|
HEPARIN, PORCINE (PF) 100 UNIT/ML (1 ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.34
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
116331
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$17.41 |
| Rate for Payer: Aetna American Axle |
$12.57
|
| Rate for Payer: Aetna Commercial |
$16.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.57
|
| Rate for Payer: Cash Price |
$15.47
|
| Rate for Payer: Cofinity Commercial |
$13.54
|
| Rate for Payer: Cofinity Commercial |
$16.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.47
|
| Rate for Payer: Healthscope Commercial |
$17.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.44
|
| Rate for Payer: PHP Commercial |
$16.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.54
|
| Rate for Payer: Priority Health SBD |
$12.18
|
| Rate for Payer: UMR Bronson Commercial |
$8.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.50
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$10.25
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
116327
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.51 |
| Max. Negotiated Rate |
$9.22 |
| Rate for Payer: Aetna American Axle |
$6.66
|
| Rate for Payer: Aetna American Axle |
$7.23
|
| Rate for Payer: Aetna American Axle |
$8.45
|
| Rate for Payer: Aetna American Axle |
$7.15
|
| Rate for Payer: Aetna Commercial |
$9.46
|
| Rate for Payer: Aetna Commercial |
$8.71
|
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: Aetna Commercial |
$11.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.15
|
| Rate for Payer: Cash Price |
$8.90
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$8.20
|
| Rate for Payer: Cofinity Commercial |
$7.70
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$9.57
|
| Rate for Payer: Cofinity Commercial |
$7.79
|
| Rate for Payer: Cofinity Commercial |
$8.82
|
| Rate for Payer: Cofinity Commercial |
$9.10
|
| Rate for Payer: Cofinity Commercial |
$7.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.20
|
| Rate for Payer: Healthscope Commercial |
$11.70
|
| Rate for Payer: Healthscope Commercial |
$9.22
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: Healthscope Commercial |
$10.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.71
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: PHP Commercial |
$8.71
|
| Rate for Payer: PHP Commercial |
$11.05
|
| Rate for Payer: PHP Commercial |
$9.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.18
|
| Rate for Payer: Priority Health SBD |
$6.46
|
| Rate for Payer: Priority Health SBD |
$7.01
|
| Rate for Payer: Priority Health SBD |
$6.93
|
| Rate for Payer: Priority Health SBD |
$8.19
|
| Rate for Payer: UMR Bronson Commercial |
$5.72
|
| Rate for Payer: UMR Bronson Commercial |
$4.51
|
| Rate for Payer: UMR Bronson Commercial |
$4.84
|
| Rate for Payer: UMR Bronson Commercial |
$4.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.75
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$8.38
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
116327
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$7.54 |
| Rate for Payer: Aetna American Axle |
$5.45
|
| Rate for Payer: Aetna American Axle |
$8.45
|
| Rate for Payer: Aetna American Axle |
$8.78
|
| Rate for Payer: Aetna Commercial |
$11.05
|
| Rate for Payer: Aetna Commercial |
$7.12
|
| Rate for Payer: Aetna Commercial |
$11.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.78
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS Complete |
$3.35
|
| Rate for Payer: BCBS Complete |
$5.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: Cash Price |
$6.70
|
| Rate for Payer: Cash Price |
$6.70
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cofinity Commercial |
$9.45
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$5.87
|
| Rate for Payer: Cofinity Commercial |
$7.21
|
| Rate for Payer: Cofinity Commercial |
$9.10
|
| Rate for Payer: Cofinity Commercial |
$11.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$12.15
|
| Rate for Payer: Healthscope Commercial |
$7.54
|
| Rate for Payer: Healthscope Commercial |
$11.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.05
|
| Rate for Payer: PHP Commercial |
$11.05
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Commercial |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health SBD |
$8.50
|
| Rate for Payer: Priority Health SBD |
$5.28
|
| Rate for Payer: Priority Health SBD |
$8.19
|
| Rate for Payer: UMR Bronson Commercial |
$3.10
|
| Rate for Payer: UMR Bronson Commercial |
$4.81
|
| Rate for Payer: UMR Bronson Commercial |
$5.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.12
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE (CUSTOM NO PRIOR AUTH CREATED)
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
300951
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$11.70 |
| Rate for Payer: Aetna American Axle |
$8.45
|
| Rate for Payer: Aetna American Axle |
$6.66
|
| Rate for Payer: Aetna Commercial |
$11.05
|
| Rate for Payer: Aetna Commercial |
$8.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.45
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS Complete |
$4.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$8.20
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$8.20
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$9.10
|
| Rate for Payer: Cofinity Commercial |
$7.18
|
| Rate for Payer: Cofinity Commercial |
$8.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.20
|
| Rate for Payer: Healthscope Commercial |
$9.22
|
| Rate for Payer: Healthscope Commercial |
$11.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.05
|
| Rate for Payer: PHP Commercial |
$8.71
|
| Rate for Payer: PHP Commercial |
$11.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.18
|
| Rate for Payer: Priority Health SBD |
$8.19
|
| Rate for Payer: Priority Health SBD |
$6.46
|
| Rate for Payer: UMR Bronson Commercial |
$4.81
|
| Rate for Payer: UMR Bronson Commercial |
$3.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.75
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE (CUSTOM NO PRIOR AUTH CREATED)
|
Facility
|
IP
|
$10.25
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
300951
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.51 |
| Max. Negotiated Rate |
$9.22 |
| Rate for Payer: Aetna American Axle |
$6.66
|
| Rate for Payer: Aetna American Axle |
$7.23
|
| Rate for Payer: Aetna American Axle |
$7.15
|
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: Aetna Commercial |
$8.71
|
| Rate for Payer: Aetna Commercial |
$9.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.66
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.90
|
| Rate for Payer: Cash Price |
$8.20
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$9.57
|
| Rate for Payer: Cofinity Commercial |
$7.18
|
| Rate for Payer: Cofinity Commercial |
$8.82
|
| Rate for Payer: Cofinity Commercial |
$7.70
|
| Rate for Payer: Cofinity Commercial |
$7.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Healthscope Commercial |
$9.22
|
| Rate for Payer: Healthscope Commercial |
$10.02
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.71
|
| Rate for Payer: PHP Commercial |
$9.46
|
| Rate for Payer: PHP Commercial |
$8.71
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.70
|
| Rate for Payer: Priority Health SBD |
$6.93
|
| Rate for Payer: Priority Health SBD |
$6.46
|
| Rate for Payer: Priority Health SBD |
$7.01
|
| Rate for Payer: UMR Bronson Commercial |
$4.84
|
| Rate for Payer: UMR Bronson Commercial |
$4.51
|
| Rate for Payer: UMR Bronson Commercial |
$4.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.35
|
|
|
HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$10.00
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
105460
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Aetna American Axle |
$6.50
|
| Rate for Payer: Aetna American Axle |
$10.58
|
| Rate for Payer: Aetna American Axle |
$6.99
|
| Rate for Payer: Aetna American Axle |
$8.34
|
| Rate for Payer: Aetna American Axle |
$7.31
|
| Rate for Payer: Aetna Commercial |
$9.56
|
| Rate for Payer: Aetna Commercial |
$8.50
|
| Rate for Payer: Aetna Commercial |
$13.84
|
| Rate for Payer: Aetna Commercial |
$10.91
|
| Rate for Payer: Aetna Commercial |
$9.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.31
|
| Rate for Payer: Cash Price |
$13.02
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$8.60
|
| Rate for Payer: Cash Price |
$10.26
|
| Rate for Payer: Cofinity Commercial |
$9.68
|
| Rate for Payer: Cofinity Commercial |
$7.00
|
| Rate for Payer: Cofinity Commercial |
$8.60
|
| Rate for Payer: Cofinity Commercial |
$7.52
|
| Rate for Payer: Cofinity Commercial |
$9.24
|
| Rate for Payer: Cofinity Commercial |
$7.88
|
| Rate for Payer: Cofinity Commercial |
$11.03
|
| Rate for Payer: Cofinity Commercial |
$8.98
|
| Rate for Payer: Cofinity Commercial |
$11.40
|
| Rate for Payer: Cofinity Commercial |
$14.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.60
|
| Rate for Payer: Healthscope Commercial |
$11.55
|
| Rate for Payer: Healthscope Commercial |
$14.65
|
| Rate for Payer: Healthscope Commercial |
$9.68
|
| Rate for Payer: Healthscope Commercial |
$9.00
|
| Rate for Payer: Healthscope Commercial |
$10.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.84
|
| Rate for Payer: PHP Commercial |
$10.91
|
| Rate for Payer: PHP Commercial |
$13.84
|
| Rate for Payer: PHP Commercial |
$9.56
|
| Rate for Payer: PHP Commercial |
$9.14
|
| Rate for Payer: PHP Commercial |
$8.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.98
|
| Rate for Payer: Priority Health SBD |
$6.77
|
| Rate for Payer: Priority Health SBD |
$10.26
|
| Rate for Payer: Priority Health SBD |
$8.08
|
| Rate for Payer: Priority Health SBD |
$6.30
|
| Rate for Payer: Priority Health SBD |
$7.09
|
| Rate for Payer: UMR Bronson Commercial |
$4.73
|
| Rate for Payer: UMR Bronson Commercial |
$4.40
|
| Rate for Payer: UMR Bronson Commercial |
$5.65
|
| Rate for Payer: UMR Bronson Commercial |
$7.16
|
| Rate for Payer: UMR Bronson Commercial |
$4.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.06
|
|
|
HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$14.50
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
105460
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$13.05 |
| Rate for Payer: Aetna American Axle |
$9.42
|
| Rate for Payer: Aetna American Axle |
$6.50
|
| Rate for Payer: Aetna American Axle |
$6.99
|
| Rate for Payer: Aetna Commercial |
$8.50
|
| Rate for Payer: Aetna Commercial |
$12.32
|
| Rate for Payer: Aetna Commercial |
$9.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.50
|
| Rate for Payer: BCBS Complete |
$5.80
|
| Rate for Payer: BCBS Complete |
$4.30
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$11.60
|
| Rate for Payer: Cash Price |
$11.60
|
| Rate for Payer: Cash Price |
$8.60
|
| Rate for Payer: Cash Price |
$8.60
|
| Rate for Payer: Cofinity Commercial |
$7.52
|
| Rate for Payer: Cofinity Commercial |
$10.15
|
| Rate for Payer: Cofinity Commercial |
$7.00
|
| Rate for Payer: Cofinity Commercial |
$12.47
|
| Rate for Payer: Cofinity Commercial |
$8.60
|
| Rate for Payer: Cofinity Commercial |
$9.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.60
|
| Rate for Payer: Healthscope Commercial |
$9.68
|
| Rate for Payer: Healthscope Commercial |
$9.00
|
| Rate for Payer: Healthscope Commercial |
$13.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12.32
|
| Rate for Payer: PHP Commercial |
$8.50
|
| Rate for Payer: PHP Commercial |
$12.32
|
| Rate for Payer: PHP Commercial |
$9.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.00
|
| Rate for Payer: Priority Health SBD |
$6.30
|
| Rate for Payer: Priority Health SBD |
$6.77
|
| Rate for Payer: Priority Health SBD |
$9.14
|
| Rate for Payer: UMR Bronson Commercial |
$3.98
|
| Rate for Payer: UMR Bronson Commercial |
$3.70
|
| Rate for Payer: UMR Bronson Commercial |
$5.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.06
|
|
|
HEPARIN (PORCINE) (PF) 2,000 UNIT/1,000 ML IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
IP
|
$63.80
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
118364
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.07 |
| Max. Negotiated Rate |
$57.42 |
| Rate for Payer: Aetna American Axle |
$41.47
|
| Rate for Payer: Aetna American Axle |
$62.20
|
| Rate for Payer: Aetna Commercial |
$81.34
|
| Rate for Payer: Aetna Commercial |
$54.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.20
|
| Rate for Payer: Cash Price |
$76.56
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cofinity Commercial |
$44.66
|
| Rate for Payer: Cofinity Commercial |
$54.87
|
| Rate for Payer: Cofinity Commercial |
$82.30
|
| Rate for Payer: Cofinity Commercial |
$66.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.56
|
| Rate for Payer: Healthscope Commercial |
$86.13
|
| Rate for Payer: Healthscope Commercial |
$57.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.23
|
| Rate for Payer: PHP Commercial |
$54.23
|
| Rate for Payer: PHP Commercial |
$81.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.99
|
| Rate for Payer: Priority Health SBD |
$40.19
|
| Rate for Payer: Priority Health SBD |
$60.29
|
| Rate for Payer: UMR Bronson Commercial |
$28.07
|
| Rate for Payer: UMR Bronson Commercial |
$42.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.78
|
|
|
HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION
|
Facility
|
IP
|
$104.05
|
|
|
Service Code
|
HCPCS 90633
|
| Hospital Charge Code |
91045
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$45.78 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna American Axle |
$67.63
|
| Rate for Payer: Aetna Commercial |
$88.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.63
|
| Rate for Payer: Cash Price |
$83.24
|
| Rate for Payer: Cofinity Commercial |
$72.84
|
| Rate for Payer: Cofinity Commercial |
$89.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.24
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.44
|
| Rate for Payer: PHP Commercial |
$88.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.84
|
| Rate for Payer: Priority Health SBD |
$65.55
|
| Rate for Payer: UMR Bronson Commercial |
$45.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.04
|
|
|
HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE
|
Facility
|
IP
|
$96.96
|
|
|
Service Code
|
HCPCS 90633
|
| Hospital Charge Code |
160075
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$42.66 |
| Max. Negotiated Rate |
$87.26 |
| Rate for Payer: Aetna American Axle |
$63.02
|
| Rate for Payer: Aetna Commercial |
$82.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.02
|
| Rate for Payer: Cash Price |
$77.57
|
| Rate for Payer: Cofinity Commercial |
$67.87
|
| Rate for Payer: Cofinity Commercial |
$83.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.57
|
| Rate for Payer: Healthscope Commercial |
$87.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.42
|
| Rate for Payer: PHP Commercial |
$82.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.87
|
| Rate for Payer: Priority Health SBD |
$61.08
|
| Rate for Payer: UMR Bronson Commercial |
$42.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.72
|
|
|
HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION
|
Facility
|
OP
|
$2,111.52
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
91047
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$75.43 |
| Max. Negotiated Rate |
$1,900.37 |
| Rate for Payer: Aetna American Axle |
$1,372.49
|
| Rate for Payer: Aetna Commercial |
$1,794.79
|
| Rate for Payer: Aetna Medicare |
$143.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,372.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.36
|
| Rate for Payer: BCBS Complete |
$79.21
|
| Rate for Payer: BCBS MAPPO |
$137.89
|
| Rate for Payer: BCBS Trust/PPO |
$480.86
|
| Rate for Payer: BCN Medicare Advantage |
$137.89
|
| Rate for Payer: Cash Price |
$1,689.22
|
| Rate for Payer: Cash Price |
$1,689.22
|
| Rate for Payer: Cofinity Commercial |
$1,478.06
|
| Rate for Payer: Cofinity Commercial |
$1,815.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.89
|
| Rate for Payer: Healthscope Commercial |
$1,900.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,478.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,583.64
|
| Rate for Payer: Mclaren Medicaid |
$75.43
|
| Rate for Payer: Mclaren Medicare |
$137.89
|
| Rate for Payer: Meridian Medicaid |
$79.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$144.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$158.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,794.79
|
| Rate for Payer: PACE Medicare |
$131.00
|
| Rate for Payer: PACE SWMI |
$137.89
|
| Rate for Payer: PHP Commercial |
$1,794.79
|
| Rate for Payer: PHP Medicare Advantage |
$137.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,478.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$404.06
|
| Rate for Payer: Priority Health Medicare |
$137.89
|
| Rate for Payer: Priority Health Narrow Network |
$323.25
|
| Rate for Payer: Priority Health SBD |
$1,330.26
|
| Rate for Payer: Railroad Medicare Medicare |
$137.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.89
|
| Rate for Payer: UHC Medicare Advantage |
$142.03
|
| Rate for Payer: UMR Bronson Commercial |
$781.26
|
| Rate for Payer: VA VA |
$137.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,583.64
|
|
|
HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML INTRAMUSCULAR SOLUTION
|
Facility
|
IP
|
$495.27
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
116868
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$217.92 |
| Max. Negotiated Rate |
$445.74 |
| Rate for Payer: Aetna American Axle |
$321.93
|
| Rate for Payer: Aetna Commercial |
$420.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.93
|
| Rate for Payer: Cash Price |
$396.22
|
| Rate for Payer: Cofinity Commercial |
$346.69
|
| Rate for Payer: Cofinity Commercial |
$425.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.22
|
| Rate for Payer: Healthscope Commercial |
$445.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$346.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$420.98
|
| Rate for Payer: PHP Commercial |
$420.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.69
|
| Rate for Payer: Priority Health SBD |
$312.02
|
| Rate for Payer: UMR Bronson Commercial |
$217.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.45
|
|
|
HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML INTRAMUSCULAR SYRINGE
|
Facility
|
IP
|
$495.27
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
116867
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$217.92 |
| Max. Negotiated Rate |
$445.74 |
| Rate for Payer: Aetna American Axle |
$321.93
|
| Rate for Payer: Aetna Commercial |
$420.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.93
|
| Rate for Payer: Cash Price |
$396.22
|
| Rate for Payer: Cofinity Commercial |
$346.69
|
| Rate for Payer: Cofinity Commercial |
$425.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.22
|
| Rate for Payer: Healthscope Commercial |
$445.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$346.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$420.98
|
| Rate for Payer: PHP Commercial |
$420.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.69
|
| Rate for Payer: Priority Health SBD |
$312.02
|
| Rate for Payer: UMR Bronson Commercial |
$217.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.45
|
|
|
HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE
|
Facility
|
IP
|
$104.68
|
|
|
Service Code
|
HCPCS 90744
|
| Hospital Charge Code |
117061
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$46.06 |
| Max. Negotiated Rate |
$94.21 |
| Rate for Payer: Aetna American Axle |
$68.04
|
| Rate for Payer: Aetna Commercial |
$88.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.04
|
| Rate for Payer: Cash Price |
$83.74
|
| Rate for Payer: Cofinity Commercial |
$73.28
|
| Rate for Payer: Cofinity Commercial |
$90.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.74
|
| Rate for Payer: Healthscope Commercial |
$94.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.98
|
| Rate for Payer: PHP Commercial |
$88.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.28
|
| Rate for Payer: Priority Health SBD |
$65.95
|
| Rate for Payer: UMR Bronson Commercial |
$46.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.51
|
|
|
HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/ML INTRAMUSCULAR SUSP
|
Facility
|
IP
|
$153.75
|
|
|
Service Code
|
HCPCS 90746
|
| Hospital Charge Code |
118174
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$67.65 |
| Max. Negotiated Rate |
$138.38 |
| Rate for Payer: Aetna American Axle |
$99.94
|
| Rate for Payer: Aetna American Axle |
$120.65
|
| Rate for Payer: Aetna Commercial |
$157.77
|
| Rate for Payer: Aetna Commercial |
$130.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.65
|
| Rate for Payer: Cash Price |
$148.49
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cofinity Commercial |
$107.62
|
| Rate for Payer: Cofinity Commercial |
$159.62
|
| Rate for Payer: Cofinity Commercial |
$129.93
|
| Rate for Payer: Cofinity Commercial |
$132.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.49
|
| Rate for Payer: Healthscope Commercial |
$167.05
|
| Rate for Payer: Healthscope Commercial |
$138.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$130.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$157.77
|
| Rate for Payer: PHP Commercial |
$130.69
|
| Rate for Payer: PHP Commercial |
$157.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.93
|
| Rate for Payer: Priority Health SBD |
$96.86
|
| Rate for Payer: Priority Health SBD |
$116.93
|
| Rate for Payer: UMR Bronson Commercial |
$67.65
|
| Rate for Payer: UMR Bronson Commercial |
$81.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.21
|
|
|
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC
|
Facility
|
IP
|
$40,357.17
|
|
|
Service Code
|
MS-DRG 421
|
| Min. Negotiated Rate |
$13,002.26 |
| Max. Negotiated Rate |
$40,357.17 |
| Rate for Payer: Aetna Medicare |
$14,234.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,108.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,108.24
|
| Rate for Payer: BCBS MAPPO |
$13,686.59
|
| Rate for Payer: BCBS Trust/PPO |
$40,357.17
|
| Rate for Payer: BCN Medicare Advantage |
$13,686.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,686.59
|
| Rate for Payer: Mclaren Medicare |
$13,686.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,370.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,739.58
|
| Rate for Payer: PACE Medicare |
$13,002.26
|
| Rate for Payer: PACE SWMI |
$13,686.59
|
| Rate for Payer: PHP Medicare Advantage |
$13,686.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24,532.62
|
| Rate for Payer: Priority Health Medicare |
$13,686.59
|
| Rate for Payer: Priority Health Narrow Network |
$19,626.10
|
| Rate for Payer: Railroad Medicare Medicare |
$13,686.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,078.24
|
| Rate for Payer: UHC Core |
$21,383.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,686.59
|
| Rate for Payer: UHC Exchange |
$17,000.26
|
| Rate for Payer: UHC Medicare Advantage |
$14,097.19
|
| Rate for Payer: VA VA |
$13,686.59
|
|
|
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC
|
Facility
|
IP
|
$84,106.76
|
|
|
Service Code
|
MS-DRG 420
|
| Min. Negotiated Rate |
$23,918.93 |
| Max. Negotiated Rate |
$84,106.76 |
| Rate for Payer: Aetna Medicare |
$26,184.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31,472.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31,472.28
|
| Rate for Payer: BCBS MAPPO |
$25,177.82
|
| Rate for Payer: BCBS Trust/PPO |
$84,106.76
|
| Rate for Payer: BCN Medicare Advantage |
$25,177.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,177.82
|
| Rate for Payer: Mclaren Medicare |
$25,177.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26,436.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28,954.49
|
| Rate for Payer: PACE Medicare |
$23,918.93
|
| Rate for Payer: PACE SWMI |
$25,177.82
|
| Rate for Payer: PHP Medicare Advantage |
$25,177.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45,931.22
|
| Rate for Payer: Priority Health Medicare |
$25,177.82
|
| Rate for Payer: Priority Health Narrow Network |
$36,744.98
|
| Rate for Payer: Railroad Medicare Medicare |
$25,177.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48,825.00
|
| Rate for Payer: UHC Core |
$40,035.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$25,177.82
|
| Rate for Payer: UHC Exchange |
$31,828.76
|
| Rate for Payer: UHC Medicare Advantage |
$25,933.15
|
| Rate for Payer: VA VA |
$25,177.82
|
|
|
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$33,308.49
|
|
|
Service Code
|
MS-DRG 422
|
| Min. Negotiated Rate |
$10,816.27 |
| Max. Negotiated Rate |
$33,308.49 |
| Rate for Payer: Aetna Medicare |
$11,840.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,231.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,231.94
|
| Rate for Payer: BCBS MAPPO |
$11,385.55
|
| Rate for Payer: BCBS Trust/PPO |
$33,308.49
|
| Rate for Payer: BCN Medicare Advantage |
$11,385.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,385.55
|
| Rate for Payer: Mclaren Medicare |
$11,385.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11,954.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,093.38
|
| Rate for Payer: PACE Medicare |
$10,816.27
|
| Rate for Payer: PACE SWMI |
$11,385.55
|
| Rate for Payer: PHP Medicare Advantage |
$11,385.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,247.74
|
| Rate for Payer: Priority Health Medicare |
$11,385.55
|
| Rate for Payer: Priority Health Narrow Network |
$16,198.19
|
| Rate for Payer: Railroad Medicare Medicare |
$11,385.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21,523.39
|
| Rate for Payer: UHC Core |
$17,648.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,385.55
|
| Rate for Payer: UHC Exchange |
$14,030.98
|
| Rate for Payer: UHC Medicare Advantage |
$11,727.12
|
| Rate for Payer: VA VA |
$11,385.55
|
|
|
HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE
|
Facility
|
IP
|
$315.04
|
|
|
Service Code
|
NDC 58160-811-43
|
| Hospital Charge Code |
34550
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$138.62 |
| Max. Negotiated Rate |
$283.54 |
| Rate for Payer: Aetna American Axle |
$204.78
|
| Rate for Payer: Aetna Commercial |
$267.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.78
|
| Rate for Payer: Cash Price |
$252.03
|
| Rate for Payer: Cofinity Commercial |
$220.53
|
| Rate for Payer: Cofinity Commercial |
$270.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.03
|
| Rate for Payer: Healthscope Commercial |
$283.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$267.78
|
| Rate for Payer: PHP Commercial |
$267.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.53
|
| Rate for Payer: Priority Health SBD |
$198.48
|
| Rate for Payer: UMR Bronson Commercial |
$138.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.28
|
|
|
HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE
|
Facility
|
IP
|
$315.04
|
|
|
Service Code
|
NDC 58160-811-52
|
| Hospital Charge Code |
34550
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$138.62 |
| Max. Negotiated Rate |
$283.54 |
| Rate for Payer: Aetna American Axle |
$204.78
|
| Rate for Payer: Aetna Commercial |
$267.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.78
|
| Rate for Payer: Cash Price |
$252.03
|
| Rate for Payer: Cofinity Commercial |
$220.53
|
| Rate for Payer: Cofinity Commercial |
$270.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.03
|
| Rate for Payer: Healthscope Commercial |
$283.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$267.78
|
| Rate for Payer: PHP Commercial |
$267.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.53
|
| Rate for Payer: Priority Health SBD |
$198.48
|
| Rate for Payer: UMR Bronson Commercial |
$138.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.28
|
|
|
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC
|
Facility
|
IP
|
$32,856.17
|
|
|
Service Code
|
MS-DRG 354
|
| Min. Negotiated Rate |
$13,062.28 |
| Max. Negotiated Rate |
$32,856.17 |
| Rate for Payer: Aetna Medicare |
$14,299.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,187.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,187.21
|
| Rate for Payer: BCBS MAPPO |
$13,749.77
|
| Rate for Payer: BCBS Trust/PPO |
$32,856.17
|
| Rate for Payer: BCN Medicare Advantage |
$13,749.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,749.77
|
| Rate for Payer: Mclaren Medicare |
$13,749.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,437.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,812.24
|
| Rate for Payer: PACE Medicare |
$13,062.28
|
| Rate for Payer: PACE SWMI |
$13,749.77
|
| Rate for Payer: PHP Medicare Advantage |
$13,749.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24,650.29
|
| Rate for Payer: Priority Health Medicare |
$13,749.77
|
| Rate for Payer: Priority Health Narrow Network |
$19,720.23
|
| Rate for Payer: Railroad Medicare Medicare |
$13,749.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,203.32
|
| Rate for Payer: UHC Core |
$21,486.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,749.77
|
| Rate for Payer: UHC Exchange |
$17,081.80
|
| Rate for Payer: UHC Medicare Advantage |
$14,162.26
|
| Rate for Payer: VA VA |
$13,749.77
|
|
|
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC
|
Facility
|
IP
|
$63,229.59
|
|
|
Service Code
|
MS-DRG 353
|
| Min. Negotiated Rate |
$21,894.75 |
| Max. Negotiated Rate |
$63,229.59 |
| Rate for Payer: Aetna Medicare |
$23,968.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,808.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,808.89
|
| Rate for Payer: BCBS MAPPO |
$23,047.11
|
| Rate for Payer: BCBS Trust/PPO |
$63,229.59
|
| Rate for Payer: BCN Medicare Advantage |
$23,047.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,047.11
|
| Rate for Payer: Mclaren Medicare |
$23,047.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24,199.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,504.18
|
| Rate for Payer: PACE Medicare |
$21,894.75
|
| Rate for Payer: PACE SWMI |
$23,047.11
|
| Rate for Payer: PHP Medicare Advantage |
$23,047.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41,963.47
|
| Rate for Payer: Priority Health Medicare |
$23,047.11
|
| Rate for Payer: Priority Health Narrow Network |
$33,570.78
|
| Rate for Payer: Railroad Medicare Medicare |
$23,047.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,607.27
|
| Rate for Payer: UHC Core |
$36,577.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,047.11
|
| Rate for Payer: UHC Exchange |
$29,079.24
|
| Rate for Payer: UHC Medicare Advantage |
$23,738.52
|
| Rate for Payer: VA VA |
$23,047.11
|
|
|
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC
|
Facility
|
IP
|
$27,739.90
|
|
|
Service Code
|
MS-DRG 355
|
| Min. Negotiated Rate |
$10,461.96 |
| Max. Negotiated Rate |
$27,739.90 |
| Rate for Payer: Aetna Medicare |
$11,453.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,765.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,765.74
|
| Rate for Payer: BCBS MAPPO |
$11,012.59
|
| Rate for Payer: BCBS Trust/PPO |
$27,739.90
|
| Rate for Payer: BCN Medicare Advantage |
$11,012.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,012.59
|
| Rate for Payer: Mclaren Medicare |
$11,012.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11,563.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,664.48
|
| Rate for Payer: PACE Medicare |
$10,461.96
|
| Rate for Payer: PACE SWMI |
$11,012.59
|
| Rate for Payer: PHP Medicare Advantage |
$11,012.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,553.20
|
| Rate for Payer: Priority Health Medicare |
$11,012.59
|
| Rate for Payer: Priority Health Narrow Network |
$15,642.56
|
| Rate for Payer: Railroad Medicare Medicare |
$11,012.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20,785.10
|
| Rate for Payer: UHC Core |
$17,043.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,012.59
|
| Rate for Payer: UHC Exchange |
$13,549.69
|
| Rate for Payer: UHC Medicare Advantage |
$11,342.97
|
| Rate for Payer: VA VA |
$11,012.59
|
|
|
HH CATHETER LEG STRAP BARD
|
Facility
|
OP
|
$12.47
|
|
|
Service Code
|
HCPCS A4334
|
| Hospital Charge Code |
27000598
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.61 |
| Max. Negotiated Rate |
$20.74 |
| Rate for Payer: Aetna American Axle |
$8.11
|
| Rate for Payer: Aetna Commercial |
$10.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.11
|
| Rate for Payer: BCBS Complete |
$4.99
|
| Rate for Payer: BCBS Trust/PPO |
$20.74
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$10.72
|
| Rate for Payer: Cofinity Commercial |
$8.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$11.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.60
|
| Rate for Payer: PHP Commercial |
$10.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.73
|
| Rate for Payer: Priority Health SBD |
$7.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.05
|
| Rate for Payer: UHC Exchange |
$6.71
|
| Rate for Payer: UMR Bronson Commercial |
$4.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.35
|
|
|
HH CATHETER LEG STRAP BARD
|
Facility
|
IP
|
$12.47
|
|
|
Service Code
|
HCPCS A4334
|
| Hospital Charge Code |
27000598
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.49 |
| Max. Negotiated Rate |
$11.22 |
| Rate for Payer: Aetna American Axle |
$8.11
|
| Rate for Payer: Aetna Commercial |
$10.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.11
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$8.73
|
| Rate for Payer: Cofinity Commercial |
$10.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$11.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.60
|
| Rate for Payer: PHP Commercial |
$10.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.73
|
| Rate for Payer: Priority Health SBD |
$7.86
|
| Rate for Payer: UMR Bronson Commercial |
$5.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.35
|
|
