|
BISACODYL 5 MG TABLET,DELAYED RELEASE
|
Facility
|
IP
|
$12.93
|
|
|
Service Code
|
NDC 5084460756
|
| Hospital Charge Code |
1079
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.69 |
| Max. Negotiated Rate |
$11.64 |
| Rate for Payer: Aetna American Axle |
$8.40
|
| Rate for Payer: Aetna Commercial |
$10.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.40
|
| Rate for Payer: Cash Price |
$10.34
|
| Rate for Payer: Cofinity Commercial |
$11.12
|
| Rate for Payer: Cofinity Commercial |
$9.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.34
|
| Rate for Payer: Healthscope Commercial |
$11.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.99
|
| Rate for Payer: PHP Commercial |
$10.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.05
|
| Rate for Payer: Priority Health SBD |
$8.15
|
| Rate for Payer: UMR Bronson Commercial |
$5.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.70
|
|
|
BISACODYL 5 MG TABLET,DELAYED RELEASE
|
Facility
|
IP
|
$0.59
|
|
|
Service Code
|
NDC 9900-0019-26
|
| Hospital Charge Code |
1079
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.26 |
| Max. Negotiated Rate |
$0.53 |
| Rate for Payer: Aetna American Axle |
$0.38
|
| Rate for Payer: Aetna Commercial |
$0.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.38
|
| Rate for Payer: Cash Price |
$0.47
|
| Rate for Payer: Cofinity Commercial |
$0.41
|
| Rate for Payer: Cofinity Commercial |
$0.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.47
|
| Rate for Payer: Healthscope Commercial |
$0.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.50
|
| Rate for Payer: PHP Commercial |
$0.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.41
|
| Rate for Payer: Priority Health SBD |
$0.37
|
| Rate for Payer: UMR Bronson Commercial |
$0.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.44
|
|
|
BISACODYL 5 MG TABLET,DELAYED RELEASE
|
Facility
|
IP
|
$5.88
|
|
|
Service Code
|
NDC 0904-6407-61
|
| Hospital Charge Code |
1079
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$5.29 |
| Rate for Payer: Aetna American Axle |
$3.82
|
| Rate for Payer: Aetna Commercial |
$5.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.82
|
| Rate for Payer: Cash Price |
$4.70
|
| Rate for Payer: Cofinity Commercial |
$4.12
|
| Rate for Payer: Cofinity Commercial |
$5.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.70
|
| Rate for Payer: Healthscope Commercial |
$5.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5.00
|
| Rate for Payer: PHP Commercial |
$5.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.12
|
| Rate for Payer: Priority Health SBD |
$3.70
|
| Rate for Payer: UMR Bronson Commercial |
$2.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.41
|
|
|
BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSPENSION
|
Facility
|
IP
|
$21.24
|
|
|
Service Code
|
NDC 149003956
|
| Hospital Charge Code |
1090
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$19.12 |
| Rate for Payer: Aetna American Axle |
$13.81
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.81
|
| Rate for Payer: Cash Price |
$16.99
|
| Rate for Payer: Cofinity Commercial |
$14.87
|
| Rate for Payer: Cofinity Commercial |
$18.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.99
|
| Rate for Payer: Healthscope Commercial |
$19.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.05
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.87
|
| Rate for Payer: Priority Health SBD |
$13.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.93
|
|
|
BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSPENSION
|
Facility
|
IP
|
$29.74
|
|
|
Service Code
|
NDC 0904-1313-09
|
| Hospital Charge Code |
1090
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.09 |
| Max. Negotiated Rate |
$26.77 |
| Rate for Payer: Aetna American Axle |
$19.33
|
| Rate for Payer: Aetna Commercial |
$25.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.33
|
| Rate for Payer: Cash Price |
$23.79
|
| Rate for Payer: Cofinity Commercial |
$20.82
|
| Rate for Payer: Cofinity Commercial |
$25.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.79
|
| Rate for Payer: Healthscope Commercial |
$26.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.28
|
| Rate for Payer: PHP Commercial |
$25.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.82
|
| Rate for Payer: Priority Health SBD |
$18.74
|
| Rate for Payer: UMR Bronson Commercial |
$13.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.30
|
|
|
BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSPENSION
|
Facility
|
IP
|
$21.33
|
|
|
Service Code
|
NDC 149003908
|
| Hospital Charge Code |
1090
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.39 |
| Max. Negotiated Rate |
$19.20 |
| Rate for Payer: Aetna American Axle |
$13.86
|
| Rate for Payer: Aetna Commercial |
$18.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.86
|
| Rate for Payer: Cash Price |
$17.06
|
| Rate for Payer: Cofinity Commercial |
$14.93
|
| Rate for Payer: Cofinity Commercial |
$18.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.06
|
| Rate for Payer: Healthscope Commercial |
$19.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.13
|
| Rate for Payer: PHP Commercial |
$18.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.93
|
| Rate for Payer: Priority Health SBD |
$13.44
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.00
|
|
|
BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSPENSION
|
Facility
|
IP
|
$10.67
|
|
|
Service Code
|
NDC 0536-1286-36
|
| Hospital Charge Code |
1090
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.69 |
| Max. Negotiated Rate |
$9.60 |
| Rate for Payer: Aetna American Axle |
$6.94
|
| Rate for Payer: Aetna Commercial |
$9.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.94
|
| Rate for Payer: Cash Price |
$8.54
|
| Rate for Payer: Cofinity Commercial |
$7.47
|
| Rate for Payer: Cofinity Commercial |
$9.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.54
|
| Rate for Payer: Healthscope Commercial |
$9.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.07
|
| Rate for Payer: PHP Commercial |
$9.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.47
|
| Rate for Payer: Priority Health SBD |
$6.72
|
| Rate for Payer: UMR Bronson Commercial |
$4.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.00
|
|
|
BISOPROLOL 10 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET
|
Facility
|
IP
|
$326.80
|
|
|
Service Code
|
NDC 0378-0505-01
|
| Hospital Charge Code |
18289
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$143.79 |
| Max. Negotiated Rate |
$294.12 |
| Rate for Payer: Aetna American Axle |
$212.42
|
| Rate for Payer: Aetna Commercial |
$277.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.42
|
| Rate for Payer: Cash Price |
$261.44
|
| Rate for Payer: Cofinity Commercial |
$228.76
|
| Rate for Payer: Cofinity Commercial |
$281.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.44
|
| Rate for Payer: Healthscope Commercial |
$294.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$228.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$245.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$277.78
|
| Rate for Payer: PHP Commercial |
$277.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.76
|
| Rate for Payer: Priority Health SBD |
$205.88
|
| Rate for Payer: UMR Bronson Commercial |
$143.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$245.10
|
|
|
BISOPROLOL 10 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET
|
Facility
|
IP
|
$90.29
|
|
|
Service Code
|
NDC 0093-3243-56
|
| Hospital Charge Code |
18289
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.73 |
| Max. Negotiated Rate |
$81.26 |
| Rate for Payer: Aetna American Axle |
$58.69
|
| Rate for Payer: Aetna Commercial |
$76.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.69
|
| Rate for Payer: Cash Price |
$72.23
|
| Rate for Payer: Cofinity Commercial |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$77.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.23
|
| Rate for Payer: Healthscope Commercial |
$81.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.75
|
| Rate for Payer: PHP Commercial |
$76.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.20
|
| Rate for Payer: Priority Health SBD |
$56.88
|
| Rate for Payer: UMR Bronson Commercial |
$39.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.72
|
|
|
BISOPROLOL 10 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET
|
Facility
|
IP
|
$128.25
|
|
|
Service Code
|
NDC 29300-189-13
|
| Hospital Charge Code |
18289
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$56.43 |
| Max. Negotiated Rate |
$115.42 |
| Rate for Payer: Aetna American Axle |
$83.36
|
| Rate for Payer: Aetna Commercial |
$109.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.36
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Cofinity Commercial |
$110.30
|
| Rate for Payer: Cofinity Commercial |
$89.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.60
|
| Rate for Payer: Healthscope Commercial |
$115.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.01
|
| Rate for Payer: PHP Commercial |
$109.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.78
|
| Rate for Payer: Priority Health SBD |
$80.80
|
| Rate for Payer: UMR Bronson Commercial |
$56.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.19
|
|
|
BISOPROLOL 2.5 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET
|
Facility
|
IP
|
$375.25
|
|
|
Service Code
|
NDC 29300-187-01
|
| Hospital Charge Code |
18291
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$165.11 |
| Max. Negotiated Rate |
$337.72 |
| Rate for Payer: Aetna American Axle |
$243.91
|
| Rate for Payer: Aetna Commercial |
$318.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.91
|
| Rate for Payer: Cash Price |
$300.20
|
| Rate for Payer: Cofinity Commercial |
$262.68
|
| Rate for Payer: Cofinity Commercial |
$322.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.20
|
| Rate for Payer: Healthscope Commercial |
$337.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$262.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.96
|
| Rate for Payer: PHP Commercial |
$318.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.68
|
| Rate for Payer: Priority Health SBD |
$236.41
|
| Rate for Payer: UMR Bronson Commercial |
$165.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.44
|
|
|
BISOPROLOL 2.5 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET
|
Facility
|
IP
|
$128.25
|
|
|
Service Code
|
NDC 29300-187-13
|
| Hospital Charge Code |
18291
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$56.43 |
| Max. Negotiated Rate |
$115.42 |
| Rate for Payer: Aetna American Axle |
$83.36
|
| Rate for Payer: Aetna Commercial |
$109.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.36
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Cofinity Commercial |
$110.30
|
| Rate for Payer: Cofinity Commercial |
$89.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.60
|
| Rate for Payer: Healthscope Commercial |
$115.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.01
|
| Rate for Payer: PHP Commercial |
$109.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.78
|
| Rate for Payer: Priority Health SBD |
$80.80
|
| Rate for Payer: UMR Bronson Commercial |
$56.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.19
|
|
|
BISOPROLOL 5 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET
|
Facility
|
IP
|
$375.25
|
|
|
Service Code
|
NDC 29300-188-01
|
| Hospital Charge Code |
18290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$165.11 |
| Max. Negotiated Rate |
$337.72 |
| Rate for Payer: Aetna American Axle |
$243.91
|
| Rate for Payer: Aetna Commercial |
$318.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.91
|
| Rate for Payer: Cash Price |
$300.20
|
| Rate for Payer: Cofinity Commercial |
$262.68
|
| Rate for Payer: Cofinity Commercial |
$322.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.20
|
| Rate for Payer: Healthscope Commercial |
$337.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$262.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.96
|
| Rate for Payer: PHP Commercial |
$318.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.68
|
| Rate for Payer: Priority Health SBD |
$236.41
|
| Rate for Payer: UMR Bronson Commercial |
$165.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.44
|
|
|
BISOPROLOL 5 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET
|
Facility
|
IP
|
$444.15
|
|
|
Service Code
|
NDC 0185-0704-01
|
| Hospital Charge Code |
18290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$195.43 |
| Max. Negotiated Rate |
$399.74 |
| Rate for Payer: Aetna American Axle |
$288.70
|
| Rate for Payer: Aetna Commercial |
$377.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.70
|
| Rate for Payer: Cash Price |
$355.32
|
| Rate for Payer: Cofinity Commercial |
$310.90
|
| Rate for Payer: Cofinity Commercial |
$381.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$355.32
|
| Rate for Payer: Healthscope Commercial |
$399.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$310.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$333.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$377.53
|
| Rate for Payer: PHP Commercial |
$377.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$310.90
|
| Rate for Payer: Priority Health SBD |
$279.81
|
| Rate for Payer: UMR Bronson Commercial |
$195.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$333.11
|
|
|
BISOPROLOL FUMARATE 5 MG TABLET
|
Facility
|
IP
|
$82.80
|
|
|
Service Code
|
NDC 29300-126-13
|
| Hospital Charge Code |
18288
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$36.43 |
| Max. Negotiated Rate |
$74.52 |
| Rate for Payer: Aetna American Axle |
$53.82
|
| Rate for Payer: Aetna Commercial |
$70.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.82
|
| Rate for Payer: Cash Price |
$66.24
|
| Rate for Payer: Cofinity Commercial |
$57.96
|
| Rate for Payer: Cofinity Commercial |
$71.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.24
|
| Rate for Payer: Healthscope Commercial |
$74.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.38
|
| Rate for Payer: PHP Commercial |
$70.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.96
|
| Rate for Payer: Priority Health SBD |
$52.16
|
| Rate for Payer: UMR Bronson Commercial |
$36.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.10
|
|
|
BISOPROLOL FUMARATE 5 MG TABLET
|
Facility
|
IP
|
$77.04
|
|
|
Service Code
|
NDC 52817-270-30
|
| Hospital Charge Code |
18288
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$33.90 |
| Max. Negotiated Rate |
$69.34 |
| Rate for Payer: Aetna American Axle |
$50.08
|
| Rate for Payer: Aetna Commercial |
$65.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.08
|
| Rate for Payer: Cash Price |
$61.63
|
| Rate for Payer: Cofinity Commercial |
$53.93
|
| Rate for Payer: Cofinity Commercial |
$66.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.63
|
| Rate for Payer: Healthscope Commercial |
$69.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.48
|
| Rate for Payer: PHP Commercial |
$65.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.93
|
| Rate for Payer: Priority Health SBD |
$48.54
|
| Rate for Payer: UMR Bronson Commercial |
$33.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.78
|
|
|
BISOPROLOL FUMARATE 5 MG TABLET
|
Facility
|
IP
|
$60.99
|
|
|
Service Code
|
NDC 70954-455-10
|
| Hospital Charge Code |
18288
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$26.84 |
| Max. Negotiated Rate |
$54.89 |
| Rate for Payer: Aetna American Axle |
$39.64
|
| Rate for Payer: Aetna Commercial |
$51.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.64
|
| Rate for Payer: Cash Price |
$48.79
|
| Rate for Payer: Cofinity Commercial |
$42.69
|
| Rate for Payer: Cofinity Commercial |
$52.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.79
|
| Rate for Payer: Healthscope Commercial |
$54.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.84
|
| Rate for Payer: PHP Commercial |
$51.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.69
|
| Rate for Payer: Priority Health SBD |
$38.42
|
| Rate for Payer: UMR Bronson Commercial |
$26.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.74
|
|
|
BIVALIRUDIN 250 MG/50 ML (5 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$186.24
|
|
|
Service Code
|
HCPCS J0583
|
| Hospital Charge Code |
192876
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$81.95 |
| Max. Negotiated Rate |
$167.62 |
| Rate for Payer: Aetna American Axle |
$121.06
|
| Rate for Payer: Aetna American Axle |
$323.97
|
| Rate for Payer: Aetna Commercial |
$158.30
|
| Rate for Payer: Aetna Commercial |
$423.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$323.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.06
|
| Rate for Payer: Cash Price |
$398.74
|
| Rate for Payer: Cash Price |
$148.99
|
| Rate for Payer: Cofinity Commercial |
$428.64
|
| Rate for Payer: Cofinity Commercial |
$160.17
|
| Rate for Payer: Cofinity Commercial |
$130.37
|
| Rate for Payer: Cofinity Commercial |
$348.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.74
|
| Rate for Payer: Healthscope Commercial |
$448.58
|
| Rate for Payer: Healthscope Commercial |
$167.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$348.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$130.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$373.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$423.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$158.30
|
| Rate for Payer: PHP Commercial |
$423.66
|
| Rate for Payer: PHP Commercial |
$158.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.37
|
| Rate for Payer: Priority Health SBD |
$314.00
|
| Rate for Payer: Priority Health SBD |
$117.33
|
| Rate for Payer: UMR Bronson Commercial |
$81.95
|
| Rate for Payer: UMR Bronson Commercial |
$219.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$373.82
|
|
|
BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION
|
Facility
|
IP
|
$192.98
|
|
|
Service Code
|
HCPCS J0583
|
| Hospital Charge Code |
29396
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$84.91 |
| Max. Negotiated Rate |
$173.68 |
| Rate for Payer: Aetna American Axle |
$125.44
|
| Rate for Payer: Aetna American Axle |
$289.87
|
| Rate for Payer: Aetna American Axle |
$118.83
|
| Rate for Payer: Aetna American Axle |
$133.08
|
| Rate for Payer: Aetna American Axle |
$160.95
|
| Rate for Payer: Aetna Commercial |
$164.03
|
| Rate for Payer: Aetna Commercial |
$155.40
|
| Rate for Payer: Aetna Commercial |
$379.06
|
| Rate for Payer: Aetna Commercial |
$210.48
|
| Rate for Payer: Aetna Commercial |
$174.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.87
|
| Rate for Payer: Cash Price |
$146.26
|
| Rate for Payer: Cash Price |
$356.76
|
| Rate for Payer: Cash Price |
$163.79
|
| Rate for Payer: Cash Price |
$198.10
|
| Rate for Payer: Cash Price |
$154.38
|
| Rate for Payer: Cofinity Commercial |
$173.33
|
| Rate for Payer: Cofinity Commercial |
$383.52
|
| Rate for Payer: Cofinity Commercial |
$312.16
|
| Rate for Payer: Cofinity Commercial |
$157.23
|
| Rate for Payer: Cofinity Commercial |
$127.97
|
| Rate for Payer: Cofinity Commercial |
$135.09
|
| Rate for Payer: Cofinity Commercial |
$165.96
|
| Rate for Payer: Cofinity Commercial |
$176.08
|
| Rate for Payer: Cofinity Commercial |
$143.32
|
| Rate for Payer: Cofinity Commercial |
$212.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.79
|
| Rate for Payer: Healthscope Commercial |
$173.68
|
| Rate for Payer: Healthscope Commercial |
$401.36
|
| Rate for Payer: Healthscope Commercial |
$164.54
|
| Rate for Payer: Healthscope Commercial |
$184.27
|
| Rate for Payer: Healthscope Commercial |
$222.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$143.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$137.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$379.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$174.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$210.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$155.40
|
| Rate for Payer: PHP Commercial |
$210.48
|
| Rate for Payer: PHP Commercial |
$164.03
|
| Rate for Payer: PHP Commercial |
$155.40
|
| Rate for Payer: PHP Commercial |
$379.06
|
| Rate for Payer: PHP Commercial |
$174.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.97
|
| Rate for Payer: Priority Health SBD |
$156.00
|
| Rate for Payer: Priority Health SBD |
$115.18
|
| Rate for Payer: Priority Health SBD |
$280.95
|
| Rate for Payer: Priority Health SBD |
$121.58
|
| Rate for Payer: Priority Health SBD |
$128.99
|
| Rate for Payer: UMR Bronson Commercial |
$90.09
|
| Rate for Payer: UMR Bronson Commercial |
$80.44
|
| Rate for Payer: UMR Bronson Commercial |
$84.91
|
| Rate for Payer: UMR Bronson Commercial |
$108.95
|
| Rate for Payer: UMR Bronson Commercial |
$196.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$137.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.46
|
|
|
BLADDER INSTILLATION OF ANTICARCINOGENIC AGENT (INCLUDING RETENTION TIME)
|
Facility
|
OP
|
$1,911.48
|
|
|
Service Code
|
CPT 51720
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$42.24 |
| Max. Negotiated Rate |
$1,911.48 |
| Rate for Payer: Aetna Medicare |
$631.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$759.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$759.00
|
| Rate for Payer: BCBS Complete |
$348.78
|
| Rate for Payer: BCBS MAPPO |
$607.20
|
| Rate for Payer: BCBS Trust/PPO |
$668.74
|
| Rate for Payer: BCN Medicare Advantage |
$607.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.20
|
| Rate for Payer: Mclaren Medicaid |
$332.14
|
| Rate for Payer: Mclaren Medicare |
$607.20
|
| Rate for Payer: Meridian Medicaid |
$348.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$637.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$698.28
|
| Rate for Payer: PACE Medicare |
$576.84
|
| Rate for Payer: PACE SWMI |
$607.20
|
| Rate for Payer: PHP Medicare Advantage |
$607.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,911.48
|
| Rate for Payer: Priority Health Medicare |
$607.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,529.18
|
| Rate for Payer: Railroad Medicare Medicare |
$607.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.46
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$607.20
|
| Rate for Payer: UHC Exchange |
$42.24
|
| Rate for Payer: UHC Medicare Advantage |
$625.42
|
| Rate for Payer: VA VA |
$607.20
|
|
|
BLADDER INSTILLATION OF ANTICARCINOGENIC AGENT (INCLUDING RETENTION TIME)
|
Facility
|
OP
|
$1,911.48
|
|
|
Service Code
|
CPT 51720
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$42.24 |
| Max. Negotiated Rate |
$1,911.48 |
| Rate for Payer: Aetna Medicare |
$631.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$759.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$759.00
|
| Rate for Payer: BCBS Complete |
$348.78
|
| Rate for Payer: BCBS MAPPO |
$607.20
|
| Rate for Payer: BCBS Trust/PPO |
$668.74
|
| Rate for Payer: BCN Medicare Advantage |
$607.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.20
|
| Rate for Payer: Mclaren Medicaid |
$332.14
|
| Rate for Payer: Mclaren Medicare |
$607.20
|
| Rate for Payer: Meridian Medicaid |
$348.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$637.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$698.28
|
| Rate for Payer: PACE Medicare |
$576.84
|
| Rate for Payer: PACE SWMI |
$607.20
|
| Rate for Payer: PHP Medicare Advantage |
$607.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,911.48
|
| Rate for Payer: Priority Health Medicare |
$607.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,529.18
|
| Rate for Payer: Railroad Medicare Medicare |
$607.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.46
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$607.20
|
| Rate for Payer: UHC Exchange |
$42.24
|
| Rate for Payer: UHC Medicare Advantage |
$625.42
|
| Rate for Payer: VA VA |
$607.20
|
|
|
BLADDER IRRIGATION, SIMPLE, LAVAGE AND/OR INSTILLATION
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
CPT 51700
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$29.14 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna Medicare |
$228.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.60
|
| Rate for Payer: BCBS Complete |
$126.18
|
| Rate for Payer: BCBS MAPPO |
$219.68
|
| Rate for Payer: BCBS Trust/PPO |
$229.78
|
| Rate for Payer: BCN Medicare Advantage |
$219.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.68
|
| Rate for Payer: Mclaren Medicaid |
$120.16
|
| Rate for Payer: Mclaren Medicare |
$219.68
|
| Rate for Payer: Meridian Medicaid |
$126.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.63
|
| Rate for Payer: PACE Medicare |
$208.70
|
| Rate for Payer: PACE SWMI |
$219.68
|
| Rate for Payer: PHP Medicare Advantage |
$219.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$691.57
|
| Rate for Payer: Priority Health Medicare |
$219.68
|
| Rate for Payer: Priority Health Narrow Network |
$553.26
|
| Rate for Payer: Railroad Medicare Medicare |
$219.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.05
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.68
|
| Rate for Payer: UHC Exchange |
$29.14
|
| Rate for Payer: UHC Medicare Advantage |
$226.27
|
| Rate for Payer: VA VA |
$219.68
|
|
|
BLADDER IRRIGATION, SIMPLE, LAVAGE AND/OR INSTILLATION
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
CPT 51700
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$29.14 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna Medicare |
$228.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.60
|
| Rate for Payer: BCBS Complete |
$126.18
|
| Rate for Payer: BCBS MAPPO |
$219.68
|
| Rate for Payer: BCBS Trust/PPO |
$229.78
|
| Rate for Payer: BCN Medicare Advantage |
$219.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.68
|
| Rate for Payer: Mclaren Medicaid |
$120.16
|
| Rate for Payer: Mclaren Medicare |
$219.68
|
| Rate for Payer: Meridian Medicaid |
$126.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.63
|
| Rate for Payer: PACE Medicare |
$208.70
|
| Rate for Payer: PACE SWMI |
$219.68
|
| Rate for Payer: PHP Medicare Advantage |
$219.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$691.57
|
| Rate for Payer: Priority Health Medicare |
$219.68
|
| Rate for Payer: Priority Health Narrow Network |
$553.26
|
| Rate for Payer: Railroad Medicare Medicare |
$219.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.05
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.68
|
| Rate for Payer: UHC Exchange |
$29.14
|
| Rate for Payer: UHC Medicare Advantage |
$226.27
|
| Rate for Payer: VA VA |
$219.68
|
|
|
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION
|
Facility
|
IP
|
$284.88
|
|
|
Service Code
|
HCPCS J9040
|
| Hospital Charge Code |
9289
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$125.35 |
| Max. Negotiated Rate |
$256.39 |
| Rate for Payer: Aetna American Axle |
$185.17
|
| Rate for Payer: Aetna American Axle |
$178.29
|
| Rate for Payer: Aetna American Axle |
$319.86
|
| Rate for Payer: Aetna Commercial |
$418.28
|
| Rate for Payer: Aetna Commercial |
$233.15
|
| Rate for Payer: Aetna Commercial |
$242.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$319.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.17
|
| Rate for Payer: Cash Price |
$227.90
|
| Rate for Payer: Cash Price |
$219.43
|
| Rate for Payer: Cash Price |
$393.68
|
| Rate for Payer: Cofinity Commercial |
$199.42
|
| Rate for Payer: Cofinity Commercial |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$235.89
|
| Rate for Payer: Cofinity Commercial |
$245.00
|
| Rate for Payer: Cofinity Commercial |
$344.47
|
| Rate for Payer: Cofinity Commercial |
$423.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$393.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.43
|
| Rate for Payer: Healthscope Commercial |
$442.89
|
| Rate for Payer: Healthscope Commercial |
$256.39
|
| Rate for Payer: Healthscope Commercial |
$246.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$344.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$192.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$369.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$242.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$418.28
|
| Rate for Payer: PHP Commercial |
$233.15
|
| Rate for Payer: PHP Commercial |
$242.15
|
| Rate for Payer: PHP Commercial |
$418.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.47
|
| Rate for Payer: Priority Health SBD |
$310.02
|
| Rate for Payer: Priority Health SBD |
$179.47
|
| Rate for Payer: Priority Health SBD |
$172.80
|
| Rate for Payer: UMR Bronson Commercial |
$216.52
|
| Rate for Payer: UMR Bronson Commercial |
$125.35
|
| Rate for Payer: UMR Bronson Commercial |
$120.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$369.08
|
|
|
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION
|
Facility
|
OP
|
$536.32
|
|
|
Service Code
|
HCPCS J9040
|
| Hospital Charge Code |
17012
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$67.94 |
| Max. Negotiated Rate |
$482.69 |
| Rate for Payer: Aetna American Axle |
$348.61
|
| Rate for Payer: Aetna American Axle |
$316.68
|
| Rate for Payer: Aetna American Axle |
$242.52
|
| Rate for Payer: Aetna American Axle |
$593.26
|
| Rate for Payer: Aetna Commercial |
$455.87
|
| Rate for Payer: Aetna Commercial |
$317.14
|
| Rate for Payer: Aetna Commercial |
$775.80
|
| Rate for Payer: Aetna Commercial |
$414.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$593.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.61
|
| Rate for Payer: BCBS Complete |
$149.24
|
| Rate for Payer: BCBS Complete |
$214.53
|
| Rate for Payer: BCBS Complete |
$365.08
|
| Rate for Payer: BCBS Complete |
$194.88
|
| Rate for Payer: BCBS Trust/PPO |
$67.94
|
| Rate for Payer: BCBS Trust/PPO |
$67.94
|
| Rate for Payer: BCBS Trust/PPO |
$67.94
|
| Rate for Payer: BCBS Trust/PPO |
$67.94
|
| Rate for Payer: Cash Price |
$389.76
|
| Rate for Payer: Cash Price |
$298.48
|
| Rate for Payer: Cash Price |
$429.06
|
| Rate for Payer: Cash Price |
$730.16
|
| Rate for Payer: Cash Price |
$298.48
|
| Rate for Payer: Cash Price |
$389.76
|
| Rate for Payer: Cash Price |
$429.06
|
| Rate for Payer: Cash Price |
$730.16
|
| Rate for Payer: Cofinity Commercial |
$261.17
|
| Rate for Payer: Cofinity Commercial |
$784.92
|
| Rate for Payer: Cofinity Commercial |
$638.89
|
| Rate for Payer: Cofinity Commercial |
$341.04
|
| Rate for Payer: Cofinity Commercial |
$418.99
|
| Rate for Payer: Cofinity Commercial |
$461.24
|
| Rate for Payer: Cofinity Commercial |
$375.42
|
| Rate for Payer: Cofinity Commercial |
$320.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$389.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$730.16
|
| Rate for Payer: Healthscope Commercial |
$482.69
|
| Rate for Payer: Healthscope Commercial |
$821.43
|
| Rate for Payer: Healthscope Commercial |
$335.79
|
| Rate for Payer: Healthscope Commercial |
$438.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$638.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$375.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$341.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$261.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$365.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$402.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$684.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$455.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$775.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$414.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$317.14
|
| Rate for Payer: PHP Commercial |
$775.80
|
| Rate for Payer: PHP Commercial |
$317.14
|
| Rate for Payer: PHP Commercial |
$455.87
|
| Rate for Payer: PHP Commercial |
$414.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$375.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$638.89
|
| Rate for Payer: Priority Health SBD |
$337.88
|
| Rate for Payer: Priority Health SBD |
$306.94
|
| Rate for Payer: Priority Health SBD |
$575.00
|
| Rate for Payer: Priority Health SBD |
$235.05
|
| Rate for Payer: UMR Bronson Commercial |
$180.26
|
| Rate for Payer: UMR Bronson Commercial |
$138.05
|
| Rate for Payer: UMR Bronson Commercial |
$198.44
|
| Rate for Payer: UMR Bronson Commercial |
$337.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$365.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$402.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$684.52
|
|
