|
GLYCERIN (ADULT) RECTAL SUPPOSITORY
|
Facility
|
IP
|
$2.52
|
|
|
Service Code
|
NDC 09900001155
|
| Hospital Charge Code |
15053
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.11 |
| Max. Negotiated Rate |
$2.27 |
| Rate for Payer: Aetna American Axle |
$1.64
|
| Rate for Payer: Aetna Commercial |
$2.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.64
|
| Rate for Payer: Cash Price |
$2.02
|
| Rate for Payer: Cofinity Commercial |
$1.76
|
| Rate for Payer: Cofinity Commercial |
$2.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.02
|
| Rate for Payer: Healthscope Commercial |
$2.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.14
|
| Rate for Payer: PHP Commercial |
$2.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.64
|
| Rate for Payer: Priority Health SBD |
$1.59
|
| Rate for Payer: UMR Bronson Commercial |
$1.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.89
|
|
|
GLYCERIN (ADULT) RECTAL SUPPOSITORY
|
Facility
|
IP
|
$41.74
|
|
|
Service Code
|
NDC 58980041012
|
| Hospital Charge Code |
15053
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$18.37 |
| Max. Negotiated Rate |
$37.57 |
| Rate for Payer: Aetna American Axle |
$27.13
|
| Rate for Payer: Aetna Commercial |
$35.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.13
|
| Rate for Payer: Cash Price |
$33.39
|
| Rate for Payer: Cofinity Commercial |
$29.22
|
| Rate for Payer: Cofinity Commercial |
$35.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.39
|
| Rate for Payer: Healthscope Commercial |
$37.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.48
|
| Rate for Payer: PHP Commercial |
$35.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.13
|
| Rate for Payer: Priority Health SBD |
$26.30
|
| Rate for Payer: UMR Bronson Commercial |
$18.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.30
|
|
|
GLYCERIN (ADULT) RECTAL SUPPOSITORY
|
Facility
|
OP
|
$35.82
|
|
|
Service Code
|
NDC 00132007912
|
| Hospital Charge Code |
15053
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.25 |
| Max. Negotiated Rate |
$32.24 |
| Rate for Payer: Aetna American Axle |
$23.28
|
| Rate for Payer: Aetna Commercial |
$30.45
|
| Rate for Payer: Aetna Medicare |
$17.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.28
|
| Rate for Payer: BCBS Complete |
$14.33
|
| Rate for Payer: Cash Price |
$28.66
|
| Rate for Payer: Cofinity Commercial |
$25.07
|
| Rate for Payer: Cofinity Commercial |
$30.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.66
|
| Rate for Payer: Healthscope Commercial |
$32.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.45
|
| Rate for Payer: PHP Commercial |
$30.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.28
|
| Rate for Payer: Priority Health SBD |
$22.57
|
| Rate for Payer: UMR Bronson Commercial |
$13.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.86
|
|
|
GLYCERIN (ADULT) RECTAL SUPPOSITORY
|
Facility
|
IP
|
$35.82
|
|
|
Service Code
|
NDC 00132007912
|
| Hospital Charge Code |
15053
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$15.76 |
| Max. Negotiated Rate |
$32.24 |
| Rate for Payer: Aetna American Axle |
$23.28
|
| Rate for Payer: Aetna Commercial |
$30.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.28
|
| Rate for Payer: Cash Price |
$28.66
|
| Rate for Payer: Cofinity Commercial |
$25.07
|
| Rate for Payer: Cofinity Commercial |
$30.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.66
|
| Rate for Payer: Healthscope Commercial |
$32.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.45
|
| Rate for Payer: PHP Commercial |
$30.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.28
|
| Rate for Payer: Priority Health SBD |
$22.57
|
| Rate for Payer: UMR Bronson Commercial |
$15.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.86
|
|
|
GLYCERIN (ADULT) RECTAL SUPPOSITORY
|
Facility
|
OP
|
$41.74
|
|
|
Service Code
|
NDC 58980041012
|
| Hospital Charge Code |
15053
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$15.44 |
| Max. Negotiated Rate |
$37.57 |
| Rate for Payer: Aetna American Axle |
$27.13
|
| Rate for Payer: Aetna Commercial |
$35.48
|
| Rate for Payer: Aetna Medicare |
$20.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.13
|
| Rate for Payer: BCBS Complete |
$16.70
|
| Rate for Payer: Cash Price |
$33.39
|
| Rate for Payer: Cofinity Commercial |
$29.22
|
| Rate for Payer: Cofinity Commercial |
$35.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.39
|
| Rate for Payer: Healthscope Commercial |
$37.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.48
|
| Rate for Payer: PHP Commercial |
$35.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.13
|
| Rate for Payer: Priority Health SBD |
$26.30
|
| Rate for Payer: UMR Bronson Commercial |
$15.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.30
|
|
|
GLYCERIN (BULK) 100 % LIQUID
|
Facility
|
OP
|
$70.50
|
|
|
Service Code
|
NDC 51552009404
|
| Hospital Charge Code |
28815
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$26.08 |
| Max. Negotiated Rate |
$63.45 |
| Rate for Payer: Aetna American Axle |
$45.82
|
| Rate for Payer: Aetna Commercial |
$59.92
|
| Rate for Payer: Aetna Medicare |
$35.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.82
|
| Rate for Payer: BCBS Complete |
$28.20
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cofinity Commercial |
$49.35
|
| Rate for Payer: Cofinity Commercial |
$60.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.40
|
| Rate for Payer: Healthscope Commercial |
$63.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.92
|
| Rate for Payer: PHP Commercial |
$59.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.82
|
| Rate for Payer: Priority Health SBD |
$44.42
|
| Rate for Payer: UMR Bronson Commercial |
$26.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.88
|
|
|
GLYCERIN (BULK) 100 % LIQUID
|
Facility
|
IP
|
$220.00
|
|
|
Service Code
|
NDC 09900001967
|
| Hospital Charge Code |
28815
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$198.00 |
| Rate for Payer: Aetna American Axle |
$143.00
|
| Rate for Payer: Aetna Commercial |
$187.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cofinity Commercial |
$154.00
|
| Rate for Payer: Cofinity Commercial |
$189.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$154.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.00
|
| Rate for Payer: Healthscope Commercial |
$198.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.00
|
| Rate for Payer: PHP Commercial |
$187.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.00
|
| Rate for Payer: Priority Health SBD |
$138.60
|
| Rate for Payer: UMR Bronson Commercial |
$96.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.00
|
|
|
GLYCERIN (BULK) 100 % LIQUID
|
Facility
|
OP
|
$220.00
|
|
|
Service Code
|
NDC 09900001967
|
| Hospital Charge Code |
28815
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.40 |
| Max. Negotiated Rate |
$198.00 |
| Rate for Payer: Aetna American Axle |
$143.00
|
| Rate for Payer: Aetna Commercial |
$187.00
|
| Rate for Payer: Aetna Medicare |
$110.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.00
|
| Rate for Payer: BCBS Complete |
$88.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cofinity Commercial |
$154.00
|
| Rate for Payer: Cofinity Commercial |
$189.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$154.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.00
|
| Rate for Payer: Healthscope Commercial |
$198.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.00
|
| Rate for Payer: PHP Commercial |
$187.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.00
|
| Rate for Payer: Priority Health SBD |
$138.60
|
| Rate for Payer: UMR Bronson Commercial |
$81.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.00
|
|
|
GLYCERIN (BULK) 100 % LIQUID
|
Facility
|
IP
|
$70.50
|
|
|
Service Code
|
NDC 51552009404
|
| Hospital Charge Code |
28815
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.02 |
| Max. Negotiated Rate |
$63.45 |
| Rate for Payer: Aetna American Axle |
$45.82
|
| Rate for Payer: Aetna Commercial |
$59.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.82
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cofinity Commercial |
$49.35
|
| Rate for Payer: Cofinity Commercial |
$60.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.40
|
| Rate for Payer: Healthscope Commercial |
$63.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.92
|
| Rate for Payer: PHP Commercial |
$59.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.82
|
| Rate for Payer: Priority Health SBD |
$44.42
|
| Rate for Payer: UMR Bronson Commercial |
$31.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.88
|
|
|
GLYCERIN (CHILD) RECTAL SUPPOSITORY
|
Facility
|
OP
|
$37.51
|
|
|
Service Code
|
NDC 00132008112
|
| Hospital Charge Code |
3492
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.88 |
| Max. Negotiated Rate |
$33.76 |
| Rate for Payer: Aetna American Axle |
$24.38
|
| Rate for Payer: Aetna Commercial |
$31.88
|
| Rate for Payer: Aetna Medicare |
$18.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.38
|
| Rate for Payer: BCBS Complete |
$15.00
|
| Rate for Payer: Cash Price |
$30.01
|
| Rate for Payer: Cofinity Commercial |
$26.26
|
| Rate for Payer: Cofinity Commercial |
$32.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.01
|
| Rate for Payer: Healthscope Commercial |
$33.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.88
|
| Rate for Payer: PHP Commercial |
$31.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.38
|
| Rate for Payer: Priority Health SBD |
$23.63
|
| Rate for Payer: UMR Bronson Commercial |
$13.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.13
|
|
|
GLYCERIN (CHILD) RECTAL SUPPOSITORY
|
Facility
|
IP
|
$71.02
|
|
|
Service Code
|
NDC 58980040925
|
| Hospital Charge Code |
3492
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.25 |
| Max. Negotiated Rate |
$63.92 |
| Rate for Payer: Aetna American Axle |
$46.16
|
| Rate for Payer: Aetna Commercial |
$60.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.16
|
| Rate for Payer: Cash Price |
$56.82
|
| Rate for Payer: Cofinity Commercial |
$49.71
|
| Rate for Payer: Cofinity Commercial |
$61.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.82
|
| Rate for Payer: Healthscope Commercial |
$63.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.37
|
| Rate for Payer: PHP Commercial |
$60.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.16
|
| Rate for Payer: Priority Health SBD |
$44.74
|
| Rate for Payer: UMR Bronson Commercial |
$31.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.26
|
|
|
GLYCERIN (CHILD) RECTAL SUPPOSITORY
|
Facility
|
OP
|
$2.99
|
|
|
Service Code
|
NDC 09900001043
|
| Hospital Charge Code |
3492
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.11 |
| Max. Negotiated Rate |
$2.69 |
| Rate for Payer: Aetna American Axle |
$1.94
|
| Rate for Payer: Aetna Commercial |
$2.54
|
| Rate for Payer: Aetna Medicare |
$1.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.94
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: Cash Price |
$2.39
|
| Rate for Payer: Cofinity Commercial |
$2.09
|
| Rate for Payer: Cofinity Commercial |
$2.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.39
|
| Rate for Payer: Healthscope Commercial |
$2.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.54
|
| Rate for Payer: PHP Commercial |
$2.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.94
|
| Rate for Payer: Priority Health SBD |
$1.88
|
| Rate for Payer: UMR Bronson Commercial |
$1.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.24
|
|
|
GLYCERIN (CHILD) RECTAL SUPPOSITORY
|
Facility
|
IP
|
$2.99
|
|
|
Service Code
|
NDC 09900001043
|
| Hospital Charge Code |
3492
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.32 |
| Max. Negotiated Rate |
$2.69 |
| Rate for Payer: Aetna American Axle |
$1.94
|
| Rate for Payer: Aetna Commercial |
$2.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.94
|
| Rate for Payer: Cash Price |
$2.39
|
| Rate for Payer: Cofinity Commercial |
$2.09
|
| Rate for Payer: Cofinity Commercial |
$2.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.39
|
| Rate for Payer: Healthscope Commercial |
$2.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.54
|
| Rate for Payer: PHP Commercial |
$2.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.94
|
| Rate for Payer: Priority Health SBD |
$1.88
|
| Rate for Payer: UMR Bronson Commercial |
$1.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.24
|
|
|
GLYCERIN (CHILD) RECTAL SUPPOSITORY
|
Facility
|
OP
|
$71.02
|
|
|
Service Code
|
NDC 58980040925
|
| Hospital Charge Code |
3492
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$26.28 |
| Max. Negotiated Rate |
$63.92 |
| Rate for Payer: Aetna American Axle |
$46.16
|
| Rate for Payer: Aetna Commercial |
$60.37
|
| Rate for Payer: Aetna Medicare |
$35.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.16
|
| Rate for Payer: BCBS Complete |
$28.41
|
| Rate for Payer: Cash Price |
$56.82
|
| Rate for Payer: Cofinity Commercial |
$49.71
|
| Rate for Payer: Cofinity Commercial |
$61.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.82
|
| Rate for Payer: Healthscope Commercial |
$63.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.37
|
| Rate for Payer: PHP Commercial |
$60.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.16
|
| Rate for Payer: Priority Health SBD |
$44.74
|
| Rate for Payer: UMR Bronson Commercial |
$26.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.26
|
|
|
GLYCERIN (CHILD) RECTAL SUPPOSITORY
|
Facility
|
IP
|
$37.51
|
|
|
Service Code
|
NDC 00132008112
|
| Hospital Charge Code |
3492
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$33.76 |
| Rate for Payer: Aetna American Axle |
$24.38
|
| Rate for Payer: Aetna Commercial |
$31.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.38
|
| Rate for Payer: Cash Price |
$30.01
|
| Rate for Payer: Cofinity Commercial |
$26.26
|
| Rate for Payer: Cofinity Commercial |
$32.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.01
|
| Rate for Payer: Healthscope Commercial |
$33.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.88
|
| Rate for Payer: PHP Commercial |
$31.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.38
|
| Rate for Payer: Priority Health SBD |
$23.63
|
| Rate for Payer: UMR Bronson Commercial |
$16.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.13
|
|
|
GLYCERIN (CHILD) RECTAL SUPPOSITORY
|
Facility
|
OP
|
$49.35
|
|
|
Service Code
|
NDC 70000042901
|
| Hospital Charge Code |
3492
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$18.26 |
| Max. Negotiated Rate |
$44.42 |
| Rate for Payer: Aetna American Axle |
$32.08
|
| Rate for Payer: Aetna Commercial |
$41.95
|
| Rate for Payer: Aetna Medicare |
$24.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.08
|
| Rate for Payer: BCBS Complete |
$19.74
|
| Rate for Payer: Cash Price |
$39.48
|
| Rate for Payer: Cofinity Commercial |
$34.54
|
| Rate for Payer: Cofinity Commercial |
$42.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.48
|
| Rate for Payer: Healthscope Commercial |
$44.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.95
|
| Rate for Payer: PHP Commercial |
$41.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.08
|
| Rate for Payer: Priority Health SBD |
$31.09
|
| Rate for Payer: UMR Bronson Commercial |
$18.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.01
|
|
|
GLYCERIN (CHILD) RECTAL SUPPOSITORY
|
Facility
|
IP
|
$49.35
|
|
|
Service Code
|
NDC 70000042901
|
| Hospital Charge Code |
3492
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$21.71 |
| Max. Negotiated Rate |
$44.42 |
| Rate for Payer: Aetna American Axle |
$32.08
|
| Rate for Payer: Aetna Commercial |
$41.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.08
|
| Rate for Payer: Cash Price |
$39.48
|
| Rate for Payer: Cofinity Commercial |
$34.54
|
| Rate for Payer: Cofinity Commercial |
$42.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.48
|
| Rate for Payer: Healthscope Commercial |
$44.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.95
|
| Rate for Payer: PHP Commercial |
$41.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.08
|
| Rate for Payer: Priority Health SBD |
$31.09
|
| Rate for Payer: UMR Bronson Commercial |
$21.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.01
|
|
|
GLYCERIN-WITCH HAZEL 12.5 %-50 % TOPICAL PADS
|
Facility
|
IP
|
$12.78
|
|
|
Service Code
|
NDC 50289825005
|
| Hospital Charge Code |
116088
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.62 |
| Max. Negotiated Rate |
$11.50 |
| Rate for Payer: Aetna American Axle |
$8.31
|
| Rate for Payer: Aetna Commercial |
$10.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.31
|
| Rate for Payer: Cash Price |
$10.22
|
| Rate for Payer: Cofinity Commercial |
$10.99
|
| Rate for Payer: Cofinity Commercial |
$8.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.22
|
| Rate for Payer: Healthscope Commercial |
$11.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.86
|
| Rate for Payer: PHP Commercial |
$10.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.31
|
| Rate for Payer: Priority Health SBD |
$8.05
|
| Rate for Payer: UMR Bronson Commercial |
$5.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.58
|
|
|
GLYCERIN-WITCH HAZEL 12.5 %-50 % TOPICAL PADS
|
Facility
|
OP
|
$12.78
|
|
|
Service Code
|
NDC 50289825005
|
| Hospital Charge Code |
116088
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.73 |
| Max. Negotiated Rate |
$11.50 |
| Rate for Payer: Aetna American Axle |
$8.31
|
| Rate for Payer: Aetna Commercial |
$10.86
|
| Rate for Payer: Aetna Medicare |
$6.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.31
|
| Rate for Payer: BCBS Complete |
$5.11
|
| Rate for Payer: Cash Price |
$10.22
|
| Rate for Payer: Cofinity Commercial |
$10.99
|
| Rate for Payer: Cofinity Commercial |
$8.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.22
|
| Rate for Payer: Healthscope Commercial |
$11.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.86
|
| Rate for Payer: PHP Commercial |
$10.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.31
|
| Rate for Payer: Priority Health SBD |
$8.05
|
| Rate for Payer: UMR Bronson Commercial |
$4.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.58
|
|
|
GLYCERIN-WITCH HAZEL 12.5 %-50 % TOPICAL PADS
|
Facility
|
IP
|
$11.70
|
|
|
Service Code
|
NDC 50289325001
|
| Hospital Charge Code |
116088
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$10.53 |
| Rate for Payer: Aetna American Axle |
$7.60
|
| Rate for Payer: Aetna Commercial |
$9.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.60
|
| Rate for Payer: Cash Price |
$9.36
|
| Rate for Payer: Cofinity Commercial |
$10.06
|
| Rate for Payer: Cofinity Commercial |
$8.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.36
|
| Rate for Payer: Healthscope Commercial |
$10.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.94
|
| Rate for Payer: PHP Commercial |
$9.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.60
|
| Rate for Payer: Priority Health SBD |
$7.37
|
| Rate for Payer: UMR Bronson Commercial |
$5.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.78
|
|
|
GLYCERIN-WITCH HAZEL 12.5 %-50 % TOPICAL PADS
|
Facility
|
OP
|
$11.70
|
|
|
Service Code
|
NDC 50289325001
|
| Hospital Charge Code |
116088
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.33 |
| Max. Negotiated Rate |
$10.53 |
| Rate for Payer: Aetna American Axle |
$7.60
|
| Rate for Payer: Aetna Commercial |
$9.94
|
| Rate for Payer: Aetna Medicare |
$5.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.60
|
| Rate for Payer: BCBS Complete |
$4.68
|
| Rate for Payer: Cash Price |
$9.36
|
| Rate for Payer: Cofinity Commercial |
$10.06
|
| Rate for Payer: Cofinity Commercial |
$8.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.36
|
| Rate for Payer: Healthscope Commercial |
$10.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.94
|
| Rate for Payer: PHP Commercial |
$9.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.60
|
| Rate for Payer: Priority Health SBD |
$7.37
|
| Rate for Payer: UMR Bronson Commercial |
$4.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.78
|
|
|
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$21.73
|
|
|
Service Code
|
HCPCS J1596
|
| Hospital Charge Code |
3497
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$19.56 |
| Rate for Payer: Aetna American Axle |
$14.12
|
| Rate for Payer: Aetna American Axle |
$11.21
|
| Rate for Payer: Aetna American Axle |
$89.09
|
| Rate for Payer: Aetna American Axle |
$11.12
|
| Rate for Payer: Aetna American Axle |
$15.03
|
| Rate for Payer: Aetna American Axle |
$13.88
|
| Rate for Payer: Aetna American Axle |
$31.99
|
| Rate for Payer: Aetna American Axle |
$31.82
|
| Rate for Payer: Aetna American Axle |
$18.97
|
| Rate for Payer: Aetna American Axle |
$11.85
|
| Rate for Payer: Aetna American Axle |
$16.45
|
| Rate for Payer: Aetna American Axle |
$10.52
|
| Rate for Payer: Aetna American Axle |
$14.53
|
| Rate for Payer: Aetna American Axle |
$59.64
|
| Rate for Payer: Aetna Commercial |
$14.66
|
| Rate for Payer: Aetna Commercial |
$41.84
|
| Rate for Payer: Aetna Commercial |
$21.51
|
| Rate for Payer: Aetna Commercial |
$19.65
|
| Rate for Payer: Aetna Commercial |
$15.50
|
| Rate for Payer: Aetna Commercial |
$24.80
|
| Rate for Payer: Aetna Commercial |
$19.00
|
| Rate for Payer: Aetna Commercial |
$18.47
|
| Rate for Payer: Aetna Commercial |
$14.54
|
| Rate for Payer: Aetna Commercial |
$18.15
|
| Rate for Payer: Aetna Commercial |
$116.50
|
| Rate for Payer: Aetna Commercial |
$13.76
|
| Rate for Payer: Aetna Commercial |
$41.61
|
| Rate for Payer: Aetna Commercial |
$78.00
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna Medicare |
$0.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.73
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS MAPPO |
$0.58
|
| Rate for Payer: BCBS Trust/PPO |
$1.35
|
| Rate for Payer: BCBS Trust/PPO |
$1.35
|
| Rate for Payer: BCBS Trust/PPO |
$1.35
|
| Rate for Payer: BCBS Trust/PPO |
$1.35
|
| Rate for Payer: BCBS Trust/PPO |
$1.35
|
| Rate for Payer: BCBS Trust/PPO |
$1.35
|
| Rate for Payer: BCBS Trust/PPO |
$1.35
|
| Rate for Payer: BCBS Trust/PPO |
$1.35
|
| Rate for Payer: BCBS Trust/PPO |
$1.35
|
| Rate for Payer: BCBS Trust/PPO |
$1.35
|
| Rate for Payer: BCBS Trust/PPO |
$1.35
|
| Rate for Payer: BCBS Trust/PPO |
$1.35
|
| Rate for Payer: BCBS Trust/PPO |
$1.35
|
| Rate for Payer: BCBS Trust/PPO |
$1.35
|
| Rate for Payer: BCN Commercial |
$1.35
|
| Rate for Payer: BCN Commercial |
$1.35
|
| Rate for Payer: BCN Commercial |
$1.35
|
| Rate for Payer: BCN Commercial |
$1.35
|
| Rate for Payer: BCN Commercial |
$1.35
|
| Rate for Payer: BCN Commercial |
$1.35
|
| Rate for Payer: BCN Commercial |
$1.35
|
| Rate for Payer: BCN Commercial |
$1.35
|
| Rate for Payer: BCN Commercial |
$1.35
|
| Rate for Payer: BCN Commercial |
$1.35
|
| Rate for Payer: BCN Commercial |
$1.35
|
| Rate for Payer: BCN Commercial |
$1.35
|
| Rate for Payer: BCN Commercial |
$1.35
|
| Rate for Payer: BCN Commercial |
$1.35
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$0.58
|
| Rate for Payer: Cash Price |
$14.58
|
| Rate for Payer: Cash Price |
$13.68
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$18.50
|
| Rate for Payer: Cash Price |
$12.95
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$18.50
|
| Rate for Payer: Cash Price |
$17.88
|
| Rate for Payer: Cash Price |
$23.34
|
| Rate for Payer: Cash Price |
$23.34
|
| Rate for Payer: Cash Price |
$17.88
|
| Rate for Payer: Cash Price |
$13.68
|
| Rate for Payer: Cash Price |
$39.16
|
| Rate for Payer: Cash Price |
$39.16
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Cash Price |
$39.38
|
| Rate for Payer: Cash Price |
$39.38
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Cash Price |
$13.80
|
| Rate for Payer: Cash Price |
$73.41
|
| Rate for Payer: Cash Price |
$73.41
|
| Rate for Payer: Cash Price |
$17.08
|
| Rate for Payer: Cash Price |
$109.65
|
| Rate for Payer: Cash Price |
$109.65
|
| Rate for Payer: Cash Price |
$12.95
|
| Rate for Payer: Cash Price |
$17.08
|
| Rate for Payer: Cash Price |
$14.58
|
| Rate for Payer: Cash Price |
$13.80
|
| Rate for Payer: Cofinity Commercial |
$13.92
|
| Rate for Payer: Cofinity Commercial |
$95.94
|
| Rate for Payer: Cofinity Commercial |
$117.87
|
| Rate for Payer: Cofinity Commercial |
$11.33
|
| Rate for Payer: Cofinity Commercial |
$11.97
|
| Rate for Payer: Cofinity Commercial |
$14.71
|
| Rate for Payer: Cofinity Commercial |
$12.08
|
| Rate for Payer: Cofinity Commercial |
$14.84
|
| Rate for Payer: Cofinity Commercial |
$12.76
|
| Rate for Payer: Cofinity Commercial |
$15.68
|
| Rate for Payer: Cofinity Commercial |
$14.94
|
| Rate for Payer: Cofinity Commercial |
$18.36
|
| Rate for Payer: Cofinity Commercial |
$15.21
|
| Rate for Payer: Cofinity Commercial |
$18.69
|
| Rate for Payer: Cofinity Commercial |
$15.64
|
| Rate for Payer: Cofinity Commercial |
$19.22
|
| Rate for Payer: Cofinity Commercial |
$16.18
|
| Rate for Payer: Cofinity Commercial |
$19.88
|
| Rate for Payer: Cofinity Commercial |
$17.72
|
| Rate for Payer: Cofinity Commercial |
$21.77
|
| Rate for Payer: Cofinity Commercial |
$20.43
|
| Rate for Payer: Cofinity Commercial |
$25.09
|
| Rate for Payer: Cofinity Commercial |
$34.26
|
| Rate for Payer: Cofinity Commercial |
$42.10
|
| Rate for Payer: Cofinity Commercial |
$34.45
|
| Rate for Payer: Cofinity Commercial |
$42.33
|
| Rate for Payer: Cofinity Commercial |
$64.23
|
| Rate for Payer: Cofinity Commercial |
$78.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$95.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.58
|
| Rate for Payer: Healthscope Commercial |
$15.39
|
| Rate for Payer: Healthscope Commercial |
$16.41
|
| Rate for Payer: Healthscope Commercial |
$14.57
|
| Rate for Payer: Healthscope Commercial |
$15.52
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Healthscope Commercial |
$44.30
|
| Rate for Payer: Healthscope Commercial |
$19.56
|
| Rate for Payer: Healthscope Commercial |
$82.58
|
| Rate for Payer: Healthscope Commercial |
$22.78
|
| Rate for Payer: Healthscope Commercial |
$123.35
|
| Rate for Payer: Healthscope Commercial |
$20.12
|
| Rate for Payer: Healthscope Commercial |
$26.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.67
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.31
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Mclaren Medicare |
$0.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.61
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: Meridian Medicaid |
$0.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.51
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: Nomi Health Commercial |
$1.74
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE Medicare |
$0.55
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.58
|
| Rate for Payer: PHP Commercial |
$14.66
|
| Rate for Payer: PHP Commercial |
$24.80
|
| Rate for Payer: PHP Commercial |
$41.61
|
| Rate for Payer: PHP Commercial |
$21.51
|
| Rate for Payer: PHP Commercial |
$18.47
|
| Rate for Payer: PHP Commercial |
$14.54
|
| Rate for Payer: PHP Commercial |
$18.15
|
| Rate for Payer: PHP Commercial |
$19.65
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Commercial |
$41.84
|
| Rate for Payer: PHP Commercial |
$78.00
|
| Rate for Payer: PHP Commercial |
$13.76
|
| Rate for Payer: PHP Commercial |
$15.50
|
| Rate for Payer: PHP Commercial |
$116.50
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: PHP Medicare Advantage |
$0.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.46
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Medicare |
$0.58
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health Narrow Network |
$1.17
|
| Rate for Payer: Priority Health SBD |
$10.77
|
| Rate for Payer: Priority Health SBD |
$30.84
|
| Rate for Payer: Priority Health SBD |
$14.08
|
| Rate for Payer: Priority Health SBD |
$11.48
|
| Rate for Payer: Priority Health SBD |
$10.87
|
| Rate for Payer: Priority Health SBD |
$15.95
|
| Rate for Payer: Priority Health SBD |
$18.38
|
| Rate for Payer: Priority Health SBD |
$13.45
|
| Rate for Payer: Priority Health SBD |
$31.01
|
| Rate for Payer: Priority Health SBD |
$86.35
|
| Rate for Payer: Priority Health SBD |
$10.20
|
| Rate for Payer: Priority Health SBD |
$14.57
|
| Rate for Payer: Priority Health SBD |
$57.81
|
| Rate for Payer: Priority Health SBD |
$13.69
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: Railroad Medicare Medicare |
$0.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.58
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Exchange |
$1.11
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHC Medicare Advantage |
$0.58
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UHCCP Medicaid |
$0.31
|
| Rate for Payer: UMR Bronson Commercial |
$8.27
|
| Rate for Payer: UMR Bronson Commercial |
$18.21
|
| Rate for Payer: UMR Bronson Commercial |
$9.36
|
| Rate for Payer: UMR Bronson Commercial |
$18.11
|
| Rate for Payer: UMR Bronson Commercial |
$6.38
|
| Rate for Payer: UMR Bronson Commercial |
$8.04
|
| Rate for Payer: UMR Bronson Commercial |
$7.90
|
| Rate for Payer: UMR Bronson Commercial |
$8.55
|
| Rate for Payer: UMR Bronson Commercial |
$6.33
|
| Rate for Payer: UMR Bronson Commercial |
$50.71
|
| Rate for Payer: UMR Bronson Commercial |
$6.75
|
| Rate for Payer: UMR Bronson Commercial |
$10.80
|
| Rate for Payer: UMR Bronson Commercial |
$5.99
|
| Rate for Payer: UMR Bronson Commercial |
$33.95
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: VA VA |
$0.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.14
|
|
|
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$21.35
|
|
|
Service Code
|
HCPCS J1596
|
| Hospital Charge Code |
3497
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.39 |
| Max. Negotiated Rate |
$19.22 |
| Rate for Payer: Aetna American Axle |
$13.88
|
| Rate for Payer: Aetna American Axle |
$89.09
|
| Rate for Payer: Aetna American Axle |
$10.52
|
| Rate for Payer: Aetna American Axle |
$11.21
|
| Rate for Payer: Aetna American Axle |
$31.82
|
| Rate for Payer: Aetna American Axle |
$14.12
|
| Rate for Payer: Aetna American Axle |
$59.64
|
| Rate for Payer: Aetna American Axle |
$16.45
|
| Rate for Payer: Aetna American Axle |
$15.03
|
| Rate for Payer: Aetna American Axle |
$11.85
|
| Rate for Payer: Aetna American Axle |
$18.97
|
| Rate for Payer: Aetna American Axle |
$31.99
|
| Rate for Payer: Aetna American Axle |
$14.53
|
| Rate for Payer: Aetna American Axle |
$11.12
|
| Rate for Payer: Aetna Commercial |
$19.00
|
| Rate for Payer: Aetna Commercial |
$24.80
|
| Rate for Payer: Aetna Commercial |
$13.76
|
| Rate for Payer: Aetna Commercial |
$116.50
|
| Rate for Payer: Aetna Commercial |
$14.66
|
| Rate for Payer: Aetna Commercial |
$19.65
|
| Rate for Payer: Aetna Commercial |
$18.15
|
| Rate for Payer: Aetna Commercial |
$14.54
|
| Rate for Payer: Aetna Commercial |
$15.50
|
| Rate for Payer: Aetna Commercial |
$78.00
|
| Rate for Payer: Aetna Commercial |
$41.61
|
| Rate for Payer: Aetna Commercial |
$18.47
|
| Rate for Payer: Aetna Commercial |
$41.84
|
| Rate for Payer: Aetna Commercial |
$21.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.97
|
| Rate for Payer: Cash Price |
$13.80
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$14.58
|
| Rate for Payer: Cash Price |
$18.50
|
| Rate for Payer: Cash Price |
$17.88
|
| Rate for Payer: Cash Price |
$73.41
|
| Rate for Payer: Cash Price |
$17.08
|
| Rate for Payer: Cash Price |
$12.95
|
| Rate for Payer: Cash Price |
$13.68
|
| Rate for Payer: Cash Price |
$39.38
|
| Rate for Payer: Cash Price |
$109.65
|
| Rate for Payer: Cash Price |
$23.34
|
| Rate for Payer: Cash Price |
$39.16
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Cofinity Commercial |
$15.68
|
| Rate for Payer: Cofinity Commercial |
$15.21
|
| Rate for Payer: Cofinity Commercial |
$117.87
|
| Rate for Payer: Cofinity Commercial |
$14.84
|
| Rate for Payer: Cofinity Commercial |
$12.08
|
| Rate for Payer: Cofinity Commercial |
$11.97
|
| Rate for Payer: Cofinity Commercial |
$11.33
|
| Rate for Payer: Cofinity Commercial |
$13.92
|
| Rate for Payer: Cofinity Commercial |
$14.71
|
| Rate for Payer: Cofinity Commercial |
$95.94
|
| Rate for Payer: Cofinity Commercial |
$78.91
|
| Rate for Payer: Cofinity Commercial |
$64.23
|
| Rate for Payer: Cofinity Commercial |
$42.33
|
| Rate for Payer: Cofinity Commercial |
$34.45
|
| Rate for Payer: Cofinity Commercial |
$42.10
|
| Rate for Payer: Cofinity Commercial |
$34.26
|
| Rate for Payer: Cofinity Commercial |
$25.09
|
| Rate for Payer: Cofinity Commercial |
$20.43
|
| Rate for Payer: Cofinity Commercial |
$21.77
|
| Rate for Payer: Cofinity Commercial |
$17.72
|
| Rate for Payer: Cofinity Commercial |
$12.76
|
| Rate for Payer: Cofinity Commercial |
$18.69
|
| Rate for Payer: Cofinity Commercial |
$19.88
|
| Rate for Payer: Cofinity Commercial |
$16.18
|
| Rate for Payer: Cofinity Commercial |
$19.22
|
| Rate for Payer: Cofinity Commercial |
$15.64
|
| Rate for Payer: Cofinity Commercial |
$14.94
|
| Rate for Payer: Cofinity Commercial |
$18.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$95.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.41
|
| Rate for Payer: Healthscope Commercial |
$82.58
|
| Rate for Payer: Healthscope Commercial |
$16.41
|
| Rate for Payer: Healthscope Commercial |
$22.78
|
| Rate for Payer: Healthscope Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$123.35
|
| Rate for Payer: Healthscope Commercial |
$14.57
|
| Rate for Payer: Healthscope Commercial |
$15.39
|
| Rate for Payer: Healthscope Commercial |
$19.22
|
| Rate for Payer: Healthscope Commercial |
$15.52
|
| Rate for Payer: Healthscope Commercial |
$19.56
|
| Rate for Payer: Healthscope Commercial |
$20.12
|
| Rate for Payer: Healthscope Commercial |
$44.30
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Healthscope Commercial |
$26.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.08
|
| Rate for Payer: UMR Bronson Commercial |
$60.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.15
|
| Rate for Payer: PHP Commercial |
$116.50
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Commercial |
$41.84
|
| Rate for Payer: PHP Commercial |
$21.51
|
| Rate for Payer: PHP Commercial |
$15.50
|
| Rate for Payer: PHP Commercial |
$24.80
|
| Rate for Payer: PHP Commercial |
$78.00
|
| Rate for Payer: PHP Commercial |
$13.76
|
| Rate for Payer: PHP Commercial |
$14.66
|
| Rate for Payer: PHP Commercial |
$14.54
|
| Rate for Payer: PHP Commercial |
$19.65
|
| Rate for Payer: PHP Commercial |
$41.61
|
| Rate for Payer: PHP Commercial |
$18.15
|
| Rate for Payer: PHP Commercial |
$18.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.99
|
| Rate for Payer: Priority Health SBD |
$10.77
|
| Rate for Payer: Priority Health SBD |
$18.38
|
| Rate for Payer: Priority Health SBD |
$31.01
|
| Rate for Payer: Priority Health SBD |
$10.87
|
| Rate for Payer: Priority Health SBD |
$11.48
|
| Rate for Payer: Priority Health SBD |
$14.08
|
| Rate for Payer: Priority Health SBD |
$13.69
|
| Rate for Payer: Priority Health SBD |
$57.81
|
| Rate for Payer: Priority Health SBD |
$15.95
|
| Rate for Payer: Priority Health SBD |
$13.45
|
| Rate for Payer: Priority Health SBD |
$10.20
|
| Rate for Payer: Priority Health SBD |
$86.35
|
| Rate for Payer: Priority Health SBD |
$14.57
|
| Rate for Payer: Priority Health SBD |
$30.84
|
| Rate for Payer: UMR Bronson Commercial |
$7.59
|
| Rate for Payer: UMR Bronson Commercial |
$7.52
|
| Rate for Payer: UMR Bronson Commercial |
$11.14
|
| Rate for Payer: UMR Bronson Commercial |
$7.12
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: UMR Bronson Commercial |
$12.84
|
| Rate for Payer: UMR Bronson Commercial |
$9.83
|
| Rate for Payer: UMR Bronson Commercial |
$21.54
|
| Rate for Payer: UMR Bronson Commercial |
$40.37
|
| Rate for Payer: UMR Bronson Commercial |
$21.66
|
| Rate for Payer: UMR Bronson Commercial |
$8.02
|
| Rate for Payer: UMR Bronson Commercial |
$9.56
|
| Rate for Payer: UMR Bronson Commercial |
$10.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.82
|
|
|
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION
|
Facility
|
OP
|
$1,684.64
|
|
|
Service Code
|
NDC 31722001647
|
| Hospital Charge Code |
107829
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$623.32 |
| Max. Negotiated Rate |
$1,516.18 |
| Rate for Payer: Aetna American Axle |
$1,095.02
|
| Rate for Payer: Aetna Commercial |
$1,431.94
|
| Rate for Payer: Aetna Medicare |
$842.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,095.02
|
| Rate for Payer: BCBS Complete |
$673.86
|
| Rate for Payer: Cash Price |
$1,347.71
|
| Rate for Payer: Cofinity Commercial |
$1,179.25
|
| Rate for Payer: Cofinity Commercial |
$1,448.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,179.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,347.71
|
| Rate for Payer: Healthscope Commercial |
$1,516.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,179.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,263.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,431.94
|
| Rate for Payer: PHP Commercial |
$1,431.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,095.02
|
| Rate for Payer: Priority Health SBD |
$1,061.32
|
| Rate for Payer: UMR Bronson Commercial |
$623.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,263.48
|
|
|
GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLUTION
|
Facility
|
IP
|
$1,366.79
|
|
|
Service Code
|
NDC 51672531609
|
| Hospital Charge Code |
107829
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$601.39 |
| Max. Negotiated Rate |
$1,230.11 |
| Rate for Payer: Aetna American Axle |
$888.41
|
| Rate for Payer: Aetna Commercial |
$1,161.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$888.41
|
| Rate for Payer: Cash Price |
$1,093.43
|
| Rate for Payer: Cofinity Commercial |
$1,175.44
|
| Rate for Payer: Cofinity Commercial |
$956.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$956.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,093.43
|
| Rate for Payer: Healthscope Commercial |
$1,230.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$956.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,025.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,161.77
|
| Rate for Payer: PHP Commercial |
$1,161.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.41
|
| Rate for Payer: Priority Health SBD |
$861.08
|
| Rate for Payer: UMR Bronson Commercial |
$601.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,025.09
|
|
