|
LIDOCAINE 5 % TOPICAL OINTMENT
|
Facility
|
OP
|
$36.60
|
|
|
Service Code
|
NDC 65162091838
|
| Hospital Charge Code |
159107
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.54 |
| Max. Negotiated Rate |
$32.94 |
| Rate for Payer: Aetna American Axle |
$23.79
|
| Rate for Payer: Aetna Commercial |
$31.11
|
| Rate for Payer: Aetna Medicare |
$18.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.79
|
| Rate for Payer: BCBS Complete |
$14.64
|
| Rate for Payer: Cash Price |
$29.28
|
| Rate for Payer: Cofinity Advantage |
$25.62
|
| Rate for Payer: Cofinity Commercial |
$31.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.28
|
| Rate for Payer: Healthscope Commercial |
$32.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.45
|
| Rate for Payer: PHP Commercial |
$31.11
|
| Rate for Payer: Priority Health SBD |
$23.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.79
|
| Rate for Payer: UHC Core |
$19.07
|
| Rate for Payer: UHC Exchange |
$14.38
|
| Rate for Payer: UMR Bronson Commercial |
$13.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.45
|
|
|
LIDOCAINE 5 % TOPICAL OINTMENT
|
Facility
|
IP
|
$28.66
|
|
|
Service Code
|
NDC 70752011303
|
| Hospital Charge Code |
159107
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$12.61 |
| Max. Negotiated Rate |
$25.79 |
| Rate for Payer: Aetna American Axle |
$18.63
|
| Rate for Payer: Aetna Commercial |
$24.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.63
|
| Rate for Payer: Cash Price |
$22.93
|
| Rate for Payer: Cofinity Advantage |
$20.06
|
| Rate for Payer: Cofinity Commercial |
$24.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.93
|
| Rate for Payer: Healthscope Commercial |
$25.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.50
|
| Rate for Payer: PHP Commercial |
$24.36
|
| Rate for Payer: Priority Health SBD |
$18.06
|
| Rate for Payer: UMR Bronson Commercial |
$12.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.50
|
|
|
LIDOCAINE 5 % TOPICAL OINTMENT
|
Facility
|
IP
|
$97.65
|
|
|
Service Code
|
NDC 51672302002
|
| Hospital Charge Code |
159107
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$42.97 |
| Max. Negotiated Rate |
$87.89 |
| Rate for Payer: Aetna American Axle |
$63.47
|
| Rate for Payer: Aetna Commercial |
$83.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.47
|
| Rate for Payer: Cash Price |
$78.12
|
| Rate for Payer: Cofinity Advantage |
$68.36
|
| Rate for Payer: Cofinity Commercial |
$83.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.12
|
| Rate for Payer: Healthscope Commercial |
$87.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.24
|
| Rate for Payer: PHP Commercial |
$83.00
|
| Rate for Payer: Priority Health SBD |
$61.52
|
| Rate for Payer: UMR Bronson Commercial |
$42.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.24
|
|
|
LIDOCAINE 5 % TOPICAL OINTMENT
|
Facility
|
OP
|
$28.66
|
|
|
Service Code
|
NDC 70752011303
|
| Hospital Charge Code |
159107
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$10.60 |
| Max. Negotiated Rate |
$25.79 |
| Rate for Payer: Aetna American Axle |
$18.63
|
| Rate for Payer: Aetna Commercial |
$24.36
|
| Rate for Payer: Aetna Medicare |
$14.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.63
|
| Rate for Payer: BCBS Complete |
$11.46
|
| Rate for Payer: Cash Price |
$22.93
|
| Rate for Payer: Cofinity Advantage |
$20.06
|
| Rate for Payer: Cofinity Commercial |
$24.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.93
|
| Rate for Payer: Healthscope Commercial |
$25.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.50
|
| Rate for Payer: PHP Commercial |
$24.36
|
| Rate for Payer: Priority Health SBD |
$18.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.63
|
| Rate for Payer: UHC Core |
$14.93
|
| Rate for Payer: UHC Exchange |
$11.26
|
| Rate for Payer: UMR Bronson Commercial |
$10.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.50
|
|
|
LIDOCAINE 5 % TOPICAL OINTMENT
|
Facility
|
IP
|
$737.67
|
|
|
Service Code
|
NDC 00168020437
|
| Hospital Charge Code |
159107
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$324.57 |
| Max. Negotiated Rate |
$663.90 |
| Rate for Payer: Aetna American Axle |
$479.49
|
| Rate for Payer: Aetna Commercial |
$627.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$479.49
|
| Rate for Payer: Cash Price |
$590.14
|
| Rate for Payer: Cofinity Advantage |
$516.37
|
| Rate for Payer: Cofinity Commercial |
$634.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$590.14
|
| Rate for Payer: Healthscope Commercial |
$663.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$516.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$553.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$627.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$553.25
|
| Rate for Payer: PHP Commercial |
$627.02
|
| Rate for Payer: Priority Health SBD |
$464.73
|
| Rate for Payer: UMR Bronson Commercial |
$324.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$553.25
|
|
|
LIDOCAINE 5 % TOPICAL OINTMENT
|
Facility
|
OP
|
$737.67
|
|
|
Service Code
|
NDC 00168020437
|
| Hospital Charge Code |
159107
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$272.94 |
| Max. Negotiated Rate |
$663.90 |
| Rate for Payer: Aetna American Axle |
$479.49
|
| Rate for Payer: Aetna Commercial |
$627.02
|
| Rate for Payer: Aetna Medicare |
$368.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$479.49
|
| Rate for Payer: BCBS Complete |
$295.07
|
| Rate for Payer: Cash Price |
$590.14
|
| Rate for Payer: Cofinity Advantage |
$516.37
|
| Rate for Payer: Cofinity Commercial |
$634.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$590.14
|
| Rate for Payer: Healthscope Commercial |
$663.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$516.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$553.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$590.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$627.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$553.25
|
| Rate for Payer: PHP Commercial |
$627.02
|
| Rate for Payer: Priority Health SBD |
$464.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$479.49
|
| Rate for Payer: UHC Core |
$384.33
|
| Rate for Payer: UHC Exchange |
$289.90
|
| Rate for Payer: UMR Bronson Commercial |
$272.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$553.25
|
|
|
LIDOCAINE 5 % TOPICAL OINTMENT
|
Facility
|
IP
|
$81.38
|
|
|
Service Code
|
NDC 51672302009
|
| Hospital Charge Code |
159107
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$35.81 |
| Max. Negotiated Rate |
$73.24 |
| Rate for Payer: Aetna American Axle |
$52.90
|
| Rate for Payer: Aetna Commercial |
$69.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.90
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cofinity Advantage |
$56.97
|
| Rate for Payer: Cofinity Commercial |
$69.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.10
|
| Rate for Payer: Healthscope Commercial |
$73.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.03
|
| Rate for Payer: PHP Commercial |
$69.17
|
| Rate for Payer: Priority Health SBD |
$51.27
|
| Rate for Payer: UMR Bronson Commercial |
$35.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.03
|
|
|
LIDOCAINE 5 % TOPICAL OINTMENT
|
Facility
|
OP
|
$70.58
|
|
|
Service Code
|
NDC 69680012035
|
| Hospital Charge Code |
159107
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$26.11 |
| Max. Negotiated Rate |
$63.52 |
| Rate for Payer: Aetna American Axle |
$45.88
|
| Rate for Payer: Aetna Commercial |
$59.99
|
| Rate for Payer: Aetna Medicare |
$35.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.88
|
| Rate for Payer: BCBS Complete |
$28.23
|
| Rate for Payer: Cash Price |
$56.46
|
| Rate for Payer: Cofinity Advantage |
$49.41
|
| Rate for Payer: Cofinity Commercial |
$60.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.46
|
| Rate for Payer: Healthscope Commercial |
$63.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.94
|
| Rate for Payer: PHP Commercial |
$59.99
|
| Rate for Payer: Priority Health SBD |
$44.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.88
|
| Rate for Payer: UHC Core |
$36.77
|
| Rate for Payer: UHC Exchange |
$27.74
|
| Rate for Payer: UMR Bronson Commercial |
$26.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.94
|
|
|
LIDOCAINE 5 % TOPICAL OINTMENT
|
Facility
|
OP
|
$81.38
|
|
|
Service Code
|
NDC 51672302009
|
| Hospital Charge Code |
159107
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$30.11 |
| Max. Negotiated Rate |
$73.24 |
| Rate for Payer: Aetna American Axle |
$52.90
|
| Rate for Payer: Aetna Commercial |
$69.17
|
| Rate for Payer: Aetna Medicare |
$40.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.90
|
| Rate for Payer: BCBS Complete |
$32.55
|
| Rate for Payer: Cash Price |
$65.10
|
| Rate for Payer: Cofinity Advantage |
$56.97
|
| Rate for Payer: Cofinity Commercial |
$69.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.10
|
| Rate for Payer: Healthscope Commercial |
$73.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.03
|
| Rate for Payer: PHP Commercial |
$69.17
|
| Rate for Payer: Priority Health SBD |
$51.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.90
|
| Rate for Payer: UHC Core |
$42.40
|
| Rate for Payer: UHC Exchange |
$31.98
|
| Rate for Payer: UMR Bronson Commercial |
$30.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.03
|
|
|
LIDOCAINE 5 % TOPICAL OINTMENT
|
Facility
|
IP
|
$70.58
|
|
|
Service Code
|
NDC 69680012035
|
| Hospital Charge Code |
159107
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.06 |
| Max. Negotiated Rate |
$63.52 |
| Rate for Payer: Aetna American Axle |
$45.88
|
| Rate for Payer: Aetna Commercial |
$59.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.88
|
| Rate for Payer: Cash Price |
$56.46
|
| Rate for Payer: Cofinity Advantage |
$49.41
|
| Rate for Payer: Cofinity Commercial |
$60.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.46
|
| Rate for Payer: Healthscope Commercial |
$63.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.94
|
| Rate for Payer: PHP Commercial |
$59.99
|
| Rate for Payer: Priority Health SBD |
$44.47
|
| Rate for Payer: UMR Bronson Commercial |
$31.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.94
|
|
|
LIDOCAINE 5 % TOPICAL OINTMENT
|
Facility
|
IP
|
$36.60
|
|
|
Service Code
|
NDC 65162091838
|
| Hospital Charge Code |
159107
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$16.10 |
| Max. Negotiated Rate |
$32.94 |
| Rate for Payer: Aetna American Axle |
$23.79
|
| Rate for Payer: Aetna Commercial |
$31.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.79
|
| Rate for Payer: Cash Price |
$29.28
|
| Rate for Payer: Cofinity Advantage |
$25.62
|
| Rate for Payer: Cofinity Commercial |
$31.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.28
|
| Rate for Payer: Healthscope Commercial |
$32.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.45
|
| Rate for Payer: PHP Commercial |
$31.11
|
| Rate for Payer: Priority Health SBD |
$23.06
|
| Rate for Payer: UMR Bronson Commercial |
$16.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.45
|
|
|
LIDOCAINE (BULK) POWDER
|
Facility
|
IP
|
$325.85
|
|
|
Service Code
|
NDC 38779008105
|
| Hospital Charge Code |
12855
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$143.37 |
| Max. Negotiated Rate |
$293.26 |
| Rate for Payer: Aetna American Axle |
$211.80
|
| Rate for Payer: Aetna Commercial |
$276.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.80
|
| Rate for Payer: Cash Price |
$260.68
|
| Rate for Payer: Cofinity Advantage |
$228.09
|
| Rate for Payer: Cofinity Commercial |
$280.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.68
|
| Rate for Payer: Healthscope Commercial |
$293.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$228.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$276.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$244.39
|
| Rate for Payer: PHP Commercial |
$276.97
|
| Rate for Payer: Priority Health SBD |
$205.29
|
| Rate for Payer: UMR Bronson Commercial |
$143.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.39
|
|
|
LIDOCAINE (BULK) POWDER
|
Facility
|
OP
|
$325.85
|
|
|
Service Code
|
NDC 38779008105
|
| Hospital Charge Code |
12855
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$120.56 |
| Max. Negotiated Rate |
$293.26 |
| Rate for Payer: Aetna American Axle |
$211.80
|
| Rate for Payer: Aetna Commercial |
$276.97
|
| Rate for Payer: Aetna Medicare |
$162.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.80
|
| Rate for Payer: BCBS Complete |
$130.34
|
| Rate for Payer: Cash Price |
$260.68
|
| Rate for Payer: Cofinity Advantage |
$228.09
|
| Rate for Payer: Cofinity Commercial |
$280.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.68
|
| Rate for Payer: Healthscope Commercial |
$293.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$228.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$276.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$244.39
|
| Rate for Payer: PHP Commercial |
$276.97
|
| Rate for Payer: Priority Health SBD |
$205.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.80
|
| Rate for Payer: UHC Core |
$169.77
|
| Rate for Payer: UHC Exchange |
$128.06
|
| Rate for Payer: UMR Bronson Commercial |
$120.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.39
|
|
|
LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION
|
Facility
|
OP
|
$16.65
|
|
|
Service Code
|
HCPCS J2004
|
| Hospital Charge Code |
14870
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$14.98 |
| Rate for Payer: Aetna American Axle |
$10.82
|
| Rate for Payer: Aetna American Axle |
$6.66
|
| Rate for Payer: Aetna American Axle |
$20.40
|
| Rate for Payer: Aetna Commercial |
$14.15
|
| Rate for Payer: Aetna Commercial |
$26.67
|
| Rate for Payer: Aetna Commercial |
$8.71
|
| Rate for Payer: Aetna Medicare |
$8.32
|
| Rate for Payer: Aetna Medicare |
$5.12
|
| Rate for Payer: Aetna Medicare |
$15.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.40
|
| Rate for Payer: BCBS Complete |
$4.10
|
| Rate for Payer: BCBS Complete |
$6.66
|
| Rate for Payer: BCBS Complete |
$12.55
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: Cash Price |
$8.20
|
| Rate for Payer: Cash Price |
$8.20
|
| Rate for Payer: Cash Price |
$25.10
|
| Rate for Payer: Cash Price |
$25.10
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cofinity Advantage |
$21.97
|
| Rate for Payer: Cofinity Advantage |
$11.65
|
| Rate for Payer: Cofinity Advantage |
$7.17
|
| Rate for Payer: Cofinity Commercial |
$8.81
|
| Rate for Payer: Cofinity Commercial |
$14.32
|
| Rate for Payer: Cofinity Commercial |
$26.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Healthscope Commercial |
$9.22
|
| Rate for Payer: Healthscope Commercial |
$14.98
|
| Rate for Payer: Healthscope Commercial |
$28.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.54
|
| Rate for Payer: PHP Commercial |
$14.15
|
| Rate for Payer: PHP Commercial |
$8.71
|
| Rate for Payer: PHP Commercial |
$26.67
|
| Rate for Payer: Priority Health SBD |
$6.46
|
| Rate for Payer: Priority Health SBD |
$19.77
|
| Rate for Payer: Priority Health SBD |
$10.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.07
|
| Rate for Payer: UHC Core |
$0.07
|
| Rate for Payer: UHC Core |
$0.07
|
| Rate for Payer: UHC Core |
$0.07
|
| Rate for Payer: UHC Exchange |
$0.07
|
| Rate for Payer: UHC Exchange |
$0.07
|
| Rate for Payer: UHC Exchange |
$0.07
|
| Rate for Payer: UMR Bronson Commercial |
$11.61
|
| Rate for Payer: UMR Bronson Commercial |
$3.79
|
| Rate for Payer: UMR Bronson Commercial |
$6.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.54
|
|
|
LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION
|
Facility
|
IP
|
$10.25
|
|
|
Service Code
|
HCPCS J2004
|
| Hospital Charge Code |
14870
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.51 |
| Max. Negotiated Rate |
$9.22 |
| Rate for Payer: Aetna American Axle |
$6.66
|
| Rate for Payer: Aetna American Axle |
$20.40
|
| Rate for Payer: Aetna American Axle |
$10.82
|
| Rate for Payer: Aetna Commercial |
$14.15
|
| Rate for Payer: Aetna Commercial |
$8.71
|
| Rate for Payer: Aetna Commercial |
$26.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.82
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cash Price |
$8.20
|
| Rate for Payer: Cash Price |
$25.10
|
| Rate for Payer: Cofinity Advantage |
$21.97
|
| Rate for Payer: Cofinity Advantage |
$7.17
|
| Rate for Payer: Cofinity Advantage |
$11.65
|
| Rate for Payer: Cofinity Commercial |
$26.99
|
| Rate for Payer: Cofinity Commercial |
$8.81
|
| Rate for Payer: Cofinity Commercial |
$14.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.10
|
| Rate for Payer: Healthscope Commercial |
$14.98
|
| Rate for Payer: Healthscope Commercial |
$28.24
|
| Rate for Payer: Healthscope Commercial |
$9.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.54
|
| Rate for Payer: PHP Commercial |
$14.15
|
| Rate for Payer: PHP Commercial |
$8.71
|
| Rate for Payer: PHP Commercial |
$26.67
|
| Rate for Payer: Priority Health SBD |
$6.46
|
| Rate for Payer: Priority Health SBD |
$10.49
|
| Rate for Payer: Priority Health SBD |
$19.77
|
| Rate for Payer: UMR Bronson Commercial |
$4.51
|
| Rate for Payer: UMR Bronson Commercial |
$13.81
|
| Rate for Payer: UMR Bronson Commercial |
$7.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.54
|
|
|
LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJECTION (COA)
|
Facility
|
OP
|
$19.23
|
|
|
Service Code
|
HCPCS J2004
|
| Hospital Charge Code |
168937
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$17.31 |
| Rate for Payer: Aetna American Axle |
$12.50
|
| Rate for Payer: Aetna Commercial |
$16.35
|
| Rate for Payer: Aetna Medicare |
$9.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.50
|
| Rate for Payer: BCBS Complete |
$7.69
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: Cash Price |
$15.38
|
| Rate for Payer: Cash Price |
$15.38
|
| Rate for Payer: Cofinity Advantage |
$13.46
|
| Rate for Payer: Cofinity Commercial |
$16.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.38
|
| Rate for Payer: Healthscope Commercial |
$17.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.42
|
| Rate for Payer: PHP Commercial |
$16.35
|
| Rate for Payer: Priority Health SBD |
$12.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.07
|
| Rate for Payer: UHC Core |
$0.07
|
| Rate for Payer: UHC Exchange |
$0.07
|
| Rate for Payer: UMR Bronson Commercial |
$7.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.42
|
|
|
LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJECTION (COA)
|
Facility
|
IP
|
$19.23
|
|
|
Service Code
|
HCPCS J2004
|
| Hospital Charge Code |
168937
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$17.31 |
| Rate for Payer: Aetna American Axle |
$12.50
|
| Rate for Payer: Aetna Commercial |
$16.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.50
|
| Rate for Payer: Cash Price |
$15.38
|
| Rate for Payer: Cofinity Advantage |
$13.46
|
| Rate for Payer: Cofinity Commercial |
$16.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.38
|
| Rate for Payer: Healthscope Commercial |
$17.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.42
|
| Rate for Payer: PHP Commercial |
$16.35
|
| Rate for Payer: Priority Health SBD |
$12.11
|
| Rate for Payer: UMR Bronson Commercial |
$8.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.42
|
|
|
LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION
|
Facility
|
OP
|
$38.05
|
|
|
Service Code
|
HCPCS J2004
|
| Hospital Charge Code |
15985
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$34.24 |
| Rate for Payer: Aetna American Axle |
$24.73
|
| Rate for Payer: Aetna American Axle |
$34.45
|
| Rate for Payer: Aetna Commercial |
$32.34
|
| Rate for Payer: Aetna Commercial |
$45.05
|
| Rate for Payer: Aetna Medicare |
$19.02
|
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.45
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS Complete |
$15.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: Cash Price |
$30.44
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$30.44
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Advantage |
$26.64
|
| Rate for Payer: Cofinity Advantage |
$37.10
|
| Rate for Payer: Cofinity Commercial |
$32.72
|
| Rate for Payer: Cofinity Commercial |
$45.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.40
|
| Rate for Payer: Healthscope Commercial |
$34.24
|
| Rate for Payer: Healthscope Commercial |
$47.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.54
|
| Rate for Payer: PHP Commercial |
$32.34
|
| Rate for Payer: PHP Commercial |
$45.05
|
| Rate for Payer: Priority Health SBD |
$23.97
|
| Rate for Payer: Priority Health SBD |
$33.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.07
|
| Rate for Payer: UHC Core |
$0.07
|
| Rate for Payer: UHC Core |
$0.07
|
| Rate for Payer: UHC Exchange |
$0.07
|
| Rate for Payer: UHC Exchange |
$0.07
|
| Rate for Payer: UMR Bronson Commercial |
$14.08
|
| Rate for Payer: UMR Bronson Commercial |
$19.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.75
|
|
|
LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION
|
Facility
|
IP
|
$38.05
|
|
|
Service Code
|
HCPCS J2004
|
| Hospital Charge Code |
15985
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.74 |
| Max. Negotiated Rate |
$34.24 |
| Rate for Payer: Aetna American Axle |
$24.73
|
| Rate for Payer: Aetna American Axle |
$34.45
|
| Rate for Payer: Aetna Commercial |
$32.34
|
| Rate for Payer: Aetna Commercial |
$45.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.45
|
| Rate for Payer: Cash Price |
$30.44
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Advantage |
$37.10
|
| Rate for Payer: Cofinity Advantage |
$26.64
|
| Rate for Payer: Cofinity Commercial |
$45.58
|
| Rate for Payer: Cofinity Commercial |
$32.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.40
|
| Rate for Payer: Healthscope Commercial |
$34.24
|
| Rate for Payer: Healthscope Commercial |
$47.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: PHP Commercial |
$32.34
|
| Rate for Payer: PHP Commercial |
$45.05
|
| Rate for Payer: Priority Health SBD |
$33.39
|
| Rate for Payer: Priority Health SBD |
$23.97
|
| Rate for Payer: UMR Bronson Commercial |
$16.74
|
| Rate for Payer: UMR Bronson Commercial |
$23.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.75
|
|
|
LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION
|
Facility
|
IP
|
$24.57
|
|
|
Service Code
|
HCPCS J2004
|
| Hospital Charge Code |
15956
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.81 |
| Max. Negotiated Rate |
$22.11 |
| Rate for Payer: Aetna American Axle |
$15.97
|
| Rate for Payer: Aetna American Axle |
$45.56
|
| Rate for Payer: Aetna American Axle |
$25.72
|
| Rate for Payer: Aetna Commercial |
$33.63
|
| Rate for Payer: Aetna Commercial |
$20.88
|
| Rate for Payer: Aetna Commercial |
$59.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.72
|
| Rate for Payer: Cash Price |
$31.66
|
| Rate for Payer: Cash Price |
$19.66
|
| Rate for Payer: Cash Price |
$56.07
|
| Rate for Payer: Cofinity Advantage |
$49.06
|
| Rate for Payer: Cofinity Advantage |
$17.20
|
| Rate for Payer: Cofinity Advantage |
$27.70
|
| Rate for Payer: Cofinity Commercial |
$60.28
|
| Rate for Payer: Cofinity Commercial |
$21.13
|
| Rate for Payer: Cofinity Commercial |
$34.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.07
|
| Rate for Payer: Healthscope Commercial |
$35.61
|
| Rate for Payer: Healthscope Commercial |
$63.08
|
| Rate for Payer: Healthscope Commercial |
$22.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.57
|
| Rate for Payer: PHP Commercial |
$33.63
|
| Rate for Payer: PHP Commercial |
$20.88
|
| Rate for Payer: PHP Commercial |
$59.58
|
| Rate for Payer: Priority Health SBD |
$15.48
|
| Rate for Payer: Priority Health SBD |
$24.93
|
| Rate for Payer: Priority Health SBD |
$44.16
|
| Rate for Payer: UMR Bronson Commercial |
$10.81
|
| Rate for Payer: UMR Bronson Commercial |
$30.84
|
| Rate for Payer: UMR Bronson Commercial |
$17.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.57
|
|
|
LIDOCAINE-EPINEPHRINE (PF) 1.5 %-1:200,000 INJECTION SOLUTION
|
Facility
|
OP
|
$39.57
|
|
|
Service Code
|
HCPCS J2004
|
| Hospital Charge Code |
15956
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$35.61 |
| Rate for Payer: Aetna American Axle |
$25.72
|
| Rate for Payer: Aetna American Axle |
$15.97
|
| Rate for Payer: Aetna American Axle |
$45.56
|
| Rate for Payer: Aetna Commercial |
$33.63
|
| Rate for Payer: Aetna Commercial |
$59.58
|
| Rate for Payer: Aetna Commercial |
$20.88
|
| Rate for Payer: Aetna Medicare |
$19.79
|
| Rate for Payer: Aetna Medicare |
$12.29
|
| Rate for Payer: Aetna Medicare |
$35.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.56
|
| Rate for Payer: BCBS Complete |
$9.83
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS Complete |
$28.04
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: Cash Price |
$19.66
|
| Rate for Payer: Cash Price |
$19.66
|
| Rate for Payer: Cash Price |
$56.07
|
| Rate for Payer: Cash Price |
$56.07
|
| Rate for Payer: Cash Price |
$31.66
|
| Rate for Payer: Cash Price |
$31.66
|
| Rate for Payer: Cofinity Advantage |
$49.06
|
| Rate for Payer: Cofinity Advantage |
$27.70
|
| Rate for Payer: Cofinity Advantage |
$17.20
|
| Rate for Payer: Cofinity Commercial |
$21.13
|
| Rate for Payer: Cofinity Commercial |
$34.03
|
| Rate for Payer: Cofinity Commercial |
$60.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.66
|
| Rate for Payer: Healthscope Commercial |
$22.11
|
| Rate for Payer: Healthscope Commercial |
$35.61
|
| Rate for Payer: Healthscope Commercial |
$63.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.57
|
| Rate for Payer: PHP Commercial |
$33.63
|
| Rate for Payer: PHP Commercial |
$20.88
|
| Rate for Payer: PHP Commercial |
$59.58
|
| Rate for Payer: Priority Health SBD |
$15.48
|
| Rate for Payer: Priority Health SBD |
$44.16
|
| Rate for Payer: Priority Health SBD |
$24.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.07
|
| Rate for Payer: UHC Core |
$0.07
|
| Rate for Payer: UHC Core |
$0.07
|
| Rate for Payer: UHC Core |
$0.07
|
| Rate for Payer: UHC Exchange |
$0.07
|
| Rate for Payer: UHC Exchange |
$0.07
|
| Rate for Payer: UHC Exchange |
$0.07
|
| Rate for Payer: UMR Bronson Commercial |
$25.93
|
| Rate for Payer: UMR Bronson Commercial |
$9.09
|
| Rate for Payer: UMR Bronson Commercial |
$14.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.57
|
|
|
LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION
|
Facility
|
IP
|
$20.87
|
|
|
Service Code
|
HCPCS J2004
|
| Hospital Charge Code |
10431
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.18 |
| Max. Negotiated Rate |
$18.78 |
| Rate for Payer: Aetna American Axle |
$13.57
|
| Rate for Payer: Aetna American Axle |
$52.64
|
| Rate for Payer: Aetna American Axle |
$25.69
|
| Rate for Payer: Aetna Commercial |
$33.59
|
| Rate for Payer: Aetna Commercial |
$17.74
|
| Rate for Payer: Aetna Commercial |
$68.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.69
|
| Rate for Payer: Cash Price |
$31.62
|
| Rate for Payer: Cash Price |
$16.70
|
| Rate for Payer: Cash Price |
$64.79
|
| Rate for Payer: Cofinity Advantage |
$56.69
|
| Rate for Payer: Cofinity Advantage |
$14.61
|
| Rate for Payer: Cofinity Advantage |
$27.66
|
| Rate for Payer: Cofinity Commercial |
$69.65
|
| Rate for Payer: Cofinity Commercial |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$33.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.79
|
| Rate for Payer: Healthscope Commercial |
$35.57
|
| Rate for Payer: Healthscope Commercial |
$72.89
|
| Rate for Payer: Healthscope Commercial |
$18.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.74
|
| Rate for Payer: PHP Commercial |
$33.59
|
| Rate for Payer: PHP Commercial |
$17.74
|
| Rate for Payer: PHP Commercial |
$68.84
|
| Rate for Payer: Priority Health SBD |
$13.15
|
| Rate for Payer: Priority Health SBD |
$24.90
|
| Rate for Payer: Priority Health SBD |
$51.02
|
| Rate for Payer: UMR Bronson Commercial |
$9.18
|
| Rate for Payer: UMR Bronson Commercial |
$35.64
|
| Rate for Payer: UMR Bronson Commercial |
$17.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.74
|
|
|
LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION
|
Facility
|
OP
|
$39.52
|
|
|
Service Code
|
HCPCS J2004
|
| Hospital Charge Code |
10431
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$35.57 |
| Rate for Payer: Aetna American Axle |
$25.69
|
| Rate for Payer: Aetna American Axle |
$13.57
|
| Rate for Payer: Aetna American Axle |
$52.64
|
| Rate for Payer: Aetna Commercial |
$33.59
|
| Rate for Payer: Aetna Commercial |
$68.84
|
| Rate for Payer: Aetna Commercial |
$17.74
|
| Rate for Payer: Aetna Medicare |
$19.76
|
| Rate for Payer: Aetna Medicare |
$10.44
|
| Rate for Payer: Aetna Medicare |
$40.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.64
|
| Rate for Payer: BCBS Complete |
$8.35
|
| Rate for Payer: BCBS Complete |
$15.81
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: Cash Price |
$16.70
|
| Rate for Payer: Cash Price |
$16.70
|
| Rate for Payer: Cash Price |
$64.79
|
| Rate for Payer: Cash Price |
$64.79
|
| Rate for Payer: Cash Price |
$31.62
|
| Rate for Payer: Cash Price |
$31.62
|
| Rate for Payer: Cofinity Advantage |
$56.69
|
| Rate for Payer: Cofinity Advantage |
$27.66
|
| Rate for Payer: Cofinity Advantage |
$14.61
|
| Rate for Payer: Cofinity Commercial |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$33.99
|
| Rate for Payer: Cofinity Commercial |
$69.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.62
|
| Rate for Payer: Healthscope Commercial |
$18.78
|
| Rate for Payer: Healthscope Commercial |
$35.57
|
| Rate for Payer: Healthscope Commercial |
$72.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.74
|
| Rate for Payer: PHP Commercial |
$33.59
|
| Rate for Payer: PHP Commercial |
$17.74
|
| Rate for Payer: PHP Commercial |
$68.84
|
| Rate for Payer: Priority Health SBD |
$13.15
|
| Rate for Payer: Priority Health SBD |
$51.02
|
| Rate for Payer: Priority Health SBD |
$24.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.07
|
| Rate for Payer: UHC Core |
$0.07
|
| Rate for Payer: UHC Core |
$0.07
|
| Rate for Payer: UHC Core |
$0.07
|
| Rate for Payer: UHC Exchange |
$0.07
|
| Rate for Payer: UHC Exchange |
$0.07
|
| Rate for Payer: UHC Exchange |
$0.07
|
| Rate for Payer: UMR Bronson Commercial |
$29.97
|
| Rate for Payer: UMR Bronson Commercial |
$7.72
|
| Rate for Payer: UMR Bronson Commercial |
$14.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.74
|
|
|
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION
|
Facility
|
IP
|
$24.92
|
|
|
Service Code
|
HCPCS J2003
|
| Hospital Charge Code |
4452
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.96 |
| Max. Negotiated Rate |
$22.43 |
| Rate for Payer: Aetna American Axle |
$16.20
|
| Rate for Payer: Aetna American Axle |
$15.87
|
| Rate for Payer: Aetna American Axle |
$8.29
|
| Rate for Payer: Aetna American Axle |
$15.83
|
| Rate for Payer: Aetna American Axle |
$14.19
|
| Rate for Payer: Aetna American Axle |
$12.35
|
| Rate for Payer: Aetna American Axle |
$11.01
|
| Rate for Payer: Aetna American Axle |
$9.99
|
| Rate for Payer: Aetna American Axle |
$9.43
|
| Rate for Payer: Aetna Commercial |
$20.76
|
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: Aetna Commercial |
$20.71
|
| Rate for Payer: Aetna Commercial |
$14.40
|
| Rate for Payer: Aetna Commercial |
$12.32
|
| Rate for Payer: Aetna Commercial |
$10.85
|
| Rate for Payer: Aetna Commercial |
$21.18
|
| Rate for Payer: Aetna Commercial |
$13.06
|
| Rate for Payer: Aetna Commercial |
$16.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.20
|
| Rate for Payer: Cash Price |
$19.49
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cash Price |
$19.94
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$11.60
|
| Rate for Payer: Cash Price |
$12.30
|
| Rate for Payer: Cash Price |
$10.21
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cash Price |
$13.55
|
| Rate for Payer: Cofinity Advantage |
$10.76
|
| Rate for Payer: Cofinity Advantage |
$11.86
|
| Rate for Payer: Cofinity Advantage |
$13.30
|
| Rate for Payer: Cofinity Advantage |
$10.15
|
| Rate for Payer: Cofinity Advantage |
$17.44
|
| Rate for Payer: Cofinity Advantage |
$17.05
|
| Rate for Payer: Cofinity Advantage |
$15.28
|
| Rate for Payer: Cofinity Advantage |
$17.09
|
| Rate for Payer: Cofinity Advantage |
$8.93
|
| Rate for Payer: Cofinity Commercial |
$20.95
|
| Rate for Payer: Cofinity Commercial |
$12.47
|
| Rate for Payer: Cofinity Commercial |
$16.34
|
| Rate for Payer: Cofinity Commercial |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Cofinity Commercial |
$10.97
|
| Rate for Payer: Cofinity Commercial |
$21.43
|
| Rate for Payer: Cofinity Commercial |
$13.22
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Healthscope Commercial |
$21.98
|
| Rate for Payer: Healthscope Commercial |
$13.05
|
| Rate for Payer: Healthscope Commercial |
$13.83
|
| Rate for Payer: Healthscope Commercial |
$21.92
|
| Rate for Payer: Healthscope Commercial |
$19.65
|
| Rate for Payer: Healthscope Commercial |
$11.48
|
| Rate for Payer: Healthscope Commercial |
$15.25
|
| Rate for Payer: Healthscope Commercial |
$22.43
|
| Rate for Payer: Healthscope Commercial |
$17.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.27
|
| Rate for Payer: PHP Commercial |
$12.32
|
| Rate for Payer: PHP Commercial |
$14.40
|
| Rate for Payer: PHP Commercial |
$20.76
|
| Rate for Payer: PHP Commercial |
$16.15
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Commercial |
$20.71
|
| Rate for Payer: PHP Commercial |
$21.18
|
| Rate for Payer: PHP Commercial |
$13.06
|
| Rate for Payer: PHP Commercial |
$10.85
|
| Rate for Payer: Priority Health SBD |
$13.75
|
| Rate for Payer: Priority Health SBD |
$11.97
|
| Rate for Payer: Priority Health SBD |
$15.70
|
| Rate for Payer: Priority Health SBD |
$15.35
|
| Rate for Payer: Priority Health SBD |
$9.13
|
| Rate for Payer: Priority Health SBD |
$8.04
|
| Rate for Payer: Priority Health SBD |
$15.38
|
| Rate for Payer: Priority Health SBD |
$9.68
|
| Rate for Payer: Priority Health SBD |
$10.67
|
| Rate for Payer: UMR Bronson Commercial |
$5.61
|
| Rate for Payer: UMR Bronson Commercial |
$6.76
|
| Rate for Payer: UMR Bronson Commercial |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$7.45
|
| Rate for Payer: UMR Bronson Commercial |
$10.72
|
| Rate for Payer: UMR Bronson Commercial |
$8.36
|
| Rate for Payer: UMR Bronson Commercial |
$10.96
|
| Rate for Payer: UMR Bronson Commercial |
$6.38
|
| Rate for Payer: UMR Bronson Commercial |
$10.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.69
|
|
|
LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION
|
Facility
|
OP
|
$15.37
|
|
|
Service Code
|
HCPCS J2003
|
| Hospital Charge Code |
4452
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$13.83 |
| Rate for Payer: Aetna American Axle |
$9.99
|
| Rate for Payer: Aetna American Axle |
$11.01
|
| Rate for Payer: Aetna American Axle |
$14.19
|
| Rate for Payer: Aetna American Axle |
$12.35
|
| Rate for Payer: Aetna American Axle |
$9.43
|
| Rate for Payer: Aetna American Axle |
$8.29
|
| Rate for Payer: Aetna American Axle |
$16.20
|
| Rate for Payer: Aetna American Axle |
$15.87
|
| Rate for Payer: Aetna American Axle |
$15.83
|
| Rate for Payer: Aetna Commercial |
$16.15
|
| Rate for Payer: Aetna Commercial |
$12.32
|
| Rate for Payer: Aetna Commercial |
$13.06
|
| Rate for Payer: Aetna Commercial |
$10.85
|
| Rate for Payer: Aetna Commercial |
$14.40
|
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: Aetna Commercial |
$20.71
|
| Rate for Payer: Aetna Commercial |
$20.76
|
| Rate for Payer: Aetna Commercial |
$21.18
|
| Rate for Payer: Aetna Medicare |
$7.68
|
| Rate for Payer: Aetna Medicare |
$7.25
|
| Rate for Payer: Aetna Medicare |
$12.18
|
| Rate for Payer: Aetna Medicare |
$6.38
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna Medicare |
$9.50
|
| Rate for Payer: Aetna Medicare |
$8.47
|
| Rate for Payer: Aetna Medicare |
$12.21
|
| Rate for Payer: Aetna Medicare |
$10.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.01
|
| Rate for Payer: BCBS Complete |
$5.80
|
| Rate for Payer: BCBS Complete |
$6.15
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS Complete |
$9.74
|
| Rate for Payer: BCBS Complete |
$7.60
|
| Rate for Payer: BCBS Complete |
$9.97
|
| Rate for Payer: BCBS Complete |
$9.77
|
| Rate for Payer: BCBS Complete |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cash Price |
$11.60
|
| Rate for Payer: Cash Price |
$19.49
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$13.55
|
| Rate for Payer: Cash Price |
$19.49
|
| Rate for Payer: Cash Price |
$19.94
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cash Price |
$10.21
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$12.30
|
| Rate for Payer: Cash Price |
$10.21
|
| Rate for Payer: Cash Price |
$19.94
|
| Rate for Payer: Cash Price |
$12.30
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cash Price |
$11.60
|
| Rate for Payer: Cash Price |
$13.55
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cofinity Advantage |
$10.15
|
| Rate for Payer: Cofinity Advantage |
$10.76
|
| Rate for Payer: Cofinity Advantage |
$8.93
|
| Rate for Payer: Cofinity Advantage |
$11.86
|
| Rate for Payer: Cofinity Advantage |
$13.30
|
| Rate for Payer: Cofinity Advantage |
$15.28
|
| Rate for Payer: Cofinity Advantage |
$17.05
|
| Rate for Payer: Cofinity Advantage |
$17.09
|
| Rate for Payer: Cofinity Advantage |
$17.44
|
| Rate for Payer: Cofinity Commercial |
$12.47
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Cofinity Commercial |
$20.95
|
| Rate for Payer: Cofinity Commercial |
$10.97
|
| Rate for Payer: Cofinity Commercial |
$16.34
|
| Rate for Payer: Cofinity Commercial |
$13.22
|
| Rate for Payer: Cofinity Commercial |
$21.43
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$18.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.30
|
| Rate for Payer: Healthscope Commercial |
$13.83
|
| Rate for Payer: Healthscope Commercial |
$13.05
|
| Rate for Payer: Healthscope Commercial |
$11.48
|
| Rate for Payer: Healthscope Commercial |
$22.43
|
| Rate for Payer: Healthscope Commercial |
$15.25
|
| Rate for Payer: Healthscope Commercial |
$21.98
|
| Rate for Payer: Healthscope Commercial |
$21.92
|
| Rate for Payer: Healthscope Commercial |
$19.65
|
| Rate for Payer: Healthscope Commercial |
$17.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.32
|
| Rate for Payer: PHP Commercial |
$13.06
|
| Rate for Payer: PHP Commercial |
$14.40
|
| Rate for Payer: PHP Commercial |
$16.15
|
| Rate for Payer: PHP Commercial |
$21.18
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Commercial |
$10.85
|
| Rate for Payer: PHP Commercial |
$12.32
|
| Rate for Payer: PHP Commercial |
$20.71
|
| Rate for Payer: PHP Commercial |
$20.76
|
| Rate for Payer: Priority Health SBD |
$11.97
|
| Rate for Payer: Priority Health SBD |
$15.35
|
| Rate for Payer: Priority Health SBD |
$9.13
|
| Rate for Payer: Priority Health SBD |
$9.68
|
| Rate for Payer: Priority Health SBD |
$13.75
|
| Rate for Payer: Priority Health SBD |
$15.70
|
| Rate for Payer: Priority Health SBD |
$8.04
|
| Rate for Payer: Priority Health SBD |
$10.67
|
| Rate for Payer: Priority Health SBD |
$15.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UMR Bronson Commercial |
$8.08
|
| Rate for Payer: UMR Bronson Commercial |
$5.69
|
| Rate for Payer: UMR Bronson Commercial |
$7.03
|
| Rate for Payer: UMR Bronson Commercial |
$9.01
|
| Rate for Payer: UMR Bronson Commercial |
$9.04
|
| Rate for Payer: UMR Bronson Commercial |
$9.22
|
| Rate for Payer: UMR Bronson Commercial |
$4.72
|
| Rate for Payer: UMR Bronson Commercial |
$5.37
|
| Rate for Payer: UMR Bronson Commercial |
$6.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.88
|
|
