|
BISOPROLOL 2.5 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET
|
Facility
|
IP
|
$128.25
|
|
|
Service Code
|
NDC 29300018713
|
| Hospital Charge Code |
18291
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$56.43 |
| Max. Negotiated Rate |
$115.42 |
| Rate for Payer: Aetna American Axle |
$83.36
|
| Rate for Payer: Aetna Commercial |
$109.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.36
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Cofinity Advantage |
$89.78
|
| Rate for Payer: Cofinity Commercial |
$110.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.60
|
| Rate for Payer: Healthscope Commercial |
$115.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.19
|
| Rate for Payer: PHP Commercial |
$109.01
|
| Rate for Payer: Priority Health SBD |
$80.80
|
| Rate for Payer: UMR Bronson Commercial |
$56.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.19
|
|
|
BISOPROLOL 5 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET
|
Facility
|
IP
|
$375.25
|
|
|
Service Code
|
NDC 29300018801
|
| Hospital Charge Code |
18290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$165.11 |
| Max. Negotiated Rate |
$337.73 |
| Rate for Payer: Aetna American Axle |
$243.91
|
| Rate for Payer: Aetna Commercial |
$318.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.91
|
| Rate for Payer: Cash Price |
$300.20
|
| Rate for Payer: Cofinity Advantage |
$262.68
|
| Rate for Payer: Cofinity Commercial |
$322.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.20
|
| Rate for Payer: Healthscope Commercial |
$337.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$262.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.44
|
| Rate for Payer: PHP Commercial |
$318.96
|
| Rate for Payer: Priority Health SBD |
$236.41
|
| Rate for Payer: UMR Bronson Commercial |
$165.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.44
|
|
|
BISOPROLOL 5 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET
|
Facility
|
IP
|
$332.50
|
|
|
Service Code
|
NDC 00378050301
|
| Hospital Charge Code |
18290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$146.30 |
| Max. Negotiated Rate |
$299.25 |
| Rate for Payer: Aetna American Axle |
$216.12
|
| Rate for Payer: Aetna Commercial |
$282.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.12
|
| Rate for Payer: Cash Price |
$266.00
|
| Rate for Payer: Cofinity Advantage |
$232.75
|
| Rate for Payer: Cofinity Commercial |
$285.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.00
|
| Rate for Payer: Healthscope Commercial |
$299.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$232.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.38
|
| Rate for Payer: PHP Commercial |
$282.62
|
| Rate for Payer: Priority Health SBD |
$209.47
|
| Rate for Payer: UMR Bronson Commercial |
$146.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.38
|
|
|
BISOPROLOL 5 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET
|
Facility
|
OP
|
$375.25
|
|
|
Service Code
|
NDC 29300018801
|
| Hospital Charge Code |
18290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$138.84 |
| Max. Negotiated Rate |
$337.73 |
| Rate for Payer: Aetna American Axle |
$243.91
|
| Rate for Payer: Aetna Commercial |
$318.96
|
| Rate for Payer: Aetna Medicare |
$187.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.91
|
| Rate for Payer: BCBS Complete |
$150.10
|
| Rate for Payer: Cash Price |
$300.20
|
| Rate for Payer: Cofinity Advantage |
$262.68
|
| Rate for Payer: Cofinity Commercial |
$322.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.20
|
| Rate for Payer: Healthscope Commercial |
$337.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$262.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$300.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.44
|
| Rate for Payer: PHP Commercial |
$318.96
|
| Rate for Payer: Priority Health SBD |
$236.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.91
|
| Rate for Payer: UHC Core |
$195.51
|
| Rate for Payer: UHC Exchange |
$147.47
|
| Rate for Payer: UMR Bronson Commercial |
$138.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.44
|
|
|
BISOPROLOL 5 MG-HYDROCHLOROTHIAZIDE 6.25 MG TABLET
|
Facility
|
OP
|
$332.50
|
|
|
Service Code
|
NDC 00378050301
|
| Hospital Charge Code |
18290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$123.03 |
| Max. Negotiated Rate |
$299.25 |
| Rate for Payer: Aetna American Axle |
$216.12
|
| Rate for Payer: Aetna Commercial |
$282.62
|
| Rate for Payer: Aetna Medicare |
$166.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.12
|
| Rate for Payer: BCBS Complete |
$133.00
|
| Rate for Payer: Cash Price |
$266.00
|
| Rate for Payer: Cofinity Advantage |
$232.75
|
| Rate for Payer: Cofinity Commercial |
$285.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.00
|
| Rate for Payer: Healthscope Commercial |
$299.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$232.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$266.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.38
|
| Rate for Payer: PHP Commercial |
$282.62
|
| Rate for Payer: Priority Health SBD |
$209.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.12
|
| Rate for Payer: UHC Core |
$173.23
|
| Rate for Payer: UHC Exchange |
$130.67
|
| Rate for Payer: UMR Bronson Commercial |
$123.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.38
|
|
|
BISOPROLOL FUMARATE 5 MG TABLET
|
Facility
|
IP
|
$70.68
|
|
|
Service Code
|
NDC 29300012613
|
| Hospital Charge Code |
18288
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$63.61 |
| Rate for Payer: Aetna American Axle |
$45.94
|
| Rate for Payer: Aetna Commercial |
$60.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.94
|
| Rate for Payer: Cash Price |
$56.54
|
| Rate for Payer: Cofinity Advantage |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$60.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.54
|
| Rate for Payer: Healthscope Commercial |
$63.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.01
|
| Rate for Payer: PHP Commercial |
$60.08
|
| Rate for Payer: Priority Health SBD |
$44.53
|
| Rate for Payer: UMR Bronson Commercial |
$31.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.01
|
|
|
BISOPROLOL FUMARATE 5 MG TABLET
|
Facility
|
OP
|
$124.79
|
|
|
Service Code
|
NDC 70954045510
|
| Hospital Charge Code |
18288
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$46.17 |
| Max. Negotiated Rate |
$112.31 |
| Rate for Payer: Aetna American Axle |
$81.11
|
| Rate for Payer: Aetna Commercial |
$106.07
|
| Rate for Payer: Aetna Medicare |
$62.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.11
|
| Rate for Payer: BCBS Complete |
$49.92
|
| Rate for Payer: Cash Price |
$99.83
|
| Rate for Payer: Cofinity Advantage |
$87.35
|
| Rate for Payer: Cofinity Commercial |
$107.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.83
|
| Rate for Payer: Healthscope Commercial |
$112.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.59
|
| Rate for Payer: PHP Commercial |
$106.07
|
| Rate for Payer: Priority Health SBD |
$78.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.11
|
| Rate for Payer: UHC Core |
$65.02
|
| Rate for Payer: UHC Exchange |
$49.04
|
| Rate for Payer: UMR Bronson Commercial |
$46.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.59
|
|
|
BISOPROLOL FUMARATE 5 MG TABLET
|
Facility
|
IP
|
$124.79
|
|
|
Service Code
|
NDC 52817027030
|
| Hospital Charge Code |
18288
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$54.91 |
| Max. Negotiated Rate |
$112.31 |
| Rate for Payer: Aetna American Axle |
$81.11
|
| Rate for Payer: Aetna Commercial |
$106.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.11
|
| Rate for Payer: Cash Price |
$99.83
|
| Rate for Payer: Cofinity Advantage |
$87.35
|
| Rate for Payer: Cofinity Commercial |
$107.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.83
|
| Rate for Payer: Healthscope Commercial |
$112.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.59
|
| Rate for Payer: PHP Commercial |
$106.07
|
| Rate for Payer: Priority Health SBD |
$78.62
|
| Rate for Payer: UMR Bronson Commercial |
$54.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.59
|
|
|
BISOPROLOL FUMARATE 5 MG TABLET
|
Facility
|
OP
|
$70.68
|
|
|
Service Code
|
NDC 29300012613
|
| Hospital Charge Code |
18288
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$26.15 |
| Max. Negotiated Rate |
$63.61 |
| Rate for Payer: Aetna American Axle |
$45.94
|
| Rate for Payer: Aetna Commercial |
$60.08
|
| Rate for Payer: Aetna Medicare |
$35.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.94
|
| Rate for Payer: BCBS Complete |
$28.27
|
| Rate for Payer: Cash Price |
$56.54
|
| Rate for Payer: Cofinity Advantage |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$60.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.54
|
| Rate for Payer: Healthscope Commercial |
$63.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.01
|
| Rate for Payer: PHP Commercial |
$60.08
|
| Rate for Payer: Priority Health SBD |
$44.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.94
|
| Rate for Payer: UHC Core |
$36.82
|
| Rate for Payer: UHC Exchange |
$27.78
|
| Rate for Payer: UMR Bronson Commercial |
$26.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.01
|
|
|
BISOPROLOL FUMARATE 5 MG TABLET
|
Facility
|
OP
|
$124.79
|
|
|
Service Code
|
NDC 52817027030
|
| Hospital Charge Code |
18288
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$46.17 |
| Max. Negotiated Rate |
$112.31 |
| Rate for Payer: Aetna American Axle |
$81.11
|
| Rate for Payer: Aetna Commercial |
$106.07
|
| Rate for Payer: Aetna Medicare |
$62.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.11
|
| Rate for Payer: BCBS Complete |
$49.92
|
| Rate for Payer: Cash Price |
$99.83
|
| Rate for Payer: Cofinity Advantage |
$87.35
|
| Rate for Payer: Cofinity Commercial |
$107.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.83
|
| Rate for Payer: Healthscope Commercial |
$112.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.59
|
| Rate for Payer: PHP Commercial |
$106.07
|
| Rate for Payer: Priority Health SBD |
$78.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.11
|
| Rate for Payer: UHC Core |
$65.02
|
| Rate for Payer: UHC Exchange |
$49.04
|
| Rate for Payer: UMR Bronson Commercial |
$46.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.59
|
|
|
BISOPROLOL FUMARATE 5 MG TABLET
|
Facility
|
IP
|
$124.79
|
|
|
Service Code
|
NDC 70954045510
|
| Hospital Charge Code |
18288
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$54.91 |
| Max. Negotiated Rate |
$112.31 |
| Rate for Payer: Aetna American Axle |
$81.11
|
| Rate for Payer: Aetna Commercial |
$106.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.11
|
| Rate for Payer: Cash Price |
$99.83
|
| Rate for Payer: Cofinity Advantage |
$87.35
|
| Rate for Payer: Cofinity Commercial |
$107.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.83
|
| Rate for Payer: Healthscope Commercial |
$112.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.59
|
| Rate for Payer: PHP Commercial |
$106.07
|
| Rate for Payer: Priority Health SBD |
$78.62
|
| Rate for Payer: UMR Bronson Commercial |
$54.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.59
|
|
|
BIVALIRUDIN 250 MG/50 ML (5 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$481.92
|
|
|
Service Code
|
HCPCS J0583
|
| Hospital Charge Code |
192876
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.26 |
| Max. Negotiated Rate |
$433.73 |
| Rate for Payer: Aetna American Axle |
$313.25
|
| Rate for Payer: Aetna Commercial |
$409.63
|
| Rate for Payer: Aetna Medicare |
$240.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.25
|
| Rate for Payer: BCBS Complete |
$192.77
|
| Rate for Payer: BCBS Trust/PPO |
$0.48
|
| Rate for Payer: BCN Commercial |
$0.48
|
| Rate for Payer: Cash Price |
$385.54
|
| Rate for Payer: Cash Price |
$385.54
|
| Rate for Payer: Cofinity Advantage |
$337.34
|
| Rate for Payer: Cofinity Commercial |
$414.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.54
|
| Rate for Payer: Healthscope Commercial |
$433.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$337.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$385.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$361.44
|
| Rate for Payer: PHP Commercial |
$409.63
|
| Rate for Payer: Priority Health SBD |
$303.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.26
|
| Rate for Payer: UHC Core |
$0.26
|
| Rate for Payer: UHC Exchange |
$0.26
|
| Rate for Payer: UMR Bronson Commercial |
$178.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.44
|
|
|
BIVALIRUDIN 250 MG/50 ML (5 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$195.36
|
|
|
Service Code
|
HCPCS J0582
|
| Hospital Charge Code |
192876
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$175.82 |
| Rate for Payer: Aetna American Axle |
$126.98
|
| Rate for Payer: Aetna Commercial |
$166.06
|
| Rate for Payer: Aetna Medicare |
$97.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.98
|
| Rate for Payer: BCBS Complete |
$78.14
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: Cash Price |
$156.29
|
| Rate for Payer: Cash Price |
$156.29
|
| Rate for Payer: Cofinity Advantage |
$136.75
|
| Rate for Payer: Cofinity Commercial |
$168.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.29
|
| Rate for Payer: Healthscope Commercial |
$175.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$146.52
|
| Rate for Payer: PHP Commercial |
$166.06
|
| Rate for Payer: Priority Health SBD |
$123.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UMR Bronson Commercial |
$72.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.52
|
|
|
BIVALIRUDIN 250 MG/50 ML (5 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$481.92
|
|
|
Service Code
|
HCPCS J0583
|
| Hospital Charge Code |
192876
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$212.04 |
| Max. Negotiated Rate |
$433.73 |
| Rate for Payer: Aetna American Axle |
$313.25
|
| Rate for Payer: Aetna Commercial |
$409.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.25
|
| Rate for Payer: Cash Price |
$385.54
|
| Rate for Payer: Cofinity Advantage |
$337.34
|
| Rate for Payer: Cofinity Commercial |
$414.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.54
|
| Rate for Payer: Healthscope Commercial |
$433.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$337.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$361.44
|
| Rate for Payer: PHP Commercial |
$409.63
|
| Rate for Payer: Priority Health SBD |
$303.61
|
| Rate for Payer: UMR Bronson Commercial |
$212.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.44
|
|
|
BIVALIRUDIN 250 MG/50 ML (5 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$195.36
|
|
|
Service Code
|
HCPCS J0582
|
| Hospital Charge Code |
192876
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$85.96 |
| Max. Negotiated Rate |
$175.82 |
| Rate for Payer: Aetna American Axle |
$126.98
|
| Rate for Payer: Aetna Commercial |
$166.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.98
|
| Rate for Payer: Cash Price |
$156.29
|
| Rate for Payer: Cofinity Advantage |
$136.75
|
| Rate for Payer: Cofinity Commercial |
$168.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.29
|
| Rate for Payer: Healthscope Commercial |
$175.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$146.52
|
| Rate for Payer: PHP Commercial |
$166.06
|
| Rate for Payer: Priority Health SBD |
$123.08
|
| Rate for Payer: UMR Bronson Commercial |
$85.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.52
|
|
|
BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION
|
Facility
|
IP
|
$445.95
|
|
|
Service Code
|
HCPCS J0583
|
| Hospital Charge Code |
29396
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$196.22 |
| Max. Negotiated Rate |
$401.36 |
| Rate for Payer: Aetna American Axle |
$289.87
|
| Rate for Payer: Aetna American Axle |
$227.83
|
| Rate for Payer: Aetna American Axle |
$160.95
|
| Rate for Payer: Aetna American Axle |
$91.46
|
| Rate for Payer: Aetna American Axle |
$125.65
|
| Rate for Payer: Aetna American Axle |
$118.83
|
| Rate for Payer: Aetna Commercial |
$379.06
|
| Rate for Payer: Aetna Commercial |
$164.31
|
| Rate for Payer: Aetna Commercial |
$210.48
|
| Rate for Payer: Aetna Commercial |
$155.40
|
| Rate for Payer: Aetna Commercial |
$297.93
|
| Rate for Payer: Aetna Commercial |
$119.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.46
|
| Rate for Payer: Cash Price |
$356.76
|
| Rate for Payer: Cash Price |
$280.41
|
| Rate for Payer: Cash Price |
$198.10
|
| Rate for Payer: Cash Price |
$112.57
|
| Rate for Payer: Cash Price |
$154.65
|
| Rate for Payer: Cash Price |
$146.26
|
| Rate for Payer: Cofinity Advantage |
$173.33
|
| Rate for Payer: Cofinity Advantage |
$127.97
|
| Rate for Payer: Cofinity Advantage |
$98.50
|
| Rate for Payer: Cofinity Advantage |
$245.36
|
| Rate for Payer: Cofinity Advantage |
$135.32
|
| Rate for Payer: Cofinity Advantage |
$312.17
|
| Rate for Payer: Cofinity Commercial |
$157.23
|
| Rate for Payer: Cofinity Commercial |
$212.95
|
| Rate for Payer: Cofinity Commercial |
$301.44
|
| Rate for Payer: Cofinity Commercial |
$121.01
|
| Rate for Payer: Cofinity Commercial |
$166.25
|
| Rate for Payer: Cofinity Commercial |
$383.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.76
|
| Rate for Payer: Healthscope Commercial |
$315.46
|
| Rate for Payer: Healthscope Commercial |
$126.64
|
| Rate for Payer: Healthscope Commercial |
$222.86
|
| Rate for Payer: Healthscope Commercial |
$164.54
|
| Rate for Payer: Healthscope Commercial |
$173.98
|
| Rate for Payer: Healthscope Commercial |
$401.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$137.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$297.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$137.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$144.98
|
| Rate for Payer: PHP Commercial |
$164.31
|
| Rate for Payer: PHP Commercial |
$379.06
|
| Rate for Payer: PHP Commercial |
$297.93
|
| Rate for Payer: PHP Commercial |
$210.48
|
| Rate for Payer: PHP Commercial |
$119.60
|
| Rate for Payer: PHP Commercial |
$155.40
|
| Rate for Payer: Priority Health SBD |
$220.82
|
| Rate for Payer: Priority Health SBD |
$115.18
|
| Rate for Payer: Priority Health SBD |
$88.65
|
| Rate for Payer: Priority Health SBD |
$121.79
|
| Rate for Payer: Priority Health SBD |
$156.00
|
| Rate for Payer: Priority Health SBD |
$280.95
|
| Rate for Payer: UMR Bronson Commercial |
$154.22
|
| Rate for Payer: UMR Bronson Commercial |
$85.06
|
| Rate for Payer: UMR Bronson Commercial |
$108.95
|
| Rate for Payer: UMR Bronson Commercial |
$80.44
|
| Rate for Payer: UMR Bronson Commercial |
$196.22
|
| Rate for Payer: UMR Bronson Commercial |
$61.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$137.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.98
|
|
|
BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION
|
Facility
|
OP
|
$182.82
|
|
|
Service Code
|
HCPCS J0583
|
| Hospital Charge Code |
29396
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.26 |
| Max. Negotiated Rate |
$164.54 |
| Rate for Payer: Aetna American Axle |
$118.83
|
| Rate for Payer: Aetna American Axle |
$160.95
|
| Rate for Payer: Aetna American Axle |
$227.83
|
| Rate for Payer: Aetna American Axle |
$91.46
|
| Rate for Payer: Aetna American Axle |
$289.87
|
| Rate for Payer: Aetna American Axle |
$125.65
|
| Rate for Payer: Aetna Commercial |
$379.06
|
| Rate for Payer: Aetna Commercial |
$297.93
|
| Rate for Payer: Aetna Commercial |
$164.31
|
| Rate for Payer: Aetna Commercial |
$119.60
|
| Rate for Payer: Aetna Commercial |
$210.48
|
| Rate for Payer: Aetna Commercial |
$155.40
|
| Rate for Payer: Aetna Medicare |
$70.36
|
| Rate for Payer: Aetna Medicare |
$91.41
|
| Rate for Payer: Aetna Medicare |
$96.66
|
| Rate for Payer: Aetna Medicare |
$222.97
|
| Rate for Payer: Aetna Medicare |
$175.25
|
| Rate for Payer: Aetna Medicare |
$123.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.95
|
| Rate for Payer: BCBS Complete |
$77.32
|
| Rate for Payer: BCBS Complete |
$73.13
|
| Rate for Payer: BCBS Complete |
$56.28
|
| Rate for Payer: BCBS Complete |
$99.05
|
| Rate for Payer: BCBS Complete |
$140.20
|
| Rate for Payer: BCBS Complete |
$178.38
|
| Rate for Payer: BCBS Trust/PPO |
$0.48
|
| Rate for Payer: BCBS Trust/PPO |
$0.48
|
| Rate for Payer: BCBS Trust/PPO |
$0.48
|
| Rate for Payer: BCBS Trust/PPO |
$0.48
|
| Rate for Payer: BCBS Trust/PPO |
$0.48
|
| Rate for Payer: BCBS Trust/PPO |
$0.48
|
| Rate for Payer: BCN Commercial |
$0.48
|
| Rate for Payer: BCN Commercial |
$0.48
|
| Rate for Payer: BCN Commercial |
$0.48
|
| Rate for Payer: BCN Commercial |
$0.48
|
| Rate for Payer: BCN Commercial |
$0.48
|
| Rate for Payer: BCN Commercial |
$0.48
|
| Rate for Payer: Cash Price |
$356.76
|
| Rate for Payer: Cash Price |
$112.57
|
| Rate for Payer: Cash Price |
$112.57
|
| Rate for Payer: Cash Price |
$154.65
|
| Rate for Payer: Cash Price |
$154.65
|
| Rate for Payer: Cash Price |
$146.26
|
| Rate for Payer: Cash Price |
$146.26
|
| Rate for Payer: Cash Price |
$356.76
|
| Rate for Payer: Cash Price |
$280.41
|
| Rate for Payer: Cash Price |
$198.10
|
| Rate for Payer: Cash Price |
$280.41
|
| Rate for Payer: Cash Price |
$198.10
|
| Rate for Payer: Cofinity Advantage |
$173.33
|
| Rate for Payer: Cofinity Advantage |
$135.32
|
| Rate for Payer: Cofinity Advantage |
$312.17
|
| Rate for Payer: Cofinity Advantage |
$98.50
|
| Rate for Payer: Cofinity Advantage |
$127.97
|
| Rate for Payer: Cofinity Advantage |
$245.36
|
| Rate for Payer: Cofinity Commercial |
$301.44
|
| Rate for Payer: Cofinity Commercial |
$121.01
|
| Rate for Payer: Cofinity Commercial |
$157.23
|
| Rate for Payer: Cofinity Commercial |
$166.25
|
| Rate for Payer: Cofinity Commercial |
$212.95
|
| Rate for Payer: Cofinity Commercial |
$383.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.41
|
| Rate for Payer: Healthscope Commercial |
$126.64
|
| Rate for Payer: Healthscope Commercial |
$315.46
|
| Rate for Payer: Healthscope Commercial |
$173.98
|
| Rate for Payer: Healthscope Commercial |
$222.86
|
| Rate for Payer: Healthscope Commercial |
$401.36
|
| Rate for Payer: Healthscope Commercial |
$164.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$137.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$154.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$280.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$356.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$297.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$137.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$144.98
|
| Rate for Payer: PHP Commercial |
$155.40
|
| Rate for Payer: PHP Commercial |
$164.31
|
| Rate for Payer: PHP Commercial |
$210.48
|
| Rate for Payer: PHP Commercial |
$119.60
|
| Rate for Payer: PHP Commercial |
$297.93
|
| Rate for Payer: PHP Commercial |
$379.06
|
| Rate for Payer: Priority Health SBD |
$156.00
|
| Rate for Payer: Priority Health SBD |
$88.65
|
| Rate for Payer: Priority Health SBD |
$115.18
|
| Rate for Payer: Priority Health SBD |
$280.95
|
| Rate for Payer: Priority Health SBD |
$121.79
|
| Rate for Payer: Priority Health SBD |
$220.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.26
|
| Rate for Payer: UHC Core |
$0.26
|
| Rate for Payer: UHC Core |
$0.26
|
| Rate for Payer: UHC Core |
$0.26
|
| Rate for Payer: UHC Core |
$0.26
|
| Rate for Payer: UHC Core |
$0.26
|
| Rate for Payer: UHC Core |
$0.26
|
| Rate for Payer: UHC Exchange |
$0.26
|
| Rate for Payer: UHC Exchange |
$0.26
|
| Rate for Payer: UHC Exchange |
$0.26
|
| Rate for Payer: UHC Exchange |
$0.26
|
| Rate for Payer: UHC Exchange |
$0.26
|
| Rate for Payer: UHC Exchange |
$0.26
|
| Rate for Payer: UMR Bronson Commercial |
$91.62
|
| Rate for Payer: UMR Bronson Commercial |
$129.69
|
| Rate for Payer: UMR Bronson Commercial |
$67.64
|
| Rate for Payer: UMR Bronson Commercial |
$52.06
|
| Rate for Payer: UMR Bronson Commercial |
$165.00
|
| Rate for Payer: UMR Bronson Commercial |
$71.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$137.12
|
|
|
BLADDER INSTILLATION OF ANTICARCINOGENIC AGENT (INCLUDING RETENTION TIME)
|
Facility
|
OP
|
$2,246.88
|
|
|
Service Code
|
CPT 51720
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$363.38 |
| Max. Negotiated Rate |
$2,246.88 |
| Rate for Payer: Aetna Medicare |
$722.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$868.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$868.49
|
| Rate for Payer: BCBS Complete |
$381.58
|
| Rate for Payer: BCBS MAPPO |
$694.79
|
| Rate for Payer: BCBS Trust/PPO |
$847.34
|
| Rate for Payer: BCN Commercial |
$847.34
|
| Rate for Payer: BCN Medicare Advantage |
$694.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.79
|
| Rate for Payer: Mclaren Medicaid |
$694.79
|
| Rate for Payer: Mclaren Medicare |
$694.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.53
|
| Rate for Payer: Meridian Medicaid |
$729.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$799.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$764.27
|
| Rate for Payer: Nomi Health Commercial |
$2,084.37
|
| Rate for Payer: PACE Medicare |
$660.05
|
| Rate for Payer: PACE SWMI |
$694.79
|
| Rate for Payer: PHP Medicare Advantage |
$694.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,246.88
|
| Rate for Payer: Priority Health Medicare |
$694.79
|
| Rate for Payer: Priority Health Tiered Network |
$1,797.50
|
| Rate for Payer: Railroad Medicare Medicare |
$694.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$694.79
|
| Rate for Payer: UHC Medicaid |
$363.38
|
| Rate for Payer: UHCCP Medicaid |
$363.38
|
| Rate for Payer: VA VA |
$694.79
|
|
|
BLADDER IRRIGATION, SIMPLE, LAVAGE AND/OR INSTILLATION
|
Facility
|
OP
|
$805.08
|
|
|
Service Code
|
CPT 51700
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$130.20 |
| Max. Negotiated Rate |
$805.08 |
| Rate for Payer: Aetna Medicare |
$258.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.19
|
| Rate for Payer: BCBS Complete |
$136.72
|
| Rate for Payer: BCBS MAPPO |
$248.95
|
| Rate for Payer: BCBS Trust/PPO |
$291.15
|
| Rate for Payer: BCN Commercial |
$291.15
|
| Rate for Payer: BCN Medicare Advantage |
$248.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.95
|
| Rate for Payer: Mclaren Medicaid |
$248.95
|
| Rate for Payer: Mclaren Medicare |
$248.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.40
|
| Rate for Payer: Meridian Medicaid |
$261.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.85
|
| Rate for Payer: Nomi Health Commercial |
$746.85
|
| Rate for Payer: PACE Medicare |
$236.50
|
| Rate for Payer: PACE SWMI |
$248.95
|
| Rate for Payer: PHP Medicare Advantage |
$248.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$805.08
|
| Rate for Payer: Priority Health Medicare |
$248.95
|
| Rate for Payer: Priority Health Tiered Network |
$644.06
|
| Rate for Payer: Railroad Medicare Medicare |
$248.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$248.95
|
| Rate for Payer: UHC Medicaid |
$130.20
|
| Rate for Payer: UHCCP Medicaid |
$130.20
|
| Rate for Payer: VA VA |
$248.95
|
|
|
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION
|
Facility
|
IP
|
$274.29
|
|
|
Service Code
|
HCPCS J9040
|
| Hospital Charge Code |
9289
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$120.69 |
| Max. Negotiated Rate |
$246.86 |
| Rate for Payer: Aetna American Axle |
$178.29
|
| Rate for Payer: Aetna American Axle |
$319.87
|
| Rate for Payer: Aetna American Axle |
$312.34
|
| Rate for Payer: Aetna Commercial |
$408.44
|
| Rate for Payer: Aetna Commercial |
$233.15
|
| Rate for Payer: Aetna Commercial |
$418.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$319.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.34
|
| Rate for Payer: Cash Price |
$384.42
|
| Rate for Payer: Cash Price |
$219.43
|
| Rate for Payer: Cash Price |
$393.68
|
| Rate for Payer: Cofinity Advantage |
$344.47
|
| Rate for Payer: Cofinity Advantage |
$192.00
|
| Rate for Payer: Cofinity Advantage |
$336.36
|
| Rate for Payer: Cofinity Commercial |
$423.21
|
| Rate for Payer: Cofinity Commercial |
$235.89
|
| Rate for Payer: Cofinity Commercial |
$413.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$393.68
|
| Rate for Payer: Healthscope Commercial |
$432.47
|
| Rate for Payer: Healthscope Commercial |
$442.89
|
| Rate for Payer: Healthscope Commercial |
$246.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$336.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$192.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$344.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$369.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$408.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$418.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$205.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$360.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$369.07
|
| Rate for Payer: PHP Commercial |
$408.44
|
| Rate for Payer: PHP Commercial |
$233.15
|
| Rate for Payer: PHP Commercial |
$418.29
|
| Rate for Payer: Priority Health SBD |
$172.80
|
| Rate for Payer: Priority Health SBD |
$302.73
|
| Rate for Payer: Priority Health SBD |
$310.02
|
| Rate for Payer: UMR Bronson Commercial |
$120.69
|
| Rate for Payer: UMR Bronson Commercial |
$216.52
|
| Rate for Payer: UMR Bronson Commercial |
$211.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$369.07
|
|
|
BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION
|
Facility
|
OP
|
$480.52
|
|
|
Service Code
|
HCPCS J9040
|
| Hospital Charge Code |
9289
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$37.98 |
| Max. Negotiated Rate |
$432.47 |
| Rate for Payer: Aetna American Axle |
$312.34
|
| Rate for Payer: Aetna American Axle |
$178.29
|
| Rate for Payer: Aetna American Axle |
$319.87
|
| Rate for Payer: Aetna Commercial |
$408.44
|
| Rate for Payer: Aetna Commercial |
$418.29
|
| Rate for Payer: Aetna Commercial |
$233.15
|
| Rate for Payer: Aetna Medicare |
$240.26
|
| Rate for Payer: Aetna Medicare |
$137.15
|
| Rate for Payer: Aetna Medicare |
$246.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$319.87
|
| Rate for Payer: BCBS Complete |
$109.72
|
| Rate for Payer: BCBS Complete |
$192.21
|
| Rate for Payer: BCBS Complete |
$196.84
|
| Rate for Payer: BCBS Trust/PPO |
$73.23
|
| Rate for Payer: BCBS Trust/PPO |
$73.23
|
| Rate for Payer: BCBS Trust/PPO |
$73.23
|
| Rate for Payer: BCN Commercial |
$73.23
|
| Rate for Payer: BCN Commercial |
$73.23
|
| Rate for Payer: BCN Commercial |
$73.23
|
| Rate for Payer: Cash Price |
$219.43
|
| Rate for Payer: Cash Price |
$219.43
|
| Rate for Payer: Cash Price |
$393.68
|
| Rate for Payer: Cash Price |
$393.68
|
| Rate for Payer: Cash Price |
$384.42
|
| Rate for Payer: Cash Price |
$384.42
|
| Rate for Payer: Cofinity Advantage |
$344.47
|
| Rate for Payer: Cofinity Advantage |
$336.36
|
| Rate for Payer: Cofinity Advantage |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$235.89
|
| Rate for Payer: Cofinity Commercial |
$413.25
|
| Rate for Payer: Cofinity Commercial |
$423.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$393.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.42
|
| Rate for Payer: Healthscope Commercial |
$246.86
|
| Rate for Payer: Healthscope Commercial |
$432.47
|
| Rate for Payer: Healthscope Commercial |
$442.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$192.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$344.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$336.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$369.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$384.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$219.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$408.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$418.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$360.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$205.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$369.07
|
| Rate for Payer: PHP Commercial |
$408.44
|
| Rate for Payer: PHP Commercial |
$233.15
|
| Rate for Payer: PHP Commercial |
$418.29
|
| Rate for Payer: Priority Health SBD |
$172.80
|
| Rate for Payer: Priority Health SBD |
$310.02
|
| Rate for Payer: Priority Health SBD |
$302.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.98
|
| Rate for Payer: UHC Core |
$37.98
|
| Rate for Payer: UHC Core |
$37.98
|
| Rate for Payer: UHC Core |
$37.98
|
| Rate for Payer: UHC Exchange |
$37.98
|
| Rate for Payer: UHC Exchange |
$37.98
|
| Rate for Payer: UHC Exchange |
$37.98
|
| Rate for Payer: UMR Bronson Commercial |
$182.08
|
| Rate for Payer: UMR Bronson Commercial |
$101.49
|
| Rate for Payer: UMR Bronson Commercial |
$177.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$369.07
|
|
|
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION
|
Facility
|
IP
|
$912.70
|
|
|
Service Code
|
HCPCS J9040
|
| Hospital Charge Code |
17012
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$401.59 |
| Max. Negotiated Rate |
$821.43 |
| Rate for Payer: Aetna American Axle |
$593.25
|
| Rate for Payer: Aetna American Axle |
$348.61
|
| Rate for Payer: Aetna Commercial |
$455.87
|
| Rate for Payer: Aetna Commercial |
$775.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$593.25
|
| Rate for Payer: Cash Price |
$730.16
|
| Rate for Payer: Cash Price |
$429.06
|
| Rate for Payer: Cofinity Advantage |
$638.89
|
| Rate for Payer: Cofinity Advantage |
$375.42
|
| Rate for Payer: Cofinity Commercial |
$461.24
|
| Rate for Payer: Cofinity Commercial |
$784.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$730.16
|
| Rate for Payer: Healthscope Commercial |
$821.43
|
| Rate for Payer: Healthscope Commercial |
$482.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$375.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$638.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$402.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$684.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$775.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$684.52
|
| Rate for Payer: PHP Commercial |
$455.87
|
| Rate for Payer: PHP Commercial |
$775.79
|
| Rate for Payer: Priority Health SBD |
$337.88
|
| Rate for Payer: Priority Health SBD |
$575.00
|
| Rate for Payer: UMR Bronson Commercial |
$401.59
|
| Rate for Payer: UMR Bronson Commercial |
$235.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$684.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$402.24
|
|
|
BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION
|
Facility
|
OP
|
$312.63
|
|
|
Service Code
|
HCPCS J9040
|
| Hospital Charge Code |
17012
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$73.23 |
| Max. Negotiated Rate |
$281.37 |
| Rate for Payer: Aetna American Axle |
$203.21
|
| Rate for Payer: Aetna American Axle |
$318.14
|
| Rate for Payer: Aetna American Axle |
$523.21
|
| Rate for Payer: Aetna American Axle |
$348.61
|
| Rate for Payer: Aetna American Axle |
$593.25
|
| Rate for Payer: Aetna Commercial |
$775.79
|
| Rate for Payer: Aetna Commercial |
$416.02
|
| Rate for Payer: Aetna Commercial |
$265.74
|
| Rate for Payer: Aetna Commercial |
$684.20
|
| Rate for Payer: Aetna Commercial |
$455.87
|
| Rate for Payer: Aetna Medicare |
$402.47
|
| Rate for Payer: Aetna Medicare |
$456.35
|
| Rate for Payer: Aetna Medicare |
$156.31
|
| Rate for Payer: Aetna Medicare |
$244.72
|
| Rate for Payer: Aetna Medicare |
$268.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$523.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$593.25
|
| Rate for Payer: BCBS Complete |
$125.05
|
| Rate for Payer: BCBS Complete |
$365.08
|
| Rate for Payer: BCBS Complete |
$321.98
|
| Rate for Payer: BCBS Complete |
$214.53
|
| Rate for Payer: BCBS Complete |
$195.78
|
| Rate for Payer: BCBS Trust/PPO |
$73.23
|
| Rate for Payer: BCBS Trust/PPO |
$73.23
|
| Rate for Payer: BCBS Trust/PPO |
$73.23
|
| Rate for Payer: BCBS Trust/PPO |
$73.23
|
| Rate for Payer: BCBS Trust/PPO |
$73.23
|
| Rate for Payer: BCN Commercial |
$73.23
|
| Rate for Payer: BCN Commercial |
$73.23
|
| Rate for Payer: BCN Commercial |
$73.23
|
| Rate for Payer: BCN Commercial |
$73.23
|
| Rate for Payer: BCN Commercial |
$73.23
|
| Rate for Payer: Cash Price |
$730.16
|
| Rate for Payer: Cash Price |
$643.95
|
| Rate for Payer: Cash Price |
$391.55
|
| Rate for Payer: Cash Price |
$429.06
|
| Rate for Payer: Cash Price |
$250.10
|
| Rate for Payer: Cash Price |
$429.06
|
| Rate for Payer: Cash Price |
$391.55
|
| Rate for Payer: Cash Price |
$643.95
|
| Rate for Payer: Cash Price |
$730.16
|
| Rate for Payer: Cash Price |
$250.10
|
| Rate for Payer: Cofinity Advantage |
$638.89
|
| Rate for Payer: Cofinity Advantage |
$375.42
|
| Rate for Payer: Cofinity Advantage |
$218.84
|
| Rate for Payer: Cofinity Advantage |
$563.46
|
| Rate for Payer: Cofinity Advantage |
$342.61
|
| Rate for Payer: Cofinity Commercial |
$692.25
|
| Rate for Payer: Cofinity Commercial |
$268.86
|
| Rate for Payer: Cofinity Commercial |
$461.24
|
| Rate for Payer: Cofinity Commercial |
$420.92
|
| Rate for Payer: Cofinity Commercial |
$784.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$730.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$643.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.06
|
| Rate for Payer: Healthscope Commercial |
$440.50
|
| Rate for Payer: Healthscope Commercial |
$821.43
|
| Rate for Payer: Healthscope Commercial |
$724.45
|
| Rate for Payer: Healthscope Commercial |
$281.37
|
| Rate for Payer: Healthscope Commercial |
$482.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$342.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$375.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$638.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$218.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$563.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$402.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$603.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$684.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$730.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$429.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$643.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$391.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$684.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$775.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$603.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$684.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$367.08
|
| Rate for Payer: PHP Commercial |
$775.79
|
| Rate for Payer: PHP Commercial |
$416.02
|
| Rate for Payer: PHP Commercial |
$455.87
|
| Rate for Payer: PHP Commercial |
$684.20
|
| Rate for Payer: PHP Commercial |
$265.74
|
| Rate for Payer: Priority Health SBD |
$308.35
|
| Rate for Payer: Priority Health SBD |
$337.88
|
| Rate for Payer: Priority Health SBD |
$196.96
|
| Rate for Payer: Priority Health SBD |
$575.00
|
| Rate for Payer: Priority Health SBD |
$507.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$593.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.21
|
| Rate for Payer: UHC Core |
$419.37
|
| Rate for Payer: UHC Core |
$255.00
|
| Rate for Payer: UHC Core |
$162.88
|
| Rate for Payer: UHC Core |
$279.42
|
| Rate for Payer: UHC Core |
$475.52
|
| Rate for Payer: UHC Exchange |
$210.77
|
| Rate for Payer: UHC Exchange |
$316.34
|
| Rate for Payer: UHC Exchange |
$122.86
|
| Rate for Payer: UHC Exchange |
$192.35
|
| Rate for Payer: UHC Exchange |
$358.69
|
| Rate for Payer: UMR Bronson Commercial |
$115.67
|
| Rate for Payer: UMR Bronson Commercial |
$297.83
|
| Rate for Payer: UMR Bronson Commercial |
$337.70
|
| Rate for Payer: UMR Bronson Commercial |
$198.44
|
| Rate for Payer: UMR Bronson Commercial |
$181.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$402.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$684.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$603.71
|
|
|
BLEOMYCIN 60 UNIT/10 ML IN NS INTRA-LESIONAL INJECTION
|
Facility
|
IP
|
$489.44
|
|
|
Service Code
|
HCPCS J9040
|
| Hospital Charge Code |
302015
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$215.35 |
| Max. Negotiated Rate |
$440.50 |
| Rate for Payer: Aetna American Axle |
$318.14
|
| Rate for Payer: Aetna Commercial |
$416.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.14
|
| Rate for Payer: Cash Price |
$391.55
|
| Rate for Payer: Cofinity Advantage |
$342.61
|
| Rate for Payer: Cofinity Commercial |
$420.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.55
|
| Rate for Payer: Healthscope Commercial |
$440.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$342.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$367.08
|
| Rate for Payer: PHP Commercial |
$416.02
|
| Rate for Payer: Priority Health SBD |
$308.35
|
| Rate for Payer: UMR Bronson Commercial |
$215.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.08
|
|
|
BLEOMYCIN 60 UNIT/10 ML IN NS INTRA-LESIONAL INJECTION
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Facility
|
OP
|
$489.44
|
|
|
Service Code
|
HCPCS J9040
|
| Hospital Charge Code |
302015
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$73.23 |
| Max. Negotiated Rate |
$440.50 |
| Rate for Payer: Aetna American Axle |
$318.14
|
| Rate for Payer: Aetna Commercial |
$416.02
|
| Rate for Payer: Aetna Medicare |
$244.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.14
|
| Rate for Payer: BCBS Complete |
$195.78
|
| Rate for Payer: BCBS Trust/PPO |
$73.23
|
| Rate for Payer: BCN Commercial |
$73.23
|
| Rate for Payer: Cash Price |
$391.55
|
| Rate for Payer: Cash Price |
$391.55
|
| Rate for Payer: Cofinity Advantage |
$342.61
|
| Rate for Payer: Cofinity Commercial |
$420.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.55
|
| Rate for Payer: Healthscope Commercial |
$440.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$342.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$391.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$367.08
|
| Rate for Payer: PHP Commercial |
$416.02
|
| Rate for Payer: Priority Health SBD |
$308.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.14
|
| Rate for Payer: UHC Core |
$255.00
|
| Rate for Payer: UHC Exchange |
$192.35
|
| Rate for Payer: UMR Bronson Commercial |
$181.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.08
|
|
