.41
|
| Rate for Payer: Cash Price |
$1,060.20
|
| Rate for Payer: Cofinity Advantage |
$927.67
|
| Rate for Payer: Cofinity Commercial |
$1,139.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,060.20
|
| Rate for Payer: Healthscope Commercial |
$1,192.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$927.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$993.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,126.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$993.94
|
| Rate for Payer: PHP Commercial |
$1,126.46
|
| Rate for Payer: Priority Health SBD |
$834.91
|
| Rate for Payer: UMR Bronson Commercial |
$583.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$993.94
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
OP
|
$104.34
|
|
|
Service Code
|
NDC 00904619546
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$38.61 |
| Max. Negotiated Rate |
$93.91 |
| Rate for Payer: Aetna American Axle |
$67.82
|
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Medicare |
$52.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.82
|
| Rate for Payer: BCBS Complete |
$41.74
|
| Rate for Payer: Cash Price |
$83.47
|
| Rate for Payer: Cofinity Advantage |
$73.04
|
| Rate for Payer: Cofinity Commercial |
$89.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.47
|
| Rate for Payer: Healthscope Commercial |
$93.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.25
|
| Rate for Payer: PHP Commercial |
$88.69
|
| Rate for Payer: Priority Health SBD |
$65.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.82
|
| Rate for Payer: UHC Core |
$54.36
|
| Rate for Payer: UHC Exchange |
$41.01
|
| Rate for Payer: UMR Bronson Commercial |
$38.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.25
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
OP
|
$133.95
|
|
|
Service Code
|
NDC 68382020906
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.56 |
| Max. Negotiated Rate |
$120.56 |
| Rate for Payer: Aetna American Axle |
$87.07
|
| Rate for Payer: Aetna Commercial |
$113.86
|
| Rate for Payer: Aetna Medicare |
$66.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.07
|
| Rate for Payer: BCBS Complete |
$53.58
|
| Rate for Payer: Cash Price |
$107.16
|
| Rate for Payer: Cofinity Advantage |
$93.77
|
| Rate for Payer: Cofinity Commercial |
$115.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.16
|
| Rate for Payer: Healthscope Commercial |
$120.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.46
|
| Rate for Payer: PHP Commercial |
$113.86
|
| Rate for Payer: Priority Health SBD |
$84.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.07
|
| Rate for Payer: UHC Core |
$69.79
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UMR Bronson Commercial |
$49.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.46
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
IP
|
$79.52
|
|
|
Service Code
|
NDC 51991062033
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$34.99 |
| Max. Negotiated Rate |
$71.57 |
| Rate for Payer: Aetna American Axle |
$51.69
|
| Rate for Payer: Aetna Commercial |
$67.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.69
|
| Rate for Payer: Cash Price |
$63.62
|
| Rate for Payer: Cofinity Advantage |
$55.66
|
| Rate for Payer: Cofinity Commercial |
$68.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.62
|
| Rate for Payer: Healthscope Commercial |
$71.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.64
|
| Rate for Payer: PHP Commercial |
$67.59
|
| Rate for Payer: Priority Health SBD |
$50.10
|
| Rate for Payer: UMR Bronson Commercial |
$34.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.64
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
IP
|
$40.89
|
|
|
Service Code
|
NDC 16729003510
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$17.99 |
| Max. Negotiated Rate |
$36.80 |
| Rate for Payer: Aetna American Axle |
$26.58
|
| Rate for Payer: Aetna Commercial |
$34.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.58
|
| Rate for Payer: Cash Price |
$32.71
|
| Rate for Payer: Cofinity Advantage |
$28.62
|
| Rate for Payer: Cofinity Commercial |
$35.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.71
|
| Rate for Payer: Healthscope Commercial |
$36.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.67
|
| Rate for Payer: PHP Commercial |
$34.76
|
| Rate for Payer: Priority Health SBD |
$25.76
|
| Rate for Payer: UMR Bronson Commercial |
$17.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.67
|
|
|
ANASTROZOLE 1 MG TABLET
|
Facility
|
OP
|
$2.74
|
|
|
Service Code
|
NDC 50268007511
|
| Hospital Charge Code |
16205
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.01 |
| Max. Negotiated Rate |
$2.47 |
| Rate for Payer: Aetna American Axle |
$1.78
|
| Rate for Payer: Aetna Commercial |
$2.33
|
| Rate for Payer: Aetna Medicare |
$1.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.78
|
| Rate for Payer: BCBS Complete |
$1.10
|
| Rate for Payer: Cash Price |
$2.19
|
| Rate for Payer: Cofinity Advantage |
$1.92
|
| Rate for Payer: Cofinity Commercial |
$2.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.19
|
| Rate for Payer: Healthscope Commercial |
$2.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.06
|
| Rate for Payer: PHP Commercial |
$2.33
|
| Rate for Payer: Priority Health SBD |
$1.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.78
|
| Rate for Payer: UHC Core |
$1.43
|
| Rate for Payer: UHC Exchange |
$1.08
|
| Rate for Payer: UMR Bronson Commercial |
$1.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.06
|
|
|
ANGINA PECTORIS
|
Facility
|
IP
|
$16,292.17
|
|
|
Service Code
|
MSDRG 311
|
| Min. Negotiated Rate |
$6,139.61 |
| Max. Negotiated Rate |
$16,292.17 |
| Rate for Payer: Aetna Medicare |
$6,721.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,078.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,078.44
|
| Rate for Payer: BCBS MAPPO |
$6,462.75
|
| Rate for Payer: BCBS Trust/PPO |
$16,292.17
|
| Rate for Payer: BCN Commercial |
$16,292.17
|
| Rate for Payer: BCN Medicare Advantage |
$6,462.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,462.75
|
| Rate for Payer: Mclaren Medicare |
$6,462.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,785.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,432.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,109.02
|
| Rate for Payer: Nomi Health Commercial |
$9,054.51
|
| Rate for Payer: PACE Medicare |
$6,139.61
|
| Rate for Payer: PACE SWMI |
$6,462.75
|
| Rate for Payer: PHP Medicare Advantage |
$6,462.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,316.13
|
| Rate for Payer: Priority Health Medicare |
$6,462.75
|
| Rate for Payer: Priority Health Tiered Network |
$9,052.90
|
| Rate for Payer: Railroad Medicare Medicare |
$6,462.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,440.97
|
| Rate for Payer: UHC Core |
$9,571.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,462.75
|
| Rate for Payer: UHC Exchange |
$7,817.06
|
| Rate for Payer: VA VA |
$6,462.75
|
|
|
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS
|
Facility
|
IP
|
$3,144.66
|
|
|
Service Code
|
APR-DRG 1981
|
| Min. Negotiated Rate |
$2,994.92 |
| Max. Negotiated Rate |
$3,144.66 |
| Rate for Payer: BCBS Complete |
$3,144.66
|
| Rate for Payer: Mclaren Medicaid |
$2,994.92
|
| Rate for Payer: Meridian Medicaid |
$3,144.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,994.92
|
| Rate for Payer: UHC Medicaid |
$2,994.92
|
| Rate for Payer: UHCCP Medicaid |
$2,994.92
|
|
|
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS
|
Facility
|
IP
|
$3,710.64
|
|
|
Service Code
|
APR-DRG 1982
|
| Min. Negotiated Rate |
$3,533.95 |
| Max. Negotiated Rate |
$3,710.64 |
| Rate for Payer: BCBS Complete |
$3,710.64
|
| Rate for Payer: Mclaren Medicaid |
$3,533.95
|
| Rate for Payer: Meridian Medicaid |
$3,710.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,533.95
|
| Rate for Payer: UHC Medicaid |
$3,533.95
|
| Rate for Payer: UHCCP Medicaid |
$3,533.95
|
|
|
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS
|
Facility
|
IP
|
$4,909.79
|
|
|
Service Code
|
APR-DRG 1983
|
| Min. Negotiated Rate |
$4,675.99 |
| Max. Negotiated Rate |
$4,909.79 |
| Rate for Payer: BCBS Complete |
$4,909.79
|
| Rate for Payer: Mclaren Medicaid |
$4,675.99
|
| Rate for Payer: Meridian Medicaid |
$4,909.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,675.99
|
| Rate for Payer: UHC Medicaid |
$4,675.99
|
| Rate for Payer: UHCCP Medicaid |
$4,675.99
|
|
|
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS
|
Facility
|
IP
|
$10,279.02
|
|
|
Service Code
|
APR-DRG 1984
|
| Min. Negotiated Rate |
$9,789.55 |
| Max. Negotiated Rate |
$10,279.02 |
| Rate for Payer: BCBS Complete |
$10,279.02
|
| Rate for Payer: Mclaren Medicaid |
$9,789.55
|
| Rate for Payer: Meridian Medicaid |
$10,279.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,789.55
|
| Rate for Payer: UHC Medicaid |
$9,789.55
|
| Rate for Payer: UHCCP Medicaid |
$9,789.55
|
|
|
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$140.31
|
|
|
Service Code
|
HCPCS J0348
|
| Hospital Charge Code |
88093
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.84 |
| Max. Negotiated Rate |
$126.28 |
| Rate for Payer: Aetna American Axle |
$91.20
|
| Rate for Payer: Aetna Commercial |
$119.26
|
| Rate for Payer: Aetna Medicare |
$70.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.20
|
| Rate for Payer: BCBS Complete |
$56.12
|
| Rate for Payer: BCBS Trust/PPO |
$1.62
|
| Rate for Payer: BCN Commercial |
$1.62
|
| Rate for Payer: Cash Price |
$112.25
|
| Rate for Payer: Cash Price |
$112.25
|
| Rate for Payer: Cofinity Advantage |
$98.22
|
| Rate for Payer: Cofinity Commercial |
$120.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.25
|
| Rate for Payer: Healthscope Commercial |
$126.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.23
|
| Rate for Payer: PHP Commercial |
$119.26
|
| Rate for Payer: Priority Health SBD |
$88.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.84
|
| Rate for Payer: UHC Core |
$0.84
|
| Rate for Payer: UHC Exchange |
$0.84
|
| Rate for Payer: UMR Bronson Commercial |
$51.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.23
|
|
|
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$140.31
|
|
|
Service Code
|
HCPCS J0348
|
| Hospital Charge Code |
88093
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$61.74 |
| Max. Negotiated Rate |
$126.28 |
| Rate for Payer: Aetna American Axle |
$91.20
|
| Rate for Payer: Aetna Commercial |
$119.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.20
|
| Rate for Payer: Cash Price |
$112.25
|
| Rate for Payer: Cofinity Advantage |
$98.22
|
| Rate for Payer: Cofinity Commercial |
$120.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.25
|
| Rate for Payer: Healthscope Commercial |
$126.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.23
|
| Rate for Payer: PHP Commercial |
$119.26
|
| Rate for Payer: Priority Health SBD |
$88.40
|
| Rate for Payer: UMR Bronson Commercial |
$61.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.23
|
|
|
ANIDULAFUNGIN 50 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$55.06
|
|
|
Service Code
|
HCPCS J0348
|
| Hospital Charge Code |
76344
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.23 |
| Max. Negotiated Rate |
$49.55 |
| Rate for Payer: Aetna American Axle |
$35.79
|
| Rate for Payer: Aetna Commercial |
$46.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.79
|
| Rate for Payer: Cash Price |
$44.05
|
| Rate for Payer: Cofinity Advantage |
$38.54
|
| Rate for Payer: Cofinity Commercial |
$47.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.05
|
| Rate for Payer: Healthscope Commercial |
$49.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.30
|
| Rate for Payer: PHP Commercial |
$46.80
|
| Rate for Payer: Priority Health SBD |
$34.69
|
| Rate for Payer: UMR Bronson Commercial |
$24.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.30
|
|
