|
BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); 1 LESION
|
Facility
|
OP
|
$2,967.88
|
|
|
Service Code
|
CPT 56605
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$479.98 |
| Max. Negotiated Rate |
$2,967.88 |
| Rate for Payer: Aetna Medicare |
$954.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,147.17
|
| Rate for Payer: BCBS Complete |
$504.02
|
| Rate for Payer: BCBS MAPPO |
$917.74
|
| Rate for Payer: BCBS Trust/PPO |
$953.20
|
| Rate for Payer: BCN Commercial |
$953.20
|
| Rate for Payer: BCN Medicare Advantage |
$917.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$917.74
|
| Rate for Payer: Mclaren Medicaid |
$917.74
|
| Rate for Payer: Mclaren Medicare |
$917.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$963.63
|
| Rate for Payer: Meridian Medicaid |
$963.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,055.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,009.51
|
| Rate for Payer: Nomi Health Commercial |
$2,753.22
|
| Rate for Payer: PACE Medicare |
$871.85
|
| Rate for Payer: PACE SWMI |
$917.74
|
| Rate for Payer: PHP Medicare Advantage |
$917.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,967.88
|
| Rate for Payer: Priority Health Medicare |
$917.74
|
| Rate for Payer: Priority Health Tiered Network |
$2,374.30
|
| Rate for Payer: Railroad Medicare Medicare |
$917.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$917.74
|
| Rate for Payer: UHC Medicaid |
$479.98
|
| Rate for Payer: UHCCP Medicaid |
$479.98
|
| Rate for Payer: VA VA |
$917.74
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, DEEP AXILLARY NODE(S)
|
Facility
|
OP
|
$12,616.62
|
|
|
Service Code
|
CPT 38525
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,040.41 |
| Max. Negotiated Rate |
$12,616.62 |
| Rate for Payer: Aetna Medicare |
$4,057.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,941.07
|
| Rate for Payer: BCN Commercial |
$3,941.07
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Mclaren Medicaid |
$3,901.35
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$4,096.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Nomi Health Commercial |
$11,704.05
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,616.62
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health Tiered Network |
$10,093.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,901.35
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, DEEP CERVICAL NODE(S)
|
Facility
|
OP
|
$12,616.62
|
|
|
Service Code
|
CPT 38510
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,040.41 |
| Max. Negotiated Rate |
$12,616.62 |
| Rate for Payer: Aetna Medicare |
$4,057.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$4,906.39
|
| Rate for Payer: BCN Commercial |
$4,906.39
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Mclaren Medicaid |
$3,901.35
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$4,096.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Nomi Health Commercial |
$11,704.05
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,616.62
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health Tiered Network |
$10,093.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,901.35
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, INGUINOFEMORAL NODE(S)
|
Facility
|
OP
|
$12,616.62
|
|
|
Service Code
|
CPT 38531
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,040.41 |
| Max. Negotiated Rate |
$12,616.62 |
| Rate for Payer: Aetna Medicare |
$4,057.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,618.39
|
| Rate for Payer: BCN Commercial |
$3,618.39
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Mclaren Medicaid |
$3,901.35
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$4,096.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Nomi Health Commercial |
$11,704.05
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,616.62
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health Tiered Network |
$10,093.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,901.35
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, SUPERFICIAL
|
Facility
|
OP
|
$12,616.62
|
|
|
Service Code
|
CPT 38500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,040.41 |
| Max. Negotiated Rate |
$12,616.62 |
| Rate for Payer: Aetna Medicare |
$4,057.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,907.70
|
| Rate for Payer: BCN Commercial |
$3,907.70
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Mclaren Medicaid |
$3,901.35
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$4,096.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Nomi Health Commercial |
$11,704.05
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,616.62
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health Tiered Network |
$10,093.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,901.35
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
BIOPSY; OROPHARYNX
|
Facility
|
OP
|
$4,999.64
|
|
|
Service Code
|
CPT 42800
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$166.37 |
| Max. Negotiated Rate |
$4,999.64 |
| Rate for Payer: Aetna Medicare |
$1,607.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,932.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,932.50
|
| Rate for Payer: BCBS Complete |
$849.06
|
| Rate for Payer: BCBS MAPPO |
$1,546.00
|
| Rate for Payer: BCBS Trust/PPO |
$166.37
|
| Rate for Payer: BCN Commercial |
$166.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,546.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.00
|
| Rate for Payer: Mclaren Medicaid |
$1,546.00
|
| Rate for Payer: Mclaren Medicare |
$1,546.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,623.30
|
| Rate for Payer: Meridian Medicaid |
$1,623.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,777.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,700.60
|
| Rate for Payer: Nomi Health Commercial |
$4,638.00
|
| Rate for Payer: PACE Medicare |
$1,468.70
|
| Rate for Payer: PACE SWMI |
$1,546.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,546.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,999.64
|
| Rate for Payer: Priority Health Medicare |
$1,546.00
|
| Rate for Payer: Priority Health Tiered Network |
$3,999.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,546.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,546.00
|
| Rate for Payer: UHC Medicaid |
$808.56
|
| Rate for Payer: UHCCP Medicaid |
$808.56
|
| Rate for Payer: VA VA |
$1,546.00
|
|
|
BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH
|
Facility
|
OP
|
$1,875.98
|
|
|
Service Code
|
CPT 55700
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,875.98 |
| Max. Negotiated Rate |
$1,875.98 |
| Rate for Payer: BCBS Trust/PPO |
$1,875.98
|
| Rate for Payer: BCN Commercial |
$1,875.98
|
|
|
BIOPSY, PROSTATE, TRANSRECTAL, ULTRASOUND-GUIDED (IE, SEXTANT, ULTRASOUND-LOCALIZED DISCRETE LESION[S])
|
Facility
|
OP
|
$11,358.48
|
|
|
Service Code
|
CPT 55707
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,836.94 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Mclaren Medicaid |
$3,512.31
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
BIOPSY, PROSTATE, TRANSRECTAL, ULTRASOUND-GUIDED (IE, SEXTANT) WITH MRI-FUSION-GUIDANCE, FIRST TARGETED LESION
|
Facility
|
OP
|
$11,358.48
|
|
|
Service Code
|
CPT 55708
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,836.94 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Mclaren Medicaid |
$3,512.31
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
BIOTIN 5 MG CAPSULE
|
Facility
|
OP
|
$142.18
|
|
|
Service Code
|
NDC 40985027116
|
| Hospital Charge Code |
9277
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.61 |
| Max. Negotiated Rate |
$127.96 |
| Rate for Payer: Aetna American Axle |
$92.42
|
| Rate for Payer: Aetna Commercial |
$120.85
|
| Rate for Payer: Aetna Medicare |
$71.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.42
|
| Rate for Payer: BCBS Complete |
$56.87
|
| Rate for Payer: Cash Price |
$113.74
|
| Rate for Payer: Cofinity Advantage |
$99.53
|
| Rate for Payer: Cofinity Commercial |
$122.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.74
|
| Rate for Payer: Healthscope Commercial |
$127.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.64
|
| Rate for Payer: PHP Commercial |
$120.85
|
| Rate for Payer: Priority Health SBD |
$89.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.42
|
| Rate for Payer: UHC Core |
$74.08
|
| Rate for Payer: UHC Exchange |
$55.88
|
| Rate for Payer: UMR Bronson Commercial |
$52.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.64
|
|
|
BIOTIN 5 MG CAPSULE
|
Facility
|
IP
|
$142.18
|
|
|
Service Code
|
NDC 40985027116
|
| Hospital Charge Code |
9277
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$62.56 |
| Max. Negotiated Rate |
$127.96 |
| Rate for Payer: Aetna American Axle |
$92.42
|
| Rate for Payer: Aetna Commercial |
$120.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.42
|
| Rate for Payer: Cash Price |
$113.74
|
| Rate for Payer: Cofinity Advantage |
$99.53
|
| Rate for Payer: Cofinity Commercial |
$122.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.74
|
| Rate for Payer: Healthscope Commercial |
$127.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.64
|
| Rate for Payer: PHP Commercial |
$120.85
|
| Rate for Payer: Priority Health SBD |
$89.57
|
| Rate for Payer: UMR Bronson Commercial |
$62.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.64
|
|
|
BIPOLAR DISORDERS
|
Facility
|
IP
|
$3,605.32
|
|
|
Service Code
|
APR-DRG 7532
|
| Min. Negotiated Rate |
$3,433.63 |
| Max. Negotiated Rate |
$3,605.32 |
| Rate for Payer: BCBS Complete |
$3,605.32
|
| Rate for Payer: Mclaren Medicaid |
$3,433.63
|
| Rate for Payer: Meridian Medicaid |
$3,605.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,433.63
|
| Rate for Payer: UHC Medicaid |
$3,433.63
|
| Rate for Payer: UHCCP Medicaid |
$3,433.63
|
|
|
BIPOLAR DISORDERS
|
Facility
|
IP
|
$2,869.24
|
|
|
Service Code
|
APR-DRG 7531
|
| Min. Negotiated Rate |
$2,732.61 |
| Max. Negotiated Rate |
$2,869.24 |
| Rate for Payer: BCBS Complete |
$2,869.24
|
| Rate for Payer: Mclaren Medicaid |
$2,732.61
|
| Rate for Payer: Meridian Medicaid |
$2,869.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,732.61
|
| Rate for Payer: UHC Medicaid |
$2,732.61
|
| Rate for Payer: UHCCP Medicaid |
$2,732.61
|
|
|
BIPOLAR DISORDERS
|
Facility
|
IP
|
$13,266.30
|
|
|
Service Code
|
APR-DRG 7534
|
| Min. Negotiated Rate |
$12,634.57 |
| Max. Negotiated Rate |
$13,266.30 |
| Rate for Payer: BCBS Complete |
$13,266.30
|
| Rate for Payer: Mclaren Medicaid |
$12,634.57
|
| Rate for Payer: Meridian Medicaid |
$13,266.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,634.57
|
| Rate for Payer: UHC Medicaid |
$12,634.57
|
| Rate for Payer: UHCCP Medicaid |
$12,634.57
|
|
|
BIPOLAR DISORDERS
|
Facility
|
IP
|
$6,997.56
|
|
|
Service Code
|
APR-DRG 7533
|
| Min. Negotiated Rate |
$6,664.34 |
| Max. Negotiated Rate |
$6,997.56 |
| Rate for Payer: BCBS Complete |
$6,997.56
|
| Rate for Payer: Mclaren Medicaid |
$6,664.34
|
| Rate for Payer: Meridian Medicaid |
$6,997.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,664.34
|
| Rate for Payer: UHC Medicaid |
$6,664.34
|
| Rate for Payer: UHCCP Medicaid |
$6,664.34
|
|
|
BISACODYL 10 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$26.94
|
|
|
Service Code
|
NDC 81421002101
|
| Hospital Charge Code |
1080
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.85 |
| Max. Negotiated Rate |
$24.25 |
| Rate for Payer: Aetna American Axle |
$17.51
|
| Rate for Payer: Aetna Commercial |
$22.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.51
|
| Rate for Payer: Cash Price |
$21.55
|
| Rate for Payer: Cofinity Advantage |
$18.86
|
| Rate for Payer: Cofinity Commercial |
$23.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.55
|
| Rate for Payer: Healthscope Commercial |
$24.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.20
|
| Rate for Payer: PHP Commercial |
$22.90
|
| Rate for Payer: Priority Health SBD |
$16.97
|
| Rate for Payer: UMR Bronson Commercial |
$11.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.20
|
|
|
BISACODYL 10 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$36.38
|
|
|
Service Code
|
NDC 68784010212
|
| Hospital Charge Code |
1080
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$16.01 |
| Max. Negotiated Rate |
$32.74 |
| Rate for Payer: Aetna American Axle |
$23.65
|
| Rate for Payer: Aetna Commercial |
$30.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.65
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cofinity Advantage |
$25.47
|
| Rate for Payer: Cofinity Commercial |
$31.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.10
|
| Rate for Payer: Healthscope Commercial |
$32.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.29
|
| Rate for Payer: PHP Commercial |
$30.92
|
| Rate for Payer: Priority Health SBD |
$22.92
|
| Rate for Payer: UMR Bronson Commercial |
$16.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.29
|
|
|
BISACODYL 10 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$45.55
|
|
|
Service Code
|
NDC 81421002102
|
| Hospital Charge Code |
1080
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$16.85 |
| Max. Negotiated Rate |
$40.99 |
| Rate for Payer: Aetna American Axle |
$29.61
|
| Rate for Payer: Aetna Commercial |
$38.72
|
| Rate for Payer: Aetna Medicare |
$22.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.61
|
| Rate for Payer: BCBS Complete |
$18.22
|
| Rate for Payer: Cash Price |
$36.44
|
| Rate for Payer: Cofinity Advantage |
$31.89
|
| Rate for Payer: Cofinity Commercial |
$39.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.44
|
| Rate for Payer: Healthscope Commercial |
$40.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.16
|
| Rate for Payer: PHP Commercial |
$38.72
|
| Rate for Payer: Priority Health SBD |
$28.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.61
|
| Rate for Payer: UHC Core |
$23.73
|
| Rate for Payer: UHC Exchange |
$17.90
|
| Rate for Payer: UMR Bronson Commercial |
$16.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.16
|
|
|
BISACODYL 10 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$217.38
|
|
|
Service Code
|
NDC 00574705050
|
| Hospital Charge Code |
1080
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$95.65 |
| Max. Negotiated Rate |
$195.64 |
| Rate for Payer: Aetna American Axle |
$141.30
|
| Rate for Payer: Aetna Commercial |
$184.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.30
|
| Rate for Payer: Cash Price |
$173.90
|
| Rate for Payer: Cofinity Advantage |
$152.17
|
| Rate for Payer: Cofinity Commercial |
$186.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.90
|
| Rate for Payer: Healthscope Commercial |
$195.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.03
|
| Rate for Payer: PHP Commercial |
$184.77
|
| Rate for Payer: Priority Health SBD |
$136.95
|
| Rate for Payer: UMR Bronson Commercial |
$95.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.03
|
|
|
BISACODYL 10 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$36.38
|
|
|
Service Code
|
NDC 68784010212
|
| Hospital Charge Code |
1080
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$32.74 |
| Rate for Payer: Aetna American Axle |
$23.65
|
| Rate for Payer: Aetna Commercial |
$30.92
|
| Rate for Payer: Aetna Medicare |
$18.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.65
|
| Rate for Payer: BCBS Complete |
$14.55
|
| Rate for Payer: Cash Price |
$29.10
|
| Rate for Payer: Cofinity Advantage |
$25.47
|
| Rate for Payer: Cofinity Commercial |
$31.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.10
|
| Rate for Payer: Healthscope Commercial |
$32.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.29
|
| Rate for Payer: PHP Commercial |
$30.92
|
| Rate for Payer: Priority Health SBD |
$22.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.65
|
| Rate for Payer: UHC Core |
$18.95
|
| Rate for Payer: UHC Exchange |
$14.30
|
| Rate for Payer: UMR Bronson Commercial |
$13.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.29
|
|
|
BISACODYL 10 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$26.94
|
|
|
Service Code
|
NDC 81421002101
|
| Hospital Charge Code |
1080
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.97 |
| Max. Negotiated Rate |
$24.25 |
| Rate for Payer: Aetna American Axle |
$17.51
|
| Rate for Payer: Aetna Commercial |
$22.90
|
| Rate for Payer: Aetna Medicare |
$13.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.51
|
| Rate for Payer: BCBS Complete |
$10.78
|
| Rate for Payer: Cash Price |
$21.55
|
| Rate for Payer: Cofinity Advantage |
$18.86
|
| Rate for Payer: Cofinity Commercial |
$23.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.55
|
| Rate for Payer: Healthscope Commercial |
$24.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.20
|
| Rate for Payer: PHP Commercial |
$22.90
|
| Rate for Payer: Priority Health SBD |
$16.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.51
|
| Rate for Payer: UHC Core |
$14.04
|
| Rate for Payer: UHC Exchange |
$10.59
|
| Rate for Payer: UMR Bronson Commercial |
$9.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.20
|
|
|
BISACODYL 10 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$217.38
|
|
|
Service Code
|
NDC 00574705050
|
| Hospital Charge Code |
1080
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$80.43 |
| Max. Negotiated Rate |
$195.64 |
| Rate for Payer: Aetna American Axle |
$141.30
|
| Rate for Payer: Aetna Commercial |
$184.77
|
| Rate for Payer: Aetna Medicare |
$108.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.30
|
| Rate for Payer: BCBS Complete |
$86.95
|
| Rate for Payer: Cash Price |
$173.90
|
| Rate for Payer: Cofinity Advantage |
$152.17
|
| Rate for Payer: Cofinity Commercial |
$186.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.90
|
| Rate for Payer: Healthscope Commercial |
$195.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$173.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.03
|
| Rate for Payer: PHP Commercial |
$184.77
|
| Rate for Payer: Priority Health SBD |
$136.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.30
|
| Rate for Payer: UHC Core |
$113.25
|
| Rate for Payer: UHC Exchange |
$85.43
|
| Rate for Payer: UMR Bronson Commercial |
$80.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.03
|
|
|
BISACODYL 10 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$37.85
|
|
|
Service Code
|
NDC 00904714212
|
| Hospital Charge Code |
1080
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$34.06 |
| Rate for Payer: Aetna American Axle |
$24.60
|
| Rate for Payer: Aetna Commercial |
$32.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.60
|
| Rate for Payer: Cash Price |
$30.28
|
| Rate for Payer: Cofinity Advantage |
$26.50
|
| Rate for Payer: Cofinity Commercial |
$32.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.28
|
| Rate for Payer: Healthscope Commercial |
$34.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.39
|
| Rate for Payer: PHP Commercial |
$32.17
|
| Rate for Payer: Priority Health SBD |
$23.85
|
| Rate for Payer: UMR Bronson Commercial |
$16.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.39
|
|
|
BISACODYL 10 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$37.85
|
|
|
Service Code
|
NDC 00904714212
|
| Hospital Charge Code |
1080
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$34.06 |
| Rate for Payer: Aetna American Axle |
$24.60
|
| Rate for Payer: Aetna Commercial |
$32.17
|
| Rate for Payer: Aetna Medicare |
$18.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.60
|
| Rate for Payer: BCBS Complete |
$15.14
|
| Rate for Payer: Cash Price |
$30.28
|
| Rate for Payer: Cofinity Advantage |
$26.50
|
| Rate for Payer: Cofinity Commercial |
$32.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.28
|
| Rate for Payer: Healthscope Commercial |
$34.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.39
|
| Rate for Payer: PHP Commercial |
$32.17
|
| Rate for Payer: Priority Health SBD |
$23.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.60
|
| Rate for Payer: UHC Core |
$19.72
|
| Rate for Payer: UHC Exchange |
$14.88
|
| Rate for Payer: UMR Bronson Commercial |
$14.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.39
|
|
|
BISACODYL 10 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$45.55
|
|
|
Service Code
|
NDC 81421002102
|
| Hospital Charge Code |
1080
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.04 |
| Max. Negotiated Rate |
$40.99 |
| Rate for Payer: Aetna American Axle |
$29.61
|
| Rate for Payer: Aetna Commercial |
$38.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.61
|
| Rate for Payer: Cash Price |
$36.44
|
| Rate for Payer: Cofinity Advantage |
$31.89
|
| Rate for Payer: Cofinity Commercial |
$39.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.44
|
| Rate for Payer: Healthscope Commercial |
$40.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.16
|
| Rate for Payer: PHP Commercial |
$38.72
|
| Rate for Payer: Priority Health SBD |
$28.70
|
| Rate for Payer: UMR Bronson Commercial |
$20.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.16
|
|
