|
LUBIPROSTONE 8 MCG CAPSULE
|
Facility
|
IP
|
$1,021.65
|
|
|
Service Code
|
NDC 0254-3028-02
|
| Hospital Charge Code |
91534
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$449.53 |
| Max. Negotiated Rate |
$919.48 |
| Rate for Payer: Aetna American Axle |
$664.07
|
| Rate for Payer: Aetna Commercial |
$868.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$664.07
|
| Rate for Payer: Cash Price |
$817.32
|
| Rate for Payer: Cofinity Commercial |
$715.16
|
| Rate for Payer: Cofinity Commercial |
$878.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.32
|
| Rate for Payer: Healthscope Commercial |
$919.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$715.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$766.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$868.40
|
| Rate for Payer: PHP Commercial |
$868.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$715.16
|
| Rate for Payer: Priority Health SBD |
$643.64
|
| Rate for Payer: UMR Bronson Commercial |
$449.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$766.24
|
|
|
LUBIPROSTONE 8 MCG CAPSULE
|
Facility
|
IP
|
$1,276.95
|
|
|
Service Code
|
NDC 64764-080-60
|
| Hospital Charge Code |
91534
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$561.86 |
| Max. Negotiated Rate |
$1,149.26 |
| Rate for Payer: Aetna American Axle |
$830.02
|
| Rate for Payer: Aetna Commercial |
$1,085.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$830.02
|
| Rate for Payer: Cash Price |
$1,021.56
|
| Rate for Payer: Cofinity Commercial |
$1,098.18
|
| Rate for Payer: Cofinity Commercial |
$893.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,021.56
|
| Rate for Payer: Healthscope Commercial |
$1,149.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$893.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$957.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,085.41
|
| Rate for Payer: PHP Commercial |
$1,085.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$893.86
|
| Rate for Payer: Priority Health SBD |
$804.48
|
| Rate for Payer: UMR Bronson Commercial |
$561.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$957.71
|
|
|
LUNG TRANSPLANT
|
Facility
|
IP
|
$227,171.19
|
|
|
Service Code
|
MS-DRG 007
|
| Min. Negotiated Rate |
$90,285.77 |
| Max. Negotiated Rate |
$227,171.19 |
| Rate for Payer: Aetna Medicare |
$98,839.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118,797.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118,797.06
|
| Rate for Payer: BCBS MAPPO |
$95,037.65
|
| Rate for Payer: BCBS Trust/PPO |
$227,171.19
|
| Rate for Payer: BCN Medicare Advantage |
$95,037.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95,037.65
|
| Rate for Payer: Mclaren Medicare |
$95,037.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$99,789.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109,293.30
|
| Rate for Payer: PACE Medicare |
$90,285.77
|
| Rate for Payer: PACE SWMI |
$95,037.65
|
| Rate for Payer: PHP Medicare Advantage |
$95,037.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176,021.86
|
| Rate for Payer: Priority Health Medicare |
$95,037.65
|
| Rate for Payer: Priority Health Narrow Network |
$140,817.49
|
| Rate for Payer: Railroad Medicare Medicare |
$95,037.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187,111.67
|
| Rate for Payer: UHC Core |
$153,428.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$95,037.65
|
| Rate for Payer: UHC Exchange |
$121,977.08
|
| Rate for Payer: UHC Medicare Advantage |
$97,888.78
|
| Rate for Payer: VA VA |
$95,037.65
|
|
|
LURASIDONE 20 MG TABLET
|
Facility
|
IP
|
$204.34
|
|
|
Service Code
|
NDC 13668-464-30
|
| Hospital Charge Code |
158952
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$89.91 |
| Max. Negotiated Rate |
$183.91 |
| Rate for Payer: Aetna American Axle |
$132.82
|
| Rate for Payer: Aetna Commercial |
$173.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.82
|
| Rate for Payer: Cash Price |
$163.47
|
| Rate for Payer: Cofinity Commercial |
$143.04
|
| Rate for Payer: Cofinity Commercial |
$175.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.47
|
| Rate for Payer: Healthscope Commercial |
$183.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$143.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.69
|
| Rate for Payer: PHP Commercial |
$173.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.04
|
| Rate for Payer: Priority Health SBD |
$128.73
|
| Rate for Payer: UMR Bronson Commercial |
$89.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.26
|
|
|
LURASIDONE 20 MG TABLET
|
Facility
|
IP
|
$101.52
|
|
|
Service Code
|
NDC 67877-638-30
|
| Hospital Charge Code |
158952
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$44.67 |
| Max. Negotiated Rate |
$91.37 |
| Rate for Payer: Aetna American Axle |
$65.99
|
| Rate for Payer: Aetna Commercial |
$86.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.99
|
| Rate for Payer: Cash Price |
$81.22
|
| Rate for Payer: Cofinity Commercial |
$71.06
|
| Rate for Payer: Cofinity Commercial |
$87.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.22
|
| Rate for Payer: Healthscope Commercial |
$91.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.29
|
| Rate for Payer: PHP Commercial |
$86.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.06
|
| Rate for Payer: Priority Health SBD |
$63.96
|
| Rate for Payer: UMR Bronson Commercial |
$44.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.14
|
|
|
LURASIDONE 20 MG TABLET
|
Facility
|
IP
|
$89.28
|
|
|
Service Code
|
NDC 68180-670-06
|
| Hospital Charge Code |
158952
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$80.35 |
| Rate for Payer: Aetna American Axle |
$58.03
|
| Rate for Payer: Aetna Commercial |
$75.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.03
|
| Rate for Payer: Cash Price |
$71.42
|
| Rate for Payer: Cofinity Commercial |
$62.50
|
| Rate for Payer: Cofinity Commercial |
$76.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.42
|
| Rate for Payer: Healthscope Commercial |
$80.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.89
|
| Rate for Payer: PHP Commercial |
$75.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.50
|
| Rate for Payer: Priority Health SBD |
$56.25
|
| Rate for Payer: UMR Bronson Commercial |
$39.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.96
|
|
|
LURASIDONE 20 MG TABLET
|
Facility
|
IP
|
$4,735.26
|
|
|
Service Code
|
NDC 63402-302-30
|
| Hospital Charge Code |
158952
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,083.51 |
| Max. Negotiated Rate |
$4,261.73 |
| Rate for Payer: Aetna American Axle |
$3,077.92
|
| Rate for Payer: Aetna Commercial |
$4,024.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,077.92
|
| Rate for Payer: Cash Price |
$3,788.21
|
| Rate for Payer: Cofinity Commercial |
$3,314.68
|
| Rate for Payer: Cofinity Commercial |
$4,072.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,788.21
|
| Rate for Payer: Healthscope Commercial |
$4,261.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,314.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,551.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,024.97
|
| Rate for Payer: PHP Commercial |
$4,024.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,314.68
|
| Rate for Payer: Priority Health SBD |
$2,983.21
|
| Rate for Payer: UMR Bronson Commercial |
$2,083.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,551.44
|
|
|
LURASIDONE 40 MG TABLET
|
Facility
|
IP
|
$61.28
|
|
|
Service Code
|
NDC 67877-639-30
|
| Hospital Charge Code |
107668
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$26.96 |
| Max. Negotiated Rate |
$55.15 |
| Rate for Payer: Aetna American Axle |
$39.83
|
| Rate for Payer: Aetna Commercial |
$52.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.83
|
| Rate for Payer: Cash Price |
$49.02
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Cofinity Commercial |
$52.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.02
|
| Rate for Payer: Healthscope Commercial |
$55.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.09
|
| Rate for Payer: PHP Commercial |
$52.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
| Rate for Payer: Priority Health SBD |
$38.61
|
| Rate for Payer: UMR Bronson Commercial |
$26.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.96
|
|
|
LURASIDONE 40 MG TABLET
|
Facility
|
IP
|
$89.28
|
|
|
Service Code
|
NDC 72205-208-30
|
| Hospital Charge Code |
107668
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$80.35 |
| Rate for Payer: Aetna American Axle |
$58.03
|
| Rate for Payer: Aetna Commercial |
$75.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.03
|
| Rate for Payer: Cash Price |
$71.42
|
| Rate for Payer: Cofinity Commercial |
$62.50
|
| Rate for Payer: Cofinity Commercial |
$76.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.42
|
| Rate for Payer: Healthscope Commercial |
$80.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.89
|
| Rate for Payer: PHP Commercial |
$75.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.50
|
| Rate for Payer: Priority Health SBD |
$56.25
|
| Rate for Payer: UMR Bronson Commercial |
$39.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.96
|
|
|
LURASIDONE 40 MG TABLET
|
Facility
|
IP
|
$89.28
|
|
|
Service Code
|
NDC 68180-671-06
|
| Hospital Charge Code |
107668
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$80.35 |
| Rate for Payer: Aetna American Axle |
$58.03
|
| Rate for Payer: Aetna Commercial |
$75.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.03
|
| Rate for Payer: Cash Price |
$71.42
|
| Rate for Payer: Cofinity Commercial |
$62.50
|
| Rate for Payer: Cofinity Commercial |
$76.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.42
|
| Rate for Payer: Healthscope Commercial |
$80.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.89
|
| Rate for Payer: PHP Commercial |
$75.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.50
|
| Rate for Payer: Priority Health SBD |
$56.25
|
| Rate for Payer: UMR Bronson Commercial |
$39.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.96
|
|
|
LURASIDONE 40 MG TABLET
|
Facility
|
IP
|
$4,735.26
|
|
|
Service Code
|
NDC 63402-304-30
|
| Hospital Charge Code |
107668
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,083.51 |
| Max. Negotiated Rate |
$4,261.73 |
| Rate for Payer: Aetna American Axle |
$3,077.92
|
| Rate for Payer: Aetna Commercial |
$4,024.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,077.92
|
| Rate for Payer: Cash Price |
$3,788.21
|
| Rate for Payer: Cofinity Commercial |
$3,314.68
|
| Rate for Payer: Cofinity Commercial |
$4,072.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,788.21
|
| Rate for Payer: Healthscope Commercial |
$4,261.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,314.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,551.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,024.97
|
| Rate for Payer: PHP Commercial |
$4,024.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,314.68
|
| Rate for Payer: Priority Health SBD |
$2,983.21
|
| Rate for Payer: UMR Bronson Commercial |
$2,083.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,551.44
|
|
|
LURBINECTEDIN 4 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$20,358.00
|
|
|
Service Code
|
HCPCS J9223
|
| Hospital Charge Code |
194141
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$109.40 |
| Max. Negotiated Rate |
$18,322.20 |
| Rate for Payer: Aetna American Axle |
$13,232.70
|
| Rate for Payer: Aetna Commercial |
$17,304.30
|
| Rate for Payer: Aetna Medicare |
$208.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,232.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$250.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$250.01
|
| Rate for Payer: BCBS Complete |
$114.89
|
| Rate for Payer: BCBS MAPPO |
$200.01
|
| Rate for Payer: BCBS Trust/PPO |
$646.33
|
| Rate for Payer: BCN Medicare Advantage |
$200.01
|
| Rate for Payer: Cash Price |
$16,286.40
|
| Rate for Payer: Cash Price |
$16,286.40
|
| Rate for Payer: Cofinity Commercial |
$17,507.88
|
| Rate for Payer: Cofinity Commercial |
$14,250.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,286.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.01
|
| Rate for Payer: Healthscope Commercial |
$18,322.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14,250.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,268.50
|
| Rate for Payer: Mclaren Medicaid |
$109.40
|
| Rate for Payer: Mclaren Medicare |
$200.01
|
| Rate for Payer: Meridian Medicaid |
$114.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$210.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$230.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17,304.30
|
| Rate for Payer: PACE Medicare |
$190.01
|
| Rate for Payer: PACE SWMI |
$200.01
|
| Rate for Payer: PHP Commercial |
$17,304.30
|
| Rate for Payer: PHP Medicare Advantage |
$200.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,250.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$578.03
|
| Rate for Payer: Priority Health Medicare |
$200.01
|
| Rate for Payer: Priority Health Narrow Network |
$462.42
|
| Rate for Payer: Priority Health SBD |
$12,825.54
|
| Rate for Payer: Railroad Medicare Medicare |
$200.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.01
|
| Rate for Payer: UHC Medicare Advantage |
$206.01
|
| Rate for Payer: UMR Bronson Commercial |
$7,532.46
|
| Rate for Payer: VA VA |
$200.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,268.50
|
|
|
LURBINECTEDIN 4 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$20,358.00
|
|
|
Service Code
|
HCPCS J9223
|
| Hospital Charge Code |
194141
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8,957.52 |
| Max. Negotiated Rate |
$18,322.20 |
| Rate for Payer: Aetna American Axle |
$13,232.70
|
| Rate for Payer: Aetna Commercial |
$17,304.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,232.70
|
| Rate for Payer: Cash Price |
$16,286.40
|
| Rate for Payer: Cofinity Commercial |
$14,250.60
|
| Rate for Payer: Cofinity Commercial |
$17,507.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,286.40
|
| Rate for Payer: Healthscope Commercial |
$18,322.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14,250.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,268.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17,304.30
|
| Rate for Payer: PHP Commercial |
$17,304.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,250.60
|
| Rate for Payer: Priority Health SBD |
$12,825.54
|
| Rate for Payer: UMR Bronson Commercial |
$8,957.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,268.50
|
|
|
LUSPATERCEPT-AAMT 25 MG SUBCUTANEOUS SOLUTION
|
Facility
|
OP
|
$10,077.34
|
|
|
Service Code
|
HCPCS J0896
|
| Hospital Charge Code |
192114
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.86 |
| Max. Negotiated Rate |
$9,069.61 |
| Rate for Payer: Aetna American Axle |
$6,550.27
|
| Rate for Payer: Aetna Commercial |
$8,565.74
|
| Rate for Payer: Aetna Medicare |
$41.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,550.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.96
|
| Rate for Payer: BCBS Complete |
$22.96
|
| Rate for Payer: BCBS MAPPO |
$39.97
|
| Rate for Payer: BCBS Trust/PPO |
$129.15
|
| Rate for Payer: BCN Medicare Advantage |
$39.97
|
| Rate for Payer: Cash Price |
$8,061.87
|
| Rate for Payer: Cash Price |
$8,061.87
|
| Rate for Payer: Cofinity Commercial |
$7,054.14
|
| Rate for Payer: Cofinity Commercial |
$8,666.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,061.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.97
|
| Rate for Payer: Healthscope Commercial |
$9,069.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,054.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,558.00
|
| Rate for Payer: Mclaren Medicaid |
$21.86
|
| Rate for Payer: Mclaren Medicare |
$39.97
|
| Rate for Payer: Meridian Medicaid |
$22.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,565.74
|
| Rate for Payer: PACE Medicare |
$37.97
|
| Rate for Payer: PACE SWMI |
$39.97
|
| Rate for Payer: PHP Commercial |
$8,565.74
|
| Rate for Payer: PHP Medicare Advantage |
$39.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,054.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.15
|
| Rate for Payer: Priority Health Medicare |
$39.97
|
| Rate for Payer: Priority Health Narrow Network |
$92.12
|
| Rate for Payer: Priority Health SBD |
$6,348.72
|
| Rate for Payer: Railroad Medicare Medicare |
$39.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.97
|
| Rate for Payer: UHC Medicare Advantage |
$41.17
|
| Rate for Payer: UMR Bronson Commercial |
$3,728.62
|
| Rate for Payer: VA VA |
$39.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,558.00
|
|
|
LUSPATERCEPT-AAMT 75 MG SUBCUTANEOUS SOLUTION
|
Facility
|
OP
|
$30,231.95
|
|
|
Service Code
|
HCPCS J0896
|
| Hospital Charge Code |
192115
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.86 |
| Max. Negotiated Rate |
$27,208.76 |
| Rate for Payer: Aetna American Axle |
$19,650.77
|
| Rate for Payer: Aetna Commercial |
$25,697.16
|
| Rate for Payer: Aetna Medicare |
$41.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,650.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.96
|
| Rate for Payer: BCBS Complete |
$22.96
|
| Rate for Payer: BCBS MAPPO |
$39.97
|
| Rate for Payer: BCBS Trust/PPO |
$129.15
|
| Rate for Payer: BCN Medicare Advantage |
$39.97
|
| Rate for Payer: Cash Price |
$24,185.56
|
| Rate for Payer: Cash Price |
$24,185.56
|
| Rate for Payer: Cofinity Commercial |
$25,999.48
|
| Rate for Payer: Cofinity Commercial |
$21,162.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,185.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.97
|
| Rate for Payer: Healthscope Commercial |
$27,208.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21,162.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,673.96
|
| Rate for Payer: Mclaren Medicaid |
$21.86
|
| Rate for Payer: Mclaren Medicare |
$39.97
|
| Rate for Payer: Meridian Medicaid |
$22.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25,697.16
|
| Rate for Payer: PACE Medicare |
$37.97
|
| Rate for Payer: PACE SWMI |
$39.97
|
| Rate for Payer: PHP Commercial |
$25,697.16
|
| Rate for Payer: PHP Medicare Advantage |
$39.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21,162.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.15
|
| Rate for Payer: Priority Health Medicare |
$39.97
|
| Rate for Payer: Priority Health Narrow Network |
$92.12
|
| Rate for Payer: Priority Health SBD |
$19,046.13
|
| Rate for Payer: Railroad Medicare Medicare |
$39.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.97
|
| Rate for Payer: UHC Medicare Advantage |
$41.17
|
| Rate for Payer: UMR Bronson Commercial |
$11,185.82
|
| Rate for Payer: VA VA |
$39.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,673.96
|
|
|
LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$9,213.70
|
|
|
Service Code
|
HCPCS J7504
|
| Hospital Charge Code |
10475
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4,054.03 |
| Max. Negotiated Rate |
$8,292.33 |
| Rate for Payer: Aetna American Axle |
$5,988.90
|
| Rate for Payer: Aetna Commercial |
$7,831.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,988.90
|
| Rate for Payer: Cash Price |
$7,370.96
|
| Rate for Payer: Cofinity Commercial |
$7,923.78
|
| Rate for Payer: Cofinity Commercial |
$6,449.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,370.96
|
| Rate for Payer: Healthscope Commercial |
$8,292.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,449.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,910.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,831.64
|
| Rate for Payer: PHP Commercial |
$7,831.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,449.59
|
| Rate for Payer: Priority Health SBD |
$5,804.63
|
| Rate for Payer: UMR Bronson Commercial |
$4,054.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,910.28
|
|
|
LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$49,210.12
|
|
|
Service Code
|
MS-DRG 821
|
| Min. Negotiated Rate |
$16,827.33 |
| Max. Negotiated Rate |
$49,210.12 |
| Rate for Payer: Aetna Medicare |
$18,421.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,141.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,141.22
|
| Rate for Payer: BCBS MAPPO |
$17,712.98
|
| Rate for Payer: BCBS Trust/PPO |
$49,210.12
|
| Rate for Payer: BCN Medicare Advantage |
$17,712.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,712.98
|
| Rate for Payer: Mclaren Medicare |
$17,712.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18,598.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,369.93
|
| Rate for Payer: PACE Medicare |
$16,827.33
|
| Rate for Payer: PACE SWMI |
$17,712.98
|
| Rate for Payer: PHP Medicare Advantage |
$17,712.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32,030.46
|
| Rate for Payer: Priority Health Medicare |
$17,712.98
|
| Rate for Payer: Priority Health Narrow Network |
$25,624.37
|
| Rate for Payer: Railroad Medicare Medicare |
$17,712.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34,048.45
|
| Rate for Payer: UHC Core |
$27,919.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,712.98
|
| Rate for Payer: UHC Exchange |
$22,196.00
|
| Rate for Payer: UHC Medicare Advantage |
$18,244.37
|
| Rate for Payer: VA VA |
$17,712.98
|
|
|
LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$113,030.24
|
|
|
Service Code
|
MS-DRG 820
|
| Min. Negotiated Rate |
$44,753.01 |
| Max. Negotiated Rate |
$113,030.24 |
| Rate for Payer: Aetna Medicare |
$48,992.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58,885.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58,885.54
|
| Rate for Payer: BCBS MAPPO |
$47,108.43
|
| Rate for Payer: BCBS Trust/PPO |
$113,030.24
|
| Rate for Payer: BCN Medicare Advantage |
$47,108.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47,108.43
|
| Rate for Payer: Mclaren Medicare |
$47,108.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$49,463.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54,174.69
|
| Rate for Payer: PACE Medicare |
$44,753.01
|
| Rate for Payer: PACE SWMI |
$47,108.43
|
| Rate for Payer: PHP Medicare Advantage |
$47,108.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86,769.66
|
| Rate for Payer: Priority Health Medicare |
$47,108.43
|
| Rate for Payer: Priority Health Narrow Network |
$69,415.73
|
| Rate for Payer: Railroad Medicare Medicare |
$47,108.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92,236.36
|
| Rate for Payer: UHC Core |
$75,632.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$47,108.43
|
| Rate for Payer: UHC Exchange |
$60,128.38
|
| Rate for Payer: UHC Medicare Advantage |
$48,521.68
|
| Rate for Payer: VA VA |
$47,108.43
|
|
|
LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$34,090.00
|
|
|
Service Code
|
MS-DRG 822
|
| Min. Negotiated Rate |
$9,555.66 |
| Max. Negotiated Rate |
$34,090.00 |
| Rate for Payer: Aetna Medicare |
$10,460.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,573.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,573.24
|
| Rate for Payer: BCBS MAPPO |
$10,058.59
|
| Rate for Payer: BCBS Trust/PPO |
$34,090.00
|
| Rate for Payer: BCN Medicare Advantage |
$10,058.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,058.59
|
| Rate for Payer: Mclaren Medicare |
$10,058.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,561.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,567.38
|
| Rate for Payer: PACE Medicare |
$9,555.66
|
| Rate for Payer: PACE SWMI |
$10,058.59
|
| Rate for Payer: PHP Medicare Advantage |
$10,058.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,776.68
|
| Rate for Payer: Priority Health Medicare |
$10,058.59
|
| Rate for Payer: Priority Health Narrow Network |
$14,221.34
|
| Rate for Payer: Railroad Medicare Medicare |
$10,058.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,896.66
|
| Rate for Payer: UHC Core |
$15,494.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,058.59
|
| Rate for Payer: UHC Exchange |
$12,318.63
|
| Rate for Payer: UHC Medicare Advantage |
$10,360.35
|
| Rate for Payer: VA VA |
$10,058.59
|
|
|
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC
|
Facility
|
IP
|
$36,055.09
|
|
|
Service Code
|
MS-DRG 841
|
| Min. Negotiated Rate |
$12,005.90 |
| Max. Negotiated Rate |
$36,055.09 |
| Rate for Payer: Aetna Medicare |
$13,143.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,797.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,797.24
|
| Rate for Payer: BCBS MAPPO |
$12,637.79
|
| Rate for Payer: BCBS Trust/PPO |
$36,055.09
|
| Rate for Payer: BCN Medicare Advantage |
$12,637.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,637.79
|
| Rate for Payer: Mclaren Medicare |
$12,637.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13,269.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,533.46
|
| Rate for Payer: PACE Medicare |
$12,005.90
|
| Rate for Payer: PACE SWMI |
$12,637.79
|
| Rate for Payer: PHP Medicare Advantage |
$12,637.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22,579.60
|
| Rate for Payer: Priority Health Medicare |
$12,637.79
|
| Rate for Payer: Priority Health Narrow Network |
$18,063.68
|
| Rate for Payer: Railroad Medicare Medicare |
$12,637.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,002.17
|
| Rate for Payer: UHC Core |
$19,681.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,637.79
|
| Rate for Payer: UHC Exchange |
$15,646.88
|
| Rate for Payer: UHC Medicare Advantage |
$13,016.92
|
| Rate for Payer: VA VA |
$12,637.79
|
|
|
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC
|
Facility
|
IP
|
$76,864.59
|
|
|
Service Code
|
MS-DRG 840
|
| Min. Negotiated Rate |
$23,365.49 |
| Max. Negotiated Rate |
$76,864.59 |
| Rate for Payer: Aetna Medicare |
$25,579.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30,744.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30,744.06
|
| Rate for Payer: BCBS MAPPO |
$24,595.25
|
| Rate for Payer: BCBS Trust/PPO |
$76,864.59
|
| Rate for Payer: BCN Medicare Advantage |
$24,595.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24,595.25
|
| Rate for Payer: Mclaren Medicare |
$24,595.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25,825.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28,284.54
|
| Rate for Payer: PACE Medicare |
$23,365.49
|
| Rate for Payer: PACE SWMI |
$24,595.25
|
| Rate for Payer: PHP Medicare Advantage |
$24,595.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44,846.37
|
| Rate for Payer: Priority Health Medicare |
$24,595.25
|
| Rate for Payer: Priority Health Narrow Network |
$35,877.10
|
| Rate for Payer: Railroad Medicare Medicare |
$24,595.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47,671.80
|
| Rate for Payer: UHC Core |
$39,090.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$24,595.25
|
| Rate for Payer: UHC Exchange |
$31,076.99
|
| Rate for Payer: UHC Medicare Advantage |
$25,333.11
|
| Rate for Payer: VA VA |
$24,595.25
|
|
|
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC
|
Facility
|
IP
|
$47,760.18
|
|
|
Service Code
|
MS-DRG 824
|
| Min. Negotiated Rate |
$16,833.20 |
| Max. Negotiated Rate |
$47,760.18 |
| Rate for Payer: Aetna Medicare |
$18,427.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,148.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,148.95
|
| Rate for Payer: BCBS MAPPO |
$17,719.16
|
| Rate for Payer: BCBS Trust/PPO |
$47,760.18
|
| Rate for Payer: BCN Medicare Advantage |
$17,719.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,719.16
|
| Rate for Payer: Mclaren Medicare |
$17,719.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18,605.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,377.03
|
| Rate for Payer: PACE Medicare |
$16,833.20
|
| Rate for Payer: PACE SWMI |
$17,719.16
|
| Rate for Payer: PHP Medicare Advantage |
$17,719.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32,041.94
|
| Rate for Payer: Priority Health Medicare |
$17,719.16
|
| Rate for Payer: Priority Health Narrow Network |
$25,633.55
|
| Rate for Payer: Railroad Medicare Medicare |
$17,719.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34,060.66
|
| Rate for Payer: UHC Core |
$27,929.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,719.16
|
| Rate for Payer: UHC Exchange |
$22,203.96
|
| Rate for Payer: UHC Medicare Advantage |
$18,250.73
|
| Rate for Payer: VA VA |
$17,719.16
|
|
|
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC
|
Facility
|
IP
|
$95,854.57
|
|
|
Service Code
|
MS-DRG 823
|
| Min. Negotiated Rate |
$33,443.93 |
| Max. Negotiated Rate |
$95,854.57 |
| Rate for Payer: Aetna Medicare |
$36,612.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44,005.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44,005.18
|
| Rate for Payer: BCBS MAPPO |
$35,204.14
|
| Rate for Payer: BCBS Trust/PPO |
$95,854.57
|
| Rate for Payer: BCN Medicare Advantage |
$35,204.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35,204.14
|
| Rate for Payer: Mclaren Medicare |
$35,204.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36,964.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40,484.76
|
| Rate for Payer: PACE Medicare |
$33,443.93
|
| Rate for Payer: PACE SWMI |
$35,204.14
|
| Rate for Payer: PHP Medicare Advantage |
$35,204.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64,601.90
|
| Rate for Payer: Priority Health Medicare |
$35,204.14
|
| Rate for Payer: Priority Health Narrow Network |
$51,681.52
|
| Rate for Payer: Railroad Medicare Medicare |
$35,204.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68,671.98
|
| Rate for Payer: UHC Core |
$56,309.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35,204.14
|
| Rate for Payer: UHC Exchange |
$44,766.89
|
| Rate for Payer: UHC Medicare Advantage |
$36,260.26
|
| Rate for Payer: VA VA |
$35,204.14
|
|
|
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$35,472.10
|
|
|
Service Code
|
MS-DRG 825
|
| Min. Negotiated Rate |
$9,940.73 |
| Max. Negotiated Rate |
$35,472.10 |
| Rate for Payer: Aetna Medicare |
$10,882.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,079.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,079.91
|
| Rate for Payer: BCBS MAPPO |
$10,463.93
|
| Rate for Payer: BCBS Trust/PPO |
$35,472.10
|
| Rate for Payer: BCN Medicare Advantage |
$10,463.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,463.93
|
| Rate for Payer: Mclaren Medicare |
$10,463.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,987.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,033.52
|
| Rate for Payer: PACE Medicare |
$9,940.73
|
| Rate for Payer: PACE SWMI |
$10,463.93
|
| Rate for Payer: PHP Medicare Advantage |
$10,463.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,531.49
|
| Rate for Payer: Priority Health Medicare |
$10,463.93
|
| Rate for Payer: Priority Health Narrow Network |
$14,825.19
|
| Rate for Payer: Railroad Medicare Medicare |
$10,463.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,699.02
|
| Rate for Payer: UHC Core |
$16,152.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,463.93
|
| Rate for Payer: UHC Exchange |
$12,841.68
|
| Rate for Payer: UHC Medicare Advantage |
$10,777.85
|
| Rate for Payer: VA VA |
$10,463.93
|
|
|
LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC
|
Facility
|
IP
|
$22,965.39
|
|
|
Service Code
|
MS-DRG 842
|
| Min. Negotiated Rate |
$8,293.57 |
| Max. Negotiated Rate |
$22,965.39 |
| Rate for Payer: Aetna Medicare |
$9,079.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,912.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,912.59
|
| Rate for Payer: BCBS MAPPO |
$8,730.07
|
| Rate for Payer: BCBS Trust/PPO |
$22,965.39
|
| Rate for Payer: BCN Medicare Advantage |
$8,730.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,730.07
|
| Rate for Payer: Mclaren Medicare |
$8,730.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,166.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,039.58
|
| Rate for Payer: PACE Medicare |
$8,293.57
|
| Rate for Payer: PACE SWMI |
$8,730.07
|
| Rate for Payer: PHP Medicare Advantage |
$8,730.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,302.75
|
| Rate for Payer: Priority Health Medicare |
$8,730.07
|
| Rate for Payer: Priority Health Narrow Network |
$12,242.20
|
| Rate for Payer: Railroad Medicare Medicare |
$8,730.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,266.87
|
| Rate for Payer: UHC Core |
$13,338.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,730.07
|
| Rate for Payer: UHC Exchange |
$10,604.28
|
| Rate for Payer: UHC Medicare Advantage |
$8,991.97
|
| Rate for Payer: VA VA |
$8,730.07
|
|
