|
MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLUTION
|
Facility
|
IP
|
$7,943.89
|
|
|
Service Code
|
HCPCS J2182
|
| Hospital Charge Code |
176478
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3,495.31 |
| Max. Negotiated Rate |
$7,149.50 |
| Rate for Payer: Aetna American Axle |
$5,163.53
|
| Rate for Payer: Aetna Commercial |
$6,752.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,163.53
|
| Rate for Payer: Cash Price |
$6,355.11
|
| Rate for Payer: Cofinity Commercial |
$5,560.72
|
| Rate for Payer: Cofinity Commercial |
$6,831.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,560.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,355.11
|
| Rate for Payer: Healthscope Commercial |
$7,149.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,560.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,957.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,752.31
|
| Rate for Payer: PHP Commercial |
$6,752.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,163.53
|
| Rate for Payer: Priority Health SBD |
$5,004.65
|
| Rate for Payer: UMR Bronson Commercial |
$3,495.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,957.92
|
|
|
MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLUTION
|
Facility
|
OP
|
$7,943.89
|
|
|
Service Code
|
HCPCS J2182
|
| Hospital Charge Code |
176478
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.45 |
| Max. Negotiated Rate |
$7,149.50 |
| Rate for Payer: Aetna American Axle |
$5,163.53
|
| Rate for Payer: Aetna Commercial |
$6,752.31
|
| Rate for Payer: Aetna Medicare |
$31.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,163.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.36
|
| Rate for Payer: BCBS Complete |
$17.27
|
| Rate for Payer: BCBS MAPPO |
$30.69
|
| Rate for Payer: BCBS Trust/PPO |
$82.04
|
| Rate for Payer: BCN Commercial |
$82.04
|
| Rate for Payer: BCN Medicare Advantage |
$30.69
|
| Rate for Payer: Cash Price |
$6,355.11
|
| Rate for Payer: Cash Price |
$6,355.11
|
| Rate for Payer: Cofinity Commercial |
$6,831.75
|
| Rate for Payer: Cofinity Commercial |
$5,560.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,560.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,355.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.69
|
| Rate for Payer: Healthscope Commercial |
$7,149.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,560.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,957.92
|
| Rate for Payer: Mclaren Medicaid |
$16.45
|
| Rate for Payer: Mclaren Medicare |
$30.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.22
|
| Rate for Payer: Meridian Medicaid |
$17.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,752.31
|
| Rate for Payer: Nomi Health Commercial |
$92.07
|
| Rate for Payer: PACE Medicare |
$29.16
|
| Rate for Payer: PACE SWMI |
$30.69
|
| Rate for Payer: PHP Commercial |
$6,752.31
|
| Rate for Payer: PHP Medicare Advantage |
$30.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,163.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.59
|
| Rate for Payer: Priority Health Medicare |
$30.69
|
| Rate for Payer: Priority Health Narrow Network |
$70.07
|
| Rate for Payer: Priority Health SBD |
$5,004.65
|
| Rate for Payer: Railroad Medicare Medicare |
$30.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.69
|
| Rate for Payer: UHC Exchange |
$58.65
|
| Rate for Payer: UHC Medicare Advantage |
$30.69
|
| Rate for Payer: UHCCP Medicaid |
$16.45
|
| Rate for Payer: UMR Bronson Commercial |
$2,939.24
|
| Rate for Payer: VA VA |
$30.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,957.92
|
|
|
MERCAPTOPURINE 50 MG TABLET
|
Facility
|
OP
|
$117.84
|
|
|
Service Code
|
NDC 00054458111
|
| Hospital Charge Code |
10531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.60 |
| Max. Negotiated Rate |
$106.06 |
| Rate for Payer: Aetna American Axle |
$76.60
|
| Rate for Payer: Aetna Commercial |
$100.16
|
| Rate for Payer: Aetna Medicare |
$58.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.60
|
| Rate for Payer: BCBS Complete |
$47.14
|
| Rate for Payer: Cash Price |
$94.27
|
| Rate for Payer: Cofinity Commercial |
$101.34
|
| Rate for Payer: Cofinity Commercial |
$82.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.27
|
| Rate for Payer: Healthscope Commercial |
$106.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.16
|
| Rate for Payer: PHP Commercial |
$100.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.60
|
| Rate for Payer: Priority Health SBD |
$74.24
|
| Rate for Payer: UMR Bronson Commercial |
$43.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.38
|
|
|
MERCAPTOPURINE 50 MG TABLET
|
Facility
|
IP
|
$117.84
|
|
|
Service Code
|
NDC 00054458111
|
| Hospital Charge Code |
10531
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$51.85 |
| Max. Negotiated Rate |
$106.06 |
| Rate for Payer: Aetna American Axle |
$76.60
|
| Rate for Payer: Aetna Commercial |
$100.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.60
|
| Rate for Payer: Cash Price |
$94.27
|
| Rate for Payer: Cofinity Commercial |
$101.34
|
| Rate for Payer: Cofinity Commercial |
$82.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.27
|
| Rate for Payer: Healthscope Commercial |
$106.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.16
|
| Rate for Payer: PHP Commercial |
$100.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.60
|
| Rate for Payer: Priority Health SBD |
$74.24
|
| Rate for Payer: UMR Bronson Commercial |
$51.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.38
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$23.97
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.55 |
| Max. Negotiated Rate |
$21.57 |
| Rate for Payer: Aetna American Axle |
$15.58
|
| Rate for Payer: Aetna Commercial |
$20.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.58
|
| Rate for Payer: Cash Price |
$19.18
|
| Rate for Payer: Cofinity Commercial |
$16.78
|
| Rate for Payer: Cofinity Commercial |
$20.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.18
|
| Rate for Payer: Healthscope Commercial |
$21.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.37
|
| Rate for Payer: PHP Commercial |
$20.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.58
|
| Rate for Payer: Priority Health SBD |
$15.10
|
| Rate for Payer: UMR Bronson Commercial |
$10.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.98
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$23.97
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.95 |
| Max. Negotiated Rate |
$21.57 |
| Rate for Payer: Aetna American Axle |
$15.58
|
| Rate for Payer: Aetna Commercial |
$20.37
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.58
|
| Rate for Payer: BCBS Complete |
$9.59
|
| Rate for Payer: BCBS Trust/PPO |
$0.95
|
| Rate for Payer: BCN Commercial |
$0.95
|
| Rate for Payer: Cash Price |
$19.18
|
| Rate for Payer: Cash Price |
$19.18
|
| Rate for Payer: Cofinity Commercial |
$16.78
|
| Rate for Payer: Cofinity Commercial |
$20.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.18
|
| Rate for Payer: Healthscope Commercial |
$21.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.37
|
| Rate for Payer: PHP Commercial |
$20.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.58
|
| Rate for Payer: Priority Health SBD |
$15.10
|
| Rate for Payer: UMR Bronson Commercial |
$8.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.98
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$22.72
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17380
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$20.45 |
| Rate for Payer: Aetna American Axle |
$14.77
|
| Rate for Payer: Aetna American Axle |
$15.58
|
| Rate for Payer: Aetna American Axle |
$16.73
|
| Rate for Payer: Aetna Commercial |
$20.37
|
| Rate for Payer: Aetna Commercial |
$19.31
|
| Rate for Payer: Aetna Commercial |
$21.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.58
|
| Rate for Payer: Cash Price |
$20.59
|
| Rate for Payer: Cash Price |
$19.18
|
| Rate for Payer: Cash Price |
$18.18
|
| Rate for Payer: Cofinity Commercial |
$19.54
|
| Rate for Payer: Cofinity Commercial |
$20.61
|
| Rate for Payer: Cofinity Commercial |
$16.78
|
| Rate for Payer: Cofinity Commercial |
$22.14
|
| Rate for Payer: Cofinity Commercial |
$18.02
|
| Rate for Payer: Cofinity Commercial |
$15.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.18
|
| Rate for Payer: Healthscope Commercial |
$21.57
|
| Rate for Payer: Healthscope Commercial |
$20.45
|
| Rate for Payer: Healthscope Commercial |
$23.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.37
|
| Rate for Payer: PHP Commercial |
$21.88
|
| Rate for Payer: PHP Commercial |
$20.37
|
| Rate for Payer: PHP Commercial |
$19.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.77
|
| Rate for Payer: Priority Health SBD |
$16.22
|
| Rate for Payer: Priority Health SBD |
$15.10
|
| Rate for Payer: Priority Health SBD |
$14.31
|
| Rate for Payer: UMR Bronson Commercial |
$10.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.33
|
| Rate for Payer: UMR Bronson Commercial |
$10.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.98
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$25.74
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17380
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.95 |
| Max. Negotiated Rate |
$23.17 |
| Rate for Payer: Aetna American Axle |
$16.73
|
| Rate for Payer: Aetna American Axle |
$15.58
|
| Rate for Payer: Aetna American Axle |
$14.77
|
| Rate for Payer: Aetna Commercial |
$21.88
|
| Rate for Payer: Aetna Commercial |
$19.31
|
| Rate for Payer: Aetna Commercial |
$20.37
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Aetna Medicare |
$11.36
|
| Rate for Payer: Aetna Medicare |
$12.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.58
|
| Rate for Payer: BCBS Complete |
$9.59
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS Complete |
$9.09
|
| Rate for Payer: BCBS Trust/PPO |
$0.95
|
| Rate for Payer: BCBS Trust/PPO |
$0.95
|
| Rate for Payer: BCBS Trust/PPO |
$0.95
|
| Rate for Payer: BCN Commercial |
$0.95
|
| Rate for Payer: BCN Commercial |
$0.95
|
| Rate for Payer: BCN Commercial |
$0.95
|
| Rate for Payer: Cash Price |
$19.18
|
| Rate for Payer: Cash Price |
$20.59
|
| Rate for Payer: Cash Price |
$18.18
|
| Rate for Payer: Cash Price |
$19.18
|
| Rate for Payer: Cash Price |
$18.18
|
| Rate for Payer: Cash Price |
$20.59
|
| Rate for Payer: Cofinity Commercial |
$20.61
|
| Rate for Payer: Cofinity Commercial |
$15.90
|
| Rate for Payer: Cofinity Commercial |
$19.54
|
| Rate for Payer: Cofinity Commercial |
$16.78
|
| Rate for Payer: Cofinity Commercial |
$18.02
|
| Rate for Payer: Cofinity Commercial |
$22.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.59
|
| Rate for Payer: Healthscope Commercial |
$23.17
|
| Rate for Payer: Healthscope Commercial |
$21.57
|
| Rate for Payer: Healthscope Commercial |
$20.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.88
|
| Rate for Payer: PHP Commercial |
$21.88
|
| Rate for Payer: PHP Commercial |
$19.31
|
| Rate for Payer: PHP Commercial |
$20.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.73
|
| Rate for Payer: Priority Health SBD |
$15.10
|
| Rate for Payer: Priority Health SBD |
$16.22
|
| Rate for Payer: Priority Health SBD |
$14.31
|
| Rate for Payer: UMR Bronson Commercial |
$9.52
|
| Rate for Payer: UMR Bronson Commercial |
$8.41
|
| Rate for Payer: UMR Bronson Commercial |
$8.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.30
|
|
|
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 |
$0.95 |
| Max. Negotiated Rate |
$40.05 |
| Rate for Payer: Aetna American Axle |
$28.92
|
| Rate for Payer: Aetna Commercial |
$37.82
|
| Rate for Payer: Aetna Medicare |
$22.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.92
|
| Rate for Payer: BCBS Complete |
$17.80
|
| Rate for Payer: BCBS Trust/PPO |
$0.95
|
| Rate for Payer: BCN Commercial |
$0.95
|
| Rate for Payer: Cash Price |
$35.60
|
| Rate for Payer: Cash Price |
$35.60
|
| Rate for Payer: Cofinity Commercial |
$31.15
|
| Rate for Payer: Cofinity Commercial |
$38.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.15
|
| 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 |
$37.82
|
| Rate for Payer: PHP Commercial |
$37.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.92
|
| Rate for Payer: Priority Health SBD |
$28.04
|
| Rate for Payer: UMR Bronson Commercial |
$16.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.38
|
|
|
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 |
$28.92
|
| Rate for Payer: Aetna Commercial |
$37.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.92
|
| Rate for Payer: Cash Price |
$35.60
|
| Rate for Payer: Cofinity Commercial |
$31.15
|
| Rate for Payer: Cofinity Commercial |
$38.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.15
|
| 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 |
$37.82
|
| Rate for Payer: PHP Commercial |
$37.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.92
|
| 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 INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
IP
|
$15.97
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301712
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$14.37 |
| Rate for Payer: Aetna American Axle |
$10.38
|
| Rate for Payer: Aetna Commercial |
$13.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.38
|
| Rate for Payer: Cash Price |
$12.78
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$13.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.78
|
| Rate for Payer: Healthscope Commercial |
$14.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.57
|
| Rate for Payer: PHP Commercial |
$13.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.38
|
| Rate for Payer: Priority Health SBD |
$10.06
|
| Rate for Payer: UMR Bronson Commercial |
$7.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.98
|
|
|
MEROPENEM 500 MG INTRAVENOUS MINI-BAG PLUS COMPONENT CUSTOM
|
Facility
|
OP
|
$15.97
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
301712
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.95 |
| Max. Negotiated Rate |
$14.37 |
| Rate for Payer: Aetna American Axle |
$10.38
|
| Rate for Payer: Aetna Commercial |
$13.57
|
| Rate for Payer: Aetna Medicare |
$7.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.38
|
| Rate for Payer: BCBS Complete |
$6.39
|
| Rate for Payer: BCBS Trust/PPO |
$0.95
|
| Rate for Payer: BCN Commercial |
$0.95
|
| Rate for Payer: Cash Price |
$12.78
|
| Rate for Payer: Cash Price |
$12.78
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$13.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.78
|
| Rate for Payer: Healthscope Commercial |
$14.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.57
|
| Rate for Payer: PHP Commercial |
$13.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.38
|
| Rate for Payer: Priority Health SBD |
$10.06
|
| Rate for Payer: UMR Bronson Commercial |
$5.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.98
|
|
|
MEROPENEM 500 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$15.97
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17379
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$14.37 |
| Rate for Payer: Aetna American Axle |
$10.38
|
| Rate for Payer: Aetna American Axle |
$12.28
|
| Rate for Payer: Aetna American Axle |
$12.94
|
| Rate for Payer: Aetna Commercial |
$16.06
|
| Rate for Payer: Aetna Commercial |
$13.57
|
| Rate for Payer: Aetna Commercial |
$16.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.28
|
| Rate for Payer: Cash Price |
$15.92
|
| Rate for Payer: Cash Price |
$15.11
|
| Rate for Payer: Cash Price |
$12.78
|
| Rate for Payer: Cofinity Commercial |
$13.73
|
| Rate for Payer: Cofinity Commercial |
$16.25
|
| Rate for Payer: Cofinity Commercial |
$13.22
|
| Rate for Payer: Cofinity Commercial |
$17.11
|
| Rate for Payer: Cofinity Commercial |
$13.93
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.11
|
| Rate for Payer: Healthscope Commercial |
$17.00
|
| Rate for Payer: Healthscope Commercial |
$14.37
|
| Rate for Payer: Healthscope Commercial |
$17.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.06
|
| Rate for Payer: PHP Commercial |
$16.92
|
| Rate for Payer: PHP Commercial |
$16.06
|
| Rate for Payer: PHP Commercial |
$13.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.38
|
| Rate for Payer: Priority Health SBD |
$12.54
|
| Rate for Payer: Priority Health SBD |
$11.90
|
| Rate for Payer: Priority Health SBD |
$10.06
|
| Rate for Payer: UMR Bronson Commercial |
$7.03
|
| Rate for Payer: UMR Bronson Commercial |
$8.76
|
| Rate for Payer: UMR Bronson Commercial |
$8.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.17
|
|
|
MEROPENEM 500 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$19.90
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
17379
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.95 |
| Max. Negotiated Rate |
$17.91 |
| Rate for Payer: Aetna American Axle |
$12.94
|
| Rate for Payer: Aetna American Axle |
$12.28
|
| Rate for Payer: Aetna American Axle |
$10.38
|
| Rate for Payer: Aetna Commercial |
$16.92
|
| Rate for Payer: Aetna Commercial |
$13.57
|
| Rate for Payer: Aetna Commercial |
$16.06
|
| Rate for Payer: Aetna Medicare |
$9.44
|
| Rate for Payer: Aetna Medicare |
$7.98
|
| Rate for Payer: Aetna Medicare |
$9.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.28
|
| Rate for Payer: BCBS Complete |
$7.56
|
| Rate for Payer: BCBS Complete |
$7.96
|
| Rate for Payer: BCBS Complete |
$6.39
|
| Rate for Payer: BCBS Trust/PPO |
$0.95
|
| Rate for Payer: BCBS Trust/PPO |
$0.95
|
| Rate for Payer: BCBS Trust/PPO |
$0.95
|
| Rate for Payer: BCN Commercial |
$0.95
|
| Rate for Payer: BCN Commercial |
$0.95
|
| Rate for Payer: BCN Commercial |
$0.95
|
| Rate for Payer: Cash Price |
$15.11
|
| Rate for Payer: Cash Price |
$15.92
|
| Rate for Payer: Cash Price |
$12.78
|
| Rate for Payer: Cash Price |
$15.11
|
| Rate for Payer: Cash Price |
$12.78
|
| Rate for Payer: Cash Price |
$15.92
|
| Rate for Payer: Cofinity Commercial |
$16.25
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$13.73
|
| Rate for Payer: Cofinity Commercial |
$13.22
|
| Rate for Payer: Cofinity Commercial |
$13.93
|
| Rate for Payer: Cofinity Commercial |
$17.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.92
|
| Rate for Payer: Healthscope Commercial |
$17.91
|
| Rate for Payer: Healthscope Commercial |
$17.00
|
| Rate for Payer: Healthscope Commercial |
$14.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.92
|
| Rate for Payer: PHP Commercial |
$16.92
|
| Rate for Payer: PHP Commercial |
$13.57
|
| Rate for Payer: PHP Commercial |
$16.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.94
|
| Rate for Payer: Priority Health SBD |
$11.90
|
| Rate for Payer: Priority Health SBD |
$12.54
|
| Rate for Payer: Priority Health SBD |
$10.06
|
| Rate for Payer: UMR Bronson Commercial |
$7.36
|
| Rate for Payer: UMR Bronson Commercial |
$5.91
|
| Rate for Payer: UMR Bronson Commercial |
$6.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.92
|
|
|
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 Commercial |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.88
|
| 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: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.81
|
| 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 0.00001 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 |
$1.12 |
| 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 |
$0.95
|
| Rate for Payer: BCN Commercial |
$0.95
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Commercial |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.88
|
| 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: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.81
|
| Rate for Payer: Priority Health SBD |
$0.79
|
| Rate for Payer: UMR Bronson Commercial |
$0.46
|
| 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 |
$1.12 |
| 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 |
$0.95
|
| Rate for Payer: BCN Commercial |
$0.95
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Commercial |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.88
|
| 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: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.81
|
| Rate for Payer: Priority Health SBD |
$0.79
|
| Rate for Payer: UMR Bronson Commercial |
$0.46
|
| 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 Commercial |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.88
|
| 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: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.81
|
| 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
|
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 Commercial |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.88
|
| 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: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.81
|
| 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 |
$1.12 |
| 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 |
$0.95
|
| Rate for Payer: BCN Commercial |
$0.95
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Commercial |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.88
|
| 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: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.81
|
| Rate for Payer: Priority Health SBD |
$0.79
|
| 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 Commercial |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.88
|
| 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: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.81
|
| 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 |
$1.12 |
| 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 |
$0.95
|
| Rate for Payer: BCN Commercial |
$0.95
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cofinity Commercial |
$0.88
|
| Rate for Payer: Cofinity Commercial |
$1.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.88
|
| 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: PHP Commercial |
$1.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.81
|
| Rate for Payer: Priority Health SBD |
$0.79
|
| 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
|
IP
|
$3,997.67
|
|
|
Service Code
|
NDC 58914050156
|
| Hospital Charge Code |
40369
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,758.97 |
| Max. Negotiated Rate |
$3,597.90 |
| Rate for Payer: Aetna American Axle |
$2,598.49
|
| Rate for Payer: Aetna Commercial |
$3,398.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,598.49
|
| Rate for Payer: Cash Price |
$3,198.14
|
| Rate for Payer: Cofinity Commercial |
$2,798.37
|
| Rate for Payer: Cofinity Commercial |
$3,438.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,798.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,198.14
|
| Rate for Payer: Healthscope Commercial |
$3,597.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,798.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,998.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,398.02
|
| Rate for Payer: PHP Commercial |
$3,398.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,598.49
|
| Rate for Payer: Priority Health SBD |
$2,518.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,758.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,998.25
|
|
|
MESALAMINE 1,000 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$3,997.67
|
|
|
Service Code
|
NDC 58914050156
|
| Hospital Charge Code |
40369
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,479.14 |
| Max. Negotiated Rate |
$3,597.90 |
| Rate for Payer: Aetna American Axle |
$2,598.49
|
| Rate for Payer: Aetna Commercial |
$3,398.02
|
| Rate for Payer: Aetna Medicare |
$1,998.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,598.49
|
| Rate for Payer: BCBS Complete |
$1,599.07
|
| Rate for Payer: Cash Price |
$3,198.14
|
| Rate for Payer: Cofinity Commercial |
$2,798.37
|
| Rate for Payer: Cofinity Commercial |
$3,438.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,798.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,198.14
|
| Rate for Payer: Healthscope Commercial |
$3,597.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,798.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,998.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,398.02
|
| Rate for Payer: PHP Commercial |
$3,398.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,598.49
|
| Rate for Payer: Priority Health SBD |
$2,518.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,479.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,998.25
|
|
|
MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE
|
Facility
|
OP
|
$3,865.02
|
|
|
Service Code
|
NDC 54092047612
|
| Hospital Charge Code |
78310
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,430.06 |
| Max. Negotiated Rate |
$3,478.52 |
| Rate for Payer: Healthscope Commercial |
$3,478.52
|
| Rate for Payer: Aetna American Axle |
$2,512.26
|
| Rate for Payer: Aetna Commercial |
$3,285.27
|
| Rate for Payer: Aetna Medicare |
$1,932.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,512.26
|
| Rate for Payer: BCBS Complete |
$1,546.01
|
| Rate for Payer: Cash Price |
$3,092.02
|
| Rate for Payer: Cofinity Commercial |
$2,705.51
|
| Rate for Payer: Cofinity Commercial |
$3,323.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,705.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,092.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,705.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,898.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,285.27
|
| Rate for Payer: PHP Commercial |
$3,285.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,512.26
|
| Rate for Payer: Priority Health SBD |
$2,434.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,430.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,898.76
|
|
