|
AICD LEAD PROCEDURES
|
Facility
IP
|
$76,130.82
|
|
|
Service Code
|
MS-DRG 265
|
| Min. Negotiated Rate |
$26,358.95 |
| Max. Negotiated Rate |
$76,130.82 |
| Rate for Payer: Aetna Medicare |
$28,856.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34,682.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34,682.82
|
| Rate for Payer: BCBS MAPPO |
$27,746.26
|
| Rate for Payer: BCBS Trust/PPO |
$76,130.82
|
| Rate for Payer: BCN Medicare Advantage |
$27,746.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,746.26
|
| Rate for Payer: Mclaren Medicare |
$27,746.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29,133.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,908.20
|
| Rate for Payer: PACE Medicare |
$26,358.95
|
| Rate for Payer: PACE SWMI |
$27,746.26
|
| Rate for Payer: PHP Medicare Advantage |
$27,746.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50,714.05
|
| Rate for Payer: Priority Health Medicare |
$27,746.26
|
| Rate for Payer: Priority Health Narrow Network |
$40,571.24
|
| Rate for Payer: Railroad Medicare Medicare |
$27,746.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53,909.16
|
| Rate for Payer: UHC Core |
$44,204.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$27,746.26
|
| Rate for Payer: UHC Exchange |
$35,143.09
|
| Rate for Payer: UHC Medicare Advantage |
$28,578.65
|
| Rate for Payer: VA VA |
$27,746.26
|
|
|
ALBENDAZOLE 200 MG TABLET
|
Facility
IP
|
$205.61
|
|
|
Service Code
|
NDC 72205-051-08
|
| Hospital Charge Code |
8979
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$90.47 |
| Max. Negotiated Rate |
$185.05 |
| Rate for Payer: Aetna American Axle |
$133.65
|
| Rate for Payer: Aetna Commercial |
$174.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.65
|
| Rate for Payer: Cash Price |
$164.49
|
| Rate for Payer: Cofinity Commercial |
$143.93
|
| Rate for Payer: Cofinity Commercial |
$176.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.49
|
| Rate for Payer: Healthscope Commercial |
$185.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$143.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$174.77
|
| Rate for Payer: PHP Commercial |
$174.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.93
|
| Rate for Payer: Priority Health SBD |
$129.53
|
| Rate for Payer: UMR Bronson Commercial |
$90.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.21
|
|
|
ALBENDAZOLE 200 MG TABLET
|
Facility
IP
|
$121.66
|
|
|
Service Code
|
NDC 31722-935-02
|
| Hospital Charge Code |
8979
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$53.53 |
| Max. Negotiated Rate |
$109.49 |
| Rate for Payer: Aetna American Axle |
$79.08
|
| Rate for Payer: Aetna Commercial |
$103.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.08
|
| Rate for Payer: Cash Price |
$97.33
|
| Rate for Payer: Cofinity Commercial |
$104.63
|
| Rate for Payer: Cofinity Commercial |
$85.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.33
|
| Rate for Payer: Healthscope Commercial |
$109.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.41
|
| Rate for Payer: PHP Commercial |
$103.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.16
|
| Rate for Payer: Priority Health SBD |
$76.65
|
| Rate for Payer: UMR Bronson Commercial |
$53.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.24
|
|
|
ALBUMIN, HUMAN 25 % CONTINUOUS INFUSION
|
Facility
IP
|
$173.33
|
|
|
Service Code
|
HCPCS P9047
|
| Hospital Charge Code |
180016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$76.27 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna American Axle |
$112.66
|
| Rate for Payer: Aetna Commercial |
$147.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.66
|
| Rate for Payer: Cash Price |
$138.66
|
| Rate for Payer: Cofinity Commercial |
$121.33
|
| Rate for Payer: Cofinity Commercial |
$149.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.66
|
| Rate for Payer: Healthscope Commercial |
$156.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.33
|
| Rate for Payer: PHP Commercial |
$147.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.33
|
| Rate for Payer: Priority Health SBD |
$109.20
|
| Rate for Payer: UMR Bronson Commercial |
$76.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.00
|
|
|
ALBUMIN, HUMAN 25 % FOR PARACENTESIS INJECTION SOLUTION
|
Facility
IP
|
$173.33
|
|
|
Service Code
|
HCPCS P9047
|
| Hospital Charge Code |
300360
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$76.27 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna American Axle |
$112.66
|
| Rate for Payer: Aetna American Axle |
$179.76
|
| Rate for Payer: Aetna Commercial |
$235.07
|
| Rate for Payer: Aetna Commercial |
$147.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.76
|
| Rate for Payer: Cash Price |
$138.66
|
| Rate for Payer: Cash Price |
$221.24
|
| Rate for Payer: Cofinity Commercial |
$193.58
|
| Rate for Payer: Cofinity Commercial |
$237.83
|
| Rate for Payer: Cofinity Commercial |
$121.33
|
| Rate for Payer: Cofinity Commercial |
$149.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.24
|
| Rate for Payer: Healthscope Commercial |
$156.00
|
| Rate for Payer: Healthscope Commercial |
$248.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$235.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.33
|
| Rate for Payer: PHP Commercial |
$147.33
|
| Rate for Payer: PHP Commercial |
$235.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.33
|
| Rate for Payer: Priority Health SBD |
$109.20
|
| Rate for Payer: Priority Health SBD |
$174.23
|
| Rate for Payer: UMR Bronson Commercial |
$76.27
|
| Rate for Payer: UMR Bronson Commercial |
$121.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.41
|
|
|
ALBUMIN, HUMAN 25 % FOR PARACENTESIS INJECTION SOLUTION
|
Facility
OP
|
$276.55
|
|
|
Service Code
|
HCPCS P9047
|
| Hospital Charge Code |
300360
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.03 |
| Max. Negotiated Rate |
$248.90 |
| Rate for Payer: Aetna American Axle |
$179.76
|
| Rate for Payer: Aetna American Axle |
$112.66
|
| Rate for Payer: Aetna Commercial |
$235.07
|
| Rate for Payer: Aetna Commercial |
$147.33
|
| Rate for Payer: Aetna Medicare |
$55.20
|
| Rate for Payer: Aetna Medicare |
$55.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.35
|
| Rate for Payer: BCBS Complete |
$30.49
|
| Rate for Payer: BCBS Complete |
$30.49
|
| Rate for Payer: BCBS MAPPO |
$53.08
|
| Rate for Payer: BCBS MAPPO |
$53.08
|
| Rate for Payer: BCBS Trust/PPO |
$170.54
|
| Rate for Payer: BCBS Trust/PPO |
$170.54
|
| Rate for Payer: BCN Medicare Advantage |
$53.08
|
| Rate for Payer: BCN Medicare Advantage |
$53.08
|
| Rate for Payer: Cash Price |
$138.66
|
| Rate for Payer: Cash Price |
$221.24
|
| Rate for Payer: Cash Price |
$221.24
|
| Rate for Payer: Cash Price |
$138.66
|
| Rate for Payer: Cofinity Commercial |
$121.33
|
| Rate for Payer: Cofinity Commercial |
$237.83
|
| Rate for Payer: Cofinity Commercial |
$193.58
|
| Rate for Payer: Cofinity Commercial |
$149.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.08
|
| Rate for Payer: Healthscope Commercial |
$248.90
|
| Rate for Payer: Healthscope Commercial |
$156.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.00
|
| Rate for Payer: Mclaren Medicaid |
$29.03
|
| Rate for Payer: Mclaren Medicaid |
$29.03
|
| Rate for Payer: Mclaren Medicare |
$53.08
|
| Rate for Payer: Mclaren Medicare |
$53.08
|
| Rate for Payer: Meridian Medicaid |
$30.49
|
| Rate for Payer: Meridian Medicaid |
$30.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$235.07
|
| Rate for Payer: PACE Medicare |
$50.42
|
| Rate for Payer: PACE Medicare |
$50.42
|
| Rate for Payer: PACE SWMI |
$53.08
|
| Rate for Payer: PACE SWMI |
$53.08
|
| Rate for Payer: PHP Commercial |
$147.33
|
| Rate for Payer: PHP Commercial |
$235.07
|
| Rate for Payer: PHP Medicare Advantage |
$53.08
|
| Rate for Payer: PHP Medicare Advantage |
$53.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.88
|
| Rate for Payer: Priority Health Medicare |
$53.08
|
| Rate for Payer: Priority Health Medicare |
$53.08
|
| Rate for Payer: Priority Health Narrow Network |
$124.70
|
| Rate for Payer: Priority Health Narrow Network |
$124.70
|
| Rate for Payer: Priority Health SBD |
$109.20
|
| Rate for Payer: Priority Health SBD |
$174.23
|
| Rate for Payer: Railroad Medicare Medicare |
$53.08
|
| Rate for Payer: Railroad Medicare Medicare |
$53.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.08
|
| Rate for Payer: UHC Medicare Advantage |
$54.67
|
| Rate for Payer: UHC Medicare Advantage |
$54.67
|
| Rate for Payer: UMR Bronson Commercial |
$64.13
|
| Rate for Payer: UMR Bronson Commercial |
$102.32
|
| Rate for Payer: VA VA |
$53.08
|
| Rate for Payer: VA VA |
$53.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.41
|
|
|
ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION
|
Facility
IP
|
$147.30
|
|
|
Service Code
|
HCPCS P9047
|
| Hospital Charge Code |
8981
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$64.81 |
| Max. Negotiated Rate |
$132.57 |
| Rate for Payer: Aetna American Axle |
$95.74
|
| Rate for Payer: Aetna American Axle |
$112.66
|
| Rate for Payer: Aetna Commercial |
$125.20
|
| Rate for Payer: Aetna Commercial |
$147.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.74
|
| Rate for Payer: Cash Price |
$138.66
|
| Rate for Payer: Cash Price |
$117.84
|
| Rate for Payer: Cofinity Commercial |
$149.06
|
| Rate for Payer: Cofinity Commercial |
$126.68
|
| Rate for Payer: Cofinity Commercial |
$103.11
|
| Rate for Payer: Cofinity Commercial |
$121.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.66
|
| Rate for Payer: Healthscope Commercial |
$156.00
|
| Rate for Payer: Healthscope Commercial |
$132.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.33
|
| Rate for Payer: PHP Commercial |
$147.33
|
| Rate for Payer: PHP Commercial |
$125.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.11
|
| Rate for Payer: Priority Health SBD |
$109.20
|
| Rate for Payer: Priority Health SBD |
$92.80
|
| Rate for Payer: UMR Bronson Commercial |
$76.27
|
| Rate for Payer: UMR Bronson Commercial |
$64.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.00
|
|
|
ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION
|
Facility
OP
|
$235.37
|
|
|
Service Code
|
HCPCS P9047
|
| Hospital Charge Code |
8981
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.03 |
| Max. Negotiated Rate |
$211.83 |
| Rate for Payer: Aetna American Axle |
$152.99
|
| Rate for Payer: Aetna American Axle |
$95.74
|
| Rate for Payer: Aetna American Axle |
$112.66
|
| Rate for Payer: Aetna American Axle |
$184.37
|
| Rate for Payer: Aetna Commercial |
$200.06
|
| Rate for Payer: Aetna Commercial |
$147.33
|
| Rate for Payer: Aetna Commercial |
$125.20
|
| Rate for Payer: Aetna Commercial |
$241.10
|
| Rate for Payer: Aetna Medicare |
$55.20
|
| Rate for Payer: Aetna Medicare |
$55.20
|
| Rate for Payer: Aetna Medicare |
$55.20
|
| Rate for Payer: Aetna Medicare |
$55.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.35
|
| Rate for Payer: BCBS Complete |
$30.49
|
| Rate for Payer: BCBS Complete |
$30.49
|
| Rate for Payer: BCBS Complete |
$30.49
|
| Rate for Payer: BCBS Complete |
$30.49
|
| Rate for Payer: BCBS MAPPO |
$53.08
|
| Rate for Payer: BCBS MAPPO |
$53.08
|
| Rate for Payer: BCBS MAPPO |
$53.08
|
| Rate for Payer: BCBS MAPPO |
$53.08
|
| Rate for Payer: BCBS Trust/PPO |
$170.54
|
| Rate for Payer: BCBS Trust/PPO |
$170.54
|
| Rate for Payer: BCBS Trust/PPO |
$170.54
|
| Rate for Payer: BCBS Trust/PPO |
$170.54
|
| Rate for Payer: BCN Medicare Advantage |
$53.08
|
| Rate for Payer: BCN Medicare Advantage |
$53.08
|
| Rate for Payer: BCN Medicare Advantage |
$53.08
|
| Rate for Payer: BCN Medicare Advantage |
$53.08
|
| Rate for Payer: Cash Price |
$117.84
|
| Rate for Payer: Cash Price |
$188.30
|
| Rate for Payer: Cash Price |
$117.84
|
| Rate for Payer: Cash Price |
$226.92
|
| Rate for Payer: Cash Price |
$138.66
|
| Rate for Payer: Cash Price |
$188.30
|
| Rate for Payer: Cash Price |
$226.92
|
| Rate for Payer: Cash Price |
$138.66
|
| Rate for Payer: Cofinity Commercial |
$121.33
|
| Rate for Payer: Cofinity Commercial |
$198.56
|
| Rate for Payer: Cofinity Commercial |
$164.76
|
| Rate for Payer: Cofinity Commercial |
$149.06
|
| Rate for Payer: Cofinity Commercial |
$202.42
|
| Rate for Payer: Cofinity Commercial |
$243.94
|
| Rate for Payer: Cofinity Commercial |
$126.68
|
| Rate for Payer: Cofinity Commercial |
$103.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.08
|
| Rate for Payer: Healthscope Commercial |
$255.28
|
| Rate for Payer: Healthscope Commercial |
$211.83
|
| Rate for Payer: Healthscope Commercial |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$156.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$198.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$164.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.74
|
| Rate for Payer: Mclaren Medicaid |
$29.03
|
| Rate for Payer: Mclaren Medicaid |
$29.03
|
| Rate for Payer: Mclaren Medicaid |
$29.03
|
| Rate for Payer: Mclaren Medicaid |
$29.03
|
| Rate for Payer: Mclaren Medicare |
$53.08
|
| Rate for Payer: Mclaren Medicare |
$53.08
|
| Rate for Payer: Mclaren Medicare |
$53.08
|
| Rate for Payer: Mclaren Medicare |
$53.08
|
| Rate for Payer: Meridian Medicaid |
$30.49
|
| Rate for Payer: Meridian Medicaid |
$30.49
|
| Rate for Payer: Meridian Medicaid |
$30.49
|
| Rate for Payer: Meridian Medicaid |
$30.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$200.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$241.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.20
|
| Rate for Payer: PACE Medicare |
$50.42
|
| Rate for Payer: PACE Medicare |
$50.42
|
| Rate for Payer: PACE Medicare |
$50.42
|
| Rate for Payer: PACE Medicare |
$50.42
|
| Rate for Payer: PACE SWMI |
$53.08
|
| Rate for Payer: PACE SWMI |
$53.08
|
| Rate for Payer: PACE SWMI |
$53.08
|
| Rate for Payer: PACE SWMI |
$53.08
|
| Rate for Payer: PHP Commercial |
$125.20
|
| Rate for Payer: PHP Commercial |
$147.33
|
| Rate for Payer: PHP Commercial |
$200.06
|
| Rate for Payer: PHP Commercial |
$241.10
|
| Rate for Payer: PHP Medicare Advantage |
$53.08
|
| Rate for Payer: PHP Medicare Advantage |
$53.08
|
| Rate for Payer: PHP Medicare Advantage |
$53.08
|
| Rate for Payer: PHP Medicare Advantage |
$53.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.88
|
| Rate for Payer: Priority Health Medicare |
$53.08
|
| Rate for Payer: Priority Health Medicare |
$53.08
|
| Rate for Payer: Priority Health Medicare |
$53.08
|
| Rate for Payer: Priority Health Medicare |
$53.08
|
| Rate for Payer: Priority Health Narrow Network |
$124.70
|
| Rate for Payer: Priority Health Narrow Network |
$124.70
|
| Rate for Payer: Priority Health Narrow Network |
$124.70
|
| Rate for Payer: Priority Health Narrow Network |
$124.70
|
| Rate for Payer: Priority Health SBD |
$148.28
|
| Rate for Payer: Priority Health SBD |
$178.70
|
| Rate for Payer: Priority Health SBD |
$109.20
|
| Rate for Payer: Priority Health SBD |
$92.80
|
| Rate for Payer: Railroad Medicare Medicare |
$53.08
|
| Rate for Payer: Railroad Medicare Medicare |
$53.08
|
| Rate for Payer: Railroad Medicare Medicare |
$53.08
|
| Rate for Payer: Railroad Medicare Medicare |
$53.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.08
|
| Rate for Payer: UHC Medicare Advantage |
$54.67
|
| Rate for Payer: UHC Medicare Advantage |
$54.67
|
| Rate for Payer: UHC Medicare Advantage |
$54.67
|
| Rate for Payer: UHC Medicare Advantage |
$54.67
|
| Rate for Payer: UMR Bronson Commercial |
$54.50
|
| Rate for Payer: UMR Bronson Commercial |
$87.09
|
| Rate for Payer: UMR Bronson Commercial |
$104.95
|
| Rate for Payer: UMR Bronson Commercial |
$64.13
|
| Rate for Payer: VA VA |
$53.08
|
| Rate for Payer: VA VA |
$53.08
|
| Rate for Payer: VA VA |
$53.08
|
| Rate for Payer: VA VA |
$53.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.00
|
|
|
ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION
|
Facility
IP
|
$177.48
|
|
|
Service Code
|
HCPCS P9041
|
| Hospital Charge Code |
8982
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$78.09 |
| Max. Negotiated Rate |
$159.73 |
| Rate for Payer: Aetna American Axle |
$115.36
|
| Rate for Payer: Aetna American Axle |
$99.53
|
| Rate for Payer: Aetna American Axle |
$120.64
|
| Rate for Payer: Aetna American Axle |
$117.62
|
| Rate for Payer: Aetna Commercial |
$150.86
|
| Rate for Payer: Aetna Commercial |
$130.15
|
| Rate for Payer: Aetna Commercial |
$153.82
|
| Rate for Payer: Aetna Commercial |
$157.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.36
|
| Rate for Payer: Cash Price |
$144.77
|
| Rate for Payer: Cash Price |
$122.50
|
| Rate for Payer: Cash Price |
$148.48
|
| Rate for Payer: Cash Price |
$141.98
|
| Rate for Payer: Cofinity Commercial |
$159.62
|
| Rate for Payer: Cofinity Commercial |
$131.68
|
| Rate for Payer: Cofinity Commercial |
$155.63
|
| Rate for Payer: Cofinity Commercial |
$126.67
|
| Rate for Payer: Cofinity Commercial |
$129.92
|
| Rate for Payer: Cofinity Commercial |
$107.18
|
| Rate for Payer: Cofinity Commercial |
$124.24
|
| Rate for Payer: Cofinity Commercial |
$152.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.98
|
| Rate for Payer: Healthscope Commercial |
$167.04
|
| Rate for Payer: Healthscope Commercial |
$137.81
|
| Rate for Payer: Healthscope Commercial |
$159.73
|
| Rate for Payer: Healthscope Commercial |
$162.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$124.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$157.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$130.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$150.86
|
| Rate for Payer: PHP Commercial |
$157.76
|
| Rate for Payer: PHP Commercial |
$150.86
|
| Rate for Payer: PHP Commercial |
$153.82
|
| Rate for Payer: PHP Commercial |
$130.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.18
|
| Rate for Payer: Priority Health SBD |
$114.00
|
| Rate for Payer: Priority Health SBD |
$116.93
|
| Rate for Payer: Priority Health SBD |
$96.47
|
| Rate for Payer: Priority Health SBD |
$111.81
|
| Rate for Payer: UMR Bronson Commercial |
$67.37
|
| Rate for Payer: UMR Bronson Commercial |
$81.66
|
| Rate for Payer: UMR Bronson Commercial |
$78.09
|
| Rate for Payer: UMR Bronson Commercial |
$79.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.84
|
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION
|
Facility
OP
|
$4.38
|
|
|
Service Code
|
HCPCS J7613
|
| Hospital Charge Code |
250
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$3.94 |
| Rate for Payer: Aetna American Axle |
$2.85
|
| Rate for Payer: Aetna American Axle |
$2.29
|
| Rate for Payer: Aetna Commercial |
$3.72
|
| Rate for Payer: Aetna Commercial |
$3.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.29
|
| Rate for Payer: BCBS Complete |
$1.41
|
| Rate for Payer: BCBS Complete |
$1.75
|
| Rate for Payer: BCBS Trust/PPO |
$0.13
|
| Rate for Payer: BCBS Trust/PPO |
$0.13
|
| Rate for Payer: Cash Price |
$2.82
|
| Rate for Payer: Cash Price |
$2.82
|
| Rate for Payer: Cash Price |
$3.50
|
| Rate for Payer: Cash Price |
$3.50
|
| Rate for Payer: Cofinity Commercial |
$3.04
|
| Rate for Payer: Cofinity Commercial |
$3.77
|
| Rate for Payer: Cofinity Commercial |
$3.07
|
| Rate for Payer: Cofinity Commercial |
$2.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.50
|
| Rate for Payer: Healthscope Commercial |
$3.18
|
| Rate for Payer: Healthscope Commercial |
$3.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.00
|
| Rate for Payer: PHP Commercial |
$3.00
|
| Rate for Payer: PHP Commercial |
$3.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.04
|
| Rate for Payer: Priority Health Narrow Network |
$0.03
|
| Rate for Payer: Priority Health Narrow Network |
$0.03
|
| Rate for Payer: Priority Health SBD |
$2.22
|
| Rate for Payer: Priority Health SBD |
$2.76
|
| Rate for Payer: UMR Bronson Commercial |
$1.31
|
| Rate for Payer: UMR Bronson Commercial |
$1.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.28
|
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION
|
Facility
IP
|
$2.31
|
|
|
Service Code
|
HCPCS J7613
|
| Hospital Charge Code |
250
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$2.08 |
| Rate for Payer: Aetna American Axle |
$1.50
|
| Rate for Payer: Aetna American Axle |
$2.48
|
| Rate for Payer: Aetna American Axle |
$2.29
|
| Rate for Payer: Aetna American Axle |
$2.66
|
| Rate for Payer: Aetna American Axle |
$2.11
|
| Rate for Payer: Aetna American Axle |
$2.85
|
| Rate for Payer: Aetna Commercial |
$3.72
|
| Rate for Payer: Aetna Commercial |
$1.96
|
| Rate for Payer: Aetna Commercial |
$2.76
|
| Rate for Payer: Aetna Commercial |
$3.24
|
| Rate for Payer: Aetna Commercial |
$3.48
|
| Rate for Payer: Aetna Commercial |
$3.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.48
|
| Rate for Payer: Cash Price |
$3.50
|
| Rate for Payer: Cash Price |
$2.60
|
| Rate for Payer: Cash Price |
$3.27
|
| Rate for Payer: Cash Price |
$1.85
|
| Rate for Payer: Cash Price |
$2.82
|
| Rate for Payer: Cash Price |
$3.05
|
| Rate for Payer: Cofinity Commercial |
$2.47
|
| Rate for Payer: Cofinity Commercial |
$3.04
|
| Rate for Payer: Cofinity Commercial |
$2.28
|
| Rate for Payer: Cofinity Commercial |
$2.80
|
| Rate for Payer: Cofinity Commercial |
$1.62
|
| Rate for Payer: Cofinity Commercial |
$3.28
|
| Rate for Payer: Cofinity Commercial |
$3.52
|
| Rate for Payer: Cofinity Commercial |
$2.86
|
| Rate for Payer: Cofinity Commercial |
$1.99
|
| Rate for Payer: Cofinity Commercial |
$2.67
|
| Rate for Payer: Cofinity Commercial |
$3.07
|
| Rate for Payer: Cofinity Commercial |
$3.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.27
|
| Rate for Payer: Healthscope Commercial |
$3.43
|
| Rate for Payer: Healthscope Commercial |
$2.08
|
| Rate for Payer: Healthscope Commercial |
$2.92
|
| Rate for Payer: Healthscope Commercial |
$3.18
|
| Rate for Payer: Healthscope Commercial |
$3.68
|
| Rate for Payer: Healthscope Commercial |
$3.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1.96
|
| Rate for Payer: PHP Commercial |
$2.76
|
| Rate for Payer: PHP Commercial |
$1.96
|
| Rate for Payer: PHP Commercial |
$3.24
|
| Rate for Payer: PHP Commercial |
$3.00
|
| Rate for Payer: PHP Commercial |
$3.48
|
| Rate for Payer: PHP Commercial |
$3.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.62
|
| Rate for Payer: Priority Health SBD |
$2.05
|
| Rate for Payer: Priority Health SBD |
$2.76
|
| Rate for Payer: Priority Health SBD |
$2.40
|
| Rate for Payer: Priority Health SBD |
$2.58
|
| Rate for Payer: Priority Health SBD |
$2.22
|
| Rate for Payer: Priority Health SBD |
$1.46
|
| Rate for Payer: UMR Bronson Commercial |
$1.02
|
| Rate for Payer: UMR Bronson Commercial |
$1.80
|
| Rate for Payer: UMR Bronson Commercial |
$1.68
|
| Rate for Payer: UMR Bronson Commercial |
$1.93
|
| Rate for Payer: UMR Bronson Commercial |
$1.43
|
| Rate for Payer: UMR Bronson Commercial |
$1.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.73
|
|
|
ALBUTEROL SULFATE 2 MG/5 ML ORAL SYRUP
|
Facility
IP
|
$533.55
|
|
|
Service Code
|
NDC 0472-0825-16
|
| Hospital Charge Code |
252
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$234.76 |
| Max. Negotiated Rate |
$480.20 |
| Rate for Payer: Aetna American Axle |
$346.81
|
| Rate for Payer: Aetna Commercial |
$453.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.81
|
| Rate for Payer: Cash Price |
$426.84
|
| Rate for Payer: Cofinity Commercial |
$373.48
|
| Rate for Payer: Cofinity Commercial |
$458.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.84
|
| Rate for Payer: Healthscope Commercial |
$480.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$373.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$400.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$453.52
|
| Rate for Payer: PHP Commercial |
$453.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.48
|
| Rate for Payer: Priority Health SBD |
$336.14
|
| Rate for Payer: UMR Bronson Commercial |
$234.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$400.16
|
|
|
ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION
|
Facility
IP
|
$3.36
|
|
|
Service Code
|
HCPCS J7611
|
| Hospital Charge Code |
115221
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.48 |
| Max. Negotiated Rate |
$3.02 |
| Rate for Payer: Aetna American Axle |
$2.18
|
| Rate for Payer: Aetna Commercial |
$2.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.18
|
| Rate for Payer: Cash Price |
$2.69
|
| Rate for Payer: Cofinity Commercial |
$2.35
|
| Rate for Payer: Cofinity Commercial |
$2.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.69
|
| Rate for Payer: Healthscope Commercial |
$3.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.86
|
| Rate for Payer: PHP Commercial |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.35
|
| Rate for Payer: Priority Health SBD |
$2.12
|
| Rate for Payer: UMR Bronson Commercial |
$1.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.52
|
|
|
ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION
|
Facility
OP
|
$3.36
|
|
|
Service Code
|
HCPCS J7611
|
| Hospital Charge Code |
115221
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$3.02 |
| Rate for Payer: Aetna American Axle |
$2.18
|
| Rate for Payer: Aetna Commercial |
$2.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.18
|
| Rate for Payer: BCBS Complete |
$1.34
|
| Rate for Payer: BCBS Trust/PPO |
$0.48
|
| Rate for Payer: Cash Price |
$2.69
|
| Rate for Payer: Cash Price |
$2.69
|
| Rate for Payer: Cofinity Commercial |
$2.35
|
| Rate for Payer: Cofinity Commercial |
$2.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.69
|
| Rate for Payer: Healthscope Commercial |
$3.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.86
|
| Rate for Payer: PHP Commercial |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.15
|
| Rate for Payer: Priority Health Narrow Network |
$0.12
|
| Rate for Payer: Priority Health SBD |
$2.12
|
| Rate for Payer: UMR Bronson Commercial |
$1.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.52
|
|
|
ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION
|
Facility
IP
|
$37.00
|
|
|
Service Code
|
HCPCS J7611
|
| Hospital Charge Code |
251
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.28 |
| Max. Negotiated Rate |
$33.30 |
| Rate for Payer: Aetna American Axle |
$24.05
|
| Rate for Payer: Aetna American Axle |
$107.36
|
| Rate for Payer: Aetna Commercial |
$140.39
|
| Rate for Payer: Aetna Commercial |
$31.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.36
|
| Rate for Payer: Cash Price |
$132.14
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$31.82
|
| Rate for Payer: Cofinity Commercial |
$25.90
|
| Rate for Payer: Cofinity Commercial |
$115.62
|
| Rate for Payer: Cofinity Commercial |
$142.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.60
|
| Rate for Payer: Healthscope Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$148.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$140.39
|
| Rate for Payer: PHP Commercial |
$140.39
|
| Rate for Payer: PHP Commercial |
$31.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.62
|
| Rate for Payer: Priority Health SBD |
$23.31
|
| Rate for Payer: Priority Health SBD |
$104.06
|
| Rate for Payer: UMR Bronson Commercial |
$72.67
|
| Rate for Payer: UMR Bronson Commercial |
$16.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.88
|
|
|
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL COMMON CANISTER INHALER
|
Facility
IP
|
$109.20
|
|
|
Service Code
|
NDC 9900-0011-69
|
| Hospital Charge Code |
300450
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.05 |
| Max. Negotiated Rate |
$98.28 |
| Rate for Payer: Aetna American Axle |
$70.98
|
| Rate for Payer: Aetna Commercial |
$92.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.98
|
| Rate for Payer: Cash Price |
$87.36
|
| Rate for Payer: Cofinity Commercial |
$76.44
|
| Rate for Payer: Cofinity Commercial |
$93.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.36
|
| Rate for Payer: Healthscope Commercial |
$98.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$92.82
|
| Rate for Payer: PHP Commercial |
$92.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.44
|
| Rate for Payer: Priority Health SBD |
$68.80
|
| Rate for Payer: UMR Bronson Commercial |
$48.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.90
|
|
|
ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL COMMON CANISTER INHALER
|
Facility
OP
|
$109.20
|
|
|
Service Code
|
NDC 9900-0011-69
|
| Hospital Charge Code |
300450
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$40.40 |
| Max. Negotiated Rate |
$98.28 |
| Rate for Payer: Aetna American Axle |
$70.98
|
| Rate for Payer: Aetna Commercial |
$92.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.98
|
| Rate for Payer: BCBS Complete |
$43.68
|
| Rate for Payer: Cash Price |
$87.36
|
| Rate for Payer: Cofinity Commercial |
$76.44
|
| Rate for Payer: Cofinity Commercial |
$93.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.36
|
| Rate for Payer: Healthscope Commercial |
$98.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$92.82
|
| Rate for Payer: PHP Commercial |
$92.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.44
|
| Rate for Payer: Priority Health SBD |
$68.80
|
| Rate for Payer: UMR Bronson Commercial |
$40.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.90
|
|
|
ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA
|
Facility
IP
|
$9,873.18
|
|
|
Service Code
|
MS-DRG 894
|
| Min. Negotiated Rate |
$4,692.50 |
| Max. Negotiated Rate |
$9,873.18 |
| Rate for Payer: Aetna Medicare |
$5,137.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,174.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,174.34
|
| Rate for Payer: BCBS MAPPO |
$4,939.47
|
| Rate for Payer: BCBS Trust/PPO |
$9,873.18
|
| Rate for Payer: BCN Medicare Advantage |
$4,939.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,939.47
|
| Rate for Payer: Mclaren Medicare |
$4,939.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,186.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,680.39
|
| Rate for Payer: PACE Medicare |
$4,692.50
|
| Rate for Payer: PACE SWMI |
$4,939.47
|
| Rate for Payer: PHP Medicare Advantage |
$4,939.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,244.03
|
| Rate for Payer: Priority Health Medicare |
$4,939.47
|
| Rate for Payer: Priority Health Narrow Network |
$6,595.22
|
| Rate for Payer: Railroad Medicare Medicare |
$4,939.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,763.42
|
| Rate for Payer: UHC Core |
$7,185.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,939.47
|
| Rate for Payer: UHC Exchange |
$5,712.83
|
| Rate for Payer: UHC Medicare Advantage |
$5,087.65
|
| Rate for Payer: VA VA |
$4,939.47
|
|
|
ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC
|
Facility
IP
|
$27,123.14
|
|
|
Service Code
|
MS-DRG 896
|
| Min. Negotiated Rate |
$13,503.73 |
| Max. Negotiated Rate |
$27,123.14 |
| Rate for Payer: Aetna Medicare |
$14,783.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,768.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,768.06
|
| Rate for Payer: BCBS MAPPO |
$14,214.45
|
| Rate for Payer: BCBS Trust/PPO |
$25,892.92
|
| Rate for Payer: BCN Medicare Advantage |
$14,214.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,214.45
|
| Rate for Payer: Mclaren Medicare |
$14,214.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,925.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,346.62
|
| Rate for Payer: PACE Medicare |
$13,503.73
|
| Rate for Payer: PACE SWMI |
$14,214.45
|
| Rate for Payer: PHP Medicare Advantage |
$14,214.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,515.59
|
| Rate for Payer: Priority Health Medicare |
$14,214.45
|
| Rate for Payer: Priority Health Narrow Network |
$20,412.47
|
| Rate for Payer: Railroad Medicare Medicare |
$14,214.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27,123.14
|
| Rate for Payer: UHC Core |
$22,240.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,214.45
|
| Rate for Payer: UHC Exchange |
$17,681.43
|
| Rate for Payer: UHC Medicare Advantage |
$14,640.88
|
| Rate for Payer: VA VA |
$14,214.45
|
|
|
ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC
|
Facility
IP
|
$13,051.32
|
|
|
Service Code
|
MS-DRG 897
|
| Min. Negotiated Rate |
$6,750.34 |
| Max. Negotiated Rate |
$13,051.32 |
| Rate for Payer: Aetna Medicare |
$7,389.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,882.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,882.02
|
| Rate for Payer: BCBS MAPPO |
$7,105.62
|
| Rate for Payer: BCBS Trust/PPO |
$12,325.77
|
| Rate for Payer: BCN Medicare Advantage |
$7,105.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,105.62
|
| Rate for Payer: Mclaren Medicare |
$7,105.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,460.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,171.46
|
| Rate for Payer: PACE Medicare |
$6,750.34
|
| Rate for Payer: PACE SWMI |
$7,105.62
|
| Rate for Payer: PHP Medicare Advantage |
$7,105.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,277.79
|
| Rate for Payer: Priority Health Medicare |
$7,105.62
|
| Rate for Payer: Priority Health Narrow Network |
$9,822.23
|
| Rate for Payer: Railroad Medicare Medicare |
$7,105.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,051.32
|
| Rate for Payer: UHC Core |
$10,701.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,105.62
|
| Rate for Payer: UHC Exchange |
$8,508.09
|
| Rate for Payer: UHC Medicare Advantage |
$7,318.79
|
| Rate for Payer: VA VA |
$7,105.62
|
|
|
ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY
|
Facility
IP
|
$24,540.64
|
|
|
Service Code
|
MS-DRG 895
|
| Min. Negotiated Rate |
$12,264.33 |
| Max. Negotiated Rate |
$24,540.64 |
| Rate for Payer: Aetna Medicare |
$13,426.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,137.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,137.28
|
| Rate for Payer: BCBS MAPPO |
$12,909.82
|
| Rate for Payer: BCBS Trust/PPO |
$23,462.95
|
| Rate for Payer: BCN Medicare Advantage |
$12,909.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,909.82
|
| Rate for Payer: Mclaren Medicare |
$12,909.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13,555.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,846.29
|
| Rate for Payer: PACE Medicare |
$12,264.33
|
| Rate for Payer: PACE SWMI |
$12,909.82
|
| Rate for Payer: PHP Medicare Advantage |
$12,909.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,086.15
|
| Rate for Payer: Priority Health Medicare |
$12,909.82
|
| Rate for Payer: Priority Health Narrow Network |
$18,468.92
|
| Rate for Payer: Railroad Medicare Medicare |
$12,909.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,540.64
|
| Rate for Payer: UHC Core |
$20,122.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,909.82
|
| Rate for Payer: UHC Exchange |
$15,997.91
|
| Rate for Payer: UHC Medicare Advantage |
$13,297.11
|
| Rate for Payer: VA VA |
$12,909.82
|
|
|
ALDESLEUKIN 22 MILLION UNIT INTRAVENOUS SOLUTION
|
Facility
IP
|
$24,302.94
|
|
|
Service Code
|
HCPCS J9015
|
| Hospital Charge Code |
8993
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10,693.29 |
| Max. Negotiated Rate |
$21,872.65 |
| Rate for Payer: Aetna American Axle |
$15,796.91
|
| Rate for Payer: Aetna Commercial |
$20,657.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,796.91
|
| Rate for Payer: Cash Price |
$19,442.35
|
| Rate for Payer: Cofinity Commercial |
$17,012.06
|
| Rate for Payer: Cofinity Commercial |
$20,900.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,442.35
|
| Rate for Payer: Healthscope Commercial |
$21,872.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,012.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,227.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20,657.50
|
| Rate for Payer: PHP Commercial |
$20,657.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,012.06
|
| Rate for Payer: Priority Health SBD |
$15,310.85
|
| Rate for Payer: UMR Bronson Commercial |
$10,693.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,227.20
|
|
|
ALDESLEUKIN 22 MILLION UNIT INTRAVENOUS SOLUTION
|
Facility
OP
|
$24,302.94
|
|
|
Service Code
|
HCPCS J9015
|
| Hospital Charge Code |
8993
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2,156.82 |
| Max. Negotiated Rate |
$21,872.65 |
| Rate for Payer: Aetna American Axle |
$15,796.91
|
| Rate for Payer: Aetna Commercial |
$20,657.50
|
| Rate for Payer: Aetna Medicare |
$4,100.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,796.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,928.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,928.75
|
| Rate for Payer: BCBS Complete |
$2,264.86
|
| Rate for Payer: BCBS MAPPO |
$3,943.00
|
| Rate for Payer: BCBS Trust/PPO |
$17,389.23
|
| Rate for Payer: BCN Medicare Advantage |
$3,943.00
|
| Rate for Payer: Cash Price |
$19,442.35
|
| Rate for Payer: Cash Price |
$19,442.35
|
| Rate for Payer: Cofinity Commercial |
$17,012.06
|
| Rate for Payer: Cofinity Commercial |
$20,900.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,442.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,943.00
|
| Rate for Payer: Healthscope Commercial |
$21,872.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,012.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,227.20
|
| Rate for Payer: Mclaren Medicaid |
$2,156.82
|
| Rate for Payer: Mclaren Medicare |
$3,943.00
|
| Rate for Payer: Meridian Medicaid |
$2,264.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,140.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,534.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20,657.50
|
| Rate for Payer: PACE Medicare |
$3,745.85
|
| Rate for Payer: PACE SWMI |
$3,943.00
|
| Rate for Payer: PHP Commercial |
$20,657.50
|
| Rate for Payer: PHP Medicare Advantage |
$3,943.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,156.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,012.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,655.74
|
| Rate for Payer: Priority Health Medicare |
$3,943.00
|
| Rate for Payer: Priority Health Narrow Network |
$8,524.59
|
| Rate for Payer: Priority Health SBD |
$15,310.85
|
| Rate for Payer: Railroad Medicare Medicare |
$3,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,943.00
|
| Rate for Payer: UHC Medicare Advantage |
$4,061.29
|
| Rate for Payer: UMR Bronson Commercial |
$8,992.09
|
| Rate for Payer: VA VA |
$3,943.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,227.20
|
|
|
ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION
|
Facility
IP
|
$109,073.33
|
|
|
Service Code
|
HCPCS J0202
|
| Hospital Charge Code |
173140
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$47,992.27 |
| Max. Negotiated Rate |
$98,166.00 |
| Rate for Payer: Aetna American Axle |
$70,897.66
|
| Rate for Payer: Aetna Commercial |
$92,712.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70,897.66
|
| Rate for Payer: Cash Price |
$87,258.66
|
| Rate for Payer: Cofinity Commercial |
$76,351.33
|
| Rate for Payer: Cofinity Commercial |
$93,803.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87,258.66
|
| Rate for Payer: Healthscope Commercial |
$98,166.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76,351.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81,805.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$92,712.33
|
| Rate for Payer: PHP Commercial |
$92,712.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76,351.33
|
| Rate for Payer: Priority Health SBD |
$68,716.20
|
| Rate for Payer: UMR Bronson Commercial |
$47,992.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81,805.00
|
|
|
ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION
|
Facility
OP
|
$109,073.33
|
|
|
Service Code
|
HCPCS J0202
|
| Hospital Charge Code |
173140
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,271.42 |
| Max. Negotiated Rate |
$98,166.00 |
| Rate for Payer: Aetna American Axle |
$70,897.66
|
| Rate for Payer: Aetna Commercial |
$92,712.33
|
| Rate for Payer: Aetna Medicare |
$2,417.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70,897.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,905.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,905.43
|
| Rate for Payer: BCBS Complete |
$1,335.10
|
| Rate for Payer: BCBS MAPPO |
$2,324.34
|
| Rate for Payer: BCBS Trust/PPO |
$7,511.19
|
| Rate for Payer: BCN Medicare Advantage |
$2,324.34
|
| Rate for Payer: Cash Price |
$87,258.66
|
| Rate for Payer: Cash Price |
$87,258.66
|
| Rate for Payer: Cofinity Commercial |
$76,351.33
|
| Rate for Payer: Cofinity Commercial |
$93,803.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87,258.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,324.34
|
| Rate for Payer: Healthscope Commercial |
$98,166.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76,351.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81,805.00
|
| Rate for Payer: Mclaren Medicaid |
$1,271.42
|
| Rate for Payer: Mclaren Medicare |
$2,324.34
|
| Rate for Payer: Meridian Medicaid |
$1,335.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,440.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,673.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$92,712.33
|
| Rate for Payer: PACE Medicare |
$2,208.13
|
| Rate for Payer: PACE SWMI |
$2,324.34
|
| Rate for Payer: PHP Commercial |
$92,712.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,324.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,271.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76,351.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,733.59
|
| Rate for Payer: Priority Health Medicare |
$2,324.34
|
| Rate for Payer: Priority Health Narrow Network |
$5,386.87
|
| Rate for Payer: Priority Health SBD |
$68,716.20
|
| Rate for Payer: Railroad Medicare Medicare |
$2,324.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,324.34
|
| Rate for Payer: UHC Medicare Advantage |
$2,394.07
|
| Rate for Payer: UMR Bronson Commercial |
$40,357.13
|
| Rate for Payer: VA VA |
$2,324.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81,805.00
|
|
