|
METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$141.60
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10577
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$62.30 |
| Max. Negotiated Rate |
$127.44 |
| Rate for Payer: Aetna American Axle |
$92.04
|
| Rate for Payer: Aetna American Axle |
$123.89
|
| Rate for Payer: Aetna Commercial |
$120.36
|
| Rate for Payer: Aetna Commercial |
$162.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.89
|
| Rate for Payer: Cash Price |
$113.28
|
| Rate for Payer: Cash Price |
$152.48
|
| Rate for Payer: Cofinity Commercial |
$163.92
|
| Rate for Payer: Cofinity Commercial |
$133.42
|
| Rate for Payer: Cofinity Commercial |
$121.78
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$99.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$133.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.48
|
| Rate for Payer: Healthscope Commercial |
$127.44
|
| Rate for Payer: Healthscope Commercial |
$171.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$133.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.36
|
| Rate for Payer: PHP Commercial |
$162.01
|
| Rate for Payer: PHP Commercial |
$120.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.89
|
| Rate for Payer: Priority Health SBD |
$89.21
|
| Rate for Payer: Priority Health SBD |
$120.08
|
| Rate for Payer: UMR Bronson Commercial |
$62.30
|
| Rate for Payer: UMR Bronson Commercial |
$83.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.95
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$190.60
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10577
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$171.54 |
| Rate for Payer: Aetna American Axle |
$123.89
|
| Rate for Payer: Aetna American Axle |
$92.04
|
| Rate for Payer: Aetna Commercial |
$120.36
|
| Rate for Payer: Aetna Commercial |
$162.01
|
| Rate for Payer: Aetna Medicare |
$0.22
|
| Rate for Payer: Aetna Medicare |
$0.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.26
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: Cash Price |
$113.28
|
| Rate for Payer: Cash Price |
$152.48
|
| Rate for Payer: Cash Price |
$152.48
|
| Rate for Payer: Cash Price |
$113.28
|
| Rate for Payer: Cofinity Commercial |
$121.78
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Cofinity Commercial |
$133.42
|
| Rate for Payer: Cofinity Commercial |
$163.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$99.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$133.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| Rate for Payer: Healthscope Commercial |
$171.54
|
| Rate for Payer: Healthscope Commercial |
$127.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$133.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.95
|
| Rate for Payer: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Mclaren Medicare |
$0.21
|
| Rate for Payer: Mclaren Medicare |
$0.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.36
|
| Rate for Payer: PACE Medicare |
$0.20
|
| Rate for Payer: PACE Medicare |
$0.20
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PHP Commercial |
$120.36
|
| Rate for Payer: PHP Commercial |
$162.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.89
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Priority Health SBD |
$89.21
|
| Rate for Payer: Priority Health SBD |
$120.08
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.40
|
| Rate for Payer: UHC Exchange |
$0.40
|
| Rate for Payer: UHC Medicare Advantage |
$0.21
|
| Rate for Payer: UHC Medicare Advantage |
$0.21
|
| Rate for Payer: UHCCP Medicaid |
$0.11
|
| Rate for Payer: UHCCP Medicaid |
$0.11
|
| Rate for Payer: UMR Bronson Commercial |
$52.39
|
| Rate for Payer: UMR Bronson Commercial |
$70.52
|
| Rate for Payer: VA VA |
$0.21
|
| Rate for Payer: VA VA |
$0.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.20
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION
|
Facility
|
IP
|
$17.37
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10578
|
|
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 |
$17.03
|
| Rate for Payer: Aetna Commercial |
$14.76
|
| Rate for Payer: Aetna Commercial |
$22.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.03
|
| Rate for Payer: Cash Price |
$13.90
|
| Rate for Payer: Cash Price |
$20.96
|
| Rate for Payer: Cofinity Commercial |
$22.53
|
| Rate for Payer: Cofinity Commercial |
$18.34
|
| Rate for Payer: Cofinity Commercial |
$12.16
|
| Rate for Payer: Cofinity Commercial |
$14.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.96
|
| Rate for Payer: Healthscope Commercial |
$15.63
|
| Rate for Payer: Healthscope Commercial |
$23.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.76
|
| Rate for Payer: PHP Commercial |
$22.27
|
| Rate for Payer: PHP Commercial |
$14.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.03
|
| Rate for Payer: Priority Health SBD |
$10.94
|
| Rate for Payer: Priority Health SBD |
$16.51
|
| Rate for Payer: UMR Bronson Commercial |
$7.64
|
| Rate for Payer: UMR Bronson Commercial |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.65
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION
|
Facility
|
OP
|
$26.20
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10578
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$23.58 |
| Rate for Payer: Aetna American Axle |
$17.03
|
| Rate for Payer: Aetna American Axle |
$11.29
|
| Rate for Payer: Aetna Commercial |
$14.76
|
| Rate for Payer: Aetna Commercial |
$22.27
|
| Rate for Payer: Aetna Medicare |
$0.22
|
| Rate for Payer: Aetna Medicare |
$0.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.26
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: Cash Price |
$13.90
|
| Rate for Payer: Cash Price |
$20.96
|
| Rate for Payer: Cash Price |
$20.96
|
| Rate for Payer: Cash Price |
$13.90
|
| Rate for Payer: Cofinity Commercial |
$12.16
|
| Rate for Payer: Cofinity Commercial |
$14.94
|
| Rate for Payer: Cofinity Commercial |
$18.34
|
| Rate for Payer: Cofinity Commercial |
$22.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| Rate for Payer: Healthscope Commercial |
$23.58
|
| Rate for Payer: Healthscope Commercial |
$15.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.34
|
| 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 |
$19.65
|
| Rate for Payer: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Mclaren Medicare |
$0.21
|
| Rate for Payer: Mclaren Medicare |
$0.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.76
|
| Rate for Payer: PACE Medicare |
$0.20
|
| Rate for Payer: PACE Medicare |
$0.20
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PHP Commercial |
$14.76
|
| Rate for Payer: PHP Commercial |
$22.27
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.03
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Priority Health SBD |
$10.94
|
| Rate for Payer: Priority Health SBD |
$16.51
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.40
|
| Rate for Payer: UHC Exchange |
$0.40
|
| Rate for Payer: UHC Medicare Advantage |
$0.21
|
| Rate for Payer: UHC Medicare Advantage |
$0.21
|
| Rate for Payer: UHCCP Medicaid |
$0.11
|
| Rate for Payer: UHCCP Medicaid |
$0.11
|
| Rate for Payer: UMR Bronson Commercial |
$6.43
|
| Rate for Payer: UMR Bronson Commercial |
$9.69
|
| Rate for Payer: VA VA |
$0.21
|
| Rate for Payer: VA VA |
$0.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.03
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 2 GRAM INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$352.41
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10579
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$317.17 |
| Rate for Payer: Aetna American Axle |
$229.07
|
| Rate for Payer: Aetna Commercial |
$299.55
|
| Rate for Payer: Aetna Medicare |
$0.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.26
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: Cash Price |
$281.93
|
| Rate for Payer: Cash Price |
$281.93
|
| Rate for Payer: Cofinity Commercial |
$303.07
|
| Rate for Payer: Cofinity Commercial |
$246.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$246.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| Rate for Payer: Healthscope Commercial |
$317.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.31
|
| Rate for Payer: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Mclaren Medicare |
$0.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.55
|
| Rate for Payer: PACE Medicare |
$0.20
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PHP Commercial |
$299.55
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.07
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Priority Health SBD |
$222.02
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.40
|
| Rate for Payer: UHC Medicare Advantage |
$0.21
|
| Rate for Payer: UHCCP Medicaid |
$0.11
|
| Rate for Payer: UMR Bronson Commercial |
$130.39
|
| Rate for Payer: VA VA |
$0.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.31
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 2 GRAM INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$352.41
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10579
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$155.06 |
| Max. Negotiated Rate |
$317.17 |
| Rate for Payer: Aetna American Axle |
$229.07
|
| Rate for Payer: Aetna Commercial |
$299.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.07
|
| Rate for Payer: Cash Price |
$281.93
|
| Rate for Payer: Cofinity Commercial |
$246.69
|
| Rate for Payer: Cofinity Commercial |
$303.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$246.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.93
|
| Rate for Payer: Healthscope Commercial |
$317.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.55
|
| Rate for Payer: PHP Commercial |
$299.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$229.07
|
| Rate for Payer: Priority Health SBD |
$222.02
|
| Rate for Payer: UMR Bronson Commercial |
$155.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.31
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION
|
Facility
|
OP
|
$25.13
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10580
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$22.62 |
| Rate for Payer: Aetna American Axle |
$16.33
|
| Rate for Payer: Aetna American Axle |
$10.86
|
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Commercial |
$21.36
|
| Rate for Payer: Aetna Medicare |
$0.22
|
| Rate for Payer: Aetna Medicare |
$0.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.26
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cofinity Commercial |
$11.69
|
| Rate for Payer: Cofinity Commercial |
$14.36
|
| Rate for Payer: Cofinity Commercial |
$17.59
|
| Rate for Payer: Cofinity Commercial |
$21.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| Rate for Payer: Healthscope Commercial |
$22.62
|
| Rate for Payer: Healthscope Commercial |
$15.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.59
|
| 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 |
$18.85
|
| Rate for Payer: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Mclaren Medicare |
$0.21
|
| Rate for Payer: Mclaren Medicare |
$0.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.20
|
| Rate for Payer: PACE Medicare |
$0.20
|
| Rate for Payer: PACE Medicare |
$0.20
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: PHP Commercial |
$21.36
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.33
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Priority Health SBD |
$10.52
|
| Rate for Payer: Priority Health SBD |
$15.83
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.40
|
| Rate for Payer: UHC Exchange |
$0.40
|
| Rate for Payer: UHC Medicare Advantage |
$0.21
|
| Rate for Payer: UHC Medicare Advantage |
$0.21
|
| Rate for Payer: UHCCP Medicaid |
$0.11
|
| Rate for Payer: UHCCP Medicaid |
$0.11
|
| Rate for Payer: UMR Bronson Commercial |
$6.18
|
| Rate for Payer: UMR Bronson Commercial |
$9.30
|
| Rate for Payer: VA VA |
$0.21
|
| Rate for Payer: VA VA |
$0.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.53
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION
|
Facility
|
IP
|
$16.70
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10580
|
|
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 |
$16.33
|
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Commercial |
$21.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.33
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cash Price |
$20.10
|
| Rate for Payer: Cofinity Commercial |
$21.61
|
| Rate for Payer: Cofinity Commercial |
$17.59
|
| Rate for Payer: Cofinity Commercial |
$11.69
|
| Rate for Payer: Cofinity Commercial |
$14.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.10
|
| Rate for Payer: Healthscope Commercial |
$15.03
|
| Rate for Payer: Healthscope Commercial |
$22.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.20
|
| Rate for Payer: PHP Commercial |
$21.36
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.33
|
| Rate for Payer: Priority Health SBD |
$10.52
|
| Rate for Payer: Priority Health SBD |
$15.83
|
| Rate for Payer: UMR Bronson Commercial |
$7.35
|
| Rate for Payer: UMR Bronson Commercial |
$11.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.85
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$105.11
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10581
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$46.25 |
| Max. Negotiated Rate |
$94.60 |
| Rate for Payer: Aetna American Axle |
$68.32
|
| Rate for Payer: Aetna American Axle |
$39.25
|
| Rate for Payer: Aetna Commercial |
$89.34
|
| Rate for Payer: Aetna Commercial |
$51.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.25
|
| Rate for Payer: Cash Price |
$84.09
|
| Rate for Payer: Cash Price |
$48.31
|
| Rate for Payer: Cofinity Commercial |
$51.94
|
| Rate for Payer: Cofinity Commercial |
$42.27
|
| Rate for Payer: Cofinity Commercial |
$73.58
|
| Rate for Payer: Cofinity Commercial |
$90.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$73.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.31
|
| Rate for Payer: Healthscope Commercial |
$94.60
|
| Rate for Payer: Healthscope Commercial |
$54.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.34
|
| Rate for Payer: PHP Commercial |
$51.33
|
| Rate for Payer: PHP Commercial |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.25
|
| Rate for Payer: Priority Health SBD |
$66.22
|
| Rate for Payer: Priority Health SBD |
$38.05
|
| Rate for Payer: UMR Bronson Commercial |
$46.25
|
| Rate for Payer: UMR Bronson Commercial |
$26.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.29
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$60.39
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
10581
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$54.35 |
| Rate for Payer: Aetna American Axle |
$39.25
|
| Rate for Payer: Aetna American Axle |
$68.32
|
| Rate for Payer: Aetna Commercial |
$89.34
|
| Rate for Payer: Aetna Commercial |
$51.33
|
| Rate for Payer: Aetna Medicare |
$0.22
|
| Rate for Payer: Aetna Medicare |
$0.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.26
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: Cash Price |
$84.09
|
| Rate for Payer: Cash Price |
$48.31
|
| Rate for Payer: Cash Price |
$48.31
|
| Rate for Payer: Cash Price |
$84.09
|
| Rate for Payer: Cofinity Commercial |
$73.58
|
| Rate for Payer: Cofinity Commercial |
$90.39
|
| Rate for Payer: Cofinity Commercial |
$42.27
|
| Rate for Payer: Cofinity Commercial |
$51.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$73.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| Rate for Payer: Healthscope Commercial |
$54.35
|
| Rate for Payer: Healthscope Commercial |
$94.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.29
|
| Rate for Payer: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Mclaren Medicare |
$0.21
|
| Rate for Payer: Mclaren Medicare |
$0.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.34
|
| Rate for Payer: PACE Medicare |
$0.20
|
| Rate for Payer: PACE Medicare |
$0.20
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PHP Commercial |
$89.34
|
| Rate for Payer: PHP Commercial |
$51.33
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.25
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Priority Health SBD |
$66.22
|
| Rate for Payer: Priority Health SBD |
$38.05
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.40
|
| Rate for Payer: UHC Exchange |
$0.40
|
| Rate for Payer: UHC Medicare Advantage |
$0.21
|
| Rate for Payer: UHC Medicare Advantage |
$0.21
|
| Rate for Payer: UHCCP Medicaid |
$0.11
|
| Rate for Payer: UHCCP Medicaid |
$0.11
|
| Rate for Payer: UMR Bronson Commercial |
$38.89
|
| Rate for Payer: UMR Bronson Commercial |
$22.34
|
| Rate for Payer: VA VA |
$0.21
|
| Rate for Payer: VA VA |
$0.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.83
|
|
|
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 |
$0.11 |
| 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 |
$0.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.26
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cofinity Commercial |
$30.06
|
| Rate for Payer: Cofinity Commercial |
$24.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| 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: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Mclaren Medicare |
$0.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.71
|
| Rate for Payer: PACE Medicare |
$0.20
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PHP Commercial |
$29.71
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.72
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Priority Health SBD |
$22.02
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.40
|
| Rate for Payer: UHC Medicare Advantage |
$0.21
|
| Rate for Payer: UHCCP Medicaid |
$0.11
|
| Rate for Payer: UMR Bronson Commercial |
$12.93
|
| Rate for Payer: VA VA |
$0.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.21
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOL (CODE)
|
Facility
|
IP
|
$34.95
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
163731
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.38 |
| Max. Negotiated Rate |
$31.45 |
| Rate for Payer: Aetna American Axle |
$22.72
|
| Rate for Payer: Aetna Commercial |
$29.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.72
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cofinity Commercial |
$24.46
|
| Rate for Payer: Cofinity Commercial |
$30.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.46
|
| 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: Multiplan/Beech St/PHCS Commercial |
$29.71
|
| Rate for Payer: PHP Commercial |
$29.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.72
|
| Rate for Payer: Priority Health SBD |
$22.02
|
| Rate for Payer: UMR Bronson Commercial |
$15.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.21
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION
|
Facility
|
IP
|
$34.95
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
119451
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.38 |
| Max. Negotiated Rate |
$31.45 |
| Rate for Payer: Aetna American Axle |
$22.72
|
| Rate for Payer: Aetna Commercial |
$29.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.72
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cofinity Commercial |
$24.46
|
| Rate for Payer: Cofinity Commercial |
$30.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.46
|
| 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: Multiplan/Beech St/PHCS Commercial |
$29.71
|
| Rate for Payer: PHP Commercial |
$29.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.72
|
| Rate for Payer: Priority Health SBD |
$22.02
|
| Rate for Payer: UMR Bronson Commercial |
$15.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.21
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION
|
Facility
|
OP
|
$34.95
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
119451
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| 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 |
$0.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.26
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cash Price |
$27.96
|
| Rate for Payer: Cofinity Commercial |
$30.06
|
| Rate for Payer: Cofinity Commercial |
$24.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| 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: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Mclaren Medicare |
$0.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.71
|
| Rate for Payer: PACE Medicare |
$0.20
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PHP Commercial |
$29.71
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.72
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Priority Health SBD |
$22.02
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.40
|
| Rate for Payer: UHC Medicare Advantage |
$0.21
|
| Rate for Payer: UHCCP Medicaid |
$0.11
|
| Rate for Payer: UMR Bronson Commercial |
$12.93
|
| Rate for Payer: VA VA |
$0.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.21
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION
|
Facility
|
IP
|
$21.97
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
119450
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.67 |
| Max. Negotiated Rate |
$19.77 |
| Rate for Payer: Aetna American Axle |
$14.28
|
| Rate for Payer: Aetna Commercial |
$18.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.28
|
| Rate for Payer: Cash Price |
$17.58
|
| Rate for Payer: Cofinity Commercial |
$15.38
|
| Rate for Payer: Cofinity Commercial |
$18.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.58
|
| Rate for Payer: Healthscope Commercial |
$19.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.67
|
| Rate for Payer: PHP Commercial |
$18.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health SBD |
$13.84
|
| Rate for Payer: UMR Bronson Commercial |
$9.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.48
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION
|
Facility
|
OP
|
$21.97
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
119450
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$19.77 |
| Rate for Payer: Aetna American Axle |
$14.28
|
| Rate for Payer: Aetna Commercial |
$18.67
|
| Rate for Payer: Aetna Medicare |
$0.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.26
|
| Rate for Payer: BCBS Complete |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: Cash Price |
$17.58
|
| Rate for Payer: Cash Price |
$17.58
|
| Rate for Payer: Cofinity Commercial |
$18.89
|
| Rate for Payer: Cofinity Commercial |
$15.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| Rate for Payer: Healthscope Commercial |
$19.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.48
|
| Rate for Payer: Mclaren Medicaid |
$0.11
|
| Rate for Payer: Mclaren Medicare |
$0.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Meridian Medicaid |
$0.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.67
|
| Rate for Payer: PACE Medicare |
$0.20
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PHP Commercial |
$18.67
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Priority Health SBD |
$13.84
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.40
|
| Rate for Payer: UHC Medicare Advantage |
$0.21
|
| Rate for Payer: UHCCP Medicaid |
$0.11
|
| Rate for Payer: UMR Bronson Commercial |
$8.13
|
| Rate for Payer: VA VA |
$0.21
|
| 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 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 Commercial |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$8.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.57
|
| 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: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| 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 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 Commercial |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$8.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.57
|
| 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: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| 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 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 Commercial |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$8.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.57
|
| 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: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| 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 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 Commercial |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$8.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.57
|
| 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: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| 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 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 Commercial |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$8.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.57
|
| 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: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| Rate for Payer: Priority Health SBD |
$7.71
|
| 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
|
IP
|
$15.30
|
|
|
Service Code
|
NDC 57896011603
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna American Axle |
$9.95
|
| Rate for Payer: Aetna Commercial |
$13.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.95
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.01
|
| Rate for Payer: PHP Commercial |
$13.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.95
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: UMR Bronson Commercial |
$6.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.47
|
|
|
METHYL SALICYLATE 15 %-MENTHOL 10 % TOPICAL CREAM
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
NDC 57896011603
|
| Hospital Charge Code |
76971
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna American Axle |
$9.95
|
| Rate for Payer: Aetna Commercial |
$13.01
|
| Rate for Payer: Aetna Medicare |
$7.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.95
|
| Rate for Payer: BCBS Complete |
$6.12
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.01
|
| Rate for Payer: PHP Commercial |
$13.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.95
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: UMR Bronson Commercial |
$5.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.47
|
|
|
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 Commercial |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$8.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.57
|
| 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: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.96
|
| Rate for Payer: Priority Health SBD |
$7.71
|
| 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 Commercial |
$11.40
|
| Rate for Payer: Cofinity Commercial |
$14.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.40
|
| 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: PHP Commercial |
$13.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.58
|
| Rate for Payer: Priority Health SBD |
$10.26
|
| Rate for Payer: UMR Bronson Commercial |
$6.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.21
|
|
