|
MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLUTION
|
Facility
|
OP
|
$8,599.22
|
|
|
Service Code
|
HCPCS J2182
|
| Hospital Charge Code |
176478
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.64 |
| Max. Negotiated Rate |
$7,739.30 |
| Rate for Payer: Aetna American Axle |
$5,589.49
|
| Rate for Payer: Aetna Commercial |
$7,309.34
|
| Rate for Payer: Aetna Medicare |
$33.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,589.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.77
|
| Rate for Payer: BCBS Complete |
$17.48
|
| Rate for Payer: BCBS MAPPO |
$31.82
|
| Rate for Payer: BCBS Trust/PPO |
$103.37
|
| Rate for Payer: BCN Commercial |
$103.37
|
| Rate for Payer: BCN Medicare Advantage |
$31.82
|
| Rate for Payer: Cash Price |
$6,879.38
|
| Rate for Payer: Cash Price |
$6,879.38
|
| Rate for Payer: Cofinity Advantage |
$6,019.45
|
| Rate for Payer: Cofinity Commercial |
$7,395.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,879.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.82
|
| Rate for Payer: Healthscope Commercial |
$7,739.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,019.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,449.41
|
| Rate for Payer: Mclaren Medicaid |
$31.82
|
| Rate for Payer: Mclaren Medicare |
$31.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.41
|
| Rate for Payer: Meridian Medicaid |
$33.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,309.34
|
| Rate for Payer: Nomi Health Commercial |
$95.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,449.41
|
| Rate for Payer: PACE Medicare |
$30.23
|
| Rate for Payer: PACE SWMI |
$31.82
|
| Rate for Payer: PHP Commercial |
$7,309.34
|
| Rate for Payer: PHP Medicare Advantage |
$31.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$98.63
|
| Rate for Payer: Priority Health Medicare |
$31.82
|
| Rate for Payer: Priority Health SBD |
$5,417.51
|
| Rate for Payer: Priority Health Tiered Network |
$78.90
|
| Rate for Payer: Railroad Medicare Medicare |
$31.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.62
|
| Rate for Payer: UHC Core |
$52.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.82
|
| Rate for Payer: UHC Exchange |
$52.62
|
| Rate for Payer: UHC Medicaid |
$16.64
|
| Rate for Payer: UHCCP Medicaid |
$16.64
|
| Rate for Payer: UMR Bronson Commercial |
$3,181.71
|
| Rate for Payer: VA VA |
$31.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,449.41
|
|
|
MERCAPTOPURINE 50 MG TABLET
|
Facility
|
IP
|
$120.00
|
|
|
Service Code
|
NDC 00054458111
|
| Hospital Charge Code |
10531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.80 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Aetna American Axle |
$78.00
|
| Rate for Payer: Aetna Commercial |
$102.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cofinity Advantage |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$103.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.00
|
| Rate for Payer: Healthscope Commercial |
$108.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.00
|
| Rate for Payer: PHP Commercial |
$102.00
|
| Rate for Payer: Priority Health SBD |
$75.60
|
| Rate for Payer: UMR Bronson Commercial |
$52.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.00
|
|
|
MERCAPTOPURINE 50 MG TABLET
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
NDC 00054458111
|
| Hospital Charge Code |
10531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$44.40 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Aetna American Axle |
$78.00
|
| Rate for Payer: Aetna Commercial |
$102.00
|
| Rate for Payer: Aetna Medicare |
$60.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.00
|
| Rate for Payer: BCBS Complete |
$48.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cofinity Advantage |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$103.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.00
|
| Rate for Payer: Healthscope Commercial |
$108.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.00
|
| Rate for Payer: PHP Commercial |
$102.00
|
| Rate for Payer: Priority Health SBD |
$75.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.00
|
| Rate for Payer: UHC Core |
$62.52
|
| Rate for Payer: UHC Exchange |
$47.16
|
| Rate for Payer: UMR Bronson Commercial |
$44.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.00
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$18.59
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.18 |
| Max. Negotiated Rate |
$16.73 |
| Rate for Payer: Aetna American Axle |
$12.08
|
| Rate for Payer: Aetna Commercial |
$15.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.08
|
| Rate for Payer: Cash Price |
$14.87
|
| Rate for Payer: Cofinity Advantage |
$13.01
|
| Rate for Payer: Cofinity Commercial |
$15.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.87
|
| Rate for Payer: Healthscope Commercial |
$16.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.94
|
| Rate for Payer: PHP Commercial |
$15.80
|
| Rate for Payer: Priority Health SBD |
$11.71
|
| Rate for Payer: UMR Bronson Commercial |
$8.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.94
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$18.59
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$16.73 |
| Rate for Payer: Aetna American Axle |
$12.08
|
| Rate for Payer: Aetna Commercial |
$15.80
|
| Rate for Payer: Aetna Medicare |
$9.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.08
|
| Rate for Payer: BCBS Complete |
$7.44
|
| Rate for Payer: BCBS Trust/PPO |
$1.24
|
| Rate for Payer: BCN Commercial |
$1.24
|
| Rate for Payer: Cash Price |
$14.87
|
| Rate for Payer: Cash Price |
$14.87
|
| Rate for Payer: Cofinity Advantage |
$13.01
|
| Rate for Payer: Cofinity Commercial |
$15.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.87
|
| Rate for Payer: Healthscope Commercial |
$16.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.94
|
| Rate for Payer: PHP Commercial |
$15.80
|
| Rate for Payer: Priority Health SBD |
$11.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UMR Bronson Commercial |
$6.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.94
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.10
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17380
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$17.19 |
| Rate for Payer: Aetna American Axle |
$12.41
|
| Rate for Payer: Aetna American Axle |
$12.08
|
| Rate for Payer: Aetna American Axle |
$16.21
|
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna Commercial |
$21.20
|
| Rate for Payer: Aetna Commercial |
$15.80
|
| Rate for Payer: Aetna Medicare |
$9.55
|
| Rate for Payer: Aetna Medicare |
$9.29
|
| Rate for Payer: Aetna Medicare |
$12.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.21
|
| Rate for Payer: BCBS Complete |
$7.44
|
| Rate for Payer: BCBS Complete |
$7.64
|
| Rate for Payer: BCBS Complete |
$9.98
|
| Rate for Payer: BCBS Trust/PPO |
$1.24
|
| Rate for Payer: BCBS Trust/PPO |
$1.24
|
| Rate for Payer: BCBS Trust/PPO |
$1.24
|
| Rate for Payer: BCN Commercial |
$1.24
|
| Rate for Payer: BCN Commercial |
$1.24
|
| Rate for Payer: BCN Commercial |
$1.24
|
| Rate for Payer: Cash Price |
$14.87
|
| Rate for Payer: Cash Price |
$14.87
|
| Rate for Payer: Cash Price |
$19.95
|
| Rate for Payer: Cash Price |
$19.95
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cofinity Advantage |
$17.46
|
| Rate for Payer: Cofinity Advantage |
$13.37
|
| Rate for Payer: Cofinity Advantage |
$13.01
|
| Rate for Payer: Cofinity Commercial |
$15.99
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Cofinity Commercial |
$21.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Healthscope Commercial |
$16.73
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Healthscope Commercial |
$22.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.70
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: PHP Commercial |
$15.80
|
| Rate for Payer: PHP Commercial |
$21.20
|
| Rate for Payer: Priority Health SBD |
$11.71
|
| Rate for Payer: Priority Health SBD |
$15.71
|
| Rate for Payer: Priority Health SBD |
$12.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UMR Bronson Commercial |
$9.23
|
| Rate for Payer: UMR Bronson Commercial |
$6.88
|
| Rate for Payer: UMR Bronson Commercial |
$7.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.70
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$18.59
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17380
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.18 |
| Max. Negotiated Rate |
$16.73 |
| Rate for Payer: Aetna American Axle |
$12.08
|
| Rate for Payer: Aetna American Axle |
$16.21
|
| Rate for Payer: Aetna American Axle |
$12.41
|
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna Commercial |
$15.80
|
| Rate for Payer: Aetna Commercial |
$21.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.41
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cash Price |
$14.87
|
| Rate for Payer: Cash Price |
$19.95
|
| Rate for Payer: Cofinity Advantage |
$17.46
|
| Rate for Payer: Cofinity Advantage |
$13.01
|
| Rate for Payer: Cofinity Advantage |
$13.37
|
| Rate for Payer: Cofinity Commercial |
$21.45
|
| Rate for Payer: Cofinity Commercial |
$15.99
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.95
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Healthscope Commercial |
$22.45
|
| Rate for Payer: Healthscope Commercial |
$16.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.70
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: PHP Commercial |
$15.80
|
| Rate for Payer: PHP Commercial |
$21.20
|
| Rate for Payer: Priority Health SBD |
$11.71
|
| Rate for Payer: Priority Health SBD |
$12.03
|
| Rate for Payer: Priority Health SBD |
$15.71
|
| Rate for Payer: UMR Bronson Commercial |
$8.18
|
| Rate for Payer: UMR Bronson Commercial |
$10.97
|
| Rate for Payer: UMR Bronson Commercial |
$8.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.70
|
|
|
MEROPENEM 500 MG CUSTOM INTRAVENOUS SOLUTION (CHARGE IN INCREMENTS)
|
Facility
|
IP
|
$44.50
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180571
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.58 |
| Max. Negotiated Rate |
$40.05 |
| Rate for Payer: Aetna American Axle |
$28.93
|
| Rate for Payer: Aetna Commercial |
$37.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.93
|
| Rate for Payer: Cash Price |
$35.60
|
| Rate for Payer: Cofinity Advantage |
$31.15
|
| Rate for Payer: Cofinity Commercial |
$38.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.60
|
| Rate for Payer: Healthscope Commercial |
$40.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.38
|
| Rate for Payer: PHP Commercial |
$37.83
|
| Rate for Payer: Priority Health SBD |
$28.04
|
| Rate for Payer: UMR Bronson Commercial |
$19.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.38
|
|
|
MEROPENEM 500 MG CUSTOM INTRAVENOUS SOLUTION (CHARGE IN INCREMENTS)
|
Facility
|
OP
|
$44.50
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180571
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$40.05 |
| Rate for Payer: Aetna American Axle |
$28.93
|
| Rate for Payer: Aetna Commercial |
$37.83
|
| Rate for Payer: Aetna Medicare |
$22.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.93
|
| Rate for Payer: BCBS Complete |
$17.80
|
| Rate for Payer: BCBS Trust/PPO |
$1.24
|
| Rate for Payer: BCN Commercial |
$1.24
|
| Rate for Payer: Cash Price |
$35.60
|
| Rate for Payer: Cash Price |
$35.60
|
| Rate for Payer: Cofinity Advantage |
$31.15
|
| Rate for Payer: Cofinity Commercial |
$38.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.60
|
| Rate for Payer: Healthscope Commercial |
$40.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.38
|
| Rate for Payer: PHP Commercial |
$37.83
|
| Rate for Payer: Priority Health SBD |
$28.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UMR Bronson Commercial |
$16.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.38
|
|
|
MEROPENEM 500 MG INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$15.47
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301712
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$13.92 |
| Rate for Payer: Aetna American Axle |
$10.06
|
| Rate for Payer: Aetna Commercial |
$13.15
|
| Rate for Payer: Aetna Medicare |
$7.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.06
|
| Rate for Payer: BCBS Complete |
$6.19
|
| Rate for Payer: BCBS Trust/PPO |
$1.24
|
| Rate for Payer: BCN Commercial |
$1.24
|
| Rate for Payer: Cash Price |
$12.38
|
| Rate for Payer: Cash Price |
$12.38
|
| Rate for Payer: Cofinity Advantage |
$10.83
|
| Rate for Payer: Cofinity Commercial |
$13.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.38
|
| Rate for Payer: Healthscope Commercial |
$13.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.60
|
| Rate for Payer: PHP Commercial |
$13.15
|
| Rate for Payer: Priority Health SBD |
$9.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UMR Bronson Commercial |
$5.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.60
|
|
|
MEROPENEM 500 MG INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$15.47
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301712
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.81 |
| Max. Negotiated Rate |
$13.92 |
| Rate for Payer: Aetna American Axle |
$10.06
|
| Rate for Payer: Aetna Commercial |
$13.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.06
|
| Rate for Payer: Cash Price |
$12.38
|
| Rate for Payer: Cofinity Advantage |
$10.83
|
| Rate for Payer: Cofinity Commercial |
$13.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.38
|
| Rate for Payer: Healthscope Commercial |
$13.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.60
|
| Rate for Payer: PHP Commercial |
$13.15
|
| Rate for Payer: Priority Health SBD |
$9.75
|
| Rate for Payer: UMR Bronson Commercial |
$6.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.60
|
|
|
MEROPENEM 500 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$17.48
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17379
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$15.73 |
| Rate for Payer: Aetna American Axle |
$11.36
|
| Rate for Payer: Aetna American Axle |
$10.06
|
| Rate for Payer: Aetna American Axle |
$12.28
|
| Rate for Payer: Aetna Commercial |
$14.86
|
| Rate for Payer: Aetna Commercial |
$16.06
|
| Rate for Payer: Aetna Commercial |
$13.15
|
| Rate for Payer: Aetna Medicare |
$8.74
|
| Rate for Payer: Aetna Medicare |
$7.74
|
| Rate for Payer: Aetna Medicare |
$9.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.28
|
| Rate for Payer: BCBS Complete |
$6.19
|
| Rate for Payer: BCBS Complete |
$6.99
|
| Rate for Payer: BCBS Complete |
$7.56
|
| Rate for Payer: BCBS Trust/PPO |
$1.24
|
| Rate for Payer: BCBS Trust/PPO |
$1.24
|
| Rate for Payer: BCBS Trust/PPO |
$1.24
|
| Rate for Payer: BCN Commercial |
$1.24
|
| Rate for Payer: BCN Commercial |
$1.24
|
| Rate for Payer: BCN Commercial |
$1.24
|
| Rate for Payer: Cash Price |
$12.38
|
| Rate for Payer: Cash Price |
$12.38
|
| Rate for Payer: Cash Price |
$15.11
|
| Rate for Payer: Cash Price |
$15.11
|
| Rate for Payer: Cash Price |
$13.98
|
| Rate for Payer: Cash Price |
$13.98
|
| Rate for Payer: Cofinity Advantage |
$13.22
|
| Rate for Payer: Cofinity Advantage |
$12.24
|
| Rate for Payer: Cofinity Advantage |
$10.83
|
| Rate for Payer: Cofinity Commercial |
$13.30
|
| Rate for Payer: Cofinity Commercial |
$15.03
|
| Rate for Payer: Cofinity Commercial |
$16.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.98
|
| Rate for Payer: Healthscope Commercial |
$13.92
|
| Rate for Payer: Healthscope Commercial |
$15.73
|
| Rate for Payer: Healthscope Commercial |
$17.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.17
|
| Rate for Payer: PHP Commercial |
$14.86
|
| Rate for Payer: PHP Commercial |
$13.15
|
| Rate for Payer: PHP Commercial |
$16.06
|
| Rate for Payer: Priority Health SBD |
$9.75
|
| Rate for Payer: Priority Health SBD |
$11.90
|
| Rate for Payer: Priority Health SBD |
$11.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UMR Bronson Commercial |
$6.99
|
| Rate for Payer: UMR Bronson Commercial |
$5.72
|
| Rate for Payer: UMR Bronson Commercial |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.17
|
|
|
MEROPENEM 500 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$15.47
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17379
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.81 |
| Max. Negotiated Rate |
$13.92 |
| Rate for Payer: Aetna American Axle |
$10.06
|
| Rate for Payer: Aetna American Axle |
$12.28
|
| Rate for Payer: Aetna American Axle |
$11.36
|
| Rate for Payer: Aetna Commercial |
$14.86
|
| Rate for Payer: Aetna Commercial |
$13.15
|
| Rate for Payer: Aetna Commercial |
$16.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.36
|
| Rate for Payer: Cash Price |
$13.98
|
| Rate for Payer: Cash Price |
$12.38
|
| Rate for Payer: Cash Price |
$15.11
|
| Rate for Payer: Cofinity Advantage |
$13.22
|
| Rate for Payer: Cofinity Advantage |
$10.83
|
| Rate for Payer: Cofinity Advantage |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$16.25
|
| Rate for Payer: Cofinity Commercial |
$13.30
|
| Rate for Payer: Cofinity Commercial |
$15.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.11
|
| Rate for Payer: Healthscope Commercial |
$15.73
|
| Rate for Payer: Healthscope Commercial |
$17.00
|
| Rate for Payer: Healthscope Commercial |
$13.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.17
|
| Rate for Payer: PHP Commercial |
$14.86
|
| Rate for Payer: PHP Commercial |
$13.15
|
| Rate for Payer: PHP Commercial |
$16.06
|
| Rate for Payer: Priority Health SBD |
$9.75
|
| Rate for Payer: Priority Health SBD |
$11.01
|
| Rate for Payer: Priority Health SBD |
$11.90
|
| Rate for Payer: UMR Bronson Commercial |
$6.81
|
| Rate for Payer: UMR Bronson Commercial |
$8.31
|
| Rate for Payer: UMR Bronson Commercial |
$7.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.17
|
|
|
MEROPENEM IV 0.00001 MG/ML IVPB FOR DESENSITIZATION 50 ML
|
Facility
|
OP
|
$1.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180552
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.46 |
| Max. Negotiated Rate |
$1.24 |
| Rate for Payer: Aetna American Axle |
$0.81
|
| Rate for Payer: Aetna Commercial |
$1.06
|
| Rate for Payer: Aetna Medicare |
$0.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.81
|
| Rate for Payer: BCBS Complete |
$0.50
|
| Rate for Payer: BCBS Trust/PPO |
$1.24
|
| Rate for Payer: BCN Commercial |
$1.24
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Advantage |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.00
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.94
|
| Rate for Payer: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health SBD |
$0.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UMR Bronson Commercial |
$0.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.94
|
|
|
MEROPENEM IV 0.00001 MG/ML IVPB FOR DESENSITIZATION 50 ML
|
Facility
|
IP
|
$1.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180552
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$1.12 |
| Rate for Payer: Aetna American Axle |
$0.81
|
| Rate for Payer: Aetna Commercial |
$1.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.81
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Advantage |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.00
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.94
|
| Rate for Payer: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health SBD |
$0.79
|
| Rate for Payer: UMR Bronson Commercial |
$0.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.94
|
|
|
MEROPENEM IV 0.0001 MG/ML IVPB FOR DESENSITIZATION 50 ML
|
Facility
|
IP
|
$1.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180553
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$1.12 |
| Rate for Payer: Aetna American Axle |
$0.81
|
| Rate for Payer: Aetna Commercial |
$1.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.81
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Advantage |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.00
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.94
|
| Rate for Payer: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health SBD |
$0.79
|
| Rate for Payer: UMR Bronson Commercial |
$0.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.94
|
|
|
MEROPENEM IV 0.0001 MG/ML IVPB FOR DESENSITIZATION 50 ML
|
Facility
|
OP
|
$1.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180553
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.46 |
| Max. Negotiated Rate |
$1.24 |
| Rate for Payer: Aetna American Axle |
$0.81
|
| Rate for Payer: Aetna Commercial |
$1.06
|
| Rate for Payer: Aetna Medicare |
$0.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.81
|
| Rate for Payer: BCBS Complete |
$0.50
|
| Rate for Payer: BCBS Trust/PPO |
$1.24
|
| Rate for Payer: BCN Commercial |
$1.24
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Advantage |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.00
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.94
|
| Rate for Payer: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health SBD |
$0.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UMR Bronson Commercial |
$0.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.94
|
|
|
MEROPENEM IV 0.001 MG/ML IVPB FOR DESENSITIZATION 50 ML
|
Facility
|
IP
|
$1.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180554
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$1.12 |
| Rate for Payer: Aetna American Axle |
$0.81
|
| Rate for Payer: Aetna Commercial |
$1.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.81
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Advantage |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.00
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.94
|
| Rate for Payer: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health SBD |
$0.79
|
| Rate for Payer: UMR Bronson Commercial |
$0.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.94
|
|
|
MEROPENEM IV 0.001 MG/ML IVPB FOR DESENSITIZATION 50 ML
|
Facility
|
OP
|
$1.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180554
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.46 |
| Max. Negotiated Rate |
$1.24 |
| Rate for Payer: Aetna American Axle |
$0.81
|
| Rate for Payer: Aetna Commercial |
$1.06
|
| Rate for Payer: Aetna Medicare |
$0.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.81
|
| Rate for Payer: BCBS Complete |
$0.50
|
| Rate for Payer: BCBS Trust/PPO |
$1.24
|
| Rate for Payer: BCN Commercial |
$1.24
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Advantage |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.00
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.94
|
| Rate for Payer: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health SBD |
$0.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UMR Bronson Commercial |
$0.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.94
|
|
|
MEROPENEM IV 0.01 MG/ML IVPB FOR DESENSITIZATION 50 ML
|
Facility
|
IP
|
$1.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180555
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$1.12 |
| Rate for Payer: Aetna American Axle |
$0.81
|
| Rate for Payer: Aetna Commercial |
$1.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.81
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Advantage |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.00
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.94
|
| Rate for Payer: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health SBD |
$0.79
|
| Rate for Payer: UMR Bronson Commercial |
$0.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.94
|
|
|
MEROPENEM IV 0.01 MG/ML IVPB FOR DESENSITIZATION 50 ML
|
Facility
|
OP
|
$1.25
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
180555
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.46 |
| Max. Negotiated Rate |
$1.24 |
| Rate for Payer: Aetna American Axle |
$0.81
|
| Rate for Payer: Aetna Commercial |
$1.06
|
| Rate for Payer: Aetna Medicare |
$0.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.81
|
| Rate for Payer: BCBS Complete |
$0.50
|
| Rate for Payer: BCBS Trust/PPO |
$1.24
|
| Rate for Payer: BCN Commercial |
$1.24
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Advantage |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.00
|
| Rate for Payer: Healthscope Commercial |
$1.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.94
|
| Rate for Payer: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health SBD |
$0.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.63
|
| Rate for Payer: UHC Core |
$0.63
|
| Rate for Payer: UHC Exchange |
$0.63
|
| Rate for Payer: UMR Bronson Commercial |
$0.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.94
|
|
|
MESALAMINE 1,000 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$9.08
|
|
|
Service Code
|
NDC 31722000532
|
| Hospital Charge Code |
40369
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$8.17 |
| Rate for Payer: Aetna American Axle |
$5.90
|
| Rate for Payer: Aetna Commercial |
$7.72
|
| Rate for Payer: Aetna Medicare |
$4.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.90
|
| Rate for Payer: BCBS Complete |
$3.63
|
| Rate for Payer: Cash Price |
$7.26
|
| Rate for Payer: Cofinity Advantage |
$6.36
|
| Rate for Payer: Cofinity Commercial |
$7.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.26
|
| Rate for Payer: Healthscope Commercial |
$8.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.81
|
| Rate for Payer: PHP Commercial |
$7.72
|
| Rate for Payer: Priority Health SBD |
$5.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.90
|
| Rate for Payer: UHC Core |
$4.73
|
| Rate for Payer: UHC Exchange |
$3.57
|
| Rate for Payer: UMR Bronson Commercial |
$3.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.81
|
|
|
MESALAMINE 1,000 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$272.31
|
|
|
Service Code
|
NDC 31722000530
|
| Hospital Charge Code |
40369
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$100.75 |
| Max. Negotiated Rate |
$245.08 |
| Rate for Payer: Aetna American Axle |
$177.00
|
| Rate for Payer: Aetna Commercial |
$231.46
|
| Rate for Payer: Aetna Medicare |
$136.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.00
|
| Rate for Payer: BCBS Complete |
$108.92
|
| Rate for Payer: Cash Price |
$217.85
|
| Rate for Payer: Cofinity Advantage |
$190.62
|
| Rate for Payer: Cofinity Commercial |
$234.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.85
|
| Rate for Payer: Healthscope Commercial |
$245.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$217.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.23
|
| Rate for Payer: PHP Commercial |
$231.46
|
| Rate for Payer: Priority Health SBD |
$171.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.00
|
| Rate for Payer: UHC Core |
$141.87
|
| Rate for Payer: UHC Exchange |
$107.02
|
| Rate for Payer: UMR Bronson Commercial |
$100.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.23
|
|
|
MESALAMINE 1,000 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$11.47
|
|
|
Service Code
|
NDC 16571024616
|
| Hospital Charge Code |
40369
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.24 |
| Max. Negotiated Rate |
$10.32 |
| Rate for Payer: Aetna American Axle |
$7.46
|
| Rate for Payer: Aetna Commercial |
$9.75
|
| Rate for Payer: Aetna Medicare |
$5.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.46
|
| Rate for Payer: BCBS Complete |
$4.59
|
| Rate for Payer: Cash Price |
$9.18
|
| Rate for Payer: Cofinity Advantage |
$8.03
|
| Rate for Payer: Cofinity Commercial |
$9.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.18
|
| Rate for Payer: Healthscope Commercial |
$10.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.60
|
| Rate for Payer: PHP Commercial |
$9.75
|
| Rate for Payer: Priority Health SBD |
$7.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.46
|
| Rate for Payer: UHC Core |
$5.98
|
| Rate for Payer: UHC Exchange |
$4.51
|
| Rate for Payer: UMR Bronson Commercial |
$4.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.60
|
|
|
MESALAMINE 1,000 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$272.31
|
|
|
Service Code
|
NDC 31722000530
|
| Hospital Charge Code |
40369
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.82 |
| Max. Negotiated Rate |
$245.08 |
| Rate for Payer: Aetna American Axle |
$177.00
|
| Rate for Payer: Aetna Commercial |
$231.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.00
|
| Rate for Payer: Cash Price |
$217.85
|
| Rate for Payer: Cofinity Advantage |
$190.62
|
| Rate for Payer: Cofinity Commercial |
$234.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.85
|
| Rate for Payer: Healthscope Commercial |
$245.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.23
|
| Rate for Payer: PHP Commercial |
$231.46
|
| Rate for Payer: Priority Health SBD |
$171.56
|
| Rate for Payer: UMR Bronson Commercial |
$119.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.23
|
|
