|
METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$14.82
|
|
|
Service Code
|
NDC 60687053211
|
| Hospital Charge Code |
28750
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$13.34 |
| Rate for Payer: Aetna American Axle |
$9.63
|
| Rate for Payer: Aetna Commercial |
$12.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.63
|
| Rate for Payer: Cash Price |
$11.86
|
| Rate for Payer: Cofinity Commercial |
$10.37
|
| Rate for Payer: Cofinity Commercial |
$12.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.86
|
| Rate for Payer: Healthscope Commercial |
$13.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.60
|
| Rate for Payer: PHP Commercial |
$12.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.63
|
| Rate for Payer: Priority Health SBD |
$9.34
|
| Rate for Payer: UMR Bronson Commercial |
$6.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.12
|
|
|
METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$3,958.68
|
|
|
Service Code
|
NDC 50458058501
|
| Hospital Charge Code |
28750
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,464.71 |
| Max. Negotiated Rate |
$3,562.81 |
| Rate for Payer: Aetna American Axle |
$2,573.14
|
| Rate for Payer: Aetna Commercial |
$3,364.88
|
| Rate for Payer: Aetna Medicare |
$1,979.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,573.14
|
| Rate for Payer: BCBS Complete |
$1,583.47
|
| Rate for Payer: Cash Price |
$3,166.94
|
| Rate for Payer: Cofinity Commercial |
$2,771.08
|
| Rate for Payer: Cofinity Commercial |
$3,404.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,771.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,166.94
|
| Rate for Payer: Healthscope Commercial |
$3,562.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,771.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,969.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,364.88
|
| Rate for Payer: PHP Commercial |
$3,364.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,573.14
|
| Rate for Payer: Priority Health SBD |
$2,493.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,464.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,969.01
|
|
|
METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$444.37
|
|
|
Service Code
|
NDC 60687053221
|
| Hospital Charge Code |
28750
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$195.52 |
| Max. Negotiated Rate |
$399.93 |
| Rate for Payer: Aetna American Axle |
$288.84
|
| Rate for Payer: Aetna Commercial |
$377.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.84
|
| Rate for Payer: Cash Price |
$355.50
|
| Rate for Payer: Cofinity Commercial |
$311.06
|
| Rate for Payer: Cofinity Commercial |
$382.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$311.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$355.50
|
| Rate for Payer: Healthscope Commercial |
$399.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$311.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$333.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$377.71
|
| Rate for Payer: PHP Commercial |
$377.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$288.84
|
| Rate for Payer: Priority Health SBD |
$279.95
|
| Rate for Payer: UMR Bronson Commercial |
$195.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$333.28
|
|
|
METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$470.40
|
|
|
Service Code
|
NDC 13811070610
|
| Hospital Charge Code |
28750
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$206.98 |
| Max. Negotiated Rate |
$423.36 |
| Rate for Payer: PHP Commercial |
$399.84
|
| Rate for Payer: Aetna American Axle |
$305.76
|
| Rate for Payer: Aetna Commercial |
$399.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.76
|
| Rate for Payer: Cash Price |
$376.32
|
| Rate for Payer: Cofinity Commercial |
$329.28
|
| Rate for Payer: Cofinity Commercial |
$404.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$329.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.32
|
| Rate for Payer: Healthscope Commercial |
$423.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$329.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$352.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.76
|
| Rate for Payer: Priority Health SBD |
$296.35
|
| Rate for Payer: UMR Bronson Commercial |
$206.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$352.80
|
|
|
METHYLPHENIDATE ER 20 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$1,340.50
|
|
|
Service Code
|
NDC 65580059401
|
| Hospital Charge Code |
4989
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$495.98 |
| Max. Negotiated Rate |
$1,206.45 |
| Rate for Payer: Aetna American Axle |
$871.32
|
| Rate for Payer: Aetna Commercial |
$1,139.42
|
| Rate for Payer: Aetna Medicare |
$670.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$871.32
|
| Rate for Payer: BCBS Complete |
$536.20
|
| Rate for Payer: Cash Price |
$1,072.40
|
| Rate for Payer: Cofinity Commercial |
$1,152.83
|
| Rate for Payer: Cofinity Commercial |
$938.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$938.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,072.40
|
| Rate for Payer: Healthscope Commercial |
$1,206.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$938.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,005.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,139.42
|
| Rate for Payer: PHP Commercial |
$1,139.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$871.32
|
| Rate for Payer: Priority Health SBD |
$844.52
|
| Rate for Payer: UMR Bronson Commercial |
$495.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,005.38
|
|
|
METHYLPHENIDATE ER 20 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$929.25
|
|
|
Service Code
|
NDC 10702007601
|
| Hospital Charge Code |
4989
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$343.82 |
| Max. Negotiated Rate |
$836.32 |
| Rate for Payer: Aetna American Axle |
$604.01
|
| Rate for Payer: Aetna Commercial |
$789.86
|
| Rate for Payer: Aetna Medicare |
$464.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$604.01
|
| Rate for Payer: BCBS Complete |
$371.70
|
| Rate for Payer: Cash Price |
$743.40
|
| Rate for Payer: Cofinity Commercial |
$650.48
|
| Rate for Payer: Cofinity Commercial |
$799.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$650.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$743.40
|
| Rate for Payer: Healthscope Commercial |
$836.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$650.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$696.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$789.86
|
| Rate for Payer: PHP Commercial |
$789.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.01
|
| Rate for Payer: Priority Health SBD |
$585.43
|
| Rate for Payer: UMR Bronson Commercial |
$343.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$696.94
|
|
|
METHYLPHENIDATE ER 20 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$1,340.50
|
|
|
Service Code
|
NDC 65580059401
|
| Hospital Charge Code |
4989
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$589.82 |
| Max. Negotiated Rate |
$1,206.45 |
| Rate for Payer: Aetna American Axle |
$871.32
|
| Rate for Payer: Aetna Commercial |
$1,139.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$871.32
|
| Rate for Payer: Cash Price |
$1,072.40
|
| Rate for Payer: Cofinity Commercial |
$1,152.83
|
| Rate for Payer: Cofinity Commercial |
$938.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$938.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,072.40
|
| Rate for Payer: Healthscope Commercial |
$1,206.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$938.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,005.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,139.42
|
| Rate for Payer: PHP Commercial |
$1,139.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$871.32
|
| Rate for Payer: Priority Health SBD |
$844.52
|
| Rate for Payer: UMR Bronson Commercial |
$589.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,005.38
|
|
|
METHYLPHENIDATE ER 20 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$749.00
|
|
|
Service Code
|
NDC 00406147301
|
| Hospital Charge Code |
4989
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$329.56 |
| Max. Negotiated Rate |
$674.10 |
| Rate for Payer: Aetna American Axle |
$486.85
|
| Rate for Payer: Aetna Commercial |
$636.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.85
|
| Rate for Payer: Cash Price |
$599.20
|
| Rate for Payer: Cofinity Commercial |
$524.30
|
| Rate for Payer: Cofinity Commercial |
$644.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$524.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$599.20
|
| Rate for Payer: Healthscope Commercial |
$674.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$524.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$561.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$636.65
|
| Rate for Payer: PHP Commercial |
$636.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$486.85
|
| Rate for Payer: Priority Health SBD |
$471.87
|
| Rate for Payer: UMR Bronson Commercial |
$329.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$561.75
|
|
|
METHYLPHENIDATE ER 20 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$929.25
|
|
|
Service Code
|
NDC 10702007601
|
| Hospital Charge Code |
4989
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$408.87 |
| Max. Negotiated Rate |
$836.32 |
| Rate for Payer: Aetna American Axle |
$604.01
|
| Rate for Payer: Aetna Commercial |
$789.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$604.01
|
| Rate for Payer: Cash Price |
$743.40
|
| Rate for Payer: Cofinity Commercial |
$650.48
|
| Rate for Payer: Cofinity Commercial |
$799.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$650.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$743.40
|
| Rate for Payer: Healthscope Commercial |
$836.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$650.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$696.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$789.86
|
| Rate for Payer: PHP Commercial |
$789.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.01
|
| Rate for Payer: Priority Health SBD |
$585.43
|
| Rate for Payer: UMR Bronson Commercial |
$408.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$696.94
|
|
|
METHYLPHENIDATE ER 20 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$749.00
|
|
|
Service Code
|
NDC 00406147301
|
| Hospital Charge Code |
4989
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$277.13 |
| Max. Negotiated Rate |
$674.10 |
| Rate for Payer: Aetna American Axle |
$486.85
|
| Rate for Payer: Aetna Commercial |
$636.65
|
| Rate for Payer: Aetna Medicare |
$374.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.85
|
| Rate for Payer: BCBS Complete |
$299.60
|
| Rate for Payer: Cash Price |
$599.20
|
| Rate for Payer: Cofinity Commercial |
$524.30
|
| Rate for Payer: Cofinity Commercial |
$644.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$524.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$599.20
|
| Rate for Payer: Healthscope Commercial |
$674.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$524.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$561.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$636.65
|
| Rate for Payer: PHP Commercial |
$636.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$486.85
|
| Rate for Payer: Priority Health SBD |
$471.87
|
| Rate for Payer: UMR Bronson Commercial |
$277.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$561.75
|
|
|
METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$486.50
|
|
|
Service Code
|
NDC 13811070710
|
| Hospital Charge Code |
32654
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$214.06 |
| Max. Negotiated Rate |
$437.85 |
| Rate for Payer: Aetna American Axle |
$316.22
|
| Rate for Payer: Aetna Commercial |
$413.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.22
|
| Rate for Payer: Cash Price |
$389.20
|
| Rate for Payer: Cofinity Commercial |
$340.55
|
| Rate for Payer: Cofinity Commercial |
$418.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$340.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$389.20
|
| Rate for Payer: Healthscope Commercial |
$437.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$340.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.52
|
| Rate for Payer: PHP Commercial |
$413.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$316.22
|
| Rate for Payer: Priority Health SBD |
$306.50
|
| Rate for Payer: UMR Bronson Commercial |
$214.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.88
|
|
|
METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$4,058.01
|
|
|
Service Code
|
NDC 50458058801
|
| Hospital Charge Code |
32654
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,501.46 |
| Max. Negotiated Rate |
$3,652.21 |
| Rate for Payer: Aetna American Axle |
$2,637.71
|
| Rate for Payer: Aetna Commercial |
$3,449.31
|
| Rate for Payer: Aetna Medicare |
$2,029.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,637.71
|
| Rate for Payer: BCBS Complete |
$1,623.20
|
| Rate for Payer: Cash Price |
$3,246.41
|
| Rate for Payer: Cofinity Commercial |
$2,840.61
|
| Rate for Payer: Cofinity Commercial |
$3,489.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,840.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,246.41
|
| Rate for Payer: Healthscope Commercial |
$3,652.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,840.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,043.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,449.31
|
| Rate for Payer: PHP Commercial |
$3,449.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,637.71
|
| Rate for Payer: Priority Health SBD |
$2,556.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,501.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,043.51
|
|
|
METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
OP
|
$486.50
|
|
|
Service Code
|
NDC 13811070710
|
| Hospital Charge Code |
32654
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$437.85 |
| Rate for Payer: Aetna American Axle |
$316.22
|
| Rate for Payer: Aetna Commercial |
$413.52
|
| Rate for Payer: Aetna Medicare |
$243.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.22
|
| Rate for Payer: BCBS Complete |
$194.60
|
| Rate for Payer: Cash Price |
$389.20
|
| Rate for Payer: Cofinity Commercial |
$340.55
|
| Rate for Payer: Cofinity Commercial |
$418.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$340.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$389.20
|
| Rate for Payer: Healthscope Commercial |
$437.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$340.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.52
|
| Rate for Payer: PHP Commercial |
$413.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$316.22
|
| Rate for Payer: Priority Health SBD |
$306.50
|
| Rate for Payer: UMR Bronson Commercial |
$180.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.88
|
|
|
METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR
|
Facility
|
IP
|
$4,058.01
|
|
|
Service Code
|
NDC 50458058801
|
| Hospital Charge Code |
32654
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,785.52 |
| Max. Negotiated Rate |
$3,652.21 |
| Rate for Payer: Aetna American Axle |
$2,637.71
|
| Rate for Payer: Aetna Commercial |
$3,449.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,637.71
|
| Rate for Payer: Cash Price |
$3,246.41
|
| Rate for Payer: Cofinity Commercial |
$2,840.61
|
| Rate for Payer: Cofinity Commercial |
$3,489.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,840.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,246.41
|
| Rate for Payer: Healthscope Commercial |
$3,652.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,840.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,043.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,449.31
|
| Rate for Payer: PHP Commercial |
$3,449.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,637.71
|
| Rate for Payer: Priority Health SBD |
$2,556.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,785.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,043.51
|
|
|
METHYLPHENIDATE LA 10 MG BIPHASIC 50-50 CAPSULE,EXTENDED RELEASE
|
Facility
|
OP
|
$3,873.21
|
|
|
Service Code
|
NDC 00078042405
|
| Hospital Charge Code |
38387
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,433.09 |
| Max. Negotiated Rate |
$3,485.89 |
| Rate for Payer: Aetna American Axle |
$2,517.59
|
| Rate for Payer: Aetna Commercial |
$3,292.23
|
| Rate for Payer: Aetna Medicare |
$1,936.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,517.59
|
| Rate for Payer: BCBS Complete |
$1,549.28
|
| Rate for Payer: Cash Price |
$3,098.57
|
| Rate for Payer: Cofinity Commercial |
$2,711.25
|
| Rate for Payer: Cofinity Commercial |
$3,330.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,711.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,098.57
|
| Rate for Payer: Healthscope Commercial |
$3,485.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,711.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,904.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,292.23
|
| Rate for Payer: PHP Commercial |
$3,292.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,517.59
|
| Rate for Payer: Priority Health SBD |
$2,440.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,433.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,904.91
|
|
|
METHYLPHENIDATE LA 10 MG BIPHASIC 50-50 CAPSULE,EXTENDED RELEASE
|
Facility
|
IP
|
$3,873.21
|
|
|
Service Code
|
NDC 00078042405
|
| Hospital Charge Code |
38387
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,704.21 |
| Max. Negotiated Rate |
$3,485.89 |
| Rate for Payer: Aetna American Axle |
$2,517.59
|
| Rate for Payer: Aetna Commercial |
$3,292.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,517.59
|
| Rate for Payer: Cash Price |
$3,098.57
|
| Rate for Payer: Cofinity Commercial |
$2,711.25
|
| Rate for Payer: Cofinity Commercial |
$3,330.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,711.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,098.57
|
| Rate for Payer: Healthscope Commercial |
$3,485.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,711.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,904.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,292.23
|
| Rate for Payer: PHP Commercial |
$3,292.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,517.59
|
| Rate for Payer: Priority Health SBD |
$2,440.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,704.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,904.91
|
|
|
METHYLPREDNISOLONE 16 MG TABLET
|
Facility
|
IP
|
$427.54
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
4992
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$188.12 |
| Max. Negotiated Rate |
$384.79 |
| Rate for Payer: Aetna American Axle |
$277.90
|
| Rate for Payer: Aetna American Axle |
$304.36
|
| Rate for Payer: Aetna American Axle |
$337.06
|
| Rate for Payer: Aetna Commercial |
$398.00
|
| Rate for Payer: Aetna Commercial |
$363.41
|
| Rate for Payer: Aetna Commercial |
$440.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.36
|
| Rate for Payer: Cash Price |
$414.85
|
| Rate for Payer: Cash Price |
$374.59
|
| Rate for Payer: Cash Price |
$342.03
|
| Rate for Payer: Cofinity Commercial |
$367.68
|
| Rate for Payer: Cofinity Commercial |
$402.69
|
| Rate for Payer: Cofinity Commercial |
$327.77
|
| Rate for Payer: Cofinity Commercial |
$445.96
|
| Rate for Payer: Cofinity Commercial |
$362.99
|
| Rate for Payer: Cofinity Commercial |
$299.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$327.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$299.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$362.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.59
|
| Rate for Payer: Healthscope Commercial |
$421.42
|
| Rate for Payer: Healthscope Commercial |
$384.79
|
| Rate for Payer: Healthscope Commercial |
$466.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$299.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$327.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$362.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$320.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$388.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$363.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.00
|
| Rate for Payer: PHP Commercial |
$440.78
|
| Rate for Payer: PHP Commercial |
$398.00
|
| Rate for Payer: PHP Commercial |
$363.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$337.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.90
|
| Rate for Payer: Priority Health SBD |
$326.69
|
| Rate for Payer: Priority Health SBD |
$294.99
|
| Rate for Payer: Priority Health SBD |
$269.35
|
| Rate for Payer: UMR Bronson Commercial |
$188.12
|
| Rate for Payer: UMR Bronson Commercial |
$228.17
|
| Rate for Payer: UMR Bronson Commercial |
$206.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$388.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$320.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.18
|
|
|
METHYLPREDNISOLONE 16 MG TABLET
|
Facility
|
OP
|
$518.56
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
4992
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$466.70 |
| Rate for Payer: Aetna American Axle |
$337.06
|
| Rate for Payer: Aetna American Axle |
$304.36
|
| Rate for Payer: Aetna American Axle |
$277.90
|
| Rate for Payer: Aetna Commercial |
$440.78
|
| Rate for Payer: Aetna Commercial |
$363.41
|
| Rate for Payer: Aetna Commercial |
$398.00
|
| Rate for Payer: Aetna Medicare |
$234.12
|
| Rate for Payer: Aetna Medicare |
$213.77
|
| Rate for Payer: Aetna Medicare |
$259.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.36
|
| Rate for Payer: BCBS Complete |
$187.30
|
| Rate for Payer: BCBS Complete |
$207.42
|
| Rate for Payer: BCBS Complete |
$171.02
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: Cash Price |
$374.59
|
| Rate for Payer: Cash Price |
$414.85
|
| Rate for Payer: Cash Price |
$342.03
|
| Rate for Payer: Cash Price |
$374.59
|
| Rate for Payer: Cash Price |
$342.03
|
| Rate for Payer: Cash Price |
$414.85
|
| Rate for Payer: Cofinity Commercial |
$402.69
|
| Rate for Payer: Cofinity Commercial |
$299.28
|
| Rate for Payer: Cofinity Commercial |
$367.68
|
| Rate for Payer: Cofinity Commercial |
$327.77
|
| Rate for Payer: Cofinity Commercial |
$362.99
|
| Rate for Payer: Cofinity Commercial |
$445.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$362.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$299.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$327.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.85
|
| Rate for Payer: Healthscope Commercial |
$466.70
|
| Rate for Payer: Healthscope Commercial |
$421.42
|
| Rate for Payer: Healthscope Commercial |
$384.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$299.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$327.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$362.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$320.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$388.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$363.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.78
|
| Rate for Payer: PHP Commercial |
$440.78
|
| Rate for Payer: PHP Commercial |
$363.41
|
| Rate for Payer: PHP Commercial |
$398.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$337.06
|
| Rate for Payer: Priority Health SBD |
$294.99
|
| Rate for Payer: Priority Health SBD |
$326.69
|
| Rate for Payer: Priority Health SBD |
$269.35
|
| Rate for Payer: UMR Bronson Commercial |
$191.87
|
| Rate for Payer: UMR Bronson Commercial |
$158.19
|
| Rate for Payer: UMR Bronson Commercial |
$173.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$320.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$388.92
|
|
|
METHYLPREDNISOLONE 2 MG TABLET
|
Facility
|
OP
|
$768.00
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
10573
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$691.20 |
| Rate for Payer: Aetna American Axle |
$499.20
|
| Rate for Payer: Aetna Commercial |
$652.80
|
| Rate for Payer: Aetna Medicare |
$384.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.20
|
| Rate for Payer: BCBS Complete |
$307.20
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: Cash Price |
$614.40
|
| Rate for Payer: Cash Price |
$614.40
|
| Rate for Payer: Cofinity Commercial |
$537.60
|
| Rate for Payer: Cofinity Commercial |
$660.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$537.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$614.40
|
| Rate for Payer: Healthscope Commercial |
$691.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$537.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$576.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$652.80
|
| Rate for Payer: PHP Commercial |
$652.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$499.20
|
| Rate for Payer: Priority Health SBD |
$483.84
|
| Rate for Payer: UMR Bronson Commercial |
$284.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$576.00
|
|
|
METHYLPREDNISOLONE 2 MG TABLET
|
Facility
|
IP
|
$768.00
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
10573
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$337.92 |
| Max. Negotiated Rate |
$691.20 |
| Rate for Payer: Aetna American Axle |
$499.20
|
| Rate for Payer: Aetna Commercial |
$652.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.20
|
| Rate for Payer: Cash Price |
$614.40
|
| Rate for Payer: Cofinity Commercial |
$537.60
|
| Rate for Payer: Cofinity Commercial |
$660.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$537.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$614.40
|
| Rate for Payer: Healthscope Commercial |
$691.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$537.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$576.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$652.80
|
| Rate for Payer: PHP Commercial |
$652.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$499.20
|
| Rate for Payer: Priority Health SBD |
$483.84
|
| Rate for Payer: UMR Bronson Commercial |
$337.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$576.00
|
|
|
METHYLPREDNISOLONE 4 MG TABLET
|
Facility
|
OP
|
$651.36
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
4993
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$586.22 |
| Rate for Payer: Aetna American Axle |
$423.38
|
| Rate for Payer: Aetna American Axle |
$331.66
|
| Rate for Payer: Aetna American Axle |
$184.02
|
| Rate for Payer: Aetna Commercial |
$553.66
|
| Rate for Payer: Aetna Commercial |
$240.64
|
| Rate for Payer: Aetna Commercial |
$433.70
|
| Rate for Payer: Aetna Medicare |
$255.12
|
| Rate for Payer: Aetna Medicare |
$141.55
|
| Rate for Payer: Aetna Medicare |
$325.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.66
|
| Rate for Payer: BCBS Complete |
$204.10
|
| Rate for Payer: BCBS Complete |
$260.54
|
| Rate for Payer: BCBS Complete |
$113.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: Cash Price |
$408.19
|
| Rate for Payer: Cash Price |
$521.09
|
| Rate for Payer: Cash Price |
$226.48
|
| Rate for Payer: Cash Price |
$408.19
|
| Rate for Payer: Cash Price |
$226.48
|
| Rate for Payer: Cash Price |
$521.09
|
| Rate for Payer: Cofinity Commercial |
$438.81
|
| Rate for Payer: Cofinity Commercial |
$198.17
|
| Rate for Payer: Cofinity Commercial |
$243.47
|
| Rate for Payer: Cofinity Commercial |
$357.17
|
| Rate for Payer: Cofinity Commercial |
$455.95
|
| Rate for Payer: Cofinity Commercial |
$560.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$455.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$198.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$357.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$521.09
|
| Rate for Payer: Healthscope Commercial |
$586.22
|
| Rate for Payer: Healthscope Commercial |
$459.22
|
| Rate for Payer: Healthscope Commercial |
$254.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$198.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$357.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$455.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$488.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.66
|
| Rate for Payer: PHP Commercial |
$553.66
|
| Rate for Payer: PHP Commercial |
$240.64
|
| Rate for Payer: PHP Commercial |
$433.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.38
|
| Rate for Payer: Priority Health SBD |
$321.45
|
| Rate for Payer: Priority Health SBD |
$410.36
|
| Rate for Payer: Priority Health SBD |
$178.35
|
| Rate for Payer: UMR Bronson Commercial |
$241.00
|
| Rate for Payer: UMR Bronson Commercial |
$104.75
|
| Rate for Payer: UMR Bronson Commercial |
$188.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$488.52
|
|
|
METHYLPREDNISOLONE 4 MG TABLET
|
Facility
|
IP
|
$283.10
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
4993
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$124.56 |
| Max. Negotiated Rate |
$254.79 |
| Rate for Payer: Aetna American Axle |
$184.02
|
| Rate for Payer: Aetna American Axle |
$331.66
|
| Rate for Payer: Aetna American Axle |
$423.38
|
| Rate for Payer: Aetna Commercial |
$433.70
|
| Rate for Payer: Aetna Commercial |
$240.64
|
| Rate for Payer: Aetna Commercial |
$553.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.66
|
| Rate for Payer: Cash Price |
$521.09
|
| Rate for Payer: Cash Price |
$408.19
|
| Rate for Payer: Cash Price |
$226.48
|
| Rate for Payer: Cofinity Commercial |
$243.47
|
| Rate for Payer: Cofinity Commercial |
$438.81
|
| Rate for Payer: Cofinity Commercial |
$357.17
|
| Rate for Payer: Cofinity Commercial |
$560.17
|
| Rate for Payer: Cofinity Commercial |
$455.95
|
| Rate for Payer: Cofinity Commercial |
$198.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$357.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$198.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$455.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$521.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.19
|
| Rate for Payer: Healthscope Commercial |
$459.22
|
| Rate for Payer: Healthscope Commercial |
$254.79
|
| Rate for Payer: Healthscope Commercial |
$586.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$198.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$357.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$455.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$488.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.70
|
| Rate for Payer: PHP Commercial |
$553.66
|
| Rate for Payer: PHP Commercial |
$433.70
|
| Rate for Payer: PHP Commercial |
$240.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.02
|
| Rate for Payer: Priority Health SBD |
$410.36
|
| Rate for Payer: Priority Health SBD |
$321.45
|
| Rate for Payer: Priority Health SBD |
$178.35
|
| Rate for Payer: UMR Bronson Commercial |
$124.56
|
| Rate for Payer: UMR Bronson Commercial |
$286.60
|
| Rate for Payer: UMR Bronson Commercial |
$224.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$488.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.68
|
|
|
METHYLPREDNISOLONE 8 MG TABLET
|
Facility
|
IP
|
$153.60
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
10576
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$67.58 |
| Max. Negotiated Rate |
$138.24 |
| Rate for Payer: Aetna American Axle |
$99.84
|
| Rate for Payer: Aetna American Axle |
$116.69
|
| Rate for Payer: Aetna Commercial |
$130.56
|
| Rate for Payer: Aetna Commercial |
$152.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.69
|
| Rate for Payer: Cash Price |
$122.88
|
| Rate for Payer: Cash Price |
$143.62
|
| Rate for Payer: Cofinity Commercial |
$154.39
|
| Rate for Payer: Cofinity Commercial |
$125.66
|
| Rate for Payer: Cofinity Commercial |
$107.52
|
| Rate for Payer: Cofinity Commercial |
$132.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$125.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.62
|
| Rate for Payer: Healthscope Commercial |
$138.24
|
| Rate for Payer: Healthscope Commercial |
$161.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$125.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.56
|
| Rate for Payer: PHP Commercial |
$152.59
|
| Rate for Payer: PHP Commercial |
$130.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.69
|
| Rate for Payer: Priority Health SBD |
$96.77
|
| Rate for Payer: Priority Health SBD |
$113.10
|
| Rate for Payer: UMR Bronson Commercial |
$67.58
|
| Rate for Payer: UMR Bronson Commercial |
$78.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.64
|
|
|
METHYLPREDNISOLONE 8 MG TABLET
|
Facility
|
OP
|
$153.60
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
10576
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$138.24 |
| Rate for Payer: Aetna American Axle |
$99.84
|
| Rate for Payer: Aetna American Axle |
$116.69
|
| Rate for Payer: Aetna Commercial |
$152.59
|
| Rate for Payer: Aetna Commercial |
$130.56
|
| Rate for Payer: Aetna Medicare |
$76.80
|
| Rate for Payer: Aetna Medicare |
$89.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.69
|
| Rate for Payer: BCBS Complete |
$71.81
|
| Rate for Payer: BCBS Complete |
$61.44
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.64
|
| Rate for Payer: Cash Price |
$143.62
|
| Rate for Payer: Cash Price |
$143.62
|
| Rate for Payer: Cash Price |
$122.88
|
| Rate for Payer: Cash Price |
$122.88
|
| Rate for Payer: Cofinity Commercial |
$154.39
|
| Rate for Payer: Cofinity Commercial |
$107.52
|
| Rate for Payer: Cofinity Commercial |
$125.66
|
| Rate for Payer: Cofinity Commercial |
$132.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$125.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.88
|
| Rate for Payer: Healthscope Commercial |
$161.57
|
| Rate for Payer: Healthscope Commercial |
$138.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$125.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152.59
|
| Rate for Payer: PHP Commercial |
$130.56
|
| Rate for Payer: PHP Commercial |
$152.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.69
|
| Rate for Payer: Priority Health SBD |
$113.10
|
| Rate for Payer: Priority Health SBD |
$96.77
|
| Rate for Payer: UMR Bronson Commercial |
$56.83
|
| Rate for Payer: UMR Bronson Commercial |
$66.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.20
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION
|
Facility
|
OP
|
$30.63
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
4995
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$27.57 |
| Rate for Payer: Aetna American Axle |
$19.91
|
| Rate for Payer: Aetna American Axle |
$23.41
|
| Rate for Payer: Aetna American Axle |
$17.56
|
| Rate for Payer: Aetna American Axle |
$12.42
|
| Rate for Payer: Aetna American Axle |
$19.90
|
| Rate for Payer: Aetna Commercial |
$22.96
|
| Rate for Payer: Aetna Commercial |
$30.61
|
| Rate for Payer: Aetna Commercial |
$16.24
|
| Rate for Payer: Aetna Commercial |
$26.03
|
| Rate for Payer: Aetna Commercial |
$26.04
|
| Rate for Payer: Aetna Medicare |
$0.12
|
| Rate for Payer: Aetna Medicare |
$0.12
|
| Rate for Payer: Aetna Medicare |
$0.12
|
| Rate for Payer: Aetna Medicare |
$0.12
|
| Rate for Payer: Aetna Medicare |
$0.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.15
|
| Rate for Payer: BCBS Complete |
$0.07
|
| Rate for Payer: BCBS Complete |
$0.07
|
| Rate for Payer: BCBS Complete |
$0.07
|
| Rate for Payer: BCBS Complete |
$0.07
|
| Rate for Payer: BCBS Complete |
$0.07
|
| Rate for Payer: BCBS MAPPO |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.12
|
| Rate for Payer: BCBS MAPPO |
$0.12
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCBS Trust/PPO |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Commercial |
$0.32
|
| Rate for Payer: BCN Medicare Advantage |
$0.12
|
| Rate for Payer: BCN Medicare Advantage |
$0.12
|
| Rate for Payer: BCN Medicare Advantage |
$0.12
|
| Rate for Payer: BCN Medicare Advantage |
$0.12
|
| Rate for Payer: BCN Medicare Advantage |
$0.12
|
| Rate for Payer: Cash Price |
$28.81
|
| Rate for Payer: Cash Price |
$21.61
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cash Price |
$28.81
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cash Price |
$21.61
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cash Price |
$24.50
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Cofinity Commercial |
$30.97
|
| Rate for Payer: Cofinity Commercial |
$23.23
|
| Rate for Payer: Cofinity Commercial |
$25.21
|
| Rate for Payer: Cofinity Commercial |
$26.33
|
| Rate for Payer: Cofinity Commercial |
$21.43
|
| Rate for Payer: Cofinity Commercial |
$13.37
|
| Rate for Payer: Cofinity Commercial |
$18.91
|
| Rate for Payer: Cofinity Commercial |
$26.34
|
| Rate for Payer: Cofinity Commercial |
$21.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.12
|
| Rate for Payer: Healthscope Commercial |
$24.31
|
| Rate for Payer: Healthscope Commercial |
$27.57
|
| Rate for Payer: Healthscope Commercial |
$32.41
|
| Rate for Payer: Healthscope Commercial |
$27.56
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.97
|
| Rate for Payer: Mclaren Medicaid |
$0.06
|
| Rate for Payer: Mclaren Medicaid |
$0.06
|
| Rate for Payer: Mclaren Medicaid |
$0.06
|
| Rate for Payer: Mclaren Medicaid |
$0.06
|
| Rate for Payer: Mclaren Medicaid |
$0.06
|
| Rate for Payer: Mclaren Medicare |
$0.12
|
| Rate for Payer: Mclaren Medicare |
$0.12
|
| Rate for Payer: Mclaren Medicare |
$0.12
|
| Rate for Payer: Mclaren Medicare |
$0.12
|
| Rate for Payer: Mclaren Medicare |
$0.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.13
|
| Rate for Payer: Meridian Medicaid |
$0.07
|
| Rate for Payer: Meridian Medicaid |
$0.07
|
| Rate for Payer: Meridian Medicaid |
$0.07
|
| Rate for Payer: Meridian Medicaid |
$0.07
|
| Rate for Payer: Meridian Medicaid |
$0.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.61
|
| Rate for Payer: Nomi Health Commercial |
$0.36
|
| Rate for Payer: Nomi Health Commercial |
$0.36
|
| Rate for Payer: Nomi Health Commercial |
$0.36
|
| Rate for Payer: Nomi Health Commercial |
$0.36
|
| Rate for Payer: Nomi Health Commercial |
$0.36
|
| Rate for Payer: PACE Medicare |
$0.11
|
| Rate for Payer: PACE Medicare |
$0.11
|
| Rate for Payer: PACE Medicare |
$0.11
|
| Rate for Payer: PACE Medicare |
$0.11
|
| Rate for Payer: PACE Medicare |
$0.11
|
| Rate for Payer: PACE SWMI |
$0.12
|
| Rate for Payer: PACE SWMI |
$0.12
|
| Rate for Payer: PACE SWMI |
$0.12
|
| Rate for Payer: PACE SWMI |
$0.12
|
| Rate for Payer: PACE SWMI |
$0.12
|
| Rate for Payer: PHP Commercial |
$26.03
|
| Rate for Payer: PHP Commercial |
$26.04
|
| Rate for Payer: PHP Commercial |
$30.61
|
| Rate for Payer: PHP Commercial |
$16.24
|
| Rate for Payer: PHP Commercial |
$22.96
|
| Rate for Payer: PHP Medicare Advantage |
$0.12
|
| Rate for Payer: PHP Medicare Advantage |
$0.12
|
| Rate for Payer: PHP Medicare Advantage |
$0.12
|
| Rate for Payer: PHP Medicare Advantage |
$0.12
|
| Rate for Payer: PHP Medicare Advantage |
$0.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.33
|
| Rate for Payer: Priority Health Medicare |
$0.12
|
| Rate for Payer: Priority Health Medicare |
$0.12
|
| Rate for Payer: Priority Health Medicare |
$0.12
|
| Rate for Payer: Priority Health Medicare |
$0.12
|
| Rate for Payer: Priority Health Medicare |
$0.12
|
| Rate for Payer: Priority Health Narrow Network |
$0.26
|
| Rate for Payer: Priority Health Narrow Network |
$0.26
|
| Rate for Payer: Priority Health Narrow Network |
$0.26
|
| Rate for Payer: Priority Health Narrow Network |
$0.26
|
| Rate for Payer: Priority Health Narrow Network |
$0.26
|
| Rate for Payer: Priority Health SBD |
$19.30
|
| Rate for Payer: Priority Health SBD |
$12.03
|
| Rate for Payer: Priority Health SBD |
$22.69
|
| Rate for Payer: Priority Health SBD |
$17.02
|
| Rate for Payer: Priority Health SBD |
$19.29
|
| Rate for Payer: Railroad Medicare Medicare |
$0.12
|
| Rate for Payer: Railroad Medicare Medicare |
$0.12
|
| Rate for Payer: Railroad Medicare Medicare |
$0.12
|
| Rate for Payer: Railroad Medicare Medicare |
$0.12
|
| Rate for Payer: Railroad Medicare Medicare |
$0.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.12
|
| 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 Medicare Advantage |
$0.12
|
| Rate for Payer: UHC Medicare Advantage |
$0.12
|
| Rate for Payer: UHC Medicare Advantage |
$0.12
|
| Rate for Payer: UHC Medicare Advantage |
$0.12
|
| Rate for Payer: UHC Medicare Advantage |
$0.12
|
| Rate for Payer: UHCCP Medicaid |
$0.06
|
| Rate for Payer: UHCCP Medicaid |
$0.06
|
| Rate for Payer: UHCCP Medicaid |
$0.06
|
| Rate for Payer: UHCCP Medicaid |
$0.06
|
| Rate for Payer: UHCCP Medicaid |
$0.06
|
| Rate for Payer: UMR Bronson Commercial |
$9.99
|
| Rate for Payer: UMR Bronson Commercial |
$11.33
|
| Rate for Payer: UMR Bronson Commercial |
$11.33
|
| Rate for Payer: UMR Bronson Commercial |
$13.32
|
| Rate for Payer: UMR Bronson Commercial |
$7.07
|
| Rate for Payer: VA VA |
$0.12
|
| Rate for Payer: VA VA |
$0.12
|
| Rate for Payer: VA VA |
$0.12
|
| Rate for Payer: VA VA |
$0.12
|
| Rate for Payer: VA VA |
$0.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.01
|
|
