|
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
|
|
|
BLEPHAROPLASTY, LOWER EYELID; WITH EXTENSIVE HERNIATED FAT PAD
|
Facility
|
OP
|
$5,102.91
|
|
|
Service Code
|
CPT 15821
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$540.61 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,009.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$594.67
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$540.61
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: VA VA |
$1,620.98
|
|
|
BLEPHAROPLASTY, UPPER EYELID;
|
Facility
|
OP
|
$5,102.91
|
|
|
Service Code
|
CPT 15822
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$392.60 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,336.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.86
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$392.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: VA VA |
$1,620.98
|
|
|
BLEPHAROPLASTY, UPPER EYELID; WITH EXCESSIVE SKIN WEIGHTING DOWN LID
|
Facility
|
OP
|
$5,102.91
|
|
|
Service Code
|
CPT 15823
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$540.93 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,637.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$595.02
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$540.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: VA VA |
$1,620.98
|
|
|
BLEPHAROTOMY, DRAINAGE OF ABSCESS, EYELID
|
Facility
|
OP
|
$815.16
|
|
|
Service Code
|
CPT 67700
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$113.62 |
| Max. Negotiated Rate |
$815.16 |
| Rate for Payer: Aetna Medicare |
$269.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.68
|
| Rate for Payer: BCBS Complete |
$148.74
|
| Rate for Payer: BCBS MAPPO |
$258.94
|
| Rate for Payer: BCBS Trust/PPO |
$283.08
|
| Rate for Payer: BCN Medicare Advantage |
$258.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.94
|
| Rate for Payer: Mclaren Medicaid |
$141.64
|
| Rate for Payer: Mclaren Medicare |
$258.94
|
| Rate for Payer: Meridian Medicaid |
$148.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$271.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.78
|
| Rate for Payer: PACE Medicare |
$245.99
|
| Rate for Payer: PACE SWMI |
$258.94
|
| Rate for Payer: PHP Medicare Advantage |
$258.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$141.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$815.16
|
| Rate for Payer: Priority Health Medicare |
$258.94
|
| Rate for Payer: Priority Health Narrow Network |
$652.13
|
| Rate for Payer: Railroad Medicare Medicare |
$258.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.98
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$258.94
|
| Rate for Payer: UHC Exchange |
$113.62
|
| Rate for Payer: UHC Medicare Advantage |
$266.71
|
| Rate for Payer: VA VA |
$258.94
|
|
|
BLINATUMOMAB 35 MCG INTRAVENOUS KIT
|
Facility
|
IP
|
$23,099.48
|
|
|
Service Code
|
HCPCS J9039
|
| Hospital Charge Code |
173348
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10,163.77 |
| Max. Negotiated Rate |
$20,789.53 |
| Rate for Payer: Aetna American Axle |
$15,014.66
|
| Rate for Payer: Aetna Commercial |
$19,634.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,014.66
|
| Rate for Payer: Cash Price |
$18,479.58
|
| Rate for Payer: Cofinity Commercial |
$16,169.64
|
| Rate for Payer: Cofinity Commercial |
$19,865.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18,479.58
|
| Rate for Payer: Healthscope Commercial |
$20,789.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16,169.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17,324.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19,634.56
|
| Rate for Payer: PHP Commercial |
$19,634.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16,169.64
|
| Rate for Payer: Priority Health SBD |
$14,552.67
|
| Rate for Payer: UMR Bronson Commercial |
$10,163.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17,324.61
|
|
|
BLINATUMOMAB 35 MCG INTRAVENOUS KIT
|
Facility
|
OP
|
$23,099.48
|
|
|
Service Code
|
HCPCS J9039
|
| Hospital Charge Code |
173348
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$79.62 |
| Max. Negotiated Rate |
$20,789.53 |
| Rate for Payer: Aetna American Axle |
$15,014.66
|
| Rate for Payer: Aetna Commercial |
$19,634.56
|
| Rate for Payer: Aetna Medicare |
$151.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,014.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$181.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$181.96
|
| Rate for Payer: BCBS Complete |
$83.61
|
| Rate for Payer: BCBS MAPPO |
$145.56
|
| Rate for Payer: BCBS Trust/PPO |
$470.39
|
| Rate for Payer: BCN Medicare Advantage |
$145.56
|
| Rate for Payer: Cash Price |
$18,479.58
|
| Rate for Payer: Cash Price |
$18,479.58
|
| Rate for Payer: Cofinity Commercial |
$19,865.55
|
| Rate for Payer: Cofinity Commercial |
$16,169.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18,479.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.56
|
| Rate for Payer: Healthscope Commercial |
$20,789.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16,169.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17,324.61
|
| Rate for Payer: Mclaren Medicaid |
$79.62
|
| Rate for Payer: Mclaren Medicare |
$145.56
|
| Rate for Payer: Meridian Medicaid |
$83.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$152.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$167.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19,634.56
|
| Rate for Payer: PACE Medicare |
$138.29
|
| Rate for Payer: PACE SWMI |
$145.56
|
| Rate for Payer: PHP Commercial |
$19,634.56
|
| Rate for Payer: PHP Medicare Advantage |
$145.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16,169.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$426.78
|
| Rate for Payer: Priority Health Medicare |
$145.56
|
| Rate for Payer: Priority Health Narrow Network |
$341.42
|
| Rate for Payer: Priority Health SBD |
$14,552.67
|
| Rate for Payer: Railroad Medicare Medicare |
$145.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.56
|
| Rate for Payer: UHC Medicare Advantage |
$149.93
|
| Rate for Payer: UMR Bronson Commercial |
$8,546.81
|
| Rate for Payer: VA VA |
$145.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17,324.61
|
|
|
BLINATUMOMAB 35 MCG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$16,620.15
|
|
|
Service Code
|
HCPCS J9039
|
| Hospital Charge Code |
183575
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$79.62 |
| Max. Negotiated Rate |
$14,958.14 |
| Rate for Payer: Aetna American Axle |
$10,803.10
|
| Rate for Payer: Aetna Commercial |
$14,127.13
|
| Rate for Payer: Aetna Medicare |
$151.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,803.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$181.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$181.96
|
| Rate for Payer: BCBS Complete |
$83.61
|
| Rate for Payer: BCBS MAPPO |
$145.56
|
| Rate for Payer: BCBS Trust/PPO |
$470.39
|
| Rate for Payer: BCN Medicare Advantage |
$145.56
|
| Rate for Payer: Cash Price |
$13,296.12
|
| Rate for Payer: Cash Price |
$13,296.12
|
| Rate for Payer: Cofinity Commercial |
$11,634.10
|
| Rate for Payer: Cofinity Commercial |
$14,293.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,296.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.56
|
| Rate for Payer: Healthscope Commercial |
$14,958.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,634.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,465.11
|
| Rate for Payer: Mclaren Medicaid |
$79.62
|
| Rate for Payer: Mclaren Medicare |
$145.56
|
| Rate for Payer: Meridian Medicaid |
$83.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$152.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$167.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,127.13
|
| Rate for Payer: PACE Medicare |
$138.29
|
| Rate for Payer: PACE SWMI |
$145.56
|
| Rate for Payer: PHP Commercial |
$14,127.13
|
| Rate for Payer: PHP Medicare Advantage |
$145.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,634.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$426.78
|
| Rate for Payer: Priority Health Medicare |
$145.56
|
| Rate for Payer: Priority Health Narrow Network |
$341.42
|
| Rate for Payer: Priority Health SBD |
$10,470.69
|
| Rate for Payer: Railroad Medicare Medicare |
$145.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.56
|
| Rate for Payer: UHC Medicare Advantage |
$149.93
|
| Rate for Payer: UMR Bronson Commercial |
$6,149.46
|
| Rate for Payer: VA VA |
$145.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,465.11
|
|
|
BLINATUMOMAB 35 MCG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$16,620.15
|
|
|
Service Code
|
HCPCS J9039
|
| Hospital Charge Code |
183575
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7,312.87 |
| Max. Negotiated Rate |
$14,958.14 |
| Rate for Payer: Aetna American Axle |
$10,803.10
|
| Rate for Payer: Aetna Commercial |
$14,127.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,803.10
|
| Rate for Payer: Cash Price |
$13,296.12
|
| Rate for Payer: Cofinity Commercial |
$11,634.10
|
| Rate for Payer: Cofinity Commercial |
$14,293.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,296.12
|
| Rate for Payer: Healthscope Commercial |
$14,958.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,634.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,465.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,127.13
|
| Rate for Payer: PHP Commercial |
$14,127.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,634.10
|
| Rate for Payer: Priority Health SBD |
$10,470.69
|
| Rate for Payer: UMR Bronson Commercial |
$7,312.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,465.11
|
|
|
BLUE FOOD COLOR (BULK) LIQUID
|
Facility
|
IP
|
$4.75
|
|
|
Service Code
|
NDC 5192710060
|
| Hospital Charge Code |
161587
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$4.28 |
| Rate for Payer: Aetna American Axle |
$3.09
|
| Rate for Payer: Aetna Commercial |
$4.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.09
|
| Rate for Payer: Cash Price |
$3.80
|
| Rate for Payer: Cofinity Commercial |
$3.32
|
| Rate for Payer: Cofinity Commercial |
$4.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.80
|
| Rate for Payer: Healthscope Commercial |
$4.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.04
|
| Rate for Payer: PHP Commercial |
$4.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.32
|
| Rate for Payer: Priority Health SBD |
$2.99
|
| Rate for Payer: UMR Bronson Commercial |
$2.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.56
|
|
|
BONE DISEASES AND ARTHROPATHIES WITH MCC
|
Facility
|
IP
|
$23,721.78
|
|
|
Service Code
|
MS-DRG 553
|
| Min. Negotiated Rate |
$10,380.69 |
| Max. Negotiated Rate |
$23,721.78 |
| Rate for Payer: Aetna Medicare |
$11,364.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,658.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,658.80
|
| Rate for Payer: BCBS MAPPO |
$10,927.04
|
| Rate for Payer: BCBS Trust/PPO |
$23,721.78
|
| Rate for Payer: BCN Medicare Advantage |
$10,927.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,927.04
|
| Rate for Payer: Mclaren Medicare |
$10,927.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11,473.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,566.10
|
| Rate for Payer: PACE Medicare |
$10,380.69
|
| Rate for Payer: PACE SWMI |
$10,927.04
|
| Rate for Payer: PHP Medicare Advantage |
$10,927.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,393.92
|
| Rate for Payer: Priority Health Medicare |
$10,927.04
|
| Rate for Payer: Priority Health Narrow Network |
$15,515.14
|
| Rate for Payer: Railroad Medicare Medicare |
$10,927.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20,615.78
|
| Rate for Payer: UHC Core |
$16,904.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,927.04
|
| Rate for Payer: UHC Exchange |
$13,439.32
|
| Rate for Payer: UHC Medicare Advantage |
$11,254.85
|
| Rate for Payer: VA VA |
$10,927.04
|
|
|
BONE DISEASES AND ARTHROPATHIES WITHOUT MCC
|
Facility
|
IP
|
$15,054.78
|
|
|
Service Code
|
MS-DRG 554
|
| Min. Negotiated Rate |
$6,502.92 |
| Max. Negotiated Rate |
$15,054.78 |
| Rate for Payer: Aetna Medicare |
$7,118.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,556.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,556.48
|
| Rate for Payer: BCBS MAPPO |
$6,845.18
|
| Rate for Payer: BCBS Trust/PPO |
$15,054.78
|
| Rate for Payer: BCN Medicare Advantage |
$6,845.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,845.18
|
| Rate for Payer: Mclaren Medicare |
$6,845.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,187.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,871.96
|
| Rate for Payer: PACE Medicare |
$6,502.92
|
| Rate for Payer: PACE SWMI |
$6,845.18
|
| Rate for Payer: PHP Medicare Advantage |
$6,845.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,792.76
|
| Rate for Payer: Priority Health Medicare |
$6,845.18
|
| Rate for Payer: Priority Health Narrow Network |
$9,434.21
|
| Rate for Payer: Railroad Medicare Medicare |
$6,845.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,535.74
|
| Rate for Payer: UHC Core |
$10,279.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,845.18
|
| Rate for Payer: UHC Exchange |
$8,171.98
|
| Rate for Payer: UHC Medicare Advantage |
$7,050.54
|
| Rate for Payer: VA VA |
$6,845.18
|
|
|
BONE GRAFT, ANY DONOR AREA; MAJOR OR LARGE
|
Facility
|
OP
|
$20,018.71
|
|
|
Service Code
|
CPT 20902
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$269.16 |
| Max. Negotiated Rate |
$20,018.71 |
| Rate for Payer: Aetna Medicare |
$6,613.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,948.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,948.86
|
| Rate for Payer: BCBS Complete |
$3,652.66
|
| Rate for Payer: BCBS MAPPO |
$6,359.09
|
| Rate for Payer: BCBS Trust/PPO |
$4,590.53
|
| Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
| Rate for Payer: Mclaren Medicaid |
$3,478.42
|
| Rate for Payer: Mclaren Medicare |
$6,359.09
|
| Rate for Payer: Meridian Medicaid |
$3,652.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,677.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,312.95
|
| Rate for Payer: PACE Medicare |
$6,041.14
|
| Rate for Payer: PACE SWMI |
$6,359.09
|
| Rate for Payer: PHP Medicare Advantage |
$6,359.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,478.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,018.71
|
| Rate for Payer: Priority Health Medicare |
$6,359.09
|
| Rate for Payer: Priority Health Narrow Network |
$16,014.97
|
| Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$296.08
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,359.09
|
| Rate for Payer: UHC Exchange |
$269.16
|
| Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
| Rate for Payer: VA VA |
$6,359.09
|
|
|
BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL (EG, DOWEL OR BUTTON)
|
Facility
|
OP
|
$20,018.71
|
|
|
Service Code
|
CPT 20900
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$176.49 |
| Max. Negotiated Rate |
$20,018.71 |
| Rate for Payer: Aetna Medicare |
$6,613.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,948.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,948.86
|
| Rate for Payer: BCBS Complete |
$3,652.66
|
| Rate for Payer: BCBS MAPPO |
$6,359.09
|
| Rate for Payer: BCBS Trust/PPO |
$4,518.11
|
| Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
| Rate for Payer: Mclaren Medicaid |
$3,478.42
|
| Rate for Payer: Mclaren Medicare |
$6,359.09
|
| Rate for Payer: Meridian Medicaid |
$3,652.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,677.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,312.95
|
| Rate for Payer: PACE Medicare |
$6,041.14
|
| Rate for Payer: PACE SWMI |
$6,359.09
|
| Rate for Payer: PHP Medicare Advantage |
$6,359.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,478.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,018.71
|
| Rate for Payer: Priority Health Medicare |
$6,359.09
|
| Rate for Payer: Priority Health Narrow Network |
$16,014.97
|
| Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$194.14
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,359.09
|
| Rate for Payer: UHC Exchange |
$176.49
|
| Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
| Rate for Payer: VA VA |
$6,359.09
|
|
|
BORIC ACID (BULK) POWDER
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
NDC 395030396
|
| Hospital Charge Code |
1131
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$30.52 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna American Axle |
$45.08
|
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.08
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$48.55
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.96
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health SBD |
$43.70
|
| Rate for Payer: UMR Bronson Commercial |
$30.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION
|
Facility
|
IP
|
$217.13
|
|
|
Service Code
|
HCPCS J9046
|
| Hospital Charge Code |
35839
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$95.54 |
| Max. Negotiated Rate |
$195.42 |
| Rate for Payer: Aetna American Axle |
$141.13
|
| Rate for Payer: Aetna Commercial |
$184.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.13
|
| Rate for Payer: Cash Price |
$173.70
|
| Rate for Payer: Cofinity Commercial |
$186.73
|
| Rate for Payer: Cofinity Commercial |
$151.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.70
|
| Rate for Payer: Healthscope Commercial |
$195.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$151.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$184.56
|
| Rate for Payer: PHP Commercial |
$184.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.99
|
| Rate for Payer: Priority Health SBD |
$136.79
|
| Rate for Payer: UMR Bronson Commercial |
$95.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.85
|
|
|
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION
|
Facility
|
IP
|
$333.64
|
|
|
Service Code
|
HCPCS J9048
|
| Hospital Charge Code |
35839
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$146.80 |
| Max. Negotiated Rate |
$300.28 |
| Rate for Payer: Aetna American Axle |
$216.87
|
| Rate for Payer: Aetna Commercial |
$283.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.87
|
| Rate for Payer: Cash Price |
$266.91
|
| Rate for Payer: Cofinity Commercial |
$233.55
|
| Rate for Payer: Cofinity Commercial |
$286.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.91
|
| Rate for Payer: Healthscope Commercial |
$300.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$283.59
|
| Rate for Payer: PHP Commercial |
$283.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.55
|
| Rate for Payer: Priority Health SBD |
$210.19
|
| Rate for Payer: UMR Bronson Commercial |
$146.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.23
|
|
|
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION
|
Facility
|
OP
|
$269.58
|
|
|
Service Code
|
HCPCS J9041
|
| Hospital Charge Code |
35839
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$242.62 |
| Rate for Payer: Aetna American Axle |
$175.23
|
| Rate for Payer: Aetna Commercial |
$229.14
|
| Rate for Payer: Aetna Medicare |
$2.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.45
|
| Rate for Payer: BCBS Complete |
$1.13
|
| Rate for Payer: BCBS MAPPO |
$1.96
|
| Rate for Payer: BCBS Trust/PPO |
$6.31
|
| Rate for Payer: BCN Medicare Advantage |
$1.96
|
| Rate for Payer: Cash Price |
$215.66
|
| Rate for Payer: Cash Price |
$215.66
|
| Rate for Payer: Cofinity Commercial |
$231.84
|
| Rate for Payer: Cofinity Commercial |
$188.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.96
|
| Rate for Payer: Healthscope Commercial |
$242.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$188.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.18
|
| Rate for Payer: Mclaren Medicaid |
$1.07
|
| Rate for Payer: Mclaren Medicare |
$1.96
|
| Rate for Payer: Meridian Medicaid |
$1.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.14
|
| Rate for Payer: PACE Medicare |
$1.86
|
| Rate for Payer: PACE SWMI |
$1.96
|
| Rate for Payer: PHP Commercial |
$229.14
|
| Rate for Payer: PHP Medicare Advantage |
$1.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.72
|
| Rate for Payer: Priority Health Medicare |
$1.96
|
| Rate for Payer: Priority Health Narrow Network |
$5.38
|
| Rate for Payer: Priority Health SBD |
$169.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.96
|
| Rate for Payer: UHC Medicare Advantage |
$2.02
|
| Rate for Payer: UMR Bronson Commercial |
$99.74
|
| Rate for Payer: VA VA |
$1.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.18
|
|
|
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION
|
Facility
|
IP
|
$229.75
|
|
|
Service Code
|
HCPCS J9041
|
| Hospital Charge Code |
35839
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$101.09 |
| Max. Negotiated Rate |
$206.78 |
| Rate for Payer: Aetna American Axle |
$149.34
|
| Rate for Payer: Aetna American Axle |
$4,678.36
|
| Rate for Payer: Aetna Commercial |
$195.29
|
| Rate for Payer: Aetna Commercial |
$6,117.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,678.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.34
|
| Rate for Payer: Cash Price |
$5,757.98
|
| Rate for Payer: Cash Price |
$183.80
|
| Rate for Payer: Cofinity Commercial |
$197.58
|
| Rate for Payer: Cofinity Commercial |
$160.82
|
| Rate for Payer: Cofinity Commercial |
$6,189.82
|
| Rate for Payer: Cofinity Commercial |
$5,038.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,757.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.80
|
| Rate for Payer: Healthscope Commercial |
$206.78
|
| Rate for Payer: Healthscope Commercial |
$6,477.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,038.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,398.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,117.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.29
|
| Rate for Payer: PHP Commercial |
$6,117.85
|
| Rate for Payer: PHP Commercial |
$195.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,038.23
|
| Rate for Payer: Priority Health SBD |
$4,534.41
|
| Rate for Payer: Priority Health SBD |
$144.74
|
| Rate for Payer: UMR Bronson Commercial |
$101.09
|
| Rate for Payer: UMR Bronson Commercial |
$3,166.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,398.10
|
|
|
BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION
|
Facility
|
OP
|
$217.13
|
|
|
Service Code
|
HCPCS J9046
|
| Hospital Charge Code |
35839
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$26.56 |
| Max. Negotiated Rate |
$195.42 |
| Rate for Payer: Aetna American Axle |
$141.13
|
| Rate for Payer: Aetna Commercial |
$184.56
|
| Rate for Payer: Aetna Medicare |
$50.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.68
|
| Rate for Payer: BCBS Complete |
$27.89
|
| Rate for Payer: BCBS MAPPO |
$48.55
|
| Rate for Payer: BCBS Trust/PPO |
$38.06
|
| Rate for Payer: BCN Medicare Advantage |
$48.55
|
| Rate for Payer: Cash Price |
$173.70
|
| Rate for Payer: Cash Price |
$173.70
|
| Rate for Payer: Cofinity Commercial |
$151.99
|
| Rate for Payer: Cofinity Commercial |
$186.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.55
|
| Rate for Payer: Healthscope Commercial |
$195.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$151.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.85
|
| Rate for Payer: Mclaren Medicaid |
$26.56
|
| Rate for Payer: Mclaren Medicare |
$48.55
|
| Rate for Payer: Meridian Medicaid |
$27.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$184.56
|
| Rate for Payer: PACE Medicare |
$46.12
|
| Rate for Payer: PACE SWMI |
$48.55
|
| Rate for Payer: PHP Commercial |
$184.56
|
| Rate for Payer: PHP Medicare Advantage |
$48.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.58
|
| Rate for Payer: Priority Health Medicare |
$48.55
|
| Rate for Payer: Priority Health Narrow Network |
$114.06
|
| Rate for Payer: Priority Health SBD |
$136.79
|
| Rate for Payer: Railroad Medicare Medicare |
$48.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.55
|
| Rate for Payer: UHC Medicare Advantage |
$50.00
|
| Rate for Payer: UMR Bronson Commercial |
$80.34
|
| Rate for Payer: VA VA |
$48.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.85
|
|
|
BORTEZOMIB 3.5 MG INTRAVENOUS POWDER FOR SOLUTION
|
Facility
|
OP
|
$419.43
|
|
|
Service Code
|
HCPCS J9041
|
| Hospital Charge Code |
185652
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$377.49 |
| Rate for Payer: Aetna American Axle |
$272.63
|
| Rate for Payer: Aetna Commercial |
$356.52
|
| Rate for Payer: Aetna Medicare |
$2.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.45
|
| Rate for Payer: BCBS Complete |
$1.13
|
| Rate for Payer: BCBS MAPPO |
$1.96
|
| Rate for Payer: BCBS Trust/PPO |
$6.31
|
| Rate for Payer: BCN Medicare Advantage |
$1.96
|
| Rate for Payer: Cash Price |
$335.54
|
| Rate for Payer: Cash Price |
$335.54
|
| Rate for Payer: Cofinity Commercial |
$360.71
|
| Rate for Payer: Cofinity Commercial |
$293.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.96
|
| Rate for Payer: Healthscope Commercial |
$377.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$293.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.57
|
| Rate for Payer: Mclaren Medicaid |
$1.07
|
| Rate for Payer: Mclaren Medicare |
$1.96
|
| Rate for Payer: Meridian Medicaid |
$1.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$356.52
|
| Rate for Payer: PACE Medicare |
$1.86
|
| Rate for Payer: PACE SWMI |
$1.96
|
| Rate for Payer: PHP Commercial |
$356.52
|
| Rate for Payer: PHP Medicare Advantage |
$1.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.72
|
| Rate for Payer: Priority Health Medicare |
$1.96
|
| Rate for Payer: Priority Health Narrow Network |
$5.38
|
| Rate for Payer: Priority Health SBD |
$264.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.96
|
| Rate for Payer: UHC Medicare Advantage |
$2.02
|
| Rate for Payer: UMR Bronson Commercial |
$155.19
|
| Rate for Payer: VA VA |
$1.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.57
|
|
|
BORTEZOMIB 3.5 MG INTRAVENOUS POWDER FOR SOLUTION
|
Facility
|
OP
|
$6,907.69
|
|
|
Service Code
|
HCPCS J9048
|
| Hospital Charge Code |
185652
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.63 |
| Max. Negotiated Rate |
$6,216.92 |
| Rate for Payer: Aetna American Axle |
$4,490.00
|
| Rate for Payer: Aetna American Axle |
$216.87
|
| Rate for Payer: Aetna Commercial |
$283.59
|
| Rate for Payer: Aetna Commercial |
$5,871.54
|
| Rate for Payer: Aetna Medicare |
$50.49
|
| Rate for Payer: Aetna Medicare |
$50.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,490.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.68
|
| Rate for Payer: BCBS Complete |
$27.89
|
| Rate for Payer: BCBS Complete |
$27.89
|
| Rate for Payer: BCBS MAPPO |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$48.55
|
| Rate for Payer: BCBS Trust/PPO |
$8.63
|
| Rate for Payer: BCBS Trust/PPO |
$8.63
|
| Rate for Payer: BCN Medicare Advantage |
$48.55
|
| Rate for Payer: BCN Medicare Advantage |
$48.55
|
| Rate for Payer: Cash Price |
$5,526.15
|
| Rate for Payer: Cash Price |
$5,526.15
|
| Rate for Payer: Cash Price |
$266.91
|
| Rate for Payer: Cash Price |
$266.91
|
| Rate for Payer: Cofinity Commercial |
$233.55
|
| Rate for Payer: Cofinity Commercial |
$5,940.61
|
| Rate for Payer: Cofinity Commercial |
$4,835.38
|
| Rate for Payer: Cofinity Commercial |
$286.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,526.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.55
|
| Rate for Payer: Healthscope Commercial |
$6,216.92
|
| Rate for Payer: Healthscope Commercial |
$300.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,835.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,180.77
|
| Rate for Payer: Mclaren Medicaid |
$26.56
|
| Rate for Payer: Mclaren Medicaid |
$26.56
|
| Rate for Payer: Mclaren Medicare |
$48.55
|
| Rate for Payer: Mclaren Medicare |
$48.55
|
| Rate for Payer: Meridian Medicaid |
$27.89
|
| Rate for Payer: Meridian Medicaid |
$27.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$283.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,871.54
|
| Rate for Payer: PACE Medicare |
$46.12
|
| Rate for Payer: PACE Medicare |
$46.12
|
| Rate for Payer: PACE SWMI |
$48.55
|
| Rate for Payer: PACE SWMI |
$48.55
|
| Rate for Payer: PHP Commercial |
$283.59
|
| Rate for Payer: PHP Commercial |
$5,871.54
|
| Rate for Payer: PHP Medicare Advantage |
$48.55
|
| Rate for Payer: PHP Medicare Advantage |
$48.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,835.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.58
|
| Rate for Payer: Priority Health Medicare |
$48.55
|
| Rate for Payer: Priority Health Medicare |
$48.55
|
| Rate for Payer: Priority Health Narrow Network |
$114.06
|
| Rate for Payer: Priority Health Narrow Network |
$114.06
|
| Rate for Payer: Priority Health SBD |
$210.19
|
| Rate for Payer: Priority Health SBD |
$4,351.84
|
| Rate for Payer: Railroad Medicare Medicare |
$48.55
|
| Rate for Payer: Railroad Medicare Medicare |
$48.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.55
|
| Rate for Payer: UHC Medicare Advantage |
$50.00
|
| Rate for Payer: UHC Medicare Advantage |
$50.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,555.85
|
| Rate for Payer: UMR Bronson Commercial |
$123.45
|
| Rate for Payer: VA VA |
$48.55
|
| Rate for Payer: VA VA |
$48.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,180.77
|
|
|
BORTEZOMIB 3.5 MG SUBCUTANEOUS INJECTION
|
Facility
|
OP
|
$263.53
|
|
|
Service Code
|
HCPCS J9041
|
| Hospital Charge Code |
151057
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$237.18 |
| Rate for Payer: Aetna American Axle |
$171.29
|
| Rate for Payer: Aetna American Axle |
$136.18
|
| Rate for Payer: Aetna American Axle |
$4,678.36
|
| Rate for Payer: Aetna American Axle |
$272.63
|
| Rate for Payer: Aetna Commercial |
$6,117.85
|
| Rate for Payer: Aetna Commercial |
$224.00
|
| Rate for Payer: Aetna Commercial |
$356.52
|
| Rate for Payer: Aetna Commercial |
$178.08
|
| Rate for Payer: Aetna Medicare |
$2.04
|
| Rate for Payer: Aetna Medicare |
$2.04
|
| Rate for Payer: Aetna Medicare |
$2.04
|
| Rate for Payer: Aetna Medicare |
$2.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,678.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.45
|
| Rate for Payer: BCBS Complete |
$1.13
|
| Rate for Payer: BCBS Complete |
$1.13
|
| Rate for Payer: BCBS Complete |
$1.13
|
| Rate for Payer: BCBS Complete |
$1.13
|
| Rate for Payer: BCBS MAPPO |
$1.96
|
| Rate for Payer: BCBS MAPPO |
$1.96
|
| Rate for Payer: BCBS MAPPO |
$1.96
|
| Rate for Payer: BCBS MAPPO |
$1.96
|
| Rate for Payer: BCBS Trust/PPO |
$6.31
|
| Rate for Payer: BCBS Trust/PPO |
$6.31
|
| Rate for Payer: BCBS Trust/PPO |
$6.31
|
| Rate for Payer: BCBS Trust/PPO |
$6.31
|
| Rate for Payer: BCN Medicare Advantage |
$1.96
|
| Rate for Payer: BCN Medicare Advantage |
$1.96
|
| Rate for Payer: BCN Medicare Advantage |
$1.96
|
| Rate for Payer: BCN Medicare Advantage |
$1.96
|
| Rate for Payer: Cash Price |
$167.60
|
| Rate for Payer: Cash Price |
$210.82
|
| Rate for Payer: Cash Price |
$210.82
|
| Rate for Payer: Cash Price |
$5,757.98
|
| Rate for Payer: Cash Price |
$335.54
|
| Rate for Payer: Cash Price |
$167.60
|
| Rate for Payer: Cash Price |
$335.54
|
| Rate for Payer: Cash Price |
$5,757.98
|
| Rate for Payer: Cofinity Commercial |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$180.17
|
| Rate for Payer: Cofinity Commercial |
$146.65
|
| Rate for Payer: Cofinity Commercial |
$226.64
|
| Rate for Payer: Cofinity Commercial |
$184.47
|
| Rate for Payer: Cofinity Commercial |
$5,038.23
|
| Rate for Payer: Cofinity Commercial |
$6,189.82
|
| Rate for Payer: Cofinity Commercial |
$360.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,757.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.96
|
| Rate for Payer: Healthscope Commercial |
$188.55
|
| Rate for Payer: Healthscope Commercial |
$377.49
|
| Rate for Payer: Healthscope Commercial |
$6,477.72
|
| Rate for Payer: Healthscope Commercial |
$237.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,038.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$293.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,398.10
|
| Rate for Payer: Mclaren Medicaid |
$1.07
|
| Rate for Payer: Mclaren Medicaid |
$1.07
|
| Rate for Payer: Mclaren Medicaid |
$1.07
|
| Rate for Payer: Mclaren Medicaid |
$1.07
|
| Rate for Payer: Mclaren Medicare |
$1.96
|
| Rate for Payer: Mclaren Medicare |
$1.96
|
| Rate for Payer: Mclaren Medicare |
$1.96
|
| Rate for Payer: Mclaren Medicare |
$1.96
|
| Rate for Payer: Meridian Medicaid |
$1.13
|
| Rate for Payer: Meridian Medicaid |
$1.13
|
| Rate for Payer: Meridian Medicaid |
$1.13
|
| Rate for Payer: Meridian Medicaid |
$1.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$356.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,117.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$224.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$178.08
|
| Rate for Payer: PACE Medicare |
$1.86
|
| Rate for Payer: PACE Medicare |
$1.86
|
| Rate for Payer: PACE Medicare |
$1.86
|
| Rate for Payer: PACE Medicare |
$1.86
|
| Rate for Payer: PACE SWMI |
$1.96
|
| Rate for Payer: PACE SWMI |
$1.96
|
| Rate for Payer: PACE SWMI |
$1.96
|
| Rate for Payer: PACE SWMI |
$1.96
|
| Rate for Payer: PHP Commercial |
$224.00
|
| Rate for Payer: PHP Commercial |
$178.08
|
| Rate for Payer: PHP Commercial |
$6,117.85
|
| Rate for Payer: PHP Commercial |
$356.52
|
| Rate for Payer: PHP Medicare Advantage |
$1.96
|
| Rate for Payer: PHP Medicare Advantage |
$1.96
|
| Rate for Payer: PHP Medicare Advantage |
$1.96
|
| Rate for Payer: PHP Medicare Advantage |
$1.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,038.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.72
|
| Rate for Payer: Priority Health Medicare |
$1.96
|
| Rate for Payer: Priority Health Medicare |
$1.96
|
| Rate for Payer: Priority Health Medicare |
$1.96
|
| Rate for Payer: Priority Health Medicare |
$1.96
|
| Rate for Payer: Priority Health Narrow Network |
$5.38
|
| Rate for Payer: Priority Health Narrow Network |
$5.38
|
| Rate for Payer: Priority Health Narrow Network |
$5.38
|
| Rate for Payer: Priority Health Narrow Network |
$5.38
|
| Rate for Payer: Priority Health SBD |
$264.24
|
| Rate for Payer: Priority Health SBD |
$131.98
|
| Rate for Payer: Priority Health SBD |
$4,534.41
|
| Rate for Payer: Priority Health SBD |
$166.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.96
|
| Rate for Payer: UHC Medicare Advantage |
$2.02
|
| Rate for Payer: UHC Medicare Advantage |
$2.02
|
| Rate for Payer: UHC Medicare Advantage |
$2.02
|
| Rate for Payer: UHC Medicare Advantage |
$2.02
|
| Rate for Payer: UMR Bronson Commercial |
$77.52
|
| Rate for Payer: UMR Bronson Commercial |
$2,663.06
|
| Rate for Payer: UMR Bronson Commercial |
$97.51
|
| Rate for Payer: UMR Bronson Commercial |
$155.19
|
| Rate for Payer: VA VA |
$1.96
|
| Rate for Payer: VA VA |
$1.96
|
| Rate for Payer: VA VA |
$1.96
|
| Rate for Payer: VA VA |
$1.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,398.10
|
|
|
BORTEZOMIB 3.5 MG SUBCUTANEOUS INJECTION
|
Facility
|
IP
|
$7,197.47
|
|
|
Service Code
|
HCPCS J9041
|
| Hospital Charge Code |
151057
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3,166.89 |
| Max. Negotiated Rate |
$6,477.72 |
| Rate for Payer: Aetna American Axle |
$4,678.36
|
| Rate for Payer: Aetna Commercial |
$6,117.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,678.36
|
| Rate for Payer: Cash Price |
$5,757.98
|
| Rate for Payer: Cofinity Commercial |
$6,189.82
|
| Rate for Payer: Cofinity Commercial |
$5,038.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,757.98
|
| Rate for Payer: Healthscope Commercial |
$6,477.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,038.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,398.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,117.85
|
| Rate for Payer: PHP Commercial |
$6,117.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,038.23
|
| Rate for Payer: Priority Health SBD |
$4,534.41
|
| Rate for Payer: UMR Bronson Commercial |
$3,166.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,398.10
|
|
|
BREAST AUGMENTATION WITH IMPLANT
|
Facility
|
OP
|
$26,377.89
|
|
|
Service Code
|
CPT 19325
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$607.73 |
| Max. Negotiated Rate |
$26,377.89 |
| Rate for Payer: Aetna Medicare |
$8,714.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,473.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,473.91
|
| Rate for Payer: BCBS Complete |
$4,812.97
|
| Rate for Payer: BCBS MAPPO |
$8,379.13
|
| Rate for Payer: BCBS Trust/PPO |
$5,517.71
|
| Rate for Payer: BCN Medicare Advantage |
$8,379.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,379.13
|
| Rate for Payer: Mclaren Medicaid |
$4,583.38
|
| Rate for Payer: Mclaren Medicare |
$8,379.13
|
| Rate for Payer: Meridian Medicaid |
$4,812.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8,798.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,636.00
|
| Rate for Payer: PACE Medicare |
$7,960.17
|
| Rate for Payer: PACE SWMI |
$8,379.13
|
| Rate for Payer: PHP Medicare Advantage |
$8,379.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,583.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,377.89
|
| Rate for Payer: Priority Health Medicare |
$8,379.13
|
| Rate for Payer: Priority Health Narrow Network |
$21,102.31
|
| Rate for Payer: Railroad Medicare Medicare |
$8,379.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$668.50
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,379.13
|
| Rate for Payer: UHC Exchange |
$607.73
|
| Rate for Payer: UHC Medicare Advantage |
$8,630.50
|
| Rate for Payer: VA VA |
$8,379.13
|
|
