|
HUMAN PROTHROMBIN CMPLX CONCENTRATE (PCC)-LANS 1,000 UNIT IV SOLUTION
|
Facility
|
OP
|
$6,970.60
|
|
|
Service Code
|
HCPCS J7165
|
| Hospital Charge Code |
204902
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.96 |
| Max. Negotiated Rate |
$6,273.54 |
| Rate for Payer: Aetna American Axle |
$4,530.89
|
| Rate for Payer: Aetna Commercial |
$5,925.01
|
| Rate for Payer: Aetna Medicare |
$1.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,530.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.25
|
| Rate for Payer: BCBS Complete |
$1.01
|
| Rate for Payer: BCBS MAPPO |
$1.80
|
| Rate for Payer: BCBS Trust/PPO |
$8.49
|
| Rate for Payer: BCN Commercial |
$8.49
|
| Rate for Payer: BCN Medicare Advantage |
$1.80
|
| Rate for Payer: Cash Price |
$5,576.48
|
| Rate for Payer: Cash Price |
$5,576.48
|
| Rate for Payer: Cofinity Commercial |
$5,994.72
|
| Rate for Payer: Cofinity Commercial |
$4,879.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,879.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,576.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.80
|
| Rate for Payer: Healthscope Commercial |
$6,273.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,879.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,227.95
|
| Rate for Payer: Mclaren Medicaid |
$0.96
|
| Rate for Payer: Mclaren Medicare |
$1.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.89
|
| Rate for Payer: Meridian Medicaid |
$1.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,925.01
|
| Rate for Payer: Nomi Health Commercial |
$5.40
|
| Rate for Payer: PACE Medicare |
$1.71
|
| Rate for Payer: PACE SWMI |
$1.80
|
| Rate for Payer: PHP Commercial |
$5,925.01
|
| Rate for Payer: PHP Medicare Advantage |
$1.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,530.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.75
|
| Rate for Payer: Priority Health Medicare |
$1.80
|
| Rate for Payer: Priority Health Narrow Network |
$4.60
|
| Rate for Payer: Priority Health SBD |
$4,391.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.80
|
| Rate for Payer: UHC Exchange |
$3.44
|
| Rate for Payer: UHC Medicare Advantage |
$1.80
|
| Rate for Payer: UHCCP Medicaid |
$0.96
|
| Rate for Payer: UMR Bronson Commercial |
$2,579.12
|
| Rate for Payer: VA VA |
$1.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,227.95
|
|
|
HUMAN PROTHROMBIN COMPLEX CONCENTRATE (PCC)-LANS 500 UNIT IV SOLUTION
|
Facility
|
OP
|
$3,753.41
|
|
|
Service Code
|
HCPCS J7165
|
| Hospital Charge Code |
204903
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.96 |
| Max. Negotiated Rate |
$3,378.07 |
| Rate for Payer: Aetna American Axle |
$2,439.72
|
| Rate for Payer: Aetna Commercial |
$3,190.40
|
| Rate for Payer: Aetna Medicare |
$1.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,439.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.25
|
| Rate for Payer: BCBS Complete |
$1.01
|
| Rate for Payer: BCBS MAPPO |
$1.80
|
| Rate for Payer: BCBS Trust/PPO |
$8.49
|
| Rate for Payer: BCN Commercial |
$8.49
|
| Rate for Payer: BCN Medicare Advantage |
$1.80
|
| Rate for Payer: Cash Price |
$3,002.73
|
| Rate for Payer: Cash Price |
$3,002.73
|
| Rate for Payer: Cofinity Commercial |
$3,227.93
|
| Rate for Payer: Cofinity Commercial |
$2,627.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,627.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,002.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.80
|
| Rate for Payer: Healthscope Commercial |
$3,378.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,627.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,815.06
|
| Rate for Payer: Mclaren Medicaid |
$0.96
|
| Rate for Payer: Mclaren Medicare |
$1.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.89
|
| Rate for Payer: Meridian Medicaid |
$1.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,190.40
|
| Rate for Payer: Nomi Health Commercial |
$5.40
|
| Rate for Payer: PACE Medicare |
$1.71
|
| Rate for Payer: PACE SWMI |
$1.80
|
| Rate for Payer: PHP Commercial |
$3,190.40
|
| Rate for Payer: PHP Medicare Advantage |
$1.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,439.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.75
|
| Rate for Payer: Priority Health Medicare |
$1.80
|
| Rate for Payer: Priority Health Narrow Network |
$4.60
|
| Rate for Payer: Priority Health SBD |
$2,364.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.80
|
| Rate for Payer: UHC Exchange |
$3.44
|
| Rate for Payer: UHC Medicare Advantage |
$1.80
|
| Rate for Payer: UHCCP Medicaid |
$0.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,388.76
|
| Rate for Payer: VA VA |
$1.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,815.06
|
|
|
HUMAN PROTHROMBIN COMPLEX CONCENTRATE (PCC)-LANS 500 UNIT IV SOLUTION
|
Facility
|
IP
|
$3,753.41
|
|
|
Service Code
|
HCPCS J7165
|
| Hospital Charge Code |
204903
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,651.50 |
| Max. Negotiated Rate |
$3,378.07 |
| Rate for Payer: Aetna American Axle |
$2,439.72
|
| Rate for Payer: Aetna Commercial |
$3,190.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,439.72
|
| Rate for Payer: Cash Price |
$3,002.73
|
| Rate for Payer: Cofinity Commercial |
$2,627.39
|
| Rate for Payer: Cofinity Commercial |
$3,227.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,627.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,002.73
|
| Rate for Payer: Healthscope Commercial |
$3,378.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,627.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,815.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,190.40
|
| Rate for Payer: PHP Commercial |
$3,190.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,439.72
|
| Rate for Payer: Priority Health SBD |
$2,364.65
|
| Rate for Payer: UMR Bronson Commercial |
$1,651.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,815.06
|
|
|
HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1,240 UNIT) IV SOLUTION
|
Facility
|
IP
|
$4.93
|
|
|
Service Code
|
HCPCS J7168
|
| Hospital Charge Code |
171259
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.17 |
| Max. Negotiated Rate |
$4.44 |
| Rate for Payer: Aetna American Axle |
$3.20
|
| Rate for Payer: Aetna Commercial |
$4.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.20
|
| Rate for Payer: Cash Price |
$3.94
|
| Rate for Payer: Cofinity Commercial |
$3.45
|
| Rate for Payer: Cofinity Commercial |
$4.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.94
|
| Rate for Payer: Healthscope Commercial |
$4.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.19
|
| Rate for Payer: PHP Commercial |
$4.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.20
|
| Rate for Payer: Priority Health SBD |
$3.11
|
| Rate for Payer: UMR Bronson Commercial |
$2.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.70
|
|
|
HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1,240 UNIT) IV SOLUTION
|
Facility
|
OP
|
$4.93
|
|
|
Service Code
|
HCPCS J7168
|
| Hospital Charge Code |
171259
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.18 |
| Max. Negotiated Rate |
$7.97 |
| Rate for Payer: Aetna American Axle |
$3.20
|
| Rate for Payer: Aetna Commercial |
$4.19
|
| Rate for Payer: Aetna Medicare |
$2.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.76
|
| Rate for Payer: BCBS Complete |
$1.24
|
| Rate for Payer: BCBS MAPPO |
$2.21
|
| Rate for Payer: BCBS Trust/PPO |
$7.97
|
| Rate for Payer: BCN Commercial |
$7.97
|
| Rate for Payer: BCN Medicare Advantage |
$2.21
|
| Rate for Payer: Cash Price |
$3.94
|
| Rate for Payer: Cash Price |
$3.94
|
| Rate for Payer: Cofinity Commercial |
$4.24
|
| Rate for Payer: Cofinity Commercial |
$3.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.21
|
| Rate for Payer: Healthscope Commercial |
$4.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.70
|
| Rate for Payer: Mclaren Medicaid |
$1.18
|
| Rate for Payer: Mclaren Medicare |
$2.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.32
|
| Rate for Payer: Meridian Medicaid |
$1.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.19
|
| Rate for Payer: Nomi Health Commercial |
$6.63
|
| Rate for Payer: PACE Medicare |
$2.10
|
| Rate for Payer: PACE SWMI |
$2.21
|
| Rate for Payer: PHP Commercial |
$4.19
|
| Rate for Payer: PHP Medicare Advantage |
$2.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.44
|
| Rate for Payer: Priority Health Medicare |
$2.21
|
| Rate for Payer: Priority Health Narrow Network |
$5.15
|
| Rate for Payer: Priority Health SBD |
$3.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.21
|
| Rate for Payer: UHC Exchange |
$4.22
|
| Rate for Payer: UHC Medicare Advantage |
$2.21
|
| Rate for Payer: UHCCP Medicaid |
$1.18
|
| Rate for Payer: UMR Bronson Commercial |
$1.82
|
| Rate for Payer: VA VA |
$2.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.70
|
|
|
HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION
|
Facility
|
OP
|
$4.93
|
|
|
Service Code
|
HCPCS J7168
|
| Hospital Charge Code |
170850
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.18 |
| Max. Negotiated Rate |
$7.97 |
| Rate for Payer: Aetna American Axle |
$3.20
|
| Rate for Payer: Aetna Commercial |
$4.19
|
| Rate for Payer: Aetna Medicare |
$2.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.76
|
| Rate for Payer: BCBS Complete |
$1.24
|
| Rate for Payer: BCBS MAPPO |
$2.21
|
| Rate for Payer: BCBS Trust/PPO |
$7.97
|
| Rate for Payer: BCN Commercial |
$7.97
|
| Rate for Payer: BCN Medicare Advantage |
$2.21
|
| Rate for Payer: Cash Price |
$3.94
|
| Rate for Payer: Cash Price |
$3.94
|
| Rate for Payer: Cofinity Commercial |
$4.24
|
| Rate for Payer: Cofinity Commercial |
$3.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.21
|
| Rate for Payer: Healthscope Commercial |
$4.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.70
|
| Rate for Payer: Mclaren Medicaid |
$1.18
|
| Rate for Payer: Mclaren Medicare |
$2.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.32
|
| Rate for Payer: Meridian Medicaid |
$1.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.19
|
| Rate for Payer: Nomi Health Commercial |
$6.63
|
| Rate for Payer: PACE Medicare |
$2.10
|
| Rate for Payer: PACE SWMI |
$2.21
|
| Rate for Payer: PHP Commercial |
$4.19
|
| Rate for Payer: PHP Medicare Advantage |
$2.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.44
|
| Rate for Payer: Priority Health Medicare |
$2.21
|
| Rate for Payer: Priority Health Narrow Network |
$5.15
|
| Rate for Payer: Priority Health SBD |
$3.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.21
|
| Rate for Payer: UHC Exchange |
$4.22
|
| Rate for Payer: UHC Medicare Advantage |
$2.21
|
| Rate for Payer: UHCCP Medicaid |
$1.18
|
| Rate for Payer: UMR Bronson Commercial |
$1.82
|
| Rate for Payer: VA VA |
$2.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.70
|
|
|
HUM PROTHROMBIN CPLX (PCC) 4FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION
|
Facility
|
IP
|
$4.93
|
|
|
Service Code
|
HCPCS J7168
|
| Hospital Charge Code |
170850
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.17 |
| Max. Negotiated Rate |
$4.44 |
| Rate for Payer: Aetna American Axle |
$3.20
|
| Rate for Payer: Aetna Commercial |
$4.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.20
|
| Rate for Payer: Cash Price |
$3.94
|
| Rate for Payer: Cofinity Commercial |
$3.45
|
| Rate for Payer: Cofinity Commercial |
$4.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.94
|
| Rate for Payer: Healthscope Commercial |
$4.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.19
|
| Rate for Payer: PHP Commercial |
$4.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.20
|
| Rate for Payer: Priority Health SBD |
$3.11
|
| Rate for Payer: UMR Bronson Commercial |
$2.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.70
|
|
|
HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION
|
Facility
|
OP
|
$166.66
|
|
|
Service Code
|
HCPCS J3473
|
| Hospital Charge Code |
76338
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$149.99 |
| Rate for Payer: Aetna American Axle |
$108.33
|
| Rate for Payer: Aetna Commercial |
$141.66
|
| Rate for Payer: Aetna Medicare |
$83.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.33
|
| Rate for Payer: BCBS Complete |
$66.66
|
| Rate for Payer: BCBS Trust/PPO |
$0.98
|
| Rate for Payer: BCN Commercial |
$0.98
|
| Rate for Payer: Cash Price |
$133.33
|
| Rate for Payer: Cash Price |
$133.33
|
| Rate for Payer: Cofinity Commercial |
$116.66
|
| Rate for Payer: Cofinity Commercial |
$143.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$116.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.33
|
| Rate for Payer: Healthscope Commercial |
$149.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.66
|
| Rate for Payer: PHP Commercial |
$141.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.33
|
| Rate for Payer: Priority Health SBD |
$105.00
|
| Rate for Payer: UMR Bronson Commercial |
$61.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.00
|
|
|
HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$166.66
|
|
|
Service Code
|
HCPCS J3473
|
| Hospital Charge Code |
76338
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$73.33 |
| Max. Negotiated Rate |
$149.99 |
| Rate for Payer: Aetna American Axle |
$108.33
|
| Rate for Payer: Aetna Commercial |
$141.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.33
|
| Rate for Payer: Cash Price |
$133.33
|
| Rate for Payer: Cofinity Commercial |
$116.66
|
| Rate for Payer: Cofinity Commercial |
$143.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$116.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.33
|
| Rate for Payer: Healthscope Commercial |
$149.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.66
|
| Rate for Payer: PHP Commercial |
$141.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.33
|
| Rate for Payer: Priority Health SBD |
$105.00
|
| Rate for Payer: UMR Bronson Commercial |
$73.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.00
|
|
|
HYDRALAZINE 100 MG TABLET
|
Facility
|
IP
|
$157.45
|
|
|
Service Code
|
NDC 23155083501
|
| Hospital Charge Code |
3699
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$69.28 |
| Max. Negotiated Rate |
$141.70 |
| Rate for Payer: Aetna American Axle |
$102.34
|
| Rate for Payer: Aetna Commercial |
$133.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.34
|
| Rate for Payer: Cash Price |
$125.96
|
| Rate for Payer: Cofinity Commercial |
$110.22
|
| Rate for Payer: Cofinity Commercial |
$135.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$110.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.96
|
| Rate for Payer: Healthscope Commercial |
$141.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$110.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.83
|
| Rate for Payer: PHP Commercial |
$133.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.34
|
| Rate for Payer: Priority Health SBD |
$99.19
|
| Rate for Payer: UMR Bronson Commercial |
$69.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.09
|
|
|
HYDRALAZINE 100 MG TABLET
|
Facility
|
OP
|
$157.45
|
|
|
Service Code
|
NDC 23155083501
|
| Hospital Charge Code |
3699
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$58.26 |
| Max. Negotiated Rate |
$141.70 |
| Rate for Payer: Aetna American Axle |
$102.34
|
| Rate for Payer: Aetna Commercial |
$133.83
|
| Rate for Payer: Aetna Medicare |
$78.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.34
|
| Rate for Payer: BCBS Complete |
$62.98
|
| Rate for Payer: Cash Price |
$125.96
|
| Rate for Payer: Cofinity Commercial |
$110.22
|
| Rate for Payer: Cofinity Commercial |
$135.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$110.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.96
|
| Rate for Payer: Healthscope Commercial |
$141.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$110.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.83
|
| Rate for Payer: PHP Commercial |
$133.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.34
|
| Rate for Payer: Priority Health SBD |
$99.19
|
| Rate for Payer: UMR Bronson Commercial |
$58.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.09
|
|
|
HYDRALAZINE 100 MG TABLET
|
Facility
|
IP
|
$225.15
|
|
|
Service Code
|
NDC 64380073606
|
| Hospital Charge Code |
3699
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.07 |
| Max. Negotiated Rate |
$202.64 |
| Rate for Payer: Aetna American Axle |
$146.35
|
| Rate for Payer: Aetna Commercial |
$191.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.35
|
| Rate for Payer: Cash Price |
$180.12
|
| Rate for Payer: Cofinity Commercial |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$193.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$157.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.12
|
| Rate for Payer: Healthscope Commercial |
$202.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.38
|
| Rate for Payer: PHP Commercial |
$191.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.35
|
| Rate for Payer: Priority Health SBD |
$141.84
|
| Rate for Payer: UMR Bronson Commercial |
$99.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.86
|
|
|
HYDRALAZINE 100 MG TABLET
|
Facility
|
IP
|
$310.20
|
|
|
Service Code
|
NDC 31722052201
|
| Hospital Charge Code |
3699
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$136.49 |
| Max. Negotiated Rate |
$279.18 |
| Rate for Payer: Aetna American Axle |
$201.63
|
| Rate for Payer: Aetna Commercial |
$263.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.63
|
| Rate for Payer: Cash Price |
$248.16
|
| Rate for Payer: Cofinity Commercial |
$217.14
|
| Rate for Payer: Cofinity Commercial |
$266.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$217.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.16
|
| Rate for Payer: Healthscope Commercial |
$279.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.67
|
| Rate for Payer: PHP Commercial |
$263.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.63
|
| Rate for Payer: Priority Health SBD |
$195.43
|
| Rate for Payer: UMR Bronson Commercial |
$136.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.65
|
|
|
HYDRALAZINE 100 MG TABLET
|
Facility
|
OP
|
$225.15
|
|
|
Service Code
|
NDC 64380073606
|
| Hospital Charge Code |
3699
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$83.31 |
| Max. Negotiated Rate |
$202.64 |
| Rate for Payer: Aetna American Axle |
$146.35
|
| Rate for Payer: Aetna Commercial |
$191.38
|
| Rate for Payer: Aetna Medicare |
$112.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.35
|
| Rate for Payer: BCBS Complete |
$90.06
|
| Rate for Payer: Cash Price |
$180.12
|
| Rate for Payer: Cofinity Commercial |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$193.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$157.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.12
|
| Rate for Payer: Healthscope Commercial |
$202.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.38
|
| Rate for Payer: PHP Commercial |
$191.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.35
|
| Rate for Payer: Priority Health SBD |
$141.84
|
| Rate for Payer: UMR Bronson Commercial |
$83.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.86
|
|
|
HYDRALAZINE 100 MG TABLET
|
Facility
|
IP
|
$453.55
|
|
|
Service Code
|
NDC 00904644361
|
| Hospital Charge Code |
3699
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$199.56 |
| Max. Negotiated Rate |
$408.20 |
| Rate for Payer: Aetna American Axle |
$294.81
|
| Rate for Payer: Aetna Commercial |
$385.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.81
|
| Rate for Payer: Cash Price |
$362.84
|
| Rate for Payer: Cofinity Commercial |
$317.48
|
| Rate for Payer: Cofinity Commercial |
$390.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$317.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.84
|
| Rate for Payer: Healthscope Commercial |
$408.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$317.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$340.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.52
|
| Rate for Payer: PHP Commercial |
$385.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.81
|
| Rate for Payer: Priority Health SBD |
$285.74
|
| Rate for Payer: UMR Bronson Commercial |
$199.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$340.16
|
|
|
HYDRALAZINE 100 MG TABLET
|
Facility
|
OP
|
$453.55
|
|
|
Service Code
|
NDC 00904644361
|
| Hospital Charge Code |
3699
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$167.81 |
| Max. Negotiated Rate |
$408.20 |
| Rate for Payer: Aetna American Axle |
$294.81
|
| Rate for Payer: Aetna Commercial |
$385.52
|
| Rate for Payer: Aetna Medicare |
$226.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.81
|
| Rate for Payer: BCBS Complete |
$181.42
|
| Rate for Payer: Cash Price |
$362.84
|
| Rate for Payer: Cofinity Commercial |
$317.48
|
| Rate for Payer: Cofinity Commercial |
$390.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$317.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.84
|
| Rate for Payer: Healthscope Commercial |
$408.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$317.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$340.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.52
|
| Rate for Payer: PHP Commercial |
$385.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.81
|
| Rate for Payer: Priority Health SBD |
$285.74
|
| Rate for Payer: UMR Bronson Commercial |
$167.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$340.16
|
|
|
HYDRALAZINE 100 MG TABLET
|
Facility
|
IP
|
$157.45
|
|
|
Service Code
|
NDC 23155000401
|
| Hospital Charge Code |
3699
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$69.28 |
| Max. Negotiated Rate |
$141.70 |
| Rate for Payer: Aetna American Axle |
$102.34
|
| Rate for Payer: Aetna Commercial |
$133.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.34
|
| Rate for Payer: Cash Price |
$125.96
|
| Rate for Payer: Cofinity Commercial |
$110.22
|
| Rate for Payer: Cofinity Commercial |
$135.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$110.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.96
|
| Rate for Payer: Healthscope Commercial |
$141.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$110.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.83
|
| Rate for Payer: PHP Commercial |
$133.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.34
|
| Rate for Payer: Priority Health SBD |
$99.19
|
| Rate for Payer: UMR Bronson Commercial |
$69.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.09
|
|
|
HYDRALAZINE 100 MG TABLET
|
Facility
|
OP
|
$310.20
|
|
|
Service Code
|
NDC 31722052201
|
| Hospital Charge Code |
3699
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$114.77 |
| Max. Negotiated Rate |
$279.18 |
| Rate for Payer: Aetna American Axle |
$201.63
|
| Rate for Payer: Aetna Commercial |
$263.67
|
| Rate for Payer: Aetna Medicare |
$155.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.63
|
| Rate for Payer: BCBS Complete |
$124.08
|
| Rate for Payer: Cash Price |
$248.16
|
| Rate for Payer: Cofinity Commercial |
$217.14
|
| Rate for Payer: Cofinity Commercial |
$266.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$217.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.16
|
| Rate for Payer: Healthscope Commercial |
$279.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.67
|
| Rate for Payer: PHP Commercial |
$263.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.63
|
| Rate for Payer: Priority Health SBD |
$195.43
|
| Rate for Payer: UMR Bronson Commercial |
$114.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.65
|
|
|
HYDRALAZINE 100 MG TABLET
|
Facility
|
OP
|
$157.45
|
|
|
Service Code
|
NDC 23155000401
|
| Hospital Charge Code |
3699
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$58.26 |
| Max. Negotiated Rate |
$141.70 |
| Rate for Payer: Aetna American Axle |
$102.34
|
| Rate for Payer: Aetna Commercial |
$133.83
|
| Rate for Payer: Aetna Medicare |
$78.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.34
|
| Rate for Payer: BCBS Complete |
$62.98
|
| Rate for Payer: Cash Price |
$125.96
|
| Rate for Payer: Cofinity Commercial |
$110.22
|
| Rate for Payer: Cofinity Commercial |
$135.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$110.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.96
|
| Rate for Payer: Healthscope Commercial |
$141.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$110.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.83
|
| Rate for Payer: PHP Commercial |
$133.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.34
|
| Rate for Payer: Priority Health SBD |
$99.19
|
| Rate for Payer: UMR Bronson Commercial |
$58.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.09
|
|
|
HYDRALAZINE 10 MG TABLET
|
Facility
|
OP
|
$3.93
|
|
|
Service Code
|
NDC 51079007401
|
| Hospital Charge Code |
3698
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$3.54 |
| Rate for Payer: Aetna American Axle |
$2.55
|
| Rate for Payer: Aetna Commercial |
$3.34
|
| Rate for Payer: Aetna Medicare |
$1.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.55
|
| Rate for Payer: BCBS Complete |
$1.57
|
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: Cofinity Commercial |
$2.75
|
| Rate for Payer: Cofinity Commercial |
$3.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.14
|
| Rate for Payer: Healthscope Commercial |
$3.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.34
|
| Rate for Payer: PHP Commercial |
$3.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.55
|
| Rate for Payer: Priority Health SBD |
$2.48
|
| Rate for Payer: UMR Bronson Commercial |
$1.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.95
|
|
|
HYDRALAZINE 10 MG TABLET
|
Facility
|
IP
|
$345.45
|
|
|
Service Code
|
NDC 68084044701
|
| Hospital Charge Code |
3698
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$152.00 |
| Max. Negotiated Rate |
$310.90 |
| Rate for Payer: Aetna American Axle |
$224.54
|
| Rate for Payer: Aetna Commercial |
$293.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.54
|
| Rate for Payer: Cash Price |
$276.36
|
| Rate for Payer: Cofinity Commercial |
$241.82
|
| Rate for Payer: Cofinity Commercial |
$297.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$241.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.36
|
| Rate for Payer: Healthscope Commercial |
$310.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.63
|
| Rate for Payer: PHP Commercial |
$293.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.54
|
| Rate for Payer: Priority Health SBD |
$217.63
|
| Rate for Payer: UMR Bronson Commercial |
$152.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.09
|
|
|
HYDRALAZINE 10 MG TABLET
|
Facility
|
OP
|
$345.45
|
|
|
Service Code
|
NDC 68084044711
|
| Hospital Charge Code |
3698
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$127.82 |
| Max. Negotiated Rate |
$310.90 |
| Rate for Payer: Aetna American Axle |
$224.54
|
| Rate for Payer: Aetna Commercial |
$293.63
|
| Rate for Payer: Aetna Medicare |
$172.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.54
|
| Rate for Payer: BCBS Complete |
$138.18
|
| Rate for Payer: Cash Price |
$276.36
|
| Rate for Payer: Cofinity Commercial |
$241.82
|
| Rate for Payer: Cofinity Commercial |
$297.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$241.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.36
|
| Rate for Payer: Healthscope Commercial |
$310.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.63
|
| Rate for Payer: PHP Commercial |
$293.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.54
|
| Rate for Payer: Priority Health SBD |
$217.63
|
| Rate for Payer: UMR Bronson Commercial |
$127.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.09
|
|
|
HYDRALAZINE 10 MG TABLET
|
Facility
|
IP
|
$3.93
|
|
|
Service Code
|
NDC 51079007401
|
| Hospital Charge Code |
3698
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.73 |
| Max. Negotiated Rate |
$3.54 |
| Rate for Payer: Aetna American Axle |
$2.55
|
| Rate for Payer: Aetna Commercial |
$3.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.55
|
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: Cofinity Commercial |
$2.75
|
| Rate for Payer: Cofinity Commercial |
$3.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.14
|
| Rate for Payer: Healthscope Commercial |
$3.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.34
|
| Rate for Payer: PHP Commercial |
$3.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.55
|
| Rate for Payer: Priority Health SBD |
$2.48
|
| Rate for Payer: UMR Bronson Commercial |
$1.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.95
|
|
|
HYDRALAZINE 10 MG TABLET
|
Facility
|
IP
|
$96.35
|
|
|
Service Code
|
NDC 31722051901
|
| Hospital Charge Code |
3698
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$42.39 |
| Max. Negotiated Rate |
$86.72 |
| Rate for Payer: Aetna American Axle |
$62.63
|
| Rate for Payer: Aetna Commercial |
$81.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.63
|
| Rate for Payer: Cash Price |
$77.08
|
| Rate for Payer: Cofinity Commercial |
$67.44
|
| Rate for Payer: Cofinity Commercial |
$82.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.08
|
| Rate for Payer: Healthscope Commercial |
$86.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.90
|
| Rate for Payer: PHP Commercial |
$81.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.63
|
| Rate for Payer: Priority Health SBD |
$60.70
|
| Rate for Payer: UMR Bronson Commercial |
$42.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.26
|
|
|
HYDRALAZINE 10 MG TABLET
|
Facility
|
OP
|
$96.35
|
|
|
Service Code
|
NDC 31722051901
|
| Hospital Charge Code |
3698
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$35.65 |
| Max. Negotiated Rate |
$86.72 |
| Rate for Payer: Aetna American Axle |
$62.63
|
| Rate for Payer: Aetna Commercial |
$81.90
|
| Rate for Payer: Aetna Medicare |
$48.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.63
|
| Rate for Payer: BCBS Complete |
$38.54
|
| Rate for Payer: Cash Price |
$77.08
|
| Rate for Payer: Cofinity Commercial |
$67.44
|
| Rate for Payer: Cofinity Commercial |
$82.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.08
|
| Rate for Payer: Healthscope Commercial |
$86.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.90
|
| Rate for Payer: PHP Commercial |
$81.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.63
|
| Rate for Payer: Priority Health SBD |
$60.70
|
| Rate for Payer: UMR Bronson Commercial |
$35.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.26
|
|
