|
KETAMINE 50 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$23.10
|
|
|
Service Code
|
NDC 00409205310
|
| Hospital Charge Code |
4238
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.16 |
| Max. Negotiated Rate |
$20.79 |
| Rate for Payer: Aetna American Axle |
$15.02
|
| Rate for Payer: Aetna Commercial |
$19.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.02
|
| Rate for Payer: Cash Price |
$18.48
|
| Rate for Payer: Cofinity Advantage |
$16.17
|
| Rate for Payer: Cofinity Commercial |
$19.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.48
|
| Rate for Payer: Healthscope Commercial |
$20.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.32
|
| Rate for Payer: PHP Commercial |
$19.64
|
| Rate for Payer: Priority Health SBD |
$14.55
|
| Rate for Payer: UMR Bronson Commercial |
$10.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.32
|
|
|
KETAMINE 50 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$39.06
|
|
|
Service Code
|
NDC 00143950801
|
| Hospital Charge Code |
4238
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.45 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Aetna American Axle |
$25.39
|
| Rate for Payer: Aetna Commercial |
$33.20
|
| Rate for Payer: Aetna Medicare |
$19.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.39
|
| Rate for Payer: BCBS Complete |
$15.62
|
| Rate for Payer: Cash Price |
$31.25
|
| Rate for Payer: Cofinity Advantage |
$27.34
|
| Rate for Payer: Cofinity Commercial |
$33.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.25
|
| Rate for Payer: Healthscope Commercial |
$35.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.30
|
| Rate for Payer: PHP Commercial |
$33.20
|
| Rate for Payer: Priority Health SBD |
$24.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.39
|
| Rate for Payer: UHC Core |
$20.35
|
| Rate for Payer: UHC Exchange |
$15.35
|
| Rate for Payer: UMR Bronson Commercial |
$14.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.30
|
|
|
KETAMINE 50 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$39.06
|
|
|
Service Code
|
NDC 00143950810
|
| Hospital Charge Code |
4238
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.45 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Aetna American Axle |
$25.39
|
| Rate for Payer: Aetna Commercial |
$33.20
|
| Rate for Payer: Aetna Medicare |
$19.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.39
|
| Rate for Payer: BCBS Complete |
$15.62
|
| Rate for Payer: Cash Price |
$31.25
|
| Rate for Payer: Cofinity Advantage |
$27.34
|
| Rate for Payer: Cofinity Commercial |
$33.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.25
|
| Rate for Payer: Healthscope Commercial |
$35.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.30
|
| Rate for Payer: PHP Commercial |
$33.20
|
| Rate for Payer: Priority Health SBD |
$24.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.39
|
| Rate for Payer: UHC Core |
$20.35
|
| Rate for Payer: UHC Exchange |
$15.35
|
| Rate for Payer: UMR Bronson Commercial |
$14.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.30
|
|
|
KETAMINE 50 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$23.10
|
|
|
Service Code
|
NDC 00409205310
|
| Hospital Charge Code |
4238
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.55 |
| Max. Negotiated Rate |
$20.79 |
| Rate for Payer: Aetna American Axle |
$15.02
|
| Rate for Payer: Aetna Commercial |
$19.64
|
| Rate for Payer: Aetna Medicare |
$11.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.02
|
| Rate for Payer: BCBS Complete |
$9.24
|
| Rate for Payer: Cash Price |
$18.48
|
| Rate for Payer: Cofinity Advantage |
$16.17
|
| Rate for Payer: Cofinity Commercial |
$19.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.48
|
| Rate for Payer: Healthscope Commercial |
$20.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.32
|
| Rate for Payer: PHP Commercial |
$19.64
|
| Rate for Payer: Priority Health SBD |
$14.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.02
|
| Rate for Payer: UHC Core |
$12.04
|
| Rate for Payer: UHC Exchange |
$9.08
|
| Rate for Payer: UMR Bronson Commercial |
$8.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.32
|
|
|
KETAMINE 50 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$39.06
|
|
|
Service Code
|
NDC 00143950801
|
| Hospital Charge Code |
4238
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.19 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Aetna American Axle |
$25.39
|
| Rate for Payer: Aetna Commercial |
$33.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.39
|
| Rate for Payer: Cash Price |
$31.25
|
| Rate for Payer: Cofinity Advantage |
$27.34
|
| Rate for Payer: Cofinity Commercial |
$33.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.25
|
| Rate for Payer: Healthscope Commercial |
$35.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.30
|
| Rate for Payer: PHP Commercial |
$33.20
|
| Rate for Payer: Priority Health SBD |
$24.61
|
| Rate for Payer: UMR Bronson Commercial |
$17.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.30
|
|
|
KETAMINE 50 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$32.65
|
|
|
Service Code
|
NDC 42023011410
|
| Hospital Charge Code |
4238
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.08 |
| Max. Negotiated Rate |
$29.39 |
| Rate for Payer: Aetna American Axle |
$21.22
|
| Rate for Payer: Aetna Commercial |
$27.75
|
| Rate for Payer: Aetna Medicare |
$16.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.22
|
| Rate for Payer: BCBS Complete |
$13.06
|
| Rate for Payer: Cash Price |
$26.12
|
| Rate for Payer: Cofinity Advantage |
$22.86
|
| Rate for Payer: Cofinity Commercial |
$28.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.12
|
| Rate for Payer: Healthscope Commercial |
$29.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.49
|
| Rate for Payer: PHP Commercial |
$27.75
|
| Rate for Payer: Priority Health SBD |
$20.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.22
|
| Rate for Payer: UHC Core |
$17.01
|
| Rate for Payer: UHC Exchange |
$12.83
|
| Rate for Payer: UMR Bronson Commercial |
$12.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.49
|
|
|
KETAMINE 50 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$39.06
|
|
|
Service Code
|
NDC 00143950810
|
| Hospital Charge Code |
4238
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.19 |
| Max. Negotiated Rate |
$35.15 |
| Rate for Payer: Aetna American Axle |
$25.39
|
| Rate for Payer: Aetna Commercial |
$33.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.39
|
| Rate for Payer: Cash Price |
$31.25
|
| Rate for Payer: Cofinity Advantage |
$27.34
|
| Rate for Payer: Cofinity Commercial |
$33.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.25
|
| Rate for Payer: Healthscope Commercial |
$35.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.30
|
| Rate for Payer: PHP Commercial |
$33.20
|
| Rate for Payer: Priority Health SBD |
$24.61
|
| Rate for Payer: UMR Bronson Commercial |
$17.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.30
|
|
|
KETAMINE 50 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$32.65
|
|
|
Service Code
|
NDC 42023011410
|
| Hospital Charge Code |
4238
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$14.37 |
| Max. Negotiated Rate |
$29.39 |
| Rate for Payer: Aetna American Axle |
$21.22
|
| Rate for Payer: Aetna Commercial |
$27.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.22
|
| Rate for Payer: Cash Price |
$26.12
|
| Rate for Payer: Cofinity Advantage |
$22.86
|
| Rate for Payer: Cofinity Commercial |
$28.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.12
|
| Rate for Payer: Healthscope Commercial |
$29.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.49
|
| Rate for Payer: PHP Commercial |
$27.75
|
| Rate for Payer: Priority Health SBD |
$20.57
|
| Rate for Payer: UMR Bronson Commercial |
$14.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.49
|
|
|
KETAMINE (BULK) 100 % POWDER
|
Facility
|
IP
|
$221.13
|
|
|
Service Code
|
NDC 38779175404
|
| Hospital Charge Code |
23101
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$97.30 |
| Max. Negotiated Rate |
$199.02 |
| Rate for Payer: Aetna American Axle |
$143.73
|
| Rate for Payer: Aetna Commercial |
$187.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.73
|
| Rate for Payer: Cash Price |
$176.90
|
| Rate for Payer: Cofinity Advantage |
$154.79
|
| Rate for Payer: Cofinity Commercial |
$190.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.90
|
| Rate for Payer: Healthscope Commercial |
$199.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.85
|
| Rate for Payer: PHP Commercial |
$187.96
|
| Rate for Payer: Priority Health SBD |
$139.31
|
| Rate for Payer: UMR Bronson Commercial |
$97.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.85
|
|
|
KETAMINE (BULK) 100 % POWDER
|
Facility
|
OP
|
$221.13
|
|
|
Service Code
|
NDC 38779175404
|
| Hospital Charge Code |
23101
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$81.82 |
| Max. Negotiated Rate |
$199.02 |
| Rate for Payer: Aetna American Axle |
$143.73
|
| Rate for Payer: Aetna Commercial |
$187.96
|
| Rate for Payer: Aetna Medicare |
$110.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.73
|
| Rate for Payer: BCBS Complete |
$88.45
|
| Rate for Payer: Cash Price |
$176.90
|
| Rate for Payer: Cofinity Advantage |
$154.79
|
| Rate for Payer: Cofinity Commercial |
$190.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.90
|
| Rate for Payer: Healthscope Commercial |
$199.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.85
|
| Rate for Payer: PHP Commercial |
$187.96
|
| Rate for Payer: Priority Health SBD |
$139.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.73
|
| Rate for Payer: UHC Core |
$115.21
|
| Rate for Payer: UHC Exchange |
$86.90
|
| Rate for Payer: UMR Bronson Commercial |
$81.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.85
|
|
|
KETOCONAZOLE 200 MG TABLET
|
Facility
|
OP
|
$392.64
|
|
|
Service Code
|
NDC 35573043302
|
| Hospital Charge Code |
10369
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$145.28 |
| Max. Negotiated Rate |
$353.38 |
| Rate for Payer: Aetna American Axle |
$255.22
|
| Rate for Payer: Aetna Commercial |
$333.74
|
| Rate for Payer: Aetna Medicare |
$196.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.22
|
| Rate for Payer: BCBS Complete |
$157.06
|
| Rate for Payer: Cash Price |
$314.11
|
| Rate for Payer: Cofinity Advantage |
$274.85
|
| Rate for Payer: Cofinity Commercial |
$337.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$314.11
|
| Rate for Payer: Healthscope Commercial |
$353.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$274.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$314.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$294.48
|
| Rate for Payer: PHP Commercial |
$333.74
|
| Rate for Payer: Priority Health SBD |
$247.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.22
|
| Rate for Payer: UHC Core |
$204.57
|
| Rate for Payer: UHC Exchange |
$154.31
|
| Rate for Payer: UMR Bronson Commercial |
$145.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.48
|
|
|
KETOCONAZOLE 200 MG TABLET
|
Facility
|
IP
|
$392.64
|
|
|
Service Code
|
NDC 35573043302
|
| Hospital Charge Code |
10369
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$172.76 |
| Max. Negotiated Rate |
$353.38 |
| Rate for Payer: Aetna American Axle |
$255.22
|
| Rate for Payer: Aetna Commercial |
$333.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.22
|
| Rate for Payer: Cash Price |
$314.11
|
| Rate for Payer: Cofinity Advantage |
$274.85
|
| Rate for Payer: Cofinity Commercial |
$337.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$314.11
|
| Rate for Payer: Healthscope Commercial |
$353.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$274.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$294.48
|
| Rate for Payer: PHP Commercial |
$333.74
|
| Rate for Payer: Priority Health SBD |
$247.36
|
| Rate for Payer: UMR Bronson Commercial |
$172.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.48
|
|
|
KETOCONAZOLE 2 % TOPICAL CREAM
|
Facility
|
OP
|
$73.82
|
|
|
Service Code
|
NDC 51672129801
|
| Hospital Charge Code |
10368
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$27.31 |
| Max. Negotiated Rate |
$66.44 |
| Rate for Payer: Aetna American Axle |
$47.98
|
| Rate for Payer: Aetna Commercial |
$62.75
|
| Rate for Payer: Aetna Medicare |
$36.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.98
|
| Rate for Payer: BCBS Complete |
$29.53
|
| Rate for Payer: Cash Price |
$59.06
|
| Rate for Payer: Cofinity Advantage |
$51.67
|
| Rate for Payer: Cofinity Commercial |
$63.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.06
|
| Rate for Payer: Healthscope Commercial |
$66.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.37
|
| Rate for Payer: PHP Commercial |
$62.75
|
| Rate for Payer: Priority Health SBD |
$46.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.98
|
| Rate for Payer: UHC Core |
$38.46
|
| Rate for Payer: UHC Exchange |
$29.01
|
| Rate for Payer: UMR Bronson Commercial |
$27.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.37
|
|
|
KETOCONAZOLE 2 % TOPICAL CREAM
|
Facility
|
IP
|
$73.82
|
|
|
Service Code
|
NDC 51672129801
|
| Hospital Charge Code |
10368
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$32.48 |
| Max. Negotiated Rate |
$66.44 |
| Rate for Payer: Aetna American Axle |
$47.98
|
| Rate for Payer: Aetna Commercial |
$62.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.98
|
| Rate for Payer: Cash Price |
$59.06
|
| Rate for Payer: Cofinity Advantage |
$51.67
|
| Rate for Payer: Cofinity Commercial |
$63.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.06
|
| Rate for Payer: Healthscope Commercial |
$66.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.37
|
| Rate for Payer: PHP Commercial |
$62.75
|
| Rate for Payer: Priority Health SBD |
$46.51
|
| Rate for Payer: UMR Bronson Commercial |
$32.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.37
|
|
|
KETOCONAZOLE 2 % TOPICAL CREAM
|
Facility
|
IP
|
$25.11
|
|
|
Service Code
|
NDC 21922002504
|
| Hospital Charge Code |
10368
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.05 |
| Max. Negotiated Rate |
$22.60 |
| Rate for Payer: Aetna American Axle |
$16.32
|
| Rate for Payer: Aetna Commercial |
$21.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.32
|
| Rate for Payer: Cash Price |
$20.09
|
| Rate for Payer: Cofinity Advantage |
$17.58
|
| Rate for Payer: Cofinity Commercial |
$21.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.09
|
| Rate for Payer: Healthscope Commercial |
$22.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.83
|
| Rate for Payer: PHP Commercial |
$21.34
|
| Rate for Payer: Priority Health SBD |
$15.82
|
| Rate for Payer: UMR Bronson Commercial |
$11.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.83
|
|
|
KETOCONAZOLE 2 % TOPICAL CREAM
|
Facility
|
OP
|
$25.11
|
|
|
Service Code
|
NDC 21922002504
|
| Hospital Charge Code |
10368
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.29 |
| Max. Negotiated Rate |
$22.60 |
| Rate for Payer: Aetna American Axle |
$16.32
|
| Rate for Payer: Aetna Commercial |
$21.34
|
| Rate for Payer: Aetna Medicare |
$12.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.32
|
| Rate for Payer: BCBS Complete |
$10.04
|
| Rate for Payer: Cash Price |
$20.09
|
| Rate for Payer: Cofinity Advantage |
$17.58
|
| Rate for Payer: Cofinity Commercial |
$21.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.09
|
| Rate for Payer: Healthscope Commercial |
$22.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.83
|
| Rate for Payer: PHP Commercial |
$21.34
|
| Rate for Payer: Priority Health SBD |
$15.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.32
|
| Rate for Payer: UHC Core |
$13.08
|
| Rate for Payer: UHC Exchange |
$9.87
|
| Rate for Payer: UMR Bronson Commercial |
$9.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.83
|
|
|
KETOROLAC 15 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$24.32
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
22472
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.70 |
| Max. Negotiated Rate |
$21.89 |
| Rate for Payer: Aetna American Axle |
$15.81
|
| Rate for Payer: Aetna American Axle |
$13.46
|
| Rate for Payer: Aetna American Axle |
$4.22
|
| Rate for Payer: Aetna American Axle |
$9.98
|
| Rate for Payer: Aetna American Axle |
$9.20
|
| Rate for Payer: Aetna Commercial |
$12.04
|
| Rate for Payer: Aetna Commercial |
$17.59
|
| Rate for Payer: Aetna Commercial |
$20.67
|
| Rate for Payer: Aetna Commercial |
$5.53
|
| Rate for Payer: Aetna Commercial |
$13.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.22
|
| Rate for Payer: Cash Price |
$16.56
|
| Rate for Payer: Cash Price |
$12.28
|
| Rate for Payer: Cash Price |
$5.20
|
| Rate for Payer: Cash Price |
$19.46
|
| Rate for Payer: Cash Price |
$11.33
|
| Rate for Payer: Cofinity Advantage |
$9.91
|
| Rate for Payer: Cofinity Advantage |
$4.55
|
| Rate for Payer: Cofinity Advantage |
$10.74
|
| Rate for Payer: Cofinity Advantage |
$17.02
|
| Rate for Payer: Cofinity Advantage |
$14.49
|
| Rate for Payer: Cofinity Commercial |
$5.59
|
| Rate for Payer: Cofinity Commercial |
$12.18
|
| Rate for Payer: Cofinity Commercial |
$13.20
|
| Rate for Payer: Cofinity Commercial |
$17.80
|
| Rate for Payer: Cofinity Commercial |
$20.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$13.81
|
| Rate for Payer: Healthscope Commercial |
$18.63
|
| Rate for Payer: Healthscope Commercial |
$21.89
|
| Rate for Payer: Healthscope Commercial |
$5.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.24
|
| Rate for Payer: PHP Commercial |
$17.59
|
| Rate for Payer: PHP Commercial |
$12.04
|
| Rate for Payer: PHP Commercial |
$20.67
|
| Rate for Payer: PHP Commercial |
$5.53
|
| Rate for Payer: PHP Commercial |
$13.05
|
| Rate for Payer: Priority Health SBD |
$15.32
|
| Rate for Payer: Priority Health SBD |
$4.09
|
| Rate for Payer: Priority Health SBD |
$9.67
|
| Rate for Payer: Priority Health SBD |
$8.92
|
| Rate for Payer: Priority Health SBD |
$13.04
|
| Rate for Payer: UMR Bronson Commercial |
$6.75
|
| Rate for Payer: UMR Bronson Commercial |
$2.86
|
| Rate for Payer: UMR Bronson Commercial |
$9.11
|
| Rate for Payer: UMR Bronson Commercial |
$6.23
|
| Rate for Payer: UMR Bronson Commercial |
$10.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.51
|
|
|
KETOROLAC 15 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$14.16
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
22472
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna American Axle |
$9.20
|
| Rate for Payer: Aetna American Axle |
$13.46
|
| Rate for Payer: Aetna American Axle |
$4.22
|
| Rate for Payer: Aetna American Axle |
$15.81
|
| Rate for Payer: Aetna American Axle |
$9.98
|
| Rate for Payer: Aetna Commercial |
$5.53
|
| Rate for Payer: Aetna Commercial |
$12.04
|
| Rate for Payer: Aetna Commercial |
$17.59
|
| Rate for Payer: Aetna Commercial |
$13.05
|
| Rate for Payer: Aetna Commercial |
$20.67
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: Cash Price |
$11.33
|
| Rate for Payer: Cash Price |
$11.33
|
| Rate for Payer: Cash Price |
$5.20
|
| Rate for Payer: Cash Price |
$19.46
|
| Rate for Payer: Cash Price |
$12.28
|
| Rate for Payer: Cash Price |
$5.20
|
| Rate for Payer: Cash Price |
$19.46
|
| Rate for Payer: Cash Price |
$16.56
|
| Rate for Payer: Cash Price |
$16.56
|
| Rate for Payer: Cash Price |
$12.28
|
| Rate for Payer: Cofinity Advantage |
$9.91
|
| Rate for Payer: Cofinity Advantage |
$14.49
|
| Rate for Payer: Cofinity Advantage |
$4.55
|
| Rate for Payer: Cofinity Advantage |
$17.02
|
| Rate for Payer: Cofinity Advantage |
$10.74
|
| Rate for Payer: Cofinity Commercial |
$20.92
|
| Rate for Payer: Cofinity Commercial |
$12.18
|
| Rate for Payer: Cofinity Commercial |
$5.59
|
| Rate for Payer: Cofinity Commercial |
$17.80
|
| Rate for Payer: Cofinity Commercial |
$13.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Healthscope Commercial |
$5.85
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$21.89
|
| Rate for Payer: Healthscope Commercial |
$18.63
|
| Rate for Payer: Healthscope Commercial |
$13.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.88
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.53
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.62
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PHP Commercial |
$20.67
|
| Rate for Payer: PHP Commercial |
$17.59
|
| Rate for Payer: PHP Commercial |
$12.04
|
| Rate for Payer: PHP Commercial |
$13.05
|
| Rate for Payer: PHP Commercial |
$5.53
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health SBD |
$15.32
|
| Rate for Payer: Priority Health SBD |
$13.04
|
| Rate for Payer: Priority Health SBD |
$9.67
|
| Rate for Payer: Priority Health SBD |
$4.09
|
| Rate for Payer: Priority Health SBD |
$8.92
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UMR Bronson Commercial |
$7.66
|
| Rate for Payer: UMR Bronson Commercial |
$2.40
|
| Rate for Payer: UMR Bronson Commercial |
$9.00
|
| Rate for Payer: UMR Bronson Commercial |
$5.24
|
| Rate for Payer: UMR Bronson Commercial |
$5.68
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.88
|
|
|
KETOROLAC 15MG ROPIVACAINE 0.5 % 50ML IN SODIUM CHLORIDE 0.9% ML INFILTRATION (TOTAL KNEE)
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
301036
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$48.40 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna American Axle |
$71.50
|
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Advantage |
$77.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.50
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: Priority Health SBD |
$69.30
|
| Rate for Payer: UMR Bronson Commercial |
$48.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
|
KETOROLAC 15MG ROPIVACAINE 0.5 % 50ML IN SODIUM CHLORIDE 0.9% ML INFILTRATION (TOTAL KNEE)
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
301036
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna American Axle |
$71.50
|
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Advantage |
$77.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.50
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health SBD |
$69.30
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UMR Bronson Commercial |
$40.70
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
|
KETOROLAC 15 MG ROPIVACAINE 0.5% 60 ML IN SODIUM CHLORIDE 0.9% ML INFILTRATION (TOTAL HIP)
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
301035
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna American Axle |
$71.50
|
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Advantage |
$77.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.50
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health SBD |
$69.30
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UMR Bronson Commercial |
$40.70
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
|
KETOROLAC 15 MG ROPIVACAINE 0.5% 60 ML IN SODIUM CHLORIDE 0.9% ML INFILTRATION (TOTAL HIP)
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
301035
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$48.40 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna American Axle |
$71.50
|
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Advantage |
$77.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.50
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: Priority Health SBD |
$69.30
|
| Rate for Payer: UMR Bronson Commercial |
$48.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
|
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
OP
|
$11.31
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
22473
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$10.18 |
| Rate for Payer: Aetna American Axle |
$7.35
|
| Rate for Payer: Aetna American Axle |
$7.56
|
| Rate for Payer: Aetna American Axle |
$5.30
|
| Rate for Payer: Aetna American Axle |
$13.63
|
| Rate for Payer: Aetna American Axle |
$10.40
|
| Rate for Payer: Aetna American Axle |
$10.27
|
| Rate for Payer: Aetna American Axle |
$8.20
|
| Rate for Payer: Aetna American Axle |
$7.57
|
| Rate for Payer: Aetna Commercial |
$13.60
|
| Rate for Payer: Aetna Commercial |
$9.89
|
| Rate for Payer: Aetna Commercial |
$10.73
|
| Rate for Payer: Aetna Commercial |
$9.61
|
| Rate for Payer: Aetna Commercial |
$6.93
|
| Rate for Payer: Aetna Commercial |
$13.43
|
| Rate for Payer: Aetna Commercial |
$17.82
|
| Rate for Payer: Aetna Commercial |
$9.90
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Cash Price |
$10.10
|
| Rate for Payer: Cash Price |
$10.10
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cash Price |
$12.64
|
| Rate for Payer: Cash Price |
$6.52
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Cash Price |
$9.32
|
| Rate for Payer: Cash Price |
$9.32
|
| Rate for Payer: Cash Price |
$12.64
|
| Rate for Payer: Cash Price |
$6.52
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cash Price |
$9.05
|
| Rate for Payer: Cash Price |
$9.05
|
| Rate for Payer: Cofinity Advantage |
$11.20
|
| Rate for Payer: Cofinity Advantage |
$5.71
|
| Rate for Payer: Cofinity Advantage |
$7.92
|
| Rate for Payer: Cofinity Advantage |
$11.06
|
| Rate for Payer: Cofinity Advantage |
$8.14
|
| Rate for Payer: Cofinity Advantage |
$8.83
|
| Rate for Payer: Cofinity Advantage |
$14.68
|
| Rate for Payer: Cofinity Advantage |
$8.15
|
| Rate for Payer: Cofinity Commercial |
$13.59
|
| Rate for Payer: Cofinity Commercial |
$13.76
|
| Rate for Payer: Cofinity Commercial |
$18.03
|
| Rate for Payer: Cofinity Commercial |
$9.73
|
| Rate for Payer: Cofinity Commercial |
$10.00
|
| Rate for Payer: Cofinity Commercial |
$7.01
|
| Rate for Payer: Cofinity Commercial |
$10.85
|
| Rate for Payer: Cofinity Commercial |
$10.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Healthscope Commercial |
$7.33
|
| Rate for Payer: Healthscope Commercial |
$18.87
|
| Rate for Payer: Healthscope Commercial |
$10.47
|
| Rate for Payer: Healthscope Commercial |
$14.40
|
| Rate for Payer: Healthscope Commercial |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$10.48
|
| Rate for Payer: Healthscope Commercial |
$14.22
|
| Rate for Payer: Healthscope Commercial |
$11.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.48
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.73
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.11
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PHP Commercial |
$6.93
|
| Rate for Payer: PHP Commercial |
$9.89
|
| Rate for Payer: PHP Commercial |
$9.61
|
| Rate for Payer: PHP Commercial |
$17.82
|
| Rate for Payer: PHP Commercial |
$10.73
|
| Rate for Payer: PHP Commercial |
$13.43
|
| Rate for Payer: PHP Commercial |
$9.90
|
| Rate for Payer: PHP Commercial |
$13.60
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health SBD |
$7.13
|
| Rate for Payer: Priority Health SBD |
$7.95
|
| Rate for Payer: Priority Health SBD |
$7.33
|
| Rate for Payer: Priority Health SBD |
$10.08
|
| Rate for Payer: Priority Health SBD |
$5.13
|
| Rate for Payer: Priority Health SBD |
$9.95
|
| Rate for Payer: Priority Health SBD |
$7.34
|
| Rate for Payer: Priority Health SBD |
$13.21
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UMR Bronson Commercial |
$4.31
|
| Rate for Payer: UMR Bronson Commercial |
$5.85
|
| Rate for Payer: UMR Bronson Commercial |
$4.18
|
| Rate for Payer: UMR Bronson Commercial |
$3.02
|
| Rate for Payer: UMR Bronson Commercial |
$5.92
|
| Rate for Payer: UMR Bronson Commercial |
$4.30
|
| Rate for Payer: UMR Bronson Commercial |
$4.67
|
| Rate for Payer: UMR Bronson Commercial |
$7.76
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.72
|
|
|
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION
|
Facility
|
IP
|
$12.62
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
22473
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.55 |
| Max. Negotiated Rate |
$11.36 |
| Rate for Payer: Aetna American Axle |
$8.20
|
| Rate for Payer: Aetna American Axle |
$10.40
|
| Rate for Payer: Aetna American Axle |
$13.63
|
| Rate for Payer: Aetna American Axle |
$7.35
|
| Rate for Payer: Aetna American Axle |
$7.57
|
| Rate for Payer: Aetna American Axle |
$7.56
|
| Rate for Payer: Aetna American Axle |
$5.30
|
| Rate for Payer: Aetna American Axle |
$10.27
|
| Rate for Payer: Aetna Commercial |
$6.93
|
| Rate for Payer: Aetna Commercial |
$17.82
|
| Rate for Payer: Aetna Commercial |
$10.73
|
| Rate for Payer: Aetna Commercial |
$9.61
|
| Rate for Payer: Aetna Commercial |
$9.89
|
| Rate for Payer: Aetna Commercial |
$13.60
|
| Rate for Payer: Aetna Commercial |
$9.90
|
| Rate for Payer: Aetna Commercial |
$13.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.40
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Cash Price |
$6.52
|
| Rate for Payer: Cash Price |
$10.10
|
| Rate for Payer: Cash Price |
$9.05
|
| Rate for Payer: Cash Price |
$9.32
|
| Rate for Payer: Cash Price |
$12.64
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cofinity Advantage |
$5.71
|
| Rate for Payer: Cofinity Advantage |
$8.14
|
| Rate for Payer: Cofinity Advantage |
$8.83
|
| Rate for Payer: Cofinity Advantage |
$8.15
|
| Rate for Payer: Cofinity Advantage |
$7.92
|
| Rate for Payer: Cofinity Advantage |
$11.20
|
| Rate for Payer: Cofinity Advantage |
$14.68
|
| Rate for Payer: Cofinity Advantage |
$11.06
|
| Rate for Payer: Cofinity Commercial |
$10.00
|
| Rate for Payer: Cofinity Commercial |
$9.73
|
| Rate for Payer: Cofinity Commercial |
$10.02
|
| Rate for Payer: Cofinity Commercial |
$10.85
|
| Rate for Payer: Cofinity Commercial |
$7.01
|
| Rate for Payer: Cofinity Commercial |
$13.59
|
| Rate for Payer: Cofinity Commercial |
$18.03
|
| Rate for Payer: Cofinity Commercial |
$13.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.05
|
| Rate for Payer: Healthscope Commercial |
$14.22
|
| Rate for Payer: Healthscope Commercial |
$11.36
|
| Rate for Payer: Healthscope Commercial |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$7.33
|
| Rate for Payer: Healthscope Commercial |
$18.87
|
| Rate for Payer: Healthscope Commercial |
$10.48
|
| Rate for Payer: Healthscope Commercial |
$10.47
|
| Rate for Payer: Healthscope Commercial |
$14.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.11
|
| Rate for Payer: PHP Commercial |
$10.73
|
| Rate for Payer: PHP Commercial |
$13.43
|
| Rate for Payer: PHP Commercial |
$6.93
|
| Rate for Payer: PHP Commercial |
$9.90
|
| Rate for Payer: PHP Commercial |
$9.89
|
| Rate for Payer: PHP Commercial |
$9.61
|
| Rate for Payer: PHP Commercial |
$13.60
|
| Rate for Payer: PHP Commercial |
$17.82
|
| Rate for Payer: Priority Health SBD |
$10.08
|
| Rate for Payer: Priority Health SBD |
$13.21
|
| Rate for Payer: Priority Health SBD |
$5.13
|
| Rate for Payer: Priority Health SBD |
$7.33
|
| Rate for Payer: Priority Health SBD |
$7.13
|
| Rate for Payer: Priority Health SBD |
$7.34
|
| Rate for Payer: Priority Health SBD |
$7.95
|
| Rate for Payer: Priority Health SBD |
$9.95
|
| Rate for Payer: UMR Bronson Commercial |
$4.98
|
| Rate for Payer: UMR Bronson Commercial |
$6.95
|
| Rate for Payer: UMR Bronson Commercial |
$5.13
|
| Rate for Payer: UMR Bronson Commercial |
$3.59
|
| Rate for Payer: UMR Bronson Commercial |
$9.23
|
| Rate for Payer: UMR Bronson Commercial |
$5.55
|
| Rate for Payer: UMR Bronson Commercial |
$5.12
|
| Rate for Payer: UMR Bronson Commercial |
$7.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.73
|
|
|
KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION
|
Facility
|
OP
|
$11.46
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
91349
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$10.31 |
| Rate for Payer: Aetna American Axle |
$7.45
|
| Rate for Payer: Aetna American Axle |
$18.34
|
| Rate for Payer: Aetna American Axle |
$9.22
|
| Rate for Payer: Aetna American Axle |
$7.41
|
| Rate for Payer: Aetna Commercial |
$9.74
|
| Rate for Payer: Aetna Commercial |
$23.99
|
| Rate for Payer: Aetna Commercial |
$9.69
|
| Rate for Payer: Aetna Commercial |
$12.06
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: Cash Price |
$11.35
|
| Rate for Payer: Cash Price |
$9.17
|
| Rate for Payer: Cash Price |
$9.12
|
| Rate for Payer: Cash Price |
$22.58
|
| Rate for Payer: Cash Price |
$9.17
|
| Rate for Payer: Cash Price |
$11.35
|
| Rate for Payer: Cash Price |
$22.58
|
| Rate for Payer: Cash Price |
$9.12
|
| Rate for Payer: Cofinity Advantage |
$9.93
|
| Rate for Payer: Cofinity Advantage |
$7.98
|
| Rate for Payer: Cofinity Advantage |
$19.75
|
| Rate for Payer: Cofinity Advantage |
$8.02
|
| Rate for Payer: Cofinity Commercial |
$24.27
|
| Rate for Payer: Cofinity Commercial |
$9.86
|
| Rate for Payer: Cofinity Commercial |
$12.20
|
| Rate for Payer: Cofinity Commercial |
$9.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Healthscope Commercial |
$10.31
|
| Rate for Payer: Healthscope Commercial |
$12.77
|
| Rate for Payer: Healthscope Commercial |
$25.40
|
| Rate for Payer: Healthscope Commercial |
$10.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.55
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.69
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.16
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PHP Commercial |
$9.74
|
| Rate for Payer: PHP Commercial |
$23.99
|
| Rate for Payer: PHP Commercial |
$9.69
|
| Rate for Payer: PHP Commercial |
$12.06
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health SBD |
$7.18
|
| Rate for Payer: Priority Health SBD |
$7.22
|
| Rate for Payer: Priority Health SBD |
$17.78
|
| Rate for Payer: Priority Health SBD |
$8.94
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UMR Bronson Commercial |
$5.25
|
| Rate for Payer: UMR Bronson Commercial |
$4.24
|
| Rate for Payer: UMR Bronson Commercial |
$4.22
|
| Rate for Payer: UMR Bronson Commercial |
$10.44
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.55
|
|
