|
LINACLOTIDE 72 MCG CAPSULE
|
Facility
|
IP
|
$971.59
|
|
|
Service Code
|
NDC 00456120330
|
| Hospital Charge Code |
182047
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$427.50 |
| Max. Negotiated Rate |
$874.43 |
| Rate for Payer: Aetna American Axle |
$631.53
|
| Rate for Payer: Aetna Commercial |
$825.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.53
|
| Rate for Payer: Cash Price |
$777.27
|
| Rate for Payer: Cofinity Advantage |
$680.11
|
| Rate for Payer: Cofinity Commercial |
$835.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.27
|
| Rate for Payer: Healthscope Commercial |
$874.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$680.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$728.69
|
| Rate for Payer: PHP Commercial |
$825.85
|
| Rate for Payer: Priority Health SBD |
$612.10
|
| Rate for Payer: UMR Bronson Commercial |
$427.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.69
|
|
|
LINACLOTIDE 72 MCG CAPSULE
|
Facility
|
OP
|
$971.59
|
|
|
Service Code
|
NDC 00456120330
|
| Hospital Charge Code |
182047
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$359.49 |
| Max. Negotiated Rate |
$874.43 |
| Rate for Payer: Aetna American Axle |
$631.53
|
| Rate for Payer: Aetna Commercial |
$825.85
|
| Rate for Payer: Aetna Medicare |
$485.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.53
|
| Rate for Payer: BCBS Complete |
$388.64
|
| Rate for Payer: Cash Price |
$777.27
|
| Rate for Payer: Cofinity Advantage |
$680.11
|
| Rate for Payer: Cofinity Commercial |
$835.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.27
|
| Rate for Payer: Healthscope Commercial |
$874.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$680.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$777.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$728.69
|
| Rate for Payer: PHP Commercial |
$825.85
|
| Rate for Payer: Priority Health SBD |
$612.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$631.53
|
| Rate for Payer: UHC Core |
$506.20
|
| Rate for Payer: UHC Exchange |
$381.83
|
| Rate for Payer: UMR Bronson Commercial |
$359.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.69
|
|
|
LINAGLIPTIN 5 MG TABLET
|
Facility
|
IP
|
$5,420.50
|
|
|
Service Code
|
NDC 00597014061
|
| Hospital Charge Code |
152649
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,385.02 |
| Max. Negotiated Rate |
$4,878.45 |
| Rate for Payer: Aetna American Axle |
$3,523.32
|
| Rate for Payer: Aetna Commercial |
$4,607.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,523.32
|
| Rate for Payer: Cash Price |
$4,336.40
|
| Rate for Payer: Cofinity Advantage |
$3,794.35
|
| Rate for Payer: Cofinity Commercial |
$4,661.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,336.40
|
| Rate for Payer: Healthscope Commercial |
$4,878.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,794.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,065.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,607.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,065.38
|
| Rate for Payer: PHP Commercial |
$4,607.43
|
| Rate for Payer: Priority Health SBD |
$3,414.91
|
| Rate for Payer: UMR Bronson Commercial |
$2,385.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,065.38
|
|
|
LINAGLIPTIN 5 MG TABLET
|
Facility
|
OP
|
$5,420.50
|
|
|
Service Code
|
NDC 00597014061
|
| Hospital Charge Code |
152649
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,005.59 |
| Max. Negotiated Rate |
$4,878.45 |
| Rate for Payer: Aetna American Axle |
$3,523.32
|
| Rate for Payer: Aetna Commercial |
$4,607.43
|
| Rate for Payer: Aetna Medicare |
$2,710.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,523.32
|
| Rate for Payer: BCBS Complete |
$2,168.20
|
| Rate for Payer: Cash Price |
$4,336.40
|
| Rate for Payer: Cofinity Advantage |
$3,794.35
|
| Rate for Payer: Cofinity Commercial |
$4,661.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,336.40
|
| Rate for Payer: Healthscope Commercial |
$4,878.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,794.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,065.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,336.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,607.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,065.38
|
| Rate for Payer: PHP Commercial |
$4,607.43
|
| Rate for Payer: Priority Health SBD |
$3,414.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,523.32
|
| Rate for Payer: UHC Core |
$2,824.08
|
| Rate for Payer: UHC Exchange |
$2,130.26
|
| Rate for Payer: UMR Bronson Commercial |
$2,005.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,065.38
|
|
|
LINEZOLID 100 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$2,311.58
|
|
|
Service Code
|
NDC 00054031950
|
| Hospital Charge Code |
28225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,017.10 |
| Max. Negotiated Rate |
$2,080.42 |
| Rate for Payer: Aetna American Axle |
$1,502.53
|
| Rate for Payer: Aetna Commercial |
$1,964.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,502.53
|
| Rate for Payer: Cash Price |
$1,849.26
|
| Rate for Payer: Cofinity Advantage |
$1,618.11
|
| Rate for Payer: Cofinity Commercial |
$1,987.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,849.26
|
| Rate for Payer: Healthscope Commercial |
$2,080.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,618.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,733.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,964.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,733.68
|
| Rate for Payer: PHP Commercial |
$1,964.84
|
| Rate for Payer: Priority Health SBD |
$1,456.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,017.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,733.68
|
|
|
LINEZOLID 100 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$1,115.00
|
|
|
Service Code
|
NDC 59762130801
|
| Hospital Charge Code |
28225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$490.60 |
| Max. Negotiated Rate |
$1,003.50 |
| Rate for Payer: Aetna American Axle |
$724.75
|
| Rate for Payer: Aetna Commercial |
$947.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.75
|
| Rate for Payer: Cash Price |
$892.00
|
| Rate for Payer: Cofinity Advantage |
$780.50
|
| Rate for Payer: Cofinity Commercial |
$958.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$892.00
|
| Rate for Payer: Healthscope Commercial |
$1,003.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$780.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$836.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$836.25
|
| Rate for Payer: PHP Commercial |
$947.75
|
| Rate for Payer: Priority Health SBD |
$702.45
|
| Rate for Payer: UMR Bronson Commercial |
$490.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$836.25
|
|
|
LINEZOLID 100 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$2,352.65
|
|
|
Service Code
|
NDC 00009513601
|
| Hospital Charge Code |
28225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$870.48 |
| Max. Negotiated Rate |
$2,117.39 |
| Rate for Payer: Aetna American Axle |
$1,529.22
|
| Rate for Payer: Aetna Commercial |
$1,999.75
|
| Rate for Payer: Aetna Medicare |
$1,176.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,529.22
|
| Rate for Payer: BCBS Complete |
$941.06
|
| Rate for Payer: Cash Price |
$1,882.12
|
| Rate for Payer: Cofinity Advantage |
$1,646.86
|
| Rate for Payer: Cofinity Commercial |
$2,023.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,882.12
|
| Rate for Payer: Healthscope Commercial |
$2,117.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,646.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,764.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,882.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,999.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,764.49
|
| Rate for Payer: PHP Commercial |
$1,999.75
|
| Rate for Payer: Priority Health SBD |
$1,482.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,529.22
|
| Rate for Payer: UHC Core |
$1,225.73
|
| Rate for Payer: UHC Exchange |
$924.59
|
| Rate for Payer: UMR Bronson Commercial |
$870.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,764.49
|
|
|
LINEZOLID 100 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$2,311.58
|
|
|
Service Code
|
NDC 00054031950
|
| Hospital Charge Code |
28225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$855.28 |
| Max. Negotiated Rate |
$2,080.42 |
| Rate for Payer: Aetna American Axle |
$1,502.53
|
| Rate for Payer: Aetna Commercial |
$1,964.84
|
| Rate for Payer: Aetna Medicare |
$1,155.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,502.53
|
| Rate for Payer: BCBS Complete |
$924.63
|
| Rate for Payer: Cash Price |
$1,849.26
|
| Rate for Payer: Cofinity Advantage |
$1,618.11
|
| Rate for Payer: Cofinity Commercial |
$1,987.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,849.26
|
| Rate for Payer: Healthscope Commercial |
$2,080.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,618.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,733.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,849.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,964.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,733.68
|
| Rate for Payer: PHP Commercial |
$1,964.84
|
| Rate for Payer: Priority Health SBD |
$1,456.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,502.53
|
| Rate for Payer: UHC Core |
$1,204.33
|
| Rate for Payer: UHC Exchange |
$908.45
|
| Rate for Payer: UMR Bronson Commercial |
$855.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,733.68
|
|
|
LINEZOLID 100 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$2,352.65
|
|
|
Service Code
|
NDC 00009513601
|
| Hospital Charge Code |
28225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,035.17 |
| Max. Negotiated Rate |
$2,117.39 |
| Rate for Payer: Aetna American Axle |
$1,529.22
|
| Rate for Payer: Aetna Commercial |
$1,999.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,529.22
|
| Rate for Payer: Cash Price |
$1,882.12
|
| Rate for Payer: Cofinity Advantage |
$1,646.86
|
| Rate for Payer: Cofinity Commercial |
$2,023.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,882.12
|
| Rate for Payer: Healthscope Commercial |
$2,117.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,646.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,764.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,999.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,764.49
|
| Rate for Payer: PHP Commercial |
$1,999.75
|
| Rate for Payer: Priority Health SBD |
$1,482.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,035.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,764.49
|
|
|
LINEZOLID 100 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$1,560.66
|
|
|
Service Code
|
NDC 59762130804
|
| Hospital Charge Code |
28225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$577.44 |
| Max. Negotiated Rate |
$1,404.59 |
| Rate for Payer: Aetna American Axle |
$1,014.43
|
| Rate for Payer: Aetna Commercial |
$1,326.56
|
| Rate for Payer: Aetna Medicare |
$780.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.43
|
| Rate for Payer: BCBS Complete |
$624.26
|
| Rate for Payer: Cash Price |
$1,248.53
|
| Rate for Payer: Cofinity Advantage |
$1,092.46
|
| Rate for Payer: Cofinity Commercial |
$1,342.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.53
|
| Rate for Payer: Healthscope Commercial |
$1,404.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,092.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,170.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,248.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,170.49
|
| Rate for Payer: PHP Commercial |
$1,326.56
|
| Rate for Payer: Priority Health SBD |
$983.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.43
|
| Rate for Payer: UHC Core |
$813.10
|
| Rate for Payer: UHC Exchange |
$613.34
|
| Rate for Payer: UMR Bronson Commercial |
$577.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,170.49
|
|
|
LINEZOLID 100 MG/5 ML ORAL SUSPENSION
|
Facility
|
OP
|
$1,115.00
|
|
|
Service Code
|
NDC 59762130801
|
| Hospital Charge Code |
28225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$412.55 |
| Max. Negotiated Rate |
$1,003.50 |
| Rate for Payer: Aetna American Axle |
$724.75
|
| Rate for Payer: Aetna Commercial |
$947.75
|
| Rate for Payer: Aetna Medicare |
$557.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.75
|
| Rate for Payer: BCBS Complete |
$446.00
|
| Rate for Payer: Cash Price |
$892.00
|
| Rate for Payer: Cofinity Advantage |
$780.50
|
| Rate for Payer: Cofinity Commercial |
$958.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$892.00
|
| Rate for Payer: Healthscope Commercial |
$1,003.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$780.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$836.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$892.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$836.25
|
| Rate for Payer: PHP Commercial |
$947.75
|
| Rate for Payer: Priority Health SBD |
$702.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$724.75
|
| Rate for Payer: UHC Core |
$580.91
|
| Rate for Payer: UHC Exchange |
$438.19
|
| Rate for Payer: UMR Bronson Commercial |
$412.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$836.25
|
|
|
LINEZOLID 100 MG/5 ML ORAL SUSPENSION
|
Facility
|
IP
|
$1,560.66
|
|
|
Service Code
|
NDC 59762130804
|
| Hospital Charge Code |
28225
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$686.69 |
| Max. Negotiated Rate |
$1,404.59 |
| Rate for Payer: Aetna American Axle |
$1,014.43
|
| Rate for Payer: Aetna Commercial |
$1,326.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.43
|
| Rate for Payer: Cash Price |
$1,248.53
|
| Rate for Payer: Cofinity Advantage |
$1,092.46
|
| Rate for Payer: Cofinity Commercial |
$1,342.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.53
|
| Rate for Payer: Healthscope Commercial |
$1,404.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,092.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,170.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,170.49
|
| Rate for Payer: PHP Commercial |
$1,326.56
|
| Rate for Payer: Priority Health SBD |
$983.22
|
| Rate for Payer: UMR Bronson Commercial |
$686.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,170.49
|
|
|
LINEZOLID 600 MG/300 ML INTRAVENOUS (PEDS)
|
Facility
|
OP
|
$139.20
|
|
|
Service Code
|
HCPCS J2020
|
| Hospital Charge Code |
180001
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.52 |
| Max. Negotiated Rate |
$125.28 |
| Rate for Payer: Aetna American Axle |
$90.48
|
| Rate for Payer: Aetna Commercial |
$118.32
|
| Rate for Payer: Aetna Medicare |
$69.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.48
|
| Rate for Payer: BCBS Complete |
$55.68
|
| Rate for Payer: BCBS Trust/PPO |
$8.88
|
| Rate for Payer: BCN Commercial |
$8.88
|
| Rate for Payer: Cash Price |
$111.36
|
| Rate for Payer: Cash Price |
$111.36
|
| Rate for Payer: Cofinity Advantage |
$97.44
|
| Rate for Payer: Cofinity Commercial |
$119.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.36
|
| Rate for Payer: Healthscope Commercial |
$125.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$97.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.40
|
| Rate for Payer: PHP Commercial |
$118.32
|
| Rate for Payer: Priority Health SBD |
$87.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.52
|
| Rate for Payer: UHC Core |
$4.52
|
| Rate for Payer: UHC Exchange |
$4.52
|
| Rate for Payer: UMR Bronson Commercial |
$51.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.40
|
|
|
LINEZOLID 600 MG/300 ML INTRAVENOUS (PEDS)
|
Facility
|
IP
|
$139.20
|
|
|
Service Code
|
HCPCS J2020
|
| Hospital Charge Code |
180001
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$61.25 |
| Max. Negotiated Rate |
$125.28 |
| Rate for Payer: Aetna American Axle |
$90.48
|
| Rate for Payer: Aetna Commercial |
$118.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.48
|
| Rate for Payer: Cash Price |
$111.36
|
| Rate for Payer: Cofinity Advantage |
$97.44
|
| Rate for Payer: Cofinity Commercial |
$119.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.36
|
| Rate for Payer: Healthscope Commercial |
$125.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$97.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.40
|
| Rate for Payer: PHP Commercial |
$118.32
|
| Rate for Payer: Priority Health SBD |
$87.70
|
| Rate for Payer: UMR Bronson Commercial |
$61.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.40
|
|
|
LINEZOLID 600 MG TABLET
|
Facility
|
OP
|
$354.09
|
|
|
Service Code
|
NDC 72606000103
|
| Hospital Charge Code |
28224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$131.01 |
| Max. Negotiated Rate |
$318.68 |
| Rate for Payer: Aetna American Axle |
$230.16
|
| Rate for Payer: Aetna Commercial |
$300.98
|
| Rate for Payer: Aetna Medicare |
$177.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.16
|
| Rate for Payer: BCBS Complete |
$141.64
|
| Rate for Payer: Cash Price |
$283.27
|
| Rate for Payer: Cofinity Advantage |
$247.86
|
| Rate for Payer: Cofinity Commercial |
$304.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.27
|
| Rate for Payer: Healthscope Commercial |
$318.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$247.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$283.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.57
|
| Rate for Payer: PHP Commercial |
$300.98
|
| Rate for Payer: Priority Health SBD |
$223.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.16
|
| Rate for Payer: UHC Core |
$184.48
|
| Rate for Payer: UHC Exchange |
$139.16
|
| Rate for Payer: UMR Bronson Commercial |
$131.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.57
|
|
|
LINEZOLID 600 MG TABLET
|
Facility
|
OP
|
$12.46
|
|
|
Service Code
|
NDC 60687030911
|
| Hospital Charge Code |
28224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.61 |
| Max. Negotiated Rate |
$11.21 |
| Rate for Payer: Aetna American Axle |
$8.10
|
| Rate for Payer: Aetna Commercial |
$10.59
|
| Rate for Payer: Aetna Medicare |
$6.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.10
|
| Rate for Payer: BCBS Complete |
$4.98
|
| Rate for Payer: Cash Price |
$9.97
|
| Rate for Payer: Cofinity Advantage |
$8.72
|
| Rate for Payer: Cofinity Commercial |
$10.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.97
|
| Rate for Payer: Healthscope Commercial |
$11.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.35
|
| Rate for Payer: PHP Commercial |
$10.59
|
| Rate for Payer: Priority Health SBD |
$7.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.10
|
| Rate for Payer: UHC Core |
$6.49
|
| Rate for Payer: UHC Exchange |
$4.90
|
| Rate for Payer: UMR Bronson Commercial |
$4.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.35
|
|
|
LINEZOLID 600 MG TABLET
|
Facility
|
IP
|
$12.46
|
|
|
Service Code
|
NDC 60687030911
|
| Hospital Charge Code |
28224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.48 |
| Max. Negotiated Rate |
$11.21 |
| Rate for Payer: Aetna American Axle |
$8.10
|
| Rate for Payer: Aetna Commercial |
$10.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.10
|
| Rate for Payer: Cash Price |
$9.97
|
| Rate for Payer: Cofinity Advantage |
$8.72
|
| Rate for Payer: Cofinity Commercial |
$10.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.97
|
| Rate for Payer: Healthscope Commercial |
$11.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.35
|
| Rate for Payer: PHP Commercial |
$10.59
|
| Rate for Payer: Priority Health SBD |
$7.85
|
| Rate for Payer: UMR Bronson Commercial |
$5.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.35
|
|
|
LINEZOLID 600 MG TABLET
|
Facility
|
IP
|
$373.52
|
|
|
Service Code
|
NDC 60687030921
|
| Hospital Charge Code |
28224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$164.35 |
| Max. Negotiated Rate |
$336.17 |
| Rate for Payer: Aetna American Axle |
$242.79
|
| Rate for Payer: Aetna Commercial |
$317.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.79
|
| Rate for Payer: Cash Price |
$298.82
|
| Rate for Payer: Cofinity Advantage |
$261.46
|
| Rate for Payer: Cofinity Commercial |
$321.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.82
|
| Rate for Payer: Healthscope Commercial |
$336.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$261.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.14
|
| Rate for Payer: PHP Commercial |
$317.49
|
| Rate for Payer: Priority Health SBD |
$235.32
|
| Rate for Payer: UMR Bronson Commercial |
$164.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.14
|
|
|
LINEZOLID 600 MG TABLET
|
Facility
|
IP
|
$361.31
|
|
|
Service Code
|
NDC 67877041984
|
| Hospital Charge Code |
28224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$158.98 |
| Max. Negotiated Rate |
$325.18 |
| Rate for Payer: Aetna American Axle |
$234.85
|
| Rate for Payer: Aetna Commercial |
$307.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.85
|
| Rate for Payer: Cash Price |
$289.05
|
| Rate for Payer: Cofinity Advantage |
$252.92
|
| Rate for Payer: Cofinity Commercial |
$310.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.05
|
| Rate for Payer: Healthscope Commercial |
$325.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$252.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$307.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$270.98
|
| Rate for Payer: PHP Commercial |
$307.11
|
| Rate for Payer: Priority Health SBD |
$227.63
|
| Rate for Payer: UMR Bronson Commercial |
$158.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.98
|
|
|
LINEZOLID 600 MG TABLET
|
Facility
|
IP
|
$354.09
|
|
|
Service Code
|
NDC 72606000103
|
| Hospital Charge Code |
28224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$155.80 |
| Max. Negotiated Rate |
$318.68 |
| Rate for Payer: Aetna American Axle |
$230.16
|
| Rate for Payer: Aetna Commercial |
$300.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.16
|
| Rate for Payer: Cash Price |
$283.27
|
| Rate for Payer: Cofinity Advantage |
$247.86
|
| Rate for Payer: Cofinity Commercial |
$304.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.27
|
| Rate for Payer: Healthscope Commercial |
$318.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$247.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.57
|
| Rate for Payer: PHP Commercial |
$300.98
|
| Rate for Payer: Priority Health SBD |
$223.08
|
| Rate for Payer: UMR Bronson Commercial |
$155.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.57
|
|
|
LINEZOLID 600 MG TABLET
|
Facility
|
OP
|
$339.55
|
|
|
Service Code
|
NDC 00904655304
|
| Hospital Charge Code |
28224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$125.63 |
| Max. Negotiated Rate |
$305.60 |
| Rate for Payer: Aetna American Axle |
$220.71
|
| Rate for Payer: Aetna Commercial |
$288.62
|
| Rate for Payer: Aetna Medicare |
$169.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.71
|
| Rate for Payer: BCBS Complete |
$135.82
|
| Rate for Payer: Cash Price |
$271.64
|
| Rate for Payer: Cofinity Advantage |
$237.69
|
| Rate for Payer: Cofinity Commercial |
$292.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.64
|
| Rate for Payer: Healthscope Commercial |
$305.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$237.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$254.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$254.66
|
| Rate for Payer: PHP Commercial |
$288.62
|
| Rate for Payer: Priority Health SBD |
$213.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.71
|
| Rate for Payer: UHC Core |
$176.91
|
| Rate for Payer: UHC Exchange |
$133.44
|
| Rate for Payer: UMR Bronson Commercial |
$125.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$254.66
|
|
|
LINEZOLID 600 MG TABLET
|
Facility
|
IP
|
$339.55
|
|
|
Service Code
|
NDC 00904655304
|
| Hospital Charge Code |
28224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$149.40 |
| Max. Negotiated Rate |
$305.60 |
| Rate for Payer: Aetna American Axle |
$220.71
|
| Rate for Payer: Aetna Commercial |
$288.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.71
|
| Rate for Payer: Cash Price |
$271.64
|
| Rate for Payer: Cofinity Advantage |
$237.69
|
| Rate for Payer: Cofinity Commercial |
$292.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.64
|
| Rate for Payer: Healthscope Commercial |
$305.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$237.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$254.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$254.66
|
| Rate for Payer: PHP Commercial |
$288.62
|
| Rate for Payer: Priority Health SBD |
$213.92
|
| Rate for Payer: UMR Bronson Commercial |
$149.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$254.66
|
|
|
LINEZOLID 600 MG TABLET
|
Facility
|
OP
|
$174.15
|
|
|
Service Code
|
NDC 67877041920
|
| Hospital Charge Code |
28224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$64.44 |
| Max. Negotiated Rate |
$156.74 |
| Rate for Payer: Aetna American Axle |
$113.20
|
| Rate for Payer: Aetna Commercial |
$148.03
|
| Rate for Payer: Aetna Medicare |
$87.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.20
|
| Rate for Payer: BCBS Complete |
$69.66
|
| Rate for Payer: Cash Price |
$139.32
|
| Rate for Payer: Cofinity Advantage |
$121.91
|
| Rate for Payer: Cofinity Commercial |
$149.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.32
|
| Rate for Payer: Healthscope Commercial |
$156.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.61
|
| Rate for Payer: PHP Commercial |
$148.03
|
| Rate for Payer: Priority Health SBD |
$109.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.20
|
| Rate for Payer: UHC Core |
$90.73
|
| Rate for Payer: UHC Exchange |
$68.44
|
| Rate for Payer: UMR Bronson Commercial |
$64.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.61
|
|
|
LINEZOLID 600 MG TABLET
|
Facility
|
OP
|
$361.31
|
|
|
Service Code
|
NDC 67877041984
|
| Hospital Charge Code |
28224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$133.68 |
| Max. Negotiated Rate |
$325.18 |
| Rate for Payer: Aetna American Axle |
$234.85
|
| Rate for Payer: Aetna Commercial |
$307.11
|
| Rate for Payer: Aetna Medicare |
$180.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.85
|
| Rate for Payer: BCBS Complete |
$144.52
|
| Rate for Payer: Cash Price |
$289.05
|
| Rate for Payer: Cofinity Advantage |
$252.92
|
| Rate for Payer: Cofinity Commercial |
$310.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.05
|
| Rate for Payer: Healthscope Commercial |
$325.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$252.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$289.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$307.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$270.98
|
| Rate for Payer: PHP Commercial |
$307.11
|
| Rate for Payer: Priority Health SBD |
$227.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$234.85
|
| Rate for Payer: UHC Core |
$188.24
|
| Rate for Payer: UHC Exchange |
$141.99
|
| Rate for Payer: UMR Bronson Commercial |
$133.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.98
|
|
|
LINEZOLID 600 MG TABLET
|
Facility
|
IP
|
$174.15
|
|
|
Service Code
|
NDC 67877041920
|
| Hospital Charge Code |
28224
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$76.63 |
| Max. Negotiated Rate |
$156.74 |
| Rate for Payer: Aetna American Axle |
$113.20
|
| Rate for Payer: Aetna Commercial |
$148.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.20
|
| Rate for Payer: Cash Price |
$139.32
|
| Rate for Payer: Cofinity Advantage |
$121.91
|
| Rate for Payer: Cofinity Commercial |
$149.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.32
|
| Rate for Payer: Healthscope Commercial |
$156.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.61
|
| Rate for Payer: PHP Commercial |
$148.03
|
| Rate for Payer: Priority Health SBD |
$109.71
|
| Rate for Payer: UMR Bronson Commercial |
$76.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.61
|
|
