|
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 Commercial |
$51.67
|
| Rate for Payer: Cofinity Commercial |
$63.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.67
|
| 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 |
$55.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.75
|
| Rate for Payer: PHP Commercial |
$62.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.98
|
| 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 |
$55.36
|
|
|
KETOCONAZOLE 2 % TOPICAL CREAM
|
Facility
|
IP
|
$48.83
|
|
|
Service Code
|
NDC 21922002504
|
| Hospital Charge Code |
10368
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$21.49 |
| Max. Negotiated Rate |
$43.95 |
| Rate for Payer: Aetna American Axle |
$31.74
|
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.74
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Commercial |
$34.18
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$43.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: PHP Commercial |
$41.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.74
|
| Rate for Payer: Priority Health SBD |
$30.76
|
| Rate for Payer: UMR Bronson Commercial |
$21.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
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 Commercial |
$51.67
|
| Rate for Payer: Cofinity Commercial |
$63.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.67
|
| 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 |
$55.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.75
|
| Rate for Payer: PHP Commercial |
$62.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.98
|
| Rate for Payer: Priority Health SBD |
$46.51
|
| Rate for Payer: UMR Bronson Commercial |
$27.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.36
|
|
|
KETOROLAC 15 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$20.70
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
22472
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.11 |
| Max. Negotiated Rate |
$18.63 |
| Rate for Payer: Aetna American Axle |
$13.46
|
| Rate for Payer: Aetna American Axle |
$9.98
|
| Rate for Payer: Aetna American Axle |
$9.20
|
| Rate for Payer: Aetna American Axle |
$15.81
|
| Rate for Payer: Aetna Commercial |
$17.60
|
| Rate for Payer: Aetna Commercial |
$20.67
|
| Rate for Payer: Aetna Commercial |
$13.05
|
| Rate for Payer: Aetna Commercial |
$12.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.46
|
| Rate for Payer: Cash Price |
$12.28
|
| Rate for Payer: Cash Price |
$16.56
|
| Rate for Payer: Cash Price |
$11.33
|
| Rate for Payer: Cash Price |
$19.46
|
| Rate for Payer: Cofinity Commercial |
$12.18
|
| Rate for Payer: Cofinity Commercial |
$20.92
|
| Rate for Payer: Cofinity Commercial |
$17.02
|
| Rate for Payer: Cofinity Commercial |
$14.49
|
| Rate for Payer: Cofinity Commercial |
$10.74
|
| Rate for Payer: Cofinity Commercial |
$13.20
|
| Rate for Payer: Cofinity Commercial |
$17.80
|
| Rate for Payer: Cofinity Commercial |
$9.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.28
|
| Rate for Payer: Healthscope Commercial |
$18.63
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$13.82
|
| Rate for Payer: Healthscope Commercial |
$21.89
|
| 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 |
$17.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.49
|
| 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 |
$15.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.60
|
| Rate for Payer: PHP Commercial |
$17.60
|
| Rate for Payer: PHP Commercial |
$20.67
|
| Rate for Payer: PHP Commercial |
$12.04
|
| Rate for Payer: PHP Commercial |
$13.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health SBD |
$15.32
|
| Rate for Payer: Priority Health SBD |
$8.92
|
| Rate for Payer: Priority Health SBD |
$9.67
|
| Rate for Payer: Priority Health SBD |
$13.04
|
| Rate for Payer: UMR Bronson Commercial |
$9.11
|
| Rate for Payer: UMR Bronson Commercial |
$10.70
|
| Rate for Payer: UMR Bronson Commercial |
$6.75
|
| Rate for Payer: UMR Bronson Commercial |
$6.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.24
|
| 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 |
$15.52
|
|
|
KETOROLAC 15 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$24.32
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
22472
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$21.89 |
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: UMR Bronson Commercial |
$5.68
|
| Rate for Payer: UMR Bronson Commercial |
$5.24
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna American Axle |
$15.81
|
| Rate for Payer: Aetna American Axle |
$13.46
|
| Rate for Payer: Aetna American Axle |
$9.20
|
| Rate for Payer: Aetna American Axle |
$9.98
|
| Rate for Payer: Aetna Commercial |
$20.67
|
| Rate for Payer: Aetna Commercial |
$13.05
|
| Rate for Payer: Aetna Commercial |
$12.04
|
| Rate for Payer: Aetna Commercial |
$17.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: Cash Price |
$11.33
|
| Rate for Payer: Cash Price |
$12.28
|
| Rate for Payer: Cash Price |
$19.46
|
| Rate for Payer: Cash Price |
$16.56
|
| Rate for Payer: Cash Price |
$19.46
|
| Rate for Payer: Cash Price |
$16.56
|
| Rate for Payer: Cash Price |
$11.33
|
| Rate for Payer: Cash Price |
$12.28
|
| Rate for Payer: Cofinity Commercial |
$12.18
|
| Rate for Payer: Cofinity Commercial |
$9.91
|
| Rate for Payer: Cofinity Commercial |
$17.02
|
| Rate for Payer: Cofinity Commercial |
$20.92
|
| Rate for Payer: Cofinity Commercial |
$10.74
|
| Rate for Payer: Cofinity Commercial |
$17.80
|
| Rate for Payer: Cofinity Commercial |
$14.49
|
| Rate for Payer: Cofinity Commercial |
$13.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.02
|
| 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 |
$19.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Healthscope Commercial |
$18.63
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$21.89
|
| Rate for Payer: Healthscope Commercial |
$13.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.52
|
| 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 |
$18.24
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.67
|
| 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 |
$17.60
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PHP Commercial |
$20.67
|
| Rate for Payer: PHP Commercial |
$13.05
|
| Rate for Payer: PHP Commercial |
$12.04
|
| Rate for Payer: PHP Commercial |
$17.60
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health SBD |
$15.32
|
| Rate for Payer: Priority Health SBD |
$8.92
|
| Rate for Payer: Priority Health SBD |
$9.67
|
| Rate for Payer: Priority Health SBD |
$13.04
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UMR Bronson Commercial |
$7.66
|
| Rate for Payer: UMR Bronson Commercial |
$9.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.52
|
|
|
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 |
$0.39 |
| 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 |
$0.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Cofinity Commercial |
$77.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| 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 |
$0.39
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health SBD |
$69.30
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UMR Bronson Commercial |
$40.70
|
| Rate for Payer: VA VA |
$0.73
|
| 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
|
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 Commercial |
$77.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.00
|
| 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: PHP Commercial |
$93.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| 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 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 |
$0.39 |
| 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 |
$0.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Cofinity Commercial |
$77.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| 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 |
$0.39
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health SBD |
$69.30
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UMR Bronson Commercial |
$40.70
|
| Rate for Payer: VA VA |
$0.73
|
| 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 Commercial |
$77.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.00
|
| 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: PHP Commercial |
$93.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| 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
|
IP
|
$20.97
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
22473
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$18.87 |
| Rate for Payer: Aetna American Axle |
$13.63
|
| Rate for Payer: Aetna American Axle |
$11.34
|
| Rate for Payer: Aetna American Axle |
$10.40
|
| Rate for Payer: Aetna American Axle |
$8.20
|
| Rate for Payer: Aetna American Axle |
$7.35
|
| Rate for Payer: Aetna American Axle |
$7.57
|
| Rate for Payer: Aetna American Axle |
$10.27
|
| Rate for Payer: Aetna American Axle |
$17.56
|
| Rate for Payer: Aetna Commercial |
$22.97
|
| Rate for Payer: Aetna Commercial |
$17.82
|
| Rate for Payer: Aetna Commercial |
$10.73
|
| Rate for Payer: Aetna Commercial |
$13.43
|
| Rate for Payer: Aetna Commercial |
$9.90
|
| Rate for Payer: Aetna Commercial |
$9.61
|
| Rate for Payer: Aetna Commercial |
$14.83
|
| Rate for Payer: Aetna Commercial |
$13.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.40
|
| Rate for Payer: Cash Price |
$12.64
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cash Price |
$21.62
|
| Rate for Payer: Cash Price |
$9.32
|
| Rate for Payer: Cash Price |
$10.10
|
| Rate for Payer: Cash Price |
$9.05
|
| Rate for Payer: Cash Price |
$13.96
|
| Rate for Payer: Cofinity Commercial |
$13.59
|
| Rate for Payer: Cofinity Commercial |
$7.92
|
| Rate for Payer: Cofinity Commercial |
$11.06
|
| Rate for Payer: Cofinity Commercial |
$10.85
|
| Rate for Payer: Cofinity Commercial |
$10.02
|
| Rate for Payer: Cofinity Commercial |
$8.16
|
| Rate for Payer: Cofinity Commercial |
$8.83
|
| Rate for Payer: Cofinity Commercial |
$9.73
|
| Rate for Payer: Cofinity Commercial |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$13.76
|
| Rate for Payer: Cofinity Commercial |
$12.22
|
| Rate for Payer: Cofinity Commercial |
$15.01
|
| Rate for Payer: Cofinity Commercial |
$14.68
|
| Rate for Payer: Cofinity Commercial |
$18.03
|
| Rate for Payer: Cofinity Commercial |
$18.91
|
| Rate for Payer: Cofinity Commercial |
$23.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.64
|
| 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 |
$13.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.10
|
| Rate for Payer: Healthscope Commercial |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$24.32
|
| Rate for Payer: Healthscope Commercial |
$18.87
|
| Rate for Payer: Healthscope Commercial |
$14.40
|
| Rate for Payer: Healthscope Commercial |
$15.70
|
| Rate for Payer: Healthscope Commercial |
$14.22
|
| Rate for Payer: Healthscope Commercial |
$11.36
|
| Rate for Payer: Healthscope Commercial |
$10.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.73
|
| Rate for Payer: PHP Commercial |
$17.82
|
| Rate for Payer: PHP Commercial |
$10.73
|
| Rate for Payer: PHP Commercial |
$14.83
|
| Rate for Payer: PHP Commercial |
$13.43
|
| Rate for Payer: PHP Commercial |
$22.97
|
| Rate for Payer: PHP Commercial |
$9.61
|
| Rate for Payer: PHP Commercial |
$13.60
|
| Rate for Payer: PHP Commercial |
$9.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.20
|
| Rate for Payer: Priority Health SBD |
$7.95
|
| Rate for Payer: Priority Health SBD |
$7.34
|
| Rate for Payer: Priority Health SBD |
$7.13
|
| Rate for Payer: Priority Health SBD |
$9.95
|
| Rate for Payer: Priority Health SBD |
$10.99
|
| Rate for Payer: Priority Health SBD |
$10.08
|
| Rate for Payer: Priority Health SBD |
$17.02
|
| Rate for Payer: Priority Health SBD |
$13.21
|
| Rate for Payer: UMR Bronson Commercial |
$5.55
|
| Rate for Payer: UMR Bronson Commercial |
$6.95
|
| Rate for Payer: UMR Bronson Commercial |
$7.68
|
| Rate for Payer: UMR Bronson Commercial |
$9.23
|
| Rate for Payer: UMR Bronson Commercial |
$5.13
|
| Rate for Payer: UMR Bronson Commercial |
$11.89
|
| Rate for Payer: UMR Bronson Commercial |
$7.04
|
| Rate for Payer: UMR Bronson Commercial |
$4.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.00
|
|
|
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 |
$0.39 |
| Max. Negotiated Rate |
$10.18 |
| Rate for Payer: Cofinity Commercial |
$8.83
|
| Rate for Payer: Cofinity Commercial |
$13.76
|
| Rate for Payer: Cofinity Commercial |
$14.68
|
| Rate for Payer: Cofinity Commercial |
$18.03
|
| Rate for Payer: Cofinity Commercial |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$18.91
|
| Rate for Payer: Cofinity Commercial |
$15.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.83
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health SBD |
$7.95
|
| Rate for Payer: Priority Health SBD |
$13.21
|
| Rate for Payer: Priority Health SBD |
$7.34
|
| Rate for Payer: Priority Health SBD |
$10.99
|
| Rate for Payer: Priority Health SBD |
$7.13
|
| Rate for Payer: Priority Health SBD |
$9.95
|
| Rate for Payer: Priority Health SBD |
$10.08
|
| Rate for Payer: Priority Health SBD |
$17.02
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UMR Bronson Commercial |
$4.18
|
| Rate for Payer: UMR Bronson Commercial |
$7.76
|
| Rate for Payer: UMR Bronson Commercial |
$4.31
|
| Rate for Payer: UMR Bronson Commercial |
$5.85
|
| Rate for Payer: UMR Bronson Commercial |
$10.00
|
| Rate for Payer: UMR Bronson Commercial |
$6.46
|
| Rate for Payer: UMR Bronson Commercial |
$4.67
|
| Rate for Payer: UMR Bronson Commercial |
$5.92
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: Aetna American Axle |
$7.35
|
| Rate for Payer: Aetna American Axle |
$7.57
|
| Rate for Payer: Aetna American Axle |
$17.56
|
| Rate for Payer: Aetna American Axle |
$13.63
|
| Rate for Payer: Aetna American Axle |
$11.34
|
| 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 Commercial |
$14.83
|
| Rate for Payer: Aetna Commercial |
$9.90
|
| Rate for Payer: Aetna Commercial |
$13.43
|
| Rate for Payer: Aetna Commercial |
$9.61
|
| Rate for Payer: Aetna Commercial |
$22.97
|
| Rate for Payer: Aetna Commercial |
$13.60
|
| Rate for Payer: Aetna Commercial |
$17.82
|
| Rate for Payer: Aetna Commercial |
$10.73
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: Cash Price |
$10.10
|
| Rate for Payer: Cash Price |
$13.96
|
| Rate for Payer: Cash Price |
$12.64
|
| Rate for Payer: Cash Price |
$9.05
|
| Rate for Payer: Cash Price |
$9.05
|
| Rate for Payer: Cash Price |
$9.32
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cash Price |
$21.62
|
| Rate for Payer: Cash Price |
$21.62
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cash Price |
$9.32
|
| Rate for Payer: Cash Price |
$12.64
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Cash Price |
$10.10
|
| Rate for Payer: Cash Price |
$13.96
|
| Rate for Payer: Cofinity Commercial |
$8.16
|
| Rate for Payer: Cofinity Commercial |
$10.02
|
| Rate for Payer: Cofinity Commercial |
$12.22
|
| Rate for Payer: Cofinity Commercial |
$10.85
|
| Rate for Payer: Cofinity Commercial |
$23.24
|
| Rate for Payer: Cofinity Commercial |
$9.73
|
| Rate for Payer: Cofinity Commercial |
$7.92
|
| Rate for Payer: Cofinity Commercial |
$11.06
|
| Rate for Payer: Cofinity Commercial |
$13.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Healthscope Commercial |
$24.32
|
| Rate for Payer: Healthscope Commercial |
$18.87
|
| Rate for Payer: Healthscope Commercial |
$15.70
|
| 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 |
$10.48
|
| Rate for Payer: Healthscope Commercial |
$14.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.46
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.73
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PHP Commercial |
$13.43
|
| Rate for Payer: PHP Commercial |
$14.83
|
| Rate for Payer: PHP Commercial |
$13.60
|
| Rate for Payer: PHP Commercial |
$9.61
|
| Rate for Payer: PHP Commercial |
$10.73
|
| Rate for Payer: PHP Commercial |
$22.97
|
| Rate for Payer: PHP Commercial |
$17.82
|
| Rate for Payer: PHP Commercial |
$9.90
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.09
|
|
|
KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION
|
Facility
|
OP
|
$22.50
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
91349
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$20.25 |
| Rate for Payer: Aetna American Axle |
$14.62
|
| Rate for Payer: Aetna American Axle |
$10.82
|
| Rate for Payer: Aetna American Axle |
$7.45
|
| Rate for Payer: Aetna American Axle |
$9.22
|
| Rate for Payer: Aetna Commercial |
$19.12
|
| Rate for Payer: Aetna Commercial |
$12.06
|
| Rate for Payer: Aetna Commercial |
$9.74
|
| Rate for Payer: Aetna Commercial |
$14.15
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCBS Trust/PPO |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Commercial |
$1.83
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: Cash Price |
$9.17
|
| Rate for Payer: Cash Price |
$11.35
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cash Price |
$9.17
|
| Rate for Payer: Cash Price |
$11.35
|
| Rate for Payer: Cofinity Commercial |
$8.02
|
| Rate for Payer: Cofinity Commercial |
$9.86
|
| Rate for Payer: Cofinity Commercial |
$15.75
|
| Rate for Payer: Cofinity Commercial |
$19.35
|
| Rate for Payer: Cofinity Commercial |
$12.20
|
| Rate for Payer: Cofinity Commercial |
$14.32
|
| Rate for Payer: Cofinity Commercial |
$11.66
|
| Rate for Payer: Cofinity Commercial |
$9.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Healthscope Commercial |
$14.98
|
| Rate for Payer: Healthscope Commercial |
$10.31
|
| Rate for Payer: Healthscope Commercial |
$20.25
|
| Rate for Payer: Healthscope Commercial |
$12.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.49
|
| 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 |
$16.88
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicaid |
$0.39
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Mclaren Medicare |
$0.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.77
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: Meridian Medicaid |
$0.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.12
|
| 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 |
$14.15
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: Nomi Health Commercial |
$2.19
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE Medicare |
$0.69
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PHP Commercial |
$19.12
|
| Rate for Payer: PHP Commercial |
$12.06
|
| Rate for Payer: PHP Commercial |
$9.74
|
| Rate for Payer: PHP Commercial |
$14.15
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.95
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health Narrow Network |
$1.56
|
| Rate for Payer: Priority Health SBD |
$14.18
|
| Rate for Payer: Priority Health SBD |
$7.22
|
| Rate for Payer: Priority Health SBD |
$8.94
|
| Rate for Payer: Priority Health SBD |
$10.49
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.73
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Exchange |
$1.40
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UHCCP Medicaid |
$0.39
|
| Rate for Payer: UMR Bronson Commercial |
$6.16
|
| Rate for Payer: UMR Bronson Commercial |
$8.32
|
| Rate for Payer: UMR Bronson Commercial |
$5.25
|
| Rate for Payer: UMR Bronson Commercial |
$4.24
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.49
|
|
|
KETOROLAC 60 MG/2 ML INTRAMUSCULAR SOLUTION
|
Facility
|
IP
|
$16.65
|
|
|
Service Code
|
HCPCS J1885
|
| Hospital Charge Code |
91349
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$14.98 |
| Rate for Payer: Aetna American Axle |
$10.82
|
| Rate for Payer: Aetna American Axle |
$9.22
|
| Rate for Payer: Aetna American Axle |
$7.45
|
| Rate for Payer: Aetna American Axle |
$14.62
|
| Rate for Payer: Aetna Commercial |
$14.15
|
| Rate for Payer: Aetna Commercial |
$19.12
|
| Rate for Payer: Aetna Commercial |
$12.06
|
| Rate for Payer: Aetna Commercial |
$9.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.82
|
| Rate for Payer: Cash Price |
$11.35
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cash Price |
$9.17
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cofinity Commercial |
$8.02
|
| Rate for Payer: Cofinity Commercial |
$19.35
|
| Rate for Payer: Cofinity Commercial |
$15.75
|
| Rate for Payer: Cofinity Commercial |
$11.66
|
| Rate for Payer: Cofinity Commercial |
$12.20
|
| Rate for Payer: Cofinity Commercial |
$9.93
|
| Rate for Payer: Cofinity Commercial |
$14.32
|
| Rate for Payer: Cofinity Commercial |
$9.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.35
|
| Rate for Payer: Healthscope Commercial |
$14.98
|
| Rate for Payer: Healthscope Commercial |
$10.31
|
| Rate for Payer: Healthscope Commercial |
$12.77
|
| Rate for Payer: Healthscope Commercial |
$20.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.66
|
| 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 |
$12.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.15
|
| Rate for Payer: PHP Commercial |
$14.15
|
| Rate for Payer: PHP Commercial |
$19.12
|
| Rate for Payer: PHP Commercial |
$9.74
|
| Rate for Payer: PHP Commercial |
$12.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.45
|
| Rate for Payer: Priority Health SBD |
$14.18
|
| Rate for Payer: Priority Health SBD |
$7.22
|
| Rate for Payer: Priority Health SBD |
$8.94
|
| Rate for Payer: Priority Health SBD |
$10.49
|
| Rate for Payer: UMR Bronson Commercial |
$7.33
|
| Rate for Payer: UMR Bronson Commercial |
$9.90
|
| Rate for Payer: UMR Bronson Commercial |
$6.24
|
| Rate for Payer: UMR Bronson Commercial |
$5.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.49
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
OP
|
$359.10
|
|
|
Service Code
|
NDC 49884012201
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$132.87 |
| Max. Negotiated Rate |
$323.19 |
| Rate for Payer: Aetna American Axle |
$233.42
|
| Rate for Payer: Aetna Commercial |
$305.24
|
| Rate for Payer: Aetna Medicare |
$179.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.42
|
| Rate for Payer: BCBS Complete |
$143.64
|
| Rate for Payer: Cash Price |
$287.28
|
| Rate for Payer: Cofinity Commercial |
$251.37
|
| Rate for Payer: Cofinity Commercial |
$308.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$251.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.28
|
| Rate for Payer: Healthscope Commercial |
$323.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.24
|
| Rate for Payer: PHP Commercial |
$305.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.42
|
| Rate for Payer: Priority Health SBD |
$226.23
|
| Rate for Payer: UMR Bronson Commercial |
$132.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.32
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
IP
|
$3.24
|
|
|
Service Code
|
NDC 60687043911
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.43 |
| Max. Negotiated Rate |
$2.92 |
| Rate for Payer: Aetna American Axle |
$2.11
|
| Rate for Payer: Aetna Commercial |
$2.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.11
|
| Rate for Payer: Cash Price |
$2.59
|
| Rate for Payer: Cofinity Commercial |
$2.27
|
| Rate for Payer: Cofinity Commercial |
$2.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.59
|
| Rate for Payer: Healthscope Commercial |
$2.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.75
|
| Rate for Payer: PHP Commercial |
$2.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.11
|
| Rate for Payer: Priority Health SBD |
$2.04
|
| Rate for Payer: UMR Bronson Commercial |
$1.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.43
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
OP
|
$221.35
|
|
|
Service Code
|
NDC 00904710961
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$81.90 |
| Max. Negotiated Rate |
$199.22 |
| Rate for Payer: Aetna American Axle |
$143.88
|
| Rate for Payer: Aetna Commercial |
$188.15
|
| Rate for Payer: Aetna Medicare |
$110.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.88
|
| Rate for Payer: BCBS Complete |
$88.54
|
| Rate for Payer: Cash Price |
$177.08
|
| Rate for Payer: Cofinity Commercial |
$154.94
|
| Rate for Payer: Cofinity Commercial |
$190.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$154.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.08
|
| Rate for Payer: Healthscope Commercial |
$199.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.15
|
| Rate for Payer: PHP Commercial |
$188.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.88
|
| Rate for Payer: Priority Health SBD |
$139.45
|
| Rate for Payer: UMR Bronson Commercial |
$81.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.01
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
IP
|
$323.95
|
|
|
Service Code
|
NDC 60687043901
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$142.54 |
| Max. Negotiated Rate |
$291.56 |
| Rate for Payer: Aetna American Axle |
$210.57
|
| Rate for Payer: Aetna Commercial |
$275.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.57
|
| Rate for Payer: Cash Price |
$259.16
|
| Rate for Payer: Cofinity Commercial |
$226.76
|
| Rate for Payer: Cofinity Commercial |
$278.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$226.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.16
|
| Rate for Payer: Healthscope Commercial |
$291.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$226.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$242.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275.36
|
| Rate for Payer: PHP Commercial |
$275.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.57
|
| Rate for Payer: Priority Health SBD |
$204.09
|
| Rate for Payer: UMR Bronson Commercial |
$142.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$242.96
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
IP
|
$439.45
|
|
|
Service Code
|
NDC 68382079801
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$193.36 |
| Max. Negotiated Rate |
$395.50 |
| Rate for Payer: Aetna American Axle |
$285.64
|
| Rate for Payer: Aetna Commercial |
$373.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.64
|
| Rate for Payer: Cash Price |
$351.56
|
| Rate for Payer: Cofinity Commercial |
$307.62
|
| Rate for Payer: Cofinity Commercial |
$377.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$307.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.56
|
| Rate for Payer: Healthscope Commercial |
$395.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$307.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.53
|
| Rate for Payer: PHP Commercial |
$373.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.64
|
| Rate for Payer: Priority Health SBD |
$276.85
|
| Rate for Payer: UMR Bronson Commercial |
$193.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.59
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
OP
|
$2.86
|
|
|
Service Code
|
NDC 51079092801
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$2.57 |
| Rate for Payer: Aetna American Axle |
$1.86
|
| Rate for Payer: Aetna Commercial |
$2.43
|
| Rate for Payer: Aetna Medicare |
$1.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.86
|
| Rate for Payer: BCBS Complete |
$1.14
|
| Rate for Payer: Cash Price |
$2.29
|
| Rate for Payer: Cofinity Commercial |
$2.00
|
| Rate for Payer: Cofinity Commercial |
$2.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.29
|
| Rate for Payer: Healthscope Commercial |
$2.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.43
|
| Rate for Payer: PHP Commercial |
$2.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.86
|
| Rate for Payer: Priority Health SBD |
$1.80
|
| Rate for Payer: UMR Bronson Commercial |
$1.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.14
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
OP
|
$439.45
|
|
|
Service Code
|
NDC 68382079801
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$162.60 |
| Max. Negotiated Rate |
$395.50 |
| Rate for Payer: Aetna American Axle |
$285.64
|
| Rate for Payer: Aetna Commercial |
$373.53
|
| Rate for Payer: Aetna Medicare |
$219.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.64
|
| Rate for Payer: BCBS Complete |
$175.78
|
| Rate for Payer: Cash Price |
$351.56
|
| Rate for Payer: Cofinity Commercial |
$307.62
|
| Rate for Payer: Cofinity Commercial |
$377.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$307.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.56
|
| Rate for Payer: Healthscope Commercial |
$395.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$307.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.53
|
| Rate for Payer: PHP Commercial |
$373.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.64
|
| Rate for Payer: Priority Health SBD |
$276.85
|
| Rate for Payer: UMR Bronson Commercial |
$162.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.59
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
OP
|
$3.24
|
|
|
Service Code
|
NDC 60687043911
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$2.92 |
| Rate for Payer: Aetna American Axle |
$2.11
|
| Rate for Payer: Aetna Commercial |
$2.75
|
| Rate for Payer: Aetna Medicare |
$1.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.11
|
| Rate for Payer: BCBS Complete |
$1.30
|
| Rate for Payer: Cash Price |
$2.59
|
| Rate for Payer: Cofinity Commercial |
$2.27
|
| Rate for Payer: Cofinity Commercial |
$2.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.59
|
| Rate for Payer: Healthscope Commercial |
$2.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.75
|
| Rate for Payer: PHP Commercial |
$2.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.11
|
| Rate for Payer: Priority Health SBD |
$2.04
|
| Rate for Payer: UMR Bronson Commercial |
$1.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.43
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
IP
|
$359.10
|
|
|
Service Code
|
NDC 49884012201
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$158.00 |
| Max. Negotiated Rate |
$323.19 |
| Rate for Payer: Aetna American Axle |
$233.42
|
| Rate for Payer: Aetna Commercial |
$305.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.42
|
| Rate for Payer: Cash Price |
$287.28
|
| Rate for Payer: Cofinity Commercial |
$251.37
|
| Rate for Payer: Cofinity Commercial |
$308.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$251.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.28
|
| Rate for Payer: Healthscope Commercial |
$323.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.24
|
| Rate for Payer: PHP Commercial |
$305.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.42
|
| Rate for Payer: Priority Health SBD |
$226.23
|
| Rate for Payer: UMR Bronson Commercial |
$158.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.32
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
OP
|
$323.95
|
|
|
Service Code
|
NDC 60687043901
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.86 |
| Max. Negotiated Rate |
$291.56 |
| Rate for Payer: Aetna American Axle |
$210.57
|
| Rate for Payer: Aetna Commercial |
$275.36
|
| Rate for Payer: Aetna Medicare |
$161.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.57
|
| Rate for Payer: BCBS Complete |
$129.58
|
| Rate for Payer: Cash Price |
$259.16
|
| Rate for Payer: Cofinity Commercial |
$226.76
|
| Rate for Payer: Cofinity Commercial |
$278.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$226.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.16
|
| Rate for Payer: Healthscope Commercial |
$291.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$226.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$242.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275.36
|
| Rate for Payer: PHP Commercial |
$275.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.57
|
| Rate for Payer: Priority Health SBD |
$204.09
|
| Rate for Payer: UMR Bronson Commercial |
$119.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$242.96
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
IP
|
$2.86
|
|
|
Service Code
|
NDC 51079092801
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$2.57 |
| Rate for Payer: Aetna American Axle |
$1.86
|
| Rate for Payer: Aetna Commercial |
$2.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.86
|
| Rate for Payer: Cash Price |
$2.29
|
| Rate for Payer: Cofinity Commercial |
$2.00
|
| Rate for Payer: Cofinity Commercial |
$2.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.29
|
| Rate for Payer: Healthscope Commercial |
$2.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.43
|
| Rate for Payer: PHP Commercial |
$2.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.86
|
| Rate for Payer: Priority Health SBD |
$1.80
|
| Rate for Payer: UMR Bronson Commercial |
$1.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.14
|
|
|
LABETALOL 100 MG TABLET
|
Facility
|
IP
|
$221.35
|
|
|
Service Code
|
NDC 00904710961
|
| Hospital Charge Code |
10373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$97.39 |
| Max. Negotiated Rate |
$199.22 |
| Rate for Payer: Aetna American Axle |
$143.88
|
| Rate for Payer: Aetna Commercial |
$188.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.88
|
| Rate for Payer: Cash Price |
$177.08
|
| Rate for Payer: Cofinity Commercial |
$154.94
|
| Rate for Payer: Cofinity Commercial |
$190.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$154.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.08
|
| Rate for Payer: Healthscope Commercial |
$199.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.15
|
| Rate for Payer: PHP Commercial |
$188.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.88
|
| Rate for Payer: Priority Health SBD |
$139.45
|
| Rate for Payer: UMR Bronson Commercial |
$97.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.01
|
|
