|
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); PHALANX OF TOE
|
Facility
|
OP
|
$9,057.42
|
|
|
Service Code
|
CPT 28124
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$332.03 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$379.87
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,057.42
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$7,245.94
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$365.23
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$332.03
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); TALUS OR CALCANEUS
|
Facility
|
OP
|
$9,057.42
|
|
|
Service Code
|
CPT 28120
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$491.49 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$3,232.45
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,057.42
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$7,245.94
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$540.64
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$491.49
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); TARSAL OR METATARSAL BONE, EXCEPT TALUS OR CALCANEUS
|
Facility
|
OP
|
$9,057.42
|
|
|
Service Code
|
CPT 28122
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$435.50 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,642.96
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,057.42
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$7,245.94
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$479.05
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$435.50
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
PARTIAL HYMENECTOMY OR REVISION OF HYMENAL RING
|
Facility
|
OP
|
$8,748.29
|
|
|
Service Code
|
CPT 56700
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$201.38 |
| Max. Negotiated Rate |
$8,748.29 |
| Rate for Payer: Aetna Medicare |
$2,890.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,330.28
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,748.29
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$6,998.63
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.52
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,778.95
|
| Rate for Payer: UHC Exchange |
$201.38
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: VA VA |
$2,778.95
|
|
|
PARTIAL THYROID LOBECTOMY, UNILATERAL; WITH OR WITHOUT ISTHMUSECTOMY
|
Facility
|
OP
|
$16,145.72
|
|
|
Service Code
|
CPT 60210
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$698.43 |
| Max. Negotiated Rate |
$16,145.72 |
| Rate for Payer: Aetna Medicare |
$5,333.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,411.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,411.01
|
| Rate for Payer: BCBS Complete |
$2,945.99
|
| Rate for Payer: BCBS MAPPO |
$5,128.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,658.62
|
| Rate for Payer: BCN Medicare Advantage |
$5,128.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,128.81
|
| Rate for Payer: Mclaren Medicaid |
$2,805.46
|
| Rate for Payer: Mclaren Medicare |
$5,128.81
|
| Rate for Payer: Meridian Medicaid |
$2,945.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,385.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,898.13
|
| Rate for Payer: PACE Medicare |
$4,872.37
|
| Rate for Payer: PACE SWMI |
$5,128.81
|
| Rate for Payer: PHP Medicare Advantage |
$5,128.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,805.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,145.72
|
| Rate for Payer: Priority Health Medicare |
$5,128.81
|
| Rate for Payer: Priority Health Narrow Network |
$12,916.58
|
| Rate for Payer: Railroad Medicare Medicare |
$5,128.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$768.27
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,128.81
|
| Rate for Payer: UHC Exchange |
$698.43
|
| Rate for Payer: UHC Medicare Advantage |
$5,282.67
|
| Rate for Payer: VA VA |
$5,128.81
|
|
|
PATELLECTOMY OR HEMIPATELLECTOMY
|
Facility
|
OP
|
$20,018.71
|
|
|
Service Code
|
CPT 27350
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$653.57 |
| Max. Negotiated Rate |
$20,018.71 |
| Rate for Payer: Aetna Medicare |
$6,613.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,948.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,948.86
|
| Rate for Payer: BCBS Complete |
$3,652.66
|
| Rate for Payer: BCBS MAPPO |
$6,359.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,262.55
|
| Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
| Rate for Payer: Mclaren Medicaid |
$3,478.42
|
| Rate for Payer: Mclaren Medicare |
$6,359.09
|
| Rate for Payer: Meridian Medicaid |
$3,652.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,677.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,312.95
|
| Rate for Payer: PACE Medicare |
$6,041.14
|
| Rate for Payer: PACE SWMI |
$6,359.09
|
| Rate for Payer: PHP Medicare Advantage |
$6,359.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,478.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,018.71
|
| Rate for Payer: Priority Health Medicare |
$6,359.09
|
| Rate for Payer: Priority Health Narrow Network |
$16,014.97
|
| Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$718.93
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,359.09
|
| Rate for Payer: UHC Exchange |
$653.57
|
| Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
| Rate for Payer: VA VA |
$6,359.09
|
|
|
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC
|
Facility
|
IP
|
$25,199.36
|
|
|
Service Code
|
MS-DRG 543
|
| Min. Negotiated Rate |
$8,471.45 |
| Max. Negotiated Rate |
$25,199.36 |
| Rate for Payer: Aetna Medicare |
$9,274.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,146.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,146.65
|
| Rate for Payer: BCBS MAPPO |
$8,917.32
|
| Rate for Payer: BCBS Trust/PPO |
$25,199.36
|
| Rate for Payer: BCN Medicare Advantage |
$8,917.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,917.32
|
| Rate for Payer: Mclaren Medicare |
$8,917.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,363.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,254.92
|
| Rate for Payer: PACE Medicare |
$8,471.45
|
| Rate for Payer: PACE SWMI |
$8,917.32
|
| Rate for Payer: PHP Medicare Advantage |
$8,917.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,651.46
|
| Rate for Payer: Priority Health Medicare |
$8,917.32
|
| Rate for Payer: Priority Health Narrow Network |
$12,521.17
|
| Rate for Payer: Railroad Medicare Medicare |
$8,917.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,637.54
|
| Rate for Payer: UHC Core |
$13,642.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,917.32
|
| Rate for Payer: UHC Exchange |
$10,845.92
|
| Rate for Payer: UHC Medicare Advantage |
$9,184.84
|
| Rate for Payer: VA VA |
$8,917.32
|
|
|
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC
|
Facility
|
IP
|
$48,114.50
|
|
|
Service Code
|
MS-DRG 542
|
| Min. Negotiated Rate |
$13,837.56 |
| Max. Negotiated Rate |
$48,114.50 |
| Rate for Payer: Aetna Medicare |
$15,148.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,207.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,207.31
|
| Rate for Payer: BCBS MAPPO |
$14,565.85
|
| Rate for Payer: BCBS Trust/PPO |
$48,114.50
|
| Rate for Payer: BCN Medicare Advantage |
$14,565.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,565.85
|
| Rate for Payer: Mclaren Medicare |
$14,565.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15,294.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,750.73
|
| Rate for Payer: PACE Medicare |
$13,837.56
|
| Rate for Payer: PACE SWMI |
$14,565.85
|
| Rate for Payer: PHP Medicare Advantage |
$14,565.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26,169.95
|
| Rate for Payer: Priority Health Medicare |
$14,565.85
|
| Rate for Payer: Priority Health Narrow Network |
$20,935.96
|
| Rate for Payer: Railroad Medicare Medicare |
$14,565.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27,818.72
|
| Rate for Payer: UHC Core |
$22,810.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,565.85
|
| Rate for Payer: UHC Exchange |
$18,134.87
|
| Rate for Payer: UHC Medicare Advantage |
$15,002.83
|
| Rate for Payer: VA VA |
$14,565.85
|
|
|
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$18,721.11
|
|
|
Service Code
|
MS-DRG 544
|
| Min. Negotiated Rate |
$6,105.39 |
| Max. Negotiated Rate |
$18,721.11 |
| Rate for Payer: Aetna Medicare |
$6,683.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,033.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,033.41
|
| Rate for Payer: BCBS MAPPO |
$6,426.73
|
| Rate for Payer: BCBS Trust/PPO |
$18,721.11
|
| Rate for Payer: BCN Medicare Advantage |
$6,426.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,426.73
|
| Rate for Payer: Mclaren Medicare |
$6,426.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,748.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,390.74
|
| Rate for Payer: PACE Medicare |
$6,105.39
|
| Rate for Payer: PACE SWMI |
$6,426.73
|
| Rate for Payer: PHP Medicare Advantage |
$6,426.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,013.56
|
| Rate for Payer: Priority Health Medicare |
$6,426.73
|
| Rate for Payer: Priority Health Narrow Network |
$8,810.85
|
| Rate for Payer: Railroad Medicare Medicare |
$6,426.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,707.45
|
| Rate for Payer: UHC Core |
$9,599.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,426.73
|
| Rate for Payer: UHC Exchange |
$7,632.02
|
| Rate for Payer: UHC Medicare Advantage |
$6,619.53
|
| Rate for Payer: VA VA |
$6,426.73
|
|
|
PATIROMER CALCIUM SORBITEX 8.4 GRAM ORAL POWDER PACKET
|
Facility
|
IP
|
$3,304.59
|
|
|
Service Code
|
NDC 53436-084-30
|
| Hospital Charge Code |
176467
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,454.02 |
| Max. Negotiated Rate |
$2,974.13 |
| Rate for Payer: Aetna American Axle |
$2,147.98
|
| Rate for Payer: Aetna Commercial |
$2,808.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,147.98
|
| Rate for Payer: Cash Price |
$2,643.67
|
| Rate for Payer: Cofinity Commercial |
$2,313.21
|
| Rate for Payer: Cofinity Commercial |
$2,841.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,643.67
|
| Rate for Payer: Healthscope Commercial |
$2,974.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,313.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,478.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,808.90
|
| Rate for Payer: PHP Commercial |
$2,808.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,313.21
|
| Rate for Payer: Priority Health SBD |
$2,081.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,454.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,478.44
|
|
|
PATIROMER CALCIUM SORBITEX 8.4 GRAM ORAL POWDER PACKET
|
Facility
|
IP
|
$588.79
|
|
|
Service Code
|
NDC 53436-084-04
|
| Hospital Charge Code |
176467
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$259.07 |
| Max. Negotiated Rate |
$529.91 |
| Rate for Payer: Aetna American Axle |
$382.71
|
| Rate for Payer: Aetna Commercial |
$500.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.71
|
| Rate for Payer: Cash Price |
$471.03
|
| Rate for Payer: Cofinity Commercial |
$412.15
|
| Rate for Payer: Cofinity Commercial |
$506.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$471.03
|
| Rate for Payer: Healthscope Commercial |
$529.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$412.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.47
|
| Rate for Payer: PHP Commercial |
$500.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.15
|
| Rate for Payer: Priority Health SBD |
$370.94
|
| Rate for Payer: UMR Bronson Commercial |
$259.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.59
|
|
|
PATIROMER CALCIUM SORBITEX 8.4 GRAM ORAL POWDER PACKET
|
Facility
|
IP
|
$110.16
|
|
|
Service Code
|
NDC 53436-084-01
|
| Hospital Charge Code |
176467
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.47 |
| Max. Negotiated Rate |
$99.14 |
| Rate for Payer: Aetna American Axle |
$71.60
|
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.60
|
| Rate for Payer: Cash Price |
$88.13
|
| Rate for Payer: Cofinity Commercial |
$77.11
|
| Rate for Payer: Cofinity Commercial |
$94.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.13
|
| Rate for Payer: Healthscope Commercial |
$99.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.64
|
| Rate for Payer: PHP Commercial |
$93.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.11
|
| Rate for Payer: Priority Health SBD |
$69.40
|
| Rate for Payer: UMR Bronson Commercial |
$48.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.62
|
|
|
PATISIRAN (LIPID COMPLEX) 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$25,441.00
|
|
|
Service Code
|
HCPCS J0222
|
| Hospital Charge Code |
188116
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11,194.04 |
| Max. Negotiated Rate |
$22,896.90 |
| Rate for Payer: Aetna American Axle |
$16,536.65
|
| Rate for Payer: Aetna Commercial |
$21,624.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16,536.65
|
| Rate for Payer: Cash Price |
$20,352.80
|
| Rate for Payer: Cofinity Commercial |
$17,808.70
|
| Rate for Payer: Cofinity Commercial |
$21,879.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,352.80
|
| Rate for Payer: Healthscope Commercial |
$22,896.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,808.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19,080.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21,624.85
|
| Rate for Payer: PHP Commercial |
$21,624.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,808.70
|
| Rate for Payer: Priority Health SBD |
$16,027.83
|
| Rate for Payer: UMR Bronson Commercial |
$11,194.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19,080.75
|
|
|
PATISIRAN (LIPID COMPLEX) 2 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$25,441.00
|
|
|
Service Code
|
HCPCS J0222
|
| Hospital Charge Code |
188116
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$54.69 |
| Max. Negotiated Rate |
$22,896.90 |
| Rate for Payer: Aetna American Axle |
$16,536.65
|
| Rate for Payer: Aetna Commercial |
$21,624.85
|
| Rate for Payer: Aetna Medicare |
$103.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16,536.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$124.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$124.97
|
| Rate for Payer: BCBS Complete |
$57.43
|
| Rate for Payer: BCBS MAPPO |
$99.98
|
| Rate for Payer: BCBS Trust/PPO |
$323.07
|
| Rate for Payer: BCN Medicare Advantage |
$99.98
|
| Rate for Payer: Cash Price |
$20,352.80
|
| Rate for Payer: Cash Price |
$20,352.80
|
| Rate for Payer: Cofinity Commercial |
$17,808.70
|
| Rate for Payer: Cofinity Commercial |
$21,879.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,352.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.98
|
| Rate for Payer: Healthscope Commercial |
$22,896.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,808.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19,080.75
|
| Rate for Payer: Mclaren Medicaid |
$54.69
|
| Rate for Payer: Mclaren Medicare |
$99.98
|
| Rate for Payer: Meridian Medicaid |
$57.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$104.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21,624.85
|
| Rate for Payer: PACE Medicare |
$94.98
|
| Rate for Payer: PACE SWMI |
$99.98
|
| Rate for Payer: PHP Commercial |
$21,624.85
|
| Rate for Payer: PHP Medicare Advantage |
$99.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,808.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$294.20
|
| Rate for Payer: Priority Health Medicare |
$99.98
|
| Rate for Payer: Priority Health Narrow Network |
$235.36
|
| Rate for Payer: Priority Health SBD |
$16,027.83
|
| Rate for Payer: Railroad Medicare Medicare |
$99.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.98
|
| Rate for Payer: UHC Medicare Advantage |
$102.98
|
| Rate for Payer: UMR Bronson Commercial |
$9,413.17
|
| Rate for Payer: VA VA |
$99.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19,080.75
|
|
|
PEDIATRIC CHEWABLE MULTIVITAMIN WITH MINERALS TABLET WRAPPER
|
Facility
|
IP
|
$77.55
|
|
|
Service Code
|
NDC 9629512826
|
| Hospital Charge Code |
301519
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$34.12 |
| Max. Negotiated Rate |
$69.80 |
| Rate for Payer: Aetna American Axle |
$50.41
|
| Rate for Payer: Aetna Commercial |
$65.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.41
|
| Rate for Payer: Cash Price |
$62.04
|
| Rate for Payer: Cofinity Commercial |
$54.28
|
| Rate for Payer: Cofinity Commercial |
$66.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.04
|
| Rate for Payer: Healthscope Commercial |
$69.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.92
|
| Rate for Payer: PHP Commercial |
$65.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.28
|
| Rate for Payer: Priority Health SBD |
$48.86
|
| Rate for Payer: UMR Bronson Commercial |
$34.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.16
|
|
|
PEDIATRIC COMPLEAT CUSTOM
|
Facility
|
IP
|
$6.00
|
|
|
Service Code
|
NDC 4390014240
|
| Hospital Charge Code |
180159
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.64 |
| Max. Negotiated Rate |
$5.40 |
| Rate for Payer: Aetna American Axle |
$3.90
|
| Rate for Payer: Aetna Commercial |
$5.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.90
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$5.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.80
|
| Rate for Payer: Healthscope Commercial |
$5.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5.10
|
| Rate for Payer: PHP Commercial |
$5.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.20
|
| Rate for Payer: Priority Health SBD |
$3.78
|
| Rate for Payer: UMR Bronson Commercial |
$2.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.50
|
|
|
PEDIATRIC MULTIVITAMIN CHEWABLE TABLET
|
Facility
|
IP
|
$197.40
|
|
|
Service Code
|
NDC 1650008619
|
| Hospital Charge Code |
17687
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$86.86 |
| Max. Negotiated Rate |
$177.66 |
| Rate for Payer: Aetna American Axle |
$128.31
|
| Rate for Payer: Aetna Commercial |
$167.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.31
|
| Rate for Payer: Cash Price |
$157.92
|
| Rate for Payer: Cofinity Commercial |
$138.18
|
| Rate for Payer: Cofinity Commercial |
$169.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.92
|
| Rate for Payer: Healthscope Commercial |
$177.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$167.79
|
| Rate for Payer: PHP Commercial |
$167.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.18
|
| Rate for Payer: Priority Health SBD |
$124.36
|
| Rate for Payer: UMR Bronson Commercial |
$86.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.05
|
|
|
PEDIATRIC MULTIVITAMIN NO.118 ORAL LIQUID
|
Facility
|
IP
|
$10.58
|
|
|
Service Code
|
NDC 9900-0018-51
|
| Hospital Charge Code |
175996
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.66 |
| Max. Negotiated Rate |
$9.52 |
| Rate for Payer: Aetna American Axle |
$6.88
|
| Rate for Payer: Aetna Commercial |
$8.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.88
|
| Rate for Payer: Cash Price |
$8.46
|
| Rate for Payer: Cofinity Commercial |
$7.41
|
| Rate for Payer: Cofinity Commercial |
$9.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.46
|
| Rate for Payer: Healthscope Commercial |
$9.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.99
|
| Rate for Payer: PHP Commercial |
$8.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.41
|
| Rate for Payer: Priority Health SBD |
$6.67
|
| Rate for Payer: UMR Bronson Commercial |
$4.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.94
|
|
|
PEDIATRIC MULTIVITAMIN NO.118 ORAL LIQUID
|
Facility
|
IP
|
$167.09
|
|
|
Service Code
|
NDC 7985408009
|
| Hospital Charge Code |
175996
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$73.52 |
| Max. Negotiated Rate |
$150.38 |
| Rate for Payer: Aetna American Axle |
$108.61
|
| Rate for Payer: Aetna Commercial |
$142.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.61
|
| Rate for Payer: Cash Price |
$133.67
|
| Rate for Payer: Cofinity Commercial |
$116.96
|
| Rate for Payer: Cofinity Commercial |
$143.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.67
|
| Rate for Payer: Healthscope Commercial |
$150.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.03
|
| Rate for Payer: PHP Commercial |
$142.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.96
|
| Rate for Payer: Priority Health SBD |
$105.27
|
| Rate for Payer: UMR Bronson Commercial |
$73.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.32
|
|
|
PEDIATRIC MULTIVITAMIN NO.118 ORAL LIQUID
|
Facility
|
IP
|
$189.37
|
|
|
Service Code
|
NDC 54629-0800-98
|
| Hospital Charge Code |
175996
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$83.32 |
| Max. Negotiated Rate |
$170.43 |
| Rate for Payer: Aetna American Axle |
$123.09
|
| Rate for Payer: Aetna Commercial |
$160.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.09
|
| Rate for Payer: Cash Price |
$151.50
|
| Rate for Payer: Cofinity Commercial |
$132.56
|
| Rate for Payer: Cofinity Commercial |
$162.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.50
|
| Rate for Payer: Healthscope Commercial |
$170.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$132.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$160.96
|
| Rate for Payer: PHP Commercial |
$160.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.56
|
| Rate for Payer: Priority Health SBD |
$119.30
|
| Rate for Payer: UMR Bronson Commercial |
$83.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.03
|
|
|
PEDIATRIC MULTIVITAMIN NO.128-VITAMIN K 500 MCG/ML ORAL LIQUID
|
Facility
|
IP
|
$148.32
|
|
|
Service Code
|
NDC 6817600010
|
| Hospital Charge Code |
176647
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$65.26 |
| Max. Negotiated Rate |
$133.49 |
| Rate for Payer: Aetna American Axle |
$96.41
|
| Rate for Payer: Aetna Commercial |
$126.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.41
|
| Rate for Payer: Cash Price |
$118.66
|
| Rate for Payer: Cofinity Commercial |
$103.82
|
| Rate for Payer: Cofinity Commercial |
$127.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.66
|
| Rate for Payer: Healthscope Commercial |
$133.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$126.07
|
| Rate for Payer: PHP Commercial |
$126.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.82
|
| Rate for Payer: Priority Health SBD |
$93.44
|
| Rate for Payer: UMR Bronson Commercial |
$65.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.24
|
|
|
PEDIATRIC MULTIVITAMIN NO.189-FERROUS SULFATE 11 MG/ML ORAL DROPS
|
Facility
|
IP
|
$101.18
|
|
|
Service Code
|
NDC 87040501
|
| Hospital Charge Code |
194037
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$44.52 |
| Max. Negotiated Rate |
$91.06 |
| Rate for Payer: Aetna American Axle |
$65.77
|
| Rate for Payer: Aetna Commercial |
$86.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.77
|
| Rate for Payer: Cash Price |
$80.94
|
| Rate for Payer: Cofinity Commercial |
$70.83
|
| Rate for Payer: Cofinity Commercial |
$87.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.94
|
| Rate for Payer: Healthscope Commercial |
$91.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.00
|
| Rate for Payer: PHP Commercial |
$86.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.83
|
| Rate for Payer: Priority Health SBD |
$63.74
|
| Rate for Payer: UMR Bronson Commercial |
$44.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.88
|
|
|
PEDIATRIC MULTIVITAMIN NO.192 250 MCG-50 MG-10 MCG/ML ORAL DROPS
|
Facility
|
IP
|
$101.18
|
|
|
Service Code
|
NDC 87040203
|
| Hospital Charge Code |
194364
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$44.52 |
| Max. Negotiated Rate |
$91.06 |
| Rate for Payer: Aetna American Axle |
$65.77
|
| Rate for Payer: Aetna Commercial |
$86.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.77
|
| Rate for Payer: Cash Price |
$80.94
|
| Rate for Payer: Cofinity Commercial |
$70.83
|
| Rate for Payer: Cofinity Commercial |
$87.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.94
|
| Rate for Payer: Healthscope Commercial |
$91.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.00
|
| Rate for Payer: PHP Commercial |
$86.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.83
|
| Rate for Payer: Priority Health SBD |
$63.74
|
| Rate for Payer: UMR Bronson Commercial |
$44.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.88
|
|
|
PEDIATRIC NUTRITION, IRON, LF-FIBER 0.03 GRAM-0.6 KCAL/ML ORAL LIQUID
|
Facility
|
IP
|
$5.69
|
|
|
Service Code
|
NDC 7007467613
|
| Hospital Charge Code |
120007
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.50 |
| Max. Negotiated Rate |
$5.12 |
| Rate for Payer: Aetna American Axle |
$3.70
|
| Rate for Payer: Aetna Commercial |
$4.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.70
|
| Rate for Payer: Cash Price |
$4.55
|
| Rate for Payer: Cofinity Commercial |
$3.98
|
| Rate for Payer: Cofinity Commercial |
$4.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.55
|
| Rate for Payer: Healthscope Commercial |
$5.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.84
|
| Rate for Payer: PHP Commercial |
$4.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.98
|
| Rate for Payer: Priority Health SBD |
$3.58
|
| Rate for Payer: UMR Bronson Commercial |
$2.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.27
|
|
|
PEDS ECHO LIMITED W/DEFINITY
|
Facility
|
OP
|
$1,356.97
|
|
|
Service Code
|
HCPCS C8922
|
| Hospital Charge Code |
48000029
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$389.31 |
| Max. Negotiated Rate |
$2,240.48 |
| Rate for Payer: Aetna American Axle |
$882.03
|
| Rate for Payer: Aetna Commercial |
$1,153.42
|
| Rate for Payer: Aetna Medicare |
$740.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$882.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$889.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$889.64
|
| Rate for Payer: BCBS Complete |
$408.81
|
| Rate for Payer: BCBS MAPPO |
$711.71
|
| Rate for Payer: BCBS Trust/PPO |
$888.23
|
| Rate for Payer: BCN Medicare Advantage |
$711.71
|
| Rate for Payer: Cash Price |
$1,085.58
|
| Rate for Payer: Cash Price |
$1,085.58
|
| Rate for Payer: Cash Price |
$1,085.58
|
| Rate for Payer: Cofinity Commercial |
$949.88
|
| Rate for Payer: Cofinity Commercial |
$1,166.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,085.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$711.71
|
| Rate for Payer: Healthscope Commercial |
$1,221.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$949.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,017.73
|
| Rate for Payer: Mclaren Medicaid |
$389.31
|
| Rate for Payer: Mclaren Medicare |
$711.71
|
| Rate for Payer: Meridian Medicaid |
$408.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$747.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$818.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,153.42
|
| Rate for Payer: PACE Medicare |
$676.12
|
| Rate for Payer: PACE SWMI |
$711.71
|
| Rate for Payer: PHP Commercial |
$1,153.42
|
| Rate for Payer: PHP Medicare Advantage |
$711.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$949.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,240.48
|
| Rate for Payer: Priority Health Medicare |
$711.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,792.38
|
| Rate for Payer: Priority Health SBD |
$854.89
|
| Rate for Payer: Railroad Medicare Medicare |
$711.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,995.42
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$711.71
|
| Rate for Payer: UHC Exchange |
$1,360.15
|
| Rate for Payer: UHC Medicare Advantage |
$733.06
|
| Rate for Payer: UMR Bronson Commercial |
$502.08
|
| Rate for Payer: VA VA |
$711.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,017.73
|
|
