|
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY
|
Facility
|
IP
|
$118.81
|
|
|
Service Code
|
NDC 24208039915
|
| Hospital Charge Code |
16071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.28 |
| Max. Negotiated Rate |
$106.93 |
| Rate for Payer: Aetna American Axle |
$77.23
|
| Rate for Payer: Aetna Commercial |
$100.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.23
|
| Rate for Payer: Cash Price |
$95.05
|
| Rate for Payer: Cofinity Advantage |
$83.17
|
| Rate for Payer: Cofinity Commercial |
$102.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.05
|
| Rate for Payer: Healthscope Commercial |
$106.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.11
|
| Rate for Payer: PHP Commercial |
$100.99
|
| Rate for Payer: Priority Health SBD |
$74.85
|
| Rate for Payer: UMR Bronson Commercial |
$52.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.11
|
|
|
IPRATROPIUM BROMIDE 42 MCG (0.06 %) NASAL SPRAY
|
Facility
|
OP
|
$117.18
|
|
|
Service Code
|
NDC 00054004641
|
| Hospital Charge Code |
16071
|
|
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 42 MCG (0.06 %) NASAL SPRAY
|
Facility
|
OP
|
$118.81
|
|
|
Service Code
|
NDC 24208039915
|
| Hospital Charge Code |
16071
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$106.93 |
| Rate for Payer: Aetna American Axle |
$77.23
|
| Rate for Payer: Aetna Commercial |
$100.99
|
| Rate for Payer: Aetna Medicare |
$59.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.23
|
| Rate for Payer: BCBS Complete |
$47.52
|
| Rate for Payer: Cash Price |
$95.05
|
| Rate for Payer: Cofinity Advantage |
$83.17
|
| Rate for Payer: Cofinity Commercial |
$102.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.05
|
| Rate for Payer: Healthscope Commercial |
$106.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.11
|
| Rate for Payer: PHP Commercial |
$100.99
|
| Rate for Payer: Priority Health SBD |
$74.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.23
|
| Rate for Payer: UHC Core |
$61.90
|
| Rate for Payer: UHC Exchange |
$46.69
|
| Rate for Payer: UMR Bronson Commercial |
$43.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.11
|
|
|
IRBESARTAN 150 MG TABLET
|
Facility
|
IP
|
$79.67
|
|
|
Service Code
|
NDC 43547037503
|
| Hospital Charge Code |
21848
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$35.05 |
| Max. Negotiated Rate |
$71.70 |
| Rate for Payer: Aetna American Axle |
$51.79
|
| Rate for Payer: Aetna Commercial |
$67.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.79
|
| Rate for Payer: Cash Price |
$63.74
|
| Rate for Payer: Cofinity Advantage |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$68.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.74
|
| Rate for Payer: Healthscope Commercial |
$71.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.75
|
| Rate for Payer: PHP Commercial |
$67.72
|
| Rate for Payer: Priority Health SBD |
$50.19
|
| Rate for Payer: UMR Bronson Commercial |
$35.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.75
|
|
|
IRBESARTAN 150 MG TABLET
|
Facility
|
IP
|
$98.04
|
|
|
Service Code
|
NDC 62332004230
|
| Hospital Charge Code |
21848
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.14 |
| Max. Negotiated Rate |
$88.24 |
| Rate for Payer: Aetna American Axle |
$63.73
|
| Rate for Payer: Aetna Commercial |
$83.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.73
|
| Rate for Payer: Cash Price |
$78.43
|
| Rate for Payer: Cofinity Advantage |
$68.63
|
| Rate for Payer: Cofinity Commercial |
$84.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.43
|
| Rate for Payer: Healthscope Commercial |
$88.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.53
|
| Rate for Payer: PHP Commercial |
$83.33
|
| Rate for Payer: Priority Health SBD |
$61.77
|
| Rate for Payer: UMR Bronson Commercial |
$43.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.53
|
|
|
IRBESARTAN 150 MG TABLET
|
Facility
|
OP
|
$98.04
|
|
|
Service Code
|
NDC 62332004230
|
| Hospital Charge Code |
21848
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$36.27 |
| Max. Negotiated Rate |
$88.24 |
| Rate for Payer: Aetna American Axle |
$63.73
|
| Rate for Payer: Aetna Commercial |
$83.33
|
| Rate for Payer: Aetna Medicare |
$49.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.73
|
| Rate for Payer: BCBS Complete |
$39.22
|
| Rate for Payer: Cash Price |
$78.43
|
| Rate for Payer: Cofinity Advantage |
$68.63
|
| Rate for Payer: Cofinity Commercial |
$84.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.43
|
| Rate for Payer: Healthscope Commercial |
$88.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.53
|
| Rate for Payer: PHP Commercial |
$83.33
|
| Rate for Payer: Priority Health SBD |
$61.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.73
|
| Rate for Payer: UHC Core |
$51.08
|
| Rate for Payer: UHC Exchange |
$38.53
|
| Rate for Payer: UMR Bronson Commercial |
$36.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.53
|
|
|
IRBESARTAN 150 MG TABLET
|
Facility
|
IP
|
$790.21
|
|
|
Service Code
|
NDC 00024585130
|
| Hospital Charge Code |
21848
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$347.69 |
| Max. Negotiated Rate |
$711.19 |
| Rate for Payer: Aetna American Axle |
$513.64
|
| Rate for Payer: Aetna Commercial |
$671.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.64
|
| Rate for Payer: Cash Price |
$632.17
|
| Rate for Payer: Cofinity Advantage |
$553.15
|
| Rate for Payer: Cofinity Commercial |
$679.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.17
|
| Rate for Payer: Healthscope Commercial |
$711.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$553.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$592.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$592.66
|
| Rate for Payer: PHP Commercial |
$671.68
|
| Rate for Payer: Priority Health SBD |
$497.83
|
| Rate for Payer: UMR Bronson Commercial |
$347.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$592.66
|
|
|
IRBESARTAN 150 MG TABLET
|
Facility
|
OP
|
$98.04
|
|
|
Service Code
|
NDC 59746044830
|
| Hospital Charge Code |
21848
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$36.27 |
| Max. Negotiated Rate |
$88.24 |
| Rate for Payer: Aetna American Axle |
$63.73
|
| Rate for Payer: Aetna Commercial |
$83.33
|
| Rate for Payer: Aetna Medicare |
$49.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.73
|
| Rate for Payer: BCBS Complete |
$39.22
|
| Rate for Payer: Cash Price |
$78.43
|
| Rate for Payer: Cofinity Advantage |
$68.63
|
| Rate for Payer: Cofinity Commercial |
$84.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.43
|
| Rate for Payer: Healthscope Commercial |
$88.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.53
|
| Rate for Payer: PHP Commercial |
$83.33
|
| Rate for Payer: Priority Health SBD |
$61.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.73
|
| Rate for Payer: UHC Core |
$51.08
|
| Rate for Payer: UHC Exchange |
$38.53
|
| Rate for Payer: UMR Bronson Commercial |
$36.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.53
|
|
|
IRBESARTAN 150 MG TABLET
|
Facility
|
IP
|
$344.75
|
|
|
Service Code
|
NDC 42658012204
|
| Hospital Charge Code |
21848
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$151.69 |
| Max. Negotiated Rate |
$310.27 |
| Rate for Payer: Aetna American Axle |
$224.09
|
| Rate for Payer: Aetna Commercial |
$293.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.09
|
| Rate for Payer: Cash Price |
$275.80
|
| Rate for Payer: Cofinity Advantage |
$241.32
|
| Rate for Payer: Cofinity Commercial |
$296.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.80
|
| Rate for Payer: Healthscope Commercial |
$310.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.56
|
| Rate for Payer: PHP Commercial |
$293.04
|
| Rate for Payer: Priority Health SBD |
$217.19
|
| Rate for Payer: UMR Bronson Commercial |
$151.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.56
|
|
|
IRBESARTAN 150 MG TABLET
|
Facility
|
IP
|
$79.67
|
|
|
Service Code
|
NDC 43547027803
|
| Hospital Charge Code |
21848
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$35.05 |
| Max. Negotiated Rate |
$71.70 |
| Rate for Payer: Aetna American Axle |
$51.79
|
| Rate for Payer: Aetna Commercial |
$67.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.79
|
| Rate for Payer: Cash Price |
$63.74
|
| Rate for Payer: Cofinity Advantage |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$68.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.74
|
| Rate for Payer: Healthscope Commercial |
$71.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.75
|
| Rate for Payer: PHP Commercial |
$67.72
|
| Rate for Payer: Priority Health SBD |
$50.19
|
| Rate for Payer: UMR Bronson Commercial |
$35.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.75
|
|
|
IRBESARTAN 150 MG TABLET
|
Facility
|
OP
|
$79.67
|
|
|
Service Code
|
NDC 43547037503
|
| Hospital Charge Code |
21848
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$29.48 |
| Max. Negotiated Rate |
$71.70 |
| Rate for Payer: Aetna American Axle |
$51.79
|
| Rate for Payer: Aetna Commercial |
$67.72
|
| Rate for Payer: Aetna Medicare |
$39.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.79
|
| Rate for Payer: BCBS Complete |
$31.87
|
| Rate for Payer: Cash Price |
$63.74
|
| Rate for Payer: Cofinity Advantage |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$68.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.74
|
| Rate for Payer: Healthscope Commercial |
$71.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.75
|
| Rate for Payer: PHP Commercial |
$67.72
|
| Rate for Payer: Priority Health SBD |
$50.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.79
|
| Rate for Payer: UHC Core |
$41.51
|
| Rate for Payer: UHC Exchange |
$31.31
|
| Rate for Payer: UMR Bronson Commercial |
$29.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.75
|
|
|
IRBESARTAN 150 MG TABLET
|
Facility
|
IP
|
$98.04
|
|
|
Service Code
|
NDC 59746044830
|
| Hospital Charge Code |
21848
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.14 |
| Max. Negotiated Rate |
$88.24 |
| Rate for Payer: Aetna American Axle |
$63.73
|
| Rate for Payer: Aetna Commercial |
$83.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.73
|
| Rate for Payer: Cash Price |
$78.43
|
| Rate for Payer: Cofinity Advantage |
$68.63
|
| Rate for Payer: Cofinity Commercial |
$84.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.43
|
| Rate for Payer: Healthscope Commercial |
$88.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.53
|
| Rate for Payer: PHP Commercial |
$83.33
|
| Rate for Payer: Priority Health SBD |
$61.77
|
| Rate for Payer: UMR Bronson Commercial |
$43.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.53
|
|
|
IRBESARTAN 150 MG TABLET
|
Facility
|
OP
|
$344.75
|
|
|
Service Code
|
NDC 42658012204
|
| Hospital Charge Code |
21848
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$127.56 |
| Max. Negotiated Rate |
$310.27 |
| Rate for Payer: Aetna American Axle |
$224.09
|
| Rate for Payer: Aetna Commercial |
$293.04
|
| Rate for Payer: Aetna Medicare |
$172.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.09
|
| Rate for Payer: BCBS Complete |
$137.90
|
| Rate for Payer: Cash Price |
$275.80
|
| Rate for Payer: Cofinity Advantage |
$241.32
|
| Rate for Payer: Cofinity Commercial |
$296.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.80
|
| Rate for Payer: Healthscope Commercial |
$310.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$275.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.56
|
| Rate for Payer: PHP Commercial |
$293.04
|
| Rate for Payer: Priority Health SBD |
$217.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.09
|
| Rate for Payer: UHC Core |
$179.61
|
| Rate for Payer: UHC Exchange |
$135.49
|
| Rate for Payer: UMR Bronson Commercial |
$127.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.56
|
|
|
IRBESARTAN 150 MG TABLET
|
Facility
|
OP
|
$790.21
|
|
|
Service Code
|
NDC 00024585130
|
| Hospital Charge Code |
21848
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$292.38 |
| Max. Negotiated Rate |
$711.19 |
| Rate for Payer: Aetna American Axle |
$513.64
|
| Rate for Payer: Aetna Commercial |
$671.68
|
| Rate for Payer: Aetna Medicare |
$395.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.64
|
| Rate for Payer: BCBS Complete |
$316.08
|
| Rate for Payer: Cash Price |
$632.17
|
| Rate for Payer: Cofinity Advantage |
$553.15
|
| Rate for Payer: Cofinity Commercial |
$679.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.17
|
| Rate for Payer: Healthscope Commercial |
$711.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$553.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$592.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$632.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$592.66
|
| Rate for Payer: PHP Commercial |
$671.68
|
| Rate for Payer: Priority Health SBD |
$497.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.64
|
| Rate for Payer: UHC Core |
$411.70
|
| Rate for Payer: UHC Exchange |
$310.55
|
| Rate for Payer: UMR Bronson Commercial |
$292.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$592.66
|
|
|
IRBESARTAN 150 MG TABLET
|
Facility
|
OP
|
$79.67
|
|
|
Service Code
|
NDC 43547027803
|
| Hospital Charge Code |
21848
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$29.48 |
| Max. Negotiated Rate |
$71.70 |
| Rate for Payer: Aetna American Axle |
$51.79
|
| Rate for Payer: Aetna Commercial |
$67.72
|
| Rate for Payer: Aetna Medicare |
$39.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.79
|
| Rate for Payer: BCBS Complete |
$31.87
|
| Rate for Payer: Cash Price |
$63.74
|
| Rate for Payer: Cofinity Advantage |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$68.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.74
|
| Rate for Payer: Healthscope Commercial |
$71.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.75
|
| Rate for Payer: PHP Commercial |
$67.72
|
| Rate for Payer: Priority Health SBD |
$50.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.79
|
| Rate for Payer: UHC Core |
$41.51
|
| Rate for Payer: UHC Exchange |
$31.31
|
| Rate for Payer: UMR Bronson Commercial |
$29.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.75
|
|
|
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$209.51
|
|
|
Service Code
|
HCPCS J9206
|
| Hospital Charge Code |
17450
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$92.18 |
| Max. Negotiated Rate |
$188.56 |
| Rate for Payer: Aetna American Axle |
$136.18
|
| Rate for Payer: Aetna American Axle |
$217.07
|
| Rate for Payer: Aetna American Axle |
$157.22
|
| Rate for Payer: Aetna Commercial |
$205.60
|
| Rate for Payer: Aetna Commercial |
$178.08
|
| Rate for Payer: Aetna Commercial |
$283.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.22
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Cash Price |
$167.61
|
| Rate for Payer: Cash Price |
$267.16
|
| Rate for Payer: Cofinity Advantage |
$233.76
|
| Rate for Payer: Cofinity Advantage |
$146.66
|
| Rate for Payer: Cofinity Advantage |
$169.32
|
| Rate for Payer: Cofinity Commercial |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$180.18
|
| Rate for Payer: Cofinity Commercial |
$208.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.16
|
| Rate for Payer: Healthscope Commercial |
$217.69
|
| Rate for Payer: Healthscope Commercial |
$300.56
|
| Rate for Payer: Healthscope Commercial |
$188.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$169.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$181.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$250.46
|
| Rate for Payer: PHP Commercial |
$205.60
|
| Rate for Payer: PHP Commercial |
$178.08
|
| Rate for Payer: PHP Commercial |
$283.86
|
| Rate for Payer: Priority Health SBD |
$131.99
|
| Rate for Payer: Priority Health SBD |
$152.38
|
| Rate for Payer: Priority Health SBD |
$210.39
|
| Rate for Payer: UMR Bronson Commercial |
$92.18
|
| Rate for Payer: UMR Bronson Commercial |
$146.94
|
| Rate for Payer: UMR Bronson Commercial |
$106.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.46
|
|
|
IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$197.13
|
|
|
Service Code
|
HCPCS J9206
|
| Hospital Charge Code |
17450
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$177.42 |
| Rate for Payer: Aetna American Axle |
$128.13
|
| Rate for Payer: Aetna American Axle |
$136.18
|
| Rate for Payer: Aetna American Axle |
$157.22
|
| Rate for Payer: Aetna American Axle |
$142.71
|
| Rate for Payer: Aetna American Axle |
$86.75
|
| Rate for Payer: Aetna American Axle |
$72.89
|
| Rate for Payer: Aetna American Axle |
$217.07
|
| Rate for Payer: Aetna American Axle |
$186.28
|
| Rate for Payer: Aetna American Axle |
$173.49
|
| Rate for Payer: Aetna Commercial |
$186.63
|
| Rate for Payer: Aetna Commercial |
$113.44
|
| Rate for Payer: Aetna Commercial |
$167.56
|
| Rate for Payer: Aetna Commercial |
$95.32
|
| Rate for Payer: Aetna Commercial |
$178.08
|
| Rate for Payer: Aetna Commercial |
$205.60
|
| Rate for Payer: Aetna Commercial |
$226.87
|
| Rate for Payer: Aetna Commercial |
$243.60
|
| Rate for Payer: Aetna Commercial |
$283.86
|
| Rate for Payer: Aetna Medicare |
$98.56
|
| Rate for Payer: Aetna Medicare |
$66.73
|
| Rate for Payer: Aetna Medicare |
$133.46
|
| Rate for Payer: Aetna Medicare |
$56.07
|
| Rate for Payer: Aetna Medicare |
$166.97
|
| Rate for Payer: Aetna Medicare |
$109.78
|
| Rate for Payer: Aetna Medicare |
$104.75
|
| Rate for Payer: Aetna Medicare |
$143.29
|
| Rate for Payer: Aetna Medicare |
$120.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.18
|
| Rate for Payer: BCBS Complete |
$53.38
|
| Rate for Payer: BCBS Complete |
$78.85
|
| Rate for Payer: BCBS Complete |
$96.75
|
| Rate for Payer: BCBS Complete |
$83.80
|
| Rate for Payer: BCBS Complete |
$106.76
|
| Rate for Payer: BCBS Complete |
$87.82
|
| Rate for Payer: BCBS Complete |
$133.58
|
| Rate for Payer: BCBS Complete |
$114.64
|
| Rate for Payer: BCBS Complete |
$44.86
|
| Rate for Payer: BCBS Trust/PPO |
$5.70
|
| Rate for Payer: BCBS Trust/PPO |
$5.70
|
| Rate for Payer: BCBS Trust/PPO |
$5.70
|
| Rate for Payer: BCBS Trust/PPO |
$5.70
|
| Rate for Payer: BCBS Trust/PPO |
$5.70
|
| Rate for Payer: BCBS Trust/PPO |
$5.70
|
| Rate for Payer: BCBS Trust/PPO |
$5.70
|
| Rate for Payer: BCBS Trust/PPO |
$5.70
|
| Rate for Payer: BCBS Trust/PPO |
$5.70
|
| Rate for Payer: BCN Commercial |
$5.70
|
| Rate for Payer: BCN Commercial |
$5.70
|
| Rate for Payer: BCN Commercial |
$5.70
|
| Rate for Payer: BCN Commercial |
$5.70
|
| Rate for Payer: BCN Commercial |
$5.70
|
| Rate for Payer: BCN Commercial |
$5.70
|
| Rate for Payer: BCN Commercial |
$5.70
|
| Rate for Payer: BCN Commercial |
$5.70
|
| Rate for Payer: BCN Commercial |
$5.70
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Cash Price |
$106.77
|
| Rate for Payer: Cash Price |
$213.53
|
| Rate for Payer: Cash Price |
$175.65
|
| Rate for Payer: Cash Price |
$167.61
|
| Rate for Payer: Cash Price |
$213.53
|
| Rate for Payer: Cash Price |
$267.16
|
| Rate for Payer: Cash Price |
$229.27
|
| Rate for Payer: Cash Price |
$89.71
|
| Rate for Payer: Cash Price |
$175.65
|
| Rate for Payer: Cash Price |
$157.70
|
| Rate for Payer: Cash Price |
$89.71
|
| Rate for Payer: Cash Price |
$267.16
|
| Rate for Payer: Cash Price |
$157.70
|
| Rate for Payer: Cash Price |
$229.27
|
| Rate for Payer: Cash Price |
$106.77
|
| Rate for Payer: Cash Price |
$167.61
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Cofinity Advantage |
$93.42
|
| Rate for Payer: Cofinity Advantage |
$137.99
|
| Rate for Payer: Cofinity Advantage |
$78.50
|
| Rate for Payer: Cofinity Advantage |
$146.66
|
| Rate for Payer: Cofinity Advantage |
$153.69
|
| Rate for Payer: Cofinity Advantage |
$169.32
|
| Rate for Payer: Cofinity Advantage |
$186.84
|
| Rate for Payer: Cofinity Advantage |
$200.61
|
| Rate for Payer: Cofinity Advantage |
$233.76
|
| Rate for Payer: Cofinity Commercial |
$114.78
|
| Rate for Payer: Cofinity Commercial |
$246.47
|
| Rate for Payer: Cofinity Commercial |
$229.54
|
| Rate for Payer: Cofinity Commercial |
$96.44
|
| Rate for Payer: Cofinity Commercial |
$188.82
|
| Rate for Payer: Cofinity Commercial |
$169.53
|
| Rate for Payer: Cofinity Commercial |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$180.18
|
| Rate for Payer: Cofinity Commercial |
$208.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.70
|
| Rate for Payer: Healthscope Commercial |
$177.42
|
| Rate for Payer: Healthscope Commercial |
$120.11
|
| Rate for Payer: Healthscope Commercial |
$100.93
|
| Rate for Payer: Healthscope Commercial |
$300.56
|
| Rate for Payer: Healthscope Commercial |
$188.56
|
| Rate for Payer: Healthscope Commercial |
$257.93
|
| Rate for Payer: Healthscope Commercial |
$240.22
|
| Rate for Payer: Healthscope Commercial |
$217.69
|
| Rate for Payer: Healthscope Commercial |
$197.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$186.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$153.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$137.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$169.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$157.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$167.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$267.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$213.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$250.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$181.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.94
|
| Rate for Payer: PHP Commercial |
$167.56
|
| Rate for Payer: PHP Commercial |
$178.08
|
| Rate for Payer: PHP Commercial |
$186.63
|
| Rate for Payer: PHP Commercial |
$283.86
|
| Rate for Payer: PHP Commercial |
$205.60
|
| Rate for Payer: PHP Commercial |
$95.32
|
| Rate for Payer: PHP Commercial |
$113.44
|
| Rate for Payer: PHP Commercial |
$226.87
|
| Rate for Payer: PHP Commercial |
$243.60
|
| Rate for Payer: Priority Health SBD |
$138.32
|
| Rate for Payer: Priority Health SBD |
$168.15
|
| Rate for Payer: Priority Health SBD |
$84.08
|
| Rate for Payer: Priority Health SBD |
$124.19
|
| Rate for Payer: Priority Health SBD |
$152.38
|
| Rate for Payer: Priority Health SBD |
$210.39
|
| Rate for Payer: Priority Health SBD |
$70.65
|
| Rate for Payer: Priority Health SBD |
$131.99
|
| Rate for Payer: Priority Health SBD |
$180.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.95
|
| Rate for Payer: UHC Core |
$2.95
|
| Rate for Payer: UHC Core |
$2.95
|
| Rate for Payer: UHC Core |
$2.95
|
| Rate for Payer: UHC Core |
$2.95
|
| Rate for Payer: UHC Core |
$2.95
|
| Rate for Payer: UHC Core |
$2.95
|
| Rate for Payer: UHC Core |
$2.95
|
| Rate for Payer: UHC Core |
$2.95
|
| Rate for Payer: UHC Core |
$2.95
|
| Rate for Payer: UHC Exchange |
$2.95
|
| Rate for Payer: UHC Exchange |
$2.95
|
| Rate for Payer: UHC Exchange |
$2.95
|
| Rate for Payer: UHC Exchange |
$2.95
|
| Rate for Payer: UHC Exchange |
$2.95
|
| Rate for Payer: UHC Exchange |
$2.95
|
| Rate for Payer: UHC Exchange |
$2.95
|
| Rate for Payer: UHC Exchange |
$2.95
|
| Rate for Payer: UHC Exchange |
$2.95
|
| Rate for Payer: UMR Bronson Commercial |
$89.50
|
| Rate for Payer: UMR Bronson Commercial |
$72.94
|
| Rate for Payer: UMR Bronson Commercial |
$81.24
|
| Rate for Payer: UMR Bronson Commercial |
$98.76
|
| Rate for Payer: UMR Bronson Commercial |
$106.04
|
| Rate for Payer: UMR Bronson Commercial |
$123.56
|
| Rate for Payer: UMR Bronson Commercial |
$41.49
|
| Rate for Payer: UMR Bronson Commercial |
$49.38
|
| Rate for Payer: UMR Bronson Commercial |
$77.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.09
|
|
|
IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$259.53
|
|
|
Service Code
|
HCPCS J9206
|
| Hospital Charge Code |
91055
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$233.58 |
| Rate for Payer: Aetna American Axle |
$168.69
|
| Rate for Payer: Aetna American Axle |
$82.08
|
| Rate for Payer: Aetna American Axle |
$88.45
|
| Rate for Payer: Aetna American Axle |
$163.23
|
| Rate for Payer: Aetna Commercial |
$220.60
|
| Rate for Payer: Aetna Commercial |
$213.46
|
| Rate for Payer: Aetna Commercial |
$107.34
|
| Rate for Payer: Aetna Commercial |
$115.67
|
| Rate for Payer: Aetna Medicare |
$125.56
|
| Rate for Payer: Aetna Medicare |
$68.04
|
| Rate for Payer: Aetna Medicare |
$129.76
|
| Rate for Payer: Aetna Medicare |
$63.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.23
|
| Rate for Payer: BCBS Complete |
$50.51
|
| Rate for Payer: BCBS Complete |
$54.43
|
| Rate for Payer: BCBS Complete |
$100.45
|
| Rate for Payer: BCBS Complete |
$103.81
|
| Rate for Payer: BCBS Trust/PPO |
$5.70
|
| Rate for Payer: BCBS Trust/PPO |
$5.70
|
| Rate for Payer: BCBS Trust/PPO |
$5.70
|
| Rate for Payer: BCBS Trust/PPO |
$5.70
|
| Rate for Payer: BCN Commercial |
$5.70
|
| Rate for Payer: BCN Commercial |
$5.70
|
| Rate for Payer: BCN Commercial |
$5.70
|
| Rate for Payer: BCN Commercial |
$5.70
|
| Rate for Payer: Cash Price |
$200.90
|
| Rate for Payer: Cash Price |
$207.62
|
| Rate for Payer: Cash Price |
$101.02
|
| Rate for Payer: Cash Price |
$207.62
|
| Rate for Payer: Cash Price |
$200.90
|
| Rate for Payer: Cash Price |
$108.86
|
| Rate for Payer: Cash Price |
$108.86
|
| Rate for Payer: Cash Price |
$101.02
|
| Rate for Payer: Cofinity Advantage |
$181.67
|
| Rate for Payer: Cofinity Advantage |
$175.79
|
| Rate for Payer: Cofinity Advantage |
$95.26
|
| Rate for Payer: Cofinity Advantage |
$88.40
|
| Rate for Payer: Cofinity Commercial |
$117.03
|
| Rate for Payer: Cofinity Commercial |
$215.97
|
| Rate for Payer: Cofinity Commercial |
$223.20
|
| Rate for Payer: Cofinity Commercial |
$108.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.02
|
| Rate for Payer: Healthscope Commercial |
$226.02
|
| Rate for Payer: Healthscope Commercial |
$113.65
|
| Rate for Payer: Healthscope Commercial |
$122.47
|
| Rate for Payer: Healthscope Commercial |
$233.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$207.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$101.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$188.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.65
|
| Rate for Payer: PHP Commercial |
$107.34
|
| Rate for Payer: PHP Commercial |
$213.46
|
| Rate for Payer: PHP Commercial |
$220.60
|
| Rate for Payer: PHP Commercial |
$115.67
|
| Rate for Payer: Priority Health SBD |
$158.21
|
| Rate for Payer: Priority Health SBD |
$79.56
|
| Rate for Payer: Priority Health SBD |
$85.73
|
| Rate for Payer: Priority Health SBD |
$163.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.95
|
| Rate for Payer: UHC Core |
$2.95
|
| Rate for Payer: UHC Core |
$2.95
|
| Rate for Payer: UHC Core |
$2.95
|
| Rate for Payer: UHC Core |
$2.95
|
| Rate for Payer: UHC Exchange |
$2.95
|
| Rate for Payer: UHC Exchange |
$2.95
|
| Rate for Payer: UHC Exchange |
$2.95
|
| Rate for Payer: UHC Exchange |
$2.95
|
| Rate for Payer: UMR Bronson Commercial |
$96.03
|
| Rate for Payer: UMR Bronson Commercial |
$46.72
|
| Rate for Payer: UMR Bronson Commercial |
$50.35
|
| Rate for Payer: UMR Bronson Commercial |
$92.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.65
|
|
|
IRINOTECAN LIPOSOMAL 4.3 MG/ML INTRAVENOUS
|
Facility
|
OP
|
$13,707.97
|
|
|
Service Code
|
HCPCS J9205
|
| Hospital Charge Code |
176129
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$34.71 |
| Max. Negotiated Rate |
$12,337.17 |
| Rate for Payer: Aetna American Axle |
$8,910.18
|
| Rate for Payer: Aetna Commercial |
$11,651.77
|
| Rate for Payer: Aetna Medicare |
$69.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,910.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.96
|
| Rate for Payer: BCBS Complete |
$36.45
|
| Rate for Payer: BCBS MAPPO |
$66.37
|
| Rate for Payer: BCBS Trust/PPO |
$213.87
|
| Rate for Payer: BCN Commercial |
$213.87
|
| Rate for Payer: BCN Medicare Advantage |
$66.37
|
| Rate for Payer: Cash Price |
$10,966.38
|
| Rate for Payer: Cash Price |
$10,966.38
|
| Rate for Payer: Cofinity Advantage |
$9,595.58
|
| Rate for Payer: Cofinity Commercial |
$11,788.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,966.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.37
|
| Rate for Payer: Healthscope Commercial |
$12,337.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,595.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,280.98
|
| Rate for Payer: Mclaren Medicaid |
$66.37
|
| Rate for Payer: Mclaren Medicare |
$66.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.69
|
| Rate for Payer: Meridian Medicaid |
$69.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,651.77
|
| Rate for Payer: Nomi Health Commercial |
$199.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,280.98
|
| Rate for Payer: PACE Medicare |
$63.05
|
| Rate for Payer: PACE SWMI |
$66.37
|
| Rate for Payer: PHP Commercial |
$11,651.77
|
| Rate for Payer: PHP Medicare Advantage |
$66.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$208.17
|
| Rate for Payer: Priority Health Medicare |
$66.37
|
| Rate for Payer: Priority Health SBD |
$8,636.02
|
| Rate for Payer: Priority Health Tiered Network |
$166.54
|
| Rate for Payer: Railroad Medicare Medicare |
$66.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.83
|
| Rate for Payer: UHC Core |
$108.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$66.37
|
| Rate for Payer: UHC Exchange |
$108.83
|
| Rate for Payer: UHC Medicaid |
$34.71
|
| Rate for Payer: UHCCP Medicaid |
$34.71
|
| Rate for Payer: UMR Bronson Commercial |
$5,071.95
|
| Rate for Payer: VA VA |
$66.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,280.98
|
|
|
IRINOTECAN LIPOSOMAL 4.3 MG/ML INTRAVENOUS
|
Facility
|
IP
|
$13,707.97
|
|
|
Service Code
|
HCPCS J9205
|
| Hospital Charge Code |
176129
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6,031.51 |
| Max. Negotiated Rate |
$12,337.17 |
| Rate for Payer: Aetna American Axle |
$8,910.18
|
| Rate for Payer: Aetna Commercial |
$11,651.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,910.18
|
| Rate for Payer: Cash Price |
$10,966.38
|
| Rate for Payer: Cofinity Advantage |
$9,595.58
|
| Rate for Payer: Cofinity Commercial |
$11,788.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,966.38
|
| Rate for Payer: Healthscope Commercial |
$12,337.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,595.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,280.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,651.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,280.98
|
| Rate for Payer: PHP Commercial |
$11,651.77
|
| Rate for Payer: Priority Health SBD |
$8,636.02
|
| Rate for Payer: UMR Bronson Commercial |
$6,031.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,280.98
|
|
|
IRON DEXTRAN 50 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$169.77
|
|
|
Service Code
|
HCPCS J1750
|
| Hospital Charge Code |
186569
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$74.70 |
| Max. Negotiated Rate |
$152.79 |
| Rate for Payer: Aetna American Axle |
$110.35
|
| Rate for Payer: Aetna Commercial |
$144.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.35
|
| Rate for Payer: Cash Price |
$135.82
|
| Rate for Payer: Cofinity Advantage |
$118.84
|
| Rate for Payer: Cofinity Commercial |
$146.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.82
|
| Rate for Payer: Healthscope Commercial |
$152.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.33
|
| Rate for Payer: PHP Commercial |
$144.30
|
| Rate for Payer: Priority Health SBD |
$106.96
|
| Rate for Payer: UMR Bronson Commercial |
$74.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.33
|
|
|
IRON DEXTRAN 50 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$169.77
|
|
|
Service Code
|
HCPCS J1750
|
| Hospital Charge Code |
186569
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.47 |
| Max. Negotiated Rate |
$152.79 |
| Rate for Payer: Aetna American Axle |
$110.35
|
| Rate for Payer: Aetna Commercial |
$144.30
|
| Rate for Payer: Aetna Medicare |
$18.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.64
|
| Rate for Payer: BCBS Complete |
$9.95
|
| Rate for Payer: BCBS MAPPO |
$18.11
|
| Rate for Payer: BCBS Trust/PPO |
$58.62
|
| Rate for Payer: BCN Commercial |
$58.62
|
| Rate for Payer: BCN Medicare Advantage |
$18.11
|
| Rate for Payer: Cash Price |
$135.82
|
| Rate for Payer: Cash Price |
$135.82
|
| Rate for Payer: Cofinity Advantage |
$118.84
|
| Rate for Payer: Cofinity Commercial |
$146.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.11
|
| Rate for Payer: Healthscope Commercial |
$152.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.33
|
| Rate for Payer: Mclaren Medicaid |
$18.11
|
| Rate for Payer: Mclaren Medicare |
$18.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.02
|
| Rate for Payer: Meridian Medicaid |
$19.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.30
|
| Rate for Payer: Nomi Health Commercial |
$54.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.33
|
| Rate for Payer: PACE Medicare |
$17.20
|
| Rate for Payer: PACE SWMI |
$18.11
|
| Rate for Payer: PHP Commercial |
$144.30
|
| Rate for Payer: PHP Medicare Advantage |
$18.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$57.12
|
| Rate for Payer: Priority Health Medicare |
$18.11
|
| Rate for Payer: Priority Health SBD |
$106.96
|
| Rate for Payer: Priority Health Tiered Network |
$45.70
|
| Rate for Payer: Railroad Medicare Medicare |
$18.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.83
|
| Rate for Payer: UHC Core |
$29.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.11
|
| Rate for Payer: UHC Exchange |
$29.83
|
| Rate for Payer: UHC Medicaid |
$9.47
|
| Rate for Payer: UHCCP Medicaid |
$9.47
|
| Rate for Payer: UMR Bronson Commercial |
$62.81
|
| Rate for Payer: VA VA |
$18.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.33
|
|
|
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
HCPCS J1756
|
| Hospital Charge Code |
29132
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$30.35 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna American Axle |
$44.84
|
| Rate for Payer: Aetna American Axle |
$64.87
|
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: Aetna Commercial |
$84.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.87
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cash Price |
$79.84
|
| Rate for Payer: Cofinity Advantage |
$69.86
|
| Rate for Payer: Cofinity Advantage |
$48.29
|
| Rate for Payer: Cofinity Commercial |
$85.83
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.84
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Healthscope Commercial |
$89.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.85
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: PHP Commercial |
$84.83
|
| Rate for Payer: Priority Health SBD |
$62.87
|
| Rate for Payer: Priority Health SBD |
$43.46
|
| Rate for Payer: UMR Bronson Commercial |
$30.35
|
| Rate for Payer: UMR Bronson Commercial |
$43.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.85
|
|
|
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$71.45
|
|
|
Service Code
|
HCPCS J1756
|
| Hospital Charge Code |
29132
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$64.31 |
| Rate for Payer: Aetna American Axle |
$46.44
|
| Rate for Payer: Aetna American Axle |
$44.84
|
| Rate for Payer: Aetna American Axle |
$64.87
|
| Rate for Payer: Aetna Commercial |
$60.73
|
| Rate for Payer: Aetna Commercial |
$84.83
|
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: Aetna Medicare |
$35.73
|
| Rate for Payer: Aetna Medicare |
$34.49
|
| Rate for Payer: Aetna Medicare |
$49.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.87
|
| Rate for Payer: BCBS Complete |
$27.59
|
| Rate for Payer: BCBS Complete |
$28.58
|
| Rate for Payer: BCBS Complete |
$39.92
|
| Rate for Payer: BCBS Trust/PPO |
$0.76
|
| Rate for Payer: BCBS Trust/PPO |
$0.76
|
| Rate for Payer: BCBS Trust/PPO |
$0.76
|
| Rate for Payer: BCN Commercial |
$0.76
|
| Rate for Payer: BCN Commercial |
$0.76
|
| Rate for Payer: BCN Commercial |
$0.76
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cash Price |
$79.84
|
| Rate for Payer: Cash Price |
$79.84
|
| Rate for Payer: Cash Price |
$57.16
|
| Rate for Payer: Cash Price |
$57.16
|
| Rate for Payer: Cofinity Advantage |
$69.86
|
| Rate for Payer: Cofinity Advantage |
$50.02
|
| Rate for Payer: Cofinity Advantage |
$48.29
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Cofinity Commercial |
$61.45
|
| Rate for Payer: Cofinity Commercial |
$85.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.16
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Healthscope Commercial |
$64.31
|
| Rate for Payer: Healthscope Commercial |
$89.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.85
|
| Rate for Payer: PHP Commercial |
$60.73
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: PHP Commercial |
$84.83
|
| Rate for Payer: Priority Health SBD |
$43.46
|
| Rate for Payer: Priority Health SBD |
$62.87
|
| Rate for Payer: Priority Health SBD |
$45.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.40
|
| Rate for Payer: UHC Core |
$0.40
|
| Rate for Payer: UHC Core |
$0.40
|
| Rate for Payer: UHC Core |
$0.40
|
| Rate for Payer: UHC Exchange |
$0.40
|
| Rate for Payer: UHC Exchange |
$0.40
|
| Rate for Payer: UHC Exchange |
$0.40
|
| Rate for Payer: UMR Bronson Commercial |
$36.93
|
| Rate for Payer: UMR Bronson Commercial |
$25.52
|
| Rate for Payer: UMR Bronson Commercial |
$26.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.85
|
|
|
IRON SUCROSE 200 MG IRON/10 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$199.59
|
|
|
Service Code
|
HCPCS J1756
|
| Hospital Charge Code |
152314
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$87.82 |
| Max. Negotiated Rate |
$179.63 |
| Rate for Payer: Aetna American Axle |
$129.73
|
| Rate for Payer: Aetna Commercial |
$169.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.73
|
| Rate for Payer: Cash Price |
$159.67
|
| Rate for Payer: Cofinity Advantage |
$139.71
|
| Rate for Payer: Cofinity Commercial |
$171.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.67
|
| Rate for Payer: Healthscope Commercial |
$179.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.69
|
| Rate for Payer: PHP Commercial |
$169.65
|
| Rate for Payer: Priority Health SBD |
$125.74
|
| Rate for Payer: UMR Bronson Commercial |
$87.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.69
|
|
