|
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOL (CODE)
|
Facility
|
OP
|
$34.95
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
163731
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$31.45 |
| Rate for Payer: Aetna American Axle |
$22.72
|
| Rate for Payer: Aetna Commercial |
$29.71
|
| Rate for Payer: Aetna Medicare |
$17.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.72
|
| Rate for Payer: BCBS Complete |
$13.98
|
| Rate for Payer: BCBS Trust/PPO |
$0.83
|
| Rate for Payer: BCN Commercial |
$0.83
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cofinity Advantage |
$24.46
|
| Rate for Payer: Cofinity Commercial |
$30.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.96
|
| Rate for Payer: Healthscope Commercial |
$31.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.21
|
| Rate for Payer: PHP Commercial |
$29.71
|
| Rate for Payer: Priority Health SBD |
$22.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.43
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Exchange |
$0.43
|
| Rate for Payer: UMR Bronson Commercial |
$12.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.21
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION
|
Facility
|
IP
|
$17.37
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
119451
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.64 |
| Max. Negotiated Rate |
$15.63 |
| Rate for Payer: Aetna American Axle |
$11.29
|
| Rate for Payer: Aetna American Axle |
$22.72
|
| Rate for Payer: Aetna Commercial |
$14.76
|
| Rate for Payer: Aetna Commercial |
$29.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.72
|
| Rate for Payer: Cash Price |
$13.90
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cofinity Advantage |
$24.46
|
| Rate for Payer: Cofinity Advantage |
$12.16
|
| Rate for Payer: Cofinity Commercial |
$30.06
|
| Rate for Payer: Cofinity Commercial |
$14.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.96
|
| Rate for Payer: Healthscope Commercial |
$15.63
|
| Rate for Payer: Healthscope Commercial |
$31.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.21
|
| Rate for Payer: PHP Commercial |
$14.76
|
| Rate for Payer: PHP Commercial |
$29.71
|
| Rate for Payer: Priority Health SBD |
$22.02
|
| Rate for Payer: Priority Health SBD |
$10.94
|
| Rate for Payer: UMR Bronson Commercial |
$7.64
|
| Rate for Payer: UMR Bronson Commercial |
$15.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.21
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION
|
Facility
|
OP
|
$17.37
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
119451
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$15.63 |
| Rate for Payer: Aetna American Axle |
$11.29
|
| Rate for Payer: Aetna American Axle |
$22.72
|
| Rate for Payer: Aetna Commercial |
$14.76
|
| Rate for Payer: Aetna Commercial |
$29.71
|
| Rate for Payer: Aetna Medicare |
$8.69
|
| Rate for Payer: Aetna Medicare |
$17.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.72
|
| Rate for Payer: BCBS Complete |
$13.98
|
| Rate for Payer: BCBS Complete |
$6.95
|
| Rate for Payer: BCBS Trust/PPO |
$0.83
|
| Rate for Payer: BCBS Trust/PPO |
$0.83
|
| Rate for Payer: BCN Commercial |
$0.83
|
| Rate for Payer: BCN Commercial |
$0.83
|
| Rate for Payer: Cash Price |
$13.90
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cash Price |
$13.90
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cofinity Advantage |
$12.16
|
| Rate for Payer: Cofinity Advantage |
$24.46
|
| Rate for Payer: Cofinity Commercial |
$14.94
|
| Rate for Payer: Cofinity Commercial |
$30.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.96
|
| Rate for Payer: Healthscope Commercial |
$15.63
|
| Rate for Payer: Healthscope Commercial |
$31.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.03
|
| Rate for Payer: PHP Commercial |
$14.76
|
| Rate for Payer: PHP Commercial |
$29.71
|
| Rate for Payer: Priority Health SBD |
$10.94
|
| Rate for Payer: Priority Health SBD |
$22.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.43
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Exchange |
$0.43
|
| Rate for Payer: UHC Exchange |
$0.43
|
| Rate for Payer: UMR Bronson Commercial |
$6.43
|
| Rate for Payer: UMR Bronson Commercial |
$12.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.21
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION
|
Facility
|
OP
|
$16.70
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
119450
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$15.03 |
| Rate for Payer: Aetna American Axle |
$10.86
|
| Rate for Payer: Aetna American Axle |
$14.28
|
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Commercial |
$18.67
|
| Rate for Payer: Aetna Medicare |
$8.35
|
| Rate for Payer: Aetna Medicare |
$10.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.28
|
| Rate for Payer: BCBS Complete |
$8.79
|
| Rate for Payer: BCBS Complete |
$6.68
|
| Rate for Payer: BCBS Trust/PPO |
$0.83
|
| Rate for Payer: BCBS Trust/PPO |
$0.83
|
| Rate for Payer: BCN Commercial |
$0.83
|
| Rate for Payer: BCN Commercial |
$0.83
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cash Price |
$17.58
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cash Price |
$17.58
|
| Rate for Payer: Cofinity Advantage |
$11.69
|
| Rate for Payer: Cofinity Advantage |
$15.38
|
| Rate for Payer: Cofinity Commercial |
$14.36
|
| Rate for Payer: Cofinity Commercial |
$18.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.58
|
| Rate for Payer: Healthscope Commercial |
$15.03
|
| Rate for Payer: Healthscope Commercial |
$19.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.53
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: PHP Commercial |
$18.67
|
| Rate for Payer: Priority Health SBD |
$10.52
|
| Rate for Payer: Priority Health SBD |
$13.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.43
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Exchange |
$0.43
|
| Rate for Payer: UHC Exchange |
$0.43
|
| Rate for Payer: UMR Bronson Commercial |
$6.18
|
| Rate for Payer: UMR Bronson Commercial |
$8.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.48
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION
|
Facility
|
IP
|
$16.70
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
119450
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$15.03 |
| Rate for Payer: Aetna American Axle |
$10.86
|
| Rate for Payer: Aetna American Axle |
$14.28
|
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Commercial |
$18.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.28
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cash Price |
$17.58
|
| Rate for Payer: Cofinity Advantage |
$15.38
|
| Rate for Payer: Cofinity Advantage |
$11.69
|
| Rate for Payer: Cofinity Commercial |
$18.89
|
| Rate for Payer: Cofinity Commercial |
$14.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.58
|
| Rate for Payer: Healthscope Commercial |
$15.03
|
| Rate for Payer: Healthscope Commercial |
$19.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.48
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: PHP Commercial |
$18.67
|
| Rate for Payer: Priority Health SBD |
$13.84
|
| Rate for Payer: Priority Health SBD |
$10.52
|
| Rate for Payer: UMR Bronson Commercial |
$7.35
|
| Rate for Payer: UMR Bronson Commercial |
$9.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.48
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
IP
|
$12.24
|
|
|
Service Code
|
NDC 45802017453
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna American Axle |
$7.96
|
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.96
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Advantage |
$8.57
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.18
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health SBD |
$7.71
|
| Rate for Payer: UMR Bronson Commercial |
$5.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
IP
|
$12.24
|
|
|
Service Code
|
NDC 41167006003
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna American Axle |
$7.96
|
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.96
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Advantage |
$8.57
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.18
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health SBD |
$7.71
|
| Rate for Payer: UMR Bronson Commercial |
$5.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
IP
|
$16.83
|
|
|
Service Code
|
NDC 57896011603
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.41 |
| Max. Negotiated Rate |
$15.15 |
| Rate for Payer: Aetna American Axle |
$10.94
|
| Rate for Payer: Aetna Commercial |
$14.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.94
|
| Rate for Payer: Cash Price |
$13.46
|
| Rate for Payer: Cofinity Advantage |
$11.78
|
| Rate for Payer: Cofinity Commercial |
$14.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.46
|
| Rate for Payer: Healthscope Commercial |
$15.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.62
|
| Rate for Payer: PHP Commercial |
$14.31
|
| Rate for Payer: Priority Health SBD |
$10.60
|
| Rate for Payer: UMR Bronson Commercial |
$7.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.62
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
OP
|
$16.83
|
|
|
Service Code
|
NDC 57896011603
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$15.15 |
| Rate for Payer: Aetna American Axle |
$10.94
|
| Rate for Payer: Aetna Commercial |
$14.31
|
| Rate for Payer: Aetna Medicare |
$8.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.94
|
| Rate for Payer: BCBS Complete |
$6.73
|
| Rate for Payer: Cash Price |
$13.46
|
| Rate for Payer: Cofinity Advantage |
$11.78
|
| Rate for Payer: Cofinity Commercial |
$14.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.46
|
| Rate for Payer: Healthscope Commercial |
$15.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.62
|
| Rate for Payer: PHP Commercial |
$14.31
|
| Rate for Payer: Priority Health SBD |
$10.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.94
|
| Rate for Payer: UHC Core |
$8.77
|
| Rate for Payer: UHC Exchange |
$6.61
|
| Rate for Payer: UMR Bronson Commercial |
$6.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.62
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
OP
|
$12.24
|
|
|
Service Code
|
NDC 45802017453
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna American Axle |
$7.96
|
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: Aetna Medicare |
$6.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.96
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Advantage |
$8.57
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.18
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health SBD |
$7.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.96
|
| Rate for Payer: UHC Core |
$6.38
|
| Rate for Payer: UHC Exchange |
$4.81
|
| Rate for Payer: UMR Bronson Commercial |
$4.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
OP
|
$12.24
|
|
|
Service Code
|
NDC 41167006006
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna American Axle |
$7.96
|
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: Aetna Medicare |
$6.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.96
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Advantage |
$8.57
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.18
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health SBD |
$7.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.96
|
| Rate for Payer: UHC Core |
$6.38
|
| Rate for Payer: UHC Exchange |
$4.81
|
| Rate for Payer: UMR Bronson Commercial |
$4.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
OP
|
$16.28
|
|
|
Service Code
|
NDC 76420099901
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$14.65 |
| Rate for Payer: Aetna American Axle |
$10.58
|
| Rate for Payer: Aetna Commercial |
$13.84
|
| Rate for Payer: Aetna Medicare |
$8.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.58
|
| Rate for Payer: BCBS Complete |
$6.51
|
| Rate for Payer: Cash Price |
$13.02
|
| Rate for Payer: Cofinity Advantage |
$11.40
|
| Rate for Payer: Cofinity Commercial |
$14.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.02
|
| Rate for Payer: Healthscope Commercial |
$14.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.21
|
| Rate for Payer: PHP Commercial |
$13.84
|
| Rate for Payer: Priority Health SBD |
$10.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.58
|
| Rate for Payer: UHC Core |
$8.48
|
| Rate for Payer: UHC Exchange |
$6.40
|
| Rate for Payer: UMR Bronson Commercial |
$6.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.21
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
IP
|
$12.24
|
|
|
Service Code
|
NDC 41167060003
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna American Axle |
$7.96
|
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.96
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Advantage |
$8.57
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.18
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health SBD |
$7.71
|
| Rate for Payer: UMR Bronson Commercial |
$5.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
IP
|
$16.28
|
|
|
Service Code
|
NDC 76420099901
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.16 |
| Max. Negotiated Rate |
$14.65 |
| Rate for Payer: Aetna American Axle |
$10.58
|
| Rate for Payer: Aetna Commercial |
$13.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.58
|
| Rate for Payer: Cash Price |
$13.02
|
| Rate for Payer: Cofinity Advantage |
$11.40
|
| Rate for Payer: Cofinity Commercial |
$14.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.02
|
| Rate for Payer: Healthscope Commercial |
$14.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.21
|
| Rate for Payer: PHP Commercial |
$13.84
|
| Rate for Payer: Priority Health SBD |
$10.26
|
| Rate for Payer: UMR Bronson Commercial |
$7.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.21
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
IP
|
$12.24
|
|
|
Service Code
|
NDC 41167006006
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna American Axle |
$7.96
|
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.96
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Advantage |
$8.57
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.18
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health SBD |
$7.71
|
| Rate for Payer: UMR Bronson Commercial |
$5.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
OP
|
$12.24
|
|
|
Service Code
|
NDC 41167006003
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna American Axle |
$7.96
|
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: Aetna Medicare |
$6.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.96
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Advantage |
$8.57
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.18
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health SBD |
$7.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.96
|
| Rate for Payer: UHC Core |
$6.38
|
| Rate for Payer: UHC Exchange |
$4.81
|
| Rate for Payer: UMR Bronson Commercial |
$4.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
OP
|
$12.24
|
|
|
Service Code
|
NDC 41167060003
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna American Axle |
$7.96
|
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: Aetna Medicare |
$6.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.96
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Advantage |
$8.57
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.18
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health SBD |
$7.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.96
|
| Rate for Payer: UHC Core |
$6.38
|
| Rate for Payer: UHC Exchange |
$4.81
|
| Rate for Payer: UMR Bronson Commercial |
$4.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
METOCLOPRAMIDE 10 MG TABLET
|
Facility
|
OP
|
$173.90
|
|
|
Service Code
|
NDC 49884068901
|
| Hospital Charge Code |
5005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$64.34 |
| Max. Negotiated Rate |
$156.51 |
| Rate for Payer: Aetna American Axle |
$113.03
|
| Rate for Payer: Aetna Commercial |
$147.81
|
| Rate for Payer: Aetna Medicare |
$86.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.03
|
| Rate for Payer: BCBS Complete |
$69.56
|
| Rate for Payer: Cash Price |
$139.12
|
| Rate for Payer: Cofinity Advantage |
$121.73
|
| Rate for Payer: Cofinity Commercial |
$149.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.12
|
| Rate for Payer: Healthscope Commercial |
$156.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.43
|
| Rate for Payer: PHP Commercial |
$147.81
|
| Rate for Payer: Priority Health SBD |
$109.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.03
|
| Rate for Payer: UHC Core |
$90.60
|
| Rate for Payer: UHC Exchange |
$68.34
|
| Rate for Payer: UMR Bronson Commercial |
$64.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.43
|
|
|
METOCLOPRAMIDE 10 MG TABLET
|
Facility
|
OP
|
$96.35
|
|
|
Service Code
|
NDC 00093220301
|
| Hospital Charge Code |
5005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$35.65 |
| Max. Negotiated Rate |
$86.72 |
| Rate for Payer: Aetna American Axle |
$62.63
|
| Rate for Payer: Aetna Commercial |
$81.90
|
| Rate for Payer: Aetna Medicare |
$48.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.63
|
| Rate for Payer: BCBS Complete |
$38.54
|
| Rate for Payer: Cash Price |
$77.08
|
| Rate for Payer: Cofinity Advantage |
$67.44
|
| Rate for Payer: Cofinity Commercial |
$82.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.08
|
| Rate for Payer: Healthscope Commercial |
$86.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.26
|
| Rate for Payer: PHP Commercial |
$81.90
|
| Rate for Payer: Priority Health SBD |
$60.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.63
|
| Rate for Payer: UHC Core |
$50.20
|
| Rate for Payer: UHC Exchange |
$37.87
|
| Rate for Payer: UMR Bronson Commercial |
$35.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.26
|
|
|
METOCLOPRAMIDE 10 MG TABLET
|
Facility
|
IP
|
$173.90
|
|
|
Service Code
|
NDC 49884068901
|
| Hospital Charge Code |
5005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$76.52 |
| Max. Negotiated Rate |
$156.51 |
| Rate for Payer: Aetna American Axle |
$113.03
|
| Rate for Payer: Aetna Commercial |
$147.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.03
|
| Rate for Payer: Cash Price |
$139.12
|
| Rate for Payer: Cofinity Advantage |
$121.73
|
| Rate for Payer: Cofinity Commercial |
$149.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.12
|
| Rate for Payer: Healthscope Commercial |
$156.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.43
|
| Rate for Payer: PHP Commercial |
$147.81
|
| Rate for Payer: Priority Health SBD |
$109.56
|
| Rate for Payer: UMR Bronson Commercial |
$76.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.43
|
|
|
METOCLOPRAMIDE 10 MG TABLET
|
Facility
|
IP
|
$96.35
|
|
|
Service Code
|
NDC 00093220301
|
| Hospital Charge Code |
5005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$42.39 |
| Max. Negotiated Rate |
$86.72 |
| Rate for Payer: Aetna American Axle |
$62.63
|
| Rate for Payer: Aetna Commercial |
$81.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.63
|
| Rate for Payer: Cash Price |
$77.08
|
| Rate for Payer: Cofinity Advantage |
$67.44
|
| Rate for Payer: Cofinity Commercial |
$82.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.08
|
| Rate for Payer: Healthscope Commercial |
$86.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.26
|
| Rate for Payer: PHP Commercial |
$81.90
|
| Rate for Payer: Priority Health SBD |
$60.70
|
| Rate for Payer: UMR Bronson Commercial |
$42.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.26
|
|
|
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$655.82
|
|
|
Service Code
|
NDC 00121057616
|
| Hospital Charge Code |
77725
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$288.56 |
| Max. Negotiated Rate |
$590.24 |
| Rate for Payer: Aetna American Axle |
$426.28
|
| Rate for Payer: Aetna Commercial |
$557.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.28
|
| Rate for Payer: Cash Price |
$524.66
|
| Rate for Payer: Cofinity Advantage |
$459.07
|
| Rate for Payer: Cofinity Commercial |
$564.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.66
|
| Rate for Payer: Healthscope Commercial |
$590.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$459.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$491.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$491.87
|
| Rate for Payer: PHP Commercial |
$557.45
|
| Rate for Payer: Priority Health SBD |
$413.17
|
| Rate for Payer: UMR Bronson Commercial |
$288.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$491.87
|
|
|
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$655.82
|
|
|
Service Code
|
NDC 00121057616
|
| Hospital Charge Code |
77725
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$242.65 |
| Max. Negotiated Rate |
$590.24 |
| Rate for Payer: Aetna American Axle |
$426.28
|
| Rate for Payer: Aetna Commercial |
$557.45
|
| Rate for Payer: Aetna Medicare |
$327.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.28
|
| Rate for Payer: BCBS Complete |
$262.33
|
| Rate for Payer: Cash Price |
$524.66
|
| Rate for Payer: Cofinity Advantage |
$459.07
|
| Rate for Payer: Cofinity Commercial |
$564.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.66
|
| Rate for Payer: Healthscope Commercial |
$590.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$459.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$491.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$524.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$491.87
|
| Rate for Payer: PHP Commercial |
$557.45
|
| Rate for Payer: Priority Health SBD |
$413.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.28
|
| Rate for Payer: UHC Core |
$341.68
|
| Rate for Payer: UHC Exchange |
$257.74
|
| Rate for Payer: UMR Bronson Commercial |
$242.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$491.87
|
|
|
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$1,533.94
|
|
|
Service Code
|
NDC 62559019016
|
| Hospital Charge Code |
77725
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$567.56 |
| Max. Negotiated Rate |
$1,380.55 |
| Rate for Payer: Aetna American Axle |
$997.06
|
| Rate for Payer: Aetna Commercial |
$1,303.85
|
| Rate for Payer: Aetna Medicare |
$766.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$997.06
|
| Rate for Payer: BCBS Complete |
$613.58
|
| Rate for Payer: Cash Price |
$1,227.15
|
| Rate for Payer: Cofinity Advantage |
$1,073.76
|
| Rate for Payer: Cofinity Commercial |
$1,319.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,227.15
|
| Rate for Payer: Healthscope Commercial |
$1,380.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,073.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,150.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,227.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,303.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,150.45
|
| Rate for Payer: PHP Commercial |
$1,303.85
|
| Rate for Payer: Priority Health SBD |
$966.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$997.06
|
| Rate for Payer: UHC Core |
$799.18
|
| Rate for Payer: UHC Exchange |
$602.84
|
| Rate for Payer: UMR Bronson Commercial |
$567.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,150.45
|
|
|
METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$31.26
|
|
|
Service Code
|
NDC 00121157610
|
| Hospital Charge Code |
77725
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$28.13 |
| Rate for Payer: Aetna American Axle |
$20.32
|
| Rate for Payer: Aetna Commercial |
$26.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.32
|
| Rate for Payer: Cash Price |
$25.01
|
| Rate for Payer: Cofinity Advantage |
$21.88
|
| Rate for Payer: Cofinity Commercial |
$26.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.01
|
| Rate for Payer: Healthscope Commercial |
$28.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.45
|
| Rate for Payer: PHP Commercial |
$26.57
|
| Rate for Payer: Priority Health SBD |
$19.69
|
| Rate for Payer: UMR Bronson Commercial |
$13.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.45
|
|
