|
MICROFIBRILLAR COLLAGEN HEMOSTAT TOPICAL POWDER IN PACKET
|
Facility
|
IP
|
$511.55
|
|
|
Service Code
|
NDC 53276101001
|
| Hospital Charge Code |
159416
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$225.08 |
| Max. Negotiated Rate |
$460.39 |
| Rate for Payer: Aetna American Axle |
$332.51
|
| Rate for Payer: Aetna Commercial |
$434.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$332.51
|
| Rate for Payer: Cash Price |
$409.24
|
| Rate for Payer: Cofinity Advantage |
$358.08
|
| Rate for Payer: Cofinity Commercial |
$439.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$409.24
|
| Rate for Payer: Healthscope Commercial |
$460.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$358.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$383.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$434.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$383.66
|
| Rate for Payer: PHP Commercial |
$434.82
|
| Rate for Payer: Priority Health SBD |
$322.28
|
| Rate for Payer: UMR Bronson Commercial |
$225.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$383.66
|
|
|
MICROFIBRILLAR COLLAGEN HEMOSTAT TOPICAL POWDER IN PACKET
|
Facility
|
OP
|
$511.55
|
|
|
Service Code
|
NDC 53276101001
|
| Hospital Charge Code |
159416
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$189.27 |
| Max. Negotiated Rate |
$460.39 |
| Rate for Payer: Aetna American Axle |
$332.51
|
| Rate for Payer: Aetna Commercial |
$434.82
|
| Rate for Payer: Aetna Medicare |
$255.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$332.51
|
| Rate for Payer: BCBS Complete |
$204.62
|
| Rate for Payer: Cash Price |
$409.24
|
| Rate for Payer: Cofinity Advantage |
$358.08
|
| Rate for Payer: Cofinity Commercial |
$439.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$409.24
|
| Rate for Payer: Healthscope Commercial |
$460.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$358.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$383.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$409.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$434.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$383.66
|
| Rate for Payer: PHP Commercial |
$434.82
|
| Rate for Payer: Priority Health SBD |
$322.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.51
|
| Rate for Payer: UHC Core |
$266.52
|
| Rate for Payer: UHC Exchange |
$201.04
|
| Rate for Payer: UMR Bronson Commercial |
$189.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$383.66
|
|
|
MICRO NEEDLING
|
Professional
|
Both
|
$210.00
|
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Medicare |
$105.00
|
| Rate for Payer: BCBS Complete |
$84.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: UMR Bronson Commercial |
$96.60
|
|
|
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP
|
Facility
|
IP
|
$38.61
|
|
|
Service Code
|
NDC 60687057686
|
| Hospital Charge Code |
120031
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$16.99 |
| Max. Negotiated Rate |
$34.75 |
| Rate for Payer: Aetna American Axle |
$25.10
|
| Rate for Payer: Aetna Commercial |
$32.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.10
|
| Rate for Payer: Cash Price |
$30.89
|
| Rate for Payer: Cofinity Advantage |
$27.03
|
| Rate for Payer: Cofinity Commercial |
$33.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.89
|
| Rate for Payer: Healthscope Commercial |
$34.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.96
|
| Rate for Payer: PHP Commercial |
$32.82
|
| Rate for Payer: Priority Health SBD |
$24.32
|
| Rate for Payer: UMR Bronson Commercial |
$16.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.96
|
|
|
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP
|
Facility
|
IP
|
$47.43
|
|
|
Service Code
|
NDC 09900000015
|
| Hospital Charge Code |
120031
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.87 |
| Max. Negotiated Rate |
$42.69 |
| Rate for Payer: Aetna American Axle |
$30.83
|
| Rate for Payer: Aetna Commercial |
$40.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.83
|
| Rate for Payer: Cash Price |
$37.94
|
| Rate for Payer: Cofinity Advantage |
$33.20
|
| Rate for Payer: Cofinity Commercial |
$40.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.94
|
| Rate for Payer: Healthscope Commercial |
$42.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.57
|
| Rate for Payer: PHP Commercial |
$40.32
|
| Rate for Payer: Priority Health SBD |
$29.88
|
| Rate for Payer: UMR Bronson Commercial |
$20.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.57
|
|
|
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP
|
Facility
|
OP
|
$35.25
|
|
|
Service Code
|
NDC 00904711341
|
| Hospital Charge Code |
120031
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.04 |
| Max. Negotiated Rate |
$31.73 |
| Rate for Payer: Aetna American Axle |
$22.91
|
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: Aetna Medicare |
$17.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.91
|
| Rate for Payer: BCBS Complete |
$14.10
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cofinity Advantage |
$24.68
|
| Rate for Payer: Cofinity Commercial |
$30.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.20
|
| Rate for Payer: Healthscope Commercial |
$31.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.44
|
| Rate for Payer: PHP Commercial |
$29.96
|
| Rate for Payer: Priority Health SBD |
$22.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.91
|
| Rate for Payer: UHC Core |
$18.37
|
| Rate for Payer: UHC Exchange |
$13.85
|
| Rate for Payer: UMR Bronson Commercial |
$13.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.44
|
|
|
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP
|
Facility
|
IP
|
$38.61
|
|
|
Service Code
|
NDC 60687057640
|
| Hospital Charge Code |
120031
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$16.99 |
| Max. Negotiated Rate |
$34.75 |
| Rate for Payer: Aetna American Axle |
$25.10
|
| Rate for Payer: Aetna Commercial |
$32.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.10
|
| Rate for Payer: Cash Price |
$30.89
|
| Rate for Payer: Cofinity Advantage |
$27.03
|
| Rate for Payer: Cofinity Commercial |
$33.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.89
|
| Rate for Payer: Healthscope Commercial |
$34.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.96
|
| Rate for Payer: PHP Commercial |
$32.82
|
| Rate for Payer: Priority Health SBD |
$24.32
|
| Rate for Payer: UMR Bronson Commercial |
$16.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.96
|
|
|
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP
|
Facility
|
OP
|
$38.61
|
|
|
Service Code
|
NDC 60687057686
|
| Hospital Charge Code |
120031
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$14.29 |
| Max. Negotiated Rate |
$34.75 |
| Rate for Payer: Aetna American Axle |
$25.10
|
| Rate for Payer: Aetna Commercial |
$32.82
|
| Rate for Payer: Aetna Medicare |
$19.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.10
|
| Rate for Payer: BCBS Complete |
$15.44
|
| Rate for Payer: Cash Price |
$30.89
|
| Rate for Payer: Cofinity Advantage |
$27.03
|
| Rate for Payer: Cofinity Commercial |
$33.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.89
|
| Rate for Payer: Healthscope Commercial |
$34.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.96
|
| Rate for Payer: PHP Commercial |
$32.82
|
| Rate for Payer: Priority Health SBD |
$24.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.10
|
| Rate for Payer: UHC Core |
$20.12
|
| Rate for Payer: UHC Exchange |
$15.17
|
| Rate for Payer: UMR Bronson Commercial |
$14.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.96
|
|
|
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP
|
Facility
|
OP
|
$38.61
|
|
|
Service Code
|
NDC 60687057640
|
| Hospital Charge Code |
120031
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$14.29 |
| Max. Negotiated Rate |
$34.75 |
| Rate for Payer: Aetna American Axle |
$25.10
|
| Rate for Payer: Aetna Commercial |
$32.82
|
| Rate for Payer: Aetna Medicare |
$19.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.10
|
| Rate for Payer: BCBS Complete |
$15.44
|
| Rate for Payer: Cash Price |
$30.89
|
| Rate for Payer: Cofinity Advantage |
$27.03
|
| Rate for Payer: Cofinity Commercial |
$33.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.89
|
| Rate for Payer: Healthscope Commercial |
$34.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.96
|
| Rate for Payer: PHP Commercial |
$32.82
|
| Rate for Payer: Priority Health SBD |
$24.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.10
|
| Rate for Payer: UHC Core |
$20.12
|
| Rate for Payer: UHC Exchange |
$15.17
|
| Rate for Payer: UMR Bronson Commercial |
$14.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.96
|
|
|
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP
|
Facility
|
OP
|
$9.49
|
|
|
Service Code
|
NDC 09900000014
|
| Hospital Charge Code |
120031
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.51 |
| Max. Negotiated Rate |
$8.54 |
| Rate for Payer: Aetna American Axle |
$6.17
|
| Rate for Payer: Aetna Commercial |
$8.07
|
| Rate for Payer: Aetna Medicare |
$4.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.17
|
| Rate for Payer: BCBS Complete |
$3.80
|
| Rate for Payer: Cash Price |
$7.59
|
| Rate for Payer: Cofinity Advantage |
$6.64
|
| Rate for Payer: Cofinity Commercial |
$8.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.59
|
| Rate for Payer: Healthscope Commercial |
$8.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.12
|
| Rate for Payer: PHP Commercial |
$8.07
|
| Rate for Payer: Priority Health SBD |
$5.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.17
|
| Rate for Payer: UHC Core |
$4.94
|
| Rate for Payer: UHC Exchange |
$3.73
|
| Rate for Payer: UMR Bronson Commercial |
$3.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.12
|
|
|
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP
|
Facility
|
IP
|
$9.49
|
|
|
Service Code
|
NDC 09900000014
|
| Hospital Charge Code |
120031
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$8.54 |
| Rate for Payer: Aetna American Axle |
$6.17
|
| Rate for Payer: Aetna Commercial |
$8.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.17
|
| Rate for Payer: Cash Price |
$7.59
|
| Rate for Payer: Cofinity Advantage |
$6.64
|
| Rate for Payer: Cofinity Commercial |
$8.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.59
|
| Rate for Payer: Healthscope Commercial |
$8.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.12
|
| Rate for Payer: PHP Commercial |
$8.07
|
| Rate for Payer: Priority Health SBD |
$5.98
|
| Rate for Payer: UMR Bronson Commercial |
$4.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.12
|
|
|
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP
|
Facility
|
OP
|
$35.25
|
|
|
Service Code
|
NDC 00904711393
|
| Hospital Charge Code |
120031
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.04 |
| Max. Negotiated Rate |
$31.73 |
| Rate for Payer: Aetna American Axle |
$22.91
|
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: Aetna Medicare |
$17.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.91
|
| Rate for Payer: BCBS Complete |
$14.10
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cofinity Advantage |
$24.68
|
| Rate for Payer: Cofinity Commercial |
$30.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.20
|
| Rate for Payer: Healthscope Commercial |
$31.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.44
|
| Rate for Payer: PHP Commercial |
$29.96
|
| Rate for Payer: Priority Health SBD |
$22.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.91
|
| Rate for Payer: UHC Core |
$18.37
|
| Rate for Payer: UHC Exchange |
$13.85
|
| Rate for Payer: UMR Bronson Commercial |
$13.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.44
|
|
|
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP
|
Facility
|
IP
|
$35.25
|
|
|
Service Code
|
NDC 00904711341
|
| Hospital Charge Code |
120031
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$15.51 |
| Max. Negotiated Rate |
$31.73 |
| Rate for Payer: Aetna American Axle |
$22.91
|
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.91
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cofinity Advantage |
$24.68
|
| Rate for Payer: Cofinity Commercial |
$30.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.20
|
| Rate for Payer: Healthscope Commercial |
$31.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.44
|
| Rate for Payer: PHP Commercial |
$29.96
|
| Rate for Payer: Priority Health SBD |
$22.21
|
| Rate for Payer: UMR Bronson Commercial |
$15.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.44
|
|
|
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP
|
Facility
|
OP
|
$47.43
|
|
|
Service Code
|
NDC 09900000015
|
| Hospital Charge Code |
120031
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$17.55 |
| Max. Negotiated Rate |
$42.69 |
| Rate for Payer: Aetna American Axle |
$30.83
|
| Rate for Payer: Aetna Commercial |
$40.32
|
| Rate for Payer: Aetna Medicare |
$23.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.83
|
| Rate for Payer: BCBS Complete |
$18.97
|
| Rate for Payer: Cash Price |
$37.94
|
| Rate for Payer: Cofinity Advantage |
$33.20
|
| Rate for Payer: Cofinity Commercial |
$40.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.94
|
| Rate for Payer: Healthscope Commercial |
$42.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.57
|
| Rate for Payer: PHP Commercial |
$40.32
|
| Rate for Payer: Priority Health SBD |
$29.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.83
|
| Rate for Payer: UHC Core |
$24.71
|
| Rate for Payer: UHC Exchange |
$18.64
|
| Rate for Payer: UMR Bronson Commercial |
$17.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.57
|
|
|
MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP
|
Facility
|
IP
|
$35.25
|
|
|
Service Code
|
NDC 00904711393
|
| Hospital Charge Code |
120031
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$15.51 |
| Max. Negotiated Rate |
$31.73 |
| Rate for Payer: Aetna American Axle |
$22.91
|
| Rate for Payer: Aetna Commercial |
$29.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.91
|
| Rate for Payer: Cash Price |
$28.20
|
| Rate for Payer: Cofinity Advantage |
$24.68
|
| Rate for Payer: Cofinity Commercial |
$30.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.20
|
| Rate for Payer: Healthscope Commercial |
$31.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.44
|
| Rate for Payer: PHP Commercial |
$29.96
|
| Rate for Payer: Priority Health SBD |
$22.21
|
| Rate for Payer: UMR Bronson Commercial |
$15.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.44
|
|
|
MIDAZOLAM 1 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$23.87
|
|
|
Service Code
|
HCPCS J2250
|
| Hospital Charge Code |
10607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$21.48 |
| Rate for Payer: Aetna American Axle |
$15.52
|
| Rate for Payer: Aetna American Axle |
$10.00
|
| Rate for Payer: Aetna American Axle |
$15.57
|
| Rate for Payer: Aetna American Axle |
$9.06
|
| Rate for Payer: Aetna Commercial |
$20.37
|
| Rate for Payer: Aetna Commercial |
$20.29
|
| Rate for Payer: Aetna Commercial |
$11.85
|
| Rate for Payer: Aetna Commercial |
$13.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.06
|
| Rate for Payer: Cash Price |
$11.15
|
| Rate for Payer: Cash Price |
$19.17
|
| Rate for Payer: Cash Price |
$12.31
|
| Rate for Payer: Cash Price |
$19.10
|
| Rate for Payer: Cofinity Advantage |
$10.77
|
| Rate for Payer: Cofinity Advantage |
$9.76
|
| Rate for Payer: Cofinity Advantage |
$16.71
|
| Rate for Payer: Cofinity Advantage |
$16.77
|
| Rate for Payer: Cofinity Commercial |
$20.53
|
| Rate for Payer: Cofinity Commercial |
$11.99
|
| Rate for Payer: Cofinity Commercial |
$13.24
|
| Rate for Payer: Cofinity Commercial |
$20.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.31
|
| Rate for Payer: Healthscope Commercial |
$13.85
|
| Rate for Payer: Healthscope Commercial |
$21.56
|
| Rate for Payer: Healthscope Commercial |
$21.48
|
| Rate for Payer: Healthscope Commercial |
$12.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.46
|
| Rate for Payer: PHP Commercial |
$11.85
|
| Rate for Payer: PHP Commercial |
$20.29
|
| Rate for Payer: PHP Commercial |
$13.08
|
| Rate for Payer: PHP Commercial |
$20.37
|
| Rate for Payer: Priority Health SBD |
$15.09
|
| Rate for Payer: Priority Health SBD |
$8.78
|
| Rate for Payer: Priority Health SBD |
$15.04
|
| Rate for Payer: Priority Health SBD |
$9.70
|
| Rate for Payer: UMR Bronson Commercial |
$6.77
|
| Rate for Payer: UMR Bronson Commercial |
$10.50
|
| Rate for Payer: UMR Bronson Commercial |
$6.13
|
| Rate for Payer: UMR Bronson Commercial |
$10.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.97
|
|
|
MIDAZOLAM 1 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$23.96
|
|
|
Service Code
|
HCPCS J2250
|
| Hospital Charge Code |
10607
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$21.56 |
| Rate for Payer: Aetna American Axle |
$15.57
|
| Rate for Payer: Aetna American Axle |
$9.06
|
| Rate for Payer: Aetna American Axle |
$10.00
|
| Rate for Payer: Aetna American Axle |
$15.52
|
| Rate for Payer: Aetna Commercial |
$20.37
|
| Rate for Payer: Aetna Commercial |
$20.29
|
| Rate for Payer: Aetna Commercial |
$11.85
|
| Rate for Payer: Aetna Commercial |
$13.08
|
| Rate for Payer: Aetna Medicare |
$11.94
|
| Rate for Payer: Aetna Medicare |
$7.70
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Aetna Medicare |
$6.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.52
|
| Rate for Payer: BCBS Complete |
$5.58
|
| Rate for Payer: BCBS Complete |
$6.16
|
| Rate for Payer: BCBS Complete |
$9.55
|
| Rate for Payer: BCBS Complete |
$9.58
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: Cash Price |
$19.10
|
| Rate for Payer: Cash Price |
$19.17
|
| Rate for Payer: Cash Price |
$11.15
|
| Rate for Payer: Cash Price |
$19.17
|
| Rate for Payer: Cash Price |
$19.10
|
| Rate for Payer: Cash Price |
$12.31
|
| Rate for Payer: Cash Price |
$12.31
|
| Rate for Payer: Cash Price |
$11.15
|
| Rate for Payer: Cofinity Advantage |
$16.77
|
| Rate for Payer: Cofinity Advantage |
$16.71
|
| Rate for Payer: Cofinity Advantage |
$10.77
|
| Rate for Payer: Cofinity Advantage |
$9.76
|
| Rate for Payer: Cofinity Commercial |
$13.24
|
| Rate for Payer: Cofinity Commercial |
$20.53
|
| Rate for Payer: Cofinity Commercial |
$20.61
|
| Rate for Payer: Cofinity Commercial |
$11.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.15
|
| Rate for Payer: Healthscope Commercial |
$21.48
|
| Rate for Payer: Healthscope Commercial |
$12.55
|
| Rate for Payer: Healthscope Commercial |
$13.85
|
| Rate for Payer: Healthscope Commercial |
$21.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.97
|
| Rate for Payer: PHP Commercial |
$11.85
|
| Rate for Payer: PHP Commercial |
$20.29
|
| Rate for Payer: PHP Commercial |
$20.37
|
| Rate for Payer: PHP Commercial |
$13.08
|
| Rate for Payer: Priority Health SBD |
$15.04
|
| Rate for Payer: Priority Health SBD |
$8.78
|
| Rate for Payer: Priority Health SBD |
$9.70
|
| Rate for Payer: Priority Health SBD |
$15.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UMR Bronson Commercial |
$8.87
|
| Rate for Payer: UMR Bronson Commercial |
$5.16
|
| Rate for Payer: UMR Bronson Commercial |
$5.69
|
| Rate for Payer: UMR Bronson Commercial |
$8.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.97
|
|
|
MIDAZOLAM 2 MG/ML ORAL SYRUP
|
Facility
|
OP
|
$829.31
|
|
|
Service Code
|
NDC 00054356699
|
| Hospital Charge Code |
24176
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$306.84 |
| Max. Negotiated Rate |
$746.38 |
| Rate for Payer: Aetna American Axle |
$539.05
|
| Rate for Payer: Aetna Commercial |
$704.91
|
| Rate for Payer: Aetna Medicare |
$414.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$539.05
|
| Rate for Payer: BCBS Complete |
$331.72
|
| Rate for Payer: Cash Price |
$663.45
|
| Rate for Payer: Cofinity Advantage |
$580.52
|
| Rate for Payer: Cofinity Commercial |
$713.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$663.45
|
| Rate for Payer: Healthscope Commercial |
$746.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$580.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$621.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$663.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$704.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$621.98
|
| Rate for Payer: PHP Commercial |
$704.91
|
| Rate for Payer: Priority Health SBD |
$522.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.05
|
| Rate for Payer: UHC Core |
$432.07
|
| Rate for Payer: UHC Exchange |
$325.92
|
| Rate for Payer: UMR Bronson Commercial |
$306.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$621.98
|
|
|
MIDAZOLAM 2 MG/ML ORAL SYRUP
|
Facility
|
OP
|
$1,119.23
|
|
|
Service Code
|
NDC 00574015004
|
| Hospital Charge Code |
24176
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$414.12 |
| Max. Negotiated Rate |
$1,007.31 |
| Rate for Payer: Aetna American Axle |
$727.50
|
| Rate for Payer: Aetna Commercial |
$951.35
|
| Rate for Payer: Aetna Medicare |
$559.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.50
|
| Rate for Payer: BCBS Complete |
$447.69
|
| Rate for Payer: Cash Price |
$895.38
|
| Rate for Payer: Cofinity Advantage |
$783.46
|
| Rate for Payer: Cofinity Commercial |
$962.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.38
|
| Rate for Payer: Healthscope Commercial |
$1,007.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$783.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$839.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$895.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$839.42
|
| Rate for Payer: PHP Commercial |
$951.35
|
| Rate for Payer: Priority Health SBD |
$705.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$727.50
|
| Rate for Payer: UHC Core |
$583.12
|
| Rate for Payer: UHC Exchange |
$439.86
|
| Rate for Payer: UMR Bronson Commercial |
$414.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$839.42
|
|
|
MIDAZOLAM 2 MG/ML ORAL SYRUP
|
Facility
|
IP
|
$1,119.23
|
|
|
Service Code
|
NDC 00574015004
|
| Hospital Charge Code |
24176
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$492.46 |
| Max. Negotiated Rate |
$1,007.31 |
| Rate for Payer: Aetna American Axle |
$727.50
|
| Rate for Payer: Aetna Commercial |
$951.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.50
|
| Rate for Payer: Cash Price |
$895.38
|
| Rate for Payer: Cofinity Advantage |
$783.46
|
| Rate for Payer: Cofinity Commercial |
$962.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.38
|
| Rate for Payer: Healthscope Commercial |
$1,007.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$783.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$839.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$839.42
|
| Rate for Payer: PHP Commercial |
$951.35
|
| Rate for Payer: Priority Health SBD |
$705.11
|
| Rate for Payer: UMR Bronson Commercial |
$492.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$839.42
|
|
|
MIDAZOLAM 2 MG/ML ORAL SYRUP
|
Facility
|
IP
|
$829.31
|
|
|
Service Code
|
NDC 00054356699
|
| Hospital Charge Code |
24176
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$364.90 |
| Max. Negotiated Rate |
$746.38 |
| Rate for Payer: Aetna American Axle |
$539.05
|
| Rate for Payer: Aetna Commercial |
$704.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$539.05
|
| Rate for Payer: Cash Price |
$663.45
|
| Rate for Payer: Cofinity Advantage |
$580.52
|
| Rate for Payer: Cofinity Commercial |
$713.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$663.45
|
| Rate for Payer: Healthscope Commercial |
$746.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$580.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$621.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$704.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$621.98
|
| Rate for Payer: PHP Commercial |
$704.91
|
| Rate for Payer: Priority Health SBD |
$522.47
|
| Rate for Payer: UMR Bronson Commercial |
$364.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$621.98
|
|
|
MIDAZOLAM 5 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$31.08
|
|
|
Service Code
|
HCPCS J2250
|
| Hospital Charge Code |
10608
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$27.97 |
| Rate for Payer: Aetna American Axle |
$20.20
|
| Rate for Payer: Aetna American Axle |
$20.33
|
| Rate for Payer: Aetna American Axle |
$24.48
|
| Rate for Payer: Aetna American Axle |
$21.58
|
| Rate for Payer: Aetna American Axle |
$19.00
|
| Rate for Payer: Aetna American Axle |
$13.75
|
| Rate for Payer: Aetna American Axle |
$37.86
|
| Rate for Payer: Aetna American Axle |
$28.63
|
| Rate for Payer: Aetna American Axle |
$26.92
|
| Rate for Payer: Aetna Commercial |
$28.22
|
| Rate for Payer: Aetna Commercial |
$24.85
|
| Rate for Payer: Aetna Commercial |
$26.42
|
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: Aetna Commercial |
$26.58
|
| Rate for Payer: Aetna Commercial |
$32.01
|
| Rate for Payer: Aetna Commercial |
$35.20
|
| Rate for Payer: Aetna Commercial |
$37.44
|
| Rate for Payer: Aetna Commercial |
$49.51
|
| Rate for Payer: Aetna Medicare |
$15.54
|
| Rate for Payer: Aetna Medicare |
$14.62
|
| Rate for Payer: Aetna Medicare |
$20.70
|
| Rate for Payer: Aetna Medicare |
$10.58
|
| Rate for Payer: Aetna Medicare |
$29.12
|
| Rate for Payer: Aetna Medicare |
$16.60
|
| Rate for Payer: Aetna Medicare |
$15.63
|
| Rate for Payer: Aetna Medicare |
$22.02
|
| Rate for Payer: Aetna Medicare |
$18.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.33
|
| Rate for Payer: BCBS Complete |
$11.69
|
| Rate for Payer: BCBS Complete |
$12.43
|
| Rate for Payer: BCBS Complete |
$15.06
|
| Rate for Payer: BCBS Complete |
$12.51
|
| Rate for Payer: BCBS Complete |
$16.56
|
| Rate for Payer: BCBS Complete |
$13.28
|
| Rate for Payer: BCBS Complete |
$23.30
|
| Rate for Payer: BCBS Complete |
$17.62
|
| Rate for Payer: BCBS Complete |
$8.46
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: Cash Price |
$30.13
|
| Rate for Payer: Cash Price |
$23.38
|
| Rate for Payer: Cash Price |
$33.13
|
| Rate for Payer: Cash Price |
$26.56
|
| Rate for Payer: Cash Price |
$25.02
|
| Rate for Payer: Cash Price |
$33.13
|
| Rate for Payer: Cash Price |
$46.60
|
| Rate for Payer: Cash Price |
$35.24
|
| Rate for Payer: Cash Price |
$16.93
|
| Rate for Payer: Cash Price |
$26.56
|
| Rate for Payer: Cash Price |
$24.86
|
| Rate for Payer: Cash Price |
$16.93
|
| Rate for Payer: Cash Price |
$46.60
|
| Rate for Payer: Cash Price |
$24.86
|
| Rate for Payer: Cash Price |
$35.24
|
| Rate for Payer: Cash Price |
$23.38
|
| Rate for Payer: Cash Price |
$25.02
|
| Rate for Payer: Cash Price |
$30.13
|
| Rate for Payer: Cofinity Advantage |
$20.46
|
| Rate for Payer: Cofinity Advantage |
$21.76
|
| Rate for Payer: Cofinity Advantage |
$14.81
|
| Rate for Payer: Cofinity Advantage |
$21.89
|
| Rate for Payer: Cofinity Advantage |
$23.24
|
| Rate for Payer: Cofinity Advantage |
$26.36
|
| Rate for Payer: Cofinity Advantage |
$28.99
|
| Rate for Payer: Cofinity Advantage |
$30.84
|
| Rate for Payer: Cofinity Advantage |
$40.77
|
| Rate for Payer: Cofinity Commercial |
$25.14
|
| Rate for Payer: Cofinity Commercial |
$37.88
|
| Rate for Payer: Cofinity Commercial |
$35.61
|
| Rate for Payer: Cofinity Commercial |
$18.20
|
| Rate for Payer: Cofinity Commercial |
$28.55
|
| Rate for Payer: Cofinity Commercial |
$26.73
|
| Rate for Payer: Cofinity Commercial |
$50.09
|
| Rate for Payer: Cofinity Commercial |
$26.89
|
| Rate for Payer: Cofinity Commercial |
$32.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.86
|
| Rate for Payer: Healthscope Commercial |
$27.97
|
| Rate for Payer: Healthscope Commercial |
$26.31
|
| Rate for Payer: Healthscope Commercial |
$19.04
|
| Rate for Payer: Healthscope Commercial |
$52.42
|
| Rate for Payer: Healthscope Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$39.65
|
| Rate for Payer: Healthscope Commercial |
$37.27
|
| Rate for Payer: Healthscope Commercial |
$33.89
|
| Rate for Payer: Healthscope Commercial |
$29.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.04
|
| Rate for Payer: PHP Commercial |
$26.42
|
| Rate for Payer: PHP Commercial |
$26.58
|
| Rate for Payer: PHP Commercial |
$28.22
|
| Rate for Payer: PHP Commercial |
$49.51
|
| Rate for Payer: PHP Commercial |
$32.01
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: PHP Commercial |
$24.85
|
| Rate for Payer: PHP Commercial |
$35.20
|
| Rate for Payer: PHP Commercial |
$37.44
|
| Rate for Payer: Priority Health SBD |
$20.92
|
| Rate for Payer: Priority Health SBD |
$26.09
|
| Rate for Payer: Priority Health SBD |
$18.41
|
| Rate for Payer: Priority Health SBD |
$19.58
|
| Rate for Payer: Priority Health SBD |
$23.73
|
| Rate for Payer: Priority Health SBD |
$36.70
|
| Rate for Payer: Priority Health SBD |
$13.33
|
| Rate for Payer: Priority Health SBD |
$19.70
|
| Rate for Payer: Priority Health SBD |
$27.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UMR Bronson Commercial |
$13.93
|
| Rate for Payer: UMR Bronson Commercial |
$11.50
|
| Rate for Payer: UMR Bronson Commercial |
$12.28
|
| Rate for Payer: UMR Bronson Commercial |
$15.32
|
| Rate for Payer: UMR Bronson Commercial |
$16.30
|
| Rate for Payer: UMR Bronson Commercial |
$21.55
|
| Rate for Payer: UMR Bronson Commercial |
$7.83
|
| Rate for Payer: UMR Bronson Commercial |
$10.82
|
| Rate for Payer: UMR Bronson Commercial |
$11.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.92
|
|
|
MIDAZOLAM 5 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$58.25
|
|
|
Service Code
|
HCPCS J2250
|
| Hospital Charge Code |
10608
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$25.63 |
| Max. Negotiated Rate |
$52.42 |
| Rate for Payer: Aetna American Axle |
$37.86
|
| Rate for Payer: Aetna American Axle |
$28.63
|
| Rate for Payer: Aetna American Axle |
$13.75
|
| Rate for Payer: Aetna American Axle |
$26.92
|
| Rate for Payer: Aetna American Axle |
$24.48
|
| Rate for Payer: Aetna American Axle |
$21.58
|
| Rate for Payer: Aetna American Axle |
$20.33
|
| Rate for Payer: Aetna American Axle |
$20.20
|
| Rate for Payer: Aetna American Axle |
$19.00
|
| Rate for Payer: Aetna Commercial |
$37.44
|
| Rate for Payer: Aetna Commercial |
$32.01
|
| Rate for Payer: Aetna Commercial |
$35.20
|
| Rate for Payer: Aetna Commercial |
$26.58
|
| Rate for Payer: Aetna Commercial |
$24.85
|
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: Aetna Commercial |
$49.51
|
| Rate for Payer: Aetna Commercial |
$26.42
|
| Rate for Payer: Aetna Commercial |
$28.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.86
|
| Rate for Payer: Cash Price |
$33.13
|
| Rate for Payer: Cash Price |
$30.13
|
| Rate for Payer: Cash Price |
$46.60
|
| Rate for Payer: Cash Price |
$26.56
|
| Rate for Payer: Cash Price |
$23.38
|
| Rate for Payer: Cash Price |
$24.86
|
| Rate for Payer: Cash Price |
$16.93
|
| Rate for Payer: Cash Price |
$35.24
|
| Rate for Payer: Cash Price |
$25.02
|
| Rate for Payer: Cofinity Advantage |
$21.76
|
| Rate for Payer: Cofinity Advantage |
$21.89
|
| Rate for Payer: Cofinity Advantage |
$23.24
|
| Rate for Payer: Cofinity Advantage |
$20.46
|
| Rate for Payer: Cofinity Advantage |
$40.77
|
| Rate for Payer: Cofinity Advantage |
$28.99
|
| Rate for Payer: Cofinity Advantage |
$26.36
|
| Rate for Payer: Cofinity Advantage |
$30.84
|
| Rate for Payer: Cofinity Advantage |
$14.81
|
| Rate for Payer: Cofinity Commercial |
$35.61
|
| Rate for Payer: Cofinity Commercial |
$25.14
|
| Rate for Payer: Cofinity Commercial |
$28.55
|
| Rate for Payer: Cofinity Commercial |
$32.39
|
| Rate for Payer: Cofinity Commercial |
$37.88
|
| Rate for Payer: Cofinity Commercial |
$18.20
|
| Rate for Payer: Cofinity Commercial |
$50.09
|
| Rate for Payer: Cofinity Commercial |
$26.73
|
| Rate for Payer: Cofinity Commercial |
$26.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.13
|
| Rate for Payer: Healthscope Commercial |
$39.65
|
| Rate for Payer: Healthscope Commercial |
$26.31
|
| Rate for Payer: Healthscope Commercial |
$27.97
|
| Rate for Payer: Healthscope Commercial |
$37.27
|
| Rate for Payer: Healthscope Commercial |
$33.89
|
| Rate for Payer: Healthscope Commercial |
$19.04
|
| Rate for Payer: Healthscope Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$52.42
|
| Rate for Payer: Healthscope Commercial |
$29.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.06
|
| Rate for Payer: PHP Commercial |
$24.85
|
| Rate for Payer: PHP Commercial |
$26.58
|
| Rate for Payer: PHP Commercial |
$37.44
|
| Rate for Payer: PHP Commercial |
$28.22
|
| Rate for Payer: PHP Commercial |
$32.01
|
| Rate for Payer: PHP Commercial |
$35.20
|
| Rate for Payer: PHP Commercial |
$49.51
|
| Rate for Payer: PHP Commercial |
$26.42
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: Priority Health SBD |
$23.73
|
| Rate for Payer: Priority Health SBD |
$20.92
|
| Rate for Payer: Priority Health SBD |
$36.70
|
| Rate for Payer: Priority Health SBD |
$26.09
|
| Rate for Payer: Priority Health SBD |
$18.41
|
| Rate for Payer: Priority Health SBD |
$13.33
|
| Rate for Payer: Priority Health SBD |
$27.75
|
| Rate for Payer: Priority Health SBD |
$19.58
|
| Rate for Payer: Priority Health SBD |
$19.70
|
| Rate for Payer: UMR Bronson Commercial |
$9.31
|
| Rate for Payer: UMR Bronson Commercial |
$13.68
|
| Rate for Payer: UMR Bronson Commercial |
$16.57
|
| Rate for Payer: UMR Bronson Commercial |
$13.76
|
| Rate for Payer: UMR Bronson Commercial |
$18.22
|
| Rate for Payer: UMR Bronson Commercial |
$14.61
|
| Rate for Payer: UMR Bronson Commercial |
$25.63
|
| Rate for Payer: UMR Bronson Commercial |
$12.86
|
| Rate for Payer: UMR Bronson Commercial |
$19.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.69
|
|
|
MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$14.62
|
|
|
Service Code
|
HCPCS J2250
|
| Hospital Charge Code |
168786
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.43 |
| Max. Negotiated Rate |
$13.16 |
| Rate for Payer: Aetna American Axle |
$9.50
|
| Rate for Payer: Aetna American Axle |
$9.38
|
| Rate for Payer: Aetna American Axle |
$9.53
|
| Rate for Payer: Aetna American Axle |
$9.07
|
| Rate for Payer: Aetna American Axle |
$6.83
|
| Rate for Payer: Aetna Commercial |
$8.93
|
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna Commercial |
$12.43
|
| Rate for Payer: Aetna Commercial |
$12.46
|
| Rate for Payer: Aetna Commercial |
$11.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.53
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cash Price |
$11.73
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$8.41
|
| Rate for Payer: Cofinity Advantage |
$7.36
|
| Rate for Payer: Cofinity Advantage |
$10.26
|
| Rate for Payer: Cofinity Advantage |
$9.77
|
| Rate for Payer: Cofinity Advantage |
$10.23
|
| Rate for Payer: Cofinity Advantage |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$12.61
|
| Rate for Payer: Cofinity Commercial |
$9.04
|
| Rate for Payer: Cofinity Commercial |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Cofinity Commercial |
$12.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.73
|
| Rate for Payer: Healthscope Commercial |
$9.46
|
| Rate for Payer: Healthscope Commercial |
$12.55
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Healthscope Commercial |
$13.16
|
| Rate for Payer: Healthscope Commercial |
$13.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.96
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: PHP Commercial |
$8.93
|
| Rate for Payer: PHP Commercial |
$12.43
|
| Rate for Payer: PHP Commercial |
$12.46
|
| Rate for Payer: PHP Commercial |
$11.86
|
| Rate for Payer: Priority Health SBD |
$9.21
|
| Rate for Payer: Priority Health SBD |
$9.24
|
| Rate for Payer: Priority Health SBD |
$8.79
|
| Rate for Payer: Priority Health SBD |
$6.62
|
| Rate for Payer: Priority Health SBD |
$9.09
|
| Rate for Payer: UMR Bronson Commercial |
$6.14
|
| Rate for Payer: UMR Bronson Commercial |
$6.45
|
| Rate for Payer: UMR Bronson Commercial |
$6.35
|
| Rate for Payer: UMR Bronson Commercial |
$4.62
|
| Rate for Payer: UMR Bronson Commercial |
$6.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.46
|
|
|
MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$10.51
|
|
|
Service Code
|
HCPCS J2250
|
| Hospital Charge Code |
168786
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$9.46 |
| Rate for Payer: Aetna American Axle |
$6.83
|
| Rate for Payer: Aetna American Axle |
$9.50
|
| Rate for Payer: Aetna American Axle |
$9.38
|
| Rate for Payer: Aetna American Axle |
$9.07
|
| Rate for Payer: Aetna American Axle |
$9.53
|
| Rate for Payer: Aetna Commercial |
$8.93
|
| Rate for Payer: Aetna Commercial |
$11.86
|
| Rate for Payer: Aetna Commercial |
$12.46
|
| Rate for Payer: Aetna Commercial |
$12.43
|
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna Medicare |
$7.33
|
| Rate for Payer: Aetna Medicare |
$6.97
|
| Rate for Payer: Aetna Medicare |
$5.25
|
| Rate for Payer: Aetna Medicare |
$7.21
|
| Rate for Payer: Aetna Medicare |
$7.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.53
|
| Rate for Payer: BCBS Complete |
$5.85
|
| Rate for Payer: BCBS Complete |
$4.20
|
| Rate for Payer: BCBS Complete |
$5.58
|
| Rate for Payer: BCBS Complete |
$5.77
|
| Rate for Payer: BCBS Complete |
$5.86
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.73
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cash Price |
$8.41
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cash Price |
$8.41
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.16
|
| Rate for Payer: Cash Price |
$11.73
|
| Rate for Payer: Cofinity Advantage |
$10.23
|
| Rate for Payer: Cofinity Advantage |
$9.77
|
| Rate for Payer: Cofinity Advantage |
$10.10
|
| Rate for Payer: Cofinity Advantage |
$10.26
|
| Rate for Payer: Cofinity Advantage |
$7.36
|
| Rate for Payer: Cofinity Commercial |
$12.57
|
| Rate for Payer: Cofinity Commercial |
$9.04
|
| Rate for Payer: Cofinity Commercial |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Cofinity Commercial |
$12.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Healthscope Commercial |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$13.16
|
| Rate for Payer: Healthscope Commercial |
$9.46
|
| Rate for Payer: Healthscope Commercial |
$12.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.99
|
| Rate for Payer: PHP Commercial |
$11.86
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: PHP Commercial |
$12.46
|
| Rate for Payer: PHP Commercial |
$12.43
|
| Rate for Payer: PHP Commercial |
$8.93
|
| Rate for Payer: Priority Health SBD |
$9.09
|
| Rate for Payer: Priority Health SBD |
$6.62
|
| Rate for Payer: Priority Health SBD |
$9.21
|
| Rate for Payer: Priority Health SBD |
$9.24
|
| Rate for Payer: Priority Health SBD |
$8.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UHC Exchange |
$0.23
|
| Rate for Payer: UMR Bronson Commercial |
$3.89
|
| Rate for Payer: UMR Bronson Commercial |
$5.41
|
| Rate for Payer: UMR Bronson Commercial |
$5.34
|
| Rate for Payer: UMR Bronson Commercial |
$5.42
|
| Rate for Payer: UMR Bronson Commercial |
$5.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.88
|
|
