|
IPL CHEST FIRST
|
Professional
|
Both
|
$315.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: Aetna Medicare |
$157.50
|
| Rate for Payer: BCBS Complete |
$126.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
| Rate for Payer: UMR Bronson Commercial |
$144.90
|
|
|
IPL CHEST SECOND
|
Professional
|
Both
|
$210.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Medicare |
$105.00
|
| Rate for Payer: BCBS Complete |
$84.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: UMR Bronson Commercial |
$96.60
|
|
|
IPL FACE FIRST
|
Professional
|
Both
|
$237.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$94.80 |
| Max. Negotiated Rate |
$177.75 |
| Rate for Payer: Aetna Medicare |
$118.50
|
| Rate for Payer: BCBS Complete |
$94.80
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.75
|
| Rate for Payer: UMR Bronson Commercial |
$109.02
|
|
|
IPL FACE, NECK, CHEST FIRST
|
Professional
|
Both
|
$420.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$168.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna Medicare |
$210.00
|
| Rate for Payer: BCBS Complete |
$168.00
|
| Rate for Payer: Cash Price |
$336.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$315.00
|
| Rate for Payer: UMR Bronson Commercial |
$193.20
|
|
|
IPL FACE, NECK, CHEST SECOND
|
Professional
|
Both
|
$289.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$115.60 |
| Max. Negotiated Rate |
$216.75 |
| Rate for Payer: Aetna Medicare |
$144.50
|
| Rate for Payer: BCBS Complete |
$115.60
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.75
|
| Rate for Payer: UMR Bronson Commercial |
$132.94
|
|
|
IPL FACE & NECK FIRST
|
Professional
|
Both
|
$263.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$105.20 |
| Max. Negotiated Rate |
$197.25 |
| Rate for Payer: Aetna Medicare |
$131.50
|
| Rate for Payer: BCBS Complete |
$105.20
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
| Rate for Payer: UMR Bronson Commercial |
$120.98
|
|
|
IPL FACE & NECK SECOND
|
Professional
|
Both
|
$184.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$73.60 |
| Max. Negotiated Rate |
$138.00 |
| Rate for Payer: Aetna Medicare |
$92.00
|
| Rate for Payer: BCBS Complete |
$73.60
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.00
|
| Rate for Payer: UMR Bronson Commercial |
$84.64
|
|
|
IPL FACE SECOND
|
Professional
|
Both
|
$105.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$78.75 |
| Rate for Payer: Aetna Medicare |
$52.50
|
| Rate for Payer: BCBS Complete |
$42.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
| Rate for Payer: UMR Bronson Commercial |
$48.30
|
|
|
IPL HANDS & ARMS FIRST
|
Professional
|
Both
|
$368.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$147.20 |
| Max. Negotiated Rate |
$276.00 |
| Rate for Payer: Aetna Medicare |
$184.00
|
| Rate for Payer: BCBS Complete |
$147.20
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.00
|
| Rate for Payer: UMR Bronson Commercial |
$169.28
|
|
|
IPL HANDS & ARMS SECOND
|
Professional
|
Both
|
$237.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$94.80 |
| Max. Negotiated Rate |
$177.75 |
| Rate for Payer: Aetna Medicare |
$118.50
|
| Rate for Payer: BCBS Complete |
$94.80
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.75
|
| Rate for Payer: UMR Bronson Commercial |
$109.02
|
|
|
IPL NECK
|
Professional
|
Both
|
$105.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$78.75 |
| Rate for Payer: Aetna Medicare |
$52.50
|
| Rate for Payer: BCBS Complete |
$42.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
| Rate for Payer: UMR Bronson Commercial |
$48.30
|
|
|
IPL NOSE & CHEEKS FIRST
|
Professional
|
Both
|
$158.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$63.20 |
| Max. Negotiated Rate |
$118.50 |
| Rate for Payer: Aetna Medicare |
$79.00
|
| Rate for Payer: BCBS Complete |
$63.20
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
| Rate for Payer: UMR Bronson Commercial |
$72.68
|
|
|
IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN
|
Facility
|
OP
|
$2.90
|
|
|
Service Code
|
HCPCS J7620
|
| Hospital Charge Code |
30510
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$2.61 |
| Rate for Payer: Aetna American Axle |
$1.89
|
| Rate for Payer: Aetna American Axle |
$2.10
|
| Rate for Payer: Aetna American Axle |
$1.73
|
| Rate for Payer: Aetna American Axle |
$2.30
|
| Rate for Payer: Aetna American Axle |
$1.95
|
| Rate for Payer: Aetna American Axle |
$2.87
|
| Rate for Payer: Aetna American Axle |
$1.89
|
| Rate for Payer: Aetna American Axle |
$2.89
|
| Rate for Payer: Aetna Commercial |
$2.47
|
| Rate for Payer: Aetna Commercial |
$2.26
|
| Rate for Payer: Aetna Commercial |
$2.46
|
| Rate for Payer: Aetna Commercial |
$2.55
|
| Rate for Payer: Aetna Commercial |
$3.78
|
| Rate for Payer: Aetna Commercial |
$2.75
|
| Rate for Payer: Aetna Commercial |
$3.01
|
| Rate for Payer: Aetna Commercial |
$3.76
|
| Rate for Payer: Aetna Medicare |
$1.50
|
| Rate for Payer: Aetna Medicare |
$1.45
|
| Rate for Payer: Aetna Medicare |
$1.33
|
| Rate for Payer: Aetna Medicare |
$1.46
|
| Rate for Payer: Aetna Medicare |
$2.23
|
| Rate for Payer: Aetna Medicare |
$2.21
|
| Rate for Payer: Aetna Medicare |
$1.77
|
| Rate for Payer: Aetna Medicare |
$1.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.95
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: BCBS Complete |
$1.16
|
| Rate for Payer: BCBS Complete |
$1.42
|
| Rate for Payer: BCBS Complete |
$1.06
|
| Rate for Payer: BCBS Complete |
$1.29
|
| Rate for Payer: BCBS Complete |
$1.78
|
| Rate for Payer: BCBS Complete |
$1.77
|
| Rate for Payer: BCBS Complete |
$1.16
|
| Rate for Payer: Cash Price |
$2.13
|
| Rate for Payer: Cash Price |
$2.13
|
| Rate for Payer: Cash Price |
$2.33
|
| Rate for Payer: Cash Price |
$3.56
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.32
|
| Rate for Payer: Cash Price |
$2.33
|
| Rate for Payer: Cash Price |
$3.56
|
| Rate for Payer: Cash Price |
$3.54
|
| Rate for Payer: Cash Price |
$3.54
|
| Rate for Payer: Cash Price |
$2.83
|
| Rate for Payer: Cash Price |
$2.83
|
| Rate for Payer: Cash Price |
$2.58
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.58
|
| Rate for Payer: Cash Price |
$2.32
|
| Rate for Payer: Cofinity Advantage |
$3.09
|
| Rate for Payer: Cofinity Advantage |
$3.12
|
| Rate for Payer: Cofinity Advantage |
$2.03
|
| Rate for Payer: Cofinity Advantage |
$2.10
|
| Rate for Payer: Cofinity Advantage |
$1.86
|
| Rate for Payer: Cofinity Advantage |
$2.26
|
| Rate for Payer: Cofinity Advantage |
$2.48
|
| Rate for Payer: Cofinity Advantage |
$2.04
|
| Rate for Payer: Cofinity Commercial |
$2.29
|
| Rate for Payer: Cofinity Commercial |
$2.49
|
| Rate for Payer: Cofinity Commercial |
$2.50
|
| Rate for Payer: Cofinity Commercial |
$2.58
|
| Rate for Payer: Cofinity Commercial |
$2.78
|
| Rate for Payer: Cofinity Commercial |
$3.04
|
| Rate for Payer: Cofinity Commercial |
$3.80
|
| Rate for Payer: Cofinity Commercial |
$3.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.58
|
| Rate for Payer: Healthscope Commercial |
$2.70
|
| Rate for Payer: Healthscope Commercial |
$4.00
|
| Rate for Payer: Healthscope Commercial |
$3.19
|
| Rate for Payer: Healthscope Commercial |
$2.61
|
| Rate for Payer: Healthscope Commercial |
$2.62
|
| Rate for Payer: Healthscope Commercial |
$2.39
|
| Rate for Payer: Healthscope Commercial |
$3.98
|
| Rate for Payer: Healthscope Commercial |
$2.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.65
|
| Rate for Payer: PHP Commercial |
$2.26
|
| Rate for Payer: PHP Commercial |
$3.78
|
| Rate for Payer: PHP Commercial |
$2.55
|
| Rate for Payer: PHP Commercial |
$2.47
|
| Rate for Payer: PHP Commercial |
$2.75
|
| Rate for Payer: PHP Commercial |
$3.76
|
| Rate for Payer: PHP Commercial |
$2.46
|
| Rate for Payer: PHP Commercial |
$3.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.20
|
| Rate for Payer: Priority Health SBD |
$2.23
|
| Rate for Payer: Priority Health SBD |
$1.83
|
| Rate for Payer: Priority Health SBD |
$1.83
|
| Rate for Payer: Priority Health SBD |
$1.68
|
| Rate for Payer: Priority Health SBD |
$2.78
|
| Rate for Payer: Priority Health SBD |
$1.89
|
| Rate for Payer: Priority Health SBD |
$2.03
|
| Rate for Payer: Priority Health SBD |
$2.80
|
| Rate for Payer: Priority Health Tiered Network |
$0.16
|
| Rate for Payer: Priority Health Tiered Network |
$0.16
|
| Rate for Payer: Priority Health Tiered Network |
$0.16
|
| Rate for Payer: Priority Health Tiered Network |
$0.16
|
| Rate for Payer: Priority Health Tiered Network |
$0.16
|
| Rate for Payer: Priority Health Tiered Network |
$0.16
|
| Rate for Payer: Priority Health Tiered Network |
$0.16
|
| Rate for Payer: Priority Health Tiered Network |
$0.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.10
|
| Rate for Payer: UHC Core |
$1.68
|
| Rate for Payer: UHC Core |
$1.52
|
| Rate for Payer: UHC Core |
$2.32
|
| Rate for Payer: UHC Core |
$1.56
|
| Rate for Payer: UHC Core |
$2.30
|
| Rate for Payer: UHC Core |
$1.84
|
| Rate for Payer: UHC Core |
$1.39
|
| Rate for Payer: UHC Core |
$1.51
|
| Rate for Payer: UHC Exchange |
$1.14
|
| Rate for Payer: UHC Exchange |
$1.39
|
| Rate for Payer: UHC Exchange |
$1.75
|
| Rate for Payer: UHC Exchange |
$1.27
|
| Rate for Payer: UHC Exchange |
$1.74
|
| Rate for Payer: UHC Exchange |
$1.18
|
| Rate for Payer: UHC Exchange |
$1.14
|
| Rate for Payer: UHC Exchange |
$1.05
|
| Rate for Payer: UMR Bronson Commercial |
$1.11
|
| Rate for Payer: UMR Bronson Commercial |
$1.08
|
| Rate for Payer: UMR Bronson Commercial |
$1.20
|
| Rate for Payer: UMR Bronson Commercial |
$1.31
|
| Rate for Payer: UMR Bronson Commercial |
$1.65
|
| Rate for Payer: UMR Bronson Commercial |
$0.98
|
| Rate for Payer: UMR Bronson Commercial |
$1.07
|
| Rate for Payer: UMR Bronson Commercial |
$1.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.18
|
|
|
IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN
|
Facility
|
IP
|
$3.00
|
|
|
Service Code
|
HCPCS J7620
|
| Hospital Charge Code |
30510
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.32 |
| Max. Negotiated Rate |
$2.70 |
| Rate for Payer: Aetna American Axle |
$1.95
|
| Rate for Payer: Aetna American Axle |
$2.30
|
| Rate for Payer: Aetna American Axle |
$2.87
|
| Rate for Payer: Aetna American Axle |
$1.73
|
| Rate for Payer: Aetna American Axle |
$1.89
|
| Rate for Payer: Aetna American Axle |
$1.89
|
| Rate for Payer: Aetna American Axle |
$2.89
|
| Rate for Payer: Aetna American Axle |
$2.10
|
| Rate for Payer: Aetna Commercial |
$3.78
|
| Rate for Payer: Aetna Commercial |
$3.76
|
| Rate for Payer: Aetna Commercial |
$2.55
|
| Rate for Payer: Aetna Commercial |
$2.26
|
| Rate for Payer: Aetna Commercial |
$2.46
|
| Rate for Payer: Aetna Commercial |
$3.01
|
| Rate for Payer: Aetna Commercial |
$2.47
|
| Rate for Payer: Aetna Commercial |
$2.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.30
|
| Rate for Payer: Cash Price |
$2.32
|
| Rate for Payer: Cash Price |
$3.56
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.13
|
| Rate for Payer: Cash Price |
$2.33
|
| Rate for Payer: Cash Price |
$2.58
|
| Rate for Payer: Cash Price |
$2.83
|
| Rate for Payer: Cash Price |
$3.54
|
| Rate for Payer: Cofinity Advantage |
$3.12
|
| Rate for Payer: Cofinity Advantage |
$2.03
|
| Rate for Payer: Cofinity Advantage |
$2.10
|
| Rate for Payer: Cofinity Advantage |
$2.04
|
| Rate for Payer: Cofinity Advantage |
$1.86
|
| Rate for Payer: Cofinity Advantage |
$2.48
|
| Rate for Payer: Cofinity Advantage |
$3.09
|
| Rate for Payer: Cofinity Advantage |
$2.26
|
| Rate for Payer: Cofinity Commercial |
$2.49
|
| Rate for Payer: Cofinity Commercial |
$2.29
|
| Rate for Payer: Cofinity Commercial |
$2.50
|
| Rate for Payer: Cofinity Commercial |
$2.58
|
| Rate for Payer: Cofinity Commercial |
$3.83
|
| Rate for Payer: Cofinity Commercial |
$2.78
|
| Rate for Payer: Cofinity Commercial |
$3.80
|
| Rate for Payer: Cofinity Commercial |
$3.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.13
|
| Rate for Payer: Healthscope Commercial |
$2.91
|
| Rate for Payer: Healthscope Commercial |
$2.70
|
| Rate for Payer: Healthscope Commercial |
$2.39
|
| Rate for Payer: Healthscope Commercial |
$4.00
|
| Rate for Payer: Healthscope Commercial |
$3.98
|
| Rate for Payer: Healthscope Commercial |
$2.62
|
| Rate for Payer: Healthscope Commercial |
$2.61
|
| Rate for Payer: Healthscope Commercial |
$3.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.34
|
| Rate for Payer: PHP Commercial |
$2.55
|
| Rate for Payer: PHP Commercial |
$2.75
|
| Rate for Payer: PHP Commercial |
$3.78
|
| Rate for Payer: PHP Commercial |
$2.47
|
| Rate for Payer: PHP Commercial |
$2.46
|
| Rate for Payer: PHP Commercial |
$2.26
|
| Rate for Payer: PHP Commercial |
$3.01
|
| Rate for Payer: PHP Commercial |
$3.76
|
| Rate for Payer: Priority Health SBD |
$2.23
|
| Rate for Payer: Priority Health SBD |
$2.78
|
| Rate for Payer: Priority Health SBD |
$2.80
|
| Rate for Payer: Priority Health SBD |
$1.83
|
| Rate for Payer: Priority Health SBD |
$1.68
|
| Rate for Payer: Priority Health SBD |
$1.83
|
| Rate for Payer: Priority Health SBD |
$1.89
|
| Rate for Payer: Priority Health SBD |
$2.03
|
| Rate for Payer: UMR Bronson Commercial |
$1.17
|
| Rate for Payer: UMR Bronson Commercial |
$1.42
|
| Rate for Payer: UMR Bronson Commercial |
$1.28
|
| Rate for Payer: UMR Bronson Commercial |
$1.96
|
| Rate for Payer: UMR Bronson Commercial |
$1.94
|
| Rate for Payer: UMR Bronson Commercial |
$1.32
|
| Rate for Payer: UMR Bronson Commercial |
$1.28
|
| Rate for Payer: UMR Bronson Commercial |
$1.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.31
|
|
|
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION
|
Facility
|
IP
|
$3.53
|
|
|
Service Code
|
HCPCS J7644
|
| Hospital Charge Code |
12580
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.55 |
| Max. Negotiated Rate |
$3.18 |
| Rate for Payer: Aetna American Axle |
$2.29
|
| Rate for Payer: Aetna American Axle |
$3.02
|
| Rate for Payer: Aetna American Axle |
$3.56
|
| Rate for Payer: Aetna American Axle |
$5.69
|
| Rate for Payer: Aetna American Axle |
$4.58
|
| Rate for Payer: Aetna American Axle |
$4.39
|
| Rate for Payer: Aetna American Axle |
$2.98
|
| Rate for Payer: Aetna Commercial |
$4.65
|
| Rate for Payer: Aetna Commercial |
$3.90
|
| Rate for Payer: Aetna Commercial |
$3.00
|
| Rate for Payer: Aetna Commercial |
$3.95
|
| Rate for Payer: Aetna Commercial |
$7.45
|
| Rate for Payer: Aetna Commercial |
$5.75
|
| Rate for Payer: Aetna Commercial |
$5.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.69
|
| Rate for Payer: Cash Price |
$2.82
|
| Rate for Payer: Cash Price |
$4.38
|
| Rate for Payer: Cash Price |
$3.72
|
| Rate for Payer: Cash Price |
$3.67
|
| Rate for Payer: Cash Price |
$5.41
|
| Rate for Payer: Cash Price |
$5.64
|
| Rate for Payer: Cash Price |
$7.01
|
| Rate for Payer: Cofinity Advantage |
$4.93
|
| Rate for Payer: Cofinity Advantage |
$2.47
|
| Rate for Payer: Cofinity Advantage |
$3.21
|
| Rate for Payer: Cofinity Advantage |
$3.83
|
| Rate for Payer: Cofinity Advantage |
$3.25
|
| Rate for Payer: Cofinity Advantage |
$4.73
|
| Rate for Payer: Cofinity Advantage |
$6.13
|
| Rate for Payer: Cofinity Commercial |
$4.00
|
| Rate for Payer: Cofinity Commercial |
$7.53
|
| Rate for Payer: Cofinity Commercial |
$6.06
|
| Rate for Payer: Cofinity Commercial |
$3.04
|
| Rate for Payer: Cofinity Commercial |
$3.95
|
| Rate for Payer: Cofinity Commercial |
$5.81
|
| Rate for Payer: Cofinity Commercial |
$4.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.67
|
| Rate for Payer: Healthscope Commercial |
$7.88
|
| Rate for Payer: Healthscope Commercial |
$3.18
|
| Rate for Payer: Healthscope Commercial |
$6.34
|
| Rate for Payer: Healthscope Commercial |
$4.92
|
| Rate for Payer: Healthscope Commercial |
$4.13
|
| Rate for Payer: Healthscope Commercial |
$4.18
|
| Rate for Payer: Healthscope Commercial |
$6.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.44
|
| Rate for Payer: PHP Commercial |
$3.90
|
| Rate for Payer: PHP Commercial |
$5.99
|
| Rate for Payer: PHP Commercial |
$4.65
|
| Rate for Payer: PHP Commercial |
$7.45
|
| Rate for Payer: PHP Commercial |
$3.95
|
| Rate for Payer: PHP Commercial |
$3.00
|
| Rate for Payer: PHP Commercial |
$5.75
|
| Rate for Payer: Priority Health SBD |
$2.22
|
| Rate for Payer: Priority Health SBD |
$3.45
|
| Rate for Payer: Priority Health SBD |
$4.26
|
| Rate for Payer: Priority Health SBD |
$4.44
|
| Rate for Payer: Priority Health SBD |
$5.52
|
| Rate for Payer: Priority Health SBD |
$2.89
|
| Rate for Payer: Priority Health SBD |
$2.93
|
| Rate for Payer: UMR Bronson Commercial |
$3.85
|
| Rate for Payer: UMR Bronson Commercial |
$1.55
|
| Rate for Payer: UMR Bronson Commercial |
$2.41
|
| Rate for Payer: UMR Bronson Commercial |
$2.02
|
| Rate for Payer: UMR Bronson Commercial |
$2.97
|
| Rate for Payer: UMR Bronson Commercial |
$3.10
|
| Rate for Payer: UMR Bronson Commercial |
$2.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.57
|
|
|
IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION
|
Facility
|
OP
|
$7.05
|
|
|
Service Code
|
HCPCS J7644
|
| Hospital Charge Code |
12580
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.32 |
| Max. Negotiated Rate |
$6.34 |
| Rate for Payer: Aetna American Axle |
$4.58
|
| Rate for Payer: Aetna American Axle |
$4.39
|
| Rate for Payer: Aetna American Axle |
$3.56
|
| Rate for Payer: Aetna American Axle |
$2.29
|
| Rate for Payer: Aetna American Axle |
$3.02
|
| Rate for Payer: Aetna American Axle |
$2.98
|
| Rate for Payer: Aetna American Axle |
$5.69
|
| Rate for Payer: Aetna Commercial |
$7.45
|
| Rate for Payer: Aetna Commercial |
$3.00
|
| Rate for Payer: Aetna Commercial |
$3.95
|
| Rate for Payer: Aetna Commercial |
$4.65
|
| Rate for Payer: Aetna Commercial |
$3.90
|
| Rate for Payer: Aetna Commercial |
$5.75
|
| Rate for Payer: Aetna Commercial |
$5.99
|
| Rate for Payer: Aetna Medicare |
$1.76
|
| Rate for Payer: Aetna Medicare |
$3.38
|
| Rate for Payer: Aetna Medicare |
$2.29
|
| Rate for Payer: Aetna Medicare |
$4.38
|
| Rate for Payer: Aetna Medicare |
$2.73
|
| Rate for Payer: Aetna Medicare |
$3.52
|
| Rate for Payer: Aetna Medicare |
$2.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.56
|
| Rate for Payer: BCBS Complete |
$3.50
|
| Rate for Payer: BCBS Complete |
$2.19
|
| Rate for Payer: BCBS Complete |
$2.70
|
| Rate for Payer: BCBS Complete |
$2.82
|
| Rate for Payer: BCBS Complete |
$1.41
|
| Rate for Payer: BCBS Complete |
$1.84
|
| Rate for Payer: BCBS Complete |
$1.86
|
| Rate for Payer: BCBS Trust/PPO |
$1.27
|
| Rate for Payer: BCBS Trust/PPO |
$1.27
|
| Rate for Payer: BCBS Trust/PPO |
$1.27
|
| Rate for Payer: BCBS Trust/PPO |
$1.27
|
| Rate for Payer: BCBS Trust/PPO |
$1.27
|
| Rate for Payer: BCBS Trust/PPO |
$1.27
|
| Rate for Payer: BCBS Trust/PPO |
$1.27
|
| Rate for Payer: BCN Commercial |
$1.27
|
| Rate for Payer: BCN Commercial |
$1.27
|
| Rate for Payer: BCN Commercial |
$1.27
|
| Rate for Payer: BCN Commercial |
$1.27
|
| Rate for Payer: BCN Commercial |
$1.27
|
| Rate for Payer: BCN Commercial |
$1.27
|
| Rate for Payer: BCN Commercial |
$1.27
|
| Rate for Payer: Cash Price |
$3.67
|
| Rate for Payer: Cash Price |
$2.82
|
| Rate for Payer: Cash Price |
$3.67
|
| Rate for Payer: Cash Price |
$3.72
|
| Rate for Payer: Cash Price |
$7.01
|
| Rate for Payer: Cash Price |
$3.72
|
| Rate for Payer: Cash Price |
$7.01
|
| Rate for Payer: Cash Price |
$4.38
|
| Rate for Payer: Cash Price |
$5.41
|
| Rate for Payer: Cash Price |
$5.64
|
| Rate for Payer: Cash Price |
$4.38
|
| Rate for Payer: Cash Price |
$5.64
|
| Rate for Payer: Cash Price |
$2.82
|
| Rate for Payer: Cash Price |
$5.41
|
| Rate for Payer: Cofinity Advantage |
$3.21
|
| Rate for Payer: Cofinity Advantage |
$6.13
|
| Rate for Payer: Cofinity Advantage |
$4.93
|
| Rate for Payer: Cofinity Advantage |
$4.73
|
| Rate for Payer: Cofinity Advantage |
$3.25
|
| Rate for Payer: Cofinity Advantage |
$3.83
|
| Rate for Payer: Cofinity Advantage |
$2.47
|
| Rate for Payer: Cofinity Commercial |
$4.70
|
| Rate for Payer: Cofinity Commercial |
$3.04
|
| Rate for Payer: Cofinity Commercial |
$6.06
|
| Rate for Payer: Cofinity Commercial |
$7.53
|
| Rate for Payer: Cofinity Commercial |
$3.95
|
| Rate for Payer: Cofinity Commercial |
$4.00
|
| Rate for Payer: Cofinity Commercial |
$5.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.01
|
| Rate for Payer: Healthscope Commercial |
$7.88
|
| Rate for Payer: Healthscope Commercial |
$6.34
|
| Rate for Payer: Healthscope Commercial |
$6.08
|
| Rate for Payer: Healthscope Commercial |
$3.18
|
| Rate for Payer: Healthscope Commercial |
$4.13
|
| Rate for Payer: Healthscope Commercial |
$4.92
|
| Rate for Payer: Healthscope Commercial |
$4.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.57
|
| Rate for Payer: PHP Commercial |
$5.99
|
| Rate for Payer: PHP Commercial |
$3.00
|
| Rate for Payer: PHP Commercial |
$3.90
|
| Rate for Payer: PHP Commercial |
$7.45
|
| Rate for Payer: PHP Commercial |
$4.65
|
| Rate for Payer: PHP Commercial |
$5.75
|
| Rate for Payer: PHP Commercial |
$3.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.40
|
| Rate for Payer: Priority Health SBD |
$3.45
|
| Rate for Payer: Priority Health SBD |
$4.44
|
| Rate for Payer: Priority Health SBD |
$5.52
|
| Rate for Payer: Priority Health SBD |
$2.22
|
| Rate for Payer: Priority Health SBD |
$2.93
|
| Rate for Payer: Priority Health SBD |
$4.26
|
| Rate for Payer: Priority Health SBD |
$2.89
|
| Rate for Payer: Priority Health Tiered Network |
$0.32
|
| Rate for Payer: Priority Health Tiered Network |
$0.32
|
| Rate for Payer: Priority Health Tiered Network |
$0.32
|
| Rate for Payer: Priority Health Tiered Network |
$0.32
|
| Rate for Payer: Priority Health Tiered Network |
$0.32
|
| Rate for Payer: Priority Health Tiered Network |
$0.32
|
| Rate for Payer: Priority Health Tiered Network |
$0.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.69
|
| Rate for Payer: UHC Core |
$1.84
|
| Rate for Payer: UHC Core |
$2.39
|
| Rate for Payer: UHC Core |
$2.42
|
| Rate for Payer: UHC Core |
$4.56
|
| Rate for Payer: UHC Core |
$3.52
|
| Rate for Payer: UHC Core |
$2.85
|
| Rate for Payer: UHC Core |
$3.67
|
| Rate for Payer: UHC Exchange |
$1.39
|
| Rate for Payer: UHC Exchange |
$2.66
|
| Rate for Payer: UHC Exchange |
$3.44
|
| Rate for Payer: UHC Exchange |
$2.77
|
| Rate for Payer: UHC Exchange |
$1.80
|
| Rate for Payer: UHC Exchange |
$1.83
|
| Rate for Payer: UHC Exchange |
$2.15
|
| Rate for Payer: UMR Bronson Commercial |
$2.02
|
| Rate for Payer: UMR Bronson Commercial |
$2.61
|
| Rate for Payer: UMR Bronson Commercial |
$3.24
|
| Rate for Payer: UMR Bronson Commercial |
$2.50
|
| Rate for Payer: UMR Bronson Commercial |
$1.31
|
| Rate for Payer: UMR Bronson Commercial |
$1.72
|
| Rate for Payer: UMR Bronson Commercial |
$1.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.57
|
|
|
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY
|
Facility
|
OP
|
$117.18
|
|
|
Service Code
|
NDC 00054004544
|
| Hospital Charge Code |
16070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.36 |
| Max. Negotiated Rate |
$105.46 |
| Rate for Payer: Aetna American Axle |
$76.17
|
| Rate for Payer: Aetna Commercial |
$99.60
|
| Rate for Payer: Aetna Medicare |
$58.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.17
|
| Rate for Payer: BCBS Complete |
$46.87
|
| Rate for Payer: Cash Price |
$93.74
|
| Rate for Payer: Cofinity Advantage |
$82.03
|
| Rate for Payer: Cofinity Commercial |
$100.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.74
|
| Rate for Payer: Healthscope Commercial |
$105.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.89
|
| Rate for Payer: PHP Commercial |
$99.60
|
| Rate for Payer: Priority Health SBD |
$73.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.17
|
| Rate for Payer: UHC Core |
$61.05
|
| Rate for Payer: UHC Exchange |
$46.05
|
| Rate for Payer: UMR Bronson Commercial |
$43.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.89
|
|
|
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY
|
Facility
|
IP
|
$111.30
|
|
|
Service Code
|
NDC 69238201603
|
| Hospital Charge Code |
16070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.97 |
| Max. Negotiated Rate |
$100.17 |
| Rate for Payer: Aetna American Axle |
$72.34
|
| Rate for Payer: Aetna Commercial |
$94.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.34
|
| Rate for Payer: Cash Price |
$89.04
|
| Rate for Payer: Cofinity Advantage |
$77.91
|
| Rate for Payer: Cofinity Commercial |
$95.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.04
|
| Rate for Payer: Healthscope Commercial |
$100.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.47
|
| Rate for Payer: PHP Commercial |
$94.61
|
| Rate for Payer: Priority Health SBD |
$70.12
|
| Rate for Payer: UMR Bronson Commercial |
$48.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.47
|
|
|
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY
|
Facility
|
IP
|
$117.18
|
|
|
Service Code
|
NDC 00054004544
|
| Hospital Charge Code |
16070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$51.56 |
| Max. Negotiated Rate |
$105.46 |
| Rate for Payer: Aetna American Axle |
$76.17
|
| Rate for Payer: Aetna Commercial |
$99.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.17
|
| Rate for Payer: Cash Price |
$93.74
|
| Rate for Payer: Cofinity Advantage |
$82.03
|
| Rate for Payer: Cofinity Commercial |
$100.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.74
|
| Rate for Payer: Healthscope Commercial |
$105.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.89
|
| Rate for Payer: PHP Commercial |
$99.60
|
| Rate for Payer: Priority Health SBD |
$73.82
|
| Rate for Payer: UMR Bronson Commercial |
$51.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.89
|
|
|
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY
|
Facility
|
OP
|
$118.86
|
|
|
Service Code
|
NDC 24208039830
|
| Hospital Charge Code |
16070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.98 |
| Max. Negotiated Rate |
$106.97 |
| Rate for Payer: Aetna American Axle |
$77.26
|
| Rate for Payer: Aetna Commercial |
$101.03
|
| Rate for Payer: Aetna Medicare |
$59.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.26
|
| Rate for Payer: BCBS Complete |
$47.54
|
| Rate for Payer: Cash Price |
$95.09
|
| Rate for Payer: Cofinity Advantage |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$102.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.09
|
| Rate for Payer: Healthscope Commercial |
$106.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.14
|
| Rate for Payer: PHP Commercial |
$101.03
|
| Rate for Payer: Priority Health SBD |
$74.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.26
|
| Rate for Payer: UHC Core |
$61.93
|
| Rate for Payer: UHC Exchange |
$46.71
|
| Rate for Payer: UMR Bronson Commercial |
$43.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.14
|
|
|
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY
|
Facility
|
OP
|
$111.30
|
|
|
Service Code
|
NDC 69238201603
|
| Hospital Charge Code |
16070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$41.18 |
| Max. Negotiated Rate |
$100.17 |
| Rate for Payer: Aetna American Axle |
$72.34
|
| Rate for Payer: Aetna Commercial |
$94.61
|
| Rate for Payer: Aetna Medicare |
$55.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.34
|
| Rate for Payer: BCBS Complete |
$44.52
|
| Rate for Payer: Cash Price |
$89.04
|
| Rate for Payer: Cofinity Advantage |
$77.91
|
| Rate for Payer: Cofinity Commercial |
$95.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.04
|
| Rate for Payer: Healthscope Commercial |
$100.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.47
|
| Rate for Payer: PHP Commercial |
$94.61
|
| Rate for Payer: Priority Health SBD |
$70.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.34
|
| Rate for Payer: UHC Core |
$57.99
|
| Rate for Payer: UHC Exchange |
$43.74
|
| Rate for Payer: UMR Bronson Commercial |
$41.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.47
|
|
|
IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY
|
Facility
|
IP
|
$118.86
|
|
|
Service Code
|
NDC 24208039830
|
| Hospital Charge Code |
16070
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.30 |
| Max. Negotiated Rate |
$106.97 |
| Rate for Payer: Aetna American Axle |
$77.26
|
| Rate for Payer: Aetna Commercial |
$101.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.26
|
| Rate for Payer: Cash Price |
$95.09
|
| Rate for Payer: Cofinity Advantage |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$102.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.09
|
| Rate for Payer: Healthscope Commercial |
$106.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.14
|
| Rate for Payer: PHP Commercial |
$101.03
|
| Rate for Payer: Priority Health SBD |
$74.88
|
| Rate for Payer: UMR Bronson Commercial |
$52.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.14
|
|
|
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY
|
Facility
|
OP
|
$61.69
|
|
|
Service Code
|
NDC 72888014837
|
| Hospital Charge Code |
16071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$22.83 |
| Max. Negotiated Rate |
$55.52 |
| Rate for Payer: Aetna American Axle |
$40.10
|
| Rate for Payer: Aetna Commercial |
$52.44
|
| Rate for Payer: Aetna Medicare |
$30.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.10
|
| Rate for Payer: BCBS Complete |
$24.68
|
| Rate for Payer: Cash Price |
$49.35
|
| Rate for Payer: Cofinity Advantage |
$43.18
|
| Rate for Payer: Cofinity Commercial |
$53.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.35
|
| Rate for Payer: Healthscope Commercial |
$55.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.27
|
| Rate for Payer: PHP Commercial |
$52.44
|
| Rate for Payer: Priority Health SBD |
$38.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.10
|
| Rate for Payer: UHC Core |
$32.14
|
| Rate for Payer: UHC Exchange |
$24.24
|
| Rate for Payer: UMR Bronson Commercial |
$22.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.27
|
|
|
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY
|
Facility
|
IP
|
$117.18
|
|
|
Service Code
|
NDC 00054004641
|
| Hospital Charge Code |
16071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$51.56 |
| Max. Negotiated Rate |
$105.46 |
| Rate for Payer: Aetna American Axle |
$76.17
|
| Rate for Payer: Aetna Commercial |
$99.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.17
|
| Rate for Payer: Cash Price |
$93.74
|
| Rate for Payer: Cofinity Advantage |
$82.03
|
| Rate for Payer: Cofinity Commercial |
$100.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.74
|
| Rate for Payer: Healthscope Commercial |
$105.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.89
|
| Rate for Payer: PHP Commercial |
$99.60
|
| Rate for Payer: Priority Health SBD |
$73.82
|
| Rate for Payer: UMR Bronson Commercial |
$51.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.89
|
|
|
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY
|
Facility
|
IP
|
$61.69
|
|
|
Service Code
|
NDC 72888014837
|
| Hospital Charge Code |
16071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$27.14 |
| Max. Negotiated Rate |
$55.52 |
| Rate for Payer: Aetna American Axle |
$40.10
|
| Rate for Payer: Aetna Commercial |
$52.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.10
|
| Rate for Payer: Cash Price |
$49.35
|
| Rate for Payer: Cofinity Advantage |
$43.18
|
| Rate for Payer: Cofinity Commercial |
$53.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.35
|
| Rate for Payer: Healthscope Commercial |
$55.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.27
|
| Rate for Payer: PHP Commercial |
$52.44
|
| Rate for Payer: Priority Health SBD |
$38.86
|
| Rate for Payer: UMR Bronson Commercial |
$27.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.27
|
|
