|
GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE
|
Facility
|
IP
|
$898.28
|
|
|
Service Code
|
NDC 00009034201
|
| Hospital Charge Code |
28025
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$395.24 |
| Max. Negotiated Rate |
$808.45 |
| Rate for Payer: Aetna American Axle |
$583.88
|
| Rate for Payer: Aetna Commercial |
$763.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$583.88
|
| Rate for Payer: Cash Price |
$718.62
|
| Rate for Payer: Cofinity Commercial |
$628.80
|
| Rate for Payer: Cofinity Commercial |
$772.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$628.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$718.62
|
| Rate for Payer: Healthscope Commercial |
$808.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$628.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$673.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$763.54
|
| Rate for Payer: PHP Commercial |
$763.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.88
|
| Rate for Payer: Priority Health SBD |
$565.92
|
| Rate for Payer: UMR Bronson Commercial |
$395.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$673.71
|
|
|
GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE
|
Facility
|
OP
|
$898.28
|
|
|
Service Code
|
NDC 00009034201
|
| Hospital Charge Code |
28025
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$332.36 |
| Max. Negotiated Rate |
$808.45 |
| Rate for Payer: Aetna American Axle |
$583.88
|
| Rate for Payer: Aetna Commercial |
$763.54
|
| Rate for Payer: Aetna Medicare |
$449.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$583.88
|
| Rate for Payer: BCBS Complete |
$359.31
|
| Rate for Payer: Cash Price |
$718.62
|
| Rate for Payer: Cofinity Commercial |
$628.80
|
| Rate for Payer: Cofinity Commercial |
$772.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$628.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$718.62
|
| Rate for Payer: Healthscope Commercial |
$808.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$628.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$673.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$763.54
|
| Rate for Payer: PHP Commercial |
$763.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.88
|
| Rate for Payer: Priority Health SBD |
$565.92
|
| Rate for Payer: UMR Bronson Commercial |
$332.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$673.71
|
|
|
GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE
|
Facility
|
OP
|
$659.90
|
|
|
Service Code
|
NDC 63713001974
|
| Hospital Charge Code |
28025
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$244.16 |
| Max. Negotiated Rate |
$593.91 |
| Rate for Payer: Cofinity Commercial |
$567.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$461.93
|
| Rate for Payer: Aetna American Axle |
$428.94
|
| Rate for Payer: Aetna Commercial |
$560.92
|
| Rate for Payer: Aetna Medicare |
$329.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.94
|
| Rate for Payer: BCBS Complete |
$263.96
|
| Rate for Payer: Cash Price |
$527.92
|
| Rate for Payer: Cofinity Commercial |
$461.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$527.92
|
| Rate for Payer: Healthscope Commercial |
$593.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$461.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$494.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$560.92
|
| Rate for Payer: PHP Commercial |
$560.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.94
|
| Rate for Payer: Priority Health SBD |
$415.74
|
| Rate for Payer: UMR Bronson Commercial |
$244.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$494.92
|
|
|
GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 100 TOPICAL SPONGE
|
Facility
|
IP
|
$659.90
|
|
|
Service Code
|
NDC 63713001974
|
| Hospital Charge Code |
28025
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$290.36 |
| Max. Negotiated Rate |
$593.91 |
| Rate for Payer: Aetna American Axle |
$428.94
|
| Rate for Payer: Aetna Commercial |
$560.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.94
|
| Rate for Payer: Cash Price |
$527.92
|
| Rate for Payer: Cofinity Commercial |
$461.93
|
| Rate for Payer: Cofinity Commercial |
$567.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$461.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$527.92
|
| Rate for Payer: Healthscope Commercial |
$593.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$461.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$494.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$560.92
|
| Rate for Payer: PHP Commercial |
$560.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.94
|
| Rate for Payer: Priority Health SBD |
$415.74
|
| Rate for Payer: UMR Bronson Commercial |
$290.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$494.92
|
|
|
GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE
|
Facility
|
OP
|
$270.31
|
|
|
Service Code
|
NDC 63713001972
|
| Hospital Charge Code |
28018
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$100.01 |
| Max. Negotiated Rate |
$243.28 |
| Rate for Payer: Aetna American Axle |
$175.70
|
| Rate for Payer: Aetna Commercial |
$229.76
|
| Rate for Payer: Aetna Medicare |
$135.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.70
|
| Rate for Payer: BCBS Complete |
$108.12
|
| Rate for Payer: Cash Price |
$216.25
|
| Rate for Payer: Cofinity Commercial |
$189.22
|
| Rate for Payer: Cofinity Commercial |
$232.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$189.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.25
|
| Rate for Payer: Healthscope Commercial |
$243.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$189.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.76
|
| Rate for Payer: PHP Commercial |
$229.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.70
|
| Rate for Payer: Priority Health SBD |
$170.30
|
| Rate for Payer: UMR Bronson Commercial |
$100.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.73
|
|
|
GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE
|
Facility
|
IP
|
$370.88
|
|
|
Service Code
|
NDC 00009031508
|
| Hospital Charge Code |
28018
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$163.19 |
| Max. Negotiated Rate |
$333.79 |
| Rate for Payer: Aetna American Axle |
$241.07
|
| Rate for Payer: Aetna Commercial |
$315.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.07
|
| Rate for Payer: Cash Price |
$296.70
|
| Rate for Payer: Cofinity Commercial |
$259.62
|
| Rate for Payer: Cofinity Commercial |
$318.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$259.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.70
|
| Rate for Payer: Healthscope Commercial |
$333.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$259.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$278.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.25
|
| Rate for Payer: PHP Commercial |
$315.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health SBD |
$233.65
|
| Rate for Payer: UMR Bronson Commercial |
$163.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$278.16
|
|
|
GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE
|
Facility
|
IP
|
$270.31
|
|
|
Service Code
|
NDC 63713001972
|
| Hospital Charge Code |
28018
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$118.94 |
| Max. Negotiated Rate |
$243.28 |
| Rate for Payer: Aetna American Axle |
$175.70
|
| Rate for Payer: Aetna Commercial |
$229.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.70
|
| Rate for Payer: Cash Price |
$216.25
|
| Rate for Payer: Cofinity Commercial |
$189.22
|
| Rate for Payer: Cofinity Commercial |
$232.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$189.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.25
|
| Rate for Payer: Healthscope Commercial |
$243.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$189.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.76
|
| Rate for Payer: PHP Commercial |
$229.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.70
|
| Rate for Payer: Priority Health SBD |
$170.30
|
| Rate for Payer: UMR Bronson Commercial |
$118.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.73
|
|
|
GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 12 MM-7 MM TOPICAL SPONGE
|
Facility
|
OP
|
$370.88
|
|
|
Service Code
|
NDC 00009031508
|
| Hospital Charge Code |
28018
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$137.23 |
| Max. Negotiated Rate |
$333.79 |
| Rate for Payer: Aetna American Axle |
$241.07
|
| Rate for Payer: Aetna Commercial |
$315.25
|
| Rate for Payer: Aetna Medicare |
$185.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.07
|
| Rate for Payer: BCBS Complete |
$148.35
|
| Rate for Payer: Cash Price |
$296.70
|
| Rate for Payer: Cofinity Commercial |
$259.62
|
| Rate for Payer: Cofinity Commercial |
$318.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$259.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.70
|
| Rate for Payer: Healthscope Commercial |
$333.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$259.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$278.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.25
|
| Rate for Payer: PHP Commercial |
$315.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health SBD |
$233.65
|
| Rate for Payer: UMR Bronson Commercial |
$137.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$278.16
|
|
|
GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 50 TOPICAL SPONGE
|
Facility
|
OP
|
$402.34
|
|
|
Service Code
|
NDC 00009032301
|
| Hospital Charge Code |
28024
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$148.87 |
| Max. Negotiated Rate |
$362.11 |
| Rate for Payer: Aetna American Axle |
$261.52
|
| Rate for Payer: Aetna Commercial |
$341.99
|
| Rate for Payer: Aetna Medicare |
$201.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.52
|
| Rate for Payer: BCBS Complete |
$160.94
|
| Rate for Payer: Cash Price |
$321.87
|
| Rate for Payer: Cofinity Commercial |
$281.64
|
| Rate for Payer: Cofinity Commercial |
$346.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$281.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$321.87
|
| Rate for Payer: Healthscope Commercial |
$362.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$281.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$301.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$341.99
|
| Rate for Payer: PHP Commercial |
$341.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.52
|
| Rate for Payer: Priority Health SBD |
$253.47
|
| Rate for Payer: UMR Bronson Commercial |
$148.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$301.76
|
|
|
GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 50 TOPICAL SPONGE
|
Facility
|
IP
|
$402.34
|
|
|
Service Code
|
NDC 00009032301
|
| Hospital Charge Code |
28024
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$177.03 |
| Max. Negotiated Rate |
$362.11 |
| Rate for Payer: PHP Commercial |
$341.99
|
| Rate for Payer: Aetna American Axle |
$261.52
|
| Rate for Payer: Aetna Commercial |
$341.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.52
|
| Rate for Payer: Cash Price |
$321.87
|
| Rate for Payer: Cofinity Commercial |
$281.64
|
| Rate for Payer: Cofinity Commercial |
$346.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$281.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$321.87
|
| Rate for Payer: Healthscope Commercial |
$362.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$281.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$301.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$341.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.52
|
| Rate for Payer: Priority Health SBD |
$253.47
|
| Rate for Payer: UMR Bronson Commercial |
$177.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$301.76
|
|
|
GELATIN SPONGE,ABSORBABLE TOPICAL SYRINGE
|
Facility
|
OP
|
$1,687.92
|
|
|
Service Code
|
NDC 00009104006
|
| Hospital Charge Code |
189527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$624.53 |
| Max. Negotiated Rate |
$1,519.13 |
| Rate for Payer: Aetna American Axle |
$1,097.15
|
| Rate for Payer: Aetna Commercial |
$1,434.73
|
| Rate for Payer: Aetna Medicare |
$843.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,097.15
|
| Rate for Payer: BCBS Complete |
$675.17
|
| Rate for Payer: Cash Price |
$1,350.34
|
| Rate for Payer: Cofinity Commercial |
$1,181.54
|
| Rate for Payer: Cofinity Commercial |
$1,451.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,181.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,350.34
|
| Rate for Payer: Healthscope Commercial |
$1,519.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,181.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,265.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,434.73
|
| Rate for Payer: PHP Commercial |
$1,434.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.15
|
| Rate for Payer: Priority Health SBD |
$1,063.39
|
| Rate for Payer: UMR Bronson Commercial |
$624.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,265.94
|
|
|
GELATIN SPONGE,ABSORBABLE TOPICAL SYRINGE
|
Facility
|
IP
|
$1,687.92
|
|
|
Service Code
|
NDC 00009104006
|
| Hospital Charge Code |
189527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$742.68 |
| Max. Negotiated Rate |
$1,519.13 |
| Rate for Payer: Aetna American Axle |
$1,097.15
|
| Rate for Payer: Aetna Commercial |
$1,434.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,097.15
|
| Rate for Payer: Cash Price |
$1,350.34
|
| Rate for Payer: Cofinity Commercial |
$1,181.54
|
| Rate for Payer: Cofinity Commercial |
$1,451.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,181.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,350.34
|
| Rate for Payer: Healthscope Commercial |
$1,519.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,181.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,265.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,434.73
|
| Rate for Payer: PHP Commercial |
$1,434.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.15
|
| Rate for Payer: Priority Health SBD |
$1,063.39
|
| Rate for Payer: UMR Bronson Commercial |
$742.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,265.94
|
|
|
GELATIN SPONGE,ABSORBABLE TOPICAL SYRINGE
|
Facility
|
IP
|
$281.32
|
|
|
Service Code
|
NDC 00009104001
|
| Hospital Charge Code |
189527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$123.78 |
| Max. Negotiated Rate |
$253.19 |
| Rate for Payer: Aetna American Axle |
$182.86
|
| Rate for Payer: Aetna Commercial |
$239.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.86
|
| Rate for Payer: Cash Price |
$225.06
|
| Rate for Payer: Cofinity Commercial |
$196.92
|
| Rate for Payer: Cofinity Commercial |
$241.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$196.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.06
|
| Rate for Payer: Healthscope Commercial |
$253.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$196.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.12
|
| Rate for Payer: PHP Commercial |
$239.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.86
|
| Rate for Payer: Priority Health SBD |
$177.23
|
| Rate for Payer: UMR Bronson Commercial |
$123.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.99
|
|
|
GELATIN SPONGE,ABSORBABLE TOPICAL SYRINGE
|
Facility
|
OP
|
$281.32
|
|
|
Service Code
|
NDC 00009104001
|
| Hospital Charge Code |
189527
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$104.09 |
| Max. Negotiated Rate |
$253.19 |
| Rate for Payer: Aetna American Axle |
$182.86
|
| Rate for Payer: Aetna Commercial |
$239.12
|
| Rate for Payer: Aetna Medicare |
$140.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.86
|
| Rate for Payer: BCBS Complete |
$112.53
|
| Rate for Payer: Cash Price |
$225.06
|
| Rate for Payer: Cofinity Commercial |
$196.92
|
| Rate for Payer: Cofinity Commercial |
$241.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$196.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.06
|
| Rate for Payer: Healthscope Commercial |
$253.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$196.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.12
|
| Rate for Payer: PHP Commercial |
$239.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.86
|
| Rate for Payer: Priority Health SBD |
$177.23
|
| Rate for Payer: UMR Bronson Commercial |
$104.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.99
|
|
|
GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$290.61
|
|
|
Service Code
|
HCPCS J9201
|
| Hospital Charge Code |
155791
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.38 |
| Max. Negotiated Rate |
$261.55 |
| Rate for Payer: Aetna American Axle |
$188.90
|
| Rate for Payer: Aetna American Axle |
$153.50
|
| Rate for Payer: Aetna Commercial |
$200.73
|
| Rate for Payer: Aetna Commercial |
$247.02
|
| Rate for Payer: Aetna Medicare |
$145.30
|
| Rate for Payer: Aetna Medicare |
$118.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.90
|
| Rate for Payer: BCBS Complete |
$116.24
|
| Rate for Payer: BCBS Complete |
$94.46
|
| Rate for Payer: BCBS Trust/PPO |
$7.38
|
| Rate for Payer: BCBS Trust/PPO |
$7.38
|
| Rate for Payer: BCN Commercial |
$7.38
|
| Rate for Payer: BCN Commercial |
$7.38
|
| Rate for Payer: Cash Price |
$188.92
|
| Rate for Payer: Cash Price |
$188.92
|
| Rate for Payer: Cash Price |
$232.49
|
| Rate for Payer: Cash Price |
$232.49
|
| Rate for Payer: Cofinity Commercial |
$165.30
|
| Rate for Payer: Cofinity Commercial |
$203.09
|
| Rate for Payer: Cofinity Commercial |
$249.92
|
| Rate for Payer: Cofinity Commercial |
$203.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$165.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$203.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.92
|
| Rate for Payer: Healthscope Commercial |
$212.54
|
| Rate for Payer: Healthscope Commercial |
$261.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$165.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$203.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.73
|
| Rate for Payer: PHP Commercial |
$247.02
|
| Rate for Payer: PHP Commercial |
$200.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.90
|
| Rate for Payer: Priority Health SBD |
$183.08
|
| Rate for Payer: Priority Health SBD |
$148.77
|
| Rate for Payer: UMR Bronson Commercial |
$87.38
|
| Rate for Payer: UMR Bronson Commercial |
$107.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.96
|
|
|
GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$290.61
|
|
|
Service Code
|
HCPCS J9201
|
| Hospital Charge Code |
155791
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$127.87 |
| Max. Negotiated Rate |
$261.55 |
| Rate for Payer: Aetna American Axle |
$188.90
|
| Rate for Payer: Aetna Commercial |
$247.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.90
|
| Rate for Payer: Cash Price |
$232.49
|
| Rate for Payer: Cofinity Commercial |
$203.43
|
| Rate for Payer: Cofinity Commercial |
$249.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$203.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.49
|
| Rate for Payer: Healthscope Commercial |
$261.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$203.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.02
|
| Rate for Payer: PHP Commercial |
$247.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.90
|
| Rate for Payer: Priority Health SBD |
$183.08
|
| Rate for Payer: UMR Bronson Commercial |
$127.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.96
|
|
|
GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$469.04
|
|
|
Service Code
|
HCPCS J9201
|
| Hospital Charge Code |
155792
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.38 |
| Max. Negotiated Rate |
$422.14 |
| Rate for Payer: Aetna American Axle |
$304.88
|
| Rate for Payer: Aetna American Axle |
$168.39
|
| Rate for Payer: Aetna American Axle |
$167.17
|
| Rate for Payer: Aetna Commercial |
$398.68
|
| Rate for Payer: Aetna Commercial |
$218.60
|
| Rate for Payer: Aetna Commercial |
$220.20
|
| Rate for Payer: Aetna Medicare |
$129.53
|
| Rate for Payer: Aetna Medicare |
$128.59
|
| Rate for Payer: Aetna Medicare |
$234.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.39
|
| Rate for Payer: BCBS Complete |
$103.62
|
| Rate for Payer: BCBS Complete |
$187.62
|
| Rate for Payer: BCBS Complete |
$102.87
|
| Rate for Payer: BCBS Trust/PPO |
$7.38
|
| Rate for Payer: BCBS Trust/PPO |
$7.38
|
| Rate for Payer: BCBS Trust/PPO |
$7.38
|
| Rate for Payer: BCN Commercial |
$7.38
|
| Rate for Payer: BCN Commercial |
$7.38
|
| Rate for Payer: BCN Commercial |
$7.38
|
| Rate for Payer: Cash Price |
$207.25
|
| Rate for Payer: Cash Price |
$375.23
|
| Rate for Payer: Cash Price |
$205.74
|
| Rate for Payer: Cash Price |
$207.25
|
| Rate for Payer: Cash Price |
$205.74
|
| Rate for Payer: Cash Price |
$375.23
|
| Rate for Payer: Cofinity Commercial |
$222.79
|
| Rate for Payer: Cofinity Commercial |
$180.03
|
| Rate for Payer: Cofinity Commercial |
$221.17
|
| Rate for Payer: Cofinity Commercial |
$181.34
|
| Rate for Payer: Cofinity Commercial |
$328.33
|
| Rate for Payer: Cofinity Commercial |
$403.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$328.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$180.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$181.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.23
|
| Rate for Payer: Healthscope Commercial |
$422.14
|
| Rate for Payer: Healthscope Commercial |
$233.15
|
| Rate for Payer: Healthscope Commercial |
$231.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$328.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.68
|
| Rate for Payer: PHP Commercial |
$398.68
|
| Rate for Payer: PHP Commercial |
$218.60
|
| Rate for Payer: PHP Commercial |
$220.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.88
|
| Rate for Payer: Priority Health SBD |
$163.21
|
| Rate for Payer: Priority Health SBD |
$295.50
|
| Rate for Payer: Priority Health SBD |
$162.02
|
| Rate for Payer: UMR Bronson Commercial |
$173.54
|
| Rate for Payer: UMR Bronson Commercial |
$95.16
|
| Rate for Payer: UMR Bronson Commercial |
$95.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.78
|
|
|
GEMFIBROZIL 600 MG TABLET
|
Facility
|
OP
|
$2.09
|
|
|
Service Code
|
NDC 60687022411
|
| Hospital Charge Code |
3378
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$1.88 |
| Rate for Payer: Aetna American Axle |
$1.36
|
| Rate for Payer: Aetna Commercial |
$1.78
|
| Rate for Payer: Aetna Medicare |
$1.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.36
|
| Rate for Payer: BCBS Complete |
$0.84
|
| Rate for Payer: Cash Price |
$1.67
|
| Rate for Payer: Cofinity Commercial |
$1.46
|
| Rate for Payer: Cofinity Commercial |
$1.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.67
|
| Rate for Payer: Healthscope Commercial |
$1.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.78
|
| Rate for Payer: PHP Commercial |
$1.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.36
|
| Rate for Payer: Priority Health SBD |
$1.32
|
| Rate for Payer: UMR Bronson Commercial |
$0.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.57
|
|
|
GEMFIBROZIL 600 MG TABLET
|
Facility
|
OP
|
$208.05
|
|
|
Service Code
|
NDC 60687022401
|
| Hospital Charge Code |
3378
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$76.98 |
| Max. Negotiated Rate |
$187.24 |
| Rate for Payer: Aetna American Axle |
$135.23
|
| Rate for Payer: Aetna Commercial |
$176.84
|
| Rate for Payer: Aetna Medicare |
$104.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.23
|
| Rate for Payer: BCBS Complete |
$83.22
|
| Rate for Payer: Cash Price |
$166.44
|
| Rate for Payer: Cofinity Commercial |
$145.64
|
| Rate for Payer: Cofinity Commercial |
$178.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$145.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.44
|
| Rate for Payer: Healthscope Commercial |
$187.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.84
|
| Rate for Payer: PHP Commercial |
$176.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.23
|
| Rate for Payer: Priority Health SBD |
$131.07
|
| Rate for Payer: UMR Bronson Commercial |
$76.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.04
|
|
|
GEMFIBROZIL 600 MG TABLET
|
Facility
|
IP
|
$2.09
|
|
|
Service Code
|
NDC 60687022411
|
| Hospital Charge Code |
3378
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$1.88 |
| Rate for Payer: Aetna American Axle |
$1.36
|
| Rate for Payer: Aetna Commercial |
$1.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.36
|
| Rate for Payer: Cash Price |
$1.67
|
| Rate for Payer: Cofinity Commercial |
$1.46
|
| Rate for Payer: Cofinity Commercial |
$1.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.67
|
| Rate for Payer: Healthscope Commercial |
$1.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.78
|
| Rate for Payer: PHP Commercial |
$1.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.36
|
| Rate for Payer: Priority Health SBD |
$1.32
|
| Rate for Payer: UMR Bronson Commercial |
$0.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.57
|
|
|
GEMFIBROZIL 600 MG TABLET
|
Facility
|
IP
|
$208.05
|
|
|
Service Code
|
NDC 60687022401
|
| Hospital Charge Code |
3378
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$91.54 |
| Max. Negotiated Rate |
$187.24 |
| Rate for Payer: Aetna American Axle |
$135.23
|
| Rate for Payer: Aetna Commercial |
$176.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.23
|
| Rate for Payer: Cash Price |
$166.44
|
| Rate for Payer: Cofinity Commercial |
$145.64
|
| Rate for Payer: Cofinity Commercial |
$178.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$145.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.44
|
| Rate for Payer: Healthscope Commercial |
$187.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.84
|
| Rate for Payer: PHP Commercial |
$176.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.23
|
| Rate for Payer: Priority Health SBD |
$131.07
|
| Rate for Payer: UMR Bronson Commercial |
$91.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.04
|
|
|
GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONCENTRATION) IV SOLN
|
Facility
|
OP
|
$45,102.05
|
|
|
Service Code
|
HCPCS J9203
|
| Hospital Charge Code |
184519
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$124.95 |
| Max. Negotiated Rate |
$40,591.84 |
| Rate for Payer: Aetna American Axle |
$29,316.33
|
| Rate for Payer: Aetna Commercial |
$38,336.74
|
| Rate for Payer: Aetna Medicare |
$242.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29,316.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$291.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$291.40
|
| Rate for Payer: BCBS Complete |
$131.20
|
| Rate for Payer: BCBS MAPPO |
$233.12
|
| Rate for Payer: BCBS Trust/PPO |
$626.80
|
| Rate for Payer: BCN Commercial |
$626.80
|
| Rate for Payer: BCN Medicare Advantage |
$233.12
|
| Rate for Payer: Cash Price |
$36,081.64
|
| Rate for Payer: Cash Price |
$36,081.64
|
| Rate for Payer: Cofinity Commercial |
$38,787.76
|
| Rate for Payer: Cofinity Commercial |
$31,571.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$31,571.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36,081.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.12
|
| Rate for Payer: Healthscope Commercial |
$40,591.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31,571.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33,826.54
|
| Rate for Payer: Mclaren Medicaid |
$124.95
|
| Rate for Payer: Mclaren Medicare |
$233.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$244.78
|
| Rate for Payer: Meridian Medicaid |
$131.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$268.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38,336.74
|
| Rate for Payer: Nomi Health Commercial |
$699.36
|
| Rate for Payer: PACE Medicare |
$221.46
|
| Rate for Payer: PACE SWMI |
$233.12
|
| Rate for Payer: PHP Commercial |
$38,336.74
|
| Rate for Payer: PHP Medicare Advantage |
$233.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29,316.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$661.00
|
| Rate for Payer: Priority Health Medicare |
$233.12
|
| Rate for Payer: Priority Health Narrow Network |
$528.80
|
| Rate for Payer: Priority Health SBD |
$28,414.29
|
| Rate for Payer: Railroad Medicare Medicare |
$233.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.12
|
| Rate for Payer: UHC Exchange |
$445.52
|
| Rate for Payer: UHC Medicare Advantage |
$233.12
|
| Rate for Payer: UHCCP Medicaid |
$124.95
|
| Rate for Payer: UMR Bronson Commercial |
$16,687.76
|
| Rate for Payer: VA VA |
$233.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33,826.54
|
|
|
GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONCENTRATION) IV SOLN
|
Facility
|
IP
|
$45,102.05
|
|
|
Service Code
|
HCPCS J9203
|
| Hospital Charge Code |
184519
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19,844.90 |
| Max. Negotiated Rate |
$40,591.84 |
| Rate for Payer: Aetna American Axle |
$29,316.33
|
| Rate for Payer: Aetna Commercial |
$38,336.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29,316.33
|
| Rate for Payer: Cash Price |
$36,081.64
|
| Rate for Payer: Cofinity Commercial |
$31,571.44
|
| Rate for Payer: Cofinity Commercial |
$38,787.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$31,571.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36,081.64
|
| Rate for Payer: Healthscope Commercial |
$40,591.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31,571.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33,826.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38,336.74
|
| Rate for Payer: PHP Commercial |
$38,336.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29,316.33
|
| Rate for Payer: Priority Health SBD |
$28,414.29
|
| Rate for Payer: UMR Bronson Commercial |
$19,844.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33,826.54
|
|
|
GENIOPLASTY; SLIDING OSTEOTOMY, SINGLE PIECE
|
Facility
|
OP
|
$9,986.81
|
|
|
Service Code
|
CPT 21121
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$503.49 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,891.90
|
| Rate for Payer: BCN Commercial |
$1,891.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Nomi Health Commercial |
$6,672.75
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$553.84
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$503.49
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,703.14
|
| Rate for Payer: VA VA |
$3,177.50
|
|
|
GENTAMICIN 0.1 % TOPICAL CREAM
|
Facility
|
IP
|
$128.58
|
|
|
Service Code
|
NDC 45802005635
|
| Hospital Charge Code |
3423
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$56.58 |
| Max. Negotiated Rate |
$115.72 |
| Rate for Payer: Aetna American Axle |
$83.58
|
| Rate for Payer: Aetna Commercial |
$109.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.58
|
| Rate for Payer: Cash Price |
$102.86
|
| Rate for Payer: Cofinity Commercial |
$110.58
|
| Rate for Payer: Cofinity Commercial |
$90.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$90.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.86
|
| Rate for Payer: Healthscope Commercial |
$115.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.29
|
| Rate for Payer: PHP Commercial |
$109.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.58
|
| Rate for Payer: Priority Health SBD |
$81.01
|
| Rate for Payer: UMR Bronson Commercial |
$56.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.44
|
|
