|
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET
|
Facility
|
IP
|
$29.05
|
|
|
Service Code
|
NDC 59762-3304-3
|
| Hospital Charge Code |
5604
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$12.78 |
| Max. Negotiated Rate |
$26.14 |
| Rate for Payer: Aetna American Axle |
$18.88
|
| Rate for Payer: Aetna Commercial |
$24.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.88
|
| Rate for Payer: Cash Price |
$23.24
|
| Rate for Payer: Cofinity Commercial |
$20.34
|
| Rate for Payer: Cofinity Commercial |
$24.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.24
|
| Rate for Payer: Healthscope Commercial |
$26.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.69
|
| Rate for Payer: PHP Commercial |
$24.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.34
|
| Rate for Payer: Priority Health SBD |
$18.30
|
| Rate for Payer: UMR Bronson Commercial |
$12.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.79
|
|
|
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET
|
Facility
|
IP
|
$74.37
|
|
|
Service Code
|
NDC 43598-436-35
|
| Hospital Charge Code |
5604
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$32.72 |
| Max. Negotiated Rate |
$66.93 |
| Rate for Payer: Aetna American Axle |
$48.34
|
| Rate for Payer: Aetna Commercial |
$63.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.34
|
| Rate for Payer: Cash Price |
$59.50
|
| Rate for Payer: Cofinity Commercial |
$52.06
|
| Rate for Payer: Cofinity Commercial |
$63.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.50
|
| Rate for Payer: Healthscope Commercial |
$66.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.21
|
| Rate for Payer: PHP Commercial |
$63.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.06
|
| Rate for Payer: Priority Health SBD |
$46.85
|
| Rate for Payer: UMR Bronson Commercial |
$32.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.78
|
|
|
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET
|
Facility
|
IP
|
$74.37
|
|
|
Service Code
|
NDC 43598-436-11
|
| Hospital Charge Code |
5604
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$32.72 |
| Max. Negotiated Rate |
$66.93 |
| Rate for Payer: Aetna American Axle |
$48.34
|
| Rate for Payer: Aetna Commercial |
$63.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.34
|
| Rate for Payer: Cash Price |
$59.50
|
| Rate for Payer: Cofinity Commercial |
$52.06
|
| Rate for Payer: Cofinity Commercial |
$63.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.50
|
| Rate for Payer: Healthscope Commercial |
$66.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.21
|
| Rate for Payer: PHP Commercial |
$63.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.06
|
| Rate for Payer: Priority Health SBD |
$46.85
|
| Rate for Payer: UMR Bronson Commercial |
$32.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.78
|
|
|
NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET
|
Facility
|
IP
|
$132.46
|
|
|
Service Code
|
NDC 0071-0418-13
|
| Hospital Charge Code |
5604
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$58.28 |
| Max. Negotiated Rate |
$119.21 |
| Rate for Payer: Aetna American Axle |
$86.10
|
| Rate for Payer: Aetna Commercial |
$112.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.10
|
| Rate for Payer: Cash Price |
$105.97
|
| Rate for Payer: Cofinity Commercial |
$113.92
|
| Rate for Payer: Cofinity Commercial |
$92.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.97
|
| Rate for Payer: Healthscope Commercial |
$119.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.59
|
| Rate for Payer: PHP Commercial |
$112.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.72
|
| Rate for Payer: Priority Health SBD |
$83.45
|
| Rate for Payer: UMR Bronson Commercial |
$58.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.34
|
|
|
NITROGLYCERIN 0.6 MG/HR TRANSDERMAL 24 HOUR PATCH
|
Facility
|
IP
|
$3.65
|
|
|
Service Code
|
NDC 0378-9116-16
|
| Hospital Charge Code |
27475
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.61 |
| Max. Negotiated Rate |
$3.28 |
| Rate for Payer: Aetna American Axle |
$2.37
|
| Rate for Payer: Aetna Commercial |
$3.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.37
|
| Rate for Payer: Cash Price |
$2.92
|
| Rate for Payer: Cofinity Commercial |
$2.56
|
| Rate for Payer: Cofinity Commercial |
$3.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.92
|
| Rate for Payer: Healthscope Commercial |
$3.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.10
|
| Rate for Payer: PHP Commercial |
$3.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.56
|
| Rate for Payer: Priority Health SBD |
$2.30
|
| Rate for Payer: UMR Bronson Commercial |
$1.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.74
|
|
|
NITROGLYCERIN 0.6 MG/HR TRANSDERMAL 24 HOUR PATCH
|
Facility
|
IP
|
$109.44
|
|
|
Service Code
|
NDC 0378-9116-93
|
| Hospital Charge Code |
27475
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.15 |
| Max. Negotiated Rate |
$98.50 |
| Rate for Payer: Aetna American Axle |
$71.14
|
| Rate for Payer: Aetna Commercial |
$93.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.14
|
| Rate for Payer: Cash Price |
$87.55
|
| Rate for Payer: Cofinity Commercial |
$76.61
|
| Rate for Payer: Cofinity Commercial |
$94.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.55
|
| Rate for Payer: Healthscope Commercial |
$98.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.02
|
| Rate for Payer: PHP Commercial |
$93.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.61
|
| Rate for Payer: Priority Health SBD |
$68.95
|
| Rate for Payer: UMR Bronson Commercial |
$48.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.08
|
|
|
NITROGLYCERIN 100 MCG/ML IN HEPARINIZED SALINE 14 ML
|
Facility
|
IP
|
$11.55
|
|
|
Service Code
|
NDC 9900-0000-82
|
| Hospital Charge Code |
151054
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$10.40 |
| Rate for Payer: Aetna American Axle |
$7.51
|
| Rate for Payer: Aetna Commercial |
$9.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.51
|
| Rate for Payer: Cash Price |
$9.24
|
| Rate for Payer: Cofinity Commercial |
$8.08
|
| Rate for Payer: Cofinity Commercial |
$9.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.24
|
| Rate for Payer: Healthscope Commercial |
$10.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.82
|
| Rate for Payer: PHP Commercial |
$9.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.08
|
| Rate for Payer: Priority Health SBD |
$7.28
|
| Rate for Payer: UMR Bronson Commercial |
$5.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.66
|
|
|
NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS
|
Facility
|
IP
|
$96.39
|
|
|
Service Code
|
HCPCS J2305
|
| Hospital Charge Code |
14895
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$42.41 |
| Max. Negotiated Rate |
$86.75 |
| Rate for Payer: Aetna American Axle |
$62.65
|
| Rate for Payer: Aetna Commercial |
$81.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.65
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Cofinity Commercial |
$82.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.11
|
| Rate for Payer: Healthscope Commercial |
$86.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.93
|
| Rate for Payer: PHP Commercial |
$81.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.47
|
| Rate for Payer: Priority Health SBD |
$60.73
|
| Rate for Payer: UMR Bronson Commercial |
$42.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.29
|
|
|
NITROGLYCERIN (200 MCG/ML) IN D5W PEDIATRIC INFUSION
|
Facility
|
IP
|
$45.61
|
|
|
Service Code
|
NDC 9900-0006-49
|
| Hospital Charge Code |
180234
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$20.07 |
| Max. Negotiated Rate |
$41.05 |
| Rate for Payer: Aetna American Axle |
$29.65
|
| Rate for Payer: Aetna Commercial |
$38.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.65
|
| Rate for Payer: Cash Price |
$36.49
|
| Rate for Payer: Cofinity Commercial |
$31.93
|
| Rate for Payer: Cofinity Commercial |
$39.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.49
|
| Rate for Payer: Healthscope Commercial |
$41.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.77
|
| Rate for Payer: PHP Commercial |
$38.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.93
|
| Rate for Payer: Priority Health SBD |
$28.73
|
| Rate for Payer: UMR Bronson Commercial |
$20.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.21
|
|
|
NITROGLYCERIN (200 MCG/ML) IN D5W PEDIATRIC INFUSION
|
Facility
|
IP
|
$24.19
|
|
|
Service Code
|
NDC 9900-0007-38
|
| Hospital Charge Code |
180234
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.64 |
| Max. Negotiated Rate |
$21.77 |
| Rate for Payer: Aetna American Axle |
$15.72
|
| Rate for Payer: Aetna Commercial |
$20.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.72
|
| Rate for Payer: Cash Price |
$19.35
|
| Rate for Payer: Cofinity Commercial |
$16.93
|
| Rate for Payer: Cofinity Commercial |
$20.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$21.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.56
|
| Rate for Payer: PHP Commercial |
$20.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.93
|
| Rate for Payer: Priority Health SBD |
$15.24
|
| Rate for Payer: UMR Bronson Commercial |
$10.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.14
|
|
|
NITROGLYCERIN 200 MCG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$16.50
|
|
|
Service Code
|
NDC 9900-0006-49
|
| Hospital Charge Code |
500543
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.26 |
| Max. Negotiated Rate |
$14.85 |
| Rate for Payer: Aetna American Axle |
$10.72
|
| Rate for Payer: Aetna Commercial |
$14.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.72
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Cofinity Commercial |
$11.55
|
| Rate for Payer: Cofinity Commercial |
$14.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.20
|
| Rate for Payer: Healthscope Commercial |
$14.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.02
|
| Rate for Payer: PHP Commercial |
$14.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.55
|
| Rate for Payer: Priority Health SBD |
$10.40
|
| Rate for Payer: UMR Bronson Commercial |
$7.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.38
|
|
|
NITROGLYCERIN 200 MCG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$110.64
|
|
|
Service Code
|
NDC 0990--0000-31
|
| Hospital Charge Code |
500543
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$48.68 |
| Max. Negotiated Rate |
$99.58 |
| Rate for Payer: Aetna American Axle |
$71.92
|
| Rate for Payer: Aetna Commercial |
$94.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.92
|
| Rate for Payer: Cash Price |
$88.51
|
| Rate for Payer: Cofinity Commercial |
$77.45
|
| Rate for Payer: Cofinity Commercial |
$95.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.51
|
| Rate for Payer: Healthscope Commercial |
$99.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.04
|
| Rate for Payer: PHP Commercial |
$94.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.45
|
| Rate for Payer: Priority Health SBD |
$69.70
|
| Rate for Payer: UMR Bronson Commercial |
$48.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.98
|
|
|
NITROGLYCERIN 2 % TRANSDERMAL OINTMENT
|
Facility
|
IP
|
$11.19
|
|
|
Service Code
|
NDC 0281-0326-08
|
| Hospital Charge Code |
5606
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.92 |
| Max. Negotiated Rate |
$10.07 |
| Rate for Payer: Aetna American Axle |
$7.27
|
| Rate for Payer: Aetna Commercial |
$9.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.27
|
| Rate for Payer: Cash Price |
$8.95
|
| Rate for Payer: Cofinity Commercial |
$7.83
|
| Rate for Payer: Cofinity Commercial |
$9.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.95
|
| Rate for Payer: Healthscope Commercial |
$10.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.51
|
| Rate for Payer: PHP Commercial |
$9.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.83
|
| Rate for Payer: Priority Health SBD |
$7.05
|
| Rate for Payer: UMR Bronson Commercial |
$4.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.39
|
|
|
NITROGLYCERIN 400 MCG/SPRAY TRANSLINGUAL
|
Facility
|
IP
|
$621.98
|
|
|
Service Code
|
NDC 45802-210-01
|
| Hospital Charge Code |
27096
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$273.67 |
| Max. Negotiated Rate |
$559.78 |
| Rate for Payer: Aetna American Axle |
$404.29
|
| Rate for Payer: Aetna Commercial |
$528.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.29
|
| Rate for Payer: Cash Price |
$497.58
|
| Rate for Payer: Cofinity Commercial |
$435.39
|
| Rate for Payer: Cofinity Commercial |
$534.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$497.58
|
| Rate for Payer: Healthscope Commercial |
$559.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$435.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$466.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$528.68
|
| Rate for Payer: PHP Commercial |
$528.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.39
|
| Rate for Payer: Priority Health SBD |
$391.85
|
| Rate for Payer: UMR Bronson Commercial |
$273.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$466.48
|
|
|
NITROGLYCERIN 400 MCG/SPRAY TRANSLINGUAL
|
Facility
|
IP
|
$319.30
|
|
|
Service Code
|
NDC 28595-120-49
|
| Hospital Charge Code |
27096
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$140.49 |
| Max. Negotiated Rate |
$287.37 |
| Rate for Payer: Aetna American Axle |
$207.54
|
| Rate for Payer: Aetna Commercial |
$271.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.54
|
| Rate for Payer: Cash Price |
$255.44
|
| Rate for Payer: Cofinity Commercial |
$223.51
|
| Rate for Payer: Cofinity Commercial |
$274.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.44
|
| Rate for Payer: Healthscope Commercial |
$287.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$223.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$239.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$271.40
|
| Rate for Payer: PHP Commercial |
$271.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.51
|
| Rate for Payer: Priority Health SBD |
$201.16
|
| Rate for Payer: UMR Bronson Commercial |
$140.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$239.48
|
|
|
NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$48.51
|
|
|
Service Code
|
HCPCS J2305
|
| Hospital Charge Code |
5599
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.34 |
| Max. Negotiated Rate |
$43.66 |
| Rate for Payer: Aetna American Axle |
$31.53
|
| Rate for Payer: Aetna Commercial |
$41.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.53
|
| Rate for Payer: Cash Price |
$38.81
|
| Rate for Payer: Cofinity Commercial |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$41.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.81
|
| Rate for Payer: Healthscope Commercial |
$43.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.23
|
| Rate for Payer: PHP Commercial |
$41.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health SBD |
$30.56
|
| Rate for Payer: UMR Bronson Commercial |
$21.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.38
|
|
|
NITROGLYCERIN 50 MG/250 ML (200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS
|
Facility
|
IP
|
$87.21
|
|
|
Service Code
|
HCPCS J2305
|
| Hospital Charge Code |
15859
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$38.37 |
| Max. Negotiated Rate |
$78.49 |
| Rate for Payer: Aetna American Axle |
$56.69
|
| Rate for Payer: Aetna Commercial |
$74.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.69
|
| Rate for Payer: Cash Price |
$69.77
|
| Rate for Payer: Cofinity Commercial |
$61.05
|
| Rate for Payer: Cofinity Commercial |
$75.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.77
|
| Rate for Payer: Healthscope Commercial |
$78.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.13
|
| Rate for Payer: PHP Commercial |
$74.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.05
|
| Rate for Payer: Priority Health SBD |
$54.94
|
| Rate for Payer: UMR Bronson Commercial |
$38.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.41
|
|
|
NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14,003.06
|
|
|
Service Code
|
HCPCS J9299
|
| Hospital Charge Code |
173434
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6,161.35 |
| Max. Negotiated Rate |
$12,602.75 |
| Rate for Payer: Aetna American Axle |
$9,101.99
|
| Rate for Payer: Aetna Commercial |
$11,902.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,101.99
|
| Rate for Payer: Cash Price |
$11,202.45
|
| Rate for Payer: Cofinity Commercial |
$12,042.63
|
| Rate for Payer: Cofinity Commercial |
$9,802.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,202.45
|
| Rate for Payer: Healthscope Commercial |
$12,602.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,802.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,502.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,902.60
|
| Rate for Payer: PHP Commercial |
$11,902.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,802.14
|
| Rate for Payer: Priority Health SBD |
$8,821.93
|
| Rate for Payer: UMR Bronson Commercial |
$6,161.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,502.30
|
|
|
NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14,003.06
|
|
|
Service Code
|
HCPCS J9299
|
| Hospital Charge Code |
173434
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.01 |
| Max. Negotiated Rate |
$12,602.75 |
| Rate for Payer: Aetna American Axle |
$9,101.99
|
| Rate for Payer: Aetna Commercial |
$11,902.60
|
| Rate for Payer: Aetna Medicare |
$32.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,101.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.86
|
| Rate for Payer: BCBS Complete |
$17.86
|
| Rate for Payer: BCBS MAPPO |
$31.09
|
| Rate for Payer: BCBS Trust/PPO |
$100.45
|
| Rate for Payer: BCN Medicare Advantage |
$31.09
|
| Rate for Payer: Cash Price |
$11,202.45
|
| Rate for Payer: Cash Price |
$11,202.45
|
| Rate for Payer: Cofinity Commercial |
$9,802.14
|
| Rate for Payer: Cofinity Commercial |
$12,042.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,202.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.09
|
| Rate for Payer: Healthscope Commercial |
$12,602.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,802.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,502.30
|
| Rate for Payer: Mclaren Medicaid |
$17.01
|
| Rate for Payer: Mclaren Medicare |
$31.09
|
| Rate for Payer: Meridian Medicaid |
$17.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,902.60
|
| Rate for Payer: PACE Medicare |
$29.53
|
| Rate for Payer: PACE SWMI |
$31.09
|
| Rate for Payer: PHP Commercial |
$11,902.60
|
| Rate for Payer: PHP Medicare Advantage |
$31.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,802.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.36
|
| Rate for Payer: Priority Health Medicare |
$31.09
|
| Rate for Payer: Priority Health Narrow Network |
$71.49
|
| Rate for Payer: Priority Health SBD |
$8,821.93
|
| Rate for Payer: Railroad Medicare Medicare |
$31.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.09
|
| Rate for Payer: UHC Medicare Advantage |
$32.02
|
| Rate for Payer: UMR Bronson Commercial |
$5,181.13
|
| Rate for Payer: VA VA |
$31.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,502.30
|
|
|
NIVOLUMAB 120 MG/12 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$16,803.67
|
|
|
Service Code
|
HCPCS J9299
|
| Hospital Charge Code |
198262
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.01 |
| Max. Negotiated Rate |
$15,123.30 |
| Rate for Payer: Aetna American Axle |
$10,922.39
|
| Rate for Payer: Aetna Commercial |
$14,283.12
|
| Rate for Payer: Aetna Medicare |
$32.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,922.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.86
|
| Rate for Payer: BCBS Complete |
$17.86
|
| Rate for Payer: BCBS MAPPO |
$31.09
|
| Rate for Payer: BCBS Trust/PPO |
$100.45
|
| Rate for Payer: BCN Medicare Advantage |
$31.09
|
| Rate for Payer: Cash Price |
$13,442.94
|
| Rate for Payer: Cash Price |
$13,442.94
|
| Rate for Payer: Cofinity Commercial |
$11,762.57
|
| Rate for Payer: Cofinity Commercial |
$14,451.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,442.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.09
|
| Rate for Payer: Healthscope Commercial |
$15,123.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,762.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,602.75
|
| Rate for Payer: Mclaren Medicaid |
$17.01
|
| Rate for Payer: Mclaren Medicare |
$31.09
|
| Rate for Payer: Meridian Medicaid |
$17.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,283.12
|
| Rate for Payer: PACE Medicare |
$29.53
|
| Rate for Payer: PACE SWMI |
$31.09
|
| Rate for Payer: PHP Commercial |
$14,283.12
|
| Rate for Payer: PHP Medicare Advantage |
$31.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,762.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.36
|
| Rate for Payer: Priority Health Medicare |
$31.09
|
| Rate for Payer: Priority Health Narrow Network |
$71.49
|
| Rate for Payer: Priority Health SBD |
$10,586.31
|
| Rate for Payer: Railroad Medicare Medicare |
$31.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.09
|
| Rate for Payer: UHC Medicare Advantage |
$32.02
|
| Rate for Payer: UMR Bronson Commercial |
$6,217.36
|
| Rate for Payer: VA VA |
$31.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,602.75
|
|
|
NIVOLUMAB 240 MG/24 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$23,951.85
|
|
|
Service Code
|
HCPCS J9299
|
| Hospital Charge Code |
185666
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.01 |
| Max. Negotiated Rate |
$21,556.66 |
| Rate for Payer: Aetna American Axle |
$15,568.70
|
| Rate for Payer: Aetna Commercial |
$20,359.07
|
| Rate for Payer: Aetna Medicare |
$32.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15,568.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.86
|
| Rate for Payer: BCBS Complete |
$17.86
|
| Rate for Payer: BCBS MAPPO |
$31.09
|
| Rate for Payer: BCBS Trust/PPO |
$100.45
|
| Rate for Payer: BCN Medicare Advantage |
$31.09
|
| Rate for Payer: Cash Price |
$19,161.48
|
| Rate for Payer: Cash Price |
$19,161.48
|
| Rate for Payer: Cofinity Commercial |
$16,766.30
|
| Rate for Payer: Cofinity Commercial |
$20,598.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,161.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.09
|
| Rate for Payer: Healthscope Commercial |
$21,556.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16,766.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17,963.89
|
| Rate for Payer: Mclaren Medicaid |
$17.01
|
| Rate for Payer: Mclaren Medicare |
$31.09
|
| Rate for Payer: Meridian Medicaid |
$17.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20,359.07
|
| Rate for Payer: PACE Medicare |
$29.53
|
| Rate for Payer: PACE SWMI |
$31.09
|
| Rate for Payer: PHP Commercial |
$20,359.07
|
| Rate for Payer: PHP Medicare Advantage |
$31.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16,766.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.36
|
| Rate for Payer: Priority Health Medicare |
$31.09
|
| Rate for Payer: Priority Health Narrow Network |
$71.49
|
| Rate for Payer: Priority Health SBD |
$15,089.67
|
| Rate for Payer: Railroad Medicare Medicare |
$31.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.09
|
| Rate for Payer: UHC Medicare Advantage |
$32.02
|
| Rate for Payer: UMR Bronson Commercial |
$8,862.18
|
| Rate for Payer: VA VA |
$31.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17,963.89
|
|
|
NIVOLUMAB 240 MG-RELATLIMAB-RMBW 80 MG/20 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$65,250.84
|
|
|
Service Code
|
HCPCS J9298
|
| Hospital Charge Code |
199621
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$102.37 |
| Max. Negotiated Rate |
$58,725.76 |
| Rate for Payer: Aetna American Axle |
$42,413.05
|
| Rate for Payer: Aetna Commercial |
$55,463.21
|
| Rate for Payer: Aetna Medicare |
$194.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42,413.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$233.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$233.94
|
| Rate for Payer: BCBS Complete |
$107.50
|
| Rate for Payer: BCBS MAPPO |
$187.15
|
| Rate for Payer: BCBS Trust/PPO |
$604.78
|
| Rate for Payer: BCN Medicare Advantage |
$187.15
|
| Rate for Payer: Cash Price |
$52,200.67
|
| Rate for Payer: Cash Price |
$52,200.67
|
| Rate for Payer: Cofinity Commercial |
$56,115.72
|
| Rate for Payer: Cofinity Commercial |
$45,675.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52,200.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.15
|
| Rate for Payer: Healthscope Commercial |
$58,725.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45,675.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48,938.13
|
| Rate for Payer: Mclaren Medicaid |
$102.37
|
| Rate for Payer: Mclaren Medicare |
$187.15
|
| Rate for Payer: Meridian Medicaid |
$107.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$196.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$215.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55,463.21
|
| Rate for Payer: PACE Medicare |
$177.80
|
| Rate for Payer: PACE SWMI |
$187.15
|
| Rate for Payer: PHP Commercial |
$55,463.21
|
| Rate for Payer: PHP Medicare Advantage |
$187.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45,675.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$539.26
|
| Rate for Payer: Priority Health Medicare |
$187.15
|
| Rate for Payer: Priority Health Narrow Network |
$431.41
|
| Rate for Payer: Priority Health SBD |
$41,108.03
|
| Rate for Payer: Railroad Medicare Medicare |
$187.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$187.15
|
| Rate for Payer: UHC Medicare Advantage |
$192.77
|
| Rate for Payer: UMR Bronson Commercial |
$24,142.81
|
| Rate for Payer: VA VA |
$187.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48,938.13
|
|
|
NIVOLUMAB 40 MG/4 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$5,601.24
|
|
|
Service Code
|
HCPCS J9299
|
| Hospital Charge Code |
173433
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.01 |
| Max. Negotiated Rate |
$5,041.12 |
| Rate for Payer: Aetna American Axle |
$3,640.81
|
| Rate for Payer: Aetna Commercial |
$4,761.05
|
| Rate for Payer: Aetna Medicare |
$32.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,640.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.86
|
| Rate for Payer: BCBS Complete |
$17.86
|
| Rate for Payer: BCBS MAPPO |
$31.09
|
| Rate for Payer: BCBS Trust/PPO |
$100.45
|
| Rate for Payer: BCN Medicare Advantage |
$31.09
|
| Rate for Payer: Cash Price |
$4,480.99
|
| Rate for Payer: Cash Price |
$4,480.99
|
| Rate for Payer: Cofinity Commercial |
$3,920.87
|
| Rate for Payer: Cofinity Commercial |
$4,817.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,480.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.09
|
| Rate for Payer: Healthscope Commercial |
$5,041.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,920.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,200.93
|
| Rate for Payer: Mclaren Medicaid |
$17.01
|
| Rate for Payer: Mclaren Medicare |
$31.09
|
| Rate for Payer: Meridian Medicaid |
$17.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,761.05
|
| Rate for Payer: PACE Medicare |
$29.53
|
| Rate for Payer: PACE SWMI |
$31.09
|
| Rate for Payer: PHP Commercial |
$4,761.05
|
| Rate for Payer: PHP Medicare Advantage |
$31.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,920.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.36
|
| Rate for Payer: Priority Health Medicare |
$31.09
|
| Rate for Payer: Priority Health Narrow Network |
$71.49
|
| Rate for Payer: Priority Health SBD |
$3,528.78
|
| Rate for Payer: Railroad Medicare Medicare |
$31.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.09
|
| Rate for Payer: UHC Medicare Advantage |
$32.02
|
| Rate for Payer: UMR Bronson Commercial |
$2,072.46
|
| Rate for Payer: VA VA |
$31.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,200.93
|
|
|
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC
|
Facility
|
IP
|
$33,743.22
|
|
|
Service Code
|
MS-DRG 098
|
| Min. Negotiated Rate |
$16,259.24 |
| Max. Negotiated Rate |
$33,743.22 |
| Rate for Payer: Aetna Medicare |
$17,799.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,393.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,393.74
|
| Rate for Payer: BCBS MAPPO |
$17,114.99
|
| Rate for Payer: BCBS Trust/PPO |
$33,743.22
|
| Rate for Payer: BCN Medicare Advantage |
$17,114.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,114.99
|
| Rate for Payer: Mclaren Medicare |
$17,114.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17,970.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,682.24
|
| Rate for Payer: PACE Medicare |
$16,259.24
|
| Rate for Payer: PACE SWMI |
$17,114.99
|
| Rate for Payer: PHP Medicare Advantage |
$17,114.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30,916.90
|
| Rate for Payer: Priority Health Medicare |
$17,114.99
|
| Rate for Payer: Priority Health Narrow Network |
$24,733.52
|
| Rate for Payer: Railroad Medicare Medicare |
$17,114.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32,864.74
|
| Rate for Payer: UHC Core |
$26,948.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,114.99
|
| Rate for Payer: UHC Exchange |
$21,424.35
|
| Rate for Payer: UHC Medicare Advantage |
$17,628.44
|
| Rate for Payer: VA VA |
$17,114.99
|
|
|
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC
|
Facility
|
IP
|
$55,477.27
|
|
|
Service Code
|
MS-DRG 097
|
| Min. Negotiated Rate |
$27,111.50 |
| Max. Negotiated Rate |
$55,477.27 |
| Rate for Payer: Aetna Medicare |
$29,679.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35,673.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35,673.02
|
| Rate for Payer: BCBS MAPPO |
$28,538.42
|
| Rate for Payer: BCBS Trust/PPO |
$43,824.98
|
| Rate for Payer: BCN Medicare Advantage |
$28,538.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28,538.42
|
| Rate for Payer: Mclaren Medicare |
$28,538.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29,965.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32,819.18
|
| Rate for Payer: PACE Medicare |
$27,111.50
|
| Rate for Payer: PACE SWMI |
$28,538.42
|
| Rate for Payer: PHP Medicare Advantage |
$28,538.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52,189.22
|
| Rate for Payer: Priority Health Medicare |
$28,538.42
|
| Rate for Payer: Priority Health Narrow Network |
$41,751.38
|
| Rate for Payer: Railroad Medicare Medicare |
$28,538.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55,477.27
|
| Rate for Payer: UHC Core |
$45,490.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$28,538.42
|
| Rate for Payer: UHC Exchange |
$36,165.33
|
| Rate for Payer: UHC Medicare Advantage |
$29,394.57
|
| Rate for Payer: VA VA |
$28,538.42
|
|
