|
HEPARIN (PORCINE) (PF) 1,000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
OP
|
$87.40
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15847
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.30 |
| Max. Negotiated Rate |
$78.66 |
| Rate for Payer: Aetna American Axle |
$56.81
|
| Rate for Payer: Aetna American Axle |
$31.10
|
| Rate for Payer: Aetna American Axle |
$36.29
|
| Rate for Payer: Aetna American Axle |
$46.66
|
| Rate for Payer: Aetna Commercial |
$74.29
|
| Rate for Payer: Aetna Commercial |
$61.01
|
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna Commercial |
$47.46
|
| Rate for Payer: Aetna Medicare |
$35.89
|
| Rate for Payer: Aetna Medicare |
$27.91
|
| Rate for Payer: Aetna Medicare |
$43.70
|
| Rate for Payer: Aetna Medicare |
$23.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.66
|
| Rate for Payer: BCBS Complete |
$19.14
|
| Rate for Payer: BCBS Complete |
$22.33
|
| Rate for Payer: BCBS Complete |
$28.71
|
| Rate for Payer: BCBS Complete |
$34.96
|
| Rate for Payer: BCBS Trust/PPO |
$0.57
|
| Rate for Payer: BCBS Trust/PPO |
$0.57
|
| Rate for Payer: BCBS Trust/PPO |
$0.57
|
| Rate for Payer: BCBS Trust/PPO |
$0.57
|
| Rate for Payer: BCN Commercial |
$0.57
|
| Rate for Payer: BCN Commercial |
$0.57
|
| Rate for Payer: BCN Commercial |
$0.57
|
| Rate for Payer: BCN Commercial |
$0.57
|
| Rate for Payer: Cash Price |
$57.42
|
| Rate for Payer: Cash Price |
$69.92
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cash Price |
$69.92
|
| Rate for Payer: Cash Price |
$57.42
|
| Rate for Payer: Cash Price |
$44.66
|
| Rate for Payer: Cash Price |
$44.66
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Advantage |
$61.18
|
| Rate for Payer: Cofinity Advantage |
$50.25
|
| Rate for Payer: Cofinity Advantage |
$39.08
|
| Rate for Payer: Cofinity Advantage |
$33.49
|
| Rate for Payer: Cofinity Commercial |
$48.01
|
| Rate for Payer: Cofinity Commercial |
$61.73
|
| Rate for Payer: Cofinity Commercial |
$75.16
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$64.60
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Healthscope Commercial |
$50.25
|
| Rate for Payer: Healthscope Commercial |
$78.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.55
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: PHP Commercial |
$61.01
|
| Rate for Payer: PHP Commercial |
$74.29
|
| Rate for Payer: PHP Commercial |
$47.46
|
| Rate for Payer: Priority Health SBD |
$45.22
|
| Rate for Payer: Priority Health SBD |
$30.15
|
| Rate for Payer: Priority Health SBD |
$35.17
|
| Rate for Payer: Priority Health SBD |
$55.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UMR Bronson Commercial |
$32.34
|
| Rate for Payer: UMR Bronson Commercial |
$17.70
|
| Rate for Payer: UMR Bronson Commercial |
$20.66
|
| Rate for Payer: UMR Bronson Commercial |
$26.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.55
|
|
|
HEPARIN (PORCINE) (PF) 1,000 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
IP
|
$71.78
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15847
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$31.58 |
| Max. Negotiated Rate |
$64.60 |
| Rate for Payer: Aetna American Axle |
$46.66
|
| Rate for Payer: Aetna American Axle |
$36.29
|
| Rate for Payer: Aetna American Axle |
$56.81
|
| Rate for Payer: Aetna American Axle |
$31.10
|
| Rate for Payer: Aetna Commercial |
$74.29
|
| Rate for Payer: Aetna Commercial |
$61.01
|
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna Commercial |
$47.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.10
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cash Price |
$69.92
|
| Rate for Payer: Cash Price |
$44.66
|
| Rate for Payer: Cash Price |
$57.42
|
| Rate for Payer: Cofinity Advantage |
$39.08
|
| Rate for Payer: Cofinity Advantage |
$33.49
|
| Rate for Payer: Cofinity Advantage |
$50.25
|
| Rate for Payer: Cofinity Advantage |
$61.18
|
| Rate for Payer: Cofinity Commercial |
$61.73
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Cofinity Commercial |
$48.01
|
| Rate for Payer: Cofinity Commercial |
$75.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.66
|
| Rate for Payer: Healthscope Commercial |
$50.25
|
| Rate for Payer: Healthscope Commercial |
$78.66
|
| Rate for Payer: Healthscope Commercial |
$64.60
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.89
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: PHP Commercial |
$61.01
|
| Rate for Payer: PHP Commercial |
$47.46
|
| Rate for Payer: PHP Commercial |
$74.29
|
| Rate for Payer: Priority Health SBD |
$55.06
|
| Rate for Payer: Priority Health SBD |
$30.15
|
| Rate for Payer: Priority Health SBD |
$45.22
|
| Rate for Payer: Priority Health SBD |
$35.17
|
| Rate for Payer: UMR Bronson Commercial |
$24.57
|
| Rate for Payer: UMR Bronson Commercial |
$31.58
|
| Rate for Payer: UMR Bronson Commercial |
$21.05
|
| Rate for Payer: UMR Bronson Commercial |
$38.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.55
|
|
|
HEPARIN (PORCINE) (PF) 1,000 UNIT/500 ML IN NS CONTINUOUS INFUSION CUSTOM
|
Facility
|
IP
|
$87.40
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
300069
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$38.46 |
| Max. Negotiated Rate |
$78.66 |
| Rate for Payer: Aetna American Axle |
$56.81
|
| Rate for Payer: Aetna Commercial |
$74.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.81
|
| Rate for Payer: Cash Price |
$69.92
|
| Rate for Payer: Cofinity Advantage |
$61.18
|
| Rate for Payer: Cofinity Commercial |
$75.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.92
|
| Rate for Payer: Healthscope Commercial |
$78.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.55
|
| Rate for Payer: PHP Commercial |
$74.29
|
| Rate for Payer: Priority Health SBD |
$55.06
|
| Rate for Payer: UMR Bronson Commercial |
$38.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.55
|
|
|
HEPARIN (PORCINE) (PF) 1,000 UNIT/500 ML IN NS CONTINUOUS INFUSION CUSTOM
|
Facility
|
OP
|
$87.40
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
300069
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.30 |
| Max. Negotiated Rate |
$78.66 |
| Rate for Payer: Aetna American Axle |
$56.81
|
| Rate for Payer: Aetna Commercial |
$74.29
|
| Rate for Payer: Aetna Medicare |
$43.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.81
|
| Rate for Payer: BCBS Complete |
$34.96
|
| Rate for Payer: BCBS Trust/PPO |
$0.57
|
| Rate for Payer: BCN Commercial |
$0.57
|
| Rate for Payer: Cash Price |
$69.92
|
| Rate for Payer: Cash Price |
$69.92
|
| Rate for Payer: Cofinity Advantage |
$61.18
|
| Rate for Payer: Cofinity Commercial |
$75.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.92
|
| Rate for Payer: Healthscope Commercial |
$78.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.55
|
| Rate for Payer: PHP Commercial |
$74.29
|
| Rate for Payer: Priority Health SBD |
$55.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UMR Bronson Commercial |
$32.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.55
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML (1 ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$19.34
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
116331
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$17.41 |
| Rate for Payer: Aetna American Axle |
$12.57
|
| Rate for Payer: Aetna Commercial |
$16.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.57
|
| Rate for Payer: Cash Price |
$15.47
|
| Rate for Payer: Cofinity Advantage |
$13.54
|
| Rate for Payer: Cofinity Commercial |
$16.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.47
|
| Rate for Payer: Healthscope Commercial |
$17.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.51
|
| Rate for Payer: PHP Commercial |
$16.44
|
| Rate for Payer: Priority Health SBD |
$12.18
|
| Rate for Payer: UMR Bronson Commercial |
$8.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.51
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML (1 ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.34
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
116331
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$17.41 |
| Rate for Payer: Aetna American Axle |
$12.57
|
| Rate for Payer: Aetna Commercial |
$16.44
|
| Rate for Payer: Aetna Medicare |
$9.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.57
|
| Rate for Payer: BCBS Complete |
$7.74
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$15.47
|
| Rate for Payer: Cash Price |
$15.47
|
| Rate for Payer: Cofinity Advantage |
$13.54
|
| Rate for Payer: Cofinity Commercial |
$16.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.47
|
| Rate for Payer: Healthscope Commercial |
$17.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.51
|
| Rate for Payer: PHP Commercial |
$16.44
|
| Rate for Payer: Priority Health SBD |
$12.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UMR Bronson Commercial |
$7.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.51
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$11.00
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
116327
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$9.90 |
| Rate for Payer: Aetna American Axle |
$7.15
|
| Rate for Payer: Aetna American Axle |
$9.07
|
| Rate for Payer: Aetna American Axle |
$8.78
|
| Rate for Payer: Aetna American Axle |
$8.45
|
| Rate for Payer: Aetna American Axle |
$5.45
|
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: Aetna Commercial |
$11.05
|
| Rate for Payer: Aetna Commercial |
$7.12
|
| Rate for Payer: Aetna Commercial |
$11.86
|
| Rate for Payer: Aetna Commercial |
$11.47
|
| Rate for Payer: Aetna Medicare |
$4.19
|
| Rate for Payer: Aetna Medicare |
$6.50
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: Aetna Medicare |
$6.75
|
| Rate for Payer: Aetna Medicare |
$6.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.45
|
| Rate for Payer: BCBS Complete |
$5.58
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS Complete |
$5.40
|
| Rate for Payer: BCBS Complete |
$3.35
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cash Price |
$6.70
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$6.70
|
| Rate for Payer: Cofinity Advantage |
$9.77
|
| Rate for Payer: Cofinity Advantage |
$9.10
|
| Rate for Payer: Cofinity Advantage |
$9.45
|
| Rate for Payer: Cofinity Advantage |
$5.87
|
| Rate for Payer: Cofinity Advantage |
$7.70
|
| Rate for Payer: Cofinity Commercial |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$11.61
|
| Rate for Payer: Cofinity Commercial |
$7.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.80
|
| Rate for Payer: Healthscope Commercial |
$12.15
|
| Rate for Payer: Healthscope Commercial |
$7.54
|
| Rate for Payer: Healthscope Commercial |
$12.55
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: Healthscope Commercial |
$11.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.29
|
| Rate for Payer: PHP Commercial |
$11.05
|
| Rate for Payer: PHP Commercial |
$11.47
|
| Rate for Payer: PHP Commercial |
$7.12
|
| Rate for Payer: PHP Commercial |
$11.86
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: Priority Health SBD |
$8.51
|
| Rate for Payer: Priority Health SBD |
$6.93
|
| Rate for Payer: Priority Health SBD |
$8.79
|
| Rate for Payer: Priority Health SBD |
$5.28
|
| Rate for Payer: Priority Health SBD |
$8.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UMR Bronson Commercial |
$4.07
|
| Rate for Payer: UMR Bronson Commercial |
$5.16
|
| Rate for Payer: UMR Bronson Commercial |
$5.00
|
| Rate for Payer: UMR Bronson Commercial |
$3.10
|
| Rate for Payer: UMR Bronson Commercial |
$4.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.25
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$13.50
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
116327
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.94 |
| Max. Negotiated Rate |
$12.15 |
| Rate for Payer: Aetna American Axle |
$8.78
|
| Rate for Payer: Aetna American Axle |
$8.45
|
| Rate for Payer: Aetna American Axle |
$9.07
|
| Rate for Payer: Aetna American Axle |
$7.15
|
| Rate for Payer: Aetna Commercial |
$11.86
|
| Rate for Payer: Aetna Commercial |
$11.47
|
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: Aetna Commercial |
$11.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.15
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cofinity Advantage |
$9.10
|
| Rate for Payer: Cofinity Advantage |
$7.70
|
| Rate for Payer: Cofinity Advantage |
$9.45
|
| Rate for Payer: Cofinity Advantage |
$9.77
|
| Rate for Payer: Cofinity Commercial |
$11.61
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$12.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$11.70
|
| Rate for Payer: Healthscope Commercial |
$12.55
|
| Rate for Payer: Healthscope Commercial |
$12.15
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: PHP Commercial |
$11.47
|
| Rate for Payer: PHP Commercial |
$11.05
|
| Rate for Payer: PHP Commercial |
$11.86
|
| Rate for Payer: Priority Health SBD |
$8.79
|
| Rate for Payer: Priority Health SBD |
$6.93
|
| Rate for Payer: Priority Health SBD |
$8.51
|
| Rate for Payer: Priority Health SBD |
$8.19
|
| Rate for Payer: UMR Bronson Commercial |
$5.72
|
| Rate for Payer: UMR Bronson Commercial |
$5.94
|
| Rate for Payer: UMR Bronson Commercial |
$4.84
|
| Rate for Payer: UMR Bronson Commercial |
$6.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.46
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE (CUSTOM NO PRIOR AUTH CREATED)
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
300951
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$11.70 |
| Rate for Payer: Aetna American Axle |
$8.45
|
| Rate for Payer: Aetna American Axle |
$7.15
|
| Rate for Payer: Aetna American Axle |
$8.78
|
| Rate for Payer: Aetna Commercial |
$11.05
|
| Rate for Payer: Aetna Commercial |
$11.47
|
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: Aetna Medicare |
$6.50
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: Aetna Medicare |
$6.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.78
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS Complete |
$5.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cofinity Advantage |
$9.45
|
| Rate for Payer: Cofinity Advantage |
$9.10
|
| Rate for Payer: Cofinity Advantage |
$7.70
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$11.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: Healthscope Commercial |
$11.70
|
| Rate for Payer: Healthscope Commercial |
$12.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.12
|
| Rate for Payer: PHP Commercial |
$11.05
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: PHP Commercial |
$11.47
|
| Rate for Payer: Priority Health SBD |
$6.93
|
| Rate for Payer: Priority Health SBD |
$8.51
|
| Rate for Payer: Priority Health SBD |
$8.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UMR Bronson Commercial |
$5.00
|
| Rate for Payer: UMR Bronson Commercial |
$4.07
|
| Rate for Payer: UMR Bronson Commercial |
$4.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.12
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE (CUSTOM NO PRIOR AUTH CREATED)
|
Facility
|
IP
|
$11.00
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
300951
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$9.90 |
| Rate for Payer: Aetna American Axle |
$7.15
|
| Rate for Payer: Aetna American Axle |
$8.78
|
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: Aetna Commercial |
$11.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.78
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cofinity Advantage |
$9.45
|
| Rate for Payer: Cofinity Advantage |
$7.70
|
| Rate for Payer: Cofinity Commercial |
$11.61
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.80
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: Healthscope Commercial |
$12.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.12
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: PHP Commercial |
$11.47
|
| Rate for Payer: Priority Health SBD |
$8.51
|
| Rate for Payer: Priority Health SBD |
$6.93
|
| Rate for Payer: UMR Bronson Commercial |
$4.84
|
| Rate for Payer: UMR Bronson Commercial |
$5.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.12
|
|
|
HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$11.03
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
105460
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$9.93 |
| Rate for Payer: Aetna American Axle |
$7.17
|
| Rate for Payer: Aetna American Axle |
$6.83
|
| Rate for Payer: Aetna American Axle |
$8.34
|
| Rate for Payer: Aetna Commercial |
$9.38
|
| Rate for Payer: Aetna Commercial |
$10.91
|
| Rate for Payer: Aetna Commercial |
$8.93
|
| Rate for Payer: Aetna Medicare |
$5.51
|
| Rate for Payer: Aetna Medicare |
$5.25
|
| Rate for Payer: Aetna Medicare |
$6.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.34
|
| Rate for Payer: BCBS Complete |
$4.20
|
| Rate for Payer: BCBS Complete |
$4.41
|
| Rate for Payer: BCBS Complete |
$5.13
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cash Price |
$10.26
|
| Rate for Payer: Cash Price |
$10.26
|
| Rate for Payer: Cash Price |
$8.82
|
| Rate for Payer: Cash Price |
$8.82
|
| Rate for Payer: Cofinity Advantage |
$8.98
|
| Rate for Payer: Cofinity Advantage |
$7.72
|
| Rate for Payer: Cofinity Advantage |
$7.35
|
| Rate for Payer: Cofinity Commercial |
$9.03
|
| Rate for Payer: Cofinity Commercial |
$9.49
|
| Rate for Payer: Cofinity Commercial |
$11.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.82
|
| Rate for Payer: Healthscope Commercial |
$9.45
|
| Rate for Payer: Healthscope Commercial |
$9.93
|
| Rate for Payer: Healthscope Commercial |
$11.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.62
|
| Rate for Payer: PHP Commercial |
$9.38
|
| Rate for Payer: PHP Commercial |
$8.93
|
| Rate for Payer: PHP Commercial |
$10.91
|
| Rate for Payer: Priority Health SBD |
$6.62
|
| Rate for Payer: Priority Health SBD |
$8.08
|
| Rate for Payer: Priority Health SBD |
$6.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Core |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UHC Exchange |
$0.03
|
| Rate for Payer: UMR Bronson Commercial |
$4.75
|
| Rate for Payer: UMR Bronson Commercial |
$3.88
|
| Rate for Payer: UMR Bronson Commercial |
$4.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.62
|
|
|
HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$10.50
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
105460
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$9.45 |
| Rate for Payer: Aetna American Axle |
$6.83
|
| Rate for Payer: Aetna American Axle |
$8.34
|
| Rate for Payer: Aetna American Axle |
$7.17
|
| Rate for Payer: Aetna Commercial |
$9.38
|
| Rate for Payer: Aetna Commercial |
$8.93
|
| Rate for Payer: Aetna Commercial |
$10.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.17
|
| Rate for Payer: Cash Price |
$8.82
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cash Price |
$10.26
|
| Rate for Payer: Cofinity Advantage |
$8.98
|
| Rate for Payer: Cofinity Advantage |
$7.35
|
| Rate for Payer: Cofinity Advantage |
$7.72
|
| Rate for Payer: Cofinity Commercial |
$11.03
|
| Rate for Payer: Cofinity Commercial |
$9.03
|
| Rate for Payer: Cofinity Commercial |
$9.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.26
|
| Rate for Payer: Healthscope Commercial |
$9.93
|
| Rate for Payer: Healthscope Commercial |
$11.55
|
| Rate for Payer: Healthscope Commercial |
$9.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.62
|
| Rate for Payer: PHP Commercial |
$9.38
|
| Rate for Payer: PHP Commercial |
$8.93
|
| Rate for Payer: PHP Commercial |
$10.91
|
| Rate for Payer: Priority Health SBD |
$6.62
|
| Rate for Payer: Priority Health SBD |
$6.95
|
| Rate for Payer: Priority Health SBD |
$8.08
|
| Rate for Payer: UMR Bronson Commercial |
$4.62
|
| Rate for Payer: UMR Bronson Commercial |
$5.65
|
| Rate for Payer: UMR Bronson Commercial |
$4.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.62
|
|
|
HEPARIN (PORCINE) (PF) 2,000 UNIT/1,000 ML IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
OP
|
$73.44
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
118364
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.30 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna American Axle |
$47.74
|
| Rate for Payer: Aetna American Axle |
$41.47
|
| Rate for Payer: Aetna American Axle |
$62.20
|
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna Commercial |
$81.34
|
| Rate for Payer: Aetna Commercial |
$54.23
|
| Rate for Payer: Aetna Medicare |
$36.72
|
| Rate for Payer: Aetna Medicare |
$31.90
|
| Rate for Payer: Aetna Medicare |
$47.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.20
|
| Rate for Payer: BCBS Complete |
$25.52
|
| Rate for Payer: BCBS Complete |
$29.38
|
| Rate for Payer: BCBS Complete |
$38.28
|
| Rate for Payer: BCBS Trust/PPO |
$0.57
|
| Rate for Payer: BCBS Trust/PPO |
$0.57
|
| Rate for Payer: BCBS Trust/PPO |
$0.57
|
| Rate for Payer: BCN Commercial |
$0.57
|
| Rate for Payer: BCN Commercial |
$0.57
|
| Rate for Payer: BCN Commercial |
$0.57
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$76.56
|
| Rate for Payer: Cash Price |
$76.56
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Advantage |
$66.99
|
| Rate for Payer: Cofinity Advantage |
$51.41
|
| Rate for Payer: Cofinity Advantage |
$44.66
|
| Rate for Payer: Cofinity Commercial |
$54.87
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Cofinity Commercial |
$82.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Healthscope Commercial |
$57.42
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Healthscope Commercial |
$86.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.78
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: PHP Commercial |
$54.23
|
| Rate for Payer: PHP Commercial |
$81.34
|
| Rate for Payer: Priority Health SBD |
$40.19
|
| Rate for Payer: Priority Health SBD |
$60.29
|
| Rate for Payer: Priority Health SBD |
$46.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UMR Bronson Commercial |
$35.41
|
| Rate for Payer: UMR Bronson Commercial |
$23.61
|
| Rate for Payer: UMR Bronson Commercial |
$27.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.78
|
|
|
HEPARIN (PORCINE) (PF) 2,000 UNIT/1,000 ML IN 0.9 % SODIUM CHLORIDE IV
|
Facility
|
IP
|
$63.80
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
118364
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.07 |
| Max. Negotiated Rate |
$57.42 |
| Rate for Payer: Aetna American Axle |
$41.47
|
| Rate for Payer: Aetna American Axle |
$62.20
|
| Rate for Payer: Aetna American Axle |
$47.74
|
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna Commercial |
$54.23
|
| Rate for Payer: Aetna Commercial |
$81.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.74
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$76.56
|
| Rate for Payer: Cofinity Advantage |
$66.99
|
| Rate for Payer: Cofinity Advantage |
$44.66
|
| Rate for Payer: Cofinity Advantage |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$82.30
|
| Rate for Payer: Cofinity Commercial |
$54.87
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.56
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Healthscope Commercial |
$86.13
|
| Rate for Payer: Healthscope Commercial |
$57.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.78
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: PHP Commercial |
$54.23
|
| Rate for Payer: PHP Commercial |
$81.34
|
| Rate for Payer: Priority Health SBD |
$40.19
|
| Rate for Payer: Priority Health SBD |
$46.27
|
| Rate for Payer: Priority Health SBD |
$60.29
|
| Rate for Payer: UMR Bronson Commercial |
$28.07
|
| Rate for Payer: UMR Bronson Commercial |
$42.11
|
| Rate for Payer: UMR Bronson Commercial |
$32.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.78
|
|
|
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS
|
Facility
|
IP
|
$7,404.94
|
|
|
Service Code
|
APR-DRG 2793
|
| Min. Negotiated Rate |
$7,052.32 |
| Max. Negotiated Rate |
$7,404.94 |
| Rate for Payer: BCBS Complete |
$7,404.94
|
| Rate for Payer: Mclaren Medicaid |
$7,052.32
|
| Rate for Payer: Meridian Medicaid |
$7,404.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,052.32
|
| Rate for Payer: UHC Medicaid |
$7,052.32
|
| Rate for Payer: UHCCP Medicaid |
$7,052.32
|
|
|
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS
|
Facility
|
IP
|
$4,812.33
|
|
|
Service Code
|
APR-DRG 2792
|
| Min. Negotiated Rate |
$4,583.18 |
| Max. Negotiated Rate |
$4,812.33 |
| Rate for Payer: BCBS Complete |
$4,812.33
|
| Rate for Payer: Mclaren Medicaid |
$4,583.18
|
| Rate for Payer: Meridian Medicaid |
$4,812.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,583.18
|
| Rate for Payer: UHC Medicaid |
$4,583.18
|
| Rate for Payer: UHCCP Medicaid |
$4,583.18
|
|
|
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS
|
Facility
|
IP
|
$3,311.13
|
|
|
Service Code
|
APR-DRG 2791
|
| Min. Negotiated Rate |
$3,153.45 |
| Max. Negotiated Rate |
$3,311.13 |
| Rate for Payer: BCBS Complete |
$3,311.13
|
| Rate for Payer: Mclaren Medicaid |
$3,153.45
|
| Rate for Payer: Meridian Medicaid |
$3,311.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,153.45
|
| Rate for Payer: UHC Medicaid |
$3,153.45
|
| Rate for Payer: UHCCP Medicaid |
$3,153.45
|
|
|
HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS
|
Facility
|
IP
|
$17,029.00
|
|
|
Service Code
|
APR-DRG 2794
|
| Min. Negotiated Rate |
$16,218.10 |
| Max. Negotiated Rate |
$17,029.00 |
| Rate for Payer: BCBS Complete |
$17,029.00
|
| Rate for Payer: Mclaren Medicaid |
$16,218.10
|
| Rate for Payer: Meridian Medicaid |
$17,029.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,218.10
|
| Rate for Payer: UHC Medicaid |
$16,218.10
|
| Rate for Payer: UHCCP Medicaid |
$16,218.10
|
|
|
HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE
|
Facility
|
OP
|
$102.69
|
|
|
Service Code
|
HCPCS 90633
|
| Hospital Charge Code |
160075
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$38.00 |
| Max. Negotiated Rate |
$124.54 |
| Rate for Payer: Aetna American Axle |
$66.75
|
| Rate for Payer: Aetna Commercial |
$87.29
|
| Rate for Payer: Aetna Medicare |
$51.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.75
|
| Rate for Payer: BCBS Complete |
$41.08
|
| Rate for Payer: BCBS Trust/PPO |
$124.54
|
| Rate for Payer: BCN Commercial |
$124.54
|
| Rate for Payer: Cash Price |
$82.15
|
| Rate for Payer: Cash Price |
$82.15
|
| Rate for Payer: Cofinity Advantage |
$71.88
|
| Rate for Payer: Cofinity Commercial |
$88.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.15
|
| Rate for Payer: Healthscope Commercial |
$92.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.02
|
| Rate for Payer: PHP Commercial |
$87.29
|
| Rate for Payer: Priority Health SBD |
$64.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.97
|
| Rate for Payer: UHC Core |
$70.97
|
| Rate for Payer: UHC Exchange |
$70.97
|
| Rate for Payer: UMR Bronson Commercial |
$38.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.02
|
|
|
HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE
|
Facility
|
IP
|
$102.69
|
|
|
Service Code
|
HCPCS 90633
|
| Hospital Charge Code |
160075
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$45.18 |
| Max. Negotiated Rate |
$92.42 |
| Rate for Payer: Aetna American Axle |
$66.75
|
| Rate for Payer: Aetna Commercial |
$87.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.75
|
| Rate for Payer: Cash Price |
$82.15
|
| Rate for Payer: Cofinity Advantage |
$71.88
|
| Rate for Payer: Cofinity Commercial |
$88.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.15
|
| Rate for Payer: Healthscope Commercial |
$92.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.02
|
| Rate for Payer: PHP Commercial |
$87.29
|
| Rate for Payer: Priority Health SBD |
$64.69
|
| Rate for Payer: UMR Bronson Commercial |
$45.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.02
|
|
|
HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION
|
Facility
|
OP
|
$2,174.88
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
91047
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$73.33 |
| Max. Negotiated Rate |
$1,957.39 |
| Rate for Payer: Aetna American Axle |
$1,413.67
|
| Rate for Payer: Aetna Commercial |
$1,848.65
|
| Rate for Payer: Aetna Medicare |
$145.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,413.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.26
|
| Rate for Payer: BCBS Complete |
$77.00
|
| Rate for Payer: BCBS MAPPO |
$140.21
|
| Rate for Payer: BCBS Trust/PPO |
$503.07
|
| Rate for Payer: BCN Commercial |
$503.07
|
| Rate for Payer: BCN Medicare Advantage |
$140.21
|
| Rate for Payer: Cash Price |
$1,739.90
|
| Rate for Payer: Cash Price |
$1,739.90
|
| Rate for Payer: Cofinity Advantage |
$1,522.42
|
| Rate for Payer: Cofinity Commercial |
$1,870.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,739.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.21
|
| Rate for Payer: Healthscope Commercial |
$1,957.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,522.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,631.16
|
| Rate for Payer: Mclaren Medicaid |
$140.21
|
| Rate for Payer: Mclaren Medicare |
$140.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.22
|
| Rate for Payer: Meridian Medicaid |
$147.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,848.65
|
| Rate for Payer: Nomi Health Commercial |
$420.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,631.16
|
| Rate for Payer: PACE Medicare |
$133.20
|
| Rate for Payer: PACE SWMI |
$140.21
|
| Rate for Payer: PHP Commercial |
$1,848.65
|
| Rate for Payer: PHP Medicare Advantage |
$140.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$423.25
|
| Rate for Payer: Priority Health Medicare |
$140.21
|
| Rate for Payer: Priority Health SBD |
$1,370.17
|
| Rate for Payer: Priority Health Tiered Network |
$338.60
|
| Rate for Payer: Railroad Medicare Medicare |
$140.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.42
|
| Rate for Payer: UHC Core |
$227.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$140.21
|
| Rate for Payer: UHC Exchange |
$227.42
|
| Rate for Payer: UHC Medicaid |
$73.33
|
| Rate for Payer: UHCCP Medicaid |
$73.33
|
| Rate for Payer: UMR Bronson Commercial |
$804.71
|
| Rate for Payer: VA VA |
$140.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,631.16
|
|
|
HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML INTRAMUSCULAR SOLUTION
|
Facility
|
IP
|
$510.53
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
116868
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$224.63 |
| Max. Negotiated Rate |
$459.48 |
| Rate for Payer: Aetna American Axle |
$331.84
|
| Rate for Payer: Aetna Commercial |
$433.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.84
|
| Rate for Payer: Cash Price |
$408.42
|
| Rate for Payer: Cofinity Advantage |
$357.37
|
| Rate for Payer: Cofinity Commercial |
$439.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.42
|
| Rate for Payer: Healthscope Commercial |
$459.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$357.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.90
|
| Rate for Payer: PHP Commercial |
$433.95
|
| Rate for Payer: Priority Health SBD |
$321.63
|
| Rate for Payer: UMR Bronson Commercial |
$224.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.90
|
|
|
HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML INTRAMUSCULAR SOLUTION
|
Facility
|
OP
|
$510.53
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
116868
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$73.33 |
| Max. Negotiated Rate |
$503.07 |
| Rate for Payer: Aetna American Axle |
$331.84
|
| Rate for Payer: Aetna Commercial |
$433.95
|
| Rate for Payer: Aetna Medicare |
$145.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.26
|
| Rate for Payer: BCBS Complete |
$77.00
|
| Rate for Payer: BCBS MAPPO |
$140.21
|
| Rate for Payer: BCBS Trust/PPO |
$503.07
|
| Rate for Payer: BCN Commercial |
$503.07
|
| Rate for Payer: BCN Medicare Advantage |
$140.21
|
| Rate for Payer: Cash Price |
$408.42
|
| Rate for Payer: Cash Price |
$408.42
|
| Rate for Payer: Cofinity Advantage |
$357.37
|
| Rate for Payer: Cofinity Commercial |
$439.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.21
|
| Rate for Payer: Healthscope Commercial |
$459.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$357.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.90
|
| Rate for Payer: Mclaren Medicaid |
$140.21
|
| Rate for Payer: Mclaren Medicare |
$140.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.22
|
| Rate for Payer: Meridian Medicaid |
$147.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.95
|
| Rate for Payer: Nomi Health Commercial |
$420.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.90
|
| Rate for Payer: PACE Medicare |
$133.20
|
| Rate for Payer: PACE SWMI |
$140.21
|
| Rate for Payer: PHP Commercial |
$433.95
|
| Rate for Payer: PHP Medicare Advantage |
$140.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$423.25
|
| Rate for Payer: Priority Health Medicare |
$140.21
|
| Rate for Payer: Priority Health SBD |
$321.63
|
| Rate for Payer: Priority Health Tiered Network |
$338.60
|
| Rate for Payer: Railroad Medicare Medicare |
$140.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.42
|
| Rate for Payer: UHC Core |
$227.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$140.21
|
| Rate for Payer: UHC Exchange |
$227.42
|
| Rate for Payer: UHC Medicaid |
$73.33
|
| Rate for Payer: UHCCP Medicaid |
$73.33
|
| Rate for Payer: UMR Bronson Commercial |
$188.90
|
| Rate for Payer: VA VA |
$140.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.90
|
|
|
HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE
|
Facility
|
IP
|
$117.75
|
|
|
Service Code
|
HCPCS 90744
|
| Hospital Charge Code |
117061
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$51.81 |
| Max. Negotiated Rate |
$105.97 |
| Rate for Payer: Aetna American Axle |
$76.54
|
| Rate for Payer: Aetna Commercial |
$100.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.54
|
| Rate for Payer: Cash Price |
$94.20
|
| Rate for Payer: Cofinity Advantage |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$101.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.20
|
| Rate for Payer: Healthscope Commercial |
$105.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.31
|
| Rate for Payer: PHP Commercial |
$100.09
|
| Rate for Payer: Priority Health SBD |
$74.18
|
| Rate for Payer: UMR Bronson Commercial |
$51.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.31
|
|
|
HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE
|
Facility
|
OP
|
$117.75
|
|
|
Service Code
|
HCPCS 90744
|
| Hospital Charge Code |
117061
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$26.56 |
| Max. Negotiated Rate |
$105.97 |
| Rate for Payer: Aetna American Axle |
$76.54
|
| Rate for Payer: Aetna Commercial |
$100.09
|
| Rate for Payer: Aetna Medicare |
$58.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.54
|
| Rate for Payer: BCBS Complete |
$47.10
|
| Rate for Payer: BCBS Trust/PPO |
$93.09
|
| Rate for Payer: BCN Commercial |
$93.09
|
| Rate for Payer: Cash Price |
$94.20
|
| Rate for Payer: Cash Price |
$94.20
|
| Rate for Payer: Cofinity Advantage |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$101.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.20
|
| Rate for Payer: Healthscope Commercial |
$105.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.31
|
| Rate for Payer: PHP Commercial |
$100.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$33.20
|
| Rate for Payer: Priority Health SBD |
$74.18
|
| Rate for Payer: Priority Health Tiered Network |
$26.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.78
|
| Rate for Payer: UHC Core |
$54.78
|
| Rate for Payer: UHC Exchange |
$54.78
|
| Rate for Payer: UMR Bronson Commercial |
$43.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.31
|
|
