|
BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION
|
Facility
|
OP
|
$21.17
|
|
|
Service Code
|
NDC 00409812601
|
| Hospital Charge Code |
105634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.83 |
| Max. Negotiated Rate |
$19.05 |
| Rate for Payer: Aetna American Axle |
$13.76
|
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: Aetna Medicare |
$10.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.76
|
| Rate for Payer: BCBS Complete |
$8.47
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Advantage |
$14.82
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.88
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: Priority Health SBD |
$13.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.76
|
| Rate for Payer: UHC Core |
$11.03
|
| Rate for Payer: UHC Exchange |
$8.32
|
| Rate for Payer: UMR Bronson Commercial |
$7.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.88
|
|
|
BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION
|
Facility
|
IP
|
$20.03
|
|
|
Service Code
|
NDC 00409174971
|
| Hospital Charge Code |
105634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$18.03 |
| Rate for Payer: Aetna American Axle |
$13.02
|
| Rate for Payer: Aetna Commercial |
$17.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.02
|
| Rate for Payer: Cash Price |
$16.02
|
| Rate for Payer: Cofinity Advantage |
$14.02
|
| Rate for Payer: Cofinity Commercial |
$17.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.02
|
| Rate for Payer: Healthscope Commercial |
$18.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.02
|
| Rate for Payer: PHP Commercial |
$17.03
|
| Rate for Payer: Priority Health SBD |
$12.62
|
| Rate for Payer: UMR Bronson Commercial |
$8.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.02
|
|
|
BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION
|
Facility
|
IP
|
$21.17
|
|
|
Service Code
|
NDC 00409812601
|
| Hospital Charge Code |
105634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.31 |
| Max. Negotiated Rate |
$19.05 |
| Rate for Payer: Aetna American Axle |
$13.76
|
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.76
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Advantage |
$14.82
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.88
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: Priority Health SBD |
$13.34
|
| Rate for Payer: UMR Bronson Commercial |
$9.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.88
|
|
|
BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION
|
Facility
|
OP
|
$22.28
|
|
|
Service Code
|
NDC 00409174970
|
| Hospital Charge Code |
105634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.24 |
| Max. Negotiated Rate |
$20.05 |
| Rate for Payer: Aetna American Axle |
$14.48
|
| Rate for Payer: Aetna Commercial |
$18.94
|
| Rate for Payer: Aetna Medicare |
$11.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.48
|
| Rate for Payer: BCBS Complete |
$8.91
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cofinity Advantage |
$15.60
|
| Rate for Payer: Cofinity Commercial |
$19.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.82
|
| Rate for Payer: Healthscope Commercial |
$20.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.71
|
| Rate for Payer: PHP Commercial |
$18.94
|
| Rate for Payer: Priority Health SBD |
$14.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.48
|
| Rate for Payer: UHC Core |
$11.61
|
| Rate for Payer: UHC Exchange |
$8.76
|
| Rate for Payer: UMR Bronson Commercial |
$8.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.71
|
|
|
BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION
|
Facility
|
OP
|
$22.28
|
|
|
Service Code
|
NDC 00409174910
|
| Hospital Charge Code |
105634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.24 |
| Max. Negotiated Rate |
$20.05 |
| Rate for Payer: Aetna American Axle |
$14.48
|
| Rate for Payer: Aetna Commercial |
$18.94
|
| Rate for Payer: Aetna Medicare |
$11.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.48
|
| Rate for Payer: BCBS Complete |
$8.91
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cofinity Advantage |
$15.60
|
| Rate for Payer: Cofinity Commercial |
$19.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.82
|
| Rate for Payer: Healthscope Commercial |
$20.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.71
|
| Rate for Payer: PHP Commercial |
$18.94
|
| Rate for Payer: Priority Health SBD |
$14.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.48
|
| Rate for Payer: UHC Core |
$11.61
|
| Rate for Payer: UHC Exchange |
$8.76
|
| Rate for Payer: UMR Bronson Commercial |
$8.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.71
|
|
|
BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION
|
Facility
|
OP
|
$20.03
|
|
|
Service Code
|
NDC 00409174971
|
| Hospital Charge Code |
105634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.41 |
| Max. Negotiated Rate |
$18.03 |
| Rate for Payer: Aetna American Axle |
$13.02
|
| Rate for Payer: Aetna Commercial |
$17.03
|
| Rate for Payer: Aetna Medicare |
$10.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.02
|
| Rate for Payer: BCBS Complete |
$8.01
|
| Rate for Payer: Cash Price |
$16.02
|
| Rate for Payer: Cofinity Advantage |
$14.02
|
| Rate for Payer: Cofinity Commercial |
$17.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.02
|
| Rate for Payer: Healthscope Commercial |
$18.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.02
|
| Rate for Payer: PHP Commercial |
$17.03
|
| Rate for Payer: Priority Health SBD |
$12.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.02
|
| Rate for Payer: UHC Core |
$10.44
|
| Rate for Payer: UHC Exchange |
$7.87
|
| Rate for Payer: UMR Bronson Commercial |
$7.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.02
|
|
|
BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION
|
Facility
|
IP
|
$20.03
|
|
|
Service Code
|
NDC 00409174929
|
| Hospital Charge Code |
105634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$18.03 |
| Rate for Payer: Aetna American Axle |
$13.02
|
| Rate for Payer: Aetna Commercial |
$17.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.02
|
| Rate for Payer: Cash Price |
$16.02
|
| Rate for Payer: Cofinity Advantage |
$14.02
|
| Rate for Payer: Cofinity Commercial |
$17.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.02
|
| Rate for Payer: Healthscope Commercial |
$18.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.02
|
| Rate for Payer: PHP Commercial |
$17.03
|
| Rate for Payer: Priority Health SBD |
$12.62
|
| Rate for Payer: UMR Bronson Commercial |
$8.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.02
|
|
|
BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION
|
Facility
|
IP
|
$21.17
|
|
|
Service Code
|
NDC 00409812610
|
| Hospital Charge Code |
105634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.31 |
| Max. Negotiated Rate |
$19.05 |
| Rate for Payer: Aetna American Axle |
$13.76
|
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.76
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Advantage |
$14.82
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.88
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: Priority Health SBD |
$13.34
|
| Rate for Payer: UMR Bronson Commercial |
$9.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.88
|
|
|
BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION
|
Facility
|
IP
|
$53.94
|
|
|
Service Code
|
NDC 63323046237
|
| Hospital Charge Code |
105634
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$23.73 |
| Max. Negotiated Rate |
$48.55 |
| Rate for Payer: Aetna American Axle |
$35.06
|
| Rate for Payer: Aetna Commercial |
$45.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.06
|
| Rate for Payer: Cash Price |
$43.15
|
| Rate for Payer: Cofinity Advantage |
$37.76
|
| Rate for Payer: Cofinity Commercial |
$46.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.15
|
| Rate for Payer: Healthscope Commercial |
$48.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.45
|
| Rate for Payer: PHP Commercial |
$45.85
|
| Rate for Payer: Priority Health SBD |
$33.98
|
| Rate for Payer: UMR Bronson Commercial |
$23.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.45
|
|
|
BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION
|
Facility
|
OP
|
$22.20
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
108351
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$19.98 |
| Rate for Payer: Aetna American Axle |
$14.43
|
| Rate for Payer: Aetna American Axle |
$33.99
|
| Rate for Payer: Aetna Commercial |
$18.87
|
| Rate for Payer: Aetna Commercial |
$44.45
|
| Rate for Payer: Aetna Medicare |
$11.10
|
| Rate for Payer: Aetna Medicare |
$26.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.99
|
| Rate for Payer: BCBS Complete |
$20.92
|
| Rate for Payer: BCBS Complete |
$8.88
|
| 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: Cash Price |
$17.76
|
| Rate for Payer: Cash Price |
$41.83
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cash Price |
$41.83
|
| Rate for Payer: Cofinity Advantage |
$15.54
|
| Rate for Payer: Cofinity Advantage |
$36.60
|
| Rate for Payer: Cofinity Commercial |
$19.09
|
| Rate for Payer: Cofinity Commercial |
$44.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.83
|
| Rate for Payer: Healthscope Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$47.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.65
|
| Rate for Payer: PHP Commercial |
$18.87
|
| Rate for Payer: PHP Commercial |
$44.45
|
| Rate for Payer: Priority Health SBD |
$13.99
|
| Rate for Payer: Priority Health SBD |
$32.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UMR Bronson Commercial |
$8.21
|
| Rate for Payer: UMR Bronson Commercial |
$19.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.22
|
|
|
BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION
|
Facility
|
IP
|
$22.20
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
108351
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$19.98 |
| Rate for Payer: Aetna American Axle |
$14.43
|
| Rate for Payer: Aetna American Axle |
$33.99
|
| Rate for Payer: Aetna Commercial |
$18.87
|
| Rate for Payer: Aetna Commercial |
$44.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.99
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cash Price |
$41.83
|
| Rate for Payer: Cofinity Advantage |
$36.60
|
| Rate for Payer: Cofinity Advantage |
$15.54
|
| Rate for Payer: Cofinity Commercial |
$44.97
|
| Rate for Payer: Cofinity Commercial |
$19.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.83
|
| Rate for Payer: Healthscope Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$47.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.22
|
| Rate for Payer: PHP Commercial |
$18.87
|
| Rate for Payer: PHP Commercial |
$44.45
|
| Rate for Payer: Priority Health SBD |
$32.94
|
| Rate for Payer: Priority Health SBD |
$13.99
|
| Rate for Payer: UMR Bronson Commercial |
$9.77
|
| Rate for Payer: UMR Bronson Commercial |
$23.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.22
|
|
|
BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION
|
Facility
|
OP
|
$58.08
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
1223
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$52.27 |
| Rate for Payer: Aetna American Axle |
$37.75
|
| Rate for Payer: Aetna Commercial |
$49.37
|
| Rate for Payer: Aetna Medicare |
$29.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.75
|
| Rate for Payer: BCBS Complete |
$23.23
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$46.46
|
| Rate for Payer: Cash Price |
$46.46
|
| Rate for Payer: Cofinity Advantage |
$40.66
|
| Rate for Payer: Cofinity Commercial |
$49.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.46
|
| Rate for Payer: Healthscope Commercial |
$52.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.56
|
| Rate for Payer: PHP Commercial |
$49.37
|
| Rate for Payer: Priority Health SBD |
$36.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UMR Bronson Commercial |
$21.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.56
|
|
|
BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION
|
Facility
|
IP
|
$58.08
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
1223
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$25.56 |
| Max. Negotiated Rate |
$52.27 |
| Rate for Payer: Aetna American Axle |
$37.75
|
| Rate for Payer: Aetna Commercial |
$49.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.75
|
| Rate for Payer: Cash Price |
$46.46
|
| Rate for Payer: Cofinity Advantage |
$40.66
|
| Rate for Payer: Cofinity Commercial |
$49.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.46
|
| Rate for Payer: Healthscope Commercial |
$52.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.56
|
| Rate for Payer: PHP Commercial |
$49.37
|
| Rate for Payer: Priority Health SBD |
$36.59
|
| Rate for Payer: UMR Bronson Commercial |
$25.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.56
|
|
|
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION
|
Facility
|
OP
|
$1,148.23
|
|
|
Service Code
|
HCPCS J0666
|
| Hospital Charge Code |
155788
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$1,033.41 |
| Rate for Payer: Aetna American Axle |
$746.35
|
| Rate for Payer: Aetna Commercial |
$976.00
|
| Rate for Payer: Aetna Medicare |
$1.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$746.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.71
|
| Rate for Payer: BCBS Complete |
$0.75
|
| Rate for Payer: BCBS MAPPO |
$1.37
|
| Rate for Payer: BCBS Trust/PPO |
$4.65
|
| Rate for Payer: BCN Commercial |
$4.65
|
| Rate for Payer: BCN Medicare Advantage |
$1.37
|
| Rate for Payer: Cash Price |
$918.58
|
| Rate for Payer: Cash Price |
$918.58
|
| Rate for Payer: Cofinity Advantage |
$803.76
|
| Rate for Payer: Cofinity Commercial |
$987.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$918.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.37
|
| Rate for Payer: Healthscope Commercial |
$1,033.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$803.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$861.17
|
| Rate for Payer: Mclaren Medicaid |
$1.37
|
| Rate for Payer: Mclaren Medicare |
$1.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.44
|
| Rate for Payer: Meridian Medicaid |
$1.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$976.00
|
| Rate for Payer: Nomi Health Commercial |
$4.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$861.17
|
| Rate for Payer: PACE Medicare |
$1.30
|
| Rate for Payer: PACE SWMI |
$1.37
|
| Rate for Payer: PHP Commercial |
$976.00
|
| Rate for Payer: PHP Medicare Advantage |
$1.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.64
|
| Rate for Payer: Priority Health Medicare |
$1.37
|
| Rate for Payer: Priority Health SBD |
$723.38
|
| Rate for Payer: Priority Health Tiered Network |
$3.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.38
|
| Rate for Payer: UHC Core |
$2.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.37
|
| Rate for Payer: UHC Exchange |
$2.38
|
| Rate for Payer: UHC Medicaid |
$0.72
|
| Rate for Payer: UHCCP Medicaid |
$0.72
|
| Rate for Payer: UMR Bronson Commercial |
$424.85
|
| Rate for Payer: VA VA |
$1.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$861.17
|
|
|
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION
|
Facility
|
IP
|
$1,148.23
|
|
|
Service Code
|
HCPCS J0666
|
| Hospital Charge Code |
155788
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$505.22 |
| Max. Negotiated Rate |
$1,033.41 |
| Rate for Payer: Aetna American Axle |
$746.35
|
| Rate for Payer: Aetna Commercial |
$976.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$746.35
|
| Rate for Payer: Cash Price |
$918.58
|
| Rate for Payer: Cofinity Advantage |
$803.76
|
| Rate for Payer: Cofinity Commercial |
$987.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$918.58
|
| Rate for Payer: Healthscope Commercial |
$1,033.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$803.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$861.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$976.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$861.17
|
| Rate for Payer: PHP Commercial |
$976.00
|
| Rate for Payer: Priority Health SBD |
$723.38
|
| Rate for Payer: UMR Bronson Commercial |
$505.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$861.17
|
|
|
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION (COA)
|
Facility
|
IP
|
$21.50
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
168930
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.46 |
| Max. Negotiated Rate |
$19.35 |
| Rate for Payer: Aetna American Axle |
$13.97
|
| Rate for Payer: Aetna Commercial |
$18.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.97
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cofinity Advantage |
$15.05
|
| Rate for Payer: Cofinity Commercial |
$18.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.20
|
| Rate for Payer: Healthscope Commercial |
$19.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.12
|
| Rate for Payer: PHP Commercial |
$18.27
|
| Rate for Payer: Priority Health SBD |
$13.54
|
| Rate for Payer: UMR Bronson Commercial |
$9.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.12
|
|
|
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION (COA)
|
Facility
|
OP
|
$21.50
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
168930
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$19.35 |
| Rate for Payer: Aetna American Axle |
$13.97
|
| Rate for Payer: Aetna Commercial |
$18.27
|
| Rate for Payer: Aetna Medicare |
$10.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.97
|
| Rate for Payer: BCBS Complete |
$8.60
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cofinity Advantage |
$15.05
|
| Rate for Payer: Cofinity Commercial |
$18.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.20
|
| Rate for Payer: Healthscope Commercial |
$19.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.12
|
| Rate for Payer: PHP Commercial |
$18.27
|
| Rate for Payer: Priority Health SBD |
$13.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UMR Bronson Commercial |
$7.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.12
|
|
|
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION
|
Facility
|
IP
|
$16.82
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
1222
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.40 |
| Max. Negotiated Rate |
$15.14 |
| Rate for Payer: Aetna American Axle |
$10.93
|
| Rate for Payer: Aetna American Axle |
$13.97
|
| Rate for Payer: Aetna American Axle |
$12.84
|
| Rate for Payer: Aetna American Axle |
$22.04
|
| Rate for Payer: Aetna American Axle |
$18.14
|
| Rate for Payer: Aetna American Axle |
$12.25
|
| Rate for Payer: Aetna American Axle |
$15.27
|
| Rate for Payer: Aetna American Axle |
$12.16
|
| Rate for Payer: Aetna American Axle |
$20.68
|
| Rate for Payer: Aetna American Axle |
$14.14
|
| Rate for Payer: Aetna American Axle |
$18.10
|
| Rate for Payer: Aetna American Axle |
$10.10
|
| Rate for Payer: Aetna American Axle |
$18.19
|
| Rate for Payer: Aetna Commercial |
$16.80
|
| Rate for Payer: Aetna Commercial |
$18.27
|
| Rate for Payer: Aetna Commercial |
$27.05
|
| Rate for Payer: Aetna Commercial |
$14.30
|
| Rate for Payer: Aetna Commercial |
$19.97
|
| Rate for Payer: Aetna Commercial |
$16.02
|
| Rate for Payer: Aetna Commercial |
$28.82
|
| Rate for Payer: Aetna Commercial |
$18.49
|
| Rate for Payer: Aetna Commercial |
$23.79
|
| Rate for Payer: Aetna Commercial |
$23.71
|
| Rate for Payer: Aetna Commercial |
$15.90
|
| Rate for Payer: Aetna Commercial |
$23.66
|
| Rate for Payer: Aetna Commercial |
$13.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.25
|
| Rate for Payer: Cash Price |
$15.08
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cash Price |
$22.27
|
| Rate for Payer: Cash Price |
$18.79
|
| Rate for Payer: Cash Price |
$22.32
|
| Rate for Payer: Cash Price |
$17.40
|
| Rate for Payer: Cash Price |
$15.81
|
| Rate for Payer: Cash Price |
$14.97
|
| Rate for Payer: Cash Price |
$22.39
|
| Rate for Payer: Cash Price |
$12.43
|
| Rate for Payer: Cash Price |
$13.46
|
| Rate for Payer: Cash Price |
$27.13
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Advantage |
$10.88
|
| Rate for Payer: Cofinity Advantage |
$16.44
|
| Rate for Payer: Cofinity Advantage |
$11.77
|
| Rate for Payer: Cofinity Advantage |
$13.10
|
| Rate for Payer: Cofinity Advantage |
$23.74
|
| Rate for Payer: Cofinity Advantage |
$22.27
|
| Rate for Payer: Cofinity Advantage |
$19.59
|
| Rate for Payer: Cofinity Advantage |
$13.20
|
| Rate for Payer: Cofinity Advantage |
$19.53
|
| Rate for Payer: Cofinity Advantage |
$13.83
|
| Rate for Payer: Cofinity Advantage |
$15.05
|
| Rate for Payer: Cofinity Advantage |
$19.49
|
| Rate for Payer: Cofinity Advantage |
$15.22
|
| Rate for Payer: Cofinity Commercial |
$16.99
|
| Rate for Payer: Cofinity Commercial |
$23.94
|
| Rate for Payer: Cofinity Commercial |
$29.16
|
| Rate for Payer: Cofinity Commercial |
$16.21
|
| Rate for Payer: Cofinity Commercial |
$18.49
|
| Rate for Payer: Cofinity Commercial |
$18.70
|
| Rate for Payer: Cofinity Commercial |
$23.99
|
| Rate for Payer: Cofinity Commercial |
$24.07
|
| Rate for Payer: Cofinity Commercial |
$16.09
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Cofinity Commercial |
$20.20
|
| Rate for Payer: Cofinity Commercial |
$14.47
|
| Rate for Payer: Cofinity Commercial |
$13.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.32
|
| Rate for Payer: Healthscope Commercial |
$25.11
|
| Rate for Payer: Healthscope Commercial |
$16.96
|
| Rate for Payer: Healthscope Commercial |
$17.78
|
| Rate for Payer: Healthscope Commercial |
$21.14
|
| Rate for Payer: Healthscope Commercial |
$19.57
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Healthscope Commercial |
$16.84
|
| Rate for Payer: Healthscope Commercial |
$30.52
|
| Rate for Payer: Healthscope Commercial |
$28.64
|
| Rate for Payer: Healthscope Commercial |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$13.99
|
| Rate for Payer: Healthscope Commercial |
$25.19
|
| Rate for Payer: Healthscope Commercial |
$15.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.31
|
| Rate for Payer: PHP Commercial |
$23.66
|
| Rate for Payer: PHP Commercial |
$16.02
|
| Rate for Payer: PHP Commercial |
$27.05
|
| Rate for Payer: PHP Commercial |
$23.79
|
| Rate for Payer: PHP Commercial |
$19.97
|
| Rate for Payer: PHP Commercial |
$18.27
|
| Rate for Payer: PHP Commercial |
$16.80
|
| Rate for Payer: PHP Commercial |
$18.49
|
| Rate for Payer: PHP Commercial |
$14.30
|
| Rate for Payer: PHP Commercial |
$28.82
|
| Rate for Payer: PHP Commercial |
$15.90
|
| Rate for Payer: PHP Commercial |
$13.21
|
| Rate for Payer: PHP Commercial |
$23.71
|
| Rate for Payer: Priority Health SBD |
$21.36
|
| Rate for Payer: Priority Health SBD |
$17.58
|
| Rate for Payer: Priority Health SBD |
$17.54
|
| Rate for Payer: Priority Health SBD |
$11.79
|
| Rate for Payer: Priority Health SBD |
$12.45
|
| Rate for Payer: Priority Health SBD |
$17.63
|
| Rate for Payer: Priority Health SBD |
$9.79
|
| Rate for Payer: Priority Health SBD |
$10.60
|
| Rate for Payer: Priority Health SBD |
$13.54
|
| Rate for Payer: Priority Health SBD |
$13.70
|
| Rate for Payer: Priority Health SBD |
$20.05
|
| Rate for Payer: Priority Health SBD |
$14.80
|
| Rate for Payer: Priority Health SBD |
$11.88
|
| Rate for Payer: UMR Bronson Commercial |
$8.29
|
| Rate for Payer: UMR Bronson Commercial |
$14.92
|
| Rate for Payer: UMR Bronson Commercial |
$12.32
|
| Rate for Payer: UMR Bronson Commercial |
$9.46
|
| Rate for Payer: UMR Bronson Commercial |
$9.57
|
| Rate for Payer: UMR Bronson Commercial |
$12.28
|
| Rate for Payer: UMR Bronson Commercial |
$14.00
|
| Rate for Payer: UMR Bronson Commercial |
$8.23
|
| Rate for Payer: UMR Bronson Commercial |
$10.34
|
| Rate for Payer: UMR Bronson Commercial |
$12.25
|
| Rate for Payer: UMR Bronson Commercial |
$8.69
|
| Rate for Payer: UMR Bronson Commercial |
$7.40
|
| Rate for Payer: UMR Bronson Commercial |
$6.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.03
|
|
|
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION
|
Facility
|
OP
|
$23.49
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
1222
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$21.14 |
| Rate for Payer: Aetna American Axle |
$15.27
|
| Rate for Payer: Aetna American Axle |
$18.10
|
| Rate for Payer: Aetna American Axle |
$12.25
|
| Rate for Payer: Aetna American Axle |
$18.19
|
| Rate for Payer: Aetna American Axle |
$20.68
|
| Rate for Payer: Aetna American Axle |
$12.16
|
| Rate for Payer: Aetna American Axle |
$18.14
|
| Rate for Payer: Aetna American Axle |
$13.97
|
| Rate for Payer: Aetna American Axle |
$12.84
|
| Rate for Payer: Aetna American Axle |
$22.04
|
| Rate for Payer: Aetna American Axle |
$10.93
|
| Rate for Payer: Aetna American Axle |
$10.10
|
| Rate for Payer: Aetna American Axle |
$14.14
|
| Rate for Payer: Aetna Commercial |
$18.49
|
| Rate for Payer: Aetna Commercial |
$23.66
|
| Rate for Payer: Aetna Commercial |
$16.80
|
| Rate for Payer: Aetna Commercial |
$16.02
|
| Rate for Payer: Aetna Commercial |
$15.90
|
| Rate for Payer: Aetna Commercial |
$14.30
|
| Rate for Payer: Aetna Commercial |
$23.79
|
| Rate for Payer: Aetna Commercial |
$18.27
|
| Rate for Payer: Aetna Commercial |
$23.71
|
| Rate for Payer: Aetna Commercial |
$13.21
|
| Rate for Payer: Aetna Commercial |
$27.05
|
| Rate for Payer: Aetna Commercial |
$19.97
|
| Rate for Payer: Aetna Commercial |
$28.82
|
| Rate for Payer: Aetna Medicare |
$9.88
|
| Rate for Payer: Aetna Medicare |
$13.99
|
| Rate for Payer: Aetna Medicare |
$11.74
|
| Rate for Payer: Aetna Medicare |
$13.92
|
| Rate for Payer: Aetna Medicare |
$8.41
|
| Rate for Payer: Aetna Medicare |
$10.88
|
| Rate for Payer: Aetna Medicare |
$7.77
|
| Rate for Payer: Aetna Medicare |
$16.95
|
| Rate for Payer: Aetna Medicare |
$9.36
|
| Rate for Payer: Aetna Medicare |
$10.75
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Aetna Medicare |
$13.95
|
| Rate for Payer: Aetna Medicare |
$9.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.68
|
| Rate for Payer: BCBS Complete |
$6.73
|
| Rate for Payer: BCBS Complete |
$6.22
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: BCBS Complete |
$11.16
|
| Rate for Payer: BCBS Complete |
$8.70
|
| Rate for Payer: BCBS Complete |
$12.73
|
| Rate for Payer: BCBS Complete |
$7.90
|
| Rate for Payer: BCBS Complete |
$11.14
|
| Rate for Payer: BCBS Complete |
$7.48
|
| Rate for Payer: BCBS Complete |
$13.56
|
| Rate for Payer: BCBS Complete |
$8.60
|
| Rate for Payer: BCBS Complete |
$7.54
|
| Rate for Payer: BCBS Complete |
$11.20
|
| 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: 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: 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: 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: BCN Commercial |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$12.43
|
| Rate for Payer: Cash Price |
$18.79
|
| Rate for Payer: Cash Price |
$12.43
|
| Rate for Payer: Cash Price |
$14.97
|
| Rate for Payer: Cash Price |
$14.97
|
| Rate for Payer: Cash Price |
$13.46
|
| Rate for Payer: Cash Price |
$13.46
|
| Rate for Payer: Cash Price |
$27.13
|
| Rate for Payer: Cash Price |
$27.13
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cash Price |
$15.08
|
| Rate for Payer: Cash Price |
$15.08
|
| Rate for Payer: Cash Price |
$22.39
|
| Rate for Payer: Cash Price |
$22.39
|
| Rate for Payer: Cash Price |
$15.81
|
| Rate for Payer: Cash Price |
$15.81
|
| Rate for Payer: Cash Price |
$22.32
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cash Price |
$22.32
|
| Rate for Payer: Cash Price |
$17.40
|
| Rate for Payer: Cash Price |
$22.27
|
| Rate for Payer: Cash Price |
$17.40
|
| Rate for Payer: Cash Price |
$22.27
|
| Rate for Payer: Cash Price |
$18.79
|
| Rate for Payer: Cofinity Advantage |
$23.74
|
| Rate for Payer: Cofinity Advantage |
$19.53
|
| Rate for Payer: Cofinity Advantage |
$22.27
|
| Rate for Payer: Cofinity Advantage |
$19.59
|
| Rate for Payer: Cofinity Advantage |
$15.05
|
| Rate for Payer: Cofinity Advantage |
$13.10
|
| Rate for Payer: Cofinity Advantage |
$13.20
|
| Rate for Payer: Cofinity Advantage |
$19.49
|
| Rate for Payer: Cofinity Advantage |
$13.83
|
| Rate for Payer: Cofinity Advantage |
$11.77
|
| Rate for Payer: Cofinity Advantage |
$16.44
|
| Rate for Payer: Cofinity Advantage |
$10.88
|
| Rate for Payer: Cofinity Advantage |
$15.22
|
| Rate for Payer: Cofinity Commercial |
$24.07
|
| Rate for Payer: Cofinity Commercial |
$14.47
|
| Rate for Payer: Cofinity Commercial |
$13.36
|
| Rate for Payer: Cofinity Commercial |
$16.99
|
| Rate for Payer: Cofinity Commercial |
$16.21
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Cofinity Commercial |
$18.49
|
| Rate for Payer: Cofinity Commercial |
$23.99
|
| Rate for Payer: Cofinity Commercial |
$20.20
|
| Rate for Payer: Cofinity Commercial |
$29.16
|
| Rate for Payer: Cofinity Commercial |
$23.94
|
| Rate for Payer: Cofinity Commercial |
$16.09
|
| Rate for Payer: Cofinity Commercial |
$18.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.97
|
| Rate for Payer: Healthscope Commercial |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$25.11
|
| Rate for Payer: Healthscope Commercial |
$19.57
|
| Rate for Payer: Healthscope Commercial |
$17.78
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Healthscope Commercial |
$13.99
|
| Rate for Payer: Healthscope Commercial |
$25.19
|
| Rate for Payer: Healthscope Commercial |
$15.14
|
| Rate for Payer: Healthscope Commercial |
$30.52
|
| Rate for Payer: Healthscope Commercial |
$16.84
|
| Rate for Payer: Healthscope Commercial |
$21.14
|
| Rate for Payer: Healthscope Commercial |
$28.64
|
| Rate for Payer: Healthscope Commercial |
$16.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.62
|
| Rate for Payer: PHP Commercial |
$27.05
|
| Rate for Payer: PHP Commercial |
$19.97
|
| Rate for Payer: PHP Commercial |
$23.79
|
| Rate for Payer: PHP Commercial |
$16.02
|
| Rate for Payer: PHP Commercial |
$13.21
|
| Rate for Payer: PHP Commercial |
$14.30
|
| Rate for Payer: PHP Commercial |
$23.66
|
| Rate for Payer: PHP Commercial |
$18.49
|
| Rate for Payer: PHP Commercial |
$28.82
|
| Rate for Payer: PHP Commercial |
$18.27
|
| Rate for Payer: PHP Commercial |
$15.90
|
| Rate for Payer: PHP Commercial |
$16.80
|
| Rate for Payer: PHP Commercial |
$23.71
|
| Rate for Payer: Priority Health SBD |
$17.63
|
| Rate for Payer: Priority Health SBD |
$11.79
|
| Rate for Payer: Priority Health SBD |
$13.70
|
| Rate for Payer: Priority Health SBD |
$13.54
|
| Rate for Payer: Priority Health SBD |
$17.58
|
| Rate for Payer: Priority Health SBD |
$14.80
|
| Rate for Payer: Priority Health SBD |
$12.45
|
| Rate for Payer: Priority Health SBD |
$10.60
|
| Rate for Payer: Priority Health SBD |
$11.88
|
| Rate for Payer: Priority Health SBD |
$9.79
|
| Rate for Payer: Priority Health SBD |
$20.05
|
| Rate for Payer: Priority Health SBD |
$21.36
|
| Rate for Payer: Priority Health SBD |
$17.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UMR Bronson Commercial |
$5.75
|
| Rate for Payer: UMR Bronson Commercial |
$12.55
|
| Rate for Payer: UMR Bronson Commercial |
$7.31
|
| Rate for Payer: UMR Bronson Commercial |
$8.69
|
| Rate for Payer: UMR Bronson Commercial |
$10.36
|
| Rate for Payer: UMR Bronson Commercial |
$6.92
|
| Rate for Payer: UMR Bronson Commercial |
$11.77
|
| Rate for Payer: UMR Bronson Commercial |
$7.96
|
| Rate for Payer: UMR Bronson Commercial |
$6.97
|
| Rate for Payer: UMR Bronson Commercial |
$10.32
|
| Rate for Payer: UMR Bronson Commercial |
$8.05
|
| Rate for Payer: UMR Bronson Commercial |
$10.30
|
| Rate for Payer: UMR Bronson Commercial |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.93
|
|
|
BUPIVACAINE (PF) 0.25 % INJECTION (NO LABEL)
|
Facility
|
OP
|
$21.50
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
161537
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$19.35 |
| Rate for Payer: Aetna American Axle |
$13.97
|
| Rate for Payer: Aetna Commercial |
$18.27
|
| Rate for Payer: Aetna Medicare |
$10.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.97
|
| Rate for Payer: BCBS Complete |
$8.60
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cofinity Advantage |
$15.05
|
| Rate for Payer: Cofinity Commercial |
$18.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.20
|
| Rate for Payer: Healthscope Commercial |
$19.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.12
|
| Rate for Payer: PHP Commercial |
$18.27
|
| Rate for Payer: Priority Health SBD |
$13.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UMR Bronson Commercial |
$7.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.12
|
|
|
BUPIVACAINE (PF) 0.25 % INJECTION (NO LABEL)
|
Facility
|
IP
|
$21.50
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
161537
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.46 |
| Max. Negotiated Rate |
$19.35 |
| Rate for Payer: Aetna American Axle |
$13.97
|
| Rate for Payer: Aetna Commercial |
$18.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.97
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cofinity Advantage |
$15.05
|
| Rate for Payer: Cofinity Commercial |
$18.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.20
|
| Rate for Payer: Healthscope Commercial |
$19.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.12
|
| Rate for Payer: PHP Commercial |
$18.27
|
| Rate for Payer: Priority Health SBD |
$13.54
|
| Rate for Payer: UMR Bronson Commercial |
$9.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.12
|
|
|
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION
|
Facility
|
IP
|
$20.45
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
105640
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$18.41 |
| Rate for Payer: Aetna American Axle |
$13.29
|
| Rate for Payer: Aetna American Axle |
$11.88
|
| Rate for Payer: Aetna American Axle |
$10.10
|
| Rate for Payer: Aetna American Axle |
$10.25
|
| Rate for Payer: Aetna American Axle |
$10.78
|
| Rate for Payer: Aetna American Axle |
$9.33
|
| Rate for Payer: Aetna American Axle |
$21.26
|
| Rate for Payer: Aetna American Axle |
$15.36
|
| Rate for Payer: Aetna American Axle |
$15.02
|
| Rate for Payer: Aetna American Axle |
$13.54
|
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Aetna Commercial |
$15.53
|
| Rate for Payer: Aetna Commercial |
$13.40
|
| Rate for Payer: Aetna Commercial |
$27.80
|
| Rate for Payer: Aetna Commercial |
$17.38
|
| Rate for Payer: Aetna Commercial |
$20.09
|
| Rate for Payer: Aetna Commercial |
$12.21
|
| Rate for Payer: Aetna Commercial |
$13.21
|
| Rate for Payer: Aetna Commercial |
$19.64
|
| Rate for Payer: Aetna Commercial |
$14.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.25
|
| Rate for Payer: Cash Price |
$11.49
|
| Rate for Payer: Cash Price |
$14.62
|
| Rate for Payer: Cash Price |
$13.26
|
| Rate for Payer: Cash Price |
$26.17
|
| Rate for Payer: Cash Price |
$16.66
|
| Rate for Payer: Cash Price |
$12.43
|
| Rate for Payer: Cash Price |
$12.62
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$16.36
|
| Rate for Payer: Cash Price |
$18.48
|
| Rate for Payer: Cofinity Advantage |
$10.05
|
| Rate for Payer: Cofinity Advantage |
$10.88
|
| Rate for Payer: Cofinity Advantage |
$11.61
|
| Rate for Payer: Cofinity Advantage |
$11.04
|
| Rate for Payer: Cofinity Advantage |
$12.79
|
| Rate for Payer: Cofinity Advantage |
$14.31
|
| Rate for Payer: Cofinity Advantage |
$14.58
|
| Rate for Payer: Cofinity Advantage |
$16.17
|
| Rate for Payer: Cofinity Advantage |
$16.54
|
| Rate for Payer: Cofinity Advantage |
$22.90
|
| Rate for Payer: Cofinity Commercial |
$15.71
|
| Rate for Payer: Cofinity Commercial |
$17.91
|
| Rate for Payer: Cofinity Commercial |
$20.32
|
| Rate for Payer: Cofinity Commercial |
$13.36
|
| Rate for Payer: Cofinity Commercial |
$17.59
|
| Rate for Payer: Cofinity Commercial |
$12.35
|
| Rate for Payer: Cofinity Commercial |
$28.13
|
| Rate for Payer: Cofinity Commercial |
$13.56
|
| Rate for Payer: Cofinity Commercial |
$14.26
|
| Rate for Payer: Cofinity Commercial |
$19.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.36
|
| Rate for Payer: Healthscope Commercial |
$21.27
|
| Rate for Payer: Healthscope Commercial |
$16.44
|
| Rate for Payer: Healthscope Commercial |
$18.41
|
| Rate for Payer: Healthscope Commercial |
$12.92
|
| Rate for Payer: Healthscope Commercial |
$14.92
|
| Rate for Payer: Healthscope Commercial |
$13.99
|
| Rate for Payer: Healthscope Commercial |
$14.19
|
| Rate for Payer: Healthscope Commercial |
$29.44
|
| Rate for Payer: Healthscope Commercial |
$20.79
|
| Rate for Payer: Healthscope Commercial |
$18.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.44
|
| Rate for Payer: PHP Commercial |
$27.80
|
| Rate for Payer: PHP Commercial |
$17.38
|
| Rate for Payer: PHP Commercial |
$13.21
|
| Rate for Payer: PHP Commercial |
$17.71
|
| Rate for Payer: PHP Commercial |
$15.53
|
| Rate for Payer: PHP Commercial |
$19.64
|
| Rate for Payer: PHP Commercial |
$20.09
|
| Rate for Payer: PHP Commercial |
$14.09
|
| Rate for Payer: PHP Commercial |
$12.21
|
| Rate for Payer: PHP Commercial |
$13.40
|
| Rate for Payer: Priority Health SBD |
$13.12
|
| Rate for Payer: Priority Health SBD |
$14.89
|
| Rate for Payer: Priority Health SBD |
$20.61
|
| Rate for Payer: Priority Health SBD |
$9.94
|
| Rate for Payer: Priority Health SBD |
$14.55
|
| Rate for Payer: Priority Health SBD |
$9.05
|
| Rate for Payer: Priority Health SBD |
$9.79
|
| Rate for Payer: Priority Health SBD |
$11.51
|
| Rate for Payer: Priority Health SBD |
$12.88
|
| Rate for Payer: Priority Health SBD |
$10.45
|
| Rate for Payer: UMR Bronson Commercial |
$6.84
|
| Rate for Payer: UMR Bronson Commercial |
$14.39
|
| Rate for Payer: UMR Bronson Commercial |
$6.94
|
| Rate for Payer: UMR Bronson Commercial |
$6.32
|
| Rate for Payer: UMR Bronson Commercial |
$8.04
|
| Rate for Payer: UMR Bronson Commercial |
$10.40
|
| Rate for Payer: UMR Bronson Commercial |
$7.30
|
| Rate for Payer: UMR Bronson Commercial |
$9.00
|
| Rate for Payer: UMR Bronson Commercial |
$9.17
|
| Rate for Payer: UMR Bronson Commercial |
$10.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.72
|
|
|
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION
|
Facility
|
OP
|
$20.45
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
105640
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$18.41 |
| Rate for Payer: Aetna American Axle |
$13.29
|
| Rate for Payer: Aetna American Axle |
$10.10
|
| Rate for Payer: Aetna American Axle |
$10.78
|
| Rate for Payer: Aetna American Axle |
$15.36
|
| Rate for Payer: Aetna American Axle |
$21.26
|
| Rate for Payer: Aetna American Axle |
$15.02
|
| Rate for Payer: Aetna American Axle |
$13.54
|
| Rate for Payer: Aetna American Axle |
$11.88
|
| Rate for Payer: Aetna American Axle |
$10.25
|
| Rate for Payer: Aetna American Axle |
$9.33
|
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Aetna Commercial |
$17.38
|
| Rate for Payer: Aetna Commercial |
$13.21
|
| Rate for Payer: Aetna Commercial |
$20.09
|
| Rate for Payer: Aetna Commercial |
$27.80
|
| Rate for Payer: Aetna Commercial |
$12.21
|
| Rate for Payer: Aetna Commercial |
$14.09
|
| Rate for Payer: Aetna Commercial |
$19.64
|
| Rate for Payer: Aetna Commercial |
$15.53
|
| Rate for Payer: Aetna Commercial |
$13.40
|
| Rate for Payer: Aetna Medicare |
$16.36
|
| Rate for Payer: Aetna Medicare |
$11.55
|
| Rate for Payer: Aetna Medicare |
$7.77
|
| Rate for Payer: Aetna Medicare |
$7.18
|
| Rate for Payer: Aetna Medicare |
$7.88
|
| Rate for Payer: Aetna Medicare |
$9.13
|
| Rate for Payer: Aetna Medicare |
$8.29
|
| Rate for Payer: Aetna Medicare |
$10.22
|
| Rate for Payer: Aetna Medicare |
$10.41
|
| Rate for Payer: Aetna Medicare |
$11.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.02
|
| Rate for Payer: BCBS Complete |
$8.33
|
| Rate for Payer: BCBS Complete |
$7.31
|
| Rate for Payer: BCBS Complete |
$9.24
|
| Rate for Payer: BCBS Complete |
$8.18
|
| Rate for Payer: BCBS Complete |
$6.31
|
| Rate for Payer: BCBS Complete |
$13.08
|
| Rate for Payer: BCBS Complete |
$9.45
|
| Rate for Payer: BCBS Complete |
$6.22
|
| Rate for Payer: BCBS Complete |
$5.74
|
| Rate for Payer: BCBS Complete |
$6.63
|
| 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: 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: 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 |
$18.48
|
| Rate for Payer: Cash Price |
$16.66
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$26.17
|
| Rate for Payer: Cash Price |
$26.17
|
| Rate for Payer: Cash Price |
$16.66
|
| Rate for Payer: Cash Price |
$16.36
|
| Rate for Payer: Cash Price |
$14.62
|
| Rate for Payer: Cash Price |
$13.26
|
| Rate for Payer: Cash Price |
$12.43
|
| Rate for Payer: Cash Price |
$12.62
|
| Rate for Payer: Cash Price |
$12.62
|
| Rate for Payer: Cash Price |
$13.26
|
| Rate for Payer: Cash Price |
$11.49
|
| Rate for Payer: Cash Price |
$11.49
|
| Rate for Payer: Cash Price |
$16.36
|
| Rate for Payer: Cash Price |
$14.62
|
| Rate for Payer: Cash Price |
$18.48
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$12.43
|
| Rate for Payer: Cofinity Advantage |
$10.05
|
| Rate for Payer: Cofinity Advantage |
$10.88
|
| Rate for Payer: Cofinity Advantage |
$11.04
|
| Rate for Payer: Cofinity Advantage |
$16.17
|
| Rate for Payer: Cofinity Advantage |
$22.90
|
| Rate for Payer: Cofinity Advantage |
$14.58
|
| Rate for Payer: Cofinity Advantage |
$14.31
|
| Rate for Payer: Cofinity Advantage |
$16.54
|
| Rate for Payer: Cofinity Advantage |
$11.61
|
| Rate for Payer: Cofinity Advantage |
$12.79
|
| Rate for Payer: Cofinity Commercial |
$13.36
|
| Rate for Payer: Cofinity Commercial |
$12.35
|
| Rate for Payer: Cofinity Commercial |
$13.56
|
| Rate for Payer: Cofinity Commercial |
$14.26
|
| Rate for Payer: Cofinity Commercial |
$15.71
|
| Rate for Payer: Cofinity Commercial |
$17.59
|
| Rate for Payer: Cofinity Commercial |
$17.91
|
| Rate for Payer: Cofinity Commercial |
$19.87
|
| Rate for Payer: Cofinity Commercial |
$20.32
|
| Rate for Payer: Cofinity Commercial |
$28.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.43
|
| Rate for Payer: Healthscope Commercial |
$14.19
|
| Rate for Payer: Healthscope Commercial |
$18.75
|
| Rate for Payer: Healthscope Commercial |
$16.44
|
| Rate for Payer: Healthscope Commercial |
$29.44
|
| Rate for Payer: Healthscope Commercial |
$13.99
|
| Rate for Payer: Healthscope Commercial |
$14.92
|
| Rate for Payer: Healthscope Commercial |
$12.92
|
| Rate for Payer: Healthscope Commercial |
$18.41
|
| Rate for Payer: Healthscope Commercial |
$21.27
|
| Rate for Payer: Healthscope Commercial |
$20.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.70
|
| Rate for Payer: PHP Commercial |
$14.09
|
| Rate for Payer: PHP Commercial |
$27.80
|
| Rate for Payer: PHP Commercial |
$20.09
|
| Rate for Payer: PHP Commercial |
$15.53
|
| Rate for Payer: PHP Commercial |
$19.64
|
| Rate for Payer: PHP Commercial |
$13.21
|
| Rate for Payer: PHP Commercial |
$12.21
|
| Rate for Payer: PHP Commercial |
$17.38
|
| Rate for Payer: PHP Commercial |
$17.71
|
| Rate for Payer: PHP Commercial |
$13.40
|
| Rate for Payer: Priority Health SBD |
$12.88
|
| Rate for Payer: Priority Health SBD |
$9.94
|
| Rate for Payer: Priority Health SBD |
$10.45
|
| Rate for Payer: Priority Health SBD |
$14.55
|
| Rate for Payer: Priority Health SBD |
$13.12
|
| Rate for Payer: Priority Health SBD |
$20.61
|
| Rate for Payer: Priority Health SBD |
$14.89
|
| Rate for Payer: Priority Health SBD |
$9.05
|
| Rate for Payer: Priority Health SBD |
$9.79
|
| Rate for Payer: Priority Health SBD |
$11.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UMR Bronson Commercial |
$5.31
|
| Rate for Payer: UMR Bronson Commercial |
$6.76
|
| Rate for Payer: UMR Bronson Commercial |
$7.71
|
| Rate for Payer: UMR Bronson Commercial |
$8.55
|
| Rate for Payer: UMR Bronson Commercial |
$5.75
|
| Rate for Payer: UMR Bronson Commercial |
$6.13
|
| Rate for Payer: UMR Bronson Commercial |
$5.83
|
| Rate for Payer: UMR Bronson Commercial |
$12.10
|
| Rate for Payer: UMR Bronson Commercial |
$7.57
|
| Rate for Payer: UMR Bronson Commercial |
$8.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.44
|
|
|
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION
|
Facility
|
OP
|
$85.01
|
|
|
Service Code
|
NDC 09900001084
|
| Hospital Charge Code |
9316
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$31.45 |
| Max. Negotiated Rate |
$76.51 |
| Rate for Payer: Aetna American Axle |
$55.26
|
| Rate for Payer: Aetna Commercial |
$72.26
|
| Rate for Payer: Aetna Medicare |
$42.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.26
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: Cash Price |
$68.01
|
| Rate for Payer: Cofinity Advantage |
$59.51
|
| Rate for Payer: Cofinity Commercial |
$73.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.01
|
| Rate for Payer: Healthscope Commercial |
$76.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.76
|
| Rate for Payer: PHP Commercial |
$72.26
|
| Rate for Payer: Priority Health SBD |
$53.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.26
|
| Rate for Payer: UHC Core |
$44.29
|
| Rate for Payer: UHC Exchange |
$33.41
|
| Rate for Payer: UMR Bronson Commercial |
$31.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.76
|
|
|
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION
|
Facility
|
IP
|
$27.90
|
|
|
Service Code
|
NDC 63323047302
|
| Hospital Charge Code |
9316
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.28 |
| Max. Negotiated Rate |
$25.11 |
| Rate for Payer: Aetna American Axle |
$18.14
|
| Rate for Payer: Aetna Commercial |
$23.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.14
|
| Rate for Payer: Cash Price |
$22.32
|
| Rate for Payer: Cofinity Advantage |
$19.53
|
| Rate for Payer: Cofinity Commercial |
$23.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.32
|
| Rate for Payer: Healthscope Commercial |
$25.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.93
|
| Rate for Payer: PHP Commercial |
$23.71
|
| Rate for Payer: Priority Health SBD |
$17.58
|
| Rate for Payer: UMR Bronson Commercial |
$12.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.93
|
|
