|
ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC
|
Facility
IP
|
$43,563.63
|
|
|
Service Code
|
MS-DRG 283
|
| Min. Negotiated Rate |
$14,918.82 |
| Max. Negotiated Rate |
$43,563.63 |
| Rate for Payer: Aetna Medicare |
$16,332.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,630.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,630.02
|
| Rate for Payer: BCBS MAPPO |
$15,704.02
|
| Rate for Payer: BCBS Trust/PPO |
$43,563.63
|
| Rate for Payer: BCN Medicare Advantage |
$15,704.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,704.02
|
| Rate for Payer: Mclaren Medicare |
$15,704.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,489.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,059.62
|
| Rate for Payer: PACE Medicare |
$14,918.82
|
| Rate for Payer: PACE SWMI |
$15,704.02
|
| Rate for Payer: PHP Medicare Advantage |
$15,704.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28,289.43
|
| Rate for Payer: Priority Health Medicare |
$15,704.02
|
| Rate for Payer: Priority Health Narrow Network |
$22,631.54
|
| Rate for Payer: Railroad Medicare Medicare |
$15,704.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30,071.74
|
| Rate for Payer: UHC Core |
$24,658.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,704.02
|
| Rate for Payer: UHC Exchange |
$19,603.60
|
| Rate for Payer: UHC Medicare Advantage |
$16,175.14
|
| Rate for Payer: VA VA |
$15,704.02
|
|
|
ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC
|
Facility
IP
|
$10,875.83
|
|
|
Service Code
|
MS-DRG 285
|
| Min. Negotiated Rate |
$4,064.38 |
| Max. Negotiated Rate |
$10,875.83 |
| Rate for Payer: Aetna Medicare |
$4,449.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,347.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,347.86
|
| Rate for Payer: BCBS MAPPO |
$4,278.29
|
| Rate for Payer: BCBS Trust/PPO |
$10,875.83
|
| Rate for Payer: BCN Medicare Advantage |
$4,278.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,278.29
|
| Rate for Payer: Mclaren Medicare |
$4,278.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,492.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,920.03
|
| Rate for Payer: PACE Medicare |
$4,064.38
|
| Rate for Payer: PACE SWMI |
$4,278.29
|
| Rate for Payer: PHP Medicare Advantage |
$4,278.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,012.81
|
| Rate for Payer: Priority Health Medicare |
$4,278.29
|
| Rate for Payer: Priority Health Narrow Network |
$5,610.25
|
| Rate for Payer: Railroad Medicare Medicare |
$4,278.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,454.63
|
| Rate for Payer: UHC Core |
$6,112.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,278.29
|
| Rate for Payer: UHC Exchange |
$4,859.63
|
| Rate for Payer: UHC Medicare Advantage |
$4,406.64
|
| Rate for Payer: VA VA |
$4,278.29
|
|
|
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION
|
Facility
IP
|
$1,367.21
|
|
|
Service Code
|
NDC 50383-810-16
|
| Hospital Charge Code |
8970
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$601.57 |
| Max. Negotiated Rate |
$1,230.49 |
| Rate for Payer: Aetna American Axle |
$888.69
|
| Rate for Payer: Aetna Commercial |
$1,162.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$888.69
|
| Rate for Payer: Cash Price |
$1,093.77
|
| Rate for Payer: Cofinity Commercial |
$1,175.80
|
| Rate for Payer: Cofinity Commercial |
$957.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,093.77
|
| Rate for Payer: Healthscope Commercial |
$1,230.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$957.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,025.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,162.13
|
| Rate for Payer: PHP Commercial |
$1,162.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$957.05
|
| Rate for Payer: Priority Health SBD |
$861.34
|
| Rate for Payer: UMR Bronson Commercial |
$601.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,025.41
|
|
|
ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION
|
Facility
IP
|
$1,589.28
|
|
|
Service Code
|
NDC 0472-0082-16
|
| Hospital Charge Code |
8970
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$699.28 |
| Max. Negotiated Rate |
$1,430.35 |
| Rate for Payer: Aetna American Axle |
$1,033.03
|
| Rate for Payer: Aetna Commercial |
$1,350.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.03
|
| Rate for Payer: Cash Price |
$1,271.42
|
| Rate for Payer: Cofinity Commercial |
$1,112.50
|
| Rate for Payer: Cofinity Commercial |
$1,366.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,271.42
|
| Rate for Payer: Healthscope Commercial |
$1,430.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,112.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,191.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,350.89
|
| Rate for Payer: PHP Commercial |
$1,350.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,112.50
|
| Rate for Payer: Priority Health SBD |
$1,001.25
|
| Rate for Payer: UMR Bronson Commercial |
$699.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,191.96
|
|
|
ACYCLOVIR 200 MG CAPSULE
|
Facility
IP
|
$380.70
|
|
|
Service Code
|
NDC 69076-146-01
|
| Hospital Charge Code |
8969
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$167.51 |
| Max. Negotiated Rate |
$342.63 |
| Rate for Payer: Aetna American Axle |
$247.46
|
| Rate for Payer: Aetna Commercial |
$323.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.46
|
| Rate for Payer: Cash Price |
$304.56
|
| Rate for Payer: Cofinity Commercial |
$266.49
|
| Rate for Payer: Cofinity Commercial |
$327.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.56
|
| Rate for Payer: Healthscope Commercial |
$342.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$266.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.60
|
| Rate for Payer: PHP Commercial |
$323.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.49
|
| Rate for Payer: Priority Health SBD |
$239.84
|
| Rate for Payer: UMR Bronson Commercial |
$167.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.52
|
|
|
ACYCLOVIR 200 MG CAPSULE
|
Facility
IP
|
$2.51
|
|
|
Service Code
|
NDC 68084-107-11
|
| Hospital Charge Code |
8969
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.10 |
| Max. Negotiated Rate |
$2.26 |
| Rate for Payer: Aetna American Axle |
$1.63
|
| Rate for Payer: Aetna Commercial |
$2.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.63
|
| Rate for Payer: Cash Price |
$2.01
|
| Rate for Payer: Cofinity Commercial |
$1.76
|
| Rate for Payer: Cofinity Commercial |
$2.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.01
|
| Rate for Payer: Healthscope Commercial |
$2.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.13
|
| Rate for Payer: PHP Commercial |
$2.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.76
|
| Rate for Payer: Priority Health SBD |
$1.58
|
| Rate for Payer: UMR Bronson Commercial |
$1.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.88
|
|
|
ACYCLOVIR 200 MG CAPSULE
|
Facility
IP
|
$239.70
|
|
|
Service Code
|
NDC 75834-124-01
|
| Hospital Charge Code |
8969
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$105.47 |
| Max. Negotiated Rate |
$215.73 |
| Rate for Payer: Aetna American Axle |
$155.80
|
| Rate for Payer: Aetna Commercial |
$203.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.80
|
| Rate for Payer: Cash Price |
$191.76
|
| Rate for Payer: Cofinity Commercial |
$167.79
|
| Rate for Payer: Cofinity Commercial |
$206.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.76
|
| Rate for Payer: Healthscope Commercial |
$215.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$167.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$203.74
|
| Rate for Payer: PHP Commercial |
$203.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.79
|
| Rate for Payer: Priority Health SBD |
$151.01
|
| Rate for Payer: UMR Bronson Commercial |
$105.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.78
|
|
|
ACYCLOVIR 200 MG CAPSULE
|
Facility
IP
|
$392.45
|
|
|
Service Code
|
NDC 23155-229-01
|
| Hospital Charge Code |
8969
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$172.68 |
| Max. Negotiated Rate |
$353.20 |
| Rate for Payer: Aetna American Axle |
$255.09
|
| Rate for Payer: Aetna Commercial |
$333.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.09
|
| Rate for Payer: Cash Price |
$313.96
|
| Rate for Payer: Cofinity Commercial |
$274.72
|
| Rate for Payer: Cofinity Commercial |
$337.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.96
|
| Rate for Payer: Healthscope Commercial |
$353.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$274.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$333.58
|
| Rate for Payer: PHP Commercial |
$333.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.72
|
| Rate for Payer: Priority Health SBD |
$247.24
|
| Rate for Payer: UMR Bronson Commercial |
$172.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.34
|
|
|
ACYCLOVIR 200 MG CAPSULE
|
Facility
IP
|
$392.45
|
|
|
Service Code
|
NDC 60505-0042-6
|
| Hospital Charge Code |
8969
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$172.68 |
| Max. Negotiated Rate |
$353.20 |
| Rate for Payer: Aetna American Axle |
$255.09
|
| Rate for Payer: Aetna Commercial |
$333.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.09
|
| Rate for Payer: Cash Price |
$313.96
|
| Rate for Payer: Cofinity Commercial |
$274.72
|
| Rate for Payer: Cofinity Commercial |
$337.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.96
|
| Rate for Payer: Healthscope Commercial |
$353.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$274.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$333.58
|
| Rate for Payer: PHP Commercial |
$333.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.72
|
| Rate for Payer: Priority Health SBD |
$247.24
|
| Rate for Payer: UMR Bronson Commercial |
$172.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.34
|
|
|
ACYCLOVIR 200 MG CAPSULE
|
Facility
IP
|
$250.80
|
|
|
Service Code
|
NDC 68084-107-01
|
| Hospital Charge Code |
8969
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$110.35 |
| Max. Negotiated Rate |
$225.72 |
| Rate for Payer: Aetna American Axle |
$163.02
|
| Rate for Payer: Aetna Commercial |
$213.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.02
|
| Rate for Payer: Cash Price |
$200.64
|
| Rate for Payer: Cofinity Commercial |
$175.56
|
| Rate for Payer: Cofinity Commercial |
$215.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.64
|
| Rate for Payer: Healthscope Commercial |
$225.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$213.18
|
| Rate for Payer: PHP Commercial |
$213.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.56
|
| Rate for Payer: Priority Health SBD |
$158.00
|
| Rate for Payer: UMR Bronson Commercial |
$110.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.10
|
|
|
ACYCLOVIR 800 MG TABLET
|
Facility
IP
|
$266.95
|
|
|
Service Code
|
NDC 60505-5307-1
|
| Hospital Charge Code |
8972
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$117.46 |
| Max. Negotiated Rate |
$240.26 |
| Rate for Payer: Aetna American Axle |
$173.52
|
| Rate for Payer: Aetna Commercial |
$226.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.52
|
| Rate for Payer: Cash Price |
$213.56
|
| Rate for Payer: Cofinity Commercial |
$186.86
|
| Rate for Payer: Cofinity Commercial |
$229.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.56
|
| Rate for Payer: Healthscope Commercial |
$240.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$186.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$226.91
|
| Rate for Payer: PHP Commercial |
$226.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.86
|
| Rate for Payer: Priority Health SBD |
$168.18
|
| Rate for Payer: UMR Bronson Commercial |
$117.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.21
|
|
|
ACYCLOVIR 800 MG TABLET
|
Facility
IP
|
$256.15
|
|
|
Service Code
|
NDC 31722-778-01
|
| Hospital Charge Code |
8972
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$112.71 |
| Max. Negotiated Rate |
$230.54 |
| Rate for Payer: Aetna American Axle |
$166.50
|
| Rate for Payer: Aetna Commercial |
$217.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.50
|
| Rate for Payer: Cash Price |
$204.92
|
| Rate for Payer: Cofinity Commercial |
$179.30
|
| Rate for Payer: Cofinity Commercial |
$220.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.92
|
| Rate for Payer: Healthscope Commercial |
$230.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$179.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$217.73
|
| Rate for Payer: PHP Commercial |
$217.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.30
|
| Rate for Payer: Priority Health SBD |
$161.37
|
| Rate for Payer: UMR Bronson Commercial |
$112.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.11
|
|
|
ACYCLOVIR 800 MG TABLET
|
Facility
IP
|
$266.95
|
|
|
Service Code
|
NDC 61442-113-01
|
| Hospital Charge Code |
8972
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$117.46 |
| Max. Negotiated Rate |
$240.26 |
| Rate for Payer: Aetna American Axle |
$173.52
|
| Rate for Payer: Aetna Commercial |
$226.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.52
|
| Rate for Payer: Cash Price |
$213.56
|
| Rate for Payer: Cofinity Commercial |
$186.86
|
| Rate for Payer: Cofinity Commercial |
$229.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.56
|
| Rate for Payer: Healthscope Commercial |
$240.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$186.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$226.91
|
| Rate for Payer: PHP Commercial |
$226.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.86
|
| Rate for Payer: Priority Health SBD |
$168.18
|
| Rate for Payer: UMR Bronson Commercial |
$117.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.21
|
|
|
ACYCLOVIR 800 MG TABLET
|
Facility
IP
|
$272.65
|
|
|
Service Code
|
NDC 23155-228-01
|
| Hospital Charge Code |
8972
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.97 |
| Max. Negotiated Rate |
$245.38 |
| Rate for Payer: Aetna American Axle |
$177.22
|
| Rate for Payer: Aetna Commercial |
$231.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.22
|
| Rate for Payer: Cash Price |
$218.12
|
| Rate for Payer: Cofinity Commercial |
$190.86
|
| Rate for Payer: Cofinity Commercial |
$234.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.12
|
| Rate for Payer: Healthscope Commercial |
$245.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$231.75
|
| Rate for Payer: PHP Commercial |
$231.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.86
|
| Rate for Payer: Priority Health SBD |
$171.77
|
| Rate for Payer: UMR Bronson Commercial |
$119.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.49
|
|
|
ACYCLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION
|
Facility
IP
|
$19.18
|
|
|
Service Code
|
HCPCS J0133
|
| Hospital Charge Code |
8974
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.44 |
| Max. Negotiated Rate |
$17.26 |
| Rate for Payer: Aetna American Axle |
$12.47
|
| Rate for Payer: Aetna Commercial |
$16.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.47
|
| Rate for Payer: Cash Price |
$15.34
|
| Rate for Payer: Cofinity Commercial |
$13.43
|
| Rate for Payer: Cofinity Commercial |
$16.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.34
|
| Rate for Payer: Healthscope Commercial |
$17.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.30
|
| Rate for Payer: PHP Commercial |
$16.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.43
|
| Rate for Payer: Priority Health SBD |
$12.08
|
| Rate for Payer: UMR Bronson Commercial |
$8.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.38
|
|
|
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION
|
Facility
IP
|
$16.95
|
|
|
Service Code
|
HCPCS J0133
|
| Hospital Charge Code |
23128
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$15.26 |
| Rate for Payer: Aetna American Axle |
$11.02
|
| Rate for Payer: Aetna American Axle |
$12.10
|
| Rate for Payer: Aetna American Axle |
$12.56
|
| Rate for Payer: Aetna American Axle |
$13.04
|
| Rate for Payer: Aetna Commercial |
$15.82
|
| Rate for Payer: Aetna Commercial |
$14.41
|
| Rate for Payer: Aetna Commercial |
$16.42
|
| Rate for Payer: Aetna Commercial |
$17.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.02
|
| Rate for Payer: Cash Price |
$15.46
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cash Price |
$13.56
|
| Rate for Payer: Cash Price |
$14.89
|
| Rate for Payer: Cofinity Commercial |
$11.86
|
| Rate for Payer: Cofinity Commercial |
$17.25
|
| Rate for Payer: Cofinity Commercial |
$16.62
|
| Rate for Payer: Cofinity Commercial |
$14.04
|
| Rate for Payer: Cofinity Commercial |
$13.03
|
| Rate for Payer: Cofinity Commercial |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$14.58
|
| Rate for Payer: Cofinity Commercial |
$13.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.56
|
| Rate for Payer: Healthscope Commercial |
$15.26
|
| Rate for Payer: Healthscope Commercial |
$17.39
|
| Rate for Payer: Healthscope Commercial |
$16.75
|
| Rate for Payer: Healthscope Commercial |
$18.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.42
|
| Rate for Payer: PHP Commercial |
$15.82
|
| Rate for Payer: PHP Commercial |
$16.42
|
| Rate for Payer: PHP Commercial |
$17.05
|
| Rate for Payer: PHP Commercial |
$14.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.52
|
| Rate for Payer: Priority Health SBD |
$11.72
|
| Rate for Payer: Priority Health SBD |
$10.68
|
| Rate for Payer: Priority Health SBD |
$12.64
|
| Rate for Payer: Priority Health SBD |
$12.17
|
| Rate for Payer: UMR Bronson Commercial |
$8.50
|
| Rate for Payer: UMR Bronson Commercial |
$7.46
|
| Rate for Payer: UMR Bronson Commercial |
$8.19
|
| Rate for Payer: UMR Bronson Commercial |
$8.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.04
|
|
|
ADALIMUMAB 40 MG/0.8 ML SUBCUTANEOUS PEN KIT
|
Facility
IP
|
$5,185.36
|
|
|
Service Code
|
HCPCS J0135
|
| Hospital Charge Code |
116603
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,281.56 |
| Max. Negotiated Rate |
$4,666.82 |
| Rate for Payer: Aetna American Axle |
$3,370.48
|
| Rate for Payer: Aetna Commercial |
$4,407.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,370.48
|
| Rate for Payer: Cash Price |
$4,148.29
|
| Rate for Payer: Cofinity Commercial |
$3,629.75
|
| Rate for Payer: Cofinity Commercial |
$4,459.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,148.29
|
| Rate for Payer: Healthscope Commercial |
$4,666.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,629.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,889.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,407.56
|
| Rate for Payer: PHP Commercial |
$4,407.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,629.75
|
| Rate for Payer: Priority Health SBD |
$3,266.78
|
| Rate for Payer: UMR Bronson Commercial |
$2,281.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,889.02
|
|
|
ADENOIDECTOMY, PRIMARY; AGE 12 OR OVER
|
Facility
OP
|
$9,009.23
|
|
|
Service Code
|
CPT 42831
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$230.85 |
| Max. Negotiated Rate |
$9,009.23 |
| Rate for Payer: Aetna Medicare |
$2,976.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,651.12
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,009.23
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$7,207.38
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.94
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,861.84
|
| Rate for Payer: UHC Exchange |
$230.85
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: VA VA |
$2,861.84
|
|
|
ADENOIDECTOMY, PRIMARY; YOUNGER THAN AGE 12
|
Facility
OP
|
$9,009.23
|
|
|
Service Code
|
CPT 42830
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$212.51 |
| Max. Negotiated Rate |
$9,009.23 |
| Rate for Payer: Aetna Medicare |
$2,976.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,168.70
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,009.23
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$7,207.38
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.76
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,861.84
|
| Rate for Payer: UHC Exchange |
$212.51
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: VA VA |
$2,861.84
|
|
|
ADENOIDECTOMY, SECONDARY; AGE 12 OR OVER
|
Facility
OP
|
$9,009.23
|
|
|
Service Code
|
CPT 42836
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$244.60 |
| Max. Negotiated Rate |
$9,009.23 |
| Rate for Payer: Aetna Medicare |
$2,976.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,629.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,009.23
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$7,207.38
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.06
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,861.84
|
| Rate for Payer: UHC Exchange |
$244.60
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: VA VA |
$2,861.84
|
|
|
ADENOIDECTOMY, SECONDARY; YOUNGER THAN AGE 12
|
Facility
OP
|
$9,009.23
|
|
|
Service Code
|
CPT 42835
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$198.43 |
| Max. Negotiated Rate |
$9,009.23 |
| Rate for Payer: Aetna Medicare |
$2,976.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,629.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,009.23
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$7,207.38
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.27
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,861.84
|
| Rate for Payer: UHC Exchange |
$198.43
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: VA VA |
$2,861.84
|
|
|
ADENOSINE 3 MG/250 ML NS IV
|
Facility
IP
|
$10.88
|
|
|
Service Code
|
HCPCS J0153
|
| Hospital Charge Code |
151056
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.79 |
| Max. Negotiated Rate |
$9.79 |
| Rate for Payer: Aetna American Axle |
$7.07
|
| Rate for Payer: Aetna Commercial |
$9.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.07
|
| Rate for Payer: Cash Price |
$8.70
|
| Rate for Payer: Cofinity Commercial |
$7.62
|
| Rate for Payer: Cofinity Commercial |
$9.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.70
|
| Rate for Payer: Healthscope Commercial |
$9.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.25
|
| Rate for Payer: PHP Commercial |
$9.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.62
|
| Rate for Payer: Priority Health SBD |
$6.85
|
| Rate for Payer: UMR Bronson Commercial |
$4.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.16
|
|
|
ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION
|
Facility
IP
|
$0.15
|
|
|
Service Code
|
HCPCS J0153
|
| Hospital Charge Code |
8975
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: Aetna American Axle |
$0.10
|
| Rate for Payer: Aetna American Axle |
$16.08
|
| Rate for Payer: Aetna American Axle |
$11.73
|
| Rate for Payer: Aetna Commercial |
$0.13
|
| Rate for Payer: Aetna Commercial |
$21.03
|
| Rate for Payer: Aetna Commercial |
$15.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.10
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Cash Price |
$19.79
|
| Rate for Payer: Cash Price |
$14.44
|
| Rate for Payer: Cofinity Commercial |
$12.64
|
| Rate for Payer: Cofinity Commercial |
$0.11
|
| Rate for Payer: Cofinity Commercial |
$0.13
|
| Rate for Payer: Cofinity Commercial |
$15.52
|
| Rate for Payer: Cofinity Commercial |
$21.28
|
| Rate for Payer: Cofinity Commercial |
$17.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.12
|
| Rate for Payer: Healthscope Commercial |
$0.14
|
| Rate for Payer: Healthscope Commercial |
$16.24
|
| Rate for Payer: Healthscope Commercial |
$22.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.34
|
| Rate for Payer: PHP Commercial |
$15.34
|
| Rate for Payer: PHP Commercial |
$21.03
|
| Rate for Payer: PHP Commercial |
$0.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.32
|
| Rate for Payer: Priority Health SBD |
$11.37
|
| Rate for Payer: Priority Health SBD |
$0.09
|
| Rate for Payer: Priority Health SBD |
$15.59
|
| Rate for Payer: UMR Bronson Commercial |
$7.94
|
| Rate for Payer: UMR Bronson Commercial |
$10.89
|
| Rate for Payer: UMR Bronson Commercial |
$0.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.56
|
|
|
ADENOSINE 3 MG/ML INTRAVENOUS SYRINGE
|
Facility
IP
|
$39.13
|
|
|
Service Code
|
HCPCS J0153
|
| Hospital Charge Code |
39477
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.22 |
| Max. Negotiated Rate |
$35.22 |
| Rate for Payer: Aetna American Axle |
$25.43
|
| Rate for Payer: Aetna Commercial |
$33.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.43
|
| Rate for Payer: Cash Price |
$31.30
|
| Rate for Payer: Cofinity Commercial |
$33.65
|
| Rate for Payer: Cofinity Commercial |
$27.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.30
|
| Rate for Payer: Healthscope Commercial |
$35.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.26
|
| Rate for Payer: PHP Commercial |
$33.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.39
|
| Rate for Payer: Priority Health SBD |
$24.65
|
| Rate for Payer: UMR Bronson Commercial |
$17.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.35
|
|
|
ADENOSINE 3 MG/ML IV (CODE)
|
Facility
IP
|
$18.05
|
|
|
Service Code
|
HCPCS J0153
|
| Hospital Charge Code |
163702
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.94 |
| Max. Negotiated Rate |
$16.24 |
| Rate for Payer: Aetna American Axle |
$11.73
|
| Rate for Payer: Aetna American Axle |
$0.10
|
| Rate for Payer: Aetna Commercial |
$0.13
|
| Rate for Payer: Aetna Commercial |
$15.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.73
|
| Rate for Payer: Cash Price |
$14.44
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Cofinity Commercial |
$0.11
|
| Rate for Payer: Cofinity Commercial |
$12.64
|
| Rate for Payer: Cofinity Commercial |
$15.52
|
| Rate for Payer: Cofinity Commercial |
$0.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.44
|
| Rate for Payer: Healthscope Commercial |
$16.24
|
| Rate for Payer: Healthscope Commercial |
$0.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.34
|
| Rate for Payer: PHP Commercial |
$0.13
|
| Rate for Payer: PHP Commercial |
$15.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.11
|
| Rate for Payer: Priority Health SBD |
$0.09
|
| Rate for Payer: Priority Health SBD |
$11.37
|
| Rate for Payer: UMR Bronson Commercial |
$0.07
|
| Rate for Payer: UMR Bronson Commercial |
$7.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.11
|
|
