|
ATORVASTATIN 80 MG TABLET
|
Facility
|
IP
|
$2.48
|
|
|
Service Code
|
NDC 51079021101
|
| Hospital Charge Code |
28645
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.09 |
| Max. Negotiated Rate |
$2.23 |
| Rate for Payer: Aetna American Axle |
$1.61
|
| Rate for Payer: Aetna Commercial |
$2.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.61
|
| Rate for Payer: Cash Price |
$1.98
|
| Rate for Payer: Cofinity Advantage |
$1.74
|
| Rate for Payer: Cofinity Commercial |
$2.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.98
|
| Rate for Payer: Healthscope Commercial |
$2.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.86
|
| Rate for Payer: PHP Commercial |
$2.11
|
| Rate for Payer: Priority Health SBD |
$1.56
|
| Rate for Payer: UMR Bronson Commercial |
$1.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.86
|
|
|
ATORVASTATIN 80 MG TABLET
|
Facility
|
IP
|
$74.31
|
|
|
Service Code
|
NDC 51079021103
|
| Hospital Charge Code |
28645
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$32.70 |
| Max. Negotiated Rate |
$66.88 |
| Rate for Payer: Aetna American Axle |
$48.30
|
| Rate for Payer: Aetna Commercial |
$63.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.30
|
| Rate for Payer: Cash Price |
$59.45
|
| Rate for Payer: Cofinity Advantage |
$52.02
|
| Rate for Payer: Cofinity Commercial |
$63.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.45
|
| Rate for Payer: Healthscope Commercial |
$66.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.73
|
| Rate for Payer: PHP Commercial |
$63.16
|
| Rate for Payer: Priority Health SBD |
$46.82
|
| Rate for Payer: UMR Bronson Commercial |
$32.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.73
|
|
|
ATORVASTATIN 80 MG TABLET
|
Facility
|
OP
|
$2.49
|
|
|
Service Code
|
NDC 68084059095
|
| Hospital Charge Code |
28645
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$2.24 |
| Rate for Payer: Aetna American Axle |
$1.62
|
| Rate for Payer: Aetna Commercial |
$2.12
|
| Rate for Payer: Aetna Medicare |
$1.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.62
|
| Rate for Payer: BCBS Complete |
$1.00
|
| Rate for Payer: Cash Price |
$1.99
|
| Rate for Payer: Cofinity Advantage |
$1.74
|
| Rate for Payer: Cofinity Commercial |
$2.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.99
|
| Rate for Payer: Healthscope Commercial |
$2.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.87
|
| Rate for Payer: PHP Commercial |
$2.12
|
| Rate for Payer: Priority Health SBD |
$1.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.62
|
| Rate for Payer: UHC Core |
$1.30
|
| Rate for Payer: UHC Exchange |
$0.98
|
| Rate for Payer: UMR Bronson Commercial |
$0.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.87
|
|
|
ATORVASTATIN 80 MG TABLET
|
Facility
|
OP
|
$2.48
|
|
|
Service Code
|
NDC 51079021101
|
| Hospital Charge Code |
28645
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$2.23 |
| Rate for Payer: Aetna American Axle |
$1.61
|
| Rate for Payer: Aetna Commercial |
$2.11
|
| Rate for Payer: Aetna Medicare |
$1.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.61
|
| Rate for Payer: BCBS Complete |
$0.99
|
| Rate for Payer: Cash Price |
$1.98
|
| Rate for Payer: Cofinity Advantage |
$1.74
|
| Rate for Payer: Cofinity Commercial |
$2.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.98
|
| Rate for Payer: Healthscope Commercial |
$2.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.86
|
| Rate for Payer: PHP Commercial |
$2.11
|
| Rate for Payer: Priority Health SBD |
$1.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.61
|
| Rate for Payer: UHC Core |
$1.29
|
| Rate for Payer: UHC Exchange |
$0.97
|
| Rate for Payer: UMR Bronson Commercial |
$0.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.86
|
|
|
ATORVASTATIN 80 MG TABLET
|
Facility
|
OP
|
$74.45
|
|
|
Service Code
|
NDC 68084059025
|
| Hospital Charge Code |
28645
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$27.55 |
| Max. Negotiated Rate |
$67.00 |
| Rate for Payer: Aetna American Axle |
$48.39
|
| Rate for Payer: Aetna Commercial |
$63.28
|
| Rate for Payer: Aetna Medicare |
$37.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.39
|
| Rate for Payer: BCBS Complete |
$29.78
|
| Rate for Payer: Cash Price |
$59.56
|
| Rate for Payer: Cofinity Advantage |
$52.12
|
| Rate for Payer: Cofinity Commercial |
$64.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.56
|
| Rate for Payer: Healthscope Commercial |
$67.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.84
|
| Rate for Payer: PHP Commercial |
$63.28
|
| Rate for Payer: Priority Health SBD |
$46.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.39
|
| Rate for Payer: UHC Core |
$38.79
|
| Rate for Payer: UHC Exchange |
$29.26
|
| Rate for Payer: UMR Bronson Commercial |
$27.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
ATORVASTATIN 80 MG TABLET
|
Facility
|
IP
|
$357.44
|
|
|
Service Code
|
NDC 67877051490
|
| Hospital Charge Code |
28645
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$157.27 |
| Max. Negotiated Rate |
$321.70 |
| Rate for Payer: Aetna American Axle |
$232.34
|
| Rate for Payer: Aetna Commercial |
$303.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.34
|
| Rate for Payer: Cash Price |
$285.95
|
| Rate for Payer: Cofinity Advantage |
$250.21
|
| Rate for Payer: Cofinity Commercial |
$307.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.95
|
| Rate for Payer: Healthscope Commercial |
$321.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.08
|
| Rate for Payer: PHP Commercial |
$303.82
|
| Rate for Payer: Priority Health SBD |
$225.19
|
| Rate for Payer: UMR Bronson Commercial |
$157.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.08
|
|
|
ATORVASTATIN 80 MG TABLET
|
Facility
|
IP
|
$74.45
|
|
|
Service Code
|
NDC 68084059025
|
| Hospital Charge Code |
28645
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$32.76 |
| Max. Negotiated Rate |
$67.00 |
| Rate for Payer: Aetna American Axle |
$48.39
|
| Rate for Payer: Aetna Commercial |
$63.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.39
|
| Rate for Payer: Cash Price |
$59.56
|
| Rate for Payer: Cofinity Advantage |
$52.12
|
| Rate for Payer: Cofinity Commercial |
$64.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.56
|
| Rate for Payer: Healthscope Commercial |
$67.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.84
|
| Rate for Payer: PHP Commercial |
$63.28
|
| Rate for Payer: Priority Health SBD |
$46.90
|
| Rate for Payer: UMR Bronson Commercial |
$32.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
ATORVASTATIN 80 MG TABLET
|
Facility
|
OP
|
$74.31
|
|
|
Service Code
|
NDC 51079021103
|
| Hospital Charge Code |
28645
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$27.49 |
| Max. Negotiated Rate |
$66.88 |
| Rate for Payer: Aetna American Axle |
$48.30
|
| Rate for Payer: Aetna Commercial |
$63.16
|
| Rate for Payer: Aetna Medicare |
$37.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.30
|
| Rate for Payer: BCBS Complete |
$29.72
|
| Rate for Payer: Cash Price |
$59.45
|
| Rate for Payer: Cofinity Advantage |
$52.02
|
| Rate for Payer: Cofinity Commercial |
$63.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.45
|
| Rate for Payer: Healthscope Commercial |
$66.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.73
|
| Rate for Payer: PHP Commercial |
$63.16
|
| Rate for Payer: Priority Health SBD |
$46.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.30
|
| Rate for Payer: UHC Core |
$38.72
|
| Rate for Payer: UHC Exchange |
$29.20
|
| Rate for Payer: UMR Bronson Commercial |
$27.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.73
|
|
|
ATORVASTATIN 80 MG TABLET
|
Facility
|
IP
|
$2.49
|
|
|
Service Code
|
NDC 68084059095
|
| Hospital Charge Code |
28645
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.10 |
| Max. Negotiated Rate |
$2.24 |
| Rate for Payer: Aetna American Axle |
$1.62
|
| Rate for Payer: Aetna Commercial |
$2.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.62
|
| Rate for Payer: Cash Price |
$1.99
|
| Rate for Payer: Cofinity Advantage |
$1.74
|
| Rate for Payer: Cofinity Commercial |
$2.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.99
|
| Rate for Payer: Healthscope Commercial |
$2.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.87
|
| Rate for Payer: PHP Commercial |
$2.12
|
| Rate for Payer: Priority Health SBD |
$1.57
|
| Rate for Payer: UMR Bronson Commercial |
$1.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.87
|
|
|
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$112.95
|
|
|
Service Code
|
NDC 00173054700
|
| Hospital Charge Code |
14953
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$41.79 |
| Max. Negotiated Rate |
$101.66 |
| Rate for Payer: Aetna American Axle |
$73.42
|
| Rate for Payer: Aetna Commercial |
$96.01
|
| Rate for Payer: Aetna Medicare |
$56.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.42
|
| Rate for Payer: BCBS Complete |
$45.18
|
| Rate for Payer: Cash Price |
$90.36
|
| Rate for Payer: Cofinity Advantage |
$79.06
|
| Rate for Payer: Cofinity Commercial |
$97.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.36
|
| Rate for Payer: Healthscope Commercial |
$101.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.71
|
| Rate for Payer: PHP Commercial |
$96.01
|
| Rate for Payer: Priority Health SBD |
$71.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.42
|
| Rate for Payer: UHC Core |
$58.85
|
| Rate for Payer: UHC Exchange |
$44.39
|
| Rate for Payer: UMR Bronson Commercial |
$41.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.71
|
|
|
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$999.94
|
|
|
Service Code
|
NDC 31722062921
|
| Hospital Charge Code |
14953
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$369.98 |
| Max. Negotiated Rate |
$899.95 |
| Rate for Payer: Aetna American Axle |
$649.96
|
| Rate for Payer: Aetna Commercial |
$849.95
|
| Rate for Payer: Aetna Medicare |
$499.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.96
|
| Rate for Payer: BCBS Complete |
$399.98
|
| Rate for Payer: Cash Price |
$799.95
|
| Rate for Payer: Cofinity Advantage |
$699.96
|
| Rate for Payer: Cofinity Commercial |
$859.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$799.95
|
| Rate for Payer: Healthscope Commercial |
$899.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$699.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$749.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$799.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$849.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$749.96
|
| Rate for Payer: PHP Commercial |
$849.95
|
| Rate for Payer: Priority Health SBD |
$629.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$649.96
|
| Rate for Payer: UHC Core |
$520.97
|
| Rate for Payer: UHC Exchange |
$392.98
|
| Rate for Payer: UMR Bronson Commercial |
$369.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$749.96
|
|
|
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$5,181.82
|
|
|
Service Code
|
NDC 00173066518
|
| Hospital Charge Code |
14953
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,917.27 |
| Max. Negotiated Rate |
$4,663.64 |
| Rate for Payer: Aetna American Axle |
$3,368.18
|
| Rate for Payer: Aetna Commercial |
$4,404.55
|
| Rate for Payer: Aetna Medicare |
$2,590.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,368.18
|
| Rate for Payer: BCBS Complete |
$2,072.73
|
| Rate for Payer: Cash Price |
$4,145.46
|
| Rate for Payer: Cofinity Advantage |
$3,627.27
|
| Rate for Payer: Cofinity Commercial |
$4,456.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,145.46
|
| Rate for Payer: Healthscope Commercial |
$4,663.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,627.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,886.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,145.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,404.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,886.36
|
| Rate for Payer: PHP Commercial |
$4,404.55
|
| Rate for Payer: Priority Health SBD |
$3,264.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,368.18
|
| Rate for Payer: UHC Core |
$2,699.73
|
| Rate for Payer: UHC Exchange |
$2,036.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,917.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,886.36
|
|
|
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$112.95
|
|
|
Service Code
|
NDC 00173054700
|
| Hospital Charge Code |
14953
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.70 |
| Max. Negotiated Rate |
$101.66 |
| Rate for Payer: Aetna American Axle |
$73.42
|
| Rate for Payer: Aetna Commercial |
$96.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.42
|
| Rate for Payer: Cash Price |
$90.36
|
| Rate for Payer: Cofinity Advantage |
$79.06
|
| Rate for Payer: Cofinity Commercial |
$97.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.36
|
| Rate for Payer: Healthscope Commercial |
$101.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.71
|
| Rate for Payer: PHP Commercial |
$96.01
|
| Rate for Payer: Priority Health SBD |
$71.16
|
| Rate for Payer: UMR Bronson Commercial |
$49.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.71
|
|
|
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$5,181.82
|
|
|
Service Code
|
NDC 00173066518
|
| Hospital Charge Code |
14953
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,280.00 |
| Max. Negotiated Rate |
$4,663.64 |
| Rate for Payer: Aetna American Axle |
$3,368.18
|
| Rate for Payer: Aetna Commercial |
$4,404.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,368.18
|
| Rate for Payer: Cash Price |
$4,145.46
|
| Rate for Payer: Cofinity Advantage |
$3,627.27
|
| Rate for Payer: Cofinity Commercial |
$4,456.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,145.46
|
| Rate for Payer: Healthscope Commercial |
$4,663.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,627.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,886.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,404.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,886.36
|
| Rate for Payer: PHP Commercial |
$4,404.55
|
| Rate for Payer: Priority Health SBD |
$3,264.55
|
| Rate for Payer: UMR Bronson Commercial |
$2,280.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,886.36
|
|
|
ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$999.94
|
|
|
Service Code
|
NDC 31722062921
|
| Hospital Charge Code |
14953
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$439.97 |
| Max. Negotiated Rate |
$899.95 |
| Rate for Payer: Aetna American Axle |
$649.96
|
| Rate for Payer: Aetna Commercial |
$849.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$649.96
|
| Rate for Payer: Cash Price |
$799.95
|
| Rate for Payer: Cofinity Advantage |
$699.96
|
| Rate for Payer: Cofinity Commercial |
$859.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$799.95
|
| Rate for Payer: Healthscope Commercial |
$899.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$699.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$749.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$849.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$749.96
|
| Rate for Payer: PHP Commercial |
$849.95
|
| Rate for Payer: Priority Health SBD |
$629.96
|
| Rate for Payer: UMR Bronson Commercial |
$439.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$749.96
|
|
|
ATROPINE 0.1 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$40.41
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
730
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$36.37 |
| Rate for Payer: Aetna American Axle |
$26.27
|
| Rate for Payer: Aetna American Axle |
$18.25
|
| Rate for Payer: Aetna American Axle |
$22.97
|
| Rate for Payer: Aetna American Axle |
$23.55
|
| Rate for Payer: Aetna American Axle |
$19.47
|
| Rate for Payer: Aetna American Axle |
$47.21
|
| Rate for Payer: Aetna American Axle |
$27.94
|
| Rate for Payer: Aetna Commercial |
$61.74
|
| Rate for Payer: Aetna Commercial |
$23.87
|
| Rate for Payer: Aetna Commercial |
$30.80
|
| Rate for Payer: Aetna Commercial |
$30.04
|
| Rate for Payer: Aetna Commercial |
$34.35
|
| Rate for Payer: Aetna Commercial |
$25.46
|
| Rate for Payer: Aetna Commercial |
$36.54
|
| Rate for Payer: Aetna Medicare |
$14.04
|
| Rate for Payer: Aetna Medicare |
$36.31
|
| Rate for Payer: Aetna Medicare |
$20.20
|
| Rate for Payer: Aetna Medicare |
$21.50
|
| Rate for Payer: Aetna Medicare |
$18.11
|
| Rate for Payer: Aetna Medicare |
$14.97
|
| Rate for Payer: Aetna Medicare |
$17.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.94
|
| Rate for Payer: BCBS Complete |
$11.98
|
| Rate for Payer: BCBS Complete |
$29.05
|
| Rate for Payer: BCBS Complete |
$14.49
|
| Rate for Payer: BCBS Complete |
$16.16
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS Complete |
$11.23
|
| Rate for Payer: BCBS Complete |
$14.14
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: Cash Price |
$28.27
|
| Rate for Payer: Cash Price |
$58.10
|
| Rate for Payer: Cash Price |
$22.46
|
| Rate for Payer: Cash Price |
$32.33
|
| Rate for Payer: Cash Price |
$28.98
|
| Rate for Payer: Cash Price |
$28.98
|
| Rate for Payer: Cash Price |
$34.39
|
| Rate for Payer: Cash Price |
$22.46
|
| Rate for Payer: Cash Price |
$58.10
|
| Rate for Payer: Cash Price |
$23.96
|
| Rate for Payer: Cash Price |
$34.39
|
| Rate for Payer: Cash Price |
$32.33
|
| Rate for Payer: Cash Price |
$23.96
|
| Rate for Payer: Cash Price |
$28.27
|
| Rate for Payer: Cofinity Advantage |
$25.36
|
| Rate for Payer: Cofinity Advantage |
$24.74
|
| Rate for Payer: Cofinity Advantage |
$20.96
|
| Rate for Payer: Cofinity Advantage |
$19.66
|
| Rate for Payer: Cofinity Advantage |
$28.29
|
| Rate for Payer: Cofinity Advantage |
$30.09
|
| Rate for Payer: Cofinity Advantage |
$50.84
|
| Rate for Payer: Cofinity Commercial |
$34.75
|
| Rate for Payer: Cofinity Commercial |
$36.97
|
| Rate for Payer: Cofinity Commercial |
$62.46
|
| Rate for Payer: Cofinity Commercial |
$24.15
|
| Rate for Payer: Cofinity Commercial |
$25.76
|
| Rate for Payer: Cofinity Commercial |
$30.39
|
| Rate for Payer: Cofinity Commercial |
$31.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.10
|
| Rate for Payer: Healthscope Commercial |
$32.61
|
| Rate for Payer: Healthscope Commercial |
$38.69
|
| Rate for Payer: Healthscope Commercial |
$65.37
|
| Rate for Payer: Healthscope Commercial |
$36.37
|
| Rate for Payer: Healthscope Commercial |
$26.95
|
| Rate for Payer: Healthscope Commercial |
$25.27
|
| Rate for Payer: Healthscope Commercial |
$31.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.06
|
| Rate for Payer: PHP Commercial |
$30.80
|
| Rate for Payer: PHP Commercial |
$30.04
|
| Rate for Payer: PHP Commercial |
$23.87
|
| Rate for Payer: PHP Commercial |
$25.46
|
| Rate for Payer: PHP Commercial |
$34.35
|
| Rate for Payer: PHP Commercial |
$36.54
|
| Rate for Payer: PHP Commercial |
$61.74
|
| Rate for Payer: Priority Health SBD |
$27.08
|
| Rate for Payer: Priority Health SBD |
$22.26
|
| Rate for Payer: Priority Health SBD |
$25.46
|
| Rate for Payer: Priority Health SBD |
$45.76
|
| Rate for Payer: Priority Health SBD |
$18.87
|
| Rate for Payer: Priority Health SBD |
$17.69
|
| Rate for Payer: Priority Health SBD |
$22.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UMR Bronson Commercial |
$13.08
|
| Rate for Payer: UMR Bronson Commercial |
$13.41
|
| Rate for Payer: UMR Bronson Commercial |
$11.08
|
| Rate for Payer: UMR Bronson Commercial |
$10.39
|
| Rate for Payer: UMR Bronson Commercial |
$26.87
|
| Rate for Payer: UMR Bronson Commercial |
$15.91
|
| Rate for Payer: UMR Bronson Commercial |
$14.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.17
|
|
|
ATROPINE 0.1 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$28.08
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
730
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.36 |
| Max. Negotiated Rate |
$25.27 |
| Rate for Payer: Aetna American Axle |
$18.25
|
| Rate for Payer: Aetna American Axle |
$22.97
|
| Rate for Payer: Aetna American Axle |
$23.55
|
| Rate for Payer: Aetna American Axle |
$47.21
|
| Rate for Payer: Aetna American Axle |
$27.94
|
| Rate for Payer: Aetna American Axle |
$26.27
|
| Rate for Payer: Aetna American Axle |
$19.47
|
| Rate for Payer: Aetna Commercial |
$30.80
|
| Rate for Payer: Aetna Commercial |
$25.46
|
| Rate for Payer: Aetna Commercial |
$23.87
|
| Rate for Payer: Aetna Commercial |
$30.04
|
| Rate for Payer: Aetna Commercial |
$61.74
|
| Rate for Payer: Aetna Commercial |
$34.35
|
| Rate for Payer: Aetna Commercial |
$36.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.21
|
| Rate for Payer: Cash Price |
$22.46
|
| Rate for Payer: Cash Price |
$28.98
|
| Rate for Payer: Cash Price |
$28.27
|
| Rate for Payer: Cash Price |
$23.96
|
| Rate for Payer: Cash Price |
$32.33
|
| Rate for Payer: Cash Price |
$34.39
|
| Rate for Payer: Cash Price |
$58.10
|
| Rate for Payer: Cofinity Advantage |
$30.09
|
| Rate for Payer: Cofinity Advantage |
$19.66
|
| Rate for Payer: Cofinity Advantage |
$20.96
|
| Rate for Payer: Cofinity Advantage |
$25.36
|
| Rate for Payer: Cofinity Advantage |
$24.74
|
| Rate for Payer: Cofinity Advantage |
$28.29
|
| Rate for Payer: Cofinity Advantage |
$50.84
|
| Rate for Payer: Cofinity Commercial |
$30.39
|
| Rate for Payer: Cofinity Commercial |
$62.46
|
| Rate for Payer: Cofinity Commercial |
$36.97
|
| Rate for Payer: Cofinity Commercial |
$24.15
|
| Rate for Payer: Cofinity Commercial |
$25.76
|
| Rate for Payer: Cofinity Commercial |
$34.75
|
| Rate for Payer: Cofinity Commercial |
$31.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.96
|
| Rate for Payer: Healthscope Commercial |
$65.37
|
| Rate for Payer: Healthscope Commercial |
$25.27
|
| Rate for Payer: Healthscope Commercial |
$38.69
|
| Rate for Payer: Healthscope Commercial |
$32.61
|
| Rate for Payer: Healthscope Commercial |
$26.95
|
| Rate for Payer: Healthscope Commercial |
$31.81
|
| Rate for Payer: Healthscope Commercial |
$36.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.46
|
| Rate for Payer: PHP Commercial |
$25.46
|
| Rate for Payer: PHP Commercial |
$36.54
|
| Rate for Payer: PHP Commercial |
$30.80
|
| Rate for Payer: PHP Commercial |
$61.74
|
| Rate for Payer: PHP Commercial |
$30.04
|
| Rate for Payer: PHP Commercial |
$23.87
|
| Rate for Payer: PHP Commercial |
$34.35
|
| Rate for Payer: Priority Health SBD |
$17.69
|
| Rate for Payer: Priority Health SBD |
$22.82
|
| Rate for Payer: Priority Health SBD |
$25.46
|
| Rate for Payer: Priority Health SBD |
$27.08
|
| Rate for Payer: Priority Health SBD |
$45.76
|
| Rate for Payer: Priority Health SBD |
$18.87
|
| Rate for Payer: Priority Health SBD |
$22.26
|
| Rate for Payer: UMR Bronson Commercial |
$31.96
|
| Rate for Payer: UMR Bronson Commercial |
$12.36
|
| Rate for Payer: UMR Bronson Commercial |
$15.94
|
| Rate for Payer: UMR Bronson Commercial |
$13.18
|
| Rate for Payer: UMR Bronson Commercial |
$17.78
|
| Rate for Payer: UMR Bronson Commercial |
$18.92
|
| Rate for Payer: UMR Bronson Commercial |
$15.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.47
|
|
|
ATROPINE 0.1 MG/ML SYRINGE (CODE)
|
Facility
|
IP
|
$29.95
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
163701
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.18 |
| Max. Negotiated Rate |
$26.95 |
| Rate for Payer: Aetna American Axle |
$19.47
|
| Rate for Payer: Aetna American Axle |
$47.21
|
| Rate for Payer: Aetna American Axle |
$26.27
|
| Rate for Payer: Aetna Commercial |
$34.35
|
| Rate for Payer: Aetna Commercial |
$25.46
|
| Rate for Payer: Aetna Commercial |
$61.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.27
|
| Rate for Payer: Cash Price |
$32.33
|
| Rate for Payer: Cash Price |
$23.96
|
| Rate for Payer: Cash Price |
$58.10
|
| Rate for Payer: Cofinity Advantage |
$50.84
|
| Rate for Payer: Cofinity Advantage |
$20.96
|
| Rate for Payer: Cofinity Advantage |
$28.29
|
| Rate for Payer: Cofinity Commercial |
$62.46
|
| Rate for Payer: Cofinity Commercial |
$25.76
|
| Rate for Payer: Cofinity Commercial |
$34.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.10
|
| Rate for Payer: Healthscope Commercial |
$36.37
|
| Rate for Payer: Healthscope Commercial |
$65.37
|
| Rate for Payer: Healthscope Commercial |
$26.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.47
|
| Rate for Payer: PHP Commercial |
$34.35
|
| Rate for Payer: PHP Commercial |
$25.46
|
| Rate for Payer: PHP Commercial |
$61.74
|
| Rate for Payer: Priority Health SBD |
$18.87
|
| Rate for Payer: Priority Health SBD |
$25.46
|
| Rate for Payer: Priority Health SBD |
$45.76
|
| Rate for Payer: UMR Bronson Commercial |
$13.18
|
| Rate for Payer: UMR Bronson Commercial |
$31.96
|
| Rate for Payer: UMR Bronson Commercial |
$17.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.47
|
|
|
ATROPINE 0.1 MG/ML SYRINGE (CODE)
|
Facility
|
OP
|
$40.41
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
163701
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$36.37 |
| Rate for Payer: Aetna American Axle |
$26.27
|
| Rate for Payer: Aetna American Axle |
$19.47
|
| Rate for Payer: Aetna American Axle |
$47.21
|
| Rate for Payer: Aetna Commercial |
$34.35
|
| Rate for Payer: Aetna Commercial |
$61.74
|
| Rate for Payer: Aetna Commercial |
$25.46
|
| Rate for Payer: Aetna Medicare |
$20.20
|
| Rate for Payer: Aetna Medicare |
$14.97
|
| Rate for Payer: Aetna Medicare |
$36.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.21
|
| Rate for Payer: BCBS Complete |
$11.98
|
| Rate for Payer: BCBS Complete |
$16.16
|
| Rate for Payer: BCBS Complete |
$29.05
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: Cash Price |
$23.96
|
| Rate for Payer: Cash Price |
$23.96
|
| Rate for Payer: Cash Price |
$58.10
|
| Rate for Payer: Cash Price |
$58.10
|
| Rate for Payer: Cash Price |
$32.33
|
| Rate for Payer: Cash Price |
$32.33
|
| Rate for Payer: Cofinity Advantage |
$50.84
|
| Rate for Payer: Cofinity Advantage |
$28.29
|
| Rate for Payer: Cofinity Advantage |
$20.96
|
| Rate for Payer: Cofinity Commercial |
$25.76
|
| Rate for Payer: Cofinity Commercial |
$34.75
|
| Rate for Payer: Cofinity Commercial |
$62.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.33
|
| Rate for Payer: Healthscope Commercial |
$26.95
|
| Rate for Payer: Healthscope Commercial |
$36.37
|
| Rate for Payer: Healthscope Commercial |
$65.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.47
|
| Rate for Payer: PHP Commercial |
$34.35
|
| Rate for Payer: PHP Commercial |
$25.46
|
| Rate for Payer: PHP Commercial |
$61.74
|
| Rate for Payer: Priority Health SBD |
$18.87
|
| Rate for Payer: Priority Health SBD |
$45.76
|
| Rate for Payer: Priority Health SBD |
$25.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UMR Bronson Commercial |
$26.87
|
| Rate for Payer: UMR Bronson Commercial |
$11.08
|
| Rate for Payer: UMR Bronson Commercial |
$14.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.47
|
|
|
ATROPINE 0.4 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$33.29
|
|
|
Service Code
|
HCPCS J0462
|
| Hospital Charge Code |
731
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$29.96 |
| Rate for Payer: Aetna American Axle |
$21.64
|
| Rate for Payer: Aetna American Axle |
$80.07
|
| Rate for Payer: Aetna American Axle |
$22.91
|
| Rate for Payer: Aetna Commercial |
$28.30
|
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: Aetna Commercial |
$104.70
|
| Rate for Payer: Aetna Medicare |
$16.64
|
| Rate for Payer: Aetna Medicare |
$61.59
|
| Rate for Payer: Aetna Medicare |
$17.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.91
|
| Rate for Payer: BCBS Complete |
$49.27
|
| Rate for Payer: BCBS Complete |
$13.32
|
| Rate for Payer: BCBS Complete |
$14.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.41
|
| Rate for Payer: BCBS Trust/PPO |
$0.41
|
| Rate for Payer: BCBS Trust/PPO |
$0.41
|
| Rate for Payer: BCN Commercial |
$0.41
|
| Rate for Payer: BCN Commercial |
$0.41
|
| Rate for Payer: BCN Commercial |
$0.41
|
| Rate for Payer: Cash Price |
$98.54
|
| Rate for Payer: Cash Price |
$98.54
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Advantage |
$24.68
|
| Rate for Payer: Cofinity Advantage |
$23.30
|
| Rate for Payer: Cofinity Advantage |
$86.23
|
| Rate for Payer: Cofinity Commercial |
$105.93
|
| Rate for Payer: Cofinity Commercial |
$28.63
|
| Rate for Payer: Cofinity Commercial |
$30.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Healthscope Commercial |
$110.86
|
| Rate for Payer: Healthscope Commercial |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$31.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.44
|
| Rate for Payer: PHP Commercial |
$28.30
|
| Rate for Payer: PHP Commercial |
$104.70
|
| Rate for Payer: PHP Commercial |
$29.96
|
| Rate for Payer: Priority Health SBD |
$77.60
|
| Rate for Payer: Priority Health SBD |
$22.21
|
| Rate for Payer: Priority Health SBD |
$20.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.21
|
| Rate for Payer: UHC Core |
$0.21
|
| Rate for Payer: UHC Core |
$0.21
|
| Rate for Payer: UHC Core |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.21
|
| Rate for Payer: UMR Bronson Commercial |
$13.04
|
| Rate for Payer: UMR Bronson Commercial |
$45.58
|
| Rate for Payer: UMR Bronson Commercial |
$12.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.44
|
|
|
ATROPINE 0.4 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$33.29
|
|
|
Service Code
|
HCPCS J0462
|
| Hospital Charge Code |
731
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.65 |
| Max. Negotiated Rate |
$29.96 |
| Rate for Payer: Aetna American Axle |
$21.64
|
| Rate for Payer: Aetna American Axle |
$22.91
|
| Rate for Payer: Aetna Commercial |
$28.30
|
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.91
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cofinity Advantage |
$24.68
|
| Rate for Payer: Cofinity Advantage |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$28.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.20
|
| Rate for Payer: Healthscope Commercial |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$31.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.44
|
| Rate for Payer: PHP Commercial |
$28.30
|
| Rate for Payer: PHP Commercial |
$29.96
|
| Rate for Payer: Priority Health SBD |
$22.21
|
| Rate for Payer: Priority Health SBD |
$20.97
|
| Rate for Payer: UMR Bronson Commercial |
$14.65
|
| Rate for Payer: UMR Bronson Commercial |
$15.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.44
|
|
|
ATROPINE 0.4 MG/ML INJECTION SOLUTION WRAPPER
|
Facility
|
OP
|
$35.25
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
301845
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$31.73 |
| Rate for Payer: Aetna American Axle |
$22.91
|
| Rate for Payer: Aetna American Axle |
$80.07
|
| Rate for Payer: Aetna Commercial |
$104.70
|
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: Aetna Medicare |
$17.62
|
| Rate for Payer: Aetna Medicare |
$61.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.07
|
| Rate for Payer: BCBS Complete |
$49.27
|
| Rate for Payer: BCBS Complete |
$14.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cash Price |
$98.54
|
| Rate for Payer: Cash Price |
$98.54
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cofinity Advantage |
$24.68
|
| Rate for Payer: Cofinity Advantage |
$86.23
|
| Rate for Payer: Cofinity Commercial |
$105.93
|
| Rate for Payer: Cofinity Commercial |
$30.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.20
|
| Rate for Payer: Healthscope Commercial |
$31.73
|
| Rate for Payer: Healthscope Commercial |
$110.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.39
|
| Rate for Payer: PHP Commercial |
$104.70
|
| Rate for Payer: PHP Commercial |
$29.96
|
| Rate for Payer: Priority Health SBD |
$22.21
|
| Rate for Payer: Priority Health SBD |
$77.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Core |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UHC Exchange |
$0.17
|
| Rate for Payer: UMR Bronson Commercial |
$13.04
|
| Rate for Payer: UMR Bronson Commercial |
$45.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.44
|
|
|
ATROPINE 0.4 MG/ML INJECTION SOLUTION WRAPPER
|
Facility
|
IP
|
$35.25
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
301845
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.51 |
| Max. Negotiated Rate |
$31.73 |
| Rate for Payer: Aetna American Axle |
$22.91
|
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.91
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cofinity Advantage |
$24.68
|
| Rate for Payer: Cofinity Commercial |
$30.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.20
|
| Rate for Payer: Healthscope Commercial |
$31.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.44
|
| Rate for Payer: PHP Commercial |
$29.96
|
| Rate for Payer: Priority Health SBD |
$22.21
|
| Rate for Payer: UMR Bronson Commercial |
$15.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.44
|
|
|
ATROPINE 0.4 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$18.50
|
|
|
Service Code
|
HCPCS J0462
|
| Hospital Charge Code |
195980
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$16.65 |
| Rate for Payer: Aetna American Axle |
$12.03
|
| Rate for Payer: Aetna Commercial |
$15.72
|
| Rate for Payer: Aetna Medicare |
$9.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.03
|
| Rate for Payer: BCBS Complete |
$7.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.41
|
| Rate for Payer: BCN Commercial |
$0.41
|
| Rate for Payer: Cash Price |
$14.80
|
| Rate for Payer: Cash Price |
$14.80
|
| Rate for Payer: Cofinity Advantage |
$12.95
|
| Rate for Payer: Cofinity Commercial |
$15.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.80
|
| Rate for Payer: Healthscope Commercial |
$16.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.88
|
| Rate for Payer: PHP Commercial |
$15.72
|
| Rate for Payer: Priority Health SBD |
$11.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.21
|
| Rate for Payer: UHC Core |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.21
|
| Rate for Payer: UMR Bronson Commercial |
$6.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.88
|
|
|
ATROPINE 0.4 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$18.50
|
|
|
Service Code
|
HCPCS J0462
|
| Hospital Charge Code |
195980
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.14 |
| Max. Negotiated Rate |
$16.65 |
| Rate for Payer: Aetna American Axle |
$12.03
|
| Rate for Payer: Aetna Commercial |
$15.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.03
|
| Rate for Payer: Cash Price |
$14.80
|
| Rate for Payer: Cofinity Advantage |
$12.95
|
| Rate for Payer: Cofinity Commercial |
$15.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.80
|
| Rate for Payer: Healthscope Commercial |
$16.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.88
|
| Rate for Payer: PHP Commercial |
$15.72
|
| Rate for Payer: Priority Health SBD |
$11.65
|
| Rate for Payer: UMR Bronson Commercial |
$8.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.88
|
|
