|
ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$396.18
|
|
|
Service Code
|
HCPCS J0883
|
| Hospital Charge Code |
28947
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.53 |
| Max. Negotiated Rate |
$356.56 |
| Rate for Payer: Aetna American Axle |
$257.52
|
| Rate for Payer: Aetna American Axle |
$442.05
|
| Rate for Payer: Aetna American Axle |
$277.99
|
| Rate for Payer: Aetna American Axle |
$118.03
|
| Rate for Payer: Aetna Commercial |
$336.75
|
| Rate for Payer: Aetna Commercial |
$578.07
|
| Rate for Payer: Aetna Commercial |
$154.35
|
| Rate for Payer: Aetna Commercial |
$363.52
|
| Rate for Payer: Aetna Medicare |
$1.05
|
| Rate for Payer: Aetna Medicare |
$1.05
|
| Rate for Payer: Aetna Medicare |
$1.05
|
| Rate for Payer: Aetna Medicare |
$1.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$442.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.26
|
| Rate for Payer: BCBS Complete |
$0.55
|
| Rate for Payer: BCBS Complete |
$0.55
|
| Rate for Payer: BCBS Complete |
$0.55
|
| Rate for Payer: BCBS Complete |
$0.55
|
| Rate for Payer: BCBS MAPPO |
$1.01
|
| Rate for Payer: BCBS MAPPO |
$1.01
|
| Rate for Payer: BCBS MAPPO |
$1.01
|
| Rate for Payer: BCBS MAPPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.97
|
| Rate for Payer: BCBS Trust/PPO |
$1.97
|
| Rate for Payer: BCBS Trust/PPO |
$1.97
|
| Rate for Payer: BCBS Trust/PPO |
$1.97
|
| Rate for Payer: BCN Commercial |
$1.97
|
| Rate for Payer: BCN Commercial |
$1.97
|
| Rate for Payer: BCN Commercial |
$1.97
|
| Rate for Payer: BCN Commercial |
$1.97
|
| Rate for Payer: BCN Medicare Advantage |
$1.01
|
| Rate for Payer: BCN Medicare Advantage |
$1.01
|
| Rate for Payer: BCN Medicare Advantage |
$1.01
|
| Rate for Payer: BCN Medicare Advantage |
$1.01
|
| Rate for Payer: Cash Price |
$342.14
|
| Rate for Payer: Cash Price |
$316.94
|
| Rate for Payer: Cash Price |
$145.27
|
| Rate for Payer: Cash Price |
$544.06
|
| Rate for Payer: Cash Price |
$316.94
|
| Rate for Payer: Cash Price |
$342.14
|
| Rate for Payer: Cash Price |
$544.06
|
| Rate for Payer: Cash Price |
$145.27
|
| Rate for Payer: Cofinity Advantage |
$299.37
|
| Rate for Payer: Cofinity Advantage |
$127.11
|
| Rate for Payer: Cofinity Advantage |
$476.06
|
| Rate for Payer: Cofinity Advantage |
$277.33
|
| Rate for Payer: Cofinity Commercial |
$584.87
|
| Rate for Payer: Cofinity Commercial |
$340.71
|
| Rate for Payer: Cofinity Commercial |
$367.80
|
| Rate for Payer: Cofinity Commercial |
$156.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$544.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.01
|
| Rate for Payer: Healthscope Commercial |
$356.56
|
| Rate for Payer: Healthscope Commercial |
$384.90
|
| Rate for Payer: Healthscope Commercial |
$612.07
|
| Rate for Payer: Healthscope Commercial |
$163.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$476.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$299.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$510.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$320.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.19
|
| Rate for Payer: Mclaren Medicaid |
$1.01
|
| Rate for Payer: Mclaren Medicaid |
$1.01
|
| Rate for Payer: Mclaren Medicaid |
$1.01
|
| Rate for Payer: Mclaren Medicaid |
$1.01
|
| Rate for Payer: Mclaren Medicare |
$1.01
|
| Rate for Payer: Mclaren Medicare |
$1.01
|
| Rate for Payer: Mclaren Medicare |
$1.01
|
| Rate for Payer: Mclaren Medicare |
$1.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.06
|
| Rate for Payer: Meridian Medicaid |
$1.06
|
| Rate for Payer: Meridian Medicaid |
$1.06
|
| Rate for Payer: Meridian Medicaid |
$1.06
|
| Rate for Payer: Meridian Medicaid |
$1.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$363.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$578.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.35
|
| Rate for Payer: Nomi Health Commercial |
$3.03
|
| Rate for Payer: Nomi Health Commercial |
$3.03
|
| Rate for Payer: Nomi Health Commercial |
$3.03
|
| Rate for Payer: Nomi Health Commercial |
$3.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$320.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$510.06
|
| Rate for Payer: PACE Medicare |
$0.96
|
| Rate for Payer: PACE Medicare |
$0.96
|
| Rate for Payer: PACE Medicare |
$0.96
|
| Rate for Payer: PACE Medicare |
$0.96
|
| Rate for Payer: PACE SWMI |
$1.01
|
| Rate for Payer: PACE SWMI |
$1.01
|
| Rate for Payer: PACE SWMI |
$1.01
|
| Rate for Payer: PACE SWMI |
$1.01
|
| Rate for Payer: PHP Commercial |
$336.75
|
| Rate for Payer: PHP Commercial |
$578.07
|
| Rate for Payer: PHP Commercial |
$154.35
|
| Rate for Payer: PHP Commercial |
$363.52
|
| Rate for Payer: PHP Medicare Advantage |
$1.01
|
| Rate for Payer: PHP Medicare Advantage |
$1.01
|
| Rate for Payer: PHP Medicare Advantage |
$1.01
|
| Rate for Payer: PHP Medicare Advantage |
$1.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.51
|
| Rate for Payer: Priority Health Medicare |
$1.01
|
| Rate for Payer: Priority Health Medicare |
$1.01
|
| Rate for Payer: Priority Health Medicare |
$1.01
|
| Rate for Payer: Priority Health Medicare |
$1.01
|
| Rate for Payer: Priority Health SBD |
$114.40
|
| Rate for Payer: Priority Health SBD |
$249.59
|
| Rate for Payer: Priority Health SBD |
$428.45
|
| Rate for Payer: Priority Health SBD |
$269.43
|
| Rate for Payer: Priority Health Tiered Network |
$2.01
|
| Rate for Payer: Priority Health Tiered Network |
$2.01
|
| Rate for Payer: Priority Health Tiered Network |
$2.01
|
| Rate for Payer: Priority Health Tiered Network |
$2.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.01
|
| Rate for Payer: UHC Core |
$1.01
|
| Rate for Payer: UHC Core |
$1.01
|
| Rate for Payer: UHC Core |
$1.01
|
| Rate for Payer: UHC Core |
$1.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.01
|
| Rate for Payer: UHC Exchange |
$1.01
|
| Rate for Payer: UHC Exchange |
$1.01
|
| Rate for Payer: UHC Exchange |
$1.01
|
| Rate for Payer: UHC Exchange |
$1.01
|
| Rate for Payer: UHC Medicaid |
$0.53
|
| Rate for Payer: UHC Medicaid |
$0.53
|
| Rate for Payer: UHC Medicaid |
$0.53
|
| Rate for Payer: UHC Medicaid |
$0.53
|
| Rate for Payer: UHCCP Medicaid |
$0.53
|
| Rate for Payer: UHCCP Medicaid |
$0.53
|
| Rate for Payer: UHCCP Medicaid |
$0.53
|
| Rate for Payer: UHCCP Medicaid |
$0.53
|
| Rate for Payer: UMR Bronson Commercial |
$158.24
|
| Rate for Payer: UMR Bronson Commercial |
$146.59
|
| Rate for Payer: UMR Bronson Commercial |
$67.19
|
| Rate for Payer: UMR Bronson Commercial |
$251.63
|
| Rate for Payer: VA VA |
$1.01
|
| Rate for Payer: VA VA |
$1.01
|
| Rate for Payer: VA VA |
$1.01
|
| Rate for Payer: VA VA |
$1.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$320.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$510.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.19
|
|
|
ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$427.67
|
|
|
Service Code
|
HCPCS J0883
|
| Hospital Charge Code |
28947
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$188.17 |
| Max. Negotiated Rate |
$384.90 |
| Rate for Payer: Aetna American Axle |
$277.99
|
| Rate for Payer: Aetna American Axle |
$257.52
|
| Rate for Payer: Aetna American Axle |
$442.05
|
| Rate for Payer: Aetna American Axle |
$118.03
|
| Rate for Payer: Aetna Commercial |
$578.07
|
| Rate for Payer: Aetna Commercial |
$363.52
|
| Rate for Payer: Aetna Commercial |
$154.35
|
| Rate for Payer: Aetna Commercial |
$336.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$442.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.03
|
| Rate for Payer: Cash Price |
$145.27
|
| Rate for Payer: Cash Price |
$544.06
|
| Rate for Payer: Cash Price |
$316.94
|
| Rate for Payer: Cash Price |
$342.14
|
| Rate for Payer: Cofinity Advantage |
$277.33
|
| Rate for Payer: Cofinity Advantage |
$127.11
|
| Rate for Payer: Cofinity Advantage |
$299.37
|
| Rate for Payer: Cofinity Advantage |
$476.06
|
| Rate for Payer: Cofinity Commercial |
$367.80
|
| Rate for Payer: Cofinity Commercial |
$156.17
|
| Rate for Payer: Cofinity Commercial |
$340.71
|
| Rate for Payer: Cofinity Commercial |
$584.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$544.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.94
|
| Rate for Payer: Healthscope Commercial |
$356.56
|
| Rate for Payer: Healthscope Commercial |
$612.07
|
| Rate for Payer: Healthscope Commercial |
$384.90
|
| Rate for Payer: Healthscope Commercial |
$163.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$299.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$476.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$320.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$510.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$578.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$363.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$510.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$320.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.19
|
| Rate for Payer: PHP Commercial |
$154.35
|
| Rate for Payer: PHP Commercial |
$363.52
|
| Rate for Payer: PHP Commercial |
$336.75
|
| Rate for Payer: PHP Commercial |
$578.07
|
| Rate for Payer: Priority Health SBD |
$428.45
|
| Rate for Payer: Priority Health SBD |
$114.40
|
| Rate for Payer: Priority Health SBD |
$269.43
|
| Rate for Payer: Priority Health SBD |
$249.59
|
| Rate for Payer: UMR Bronson Commercial |
$174.32
|
| Rate for Payer: UMR Bronson Commercial |
$188.17
|
| Rate for Payer: UMR Bronson Commercial |
$79.90
|
| Rate for Payer: UMR Bronson Commercial |
$299.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$320.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$510.06
|
|
|
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$224.81
|
|
|
Service Code
|
HCPCS J0883
|
| Hospital Charge Code |
152708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$98.92 |
| Max. Negotiated Rate |
$202.33 |
| Rate for Payer: Aetna American Axle |
$146.13
|
| Rate for Payer: Aetna American Axle |
$281.24
|
| Rate for Payer: Aetna American Axle |
$278.82
|
| Rate for Payer: Aetna Commercial |
$364.62
|
| Rate for Payer: Aetna Commercial |
$191.09
|
| Rate for Payer: Aetna Commercial |
$367.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$281.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.82
|
| Rate for Payer: Cash Price |
$343.17
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Cash Price |
$346.14
|
| Rate for Payer: Cofinity Advantage |
$302.88
|
| Rate for Payer: Cofinity Advantage |
$157.37
|
| Rate for Payer: Cofinity Advantage |
$300.27
|
| Rate for Payer: Cofinity Commercial |
$372.10
|
| Rate for Payer: Cofinity Commercial |
$193.34
|
| Rate for Payer: Cofinity Commercial |
$368.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$346.14
|
| Rate for Payer: Healthscope Commercial |
$386.06
|
| Rate for Payer: Healthscope Commercial |
$389.41
|
| Rate for Payer: Healthscope Commercial |
$202.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$302.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$324.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$321.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$324.51
|
| Rate for Payer: PHP Commercial |
$364.62
|
| Rate for Payer: PHP Commercial |
$191.09
|
| Rate for Payer: PHP Commercial |
$367.78
|
| Rate for Payer: Priority Health SBD |
$141.63
|
| Rate for Payer: Priority Health SBD |
$270.24
|
| Rate for Payer: Priority Health SBD |
$272.59
|
| Rate for Payer: UMR Bronson Commercial |
$98.92
|
| Rate for Payer: UMR Bronson Commercial |
$190.38
|
| Rate for Payer: UMR Bronson Commercial |
$188.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$324.51
|
|
|
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$331.76
|
|
|
Service Code
|
HCPCS J0898
|
| Hospital Charge Code |
152708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.39 |
| Max. Negotiated Rate |
$298.58 |
| Rate for Payer: Aetna American Axle |
$215.64
|
| Rate for Payer: Aetna Commercial |
$282.00
|
| Rate for Payer: Aetna Medicare |
$165.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.64
|
| Rate for Payer: BCBS Complete |
$132.70
|
| Rate for Payer: BCBS Trust/PPO |
$4.71
|
| Rate for Payer: BCN Commercial |
$4.71
|
| Rate for Payer: Cash Price |
$265.41
|
| Rate for Payer: Cash Price |
$265.41
|
| Rate for Payer: Cofinity Advantage |
$232.23
|
| Rate for Payer: Cofinity Commercial |
$285.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.41
|
| Rate for Payer: Healthscope Commercial |
$298.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$232.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$265.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.82
|
| Rate for Payer: PHP Commercial |
$282.00
|
| Rate for Payer: Priority Health SBD |
$209.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.39
|
| Rate for Payer: UHC Core |
$2.39
|
| Rate for Payer: UHC Exchange |
$2.39
|
| Rate for Payer: UMR Bronson Commercial |
$122.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.82
|
|
|
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$432.68
|
|
|
Service Code
|
HCPCS J0883
|
| Hospital Charge Code |
152708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.53 |
| Max. Negotiated Rate |
$389.41 |
| Rate for Payer: Aetna American Axle |
$281.24
|
| Rate for Payer: Aetna American Axle |
$146.13
|
| Rate for Payer: Aetna American Axle |
$278.82
|
| Rate for Payer: Aetna Commercial |
$367.78
|
| Rate for Payer: Aetna Commercial |
$364.62
|
| Rate for Payer: Aetna Commercial |
$191.09
|
| Rate for Payer: Aetna Medicare |
$1.05
|
| Rate for Payer: Aetna Medicare |
$1.05
|
| Rate for Payer: Aetna Medicare |
$1.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$281.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.26
|
| Rate for Payer: BCBS Complete |
$0.55
|
| Rate for Payer: BCBS Complete |
$0.55
|
| Rate for Payer: BCBS Complete |
$0.55
|
| Rate for Payer: BCBS MAPPO |
$1.01
|
| Rate for Payer: BCBS MAPPO |
$1.01
|
| Rate for Payer: BCBS MAPPO |
$1.01
|
| Rate for Payer: BCBS Trust/PPO |
$1.97
|
| Rate for Payer: BCBS Trust/PPO |
$1.97
|
| Rate for Payer: BCBS Trust/PPO |
$1.97
|
| Rate for Payer: BCN Commercial |
$1.97
|
| Rate for Payer: BCN Commercial |
$1.97
|
| Rate for Payer: BCN Commercial |
$1.97
|
| Rate for Payer: BCN Medicare Advantage |
$1.01
|
| Rate for Payer: BCN Medicare Advantage |
$1.01
|
| Rate for Payer: BCN Medicare Advantage |
$1.01
|
| Rate for Payer: Cash Price |
$343.17
|
| Rate for Payer: Cash Price |
$346.14
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Cash Price |
$346.14
|
| Rate for Payer: Cash Price |
$343.17
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Cofinity Advantage |
$157.37
|
| Rate for Payer: Cofinity Advantage |
$300.27
|
| Rate for Payer: Cofinity Advantage |
$302.88
|
| Rate for Payer: Cofinity Commercial |
$368.91
|
| Rate for Payer: Cofinity Commercial |
$372.10
|
| Rate for Payer: Cofinity Commercial |
$193.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$346.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.01
|
| Rate for Payer: Healthscope Commercial |
$202.33
|
| Rate for Payer: Healthscope Commercial |
$386.06
|
| Rate for Payer: Healthscope Commercial |
$389.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$302.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$324.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.61
|
| Rate for Payer: Mclaren Medicaid |
$1.01
|
| Rate for Payer: Mclaren Medicaid |
$1.01
|
| Rate for Payer: Mclaren Medicaid |
$1.01
|
| Rate for Payer: Mclaren Medicare |
$1.01
|
| Rate for Payer: Mclaren Medicare |
$1.01
|
| Rate for Payer: Mclaren Medicare |
$1.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.06
|
| Rate for Payer: Meridian Medicaid |
$1.06
|
| Rate for Payer: Meridian Medicaid |
$1.06
|
| Rate for Payer: Meridian Medicaid |
$1.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.78
|
| Rate for Payer: Nomi Health Commercial |
$3.03
|
| Rate for Payer: Nomi Health Commercial |
$3.03
|
| Rate for Payer: Nomi Health Commercial |
$3.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$321.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$324.51
|
| Rate for Payer: PACE Medicare |
$0.96
|
| Rate for Payer: PACE Medicare |
$0.96
|
| Rate for Payer: PACE Medicare |
$0.96
|
| Rate for Payer: PACE SWMI |
$1.01
|
| Rate for Payer: PACE SWMI |
$1.01
|
| Rate for Payer: PACE SWMI |
$1.01
|
| Rate for Payer: PHP Commercial |
$367.78
|
| Rate for Payer: PHP Commercial |
$191.09
|
| Rate for Payer: PHP Commercial |
$364.62
|
| Rate for Payer: PHP Medicare Advantage |
$1.01
|
| Rate for Payer: PHP Medicare Advantage |
$1.01
|
| Rate for Payer: PHP Medicare Advantage |
$1.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.51
|
| Rate for Payer: Priority Health Medicare |
$1.01
|
| Rate for Payer: Priority Health Medicare |
$1.01
|
| Rate for Payer: Priority Health Medicare |
$1.01
|
| Rate for Payer: Priority Health SBD |
$272.59
|
| Rate for Payer: Priority Health SBD |
$270.24
|
| Rate for Payer: Priority Health SBD |
$141.63
|
| Rate for Payer: Priority Health Tiered Network |
$2.01
|
| Rate for Payer: Priority Health Tiered Network |
$2.01
|
| Rate for Payer: Priority Health Tiered Network |
$2.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.01
|
| Rate for Payer: UHC Core |
$1.01
|
| Rate for Payer: UHC Core |
$1.01
|
| Rate for Payer: UHC Core |
$1.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.01
|
| Rate for Payer: UHC Exchange |
$1.01
|
| Rate for Payer: UHC Exchange |
$1.01
|
| Rate for Payer: UHC Exchange |
$1.01
|
| Rate for Payer: UHC Medicaid |
$0.53
|
| Rate for Payer: UHC Medicaid |
$0.53
|
| Rate for Payer: UHC Medicaid |
$0.53
|
| Rate for Payer: UHCCP Medicaid |
$0.53
|
| Rate for Payer: UHCCP Medicaid |
$0.53
|
| Rate for Payer: UHCCP Medicaid |
$0.53
|
| Rate for Payer: UMR Bronson Commercial |
$158.72
|
| Rate for Payer: UMR Bronson Commercial |
$83.18
|
| Rate for Payer: UMR Bronson Commercial |
$160.09
|
| Rate for Payer: VA VA |
$1.01
|
| Rate for Payer: VA VA |
$1.01
|
| Rate for Payer: VA VA |
$1.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$324.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.72
|
|
|
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$442.43
|
|
|
Service Code
|
HCPCS J0891
|
| Hospital Charge Code |
152708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.95 |
| Max. Negotiated Rate |
$398.19 |
| Rate for Payer: Aetna American Axle |
$287.58
|
| Rate for Payer: Aetna Commercial |
$376.07
|
| Rate for Payer: Aetna Medicare |
$1.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.27
|
| Rate for Payer: BCBS Complete |
$1.00
|
| Rate for Payer: BCBS MAPPO |
$1.82
|
| Rate for Payer: BCBS Trust/PPO |
$5.82
|
| Rate for Payer: BCN Commercial |
$5.82
|
| Rate for Payer: BCN Medicare Advantage |
$1.82
|
| Rate for Payer: Cash Price |
$353.94
|
| Rate for Payer: Cash Price |
$353.94
|
| Rate for Payer: Cofinity Advantage |
$309.70
|
| Rate for Payer: Cofinity Commercial |
$380.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.82
|
| Rate for Payer: Healthscope Commercial |
$398.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$309.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$331.82
|
| Rate for Payer: Mclaren Medicaid |
$1.82
|
| Rate for Payer: Mclaren Medicare |
$1.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.91
|
| Rate for Payer: Meridian Medicaid |
$1.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.07
|
| Rate for Payer: Nomi Health Commercial |
$5.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.82
|
| Rate for Payer: PACE Medicare |
$1.73
|
| Rate for Payer: PACE SWMI |
$1.82
|
| Rate for Payer: PHP Commercial |
$376.07
|
| Rate for Payer: PHP Medicare Advantage |
$1.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.74
|
| Rate for Payer: Priority Health Medicare |
$1.82
|
| Rate for Payer: Priority Health SBD |
$278.73
|
| Rate for Payer: Priority Health Tiered Network |
$4.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.00
|
| Rate for Payer: UHC Core |
$3.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.82
|
| Rate for Payer: UHC Exchange |
$3.00
|
| Rate for Payer: UHC Medicaid |
$0.95
|
| Rate for Payer: UHCCP Medicaid |
$0.95
|
| Rate for Payer: UMR Bronson Commercial |
$163.70
|
| Rate for Payer: VA VA |
$1.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$331.82
|
|
|
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$331.76
|
|
|
Service Code
|
HCPCS J0898
|
| Hospital Charge Code |
152708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$145.97 |
| Max. Negotiated Rate |
$298.58 |
| Rate for Payer: Aetna American Axle |
$215.64
|
| Rate for Payer: Aetna Commercial |
$282.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.64
|
| Rate for Payer: Cash Price |
$265.41
|
| Rate for Payer: Cofinity Advantage |
$232.23
|
| Rate for Payer: Cofinity Commercial |
$285.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.41
|
| Rate for Payer: Healthscope Commercial |
$298.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$232.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.82
|
| Rate for Payer: PHP Commercial |
$282.00
|
| Rate for Payer: Priority Health SBD |
$209.01
|
| Rate for Payer: UMR Bronson Commercial |
$145.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.82
|
|
|
ARGATROBAN 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$442.43
|
|
|
Service Code
|
HCPCS J0891
|
| Hospital Charge Code |
152708
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$194.67 |
| Max. Negotiated Rate |
$398.19 |
| Rate for Payer: Aetna American Axle |
$287.58
|
| Rate for Payer: Aetna Commercial |
$376.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.58
|
| Rate for Payer: Cash Price |
$353.94
|
| Rate for Payer: Cofinity Advantage |
$309.70
|
| Rate for Payer: Cofinity Commercial |
$380.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.94
|
| Rate for Payer: Healthscope Commercial |
$398.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$309.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$331.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.82
|
| Rate for Payer: PHP Commercial |
$376.07
|
| Rate for Payer: Priority Health SBD |
$278.73
|
| Rate for Payer: UMR Bronson Commercial |
$194.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$331.82
|
|
|
ARGININE HCL (L-ARGININE) 10 % INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$180.96
|
|
|
Service Code
|
NDC 00009043601
|
| Hospital Charge Code |
9123
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$66.96 |
| Max. Negotiated Rate |
$162.86 |
| Rate for Payer: Aetna American Axle |
$117.62
|
| Rate for Payer: Aetna Commercial |
$153.82
|
| Rate for Payer: Aetna Medicare |
$90.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.62
|
| Rate for Payer: BCBS Complete |
$72.38
|
| Rate for Payer: Cash Price |
$144.77
|
| Rate for Payer: Cofinity Advantage |
$126.67
|
| Rate for Payer: Cofinity Commercial |
$155.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.77
|
| Rate for Payer: Healthscope Commercial |
$162.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.72
|
| Rate for Payer: PHP Commercial |
$153.82
|
| Rate for Payer: Priority Health SBD |
$114.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.62
|
| Rate for Payer: UHC Core |
$94.28
|
| Rate for Payer: UHC Exchange |
$71.12
|
| Rate for Payer: UMR Bronson Commercial |
$66.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.72
|
|
|
ARGININE HCL (L-ARGININE) 10 % INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$180.96
|
|
|
Service Code
|
NDC 00009043601
|
| Hospital Charge Code |
9123
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$79.62 |
| Max. Negotiated Rate |
$162.86 |
| Rate for Payer: Aetna American Axle |
$117.62
|
| Rate for Payer: Aetna Commercial |
$153.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.62
|
| Rate for Payer: Cash Price |
$144.77
|
| Rate for Payer: Cofinity Advantage |
$126.67
|
| Rate for Payer: Cofinity Commercial |
$155.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.77
|
| Rate for Payer: Healthscope Commercial |
$162.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.72
|
| Rate for Payer: PHP Commercial |
$153.82
|
| Rate for Payer: Priority Health SBD |
$114.00
|
| Rate for Payer: UMR Bronson Commercial |
$79.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.72
|
|
|
ARIPIPRAZOLE 15 MG TABLET
|
Facility
|
OP
|
$64.13
|
|
|
Service Code
|
NDC 67877043303
|
| Hospital Charge Code |
34370
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$23.73 |
| Max. Negotiated Rate |
$57.72 |
| Rate for Payer: Aetna American Axle |
$41.68
|
| Rate for Payer: Aetna Commercial |
$54.51
|
| Rate for Payer: Aetna Medicare |
$32.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.68
|
| Rate for Payer: BCBS Complete |
$25.65
|
| Rate for Payer: Cash Price |
$51.30
|
| Rate for Payer: Cofinity Advantage |
$44.89
|
| Rate for Payer: Cofinity Commercial |
$55.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.30
|
| Rate for Payer: Healthscope Commercial |
$57.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.10
|
| Rate for Payer: PHP Commercial |
$54.51
|
| Rate for Payer: Priority Health SBD |
$40.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.68
|
| Rate for Payer: UHC Core |
$33.41
|
| Rate for Payer: UHC Exchange |
$25.20
|
| Rate for Payer: UMR Bronson Commercial |
$23.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.10
|
|
|
ARIPIPRAZOLE 15 MG TABLET
|
Facility
|
IP
|
$2,008.88
|
|
|
Service Code
|
NDC 59148000913
|
| Hospital Charge Code |
34370
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$883.91 |
| Max. Negotiated Rate |
$1,807.99 |
| Rate for Payer: Aetna American Axle |
$1,305.77
|
| Rate for Payer: Aetna Commercial |
$1,707.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,305.77
|
| Rate for Payer: Cash Price |
$1,607.10
|
| Rate for Payer: Cofinity Advantage |
$1,406.22
|
| Rate for Payer: Cofinity Commercial |
$1,727.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,607.10
|
| Rate for Payer: Healthscope Commercial |
$1,807.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,406.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,506.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,707.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,506.66
|
| Rate for Payer: PHP Commercial |
$1,707.55
|
| Rate for Payer: Priority Health SBD |
$1,265.59
|
| Rate for Payer: UMR Bronson Commercial |
$883.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,506.66
|
|
|
ARIPIPRAZOLE 15 MG TABLET
|
Facility
|
IP
|
$64.13
|
|
|
Service Code
|
NDC 67877043303
|
| Hospital Charge Code |
34370
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$28.22 |
| Max. Negotiated Rate |
$57.72 |
| Rate for Payer: Aetna American Axle |
$41.68
|
| Rate for Payer: Aetna Commercial |
$54.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.68
|
| Rate for Payer: Cash Price |
$51.30
|
| Rate for Payer: Cofinity Advantage |
$44.89
|
| Rate for Payer: Cofinity Commercial |
$55.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.30
|
| Rate for Payer: Healthscope Commercial |
$57.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.10
|
| Rate for Payer: PHP Commercial |
$54.51
|
| Rate for Payer: Priority Health SBD |
$40.40
|
| Rate for Payer: UMR Bronson Commercial |
$28.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.10
|
|
|
ARIPIPRAZOLE 15 MG TABLET
|
Facility
|
OP
|
$2,008.88
|
|
|
Service Code
|
NDC 59148000913
|
| Hospital Charge Code |
34370
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$743.29 |
| Max. Negotiated Rate |
$1,807.99 |
| Rate for Payer: Aetna American Axle |
$1,305.77
|
| Rate for Payer: Aetna Commercial |
$1,707.55
|
| Rate for Payer: Aetna Medicare |
$1,004.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,305.77
|
| Rate for Payer: BCBS Complete |
$803.55
|
| Rate for Payer: Cash Price |
$1,607.10
|
| Rate for Payer: Cofinity Advantage |
$1,406.22
|
| Rate for Payer: Cofinity Commercial |
$1,727.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,607.10
|
| Rate for Payer: Healthscope Commercial |
$1,807.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,406.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,506.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,607.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,707.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,506.66
|
| Rate for Payer: PHP Commercial |
$1,707.55
|
| Rate for Payer: Priority Health SBD |
$1,265.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,305.77
|
| Rate for Payer: UHC Core |
$1,046.63
|
| Rate for Payer: UHC Exchange |
$789.49
|
| Rate for Payer: UMR Bronson Commercial |
$743.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,506.66
|
|
|
ARIPIPRAZOLE 15 MG TABLET
|
Facility
|
OP
|
$57.57
|
|
|
Service Code
|
NDC 65162089903
|
| Hospital Charge Code |
34370
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$51.81 |
| Rate for Payer: Aetna American Axle |
$37.42
|
| Rate for Payer: Aetna Commercial |
$48.93
|
| Rate for Payer: Aetna Medicare |
$28.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.42
|
| Rate for Payer: BCBS Complete |
$23.03
|
| Rate for Payer: Cash Price |
$46.06
|
| Rate for Payer: Cofinity Advantage |
$40.30
|
| Rate for Payer: Cofinity Commercial |
$49.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.06
|
| Rate for Payer: Healthscope Commercial |
$51.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.18
|
| Rate for Payer: PHP Commercial |
$48.93
|
| Rate for Payer: Priority Health SBD |
$36.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.42
|
| Rate for Payer: UHC Core |
$29.99
|
| Rate for Payer: UHC Exchange |
$22.63
|
| Rate for Payer: UMR Bronson Commercial |
$21.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.18
|
|
|
ARIPIPRAZOLE 15 MG TABLET
|
Facility
|
OP
|
$93.75
|
|
|
Service Code
|
NDC 27241005403
|
| Hospital Charge Code |
34370
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$34.69 |
| Max. Negotiated Rate |
$84.38 |
| Rate for Payer: Aetna American Axle |
$60.94
|
| Rate for Payer: Aetna Commercial |
$79.69
|
| Rate for Payer: Aetna Medicare |
$46.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.94
|
| Rate for Payer: BCBS Complete |
$37.50
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cofinity Advantage |
$65.62
|
| Rate for Payer: Cofinity Commercial |
$80.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.00
|
| Rate for Payer: Healthscope Commercial |
$84.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.31
|
| Rate for Payer: PHP Commercial |
$79.69
|
| Rate for Payer: Priority Health SBD |
$59.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.94
|
| Rate for Payer: UHC Core |
$48.84
|
| Rate for Payer: UHC Exchange |
$36.84
|
| Rate for Payer: UMR Bronson Commercial |
$34.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.31
|
|
|
ARIPIPRAZOLE 15 MG TABLET
|
Facility
|
OP
|
$93.75
|
|
|
Service Code
|
NDC 43598096830
|
| Hospital Charge Code |
34370
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$34.69 |
| Max. Negotiated Rate |
$84.38 |
| Rate for Payer: Aetna American Axle |
$60.94
|
| Rate for Payer: Aetna Commercial |
$79.69
|
| Rate for Payer: Aetna Medicare |
$46.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.94
|
| Rate for Payer: BCBS Complete |
$37.50
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cofinity Advantage |
$65.62
|
| Rate for Payer: Cofinity Commercial |
$80.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.00
|
| Rate for Payer: Healthscope Commercial |
$84.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.31
|
| Rate for Payer: PHP Commercial |
$79.69
|
| Rate for Payer: Priority Health SBD |
$59.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.94
|
| Rate for Payer: UHC Core |
$48.84
|
| Rate for Payer: UHC Exchange |
$36.84
|
| Rate for Payer: UMR Bronson Commercial |
$34.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.31
|
|
|
ARIPIPRAZOLE 15 MG TABLET
|
Facility
|
OP
|
$199.16
|
|
|
Service Code
|
NDC 60505267503
|
| Hospital Charge Code |
34370
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$73.69 |
| Max. Negotiated Rate |
$179.24 |
| Rate for Payer: Aetna American Axle |
$129.45
|
| Rate for Payer: Aetna Commercial |
$169.29
|
| Rate for Payer: Aetna Medicare |
$99.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.45
|
| Rate for Payer: BCBS Complete |
$79.66
|
| Rate for Payer: Cash Price |
$159.33
|
| Rate for Payer: Cofinity Advantage |
$139.41
|
| Rate for Payer: Cofinity Commercial |
$171.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.33
|
| Rate for Payer: Healthscope Commercial |
$179.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.37
|
| Rate for Payer: PHP Commercial |
$169.29
|
| Rate for Payer: Priority Health SBD |
$125.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.45
|
| Rate for Payer: UHC Core |
$103.76
|
| Rate for Payer: UHC Exchange |
$78.27
|
| Rate for Payer: UMR Bronson Commercial |
$73.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.37
|
|
|
ARIPIPRAZOLE 15 MG TABLET
|
Facility
|
IP
|
$93.75
|
|
|
Service Code
|
NDC 43598096830
|
| Hospital Charge Code |
34370
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$41.25 |
| Max. Negotiated Rate |
$84.38 |
| Rate for Payer: Aetna American Axle |
$60.94
|
| Rate for Payer: Aetna Commercial |
$79.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.94
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cofinity Advantage |
$65.62
|
| Rate for Payer: Cofinity Commercial |
$80.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.00
|
| Rate for Payer: Healthscope Commercial |
$84.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.31
|
| Rate for Payer: PHP Commercial |
$79.69
|
| Rate for Payer: Priority Health SBD |
$59.06
|
| Rate for Payer: UMR Bronson Commercial |
$41.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.31
|
|
|
ARIPIPRAZOLE 15 MG TABLET
|
Facility
|
IP
|
$57.57
|
|
|
Service Code
|
NDC 65162089903
|
| Hospital Charge Code |
34370
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$25.33 |
| Max. Negotiated Rate |
$51.81 |
| Rate for Payer: Aetna American Axle |
$37.42
|
| Rate for Payer: Aetna Commercial |
$48.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.42
|
| Rate for Payer: Cash Price |
$46.06
|
| Rate for Payer: Cofinity Advantage |
$40.30
|
| Rate for Payer: Cofinity Commercial |
$49.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.06
|
| Rate for Payer: Healthscope Commercial |
$51.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.18
|
| Rate for Payer: PHP Commercial |
$48.93
|
| Rate for Payer: Priority Health SBD |
$36.27
|
| Rate for Payer: UMR Bronson Commercial |
$25.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.18
|
|
|
ARIPIPRAZOLE 15 MG TABLET
|
Facility
|
IP
|
$199.16
|
|
|
Service Code
|
NDC 60505267503
|
| Hospital Charge Code |
34370
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$87.63 |
| Max. Negotiated Rate |
$179.24 |
| Rate for Payer: Aetna American Axle |
$129.45
|
| Rate for Payer: Aetna Commercial |
$169.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.45
|
| Rate for Payer: Cash Price |
$159.33
|
| Rate for Payer: Cofinity Advantage |
$139.41
|
| Rate for Payer: Cofinity Commercial |
$171.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.33
|
| Rate for Payer: Healthscope Commercial |
$179.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.37
|
| Rate for Payer: PHP Commercial |
$169.29
|
| Rate for Payer: Priority Health SBD |
$125.47
|
| Rate for Payer: UMR Bronson Commercial |
$87.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.37
|
|
|
ARIPIPRAZOLE 15 MG TABLET
|
Facility
|
IP
|
$93.75
|
|
|
Service Code
|
NDC 27241005403
|
| Hospital Charge Code |
34370
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$41.25 |
| Max. Negotiated Rate |
$84.38 |
| Rate for Payer: Aetna American Axle |
$60.94
|
| Rate for Payer: Aetna Commercial |
$79.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.94
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cofinity Advantage |
$65.62
|
| Rate for Payer: Cofinity Commercial |
$80.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.00
|
| Rate for Payer: Healthscope Commercial |
$84.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.31
|
| Rate for Payer: PHP Commercial |
$79.69
|
| Rate for Payer: Priority Health SBD |
$59.06
|
| Rate for Payer: UMR Bronson Commercial |
$41.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.31
|
|
|
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$437.76
|
|
|
Service Code
|
NDC 72888010020
|
| Hospital Charge Code |
40446
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$192.61 |
| Max. Negotiated Rate |
$393.98 |
| Rate for Payer: Aetna American Axle |
$284.54
|
| Rate for Payer: Aetna Commercial |
$372.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.54
|
| Rate for Payer: Cash Price |
$350.21
|
| Rate for Payer: Cofinity Advantage |
$306.43
|
| Rate for Payer: Cofinity Commercial |
$376.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.21
|
| Rate for Payer: Healthscope Commercial |
$393.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$306.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$328.32
|
| Rate for Payer: PHP Commercial |
$372.10
|
| Rate for Payer: Priority Health SBD |
$275.79
|
| Rate for Payer: UMR Bronson Commercial |
$192.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.32
|
|
|
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION
|
Facility
|
IP
|
$669.60
|
|
|
Service Code
|
NDC 66689073505
|
| Hospital Charge Code |
40446
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$294.62 |
| Max. Negotiated Rate |
$602.64 |
| Rate for Payer: Aetna American Axle |
$435.24
|
| Rate for Payer: Aetna Commercial |
$569.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$435.24
|
| Rate for Payer: Cash Price |
$535.68
|
| Rate for Payer: Cofinity Advantage |
$468.72
|
| Rate for Payer: Cofinity Commercial |
$575.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$535.68
|
| Rate for Payer: Healthscope Commercial |
$602.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$468.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$502.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$569.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$502.20
|
| Rate for Payer: PHP Commercial |
$569.16
|
| Rate for Payer: Priority Health SBD |
$421.85
|
| Rate for Payer: UMR Bronson Commercial |
$294.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$502.20
|
|
|
ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION
|
Facility
|
OP
|
$437.76
|
|
|
Service Code
|
NDC 72888010020
|
| Hospital Charge Code |
40446
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$161.97 |
| Max. Negotiated Rate |
$393.98 |
| Rate for Payer: Aetna American Axle |
$284.54
|
| Rate for Payer: Aetna Commercial |
$372.10
|
| Rate for Payer: Aetna Medicare |
$218.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.54
|
| Rate for Payer: BCBS Complete |
$175.10
|
| Rate for Payer: Cash Price |
$350.21
|
| Rate for Payer: Cofinity Advantage |
$306.43
|
| Rate for Payer: Cofinity Commercial |
$376.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.21
|
| Rate for Payer: Healthscope Commercial |
$393.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$306.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$328.32
|
| Rate for Payer: PHP Commercial |
$372.10
|
| Rate for Payer: Priority Health SBD |
$275.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$284.54
|
| Rate for Payer: UHC Core |
$228.07
|
| Rate for Payer: UHC Exchange |
$172.04
|
| Rate for Payer: UMR Bronson Commercial |
$161.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.32
|
|
